exam 3 Flashcards
(151 cards)
1
Q
clinically significant antigens can cause what
A
HDN or tranfusion rxn
2
Q
what class is clinically significant antigens IgM or IgG?
A
IgG mostly
3
Q
which phase does clinically significant antigens react?
A
AHG- 37 degrees
4
Q
insignificant antigens don’t not cause what?
A
HDN or tranfusion rxn
5
Q
what class is clinically insignificant antigens ?
A
IgM
6
Q
which phase does insignificant antigens react?
A
RT-IS
7
Q
which antigens show dosage?
A
Kidd, Duffy, Rh, M N S
8
Q
which antigens are destroyed by enzymes?
A
Duffy, M N S, s
9
Q
which antigens are enhanced by enzymes?
A
Kidd, Rh, Lewis, I, P1
10
Q
which antigen is destroyed by DTT?
A
Kell
11
Q
Acanthocytosis, muscular and neurological problems, chronic granulomatous disease are all symtoms of what?
A
McLeod syndrome
12
Q
which antigens have disulfide-bonded regions on the glycoproteins
A
Kell antigens
13
Q
this antigen is second most immunogenic next to the D
antigen
A
K (K1)
14
Q
less than 9% of the population has this antigen
A
K (K1)
15
Q
more than 90% of the population has this antigen
A
k (K2/cellano)
16
Q
Duffy antigens on the anagram are expressed as
A
Fya and Fyb
17
Q
Kidd antigens are expressed as
A
Jka and Jkb
18
Q
Lutheran antigens are expressed as
A
Lua and Lub
19
Q
Lewis antigens are expressed as
A
Lea and Leb
20
Q
other Kell antigens are
A
Kpa, Kpb and Jsa, Jsb
21
Q
Kpa is what type of antigen?
A
low frequency antigen (2%)
22
Q
Kpb is more common so it is a
A
high frequency antigen (99.9%)
23
Q
Jsa is more prevalent in which community?
A
African american
24
Q
a high frequency antigen of Kell is Jsa or Jsb?
A
Jsb (80-100%)
25
Duffy antigen expression, Common in people of African descent; resistant to Plasmodium vivax (malaria)
Fy (a-,b-)
26
Kell antigens classified as high frequency or prevalence are present in greater than 98% of the population.
k(k2), Kpb , Jsb
27
Kell antigens classified as low frequency or prevalence are present in less than 10% of the population.
K(K1) Kpa , Jsa
28
immunoglobulin class of Kell are
IgG
29
Kell ab are stimulated by what two things
pregnancy or transfusion
30
Kell ab agglutinatie best by which test?
Indirect antiglobulin test (IAT)
31
Does Kell ab bind complement?
no
32
Is Kell associated with transfusion rxn and HDN?
yes
33
K0 or K null phenotype posses elevated levels of what K antigen
Kx
34
Impaired phagocytosis is associated with what?
chronic granulomatous disease
35
-RBC abnormalities
Muscular and neurologic defects
– Increased creatine kinase (CK)
McLeod symptoms
36
antigens that must be ruled out by Homozygous expression exhibit what
dosage
37
antigens that exhibit dosage are
Duffy, Rh, Kidd, MNS
38
antigens that are clinically significant include
ABO, Rh, Kell, Kidd, Duffy, S, s U , Lub
39
antigens that are clinically insignificant are
I, Lewis, M, N, P1, Lua
40
enzymes that destroy Duffy
papain, ficin, bromelain,
trypsin
41
In the U.S. most (51%)African Americans express Kidd antigens as
Jk(a+b–)
42
most (50%) Caucasians express Kidd antigens as
Jk(a+b+)
43
When is Jk3 present?
whenever Jka and Jkb are present
44
Jk (a-, b-) are resistant to what?
2 M Urea
45
Does Duffy ab bind complement?
no
46
what does Kidd ab sometimes cause during transfusions?
delayed transfusion rxn
47
Enzymes that enhance Kidd
LISS and PEG
48
Lutheran antigens are weakly expressed on what type of sample?
cord blood
49
which Lutheran antigen is high prevalence
Lub, Lu (a-, b+) 92%
50
Lua is not clinically significant but may show mild what?
HDN
51
Lua reacts best at which phase
RT
52
Lub reacts best at which phase?
