LEC5- BLOO DGROUP SYSTEM Flashcards
1
Q
Antigens usually found on the cell surface (RBC surface
A
BLOOD GROUP SYSTEM
2
Q
Defines uniqueness of each cell
A
BLOOD GROUP SYSTEM
3
Q
Genes of each blood system are coded on different
___
A
chromosome
4
Q
CHROMOSOME 1LOCUS
A
Rh, Duffy, Scianna, Cromer, Knops
5
Q
Chromosome 4 locus
A
MNS
6
Q
Chromosome 7 locus
A
kell
7
Q
Chromosome 9 locus
A
ABO
8
Q
Chromosome 18 locus
A
kidd
9
Q
Chromosome 19 locus
A
H, Lewis, Lutheran
10
Q
Chromosome 22 locus
A
P1
11
Q
A scientific society founded in 1935
A
International Society for Blood Transfusion (ISBT)
12
Q
Aims to promote study of blood transfusion
and spread knowhow of the manner in which blood
transfusion medicine can best serve patients’ interest
A
International Society for Blood Transfusion (ISBT)
13
Q
numerical codes for blood
groups composed of 6 numbers
A
ISBT SYSTEM NUMBER
14
Q
FIRST 3 DIGITS in ISBT
A
blood group system
15
Q
last 3 DIGITS in ISBT
A
antigenic specificity
16
Q
We have about how many different blood group systems
A
36
17
Q
he Drew blood from himself and five associates,
separated the cells and serum, and then mixed
each cell sample with each serum.
A
Karl Landsteiner
18
Q
year when Karl Landsteiner dre blood from himself and other associates
A
1901
19
Q
Discovery of 4th Blood Type (AB group by
A
Von Decastello and Adriano Sturli
20
Q
Discovery of 4th Blood Type (AB group by von and adriano
A
1902
21
Q
Discovery of Subgroups of Blood Group A
▪ A1 and A2
A
Emil Frieherr Von Dungern and Ludwik Hirszfel
22
Q
year when Emil Frieherr Von Dungern and Ludwik Hirszfel
o Discovery of Subgroups of Blood Group A
▪ A1 and A2
A
1911
23
Q
he Classified Blood into A, B and O groups
A
Karl Landsteiner
24
Q
Individuals normally produce antibodies directed against
the A and/or B antigen(s) absent from their RBCs.
A
Naturally occurring ABO antibodies
25
nature of ABO antibodies
Predominantly IgM in nature
26
Best reacts with room temperature or colder
IgM
27
test we perform in visualizing ABO antibodies
ABO antibody testing - reverse typing
28
why we can't test baby's blood type in reverse ?
The production of ABO antibodies is initiated at birth, but titers are generally too low for detection
29
Antibody production
▪ ____y/o – PEAKS
5 – 10
30
Antibody production
▪ _____ – Declines
Later in Life
31
Elderly people and Infants
usually have lower levels of _____
anti-A and anti-B
32
blood A, B, AB was been characterized as what IG
nature of A, B, AB
IgM
33
blood O was been characterized as what IG
IgG
34
ABO blood unit/type that was been classified as a silent gene/amorph gene
blood O
35
temperature where IgG best reacts
37*C
36
in forward typing, what is the patient sample used
red cells
37
in reverse typing, what is the patient sample used
serum
38
the known A cells and known B cells used in reverse typing came is done or provided by making __
red cell suspensions from blood type A and B suspension
39
Reverse results with Forward typing
Reverse Grouping/ Backward/ Indirect Typing
40
INHERITANCE PATTERN OF THE ABO BLOOD GROUPS
was been described by ___
Felix berstein
41
INHERITANCE PATTERN OF THE ABO BLOOD GROUPS
* ______described by Bernstein
1924
42
Inheritance pattern follows ___
mendelian genetics
43
Demonstrated that an individual inherits one
ABO gene from each parent and that these
two genes determine which ABO antigens
are present on the RBC membrane.
