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133 Cards in this Set
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The study of the immune response |
Immunology |
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Commonly known as blood banking it's the study of the immune response with respect to the red blood cell |
Immunohematology |
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When was the first documented human blood transfusion attempt? |
1492 |
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When was the first documented successful blood transfusion? |
1818 |
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Who is the father of blood banking? |
Karl Landsteiner |
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True or false blood transfusion is the most frequently performed transplantation procedure. |
True |
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How much is a typical blood donation? |
1 pint |
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How often is someone able to donate? |
Once every 3 months. |
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Which is the safer option giving blood as a whole or giving it in components? |
Components is safer. Whole blood is very dangerous to give. |
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Where are antigens? |
On cells |
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Where are antibodies? |
In plasma or serum |
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Another term for antibodies is what? |
Immunoglobulins |
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Which is the faster immunoglobulin, IgM or IgG? |
IgG |
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What are some examples of naturally occurring antibodies? |
Anti - A, anti - B |
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What is meant when somebody says a naturally occurring antibody? |
No foreign stimulant |
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What is an allo-antibody? |
An antibody caused by a foreign stimulant |
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What are we testing in blood bank? |
Ab and ag |
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All ag cause an immune response. T/F? |
False, an immunogen does though |
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Humoral response |
A response to an invading substance (ag) that results in the production of a specific ab. An ag combines with an ab in vivo or in vitro. |
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There are ____ different blood groups with over ___ ag. |
23/200 |
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The RBC surface consists of a ___ and the ag "stick out" from it. |
Lipid bilayer |
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Ag are glyco__ or glyco__ and are characterized by___. |
Glycoproteins/glycolipids/the terminal (end) sugars of oligosaccaharide chains that attach to either a protein or a carbohydrate. |
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HLA are divided into 3 classes, what are they? |
Class 1 ag - on surface of platelets, leukocytes and most nucleated cells in the body. Class 2 ag-presenting cells - macrophages, dendritic cells, and B cells (not platelets) Class 3 - complement proteins |
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HLA stands for... |
Human leukocyte antigens |
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Where is HLA located? |
Chromosome 6 |
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How many haplotypes for HLA do you get from each parent? |
1 |
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When is matching HLA important? |
Hematopoietic progenitor cell transplants, solid organ transplants |
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What is neonatal alloimmune thrombocytopenia, and what causes it? |
Mom's ab attack baby's ag/platelet ag |
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What is post-transfusion purpura? |
When a transfusion recipient's platelets are destroyed after receiving a transfusion |
Commonly termed, the patient is refractory |
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Examples of naturally occurring antibodies are...and are formed by what age? |
Anti-A, Anti-B/4 months of age |
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When are unexpected ab or allo-antibodies formed? |
After a person is exposed to blood via transfusion or pregnancy |
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What does ABO/D typing (forward grouping) detect, what's the ag source, and what's the ab source? |
Detects A, B, and D ag. Ag source is patient's RBCS. Ab source is commercial Anti-A, Anti-B, and Anti-D. |
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ABO serum testing (reverse grouping) detects what? What's the ag source and the ab source? |
Detects ABO ab. Reverse grouping cells (A1 and B). Patient's serum or plasma. |
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When are unexpected ab or allo-antibodies formed? |
Transfusion or pregnancy |
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An allo-antibody is produced by... |
Immunogen |
Another term for foreign ag |
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The first time a person is exposed to a foreign RBC ag, the response is slow, this is what? |
Primary response and is IgM |
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If a person "mounts a response" to the ag, a second exposure will result in production of a large amount of ab. This is called... |
Anamnestic response and is IgG |
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If antibodies are already coating a person's RBCs, it means that they may have an...in this case the auto control would be ___ and the DAT would be ___. |
Auto-antibody/positive/positive |
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DAT stands for... |
Direct antiglobulin test |
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Allo-antibodies are detected using the ____ and ____ is tested. |
Antibody screen (ABSC)/plasma |
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Auto-antibodies are detected using the ___ and/or ___. What are tested? |
DAT, auto control/red cells |