AHG
53
bother lutheran antigens show what type of reactions
mixed field reactions
54
Immunoglobulin class of Lua?
mostly IgM but could be IgG
55
Immunoglobulin class of Lub
IgG
56
Lewis antigens are also found in what
secretions
57
the Lewis phenotype of a secretor
Le (a-, b+)
58
What disease is associated with Autoanti-I?
Mycoplasma pneumoniae infection.
59
What disease is associated with anti-i?
Infectious mononucleosis (EBV).
60
What antigens are coded by glycophorin A?
M and N antigens
61
rare antigen that signifies absence of glycophorin B?
anti-U
62
which Duffy antigen is seen more frequently fya or fyb?
Fya
63
does Duffy ab bind complement?
no
64
what are Duffy ab stimulated by?
pregnancy or or transfusion
65
which Duffy phenotype is found frequently in people from west and central Africa, supporting the theory of selective evolution
Fy (a-, b-)
66
does Kidd ab/ag activate complement?
yes
67
which Lutheran ab is rare?
Lub
68
which Lutheran ab reacts best at RT?
Lua
69
which Lutheran ab is IgM and sometimes IgG?
Lua
70
the Le gene is also called what?
FUT3
71
FUT3 adds what to the type 1 chain?
fucose
72
one fucose added to type 1 chain
Lea antigen
73
2 fucose added to type 1 chain
Leb antigen
74
Lewis system depends on which genes
H, Se, Le
75
If Le and 1 or 2 Se genes are inherited, red cells will be
Le(a-b+) secretor
76
If Le and 2 se genes are inherited, red cells will be
Le(a+b-) nonsecretor
77
which genes must all be inherited to convert Lea to Leb
Le, H, Se
78
antigen that is the receptor for Heliobacter pylori associated with gastritis
and peptic ulcer
Leb
79
Lewis antigens can be reduced in
pregnancy, mono, cirrhosis, and pancreatitis
80
which Lewis ab binds complement
Lea
81
immunoglobulin class of Lewis is
IgM
82
i antigen (linear) converts to I antigen (branched) at what age?
2 years
83
what kind of ab is I?
cold autoantibody
84
which phase does I react?
RT (4 degrees C) IgM
85
what testing does I interfere with
ABO testing/compatability
86
which cells are prewarmed separately before combining to prevent reactions of cold
antibodies binding at room temperature and activating complement
autoanti-I(cold autoantibody)
87
which ab can react as a compound due to having many H sites(O, A2)?
I (anti-HI)
88
P and Pk antigens are high or low frequency antigen?
high frequency
89
which P ab can be neutralized to reveal other clinically significant
antibodies.
P1
90
What antibody is associated with the Donath-Landsteiner
autoanti-P
91
biphasic hemolysin that
binds with P1 or P2 cells at low temperatures, causing lysis, before the
complement is activated
Donath-Landsteiner antibody
92
Donath-Landsteiner antibody can cause an autoimmune hemolytic anemia called what?
cold paroxysmal hemoglobinuria
93
P ab that is associated with spontaneous abortions
anti-PP1
94
What is the most common platelet antibody
HLA ab
95
Tests patient’s serum with their own cells
autocontrol
96
Blocking antibodies with soluble antigen
neutralization
97
Procedure that uses red cells(known antigens) to remove red cell antibodies from
a solution (plasma or antisera)
adsorption
98
Removing antibodies from red cells to identify bound antibodies, Useful in cases of HDN and transfusion reactions
elution
99
When should an IS XM be performed?
When antibody screen is negative and no history of antibodies.
100
tube reactions are read at which phase?
IS, 37C, AHG or IS, AHG
101
gel reactions are read at which phase?
AHG only
102
antibody interpretation: same reaction strength and in only one phase, this could be suggestive of what?
single ab
103
antibody interp: varying strengths suggestive of what?
Multiple antibodies, antibody exhibiting dosage,
antigens of differing strength
104
antibody interp: reactions in different phases, suggestive of what?
