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Haematology and Transfusion Science > TS1 - Transfusion Science 1 > Flashcards

TS1 - Transfusion Science 1 Flashcards

1
Q

Who discovered the ABO blood group?

A

Karl Landsteiner

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2
Q

What 2 possible results of mixing blood from 2 donors led to the discovery of the ABO blood group?

A
  • Grainy agglutination

- Smooth cell mixture

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3
Q

What antigens do blood group A have on their surface?

A

A

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4
Q

What antigens do blood group B have on their surface?

A

B

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5
Q

What antigens does blood group AB have on its surface?

A

A and B

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6
Q

What is Landsteiner’s law?

A

Anybody without a particular antigen automatically makes antibodies for the antigens they don’t possess

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7
Q

A person of blood group A has which antibodies in their blood?

A

anti-B

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8
Q

A person of blood group B has which antibodies in their blood?

A

anti-A

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9
Q

A person of blood group AB has which antibodies in their blood?

A

None

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10
Q

A person of blood group O has which antibodies in their blood?

A

anti-A,B

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11
Q

What other blood group systems were discovered in 1927 by Landsteiner and Levine?

A

MN and P systems

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12
Q

What did Landsteiner and Levine do to discover the MN and P systems?

A
  • Injected human red blood cells into rabbits and guinea pigs
  • mixed the serum from the rabbits with blood
  • the blood either agglutinated or remained as a smooth cell mixture
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13
Q

It was discovered that when red blood cells were injected into rabbits or guinea pigs by Landsteiner and Levine in 1927 antibodies to 3 antigens were formed, what were these named?

A

M, N and P

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14
Q

Who discovered the Rh blood group?

A

Levine and Stetson in 1939

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15
Q

What led to the discovery of the Rh blood group by Levine and Stetson?

A
  • Caring for woman gravida 2
  • fetus died, erythroblastosis foetalis
  • anti-D found in blood
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16
Q

How did Landsteiner and Wiener confirmed the existence of the Rh blood group in 1940-41?

A
  • Injected red blood cells from Rhesus macaques into rabbits or guinea pigs
  • serum from the rabbit mixed with human blood from New York
  • 85% agglutinated
  • 15% did not agglutinate
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17
Q

Antibodies have been found in serum of transfused patients or mothers of infants with HDN indicating other blood groups exist, name the 4 other main blood groups.

A
  • Lutheran
  • Kell
  • Duffy
  • Kidd
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18
Q

What are blood group antigens?

A

Inherited determinants on red blood cells capable of stimulating an antibody response in someone lacking the antigen

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19
Q

What is a blood group?

A

Antigens encoded by the same gene or cluster of genes which are inherited together

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20
Q

What are A and B antigens?

A

Carbohydrate groups found on red cell membrane surface

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21
Q

What enzyme attaches the A and B antigens to the red blood cell membrane?

A

Glycosyl-transferase

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22
Q

What enzyme attaches the H antigen to the red blood cell membrane?

A

L-fucosyltransferase

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23
Q

Which gene codes for L-fucosyltransferase?

A

FUT1

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24
Q

Which gene controls the secretin (Se) status?

A

FUT2

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25
Q

Which gene codes for L-fucosyltransferase which forms the H antigen?

A

FUT1

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26
Q

What enzyme does the A allele code for which forms the A antigen?

A

N-acetylgalactosaminyltransferase

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27
Q

What enzyme does the B allele code for which forms the B antigen?

A

D-galactosyltransferase

28
Q

What effect does the O allele have on the H antigen?

A

It leaves the H antigen unmodified

29
Q

There are 2 subgroups of type A, A1 and A2. One of these enzymes is less efficient at converting H substance to a antigen which subtype is this?

A

A2

30
Q

A1 is dominant over A2 so the A2 phenotype is only expressed if the person does not inherit the A1 gene. What effect does inheriting the A2 phenotype have on A antigen distribution on the red blood cells?

A

The A antigen is sparsely distributed

31
Q

A small percentage of people with subgroup A2 make antibodies to A1 antigen so if these individuals receive a blood transfusion they can react to the transfused blood however the reaction is not clinically significant, why is this?

A

The antibodies do not react at 37° C

32
Q

What is the difference between the A1 and the A2 allele?

