MIDTERM LECTURE L1: P BLOOD GROUP

Question 1

P blood group was discovered by

Answer 1

Landsteiner and Levine

Question 2

On what year was P blood group discovered

Answer 2

1927

Question 3

Landsteiner and Levine injected ______ to rabbits which produced an antibody

Answer 3

human RBCs

Question 4

Landsteiner and Levine injected human RBCs to rabbits and produced an antibody initially called as?


Answer 4

anti-P

Question 5

Anti-P divided humans into what two groups?


Answer 5

P+ and P-

Question 6

Due to certain discoveries of Levine and colleagues in 1951, the original antigen and phenotypes were renamed. Anti-P became?


Answer 6

anti-P1

Question 7

P+ phenotype was renamed to?


Answer 7

P1

Question 8

P- phenotype was renamed to?


Answer 8

P2

Question 9

The rare P null individual was renamed to?


Answer 9

P

Question 10

P nulls are slightly more common in what countries and state

Answer 10

• Japan
• North Sweden
• Ohio (Amish group)

Question 11

P blood group system presents any 3 antigens on the surface of RBCs. What are these antigens? 


Answer 11

P, P1, Pk

Question 12

Pk antigen was discovered by

Answer 12

Matson and coworkers

Question 13

On what year did Matson and his coworkers discovered pk antigen?

Answer 13

1959

Question 14

2 common phenotypes in P blood group 


Answer 14

P1 and P2

Question 15

3 rare phenotypes in p blood group


Answer 15

P, P1k, P2k

Question 16

Identify phenotype:

RBCs that react with anti-P1 and anti-P


Answer 16

P1 phenotype

Question 17

Identify phenotype:

RBCs that do not react with anti-P1, but do react with anti-P


Answer 17

P2 phenotype

Question 18

Identify phenotype:

RBCS that do not react with anti-P1, anti-P, or anti-Pk

Answer 18

P phenotype

Question 19

Identify phenotype:

RBCs that react with anti-P1 and anti-Pk, but not with anti-P


Answer 19

P1k phenotype

Question 20

Identify phenotype:

RBCs that react with anti-Pk but not with anti-P1 or anti-P


Answer 20

P2k phenotype

Question 21

Antibodies generally fall into what 2 categories?

Answer 21

• clinically insignificant
• potently hemolytic

Question 22

P is assigned to what blood group system? (state ISBT)

Answer 22

028

Question 23

What blood group system does P1 and Pk belonged to? (state ISBT)

Answer 23

003

Question 24

LKE and PX2 belong to what blood group system? (state ISBT)

Answer 24

209

Question 25

P is assigned to what blood group system? (state symbol)

Answer 25

GLOB (Globoside blood group system)

Question 26

LKE(Luke) and PX2 belong to what blood group system? (state symbol)

Answer 26

GLOB (Globoside collection)

Question 27

What blood group system does P1 and Pk belonged to? (state symbol)

Answer 27

P1PK

Question 28

P gene is located on what chromosome

Answer 28

chromosome 3

Question 29

The P1PK gene is located on what chromosome

Answer 29

chromosome 22

Question 30

Specify the location of P1PK gene in chromosome 22

Answer 30

22q11.2

Question 31

Specify the location of P gene on chromosome 3

Answer 31

3q26.1

Question 32

The precursor of P1 can be glycosylated to what chains

Answer 32

type 2H chains

Question 33

P1, P, or Pk may be found on what cells

Answer 33

- RBCs - lymphocytes - granulocytes - monocytes

Question 34

P can also be found on what cells

Answer 34

- platelets - epithelial cells - fibroblasts

Question 35

P and Pk can also be found in plasma as what form of lipid

Answer 35

glycosphingolipids

Question 36

P and Pk can also be found in hydatid cyst fluid as what form of substance

Answer 36

glycoproteins

Question 37

The P blood group antigens are resistant to treatment with? (enumerate)

Answer 37

- ficin - papain - dithiothreitol (DTT) - chloroquine - glycine-acid EDTA

Question 38

Reactivity of the antibodies can be greatly enhanced by testing with

Answer 38

enzyme-treated RBCs

Question 39

T/F: P1 antigen is poorly expressed at birth

Answer 39

T

Question 40

P1 antigen may take up to how many years to be fully expressed

Answer 40

7 years

Question 41

Strength of P1 antigen can vary due to what factors

Answer 41

quantity and race

Question 42

Which race has stronger expression of P1 compared to whites?

Answer 42

blacks

Question 43

Inhibits the expression of P1

Answer 43

the rare dominant gene for the In(lu) type Lu(a-b-) RBCs

Question 44

P1 individuals who inherit this modifier gene [In(lu) type Lu(a-b-)] may type serologically as?

Answer 44

P1-

Question 45

P1 antigen deteriorates rapidly on storage causing what test result

Answer 45

false negative

Question 46

What type of antibody is anti-P1

Answer 46

IgM (naturally occurring) rarely IgG

Question 47

Anti-P1 is commonly found in the sera of what individual

Answer 47

P1- individual

Question 48

At what temperature is anti-P1 optimally reactive?

Answer 48

4C

Question 49

Why is Anti-P1 typically not detected in routine testing?

