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Blood Banking (BIOL 380) > Quiz 1 > Flashcards

Quiz 1 Flashcards

0
Q

Name some Universal Precautions taken in the laboratory

A
  1. All patient specimens are considered to be biohazardous regardless of diagnosis
  2. Hand washing
  3. PPE (gloves, gowns, lab coats, goggles)
  4. Report all accidents
  5. Dispose of all needles in puncture proof boxes
  6. No mouth-to-mouth pipetting
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1
Q

Name 3 Historical Events in Blood Banking

A
  1. 1901 –> Landsteiner –> Discovered A, B, and O
  2. 1970s –> Monoclonal Antibodies
  3. WWII –> Plastic bags “Fenwal bags”
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2
Q

What is the most common method for blood collection?

A

Venipuncture

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3
Q

Why are serum separator tube not able to be used in blood banking?

A

Silicone gel interferes with some tests

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4
Q

Why are anticoagulated specimens unacceptable to be used in blood banking?

A

The binding of calcium may interfere with some tests

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5
Q

What are the purple top tubes used for (EDTA tubes)?

A

Direct antiglobulin test

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6
Q

What is the main color tube top used in blood banking? Why?

A

Red top tube and because there is no anticoagulant added

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7
Q

Wharton’s Jelly

  1. Definition
  2. Where is it found?
A
  1. Connective tissue substance coating the cord

2. Found when collecting cord blood specimen (umbilical cord)

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8
Q

What must you label specimens with?

A
  1. Patient’s name
  2. Identification number
  3. Date
  4. Time
  5. Phlebotomist identification
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9
Q

At what temperature can specimens be stored? What is the minimum amount of days a specimen is stored?

A

1-6 degrees C

7 days

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10
Q

Antigen (definition)

A
  1. Any substance that binds specifically to an antibody or T cell (TCR)
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11
Q

Immunogen or Agglutinogen (Definition)

A

Any substance that stimulates an immune response and reacts with it

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12
Q

What is the difference between an antigen and an immunogen?

A

An antigen can react with an immune response but cannot stimulate one whereas an immunogen is the first to illicit an immune response

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13
Q

Epitope or antigenic determinant (definition)

A

Discrete chemical site on an antigen that is recognized by an antibody or T cell

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14
Q

Hapten (definition)

A

Low molecular weight molecules that do not stimulate an immune response by themselves

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15
Q

What is the importance of haptens binding with carriers?

A

This is to increase their size in order to become a complete antigen (cause an immune response)

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16
Q

Immunogenicity (definition)

A

An immunogens ability to stimulate an immune response

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17
Q

Characteristics of immunogenicity

A
  1. Antigen structure and position
  2. Foreigness
  3. Dosage
  4. Route
  5. Metabolic fate
  6. Host Factors
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18
Q

List the types of antigens that have the highest immunogenicity in order from highest to lowest

A
  1. Proteins
  2. Carbohydrates
  3. Lipids
  4. Nucleic Acids
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19
Q

What types of routes can an antigen take into the body? What is the route that yields the highest immunogenicity?

A
  1. IV – highest
  2. Oral
  3. Inhalation
  4. Intramuscularly
  5. Subcutaneously
  6. Intraperitenially
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20
Q

Antibodies/Immunoglobulins (definition)

A

Proteins produced by plasma cells to react against epitopes on antigens

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21
Q

What are the major classes of antibodies in blood banking?

A

IgM and IgG

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22
Q

What antibody type(s) can cross the placenta?

A

IgG

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23
Q

What antibody type(s) are present in secretions?

A

IgA

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24
Q

What antibody type(s) fix complement?

A

IgG and IgM

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25
Q

IgG

  1. Molecular weight?
  2. Heavy chain?
  3. Structure?
A
  1. 150,000
  2. Gamma
  3. Monomer
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26
Q

IgM

  1. Molecular weight?
  2. Heavy chain?
  3. Structure?
A
  1. 900,000
  2. mu
  3. pentamer
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27
Q

What is the antibody in highest concentration in a serum sample?

A

IgG

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28
Q

What is the antibody in highest concentration in a body wide sample?

