Blood Bank (Chapters 1-4)

Front 1

The study of the immune response

Back 1

Immunology

Front 2

Commonly known as blood banking it's the study of the immune response with respect to the red blood cell

Back 2

Immunohematology

Front 3

When was the first documented human blood transfusion attempt?

Back 3

1492

Front 4

When was the first documented successful blood transfusion?

Back 4

1818

Front 5

Who is the father of blood banking?

Back 5

Karl Landsteiner

Front 6

True or false blood transfusion is the most frequently performed transplantation procedure.

Back 6

True

Front 7

How much is a typical blood donation?

Back 7

1 pint

Front 8

How often is someone able to donate?

Back 8

Once every 3 months.

Front 9

Which is the safer option giving blood as a whole or giving it in components?

Back 9

Components is safer. Whole blood is very dangerous to give.

Front 10

Where are antigens?

Back 10

On cells

Front 11

Where are antibodies?

Back 11

In plasma or serum

Front 12

Another term for antibodies is what?

Back 12

Immunoglobulins

Front 13

Which is the faster immunoglobulin, IgM or IgG?

Back 13

IgG

Front 14

What are some examples of naturally occurring antibodies?

Back 14

Anti - A, anti - B

Front 15

What is meant when somebody says a naturally occurring antibody?

Back 15

No foreign stimulant

Front 16

What is an allo-antibody?

Back 16

An antibody caused by a foreign stimulant

Front 17

What are we testing in blood bank?

Back 17

Ab and ag

Front 18

All ag cause an immune response. T/F?

Back 18

False, an immunogen does though

Front 19

Humoral response

Back 19

A response to an invading substance (ag) that results in the production of a specific ab. An ag combines with an ab in vivo or in vitro.

Front 20

There are ____ different blood groups with over ___ ag.

Back 20

23/200

Front 21

The RBC surface consists of a ___ and the ag "stick out" from it.

Back 21

Lipid bilayer

Front 22

Ag are glyco__ or glyco__ and are characterized by___.

Back 22

Glycoproteins/glycolipids/the terminal (end) sugars of oligosaccaharide chains that attach to either a protein or a carbohydrate.

Front 23

HLA are divided into 3 classes, what are they?

Back 23

Class 1 ag - on surface of platelets, leukocytes and most nucleated cells in the body.

Class 2 ag-presenting cells - macrophages, dendritic cells, and B cells (not platelets)

Class 3 - complement proteins

Front 24

HLA stands for...

Back 24

Human leukocyte antigens

Front 25

Where is HLA located?

Back 25

Chromosome 6

Front 26

How many haplotypes for HLA do you get from each parent?

Back 26

1

Front 27

When is matching HLA important?

Back 27

Hematopoietic progenitor cell transplants, solid organ transplants

Front 28

What is neonatal alloimmune thrombocytopenia, and what causes it?

Back 28

Mom's ab attack baby's ag/platelet ag

Front 29

What is post-transfusion purpura?

Back 29

When a transfusion recipient's platelets are destroyed after receiving a transfusion

Hint 29

Commonly termed, the patient is refractory

Front 30

Examples of naturally occurring antibodies are...and are formed by what age?

Back 30

Anti-A, Anti-B/4 months of age

Front 31

When are unexpected ab or allo-antibodies formed?

Back 31

After a person is exposed to blood via transfusion or pregnancy

Front 32

What does ABO/D typing (forward grouping) detect, what's the ag source, and what's the ab source?

Back 32

Detects A, B, and D ag.

Ag source is patient's RBCS.

Ab source is commercial Anti-A, Anti-B, and Anti-D.

Front 33

ABO serum testing (reverse grouping) detects what? What's the ag source and the ab source?

Back 33

Detects ABO ab.

Reverse grouping cells (A1 and B).

Patient's serum or plasma.

Front 34

When are unexpected ab or allo-antibodies formed?

Back 34

Transfusion or pregnancy

Front 35

An allo-antibody is produced by...

Back 35

Immunogen

Hint 35

Another term for foreign ag

Front 36

The first time a person is exposed to a foreign RBC ag, the response is slow, this is what?

Back 36

Primary response and is IgM

Front 37

If a person "mounts a response" to the ag, a second exposure will result in production of a large amount of ab. This is called...

Back 37

Anamnestic response and is IgG

Front 38

If antibodies are already coating a person's RBCs, it means that they may have an...in this case the auto control would be ___ and the DAT would be ___.

Back 38

Auto-antibody/positive/positive

Front 39

DAT stands for...

Back 39

Direct antiglobulin test

Front 40

Allo-antibodies are detected using the ____ and ____ is tested.

Back 40

Antibody screen (ABSC)/plasma

Front 41

Auto-antibodies are detected using the ___ and/or ___. What are tested?

Back 41

DAT, auto control/red cells

Hint 41

Positive reactions in the test tube are agglutination and hemolysis

Front 42

Factors that can influence testing include...

Back 42

Serum-to-cell ratio, temp of reaction, incubation time, pH(optimal is 7.0), ionic strength

Front 43

What are some factors affecting lattice formation?