Positive reactions in the test tube are agglutination and hemolysis |
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Factors that can influence testing include... |
Serum-to-cell ratio, temp of reaction, incubation time, pH(optimal is 7.0), ionic strength |
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What are some factors affecting lattice formation? |
Zeta potential, amount of ag and ab, centrifugation, and addition of anti-human globulin (AHG) |
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Only __ ab can activate the complement cascade by themselves. |
IgM |
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The end result of complement activation is... |
Cell lysis (seen as hemolysis in vitro) |
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What are some hemolysins? |
Anti-A, Anti-B, Anti-Le {a} |
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What are the principles of the antiglobulin test? |
It detects IgG abs and complement proteins that have attached but not caused visible agglutination/Produced by injecting animals with human ab complement/The AHG reagent will react with human IgG ab and complement if any is present in serum or on ag. This is why cells need to be washed. |
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2 components of poly specific AHG are... |
Ab to IgG (anti-IgG)/complement proteins (anti c3d, c3d) |
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Complement system |
Group of serum and proteins that clear ag, lysis cells, and vasodilate |
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Complement binds to... |
cells |
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Ab screens detect what? What is the source of ag? Of ab? |
Detects Ab w/ specificity to red cell ags. Screening cells. Patient's serum or plasma. |
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What does Ab identification identify, what's the ag source and what's the ab source? |
Identifies specificity of red cell antibodies. Ag source is panel cells. Ab source is patient's serum or plasma. |
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What does a Crossmatch determine, what's the ag source and what's the ab source? |
Determines serologic compatibility between donor and patient before transfusion. Source of ag is donor's red cells. Source of ab is patient's serum or plasma. |
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_______: strength of ag-ab reaction. |
Potency |
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SOP stands for... |
Standard Operating Procedures |
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Most reagents are made from what? |
Monoclonal ab |
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Anti-A is always dyed ____ and Anti-B is always dyed ____. |
Anti-A = BLUE!!!!
Anti-B = YELLOW!!! |
"B like a yellow bee!" |
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Screening cells are always group... |
O |
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Direct antiglobulin detects what? What does it indicate? |
Detects Ab bound to RBCS in vivo. Indicates autoimmune hemolytic anemia, HDFN, drug related problem, or transfusion reaction. |
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Indirect antiglobulin testing (2 step procedure) detects what? Indicates? |
Detects Ab bound to RBCS in vitro. Indicates specific reaction between an ab in serum and ag on RBC. |
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What are some areas associated with DAT testing? |
RBCS are agglutinates before washing due to cold reactive ab. Use of dirty or contaminated glassware. Improper centrifugation. Not adding AHG immediately after centrifuging. |
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What color dye is used for our AHG testing? |
Green |
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What enhancing media/potentiatior do we use in class? |
LISS/Lo-ION |
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Genotype |
Hereditary make up (AO, AA) |
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Phenotype |
Outward expression of the gene (AO and AA are both "group A") |
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Homozygous |
Similar pairs of genes (KK) |
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Heterozygous |
Different pairs of genes (Kk) |
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Amorph |
Unexpressed or silent gene (O or d) |
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Dominant gene vs recessive gene. |
Dominant gene is expressed while recessive isn't. |
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Codominant genes |
Genes expressed equally |
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Humans have 23 pairs of chromosomes. __ pair(s) of autosomes and __ pair(s) of sex chromosomes. |
22/1 |
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Mendelian law states.. |
Only 1 gene from each parent is passed on to the child |
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Autosomal dominant |
Found in each generation if the allele is present |
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Autosomal recessive |
2 carriers can pass on the trait but is only expressed when the recessive trait is passed by each parent to the child |
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Sex-linked dominant |
Absence of father-son transmission will be expressed if passed from father-daughter. |
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Sex-linked recessive |
Males inherit trait from carrier mothers. Children of an affected male and female who lacks the allele will have sons who are normal and daughters who are carriers. |
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A person who has a homozygous or double dose of a gene will have a ___ reaction then someone with a heterozygous or single dose of genes. |
Stronger |
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Haplotype |
Linked sets of genes inherited together |
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PCR stands for ... |
Polymerase chain reaction |
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High incidence ag |
Ag that occur in a large % of the population (>90%) |
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Low incidence ag |
Ag that occurs in less 10% of the population |