A

IgA

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29
Q

Complete Antibodies (definition)

A

Warm (37C) or cold (4C) saline agglutinations; usually of the IgM class such as anti-A and anti-B and anti-Lewis

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30
Q

Complete Antibodies (preferred characteristics)

  1. Class
  2. Temperature
  3. Medium
A
  1. IgM
  2. Cold (4C)
  3. Saline
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31
Q

Incomplete antibodies (definition)

A

Most are IgG class and at 37C, react and agglutinate only after treated with additional reagents such as albumin, antiglobulin serum, or enzymes

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32
Q

Incomplete antibodies (preferred characteristics)

  1. Class
  2. Temperature
  3. Treatment in order for cross linking?
A
  1. IgG
  2. Warm (37C)
  3. Additional reagents such as albumin, antiglobulin serum, or enzymes
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33
Q

Characteristics of a Primary Response

A
  1. Longer lag time
  2. Latent period
  3. Slower response
  4. IgG disappears quicker from system
  5. Forms memory cells
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34
Q

Characteristics of Secondary (Anamnestic) Response

A
  1. Shorter lag time (1 day or less)
  2. High titer of IgG antibodies
  3. IgG sustained longer
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35
Q

Alloimmunization–Alloantibody

A

Antibody produced in response to antigen from the same species

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36
Q

Autoantibody

A

Antibodies attacking self cells

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37
Q

Natural Antibody

A

Antibodies produced naturally (there to respond to things occurring in the body naturally)

Ex. ABO system

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38
Q

Passive Antibody

A

Antibodies given through transfusion/placenta (artificially acquired) –> temporary
–> Ex. Hepatitis B immune globulin

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39
Q

Antigen - Antibody Reactions

1. Types

A
  1. In vivo (body)

2. In vitro (test tube)

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40
Q

Antigen - Antibody Reactions

1. Characteristics

A
  • Specific
  • Firm, but reversible
  • Surface reaction
  • Fairly rapid
  • Reactants combine in varying proportions
  • Reaction dependent on attraction between molecular forces
  • Particulate antigen size
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41
Q

Methods to demonstrate (detect) antibody-antigen reactions

A
  1. Agglutination
  2. Hemolysis
  3. Precipitation
  4. Neutralization
  5. Antibody labeling - Fluorescence
  6. Complement fixation
  7. Inhibition, Elution, Absorption
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42
Q

Elution

A

Removing attached antibodies off of red blood cells

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43
Q

Absorption

A

Removing antibody from serum sample using RBC with appropriate antigen
–Autoantibodies

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44
Q

Complement

  1. Importance
  2. Inactivation
A
  1. Cells can be tested for the presence of complement which would indicate if a previous antigen-antibody reaction has occurred
  2. 56 degrees C for 30 minutes
45
Q

Dosage

A

Variable antigen strength based on quantitative differences based on genetics

46
Q

Factors affecting blood group antigen-antibody reactions

A
  • Antigen dosage
  • Red cell genotype
  • Red cell age
  • Storage temperature
  • Red cell suspension
  • Antibody
  • Avidity
  • Antibody storage
  • Reaction time
  • Reaction temperature
  • Centrifugation
  • pH
  • Ionic strength
  • Ratio of antigen and antibody
47
Q

Prozone

A

Antibody excess

48
Q

Zone of equivalence

A

Optimal concentration of antibody and antigen for best agglutination

49
Q

Postzone

A

Antigen excess

50
Q

4+

A

Solid clump of cells

51
Q

3+

A

Several large clumps

52
Q

2+

A

Medium-sized clumps with a clear background

53
Q

1+

A

Small clumps with a turbid background caused by many free cells

54
Q

Weak (+w)

A

very small clumps with a turbid background

55
Q

Very weak (+vw)

A

*Manifest only as a rough suspension when observed macroscopically, but agglutinates four or five cells when viewed microscopically

56
Q

Negative (0)

A

No agglutination

57
Q

H+

A

Hemolysis – Positive; supernate is pink to cherry

58
Q

Stages of Agglutination

A
  1. Sensitization

2. Agglutination

59
Q

Sensitization (stages of agglutination)

  1. Definition
  2. Influenced by…
A
  1. Antigen and antibody combine

2. Temperature, ionic strength, pH, time, antibody-antigen ratio

60
Q

J chain (Function)

