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exam 1 Flashcards

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1
Q

allele

A

one of two or more different genes that may occupy a specific locus on a chromosome

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2
Q

amorph (silent allele)

A

a gene that does not appear to produce a detectable antigen

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3
Q

phenotype

A

the outward expression of genes

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4
Q

genotype

A

an individuals actual genetic makeup

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5
Q

heterozygous

A

possessing different alleles at a given gene locus

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6
Q

locus

A

the site of a gene on a chromosome

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7
Q

homozygous

A

posessing a pair of identical alleles

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8
Q

dominant

A

a trait or characteristic that will be expressed in an off spring even though it is carried on only one of the homologous chromosomes

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9
Q

recessive

A

a type of gene that in the presence of its dominant allele does not express itself; expression occurs when inherited in the homozygous state

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10
Q

co-dominant (egalitarian)

A

a pair of genes in which neither is dominant over the other; they are both expressed

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11
Q

zeta potential

A

the net negative charge surrounding RBC’s causing them to repel one another

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12
Q

how does the addition of albumin to RBC effect the zeta potential?

A

works by reducing zeta potential and dispersing the charges allowing RBC to approach each other so that IgG can cross link between RBC (increased chance of agglutination)

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13
Q

IgG

A

-only Ig that cross placena (CS)
-not found in nature (pregnancies of transfusions)
-likes 37C (CS)
-needs AHG for detection
Rh, Kell, Duffy, Kidd, Ss,
D, C, E, e, c, k, Fy, Jk, S, s, LeA, LeB

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14
Q

IgM

A
  • largest “j” chain
  • 1st Ab to appear
  • found naturally
  • not clinically significant
  • ABH, Hh, Ii, Lewis, MN, P, IS phase
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15
Q

what is LISS

A

low salt media

decreases ionic strength of rxc media to reduce zeta potential

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16
Q

what are the proteolytic enzymes?

A

ficin
papain
trypsin
bromelin

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17
Q

how do the proteolytic enzymes work?

A

reduce zeta potential by removing some glycoproteins from RBC surface to make RBC more hydrophobic (more access for binding)

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18
Q

proteolytic enzymes increase reactivity for what systems

A 
Rh,
Kidd
P
Lewis
I antigens
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19
Q

proteolytic enzymes decrease or destroy reactivity for what systems?

A

duffy
M
N
S antigens

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20
Q

AGT/coombs is useful for detecting what?

A

IgG

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21
Q

DAT (direct antiglobulin test)

A

-in vivo(inside body)
-detects Ab/complement attached to RBC in vivo
useful for detecting HDN, HTR, and AIHA

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22
Q

IAT

A

in vitro
useful for compatibility testing, Ab screening, RBC phenotyping, titers
detects Ab/complement attached to RBC in vitro

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23
Q

anti-human globulin

A

obtained from immunized NON-human species bound to human globulins IgG and/or complement

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24
Q

why is AHG used?

A

used in DAT and IAT testing because the AHG will bind to IgG or complement showing the Ab-Ag rxc that usually goes undetected because of IgG’s size in comparison to IgM

