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anatomy & physiology > the blood - blood typing & transfusion > Flashcards

the blood - blood typing & transfusion Flashcards

1
Q

how long can the different components of blood be stored ?

A

-red blood cells: up to 35 days (4°C)
-platelets: up to 7 days (25°C)
-plasma: up to 3 years (-30°C)

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2
Q

leucodepletion

A

removal of WBCs:
-incidence of febrile transfusion reactions
-HLA incompatibility
-transmission of some infections

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3
Q

fresh frozen plasma (FFP)

A

given to people that are bleeding because they have fun out of one or more clotting factor(s)
-e.g. after severe bleeding

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4
Q

how are patients treated if missing one specific clotting factor ?

A

often only that factor is replaced by using synthetically made clotting factors

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5
Q

blood transfusion

A

-essential for treatment of excessive blood loss due to:
=injury or surgery: 27%
=maternity: 6%
=cancer care or anaemia: 67%
-6000 units are needed daily in the UK; annually, 2 mil donations from 1.4 mil donors

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6
Q

qualifications of a safe blood donor

A

-good health
-unpaid volunteers
-excluding risk factors
=jaundice (hepatitis?)
=travel in malarial areas
=recent tattoo/piercing
=risk factors for HIV or CJD
-screening of blood
-screening of compatibility of donor and recipient

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7
Q

how long must records of blood donations be stored ?

A

30 years

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8
Q

cell membranes contain many molecules:

A

-these molecules have lots of different roles (e.g. channels, receptors, identification)
=glycolipids (e.g. ABO Ag)
=proteins (e.g. Rhesus)
=glycoproteins
-antigens (Ag) important to immune system

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9
Q

immune system on non-self & self molecules

A

-RECOGNISES ‘non-self’ molecules on surface of cells/bacteria/viruses
-IGNORES ‘self’ molecules

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10
Q

ABO group

A

RBC type
=group A (A antigen)
=group B (B antigen)
=group AB (A & B antigens)
=group O (no antigens)

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11
Q

ABO antigens (Ag’s)

A

ABO Ag’s are sugar chains attached to the surface of the RBC via the lipid ceramide

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12
Q

gene for the ABO antigens

A

-ABO blood groups are sugars so there isnt a gene that codes for them
-instead, ABO genes code for glycosyl transferase
-glycosyl transferase is an enzyme that catalases putting the sugar groups together

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13
Q

frequencies of ABO blood group (2018 UK)

A

O+ : 35%
O- : 13%
A+ : 30%
A- : 8%
B+ : 8%
B- : 2%
AB+ : 2%
AB- : 1%

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14
Q

antibodies (Ab)

A

-proteins that recognise foreign molecules (Ag) in the body
-trigger an immune response

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15
Q

5 types of antibodies

A

classified according to their H chain:
-immunoglobin G (IgG)
-immunoglobin M (IgM)
-immunoglobin D (IgD)
-immunoglobin A (IgA)
-immunoglobin E (IgE)

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16
Q

immunoglobin M (IgM)

A

-made by natural immunity (production of Ab w/o exposure to Ag)
-made out of 5 of the IgGs stuck together
-so IgM is much larger than IgG

17
Q

antibodies present on the ABO groups

A

-A: anti-B
-B: anti-A
-AB: none
-O: anti-A and anti-B

18
Q

ABO antigens and antibodies

A

-the body makes all of the antibodies (anti-A & anti-B)
-people who are group A (A Ag on surface) will destroy any B-cells that make antibody against self (anti-A)
-but will keep B-cells making antibodies against non-self (anti-B) in their plasma

19
Q

rhesus (Rh) group

A

-rhesus is a transmembrane protein on the surface of RBCs
-the rhesus gene is autosomal recessive (most people = rhesus+)

20
Q

lots of different Rh antigens

A
  • D (most common)
  • c
  • C
  • e
  • E
21
Q

rhesus antigens and antibodies

A

A+ : A Ag & rhesus D Ag
A- : A Ag
B+ : B Ag & rhesus D Ag
B- : B Ag
O+ : rhesus D Ag
O- : none
AB+ : A Ag, B Ag & rhesus D Ag
AB- : A Ag & B Ag

22
Q

other blood group antigens

A

-more than 44 different blood groups
=e.g. Rh, Kell, Fy, Kidd & MN
-not all equally antigenic in transfusion reactions
-ABO strongest
-Rh stronger than other blood groups
=RhD evokes stronger reaction than
the other Rh antigens

23
Q

natural immunity

A

IgM antibodies (large) are produced w/o prior exposure to the ABO antigen (anti-A or anti-B)

24
Q

adaptive immunity

A

IgG antibodies (small) are produced upon exposure to other RBC Ag’s (e.g. Rhesus)

25
Q

allogenic

A

coming from different individuals of the same species but being antigenetically different

26
Q

consequences of transfusion of incorrectly matched blood

A

-ACUTE transfusion reaction
-DELAYED transfusion reaction

27
Q

acute transfusion reaction

A

-caused by ABO mismatch
-within minutes (acute)
-agglutination by IgM
-complement mediated lysis
-release of Hb (haemoglobinuria)
-breakdown to bilirubin
-toxic (fever, chills, nausea, clotting in blood vessels, necrosis of kidney)

28
Q

delayed transfusion reaction

A

-caused by mismatch of non-ABO antigens
-usually due to repeated transfusion of ABO matched blood that is incompatible for other blood group antigens (e.g. Rh, Kidd, Kell etc.)
-first mismatch triggers production of IgG antibody
-on repeat exposure, IgG binds RBCs
-IgG less effective at activating complement (less aggressive symptoms)
-fever, low Hb, increased bilirubin, mild jaundice, anaemia

29
Q

haemolytic disease of the foetus and new-born (HDFN)

A

-mother produces Ab that attack baby’s RBCs in-utero
-most common Ag involved = RhD
=(very antigenic/high frequency)
-baby’s symptoms caused by destruction of RBCs

30
Q

symptoms of HDFN

A

-enlarged liver and spleen (due to red cell lysis)
-symptoms of anaemia
-jaundice caused by elevated bilirubin
=breakdown product of haemoglobin
(is toxic, may cause brain damage)

31
Q

cause of HDFN

A

-RhD(-) mother with RhD(+) baby
-at birth or with trauma, some RBC may cross placenta from baby (or foetus) to mother
-mother raises immune response to foreign Ag on foetal RBCs (IgG)
-in subsequent pregnancies, the anti-Rh Ab can cross the placenta (as IgG) and destroy foetal RBC

32
Q

prophylactic treatment of HDFN

A

-anti-D Ab is injected into RhD(-) mother immediately after birth of first child (if RhD(+))
-neutralises RhD(+) red cell from foetus
-no anti-RhD AB raised in mother
-second RhD(+) child does not develop haemolytic disease of the newborn

33
Q

agglutination assay

A

-RBCs mixed with two separate solutions of anti-A or anti-B Ab’s to see if they agglutinate
-if the blood clumps, it indicates the presence of antigens in the blood
=e.g. a sample of type A blood will clump when tested with anti-B Ab’s as the blood contains A Ag’s
-type O blood sample will NOT agglutinate either anti-A or anti-B Ab’s as type O blood contains NO antigens

34
Q

transfusion compatibility

A

-just RBCs transfused, not whole blood
-O is universal donor
-AB group is universal recipient

35
Q

blood cross-matching

A

-blood cells from donation are mixed with plasma from the recipient
-agglutination indicates that the donor blood is incompatible

anatomy & physiology (21 decks)

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