Transfusion Medicine - Blood Groups

Front 1

What do LISS and PEG do?

Back 1

They aid in sensitization of Coomb's reactions by helping to overcome physical barriers to let antigens and antibodies get closer to each other.

NOTE:
LISS = Low Ionic Strength Saline
PEG = Polyethylene Glycol

Front 2

How long do you incubate at 37 C for:
LISS
PEG
No potentiating agent

Back 2

LISS = 10-15 minutes
PEG = 15-30 minutes
No agent = 30-60 minutes

Front 3

Which blood groups are subject to dosage effect? (4)

Back 3

Kidd
Duffy
Rh
MNS

Front 4

What are the neutralizers for these antibodies?
ABO
Lewis
P1
Sda
Chido and Rogers

Back 4

Neutralizers for these antibodies:
ABO: saliva
Lewis: saliva
P1: hydatid cyst fluid, pigeon egg fluid
Sda: urine
Chido and Rogers: serum

Front 5

In ABO/H are type 1 and 2 chains free-floating or bound to RBC?

Back 5

Type 1: free-floating
Type 2: bound to RBC

Front 6

What is the FUT2 gene also known as? What chromosome is it on? What is its function?

Back 6

FUT2:
- Secretor = Se
- Chromosome 19
- Adds fucose to type 1 chains at terminal galactose and produces free-floating H-antigen

Front 7

What is FUT1 gene also known as? What chromosome is it on? What is its function?

Back 7

FUT1:
- H gene
- Chromosome 19
- Adds fucose to terminal galactose of type 2 chains and produces RBC bound H-antigen

Front 8

What chromosome is A, B on?

Back 8

Chromosome 9

Front 9

What sugar does group A add?

Back 9

N-acetylgalactosamine gets added to type 1 or type 2 H-antigen.

Front 10

What sugar does group B add?

Back 10

Galactose gets added to type 1 or type 2 H-antigen.

Front 11

List from most to least H-antigen expression.

Back 11

O > A2 > B > A2B > A1 > A1B

Front 12

When do ABO antigens appear on fetal RBC?

Back 12

6 weeks gestation

NOTE: reaches adult levels at 4 years of age

Front 13

When do ABO antibodies appear?

Back 13

4 months of age

NOTE: reaches adult levels at 10 years of age

Front 14

What is the purpose of Ulex europaeus?

Back 14

Ulex europaeus is a lectin which agglutinates cells with H-antigen.

NOTE: Bombay phenotype will not show agglutination with Ulex europaeus lectin.

Front 15

What is the purpose of Dolichos biflorus?

Back 15

Dolichos biflorus is a lectin which agglutinates cells with A1-antigen.

NOTE: A2 or other A subtype people will not show agglutination with Dolichos biflorus lectin.

Front 16

What is the purpose of Vicea graminea?

Back 16

Vicea graminea is a lectin which agglutinates cells with the N-antigen.

Front 17

How does ABO HDFN work?

Back 17

Group O people are able to make IgG anti-A or B in addition to IgM so group O moms may have HDFN with group A, B, or AB baby.

Moms with A, B, or AB blood type can't make IgG so no HDFN there.

Front 18

What percentage of A people are A1? A2?

Back 18

A1 = 80%
A2 = 20%

Front 19

What percentage of A2 and A2B form anti-A1? Is the IgM clinically significant?

Back 19

A2: 1-8%
A2B: 25%

The IgM is not clinically significant but can cause blood testing discrepancies.

Front 20

What is the mechanism of acquired B?

Back 20

Enteric infection in an A person results in bacterial deacetylation of group A sugar resulting in a group "B" appearing sugar.

Front 21

What is the B(A) phenotype?

Back 21

B(A) is a genetic phenotype characterized by inheritance of an ABO enzyme capable B and A antigens so forward type like Aweak-B, but reverse type as Anti-A+, Anti-B-. This reaction depends on the type of monoclonal Anti-A used in forward typing.

Front 22

What is the Bombay genotype?

Back 22

h-h, se-se

Do not make H, non-secretors

Front 23

What is the para-Bombay genotype?

Back 23

h-h, Se-se or h-h, Se-Se

RBC will type like Bombay (O forward and reverse) but serum secretions show H and/or A and/or B.

Front 24

Do para-Bombay people make Anti-H?

Back 24

Yes

Front 25

What is another name for the FUT3 gene? What chromosome? What does it do?

Back 25

FUT 3
- Le
- chromosome 19
- Adds fucose to subterminal GlcNAc onto type 1 chains only

Front 26

What is the genotype of a person who is:
1. Le(a+,b-)
2. Le(a-,b+)
3. Le(a-,b-)

Back 26

1. Le(a+,b-): se, Le
2. Le(a-,b+): Se, Le
3. Le(a-,b-): se, le

Front 27

Can Le(a-,b+) people make anti-Le-a?