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25
alloantibodies
after exposure to genetically different antigens from same species
26
auto antibodies
produced to self antigens (autoimmune)
27
genotype
2 letters, what is inherited by both parents
28
phenotype
1 letter what is expressed by individual
29
dosage
a phenomenon whereby an antibody reacts more strongly without a RBC carrying a homozygous inheritance than with a heterozygous inheritance of an antigen
30
where is dosage shown?
kidd system | Rh system with C,c,E,e
31
what is the system in which the Ab are consistently and predictably present in serum of normal individuals whose RBC lack the Ag
ABO
32
what are the genotypes of the phenotype A
AA | AO
33
what are the genotypes of the phenotype B
BB | BO
34
what is the genotype of the phenotype O
OO
35
what gene is needed for the expression of ABO genes?
H gene
36
how does the H substance work?
the H gene secretes H substance that converted by A or B gene into A or B antigens
37
what ABO gene has the most H antigens on its surface?
O, because the O gene is a silent allele and doesn't alter the H substance
38
type 1 precursor chain
1,3 linkage | found in plasma
39
type 2 precursor chain
1,4 linkage | found on RBC
40
what is the order of H antigen present on cells from most to least?
O>A2>B>A2B>A1>A1B
41
how is the A antigen made?
1) add H substance (fucose) to precursor | 2) add immunodominant sugar N-Acetylgalactosamine
42
how is the B antigen made?
1) add H substance (fucose) to precursor | 2) add immunodominant sugar D- galactose
43
what is the genotype of bombay individual?
hh
44
what is the phenotype of bombaby individual?
O
45
what are bombay individuals unable to produce?
H substance
46
How does the inability to produce a certain substance affect the bombay individuals?
they can inherit A or B genes but because they lack the H substance they cannot make A or B antigens
47
what antibodies are found in the serum of bombay individuals?
anti-A anti-B anti-H
48
where are soluble Ag's found?
body secretions | sweat, saliva, etc
49
where do secretors secrete their soluble ag
body secretions
50
what can nonsecretors secrete?
A,B, or H
51
can bombay patients also be secretors/
yes, they will secrete H and whichever ABO suppressed gene they possess
52
what test is used to detect ABH substances in saliva?
neutralization tests
53
forward typing
patients RBC are added to antisera anti-A and anti- B to test for presence/absence of Antigens
54
reverse typing
patient serum is added to A1 and B cells to test for presence/absence of antibodies
55
landsteiners rule
antibodies are present in plasma only when the corresponding antigen is not present on the RBC
56
anti-A1
produced by some subgroups of A ( A2 and A2B) Ig class: M low temp. range HDNB: no no extravascular hemolysis and rare intravascular hemolysis
57
anti-A1 lectin
prepared from seeds of dolichos biflorus identifies A1 subgroup necessary when working with A2 or A2B because serum contains anti-A1
58
anti-H (autoAb)
low thermal range seldomly clinically sig. naturally occuring in A1 and A1B
59
anti-H (alloAb)
``` occurs as IgG or IgM in bombay patients CS: YES Ab class: G or M thermal: high range HDNB: yes both E and I transfusion reactions ```
60
anti-H lectin
prepared from ulex europaeus | used in secretor testing
61
anti- A,B in O serum
cannot be seperated into A or B cross reacts with both A and B antigens agglutinates RBC subgroups especially Ax
62
Lewis group system
only blood group not manufactured by the RBC
63
where is the lewis group manufactured?
tissue cells and secreted into body fluids as soluble Ag | Ag then absorbed onto RBC so not intrinsic part of RBC
64
what are the antigens of the lewis system?
LeA | LeB
65
what are the precursor chain for LeA?
type I chain with an added fucose
66
what are the precursor chains for LeB?
Type I H chain add fucose (to be LeB individual must have inherited secretor gene)
67
what is the phenotype of an individual who is both lewis and a secretor?
Le ( a-b+)
68
what is the phenotype of an individual who is NOT secretor with lewis gene
Le (a+b-)
69
why is the lewis antibody seldom clinically significant?
- soluble LeA and LeB anitgen present in donor plasma neutralize recipients antibodies - lewis antigens rapidly elute from donor RBC which are transformed to recipients lewis phenotype
70
what is the lewis system enhanced by?
enzymes
71
what are the reasons the lewis system does not cause HDFN
- LeA and LeB antigens are not well developed at birth | - anti-LeA and anti-LeB are IgM and cannot cross placenta
72
dd
this does not mean recessive for D gene this shows absence of D gene
73
does anti-D occur naturally?
no, only occurs resulting from transfusions or pregnancies (immunization)
74
T OR F | immunogenecity of D is greater than all other RBC antigens studied
true
75
fisher-race theory
3 closely linked genes inherited from each parent
76
wiener theory
1 Rh gene inherited from each parent
77
D+w
weak form of D Ag
78
how is D+w demonstrated?
IAT anti-D anti-D will be positive and the Rh control will be negative
79
Rhnull
individual who express no Rh Ag on RBC characterized by hemolytic anemia
80
Rhmod
lack most their Rh Ag expressions characterized by hemolytic anemia
81
what is the significance of D+w in donors?
- weak D blood given to Rh = patients may ellicit immune response to D - weak D cells may suffer accelerated destruction in recipient serum that already contains anti-D (severe HTR)
82
HDFN
the destruction of the RBC of a fetus and neonate by Abs produced by the mother
83
what are the two most common causes of HDFN
ABO incompatibility | Rh Antigen
84
kernicterus
infiltration of the brain and spinal cord with unconjugated billi causes permanent damage to the CNS
85
Rh HDFN general characteristics
mother Rh = | fetus Rh +
86
what happens in the second pregnancy of a rh = mother and rh + fetus?
at 28 weeks and onward the secondary response to pregnancy stimulates the Ab created from the first pregnancy into high titers. IgG crosses placenta combines with fetal Rh+ cells and starts destruction
87
ABO HDFN general characteristics
independent of Rh factor anti-A,B most potent diagnosis made when infants blood is DAT + and anit-A or B can be eluted from affected RBC
88
what pregnancies are affected by ABO HDFN?
first pregnancies and onward
89
what ABO blood group is the mother usually in ABO HDFN?
group O becuase they have naturally occuring IgG and IgM anti-A anti-B and anti-A,B
90
RHIG candidates upon testing initial visist
Ab screen for unexpected IgG Abs - anti-D is identified = no RHIG candidate - anti-D is negative = RHIG at 28 weeks
91
RHIG candidates upon testing | follow up visit:
if Rh is negative repeat Ab screen - Ab screen is = : give RHIG at 28 weeks - Ab screen is + because of anti-D: no RHIG possible HDFN - Ab screen is + because of something unrelated : RHIG at 28 weeks
92
RHIG candidates upon testing: | at delivery
- D = with history of alloanti-D: suspect HDFN test cord blood no RHIG - D = with NO history of alloanti-D: candidate RHIG - cord blood rh = : no RHIG - cord blood rh +: screen for FMH and calculate doses RHIG
93
when are intrauterine transfusions neccessary?
- MCA-PSV indicates anemia - fetal hydrops are noted on ultrasound (accumulation of fluid in 2 or more fetal compartments) - cordocentesis blood sample has Hgb level <10g/dl - amniotic fluid results are high
94
intrauterine transfusions general
access umbilical vein and inject donor cells directly goal- maintain fetal hgb above 10g/dl once performed repeated every 2-4 weeks until delivery
95
why would a DAT be performed on cord blood postnatally?
a + test confirms that infants RBC have absorbed maternal Ab (HDN)
96
RHIG or RHOGAM general
RHIG sensitizes infants Rh+ RBC within maternal circulation and are cleared by spleen and lymph nodes prevents mother's immune system to feel the need to react
97
candidates of RHIG
- rh = moms with no detectable anti-D in serum and have Rh+ infants - any rh = woman who has had miscarriage, abortion, 1st trimester amnio, trauma, ectopic pregnancy, etc unless father or fetus are known to be rh = - rh = women within child-bearing age who have to receive blood products containing rh + cells

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