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Trans lecture 2 Flashcards

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1
Q

What is hemagglutination?

A

Hemagglutination is the agglutination or clumping of red blood cells.

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2
Q

Which blood cell surface allows easy access to antigens?

A

The red cell surface allows easy access to antigens.

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3
Q

Which blood group systems have antigens protruding from the red cell surface?

A

Most blood group systems have antigens protruding from the red cell surface.

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4
Q

What are the factors that contribute to immunogenicity?

A

The factors that contribute to immunogenicity are chemical composition and antigen complexity.

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5
Q

Which antigens are the best immunogens?

A

Proteins are the best immunogens.

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6
Q

Which antigens are less immunogenic?

A

Lipids are not antigenic at all.

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7
Q

What is the role of the Degree of Foreignness in immunogenicity?

A

The Degree of Foreignness determines how immunogenic an antigen is.

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8
Q

What is the minimum size required for an antigen?

A

The antigen must be larger than 10,000 D.

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9
Q

What factors influence antigen-antibody binding?

A

Factors that influence antigen-antibody binding include electrostatic forces, hydrogen bonding, hydrophobic bonding, and van der Waals forces.

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10
Q

Which force does not influence antigen-antibody binding?

A

Covalent bonding does not influence antigen-antibody binding.

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11
Q

What is the affinity of an antibody?

A

Affinity is the strength of binding between a single antibody and epitope of an antigen.

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12
Q

What is avidity?

A

Avidity is the overall strength of reactions between several epitopes and antibodies.

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13
Q

What are the potential consequences of transfusion and pregnancy?

A

Transfusion and pregnancy have the potential to produce antigen-antibody complexes in vivo.

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14
Q

How does immunization occur in pregnancy?

A

Immunization may occur in pregnancy when fetal cells cross the placenta.

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15
Q

Which cells can autoantibodies be produced against?

A

Autoantibodies can be produced against RBCs, WBCs, and platelets.

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16
Q

How are antigen-antibody reactions detected in laboratory testing?

A

Antigen-antibody reactions in laboratory testing are detected by visible agglutination or evidence of hemolysis.

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17
Q

What is the first stage of in vitro antigen-antibody binding?

A

The first stage of in vitro antigen-antibody binding is usually not visible and does not form a visible lattice.

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18
Q

What factors can influence the first stage of in vitro antigen-antibody binding?

A

The first stage of in vitro antigen-antibody binding can be influenced by cell-to-serum ratio, temperature, incubation time, pH, and ionic strength.

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19
Q

What is the meaning of lag phase in primary immune response?

A

The lag phase in the primary immune response is the time it takes for the immune system to mount an initial response, which is typically 5 to 10 days.

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20
Q

What happens to IgM and IgG levels during a primary immune response?

A

During a primary immune response, the initial antibody isotype is IgM, which over time converts to IgG.

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21
Q

How does the concentration of IgM change in a secondary (anamnestic) immune response?

A

In a secondary (anamnestic) immune response, the concentration of IgM is lower compared to the primary response, while the concentration of IgG is increased.

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22
Q

What is the Zone of Equivalence?

A

The Zone of Equivalence is the optimum ratio of antigen and antibody, where agglutination occurs.

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23
Q

What is the Prozone?

A

The Prozone is a situation where there is an excess of antibodies, saturating all antigen sites and preventing cross linkages between cells, resulting in no visible agglutination.

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24
Q

What is the Postzone?

A

The Postzone is a situation where there is an excess of antigen, making it difficult to observe agglutination due to the presence of numerous unagglutinated antigens.