A

The A2 allele has a stop code in exon 7 and so the enzyme is weaker

33
Q

What is the difference between the O allele and the A allele?

A

The O allele has a stop codon at exon 6 so exon 7 is not translated

34
Q

The Rh blood group is a group of how many antigens?

A

45 antigens

35
Q

The Rh blood group is encoded by 2 related genes on which chromosome?

A

Chromasome 1

36
Q

There are 5 common Rh antigens which are of major importance, which ones are these?

A

D, C, c, E and e

37
Q

The RHD gene codes for which antigen?

A

RHD codes for the D antigen

38
Q

The RHCE gene codes for which antigens?

A

RHCE codes for the C/c and E/e antigens

39
Q

The majority of RHD+ people express the full antigen, however a few people have a ‘weak D’ phenotype, what does this mean?

A

They have low expression of D antigen

40
Q

Some individuals (DVI) express only part of the D antigen (partial D), why is this?

A

DVI lacks the sixth domain of the antigen

41
Q

How should all D variant donors be treated with respect to their RhD status?

A

All D variant donors should be treated as D+

42
Q

How should most weak D patients be treated with respect to there RhD status?

A

Most weak D patients are treated as D+

43
Q

Partial D patients and a few weak D patients are treated as D-, why is this?

A

They make anti-D

44
Q

The Duffy system consists of 2 antigens Duffy A and Duffy B, this leads to 3 distinct phenotypes what are these?

A

Fy(a+b-)
Fy(a-b+)
Fy(a+b+)

45
Q

The Duffy antigens code for a glycoprotein which bind what?

A

cytokines

46
Q

The null Duffy phenotype Fy(a-b-) is only found in which population?

A

black African populations where P. vivax is prevelent

47
Q

The Duffy antigen acts as a receptor for which organism?

A

P. vivax

48
Q

The Kell system consists of 26 antigens encoded by five sets of alleles, which is the most important antigen?

A

Big K

49
Q

What to the Kidd antigens code for?

A

a glycoprotein which acts as a urea

transporter

50
Q

How many phenotypes other in the Kidd blood group system on what are these?

A

There are three main phenotypes
• Jk(a+b-)
• Jk(a-b+),
• Jk(a+b+)

51
Q

The Kidd blood group system also has a null phenotype Jk(a-b-) which occurs only in which races?

A

Finns and Polynesians

52
Q

Which kid blood group phenotype is resistant to lysis in 2M urea?

A

The null phenotype Jk(a-b-)

53
Q

The Colton blood group system consists of 2 antithetical antigens, what are these?

A
  • Coa

* Cob

54
Q

What to the Colton antigens code for?

A

a glycoprotein aquaporin1 (water

channel)

55
Q

There is a rare null phenotype the Colton system Co(a-b-).

Co(a-b-) subjects are unable to produce what?

A

Concentrate urine

56
Q

Antibodies to red cell antigens can arise only as a result of sensitization by which 2 events?

A
  • Previous transfusion

* Pregnancy

57
Q

Antigens differ in what 3 factors?

A
  • Frequency
  • Copy number
  • Immunogenicity
58
Q

Antibodies differ in what 3 factors?

A
  • Frequency
  • Strength
  • Reaction temperature
59
Q

What type of antibodies are anti-A and anti-B?

A

“naturally occurring” IgM (+ IgG)

60
Q

What percentage of D- patients make antibodies after 1 units of D+ blood?

A

90%

61
Q

What percentage of D- mothers make antibodies after a D+ pregnancy?

A

20%

62
Q

Which antibody often accompanies anti-D?

A

anti-C

63
Q

Is the K (Kell) antigen strongly or weakly immunogenic?

A

K is strongly immunogenic

64
Q

What percentage of transfusion patients make unexpected antibodies?

A

2%

65
Q

How would you test whether transfusion is likely to cause antibodies to be made?

A

By performing:

  • Crossmatch
  • Antibody screen
66
Q

What is the sequence (4) of events which take place during antibody screening?

A 
• Match ABO type
• Match RhD type
• Crossmatch / screen for antibodies
• Match other common antigens (C, e, E, K, Fya)
if multiple transfusions likely

Haematology and Transfusion Science (10 decks)

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