Back 27

No

Front 28

What Lewis phenotype is at risk for childhood UTI?

Back 28

Le(a-,b-)

Front 29

What disease is associated with Auto-anti-I?

Back 29

Mycoplasma pneumoniae infection

NOTE: IgM cold agglutinin

Front 30

What disease is associated with Atuo-anti-i?

Back 30

EBV infection

NOTE: IgM cold agglutinin

Front 31

What is the parvovirus B19 receptor?

Back 31

P antigen

Front 32

What is the P1 phenotype?

Back 32

Positive for P1 and P, negative for Pk

Front 33

What antibody is associated with paroxysmal cold hemoglobinuria?

Back 33

Anti-P

Front 34

What test is done to identify Anti-P in paroxysmal cold hemoglobinuria?

Back 34

Donath-Landsteiner biphasic hemolysin

Front 35

What is meant by biphasic IgG with anti-P specificity (found in paroxysmal cold hemoglobinuria)?

Back 35

IgG binds at low temperature and hemolysis on occurs after the blood is warmed up.

Front 36

What disease conditions are associated with paroxysmal cold hemoglobinuria?

Back 36

Syphillis in anyone (classic) or viral infections in kids (more common now)

Front 37

List the Rh frequencies from most to least common in Whites and Blacks.

Back 37

Whites: R1 > r > R2 > R0
Blacks: R0 > r > R1 > R2

NOTE:
1. R0 is the most common Blacks, least common in whites.
2. r is always second most common.
3. R1 always before R2.

Front 38

What chromosome encodes the Rh genes?

Back 38

Chromosome 1

Front 39

Weak D testing is required for what people?

Back 39

Donors who are test as D-negative

Newborns who test as D-negative who have D-negative moms

Front 40

What hematologic problems do Rh=null phenotype people have?

Back 40

Warm auto-hemolytic anemia with stomatocytes

Front 41

What is the G antigen?

Back 41

G = C+D

Front 42

What is the f antigen?

Back 42

f = c+e

Front 43

Which alloantibody is good at fixing complement?

Back 43

anti-Kidd

Front 44

What is the most common Duffy phenotype in Blacks?

Back 44

Fy(a-,b-) 68%

Front 45

What type of malaria resistance do Fy(a-b-) people have?

Back 45

Plasmodium vivax, Plasmodium knowlesi

Front 46

What is the frequency of k? K?

Back 46

k = 99.8%
K = 10%

Front 47

What is the McLeod phenotype?
Kx
K and k
Anti-Ku
Clinical

Back 47

Kx absent
K and k decreased (not absent)
anti-Ku absent
Auto-immune hemolytic anemia with acanthocytes
Occasional association with X-linked chronic granulomatous disease, muscular dystrophy, and retinitis pigmentosa

Front 48

What is the Kell null phenotype.
Kx
K and k
anti-Ku

Back 48

Kx is increased
K and k absent
anti-Ku present

Front 49

Frequency in Whites:
O
A
B
AB

Back 49

Whites:
O 45%
A 40%
B 11%
AB 4%

Front 50

Frequencies in Blacks
O
A
B
AB

Back 50

Blacks:
O 49%
A 27%
B 20%
AB 4%

Front 51

Frequencies in Asians:
O
A
B
AB

Back 51

Asians:
O 40%
A 28%
B 27%
AB 5%

Front 52

Frequencies in Native Americans:
O
A
B
AB

Back 52

Native Americans:
O 79%
A 16%
B 4%
AB <1%

Front 53

What's the type?
Forward: Anti-A+, Anti-B-
Reverse: A1-, B+

Back 53

A

Front 54

What's the type?
Forward: Anti-A+, Anti-B+
Reverse: A1-, B+

Back 54

Acquired B

Front 55

What's the type?
Forward: Anti-A+, Anti-B+
Reverse: A1+, B-

Back 55

B(A) phenotype

Front 56

What's the type? (3)
Forward: Anti-A weak+, Anti-B-
Reverse: A1+/-, B+

Back 56

A2
Infant
S/p massive transfusion with O RBC

Front 57

What's the type?
Forward: Anti-A+, Anti-B-
Reverse: A1-, B-

Back 57

Type A newborn
Type A with hypogammaglobulinemia/immune suppression/transplant etc...

Front 58

What's the type?
Forward: Anti-A-, Anti-B-
Reverse: A1+, B+
Screen: All cells +

Back 58

Bombay, para-Bombay

Front 59

What percentage of Whites are D+? Blacks?

Back 59

Whites: 85%
Blacks: 92%