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25
What are Landsteiner's rules regarding antigen-antibody reactions?
According to Landsteiner's rules, if a person's cells have the antigen, the antibody should not be present in that person's serum, and if an antibody to a blood group antigen is present in the serum of a person, his or her cells should lack that antigen.
26
Where are the antigens and antibodies located in the body?
Antigens are on the cells, while antibodies are in the serum.
27
What are the antigen combining sites in antibodies called?
Fab regions
28
How are antigens and antibodies held together?
By non-covalent forces
29
What happens when an antibody molecule binds to the surface of red blood cells (RBCs)?
It increases the attraction of antibodies to the RBC surface
30
What does the term 'sensitization' refer to?
It refers to cells coated with antibody
31
Does sensitization always result in agglutination?
No, sensitization does not necessarily lead to agglutination
32
What are the different dilutions used in lab titration?
Neat, 1:2, 1:4, 1:8, 1:16
33
At which dilutions in lab titration may agglutination be observed?
Agglutination may be seen at 1:8 and 1:16 dilutions
34
What is the second stage of the agglutination process?
Lattice formation and agglutination
35
What is the lattice structure formed during the second stage of agglutination?
A lattice is essentially many antigen-antibody bridges that form between red cells and antibodies
36
What is agglutination?
Agglutination is the actual linking of cells in solution
37
What are the factors to consider for optimum reactions?
Concentration of antigen and antibody, specificity, electrical charges and pH, temperature, incubation time, and ionic strength
38
How does the concentration of antigen and antibody affect agglutination?
Working within the zone of equivalence is important, and adjusting the ratio of antigen to antibody can increase sensitivity
39
What is the recommended concentration of RBC suspensions for optimal antibody binding?
5% RBC suspensions are recommended
40
What is the 'fit' in the context of antigen-antibody reactions?
The 'fit' refers to the spatial and chemical fit between antigen and antibody
41
How do electrical charges and pH affect antigen-antibody reactions?
Electrical charges found on antigens and antibodies, and difference in pH can affect the 'fit' of the reaction
42
What is the optimal pH range for antigen-antibody reactions?
Optimal reactions occur between pH 7.0 and pH 7.2
43
What is the temperature commonly used for testing antigen-antibody reactions?
Testing is carried out at 37°C to mirror what happens in the body
44
Does temperature affect antigen-antibody binding or the rate of reaction?
Temperature affects the rate of reaction but not antigen-antibody binding. IgG reacts best at 37°C, while IgM reacts best at 4°C
45
What happens when the temperature is increased above 37°C during antigen-antibody testing?
The dissociation rate of the reaction increases, leading to false negative results
46
What is the importance of incubation time in antigen-antibody testing?
Incubating for 30 minutes at 37°C allows 75% of the antigen-antibody to be bound together, but incubation should not exceed one hour
47
What does ionic strength measure?
Ionic strength measures the intensity of the electrical field resulting from ions in a solution
48
What is typically used as a suspending medium for test cells?
NaCl (saline) is commonly used
49
What is the most common anticoagulant used in blood bank labs?
K2EDTA (pink-stoppered)
50
Why were anticoagulated specimens historically not used for testing?
It was believed that complement activation was required for detection of antibodies and anticoagulants have anticomplementary properties.
51
What is the specimen of choice for GEL methodology?
EDTA
52
What can occasionally be found in plasma samples and is difficult to distinguish from true agglutination?
Small fibrin clots
53
What is the purpose of gel methodology in blood testing?
To trap agglutinated RBCs using dextran acrylamide gel particles
54
What does the Gel method use to standardize tube methodology?
0.8% suspension of red cells
55
How are positive reactions identified in Gel methodology?
Agglutinated RBCs trapped at various levels in the gel
56
How are negative reactions identified in Gel methodology?
Non-agglutinated red cells pass through the gel, forming a button on the bottom of the reaction chamber
57
What is the purpose of microplate testing in blood group serology?
To detect antigen-antibody reactions using 96-well plates
58
How can results in microplate testing be observed?
By using a photometric device or by observing the RBC streaming pattern
59
What does hemolysis indicate in blood testing?
Ag/AB reaction in vitro, excessive RBC breakdown, release of Hgb
60
What is the significance of hemolysis in serologic testing?
It often obscures agglutination and is important for accurate interpretation of results
61
What is the purpose of solid phase red cell adherence methodology?
To detect and identify antigen-antibody reactions using chemically modified microplates coated with RBCs
62
How are RBC membranes bound to microplate walls in solid phase adherence methodology?
Screening cells are bound or adhered to the surface of the microplate walls
63
What happens when patient or donor serum is added to the wells in solid phase adherence methodology?
Red cell membranes capture IgG antibodies during the incubation phase
64
How are results interpreted in solid phase adherence methodology?
Negative: Formation of RBC button on the bottom of wells Positive: Attachment of indicator cells to the sides and bottom of the wells, with RBCs adhered to the wells
65
What are the possible outcomes of complement activation in blood banking?
Normal survival of RBCs, intravascular hemolysis, extravascular hemolysis
66
What are the advantages of using PEG as an enhancement media?
PEG produces specific reactions and is less likely to produce false-positives.
67
What are the advantages of using proteolytic enzymes for agglutination enhancement?
Proteolytic enzymes enhance agglutination of IgG antibodies.
68
Which antibodies can be detected by enzyme tests?
Enzyme tests can detect IgG antibodies in the Rh system, clinically insignificant cold ABs, and some Kidd antibodies if IAT is tested.
69
What is the one-stage method for enzyme testing?