Back 43

Zeta potential, amount of ag and ab, centrifugation, and addition of anti-human globulin (AHG)

Front 44

Only __ ab can activate the complement cascade by themselves.

Back 44

IgM

Front 45

The end result of complement activation is...

Back 45

Cell lysis (seen as hemolysis in vitro)

Front 46

What are some hemolysins?

Back 46

Anti-A, Anti-B, Anti-Le {a}

Front 47

What are the principles of the antiglobulin test?

Back 47

It detects IgG abs and complement proteins that have attached but not caused visible agglutination/Produced by injecting animals with human ab complement/The AHG reagent will react with human IgG ab and complement if any is present in serum or on ag. This is why cells need to be washed.

Front 48

2 components of poly specific AHG are...

Back 48

Ab to IgG (anti-IgG)/complement proteins (anti c3d, c3d)

Front 49

Complement system

Back 49

Group of serum and proteins that clear ag, lysis cells, and vasodilate

Front 50

Complement binds to...

Back 50

cells

Front 51

Ab screens detect what? What is the source of ag? Of ab?

Back 51

Detects Ab w/ specificity to red cell ags.

Screening cells.

Patient's serum or plasma.

Front 52

What does Ab identification identify, what's the ag source and what's the ab source?

Back 52

Identifies specificity of red cell antibodies.

Ag source is panel cells.

Ab source is patient's serum or plasma.

Front 53

What does a Crossmatch determine, what's the ag source and what's the ab source?

Back 53

Determines serologic compatibility between donor and patient before transfusion.

Source of ag is donor's red cells.

Source of ab is patient's serum or plasma.

Front 54

_______: strength of ag-ab reaction.

Back 54

Potency

Front 55

SOP stands for...

Back 55

Standard Operating Procedures

Front 56

Most reagents are made from what?

Back 56

Monoclonal ab

Front 57

Anti-A is always dyed ____ and Anti-B is always dyed ____.

Back 57

Anti-A = BLUE!!!!

Anti-B = YELLOW!!!

Hint 57

"B like a yellow bee!"

Front 58

Screening cells are always group...

Back 58

O

Front 59

Direct antiglobulin detects what? What does it indicate?

Back 59

Detects Ab bound to RBCS in vivo.

Indicates autoimmune hemolytic anemia, HDFN, drug related problem, or transfusion reaction.

Front 60

Indirect antiglobulin testing (2 step procedure) detects what? Indicates?

Back 60

Detects Ab bound to RBCS in vitro.

Indicates specific reaction between an ab in serum and ag on RBC.

Front 61

What are some areas associated with DAT testing?

Back 61

RBCS are agglutinates before washing due to cold reactive ab.

Use of dirty or contaminated glassware.

Improper centrifugation.

Not adding AHG immediately after centrifuging.

Front 62

What color dye is used for our AHG testing?

Back 62

Green

Front 63

What enhancing media/potentiatior do we use in class?

Back 63

LISS/Lo-ION

Front 64

Genotype

Back 64

Hereditary make up (AO, AA)

Front 65

Phenotype

Back 65

Outward expression of the gene (AO and AA are both "group A")

Front 66

Homozygous

Back 66

Similar pairs of genes (KK)

Front 67

Heterozygous

Back 67

Different pairs of genes (Kk)

Front 68

Amorph

Back 68

Unexpressed or silent gene (O or d)

Front 69

Dominant gene vs recessive gene.

Back 69

Dominant gene is expressed while recessive isn't.

Front 70

Codominant genes

Back 70

Genes expressed equally

Front 71

Humans have 23 pairs of chromosomes. __ pair(s) of autosomes and __ pair(s) of sex chromosomes.

Back 71

22/1

Front 72

Mendelian law states..

Back 72

Only 1 gene from each parent is passed on to the child

Front 73

Autosomal dominant

Back 73

Found in each generation if the allele is present

Front 74

Autosomal recessive

Back 74

2 carriers can pass on the trait but is only expressed when the recessive trait is passed by each parent to the child

Front 75

Sex-linked dominant

Back 75

Absence of father-son transmission will be expressed if passed from father-daughter.

Front 76

Sex-linked recessive

Back 76

Males inherit trait from carrier mothers. Children of an affected male and female who lacks the allele will have sons who are normal and daughters who are carriers.

Front 77

A person who has a homozygous or double dose of a gene will have a ___ reaction then someone with a heterozygous or single dose of genes.

Back 77

Stronger

Front 78

Haplotype

Back 78

Linked sets of genes inherited together

Front 79

PCR stands for ...

Back 79

Polymerase chain reaction

Front 80

High incidence ag

Back 80

Ag that occur in a large % of the population (>90%)

Front 81

Low incidence ag

Back 81

Ag that occurs in less 10% of the population

Front 82

Liver, heart, lung and pancreas do not need to be ABO compatible. T/F?

Back 82

FALSE. Blood types must match.

Front 83

Donated kidneys blood type do need to match the recipient's. T/F?