Combination of warm and cold antibodies, antibody with wide thermal range
105
antibody interp :All cells at 37C, negative in AHG, autocontrol
positive
rouleuax
106
antibody interp: All cells in AHG, autocontrol negative
multiple ab, ab to high frequency ag
107
antibody interp: All cells in AHG, autocontrol positive
warm autoantibody
108
Used in antibody detection and
identification to enhance an antigen–
antibody reaction
potentiators
109
if your reaction is at RT or IS it is most likely
IgM or Cold ab
110
if you have varying strenghs it is most likely
more than 1 ab or ab showing dosage
111
what type of enzymes act by removing sialic acid residues from the red cell membrane
proteolytic enzymes (papin, ficin, bromelin)
112
Enzymes, RBCs, and serum are simultaneously incubated. this type of test is called what?
one stage test
113
test that requires panel cells to be pretreated with enzymes, washed, and then used as usual
two stage test
114
which antigens are destroyed by enzymes
Duffy, M N S s
115
which antigens are enhanced by enzymes?
Kidd, Rh, Lewis, P1, I
116
antigens that occur in the population at a frequency of
98% or higher
high frequency antigens
117
if most panel cells are positive to a high frequency antigen then you can suspect an alloantibody or autoantibody ?
alloantibody
118
what type of IgM antibodies that react during IS crossmatching and sometimes at 37° C and is not clinically significant?
cold alloantibody
119
usually react with all reagents and self
and donor RBCs, regardless of the antigens present
autoantibody
120
2 things that are positive with an autoantibody?
DAT and auto-control
121
what techniques are preformed to remove autoantibodies?
adsorption and elution
122
what type of reagent should be used when trying to rule out a cold autoantibody?
monospecific
123
what is the best way to avoid false reactivity when working with a cold autoantibody?
pre warming tubes
124
what's more common cold or warm autoantibodies?
warm
125
what are mostly positive in a warm autoantibody?
most panel cells and auto control
126
this technique breaks antigen-antibody bond,
removing antibody from cell surface
elution
127
prior to elution, red cells have to be thoroughly what?
washed
128
When should an AHG XM be performed?
pos ab screen, or history of ab
129
How long is the patient sample acceptable for blood bank testing?
3 days
130
How long should the patient sample be stored?
7 days
131
What determines a successful transfusion?
no rxn, increased hct by 3% and hgb by 1 g/dL
132
When is uncrossmatched O negative blood issued when time is critical?
Emergency Release, must be signed by a physician
133
Replacement of entire blood volume within 24 hrs or 10+ units in adults?
massive transfusion(7-8 units of rbcs)
134
How is an infant younger than 4 months olds crossmatched?
Use mother’s antibody screen; IS crossmatch if screen negative.
135
what antigens are clinically significant ?
ABO, Rh, Kell (K,k,Kpa,Kpb,Jsa,Jsb), Kidd(Jka, Jkb), Duffy(Fya, Fyb), S, s, U, Lub
136
what antigens are not clinically significant ?
I, Lewis(Lea, Leb), M, N, P1, Lua
137
reactions that have the same strength and in one phase only suggest what?
single antibody
138
reactions in an ab screen with varying strengths may indicate what?
multiple ab, dosage, or antigens with diff strengths
139
reactions in an ab screen in different phases may indicate
warm or cold ab
140
when all cells are positive in AHG phase but neg in AC this may indicate what type of ab?
ab to a high frequency ag
141
when all cells are positive in AHG phase and AC is pos this may indicate what type of ab?
warm autoantibody
142
In an ab screen when all cells are pos at 37 degree but negative in AHG and pos for AC this may indicate what?
Rouleaux
143
reagents used to enhance antigen-antibody reactions, improving the detection and identification of antibodies.
potentiators
144
what is bovine used for?
for cold autoantibody reactions
145
This phenotype offers resistance to Plasmodium knowlesi and Plasmodium vivax malaria
Fy(a-, b-)
146
which blood group system is the common cause of delayed transfusion reactions?
Kidd
147
which Lewis antigen binds complement and may cause hemolysis in vitro?
Lea
148
which ab is associated with Mycoplasma pneumoniae and Cold Hemagglutinin Disease
anti-I
149
which ab is associated with Infectious Mononucleosis
anti-i
150
which P1 ab is IgM or IgM and IgG, "Clinically significant," and "Associated with spontaneous abortions."
anti-PP1Pk (Tja)
151
which antigens are coded by glycophorin B?
S,s,U antigens