In the one-stage method, serum is incubated with cells and enzyme, then read macroscopically for agglutination and hemolysis.
70
What is the advantage of the two-stage method in enzyme testing?
The two-stage method is more sensitive than the one-stage method and can't break the antibody apart.
71
How does albumin enhance antibody detection?
Albumin increases the dielectric constant and decreases the zeta potential, allowing coated cells to come closer together.
72
What antibodies can be detected if albumin is used?
Albumin can detect IgG Rh antibodies and any IgM antibody that can react at 37°C.
73
What are the disadvantages of using albumin as an enhancement media?
Albumin is relatively insensitive for both IgG and IgM antibodies and adds cost to the test, while also enhancing some clinically insignificant cold antibodies.
74
What is the main purpose of grading associated with agglutination?
Grading helps determine the strength of agglutination and is used in various procedures like antibody screen and crossmatch.
75
When is an antibody considered agglutinating?
An antibody is considered agglutinating when it is capable of producing red cell agglutination in saline.
76
When is an antibody considered non-agglutinating?
An antibody is considered non-agglutinating when its binding to red cells is not sufficient to agglutinate them in saline.
77
Can serum or plasma be used for agglutination tests?
Yes, both serum and plasma can be used for agglutination tests.
78
What are the possible consequences of activation of Hageman factor?
Possible consequences of activation of Hageman factor include coagulation activation.
79
What can lead to the occurrence of Disseminated Intravascular Coagulation (DIC)?
Disseminated Intravascular Coagulation (DIC) can occur due to small clumps of agglutinated cells in the blood stream, fibrinogen consumption, activation of fibrinogen system, and fibrin destruction.
80
How do leukocytes respond when exposed to various antigen-antibody complexes?
Leukocytes respond by secreting various cytokines, leading to fever, a drop in blood pressure, additional release of WBC's from the bone marrow, and other activities.
81
What is the most common complication of an untreated hemolytic transfusion reaction?
Renal failure is the most common complication of an untreated hemolytic transfusion reaction.
82
What factors contribute to renal failure in an untreated hemolytic transfusion reaction?
Renal failure occurs due to a combination of hypotension, contraction of blood vessels in the kidneys, intravascular clots, and toxic effects of free hemoglobin.
83
What are the signs of intravascular hemolysis?
The signs of intravascular hemolysis include a sudden drop in blood pressure due to anaphylatoxins, hemoglobinuria, hemoglobinemia, decreased haptoglobin levels, and no rise in Hct following blood transfusion.
84
What may result from large amounts of complement activation in intravascular hemolysis?
Anaphylactic shock and death may result from large amounts of complement activation in intravascular hemolysis.
85
How much should a unit of blood increase a patient's hemoglobin by?
Every unit of blood should increase a patient's hemoglobin by 10g/L.
86
What should the difference in hemoglobin levels be between blood transfusions?
The difference in hemoglobin levels between blood transfusions should be three times.
87
Why is the accessibility of antigens important for antibody-antigen reactions?
Antibodies must be able to reach antigens for agglutination to occur.
88
Where are ABO antigens located?
ABO antigens are located on the surface of red blood cells.
89
What is the role of centrifugation in agglutination reactions?
Centrifugation brings cells closer together, enhancing the antigen-antibody agglutination reaction.
90
How does the size of IgM and IgG antibodies affect their ability to reach between cells?
IgM antibodies are larger and can reach between cells further apart, resulting in agglutination.
91
What is zeta potential?
Zeta potential refers to the difference in electrostatic charges between the surface of red blood cells and the surrounding medium.
92
How does zeta potential prevent red blood cells from sticking to each other?
The negative charge produced by static acid on red blood cells creates a negative charge around them, preventing sticking in peripheral blood.
93
What is the role of potentiators in antibody testing?
Potentiators adjust the testing environment, promoting antigen-antibody agglutination by reducing zeta potential.
94
Which antibodies require potentiators for enhanced detection?
IgG antibodies are clinically significant and require potentiators for optimal reaction and detection.
95
Which enhancement solution is used to decrease zeta potential and increase agglutination?
PEG (Polyethylene Glycol) is used to decrease zeta potential and enhance agglutination.
96
What is the purpose of low ionic strength solution (LISS) in antibody testing?
LISS increases antibody uptake during sensitization, resulting in a faster turnaround time.
97
What is the scientific term for the division of immunology that deals with detection and measurement of specific antibodies?
SEROLOGY
98
What is the term used to describe antibodies that can cause a decrease in red cell survival?
CLINICALLY 'SIGNIFICANT' ANTIBODIES
99
Which antigens show dosage, meaning they require a double dose and homozygous pairing to exhibit their effect?
RH, DUFFY, M, N, C
100
What is the term for the presence of an antibody other than ABO antibodies, resulting from exposure through pregnancy or transfusion?
UNEXPECTED ANTIBODY (ATYPICAL)
101
What role does HLA typing/testing play in transplantation and transfusion?
MAJOR ROLE
102
What is the term for when the donated tissue/organ/cells recognize the host as a threat and attack the host?
GRAFT vs HOST DISEASE (GVHD)
103
What is the term for patients who receive multiple PLT transfusions and develop antibodies resulting in a poor response to PLT transfusion?
PLATELET REFRACTORIES
104
Which class of MHC antigens is found on platelets, leukocytes, and most nucleated cells?
CLASS I
105
What is the term for antigens that can induce the formation of antibodies when recognized as foreign by the immune system?
IMMUNOGENS
106
How many known red cell antigens are there?
> 300

Transfusion (7 decks)

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