Blood Groups Anticoaglulation 2

Question 0

How much time do you have to administer drugs in MI? in Stroke?

Answer 0

MI- within 12 hours

Stroke- within 3

problem with brain hemmorrhage

Question 1

What are 2 activators of Fibrinolysis?

Answer 1

clot busters sucha s tPA and urokinase

treat arterial thrombosis by dissolving fibrin clots and loosening up hemostatis plug

Question 2

What is Deep Vein Thrombosis (DVT) and Pulmoanry Emoblisms

Answer 2

rich in FIBRIN

Question 3

what is a pulmonary embolism?

Answer 3

when deep vein thrombus breaks away from site of formation and travels through the blodo to lung wher eit lodges to block blood flow in a pulmonary artery

Question 4

What factors does Warfarin inhibit and how?

Answer 4

It is a Vitamin K antagonist that slows down FIBRIN formation by indirectly inhibiting the carboyxlation of Glu residues in Factor 2, 7a (extrinsic tenase), 9 (intrinsic tenase), 10 (prothrombinase).

Also inhibits Gla modification in Protein C and Portein S

acts in liver to inhibit reductase that recycles Vit K

Question 5

What have drug companies made to alleviate drawbacks of warfarin side effects

Answer 5

orally active inhibitors of thrombin and factor xa

Question 6

what does Rivaroxaban do?

Answer 6

Inhibits Factor Xa

Question 7

What does Dabigatran do?

Answer 7

Inhibits Thrombin

Question 8

What is the normal platelet count?

Answer 8

200,000-400,000 / uL

Question 9

What platlet count until bleeding disorders observed

Answer 9

What platelet conc until count is less than 100,000/ uL

Question 10

What is platelet count when severe?

Answer 10

below 50,000 uL

Question 11

APTT

Answer 11

activated by addition of Partial Thrombopalstin: PL, aCa ions

Excluding factor VII

APTT is prolonged for deficiencies in factors invovled in either the INTRINSIC OR COMMON pathways (HMWK, PK ,fibrinogen, prothrombin as well as factors V, VIII, IX, X, XI and XII)

Question 12

PT

Answer 12

activated by addition of COMPLETE THROMBOPLASTIN (tissue fator) and calciu faoctors

PT is proleonged for deficiencies of facators in the EXTRINSIC OR COMMON PATHWAYS (Factor VII, V, X as well as prothrombina nd fibrinogen)

Question 13

TT

Answer 13

activated by addition of thrombin

prolonged with diminshed expression and/or funtion of FIBRIN

this is the only assay that testst eh activit of a single component in coagualtion

Question 14

BT

Answer 14

defined as time between inflcition of a small, standard cut and the moment when bleeding stops
thsi is extremely difficult to standardize and not often performed

Question 15

What is the H antigen?

Answer 15

It is the precursor for A and B antigens

Everybody has antigen H except for Bombay phenotype

Question 16

Which phenotype doesnt have the H antigen?

Answer 16

Bombay phenotype

Question 17

What are the antigens of blood groups?

Answer 17

Glycoproteins and Glycolipids

Question 18

Where are the antigens located? (3)

Answer 18

1 RBC cell membranes

2. most tissues, except CT , CNS, and some epithelia
3. Glycoproteins in blody fluids in 80% of the population (“secretors”)

Question 19

The termianl sugar that distinguishes the A form teh B antigen is added to the H antigen ,

Answer 19

whcih serves as a substrate to produce these antigens

Question 20

What is the precursor substance

Answer 20

THe H antigen is converted the PRECURSOR substrate to produce these antigens

Question 21

What converts the H antigen from precursor substrate to A or B antigen?

Answer 21

Oneof two fucosyltransferases encoded by related alleles: H locus (FUT1) and Se locus (FUT2)

Only a difference in four amino acids

Question 22

What is the difference between FUT1 and FUT2

Answer 22

differ mainly in where they are expresd and thus have activity

Question 23

What does FUT1 encode for?

Answer 23

alpha 1,2-fucosyltransferase that addes fucose to teh terminal galactose of ht precursor substance to produce the H antigen on proteins and lipids in teh membrane of RBC and vascular endothelium

Question 24

What does FUT2 encode for?

Answer 24

alpha 1,2 fucosyltransferase that is expresed in secretory glands (sucha s salivary glands, GI tract, and respritaory tract)

Question 25

Enzymatic a tibity requires at least one copy of ???

Answer 25

the dominant Se allele to produce H antigetn in bodily secretions

Question 26

What are indivuals taht produce H antigen secretions?

Answer 26

SECRETRS and have eithe rhe Se/se or teh Se/Se genotype 80% o the populatiosn has this secretor phenotype 20% remaining are non-secretors b/c htey ave the inactive allele (se/se gentype)

Question 27

What are the genotypes of both secretor and non--secretor populations

Answer 27

H/H or H/h genotype and thus express H antigen in teh membrane of RBC

Question 28

What is the difference between seretor and non-secretor?