A

Holds the monomers together to form dimers/pentamers

61
Q

Secretory component (function)

A
  1. Transport IgA to mucosal membrane

2. Protects IgA against proteases and pepsinogens

62
Q

Agglutination (stages of agglutination)

  1. Definition
  2. Influenced by…
A
  1. Total sum of antigen-antibody binding forming a clump

2. Number and position of antigen sites, antibody type, and zeta potential (electrostatic repulsion)

63
Q

Zeta Potential

A

Electrostatic potential of RBCs

  • Red blood cells have a negative charged cloud that repels other RBCs
  • *Allows for red blood cells to pass by each other
64
Q

Types of mediums used for agglutination tests

A
  1. Saline (IgM)
  2. High protein - Bovine albumin or PEG
  3. Enzyme systems: trypsin, papain, ficin, bromelin
  4. Low ionic strength saline (LISS)
65
Q

Types of antiglobulin reagents

A
  1. Polyspecific

2. Monospecific

66
Q

Polyspecific antiglobulin reagent

A

Usually contains anti-IgG and anti-complement (C3d)

67
Q

Monospecific antiglobulin reagent

A

Usually contains either anti-C3b or anti-C3d or anti-IgG

68
Q

Antiglobulin Test or Coombs Test

A

Antihuman sera made from rabbits by injecting with human sera components. Antibody to human globulin (reacts mainly to IgG and/or complement)

69
Q

Direct Antiglobulin Test (DAT)

  1. Definition
  2. Steps
A
  1. Red blood cell sensitization in vivo (test to see if RBC are coated with antibody)
  2. Wash RBC –> Add antiglobulin –> Look for agglutination
70
Q

Direct Antiglobulin Test (DAT) –> Positive in…

A
  • Hemolytic Disease of the Newborn
  • Autoimmune Hemolytic Anemia
  • Drug Induced
  • Chronic Lymphocytic Leukemia
71
Q

Indirect Antiglobulin Test (IDAT)

  1. Definition
  2. Steps
A
  1. Red blood cell sensitization in vitro (test patient serum for the presence of antibody by adding reagent RBC and antiglobulin)
  2. Incubate patient serum with RBC reagent antigen –> wash –> add antiglobulin –> check for agglutination
72
Q

Indirect Antiglobulin Test (IDAT) –> Positive in…

A
  • Alloimmunization (serum from previous transfusion or pregnancy)
  • Acquired hemolytic anemia (drugs)
  • Crossmatch, antibody screen
  • Detection of antigens
73
Q

Coombs check cells or Control cells

  1. Definition
  2. Confirmation of…
A
  1. O positive cells coated with anti-D (should see agglutination)
  2. Negative DAT or IDAT
74
Q

Transferases

A

Enzymes that assemble sugars and other complex molecules –> move from source to receptor)

75
Q

Alleles

A

Alternate genes on a given loci on a chromosome

76
Q

Homozygous

A

Identical alleles on a given locus

77
Q

Heterozygous

A

Alternate forms of alleles on a given locus

78
Q

Co-dominant

A

Expression of both alleles

79
Q

Amorph

A

Silent gene –> No detectable products

80
Q

H gene

A

Precursor substrate chain for A and B gene specified transferases to build on

81
Q

H Genes immunodominant sugar

A

L-Fucose

82
Q

A Gene Immundominant sugar

A

N-acetyl-D-galactosamine

83
Q

B Gene Immunodominant sugar

A

D-galactose

84
Q

O gene immunodominant sugar

A

None

85
Q

Most H antigen (reacts strongly with anti-H) –> Least H antigen (reacts less with anti-H)

A

O –> A2 –> A2B –> B –> A1 –> A1B

86
Q

Anti-H

A

Antisera from lectin or seed extract from Ulex europaeus

87
Q

Bombay

  1. Definition
  2. Characteristics
A
  1. hh or Oh or ABHnull
  2. Appear type O since lack H substance but genetically can still be A or B
    * *Has anti-H, anti-B, or anti-A
    * *No agglutination with anti-H
    * *Only Bombay blood is compatible
88
Q

What type of antibodies are anti-A and anti-B?