Answer 49

Anti-P1 is a weak, cold-reactive saline agglutinin (making it undetectable in standard routine testing conditions)

Question 50

At what temperature stronger examples of Anti-P1 react?

Answer 50

room temperature

Question 51

At what temperature rare examples of Anti-P1 react?

Answer 51

37C

Question 52

What can be detected in the antiglobulin test when using polyspecific reagents for Anti-P1?

Answer 52

complement binding in stronger examples of anti-P1

Question 53

What are the polyspecific reagents used to detect complement binding in stronger examples of anti-P1

Answer 53

anti-IgG plus anti-C3

Question 54

Antibody activity of Anti-P1 can be neutralized or inhibited with what substance

Answer 54

soluble P1 substance

Question 55

Antibody activity can often be bypassed altogether if ____ is not included

Answer 55

room temperature incubation

Question 56

What methods can enhance reactions to confirm the specificity of Anti-P1?

Answer 56

- fresh RBC preparation - incubating tests at room temperature or lower - pretreating test cells with enzymes

Question 57

T/F: HDFN is associated with anti-P1

Answer 57

F (antibody is usually IgM and the antigen is so poorly developed on fetal RBCs)

Question 58

What complications can rare examples of Anti-P1 that react at 37°C cause?

Answer 58

in vivo RBC destruction

Question 59

In vivo RBC destruction may lead to

Answer 59

both immediate and delayed hemolytic transfusion reactions (HTRs).

Question 60

Anti-P1 can be neutralized by

Answer 60

- hydatid cyst fluid from Echinococcus granulosus - pigeon droppings - turtle dove egg white

Question 61

The discovery of strong anti-P1 in two P1– individuals infected with Echinococcus granulosus tapeworms led to the identification of

Answer 61

P1 and Pk substance in hydatid cyst fluid

Question 62

Strong antibodies to P1 have also been found in patients with what infection?

Answer 62

fascioliasis (bovine liver fluke disease)

Question 63

Anti-PP1Pk was originally called

Answer 63

anti-Tja

Question 64

Anti-PP1Pk was first described in the serum of?

Answer 64

Mrs. Jay

Question 65

Mrs. Jay was an individual with what disease

Answer 65

adenocarcinoma of the stomach

Question 66

Mrs. Jay's tumor cells carried what antigens

Answer 66

P system antigens

Question 67

T in the Tja refers to

Answer 67

tumor

Question 68

T/F: Anti-PP1Pk is produced by p individuals early in life with RBC sensitization

Answer 68

F (without RBC sensitization)

Question 69

Anti-PP1Pk reacts with all RBCs except those with what phenotype

Answer 69

P phenotype

Question 70

Are the components of Anti-PP1Pk separable?

Answer 70

yes

Question 71

How are the components of Anti-PP1Pk separated?

Answer 71

through adsorption

Question 72

Components of anti-PP1Pk are what type of antibodies?

Answer 72

IgM and IgG

Question 73

T/F: anti-PP1Pk has the potential to cause severe HTRs and HDFN

Answer 73

T

Question 74

Antibody linked to increased incidence of spontaneous abortions in early pregnancy

Answer 74

Anti-PP1Pk

Question 75

Women with anti-P and anti-PP1Pk, and a history of multiple abortions, has successfully delivered infants after multiple

Answer 75

plasmaphereses

Question 76

What does plasmaphereses do

Answer 76

reduce anti- body level during pregnancy

Question 77

Anti-P is found as a naturally occurring alloantibody in the sera of what individuals

Answer 77

Pk individuals

Question 78

Key difference of anti-P and anti-PP1Pk regarding Pk phenotype

Answer 78

Anti-P does not react with cells that have the extremely rare Pk phenotype

Question 79

Can individuals producing anti-P type as P1+?

Answer 79

yes

Question 80

Alloanti-P is rarely seen, so why is it very significant in transfusion?

Answer 80

it is hemolytic with a wide thermal range of reactivity

Question 81

What condition has been associated with IgG class anti-P antibodies?

Answer 81

habitual early abortion

Question 82

Autoanti-P is also known as

Answer 82

donath-landsteiner antibody

Question 83

Antibody associated with paroxysmal cold hemoglobinuria

Answer 83

autoanti-P

Question 84

The IgG autoantibody in paroxysmal cold hemoglobinuria (PCH) is described as

Answer 84

a biphasic hemolysin

Question 85

Biphasic hemolysin meaning

Answer 85

It reacts to cold, and via complement activation, the coated RBCs lyse at 37C

Question 86

autoantibody is demonstrable only in what test

Answer 86

Donath-Landsteiner test

Question 87

Disease association of autoanti-P

Answer 87

- Parasitic infection - Early abortion - PCH - Urinary Tract Infection - Septicemia and meningitis - P antigens - pyelonephritogenic E. coli, Streptococcus suis, Shigella dysenteriae

Question 88

Sources of P1 antigen

Answer 88

- RBCs - plasma - droppings of pigeons and turtledoves - eggwhite of turtledoves

Question 89

Sources of P1 antibody

Answer 89

▪ Clonorchis sinensis ▪ Opisthorchis viverrine ▪ Ascaris suum ▪ Lumbricoides terrestris