INHERITANCE PATTERN OF THE ABO BLOOD GROUPS
44
INHERITANCE PATTERN OF THE ABO BLOOD GROUPS
how many gene from the parents
▪ 1 ABO gene from the mother
▪ 1 ABO gene from the father
45
antigens in ABO bloo dgroup system
Appear in the ___ week of fetal life
6th
46
antigens in ABO bloo dgroup system
present on the red cell membrane and in other tissues such as
salivary glands, pancreas, kidneys and
other body fluids except the cerebrospinal fluid)
47
is a precursor on which the A and B
antigens are made
H antigen
48
in order for our A and B to be expressed, must have a what gene
H gene
49
Is H antigen part of ABO blood group system?
no
50
it produces a specific enzyme that
will promote what is the antigen to be
expressed on the surface area of the red blood cells
ABH antigen
51
what are the enzymes that ABH antigen will produce to help the rbc express its antigen
Glycosyltransferases
o L-fucosyltransferase
o N-acetylgalactosaminyltransferase
o D-galactosyltransferas
52
These enzymes will add sugars to a basic precursor
molecule (paragloboside)
Glycosyltransferases:
o L-fucosyltransferase
o N-acetylgalactosaminyltransferase
o D-galactosyltransferase
53
Responsible for giving specificity to the cell
Immunodominant sugar
54
what are the Immunodominant sugar
▪ L-fuctose
▪ N-Acetylgalactosamine
▪ D-galactose
55
▪ L-fructose
this immunodominant sugar is responsible for ___
H antigen
56
▪N-Acetylgalactosamine
this immunodominant sugar is responsible for ___
A antigen
57
D-galactose
this immunodominant sugar is responsible for ___
B antigen
58
This is where the sensitization of secreted substances occurs
Type 1 Precursor Chain
59
Type 1 Precursor Chain beta linkage
1-3
60
beta linkage of type 1 precursor chain is located in
it is located within the terminal of the
D-galactose
and N-aceylglucosamine.
61
the precursor chain that is Based on the inheritance of the secretor gene
Type 1 Precursor Chain
62
the secretor gene in type 1 precursor chain is coded on
chromosome 19
63
Type 1 Precursor Chain has an expression of H gene which will express what antigen?
H antigen
64
There's another gene in TYPE 1 precursor which is SE gene, SE gene can be classified as _____
secretor gene
non secretor gene
65
if secretor SE gene, the genotype we have is
Sese or SeSe
66
if non secretor SE gene, the genotype we have is
sese - lahat small
67
The ABH antigen is formed with the same basic precursor material.
The basic material of the ABH antigen is known as the _________
paragloboside
68
can we use saliva in determination of blood type? which precursur is it associated
yes, in type 1 precursor chain
69
can a non secretor type 1 chain expressed ABH antigen in saliva?
no, there's no glycoisyltransferase and immunodominant sugar that will induce the ABH antigen to expressed it
70
Type 2 Precursor Chain
beta linkage
1-4
71
a type of precursor chain
This would be associated with the expression of ABH antigen
within the red cell membrane
type 2 Precursor Chain -
72
beta linkage of type 2 precursor chain is located in __
it is also located at the terminal of the D-galactose
and N-acetylglucosamine.
73
a type of precursor chain in order to provide expression of ABH to red cell membrane
type 2 precursor chain
74
how ABH have an expression in RBC membrane?
type 2 needs an H antigen, then H antigen will push tru to expressed ABH substances to RBC membrane
but still glycosyltransferases and immunodominant sugar is still needed
75
H gene's glycosuyltransferase and immunodominant suagr
L-fucosyltransferase l-fucose
76
A gene's glycosyltransferase and immunodominant sugar
N-acetylgalactosaminyltransferase
N-acetylgalactosamine
77
b -gene's glycosyltransferase and immunodominant sugar
D-galactosyltransferase
78
The anti H lectin na ginagamit sa laboratory
would be the
Ulex europaeus
79
H anti-sera is also known as the __which is associated from plants.
It is mainly extracted from plants
anti-H lectin
80
Using this anti-H lectin or the Ulex europaeus mas nagr-react
ang blood group ____
highest ammount or reactivity
blood group O
81
Using this anti-H lectin or the Ulex europaeus least ammount or reactivity
A1B
82
blood group A secretor, antigen in Saliva is
A and H
83
blood group B secretor, antigen in Saliva is
B and H
84
blood group AB secretor, antigen in Saliva is
A,B,H
85
blood group O secretor, antigen in Saliva is
H
86
ABH are can be expressed not only in saliva, where can we get it more?
tears, urine, digestive enzyme, milk, amniotic fluid, pathologic fluid except CSF
87
Agglutination Inhibition – involvement of ___. which are
incomplete antigens.
haptens
88
Kaya hemagglutination inhibition ang principle kasi ang indicator cells na ginagamit for the determination of secretor status would be _____
red blood cells.
89
In 1930, ______ postulated a four-allele system of inheritance
based on the discovery of Emil Frieherr von Dungern and Ludwig
O. Thompson
90
O. Thompson's four allele
A1, A2, B and O.
