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426 Blood Bank > Type&Screen > Flashcards

Type&Screen Flashcards

1
Q

IgG

A 
Monomer
Most common Abs
Cross placenta
Bind complement 
Leads to phagocytosis
4 subclasses: IgG1-4
IgG1: Fixed complement, 23 days, bind macrophage via Fc
IgG3: Fixed complement, 8 days, bind macrophage via Fc
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2
Q

Complement pathway

A
  • Classic: via C1, triggered by IgM, IgG
  • Alternative: low grade, constant, via C3. Normal: inactive bound C3 via DAF (CD55). Abnormal: Paroxymal Nocturnal Hemoglobinuria
  • Lectin: via sugar, no need C1
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3
Q

Landsteiner’s law

A

Have antigen, shouldn’t have antibody

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4
Q

Define “naturally occurring”

A
  • Immune exposure to the environment (bacteria, pollen)
  • Not require exposure to blood transfusion
  • Noticeable 3-6 months
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5
Q

Isoagglutination

A

IgM, IgG, IgA
Cause hemolysis by fixing complement
At RT (due to IgM)

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6
Q

Where ABO?

A

RBC, WBC, PLT
endothelium
epithelium
secretion

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7
Q

How much blood can cause an acute hemolytic transfusion reaction

A

10mL

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8
Q

Anti-A,B

A

Produced by group O –> react A or B cells
Mostly IgG –> cross placenta
Cause ABO HDFN (Hemolytic Disease Fetus & Newborn)

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9
Q

ABO genetic

A

H, h: chromosome 19
A,B,O: chromosome 9
* O = amorph: enzyme produced has no function

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10
Q

Precursor chains

A

Type 1: 1-3 terminal galactose & N-acetylglucosamine
Secretion & Plasma

Type 2: 1-4 terminal galactose & N-acetylglucosamine
RBC & tissue

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11
Q

H-antigen

A

HH or Hh
a-2-L-fucosyltransferase: bring L-fucose to terminal galactose
Amount of H: O>A2>B>A2B>A1>A1B

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12
Q

A-antigen

A

AO, AA, AB
a-3-N-acetyl-D-galactoseamyltransferase: bring N-acetyl-D-galactosamine to terminal Galactose
Requires L-fucose

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13
Q

B-antigen

A

BO, BB, AB
a-3-D-galactosyltransferase: bring D-galactose to terminal galactose
Requires L-fucose

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14
Q

Bombay

A

Lack of H antigen –> hh –> Denote: Oh
Plasma contains all types of Abs: anti-A, anti-B, anti-A,B, anti-H
Cause AHTR
Able to pass on A and B genes

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15
Q

ABO in newborns

A
  • Weak expression –> no isoagglutination until 4 months –> No reverse test
  • Maternal Abs can cross and attach to baby’s RBC –> no severe as weak ABO
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16
Q

FWD testing

A
  • Antigen?: Pt’s RBC + known Abs
  • Routinely test with monoclonal IgM (anti-A, anti-B, anti-D)
  • AB group requires control to R/O autoagglutination (Control: neg)
17
Q

RVS testing

A
  • Antibody (IgM)? Pt’s plasma + pool A1/B
  • Routinely test with A1 cells, B cells
  • Perform at Immediate Spin
  • No test for D
18
Q

Gel card

A

FWD: Pt’s RBC + gel with Ab –> Trapped: Pos/Pellet: Neg
RVS: Pt’s plasma + cells –> Trapped: Pos/Pellet: Neg
Mix field: May been seen in FWB when pt had a transfusion in the past.
Pro: stable vs Cons: spin 10min

19
Q

Stage of Agglutination

A
  1. Sensitization: Ab & Ag mix and bind
  2. Lattice formation: Abs cross-linking and bind multiple cells
    Happen at the same time: IgM
    Happen at different times: IgG
20
Q

Potentiators

A

Time, Temp, Medium, Conc, pH, enzymes

21
Q

Prozone

A

Too much plasma –> excess abs

22
Q

Postzone

A

Too less plasma –> excess antigen

23
Q

Zeta potential

A

Negative charge surrounding RBC to keep them away from each other

24
Q

Enhancement

A 
Standard: 37C, 30-60min
Decrease zeta potential by
- LISS: 0.2% saline --> 37C, 5-15 min
- Albumin: 22% --> 37C, 15-60 min
Dry out RBC: PEG --> bring cells closer --> 37C, 10-30 min
25
Q

Gel card pro & cons

A

Pro: smaller, no washing, clear, stable, can be automated
Cons: Expensive

26
Q

Solid-phase pro & cons

A

Pro: reduce volume, increase sensitivity, less skilled
Cons: Expensive, reagent expired, learning curve (?)

27
Q

Direct Antiglobulin Test

A

Does pt have Ab and/or Complement stuck on RBC/
In vivo
Pt’s RBC + AHG

28
Q

Indirect Antiglobunlin Test

A

Does pt have Ab that could bind RBC?
In vitro only
Pt’s plasma + Known screening cells

29
Q

IgD

A

Found on B cells (play role in B cell development)

Low level in serum

30
Q

IgE

A

Allergic reaction

Can cause allergic transfusion rxn. Med is ok

31
Q

IgA

A

Found in milk and secretion
Monomer or Dimer
IgA deficiency can develop anti-IgA –> Anaphylatic reaction

32
Q

IgM

A

Pentamer (J chain)
First Abs made when exposure
Fixes complements
React at cold temp.

33
Q

Haplotype

A

Group of genes inherited together due to close physical location
E.g: DCEce, MNSs
Rare blood tend to run in families

426 Blood Bank (9 decks)

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