Back 83

True

Hint 83

HLA used to predict survival

Front 84

Do blood types of donor and recipient need to match in cases of bone marrow donation?

Back 84

It's of secondary importance. HLA match is more important.

Front 85

Is ABO matching important for tissue, bone, or cornea transplant?

Back 85

Nope

Front 86

ISBT stands for...

Back 86

International

Society of

Blood

Transfusion

Front 87

An IgG reaction is worrisome because...

Back 87

It can cross the placenta

Hint 87

In regards to pregnancy

Front 88

Structure of H has which sugar?

Back 88

Fucose

Front 89

The H gene is present in __ of the population and is the precursor for __.

Back 89

99.9%

ABO

Front 90

Type O RBCS have large amounts of H detectable (more than A, B, or AB). T/F?

Back 90

True

Front 91

What phenotype are people who lack the H gene?

Back 91

Bombay

Front 92

Describe the Bombay phenotype.

Back 92

Can inherit A and B gene but don't express it.

Must receive blood from other Bombay.

"Para-bombay" exist also, which is where the H gene is defective.

Front 93

Put the following in order of which has the most H ag to the least.

A2, A1, B, A1B, O, A2B

Back 93

O>A2>B>A2B>A1>A1B

Front 94

N-acetyl galactosamine is the sugar in which blood type structure?

Back 94

Type A

Front 95

Galactose is the sugar for which blood type structure?

Back 95

Type B

Front 96

You begin to develop antigens around when?

Back 96

6th week of fetal life

Hint 96

<50% present at birth

Front 97

At what age do you reach adult level of ag development?

Back 97

3 years old

Front 98

Ag are found in...

Back 98

RBCS, epithelial cells, lymphocytes, platelets, solid organs.

If the person is a secretor, they are also found in saliva, urine, tears, bile, amniotic fluid, milk, and semen

Front 99

What is the most common subgroup of A? The 2nd most common?

Back 99

A1 the A2

Front 100

Lectin is used for...

Back 100

A1

Front 101

ABO ab are ____ occurring and develop in the first ___ of life.

Back 101

Naturally

6 months

Front 102

How much blood can be fatal due to wrong typing (ab)?

Back 102

150cc

Front 103

What is the most common blood type to least common?

Back 103

O

A

B

AB

Front 104

Secretors make up __ of the population

Back 104

80%

Hint 104

Se (dominant), se (recessive)

Front 105

Serum/plasma discrepancies are more common than cell discrepancies. T/F?

Back 105

True

Front 106

Who are some examples of people who may be missing reactions in ABO reverse type?

Back 106

Elderly patients, infants under 4-6 months, immunodeficient patients, and bone marrow transplant patients

Front 107

The number one error in bloodbanking is...?

Back 107

Transcription error

Front 108

__% of the US population is characterized as Rh negative.

Back 108

15

Front 109

What are the best known ag of the Rh blood group system?

Back 109

D, C, E, c, e

Front 110

If you see dCE written for Rh inheritance, the d means what?

Back 110

There is no D ag.

Front 111

Rh null is the same as Rh negative. T/F?

Back 111

FALSE. Rh nulls have NO Rh ag. Rh negative only lack the D ag.

Front 112

After ABO, what's the most important blood group system?

Back 112

Rh

Front 113

Rh ab are clinically significant because they can cause...

Back 113

Hemolytic transfusion reactions (HTR) and HDFN

Front 114

Rh ab are naturally occurring. T/F?

Back 114

False. They need antigenic stimulation.

Front 115

List the five main Rh types from most immunogenic to least.

Back 115

D>c>E>C>e

Front 116

R=?

?=absence of D

1or '=?

2 or ''=?

? or ? = C and E

Back 116

D

r

C

E

z or y

Hint 116

In this case absence of D is NOT d - weiner/fisher-race

Front 117

cde/cde =

Back 117

rr

Hint 117

Rh(D) status is negative

Front 118

R1r=

Back 118

CDe/cde

Front 119

CDe/CDe =

Back 119

R1R1

Front 120

cDE/cde =

Back 120

R2r

Front 121

R1R2 =

Back 121

CDe/cDE

Front 122

cDE/cDE =

Back 122

R2R2

Front 123

RHAG is on which chromosome?

Back 123

6

Front 124

What are the blood types for 1-4?

Back 124

1-?

2-?

3- AB pos

4- O pos

Front 125

What is true of Bombay individuals?

Back 125

They are genetically hh.

They do not make A and/or B ag on there RBCS.

They can only receive blood from other Bombay individuals.

Front 126

Lectin from dolichus biflorus will agglutinate red cells of which phenotype?

Back 126

A1 and A1B

Front 127

Complete the chart.

Back 127

Front 128

What are situations in which a weak D test MUST be performed?

Back 128

Prenatal evaluations and blood transplant recipient.

Front 129

Back 129

Front 130

The technique that uses a small amount of DNA and amplifies it for identification is called...

Back 130

PCR

Front 131

Back 131

Front 132

Back 132

Front 133

Back 133