91
how to distinguised A1 and A2
use anti a1 lectin
92
anti-A1 lectin that we have is the ____
Dolichos biflorus
93
Based sa anti-A1 lectin reagent natin, si Dolichos
biflorus, only the which subgroup of A will yield a positive result
A1
94
____ reagent in blood bank is the polyclonal human anti-AB reagent
Anti-AB
95
quantitative changes in subgroup a1 and A2
decrease number of antigen sites
decrease amount of transferase enzyme
decrease amount of branching
96
qualitative changes in subgroup a1 and A2
differences in the precursor oligosaccharide chains
subtle differences in transferase enzyme
formation of anti a1, in a percentage of some subgroups
97
which one got unexpected antibodies that is anti A1
anti a2
98
which one has decrease antigen site
A2
99
Characteristics of Weak ABO Subgroups
Decreased number of A antigen sites per RBC (resulting in weak or no
agglutination with anti-A)
Varying degrees of agglutination by human anti-A, B.
Increased variability in the detectability of H antigen, resulting in strong
reactions with Anti-H
Presence or absence of anti-A1 in the serum.
99
if a secretor, a blood group A scretor's antigen
A and H
99
which one is the most common weak ABO subgroups
weak A subgroups
m, y, x, el, end, 3
99
A1's antigen site
110-1170
99
very rare subgroups of ABO
B subgroups
m, ,x, el, , ,3
100
The Bombay phenotype was first reported by Dr. in 1952
Y.M. Bhende
100
The term “Bombay” has been used to refer to the phenotype that lacks
normal expression of the ABH antigens because of the lack inheritance of
the ____ genotype
hh
100
Designated as Oh. as its nomenclature
BOMBAY GROUP
101
The hh genotype does not elicit the production of which glycosyltransferase
a-2-L fucosyltransferase.
As a result, L-fucose is not added to the type 2 chain, and H substance
is not expressed on the RBC.
102
____ lectin can be used to differentiate and
to confirm if your patient has Bombay phenotype
Anti-h
however, only group O will turn positive to anti-h lectin
103
The reaction of the Bombay phenotype is mainly associated with the
reaction pattern of blood group ____
blood group O
104
describe the reverse and forward typing og bombay
same with blood group O
105
____ occur when unexpected reactions occur in the forward and reverse grouping
ABO discrepancies
106
ABO discrepancies can usually be resolved by repeating on the same
sample by using a _______ of RBCs if the initial test was
performed using RBCs suspended in serum or plasma.
saline suspension
107
It is important to make sure that any and all technical factors that may
have given rise to the ABO discrepancy was reviewed and corrected.
oki?
oki
108
It is also essential to acquire information regarding the patient’s age,
diagnosis, transfusion history, medications, and history of pregnancy.
true or false
true the fire
109
If the discrepancy persists and appears to be due to an error in
specimen collection or identification, a new sample should be drawn
from the patient and the RBC and serum grouping repeated
sige po
110
When a discrepancy is encountered, results must be ____, but
interpretation of the ABO type must be delayed until the discrepancy
is resolved.
recorded
111
If blood is from a potential transfusion recipient, it may be necessary
to administer Group O, Rh-compatible RBCs before the discrepancy
is resolved. - -
Rh negative for blood type O.
Rh positive for blood type AB.
112
clerical or technical issues?
mislabeled
clerical
113
clerical or technical issues?
improper recoding
clerical
114
clerical or technical issues?
deleted prcoedural step
clerical
115
clerical or technical issues?
not followiing manufacturer's intruction
technical
116
clerical or technical issues?
missed or underinterpreted weak reactions
technical
117
clerical or technical issues?
incorrect interpretation of serologic reactions
technical
118
clerical or technical issues?
missing oor incorrect reageent
technical
119
clerical or technical issues?clerical or technical issues?
equipment malfunction
tech
120
clerical or technical issues?
contaminated antisersa or cells
tech
121
incorrect cell suspension
tech
122
in emergency situation and we need the blood, we can administer
- -
Group O, Rh negative for blood type O.