A

Natural antibodies (natural immunization)

89
Q

How are anti-A and anti-B acquired?

A

Response to exposure to similar A and B substances in bacteria and plants (in gut)

90
Q

When are anti-A and anti-B present?

A

Not usually present at birth; develops in first 2-3 months in life

91
Q

What class of antibodies are anti-A and anti-B?

A

IgM

92
Q

Forward Type/Front type/Cell type

A

Patient RBC (antigen) with reagent antibody

93
Q

Reverse type/Back type/Serum type

A

Patient serum (antibody) with reagent cells

94
Q

Types of blood reagents used in blood banking:

A
  • RBCs with known antigens
  • Antisera of known antibody specificity
  • Antiglobulin which detects IgG and/or complement
  • Potentiators which enhance reaction
  • Fresh serum-Fresh complement and increased antibody titers
  • Blood samples-No hemolysis before testing
  • Lectins-plant proteins that binds specific carbs
95
Q

Importance of fresh serum reagent?

A

Fresh complement and increased antibody titers

96
Q

Subgroups of A

1. Types

A
  1. A1 and A2
97
Q

What lectin is used to determine A1?

A

Seed extract of Dolichos biflorus

98
Q

What will lectin with anti-A1 react with?

A

A1 and A1B cells but not A2 or A2B

99
Q

Secretor Gene function

A

Converts A, B, and H to water soluble so it may be found in the body fluids

100
Q

Secretor Status

A

Gives a soluble A, B, H substance in body fluids like saliva

101
Q

ABO Discrepancies

A
  1. Unexpected antigen or antibody
  2. Lack of expected antigen or antibody
  3. Weakened expression of antigen or antibody
102
Q

ABO problems that can occur in the serum

A
  • anti-A1
  • auto-antibody
  • anti-H
  • chimera
  • old age
  • newborn
  • alloantibody
  • anti-I
103
Q

ABO problems in cells

A
  • A or B subgroups
  • Acquired A or B
  • Disease (leukemia)
  • Wharton’s Jelly
  • Chimera
  • Polyagglutination
  • Dyes
  • Contaminants
  • Rouleaux
  • Panagglutination
104
Q

Methods to resolve an ABO problem

A
  • Repeat ABO type
  • Allow backtype to sit for 30 minutes
  • Repeat wash of patient cells
  • Exam for Rouleaux
  • Run autocontrol to detect autoantibody
  • Check for anti-A1
  • New patient specimen
  • Test with anti-A1B, anti-A1, and anti-H
  • DAT
  • Serum with A1, A2, B, and O cells
  • Cell and serums at room temperature and 4C
105
Q

Additional ABO problems:

A
  1. Reverse Type is weak or absent
  2. Acquired B antigen
  3. O cells given to A or B person
  4. A2 with Anti-A1
  5. Decreased transferase levels
  6. Blood group antigen altered by bacterial enzymes
  7. Decreased IgM levels with age, drugs, or disease
  8. Unexpected alloaggutinins (anti-M, anti-P, anti-A, anti-Lewis)
106
Q

Reverse Type is weak or absent

  1. Causes
  2. Procedure to determine
A
  1. agammaglobinemia or hypogammaglobinemia; newborns or elderly
  2. Check subgroups of antigen; check if other antibody levels are normal; incubate at 4C; check ABH secretor status
107
Q

Acquired B antigen

  1. Associated with…
  2. Characteristics
  3. How to detect..
A
  1. Colon carcinoma, gram negative infections, intestinal obstructions
  2. Seen when type AB with anti-B; anti-A stronger reaction than with anti-B
  3. Run autocontrol; test saliva
108
Q

O cells given to A or B person

  1. Characteristics
  2. Associated with…
A
  1. Mixed field agglutination

2. Leukemia, fetal maternal bleed, chimerism

109
Q

A2 with Anti-A1

1. Tests

A
  • Test with A, B serum and at 4C
  • Check for mixed field agglutination
  • Elution and Absorption studies
  • Secretor status
110
Q

Chimera

  1. Definition
  2. Causes
A
  1. Two different populations of red blood cells

2. Transfusions and fraternal twins

Blood Banking (BIOL 380) (5 decks)

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