Answer 28

Both have glycoproteins in their seretions Diff is that non-secretor lacks the A, B, and/or H antigenic specificaiton on their secreted glycoproteins

Question 29

How is the H antigen made?

Answer 29

by transferrng fucose onto the precursor substance type 1 or type 2. A precursor glycoprotein or glycolipid (both which are present in every indivual) is acted upon by the product (enzyme) of the H locus (FUT1) or Se locus (FUT2), to yield H antigen

Question 30

How are ABH genotypes defined?

Answer 30

by the expression of the enzymes that catalyze attachment of specific monosaccharide moieties.

Question 31

Wat are the ABO antibody specifieicties directed at?

Answer 31

not the pirmer gene porducts (enzymes); rather directed towards seocndary gene products (the oligosaccharadies)

Question 32

Int eh case of glyolipids, teh oligosacchardie chain taht carries the A, B, and/or H antigenic specificity is attached to????

Answer 32

the primary hydroxyl gorup of SPHINGOSINE

Question 33

What do indiividuals iwth A allele express? what does it recognize

Answer 33

A transferase (alpah 1,3, -N-acetyl-galactosyltransferase) which adds galactose to H antigen A transferase recognizes and transfers N-acetylgalactosamine

Question 34

What do indivduals with B allele express? What does it recognize

Answer 34

B transferase (also known as alpha 1,3-galagctosyltransferase, which adds galactose to H antigen Recognizes and transfers galactose

Question 35

What do individual with O allele express?

Answer 35

protein with a point deletion that causes a translational frameshift resultant protein is almost entirely DIFFFERNT and possesses no enzymatic activity

Question 36

What antigens does OO genotype have?

Answer 36

H antigen but neither the A nor B antigen

Question 37

which individuals have anti-H antibodies?

Answer 37

Bombay phenotype

Question 38

What genotype do indivduals with Bombay Phenotype have?

Answer 38

rare h/h se/se gentoype and thus unable to convert the precursor substanve into H antigen With no H antigen, no A or B antigens are produced eitehr. Anti H , anti A and anti B Ab that will agglutinate transfusions from blood types A, B, AB , or O

Question 39

What is the Rh antigen?

Answer 39

protein

Question 40

When do Rh antibodies occur in humans?

Answer 40

only after immuniation with RBC of non-self genotype until exposure of Rh-negative person to D antigen in Rh-positive person blood transfusions or Rh-negative women during pregnancy after exposure to Rh-pos fetal blood

Question 41

What two genes does Rh antigen arise form?

Answer 41

RhD and RhCE, each with 10 exons

Question 42

What does RhD protein express?

Answer 42

D antigen

Question 43

What does RhCcEe protein express?

Answer 43

2 antigens either C or c antigen and eitehr E or e antigen CE locus is very close to D locus and two loci are inherited together

Question 44

What is the Rh null mutation?

Answer 44

both D adn CcEe proteins are absent peopel eithe rlack DCE genes or have an abnormal regulator gene, which controls expression of DCE genes. THeir RBCs are OSMOTICALLY FRAGILE and often misshapen, suggesting that Rh D/Rh CE proteins are improtant for RBC structure

Question 45

When does HDN occur?

Answer 45

when mother produces antibodies vs RBC antigens of the fetus arising from some blood type incompatibilieies. Maternal Ab attack teh fetal RBCs causign them to hae a shortened life span resulting in acquired hymlytic anemia.

Question 46

What causes HDN? 3

Answer 46

1. Rh incompatibility where mother is Rh neg and fetus is Rh pos 2. ABO incompat where mother has type O blood, which tends to produce IgG Ab that CAN cross placenta and the fetus has type A or B blood which ten to IgM that cannot cross placenta (mild effect) 3. Incompatibility invovling other blood groops such as Kell or Duffy

Question 47

Can IgG cross placental membrane/ Can IgM?

Answer 47

IgG (type O) can cross! IgM (Type A or B) cannot cross

Question 48

When does Rh-neg maother produce anti-Rh IgG Ab?

Answer 48

after she has had at least one incompatible prgnancy (IgM Ab produced first and dont corssplacenta) during 2nd Rh-incompatible pregnancy, small amts of fetal blood normally cross placental barrier and enter maternal blood stream, stimulating IgG Ab against Rh antigen--> cross placenta to cause hemolysis of fetal RBC--> Fetus anemic and rsponse by releaseing a tone of erythroblasts (nucleated immature RBCs) into its bloods tream Erythroblastosis Fetalis in newborn --> bilirubin --> jaundance hyperbilirubinemia needst o be treated to prevent depostion of unconjugated bilirubin in brain (kernicterus) whcih can cause certebral damage or death

Question 49

What is the treatment to prevent HDN?

Answer 49

block productino of Rh Ab. During prenancy or after Rh-neg woman gives birth to Rh pos baby, given anti-Rh immune globuluin to prevent prodcutino of antbidoes against Rh antigen