Group O, Rh positive for blood type AB
123
Weakly reacting or missing antibodies
GROUP I DISCREPANCIES
124
group discrepancies where there's unexpected reaction in REVERSE TYPING
group 1
125
group 1 discrepanscies
1. Newborns
2. Elderly patients
3. Patients w/ Leukemia (hypogammaglobulinemia)
4. Patients w/ Lymphoma (hypogammaglonulinemia)
5. Patients with immunosuppressive drugs
6. Patients with congenital hypogammaglobulinemia
7. Patients w/ immunodeficiency diseases
8. Patients with bone marrow transplantations
126
Umiinom ng medication in which is used to treat autoimmune
disorders such as SLE, rheumatoid arthritis, autoimmune
thyroiditis, and even sa synthetic corticosteroids. Yung mga
umiinom ng prednisone, budesonide, cortisone, and
hydrocortisone
GROUP I DISCREPANCIES
127
Resolution of Common Group 1 Discrepancies
Enhance the weak or missing reaction in the serum by incubating the
patient serum with reagent A1 and B cells at RT for approximately 15 to 30 minutes
if no reaction, incubate in 4* same time, centri and observe the reaction
128
sample tested using control coming from the same blood
autocontrol
129
common naturally occuring antibodies for group 1
anti- I - commonly encountered cold agglutinin in adult rbc's
130
Weakly reacting or missing reacting ABO antigens
GROUP II DISCREPANCIES
131
group discrepancies where there's unexpected reaction in FORWARD TYPING
Group 2 discrepancies
132
Group ____ is the least frequently encountered ABO discrepancies.
group 2
133
group 2 discrepancies
1. Subgroups of A and B
2. Leukemias
3. Hodgkin’s disease
4. Acquired B phenomenon
5. Antibodies to low incidence antigens
6. Excess amounts of blood group specific soluble (BGSS) substances
present in plasma (carcinoma of stomach and pancreas).
134
Associated in pathologic finding. Related sa diseases of digestive tract and septicemia?
Acquired B phenomenon - group 2
135
pathologic finding, wherein the blood type is looking like blood AB
Acquired B Phenomenon
136
Disease of gastrointestinal tract.
Acquired B Phenomenon
137
associated with the deacetylase enzyme. This
enzyme produces acquired B antigen.
Deacetylation
138
The acquired B antigen is
caused by enzyme produced by those gram negative bacteria such
as
Escherichia coli O86, Clostridium tertium, and some strains of
Proteus bulgaris OX-19.
139
This _____ mainly arises when the bacterial enzymes
modify the blood group
Acquired B Phenomenon
140
solution for acquired B phenomenon
1-2 drops of hcl + 1ml of anti-b antisera
Ang solution is kailangan i-acidify the anti-B reagent
Need gumawa
ng drops of the reagent and 1 to 2 drops of 1 N of Hydrochloric acid
and you have to mix it with 1mL ng anti-B antisera. measure pH, once acidify, the true B antigen will react.
141
acquired B phenomena
Test patient serum against autologous RBCs, this will yield a
negative
reaction.
142
Protein or plasma abnormalities resulting to rouleaux formation
Group III Discrepancies
143
Discrepancies both forward and reverse typing but it has factors
to consider. It is caused by protein or plasma abnormalities and it
can be resulted in pseudoagglutination or rouleaux formation
group 3
144
group 3 discrepancies
1. Elevated levels of globulin from certain disease: -
Multiple myeloma – increased in IgG -
Waldenstroms macroglobulinemia – increased in IgM
2. Elevated levels of fibrinogen
3. Plasma expanders such as dextran or polyvinylpyrrolidone
4. Whartons Jelly
145
gelatinous substances within the umbilical cord.
Whartons Jelly
146
Whartons Jelly group discrepancies
group 3
147
Resolution of Common Group 3 Discrepancies
Perform saline dilution or saline replacement technique.
Wash cord cells six to eight times with NSS.
148
Miscellaneous -
It is also between the forward and reverse grouping that is due to
the miscellaneous problems.
GROUP IV DISCREPANCIES
149
GROUP IV DISCREPANCIES
1. Polyagglutination
2. Cold reactive antibodies
3. Unexpected ABO isoagglutinins
4. Antibodies other than anti-A and anti-B
5. RBCs with cis “AB phenotype”
150
– these are antibodies produced by an individual
that cause agglutination of RBCs with other individual
Isoagglutinins
151
mmutation in glycosyltransferases in AB phenotype
cis AB phenotype
152
Resolution of Common Group 4 Discrepancies
Potent cold autoantibodies can cause spontaneous agglutination of
the patient’s cells.
RBCs could be incubated at 37°C for a short period, then washed with
NSS and retyped.
If not successful in resolving forward type, treat patient’s RBC with
0.01M dithiothreitol to disperse to IgM related agglutination.
As for the serum, the reagent RBCs and serum can be warmed to
37°C then mixed, retested and read at 37°C.
If the reverse typing is negative – Autoabsorption is done to remove
autoantibody.
153
in group 4
If the reverse typing is negative – ___ is done to remove
autoantibody.
Autoabsorption
154