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Liver, heart, lung and pancreas do not need to be ABO compatible. T/F? |
FALSE. Blood types must match. |
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Donated kidneys blood type do need to match the recipient's. T/F? |
True |
HLA used to predict survival |
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Do blood types of donor and recipient need to match in cases of bone marrow donation? |
It's of secondary importance. HLA match is more important. |
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Is ABO matching important for tissue, bone, or cornea transplant? |
Nope |
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ISBT stands for... |
International Society of Blood Transfusion |
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An IgG reaction is worrisome because... |
It can cross the placenta |
In regards to pregnancy |
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Structure of H has which sugar? |
Fucose |
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The H gene is present in __ of the population and is the precursor for __. |
99.9% ABO |
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Type O RBCS have large amounts of H detectable (more than A, B, or AB). T/F? |
True |
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What phenotype are people who lack the H gene? |
Bombay |
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Describe the Bombay phenotype. |
Can inherit A and B gene but don't express it. Must receive blood from other Bombay. "Para-bombay" exist also, which is where the H gene is defective. |
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Put the following in order of which has the most H ag to the least. A2, A1, B, A1B, O, A2B |
O>A2>B>A2B>A1>A1B |
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N-acetyl galactosamine is the sugar in which blood type structure? |
Type A |
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Galactose is the sugar for which blood type structure? |
Type B |
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You begin to develop antigens around when? |
6th week of fetal life |
<50% present at birth |
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At what age do you reach adult level of ag development? |
3 years old |
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Ag are found in... |
RBCS, epithelial cells, lymphocytes, platelets, solid organs. If the person is a secretor, they are also found in saliva, urine, tears, bile, amniotic fluid, milk, and semen |
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What is the most common subgroup of A? The 2nd most common? |
A1 the A2 |
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Lectin is used for... |
A1 |
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ABO ab are ____ occurring and develop in the first ___ of life. |
Naturally 6 months |
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How much blood can be fatal due to wrong typing (ab)? |
150cc |
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What is the most common blood type to least common? |
O A B AB |
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Secretors make up __ of the population |
80% |
Se (dominant), se (recessive) |
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Serum/plasma discrepancies are more common than cell discrepancies. T/F? |
True |
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Who are some examples of people who may be missing reactions in ABO reverse type? |
Elderly patients, infants under 4-6 months, immunodeficient patients, and bone marrow transplant patients |
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The number one error in bloodbanking is...? |
Transcription error |
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__% of the US population is characterized as Rh negative. |
15 |
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What are the best known ag of the Rh blood group system? |
D, C, E, c, e |
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If you see dCE written for Rh inheritance, the d means what? |
There is no D ag. |
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Rh null is the same as Rh negative. T/F? |
FALSE. Rh nulls have NO Rh ag. Rh negative only lack the D ag. |
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After ABO, what's the most important blood group system? |
Rh |
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Rh ab are clinically significant because they can cause... |
Hemolytic transfusion reactions (HTR) and HDFN |
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Rh ab are naturally occurring. T/F? |
False. They need antigenic stimulation. |
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List the five main Rh types from most immunogenic to least. |
D>c>E>C>e |
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R=? ?=absence of D 1or '=? 2 or ''=? ? or ? = C and E |
D r C E z or y |
In this case absence of D is NOT d - weiner/fisher-race |
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cde/cde = |
rr |
Rh(D) status is negative |
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R1r= |
CDe/cde |
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CDe/CDe = |
R1R1 |
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cDE/cde = |
R2r |
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R1R2 = |
CDe/cDE |
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cDE/cDE = |
R2R2 |
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RHAG is on which chromosome? |
6 |
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What are the blood types for 1-4? |
1-? 2-? 3- AB pos 4- O pos |
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What is true of Bombay individuals? |
They are genetically hh. They do not make A and/or B ag on there RBCS. They can only receive blood from other Bombay individuals. |
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Lectin from dolichus biflorus will agglutinate red cells of which phenotype? |
A1 and A1B |
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Complete the chart. |
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What are situations in which a weak D test MUST be performed? |
Prenatal evaluations and blood transplant recipient. |
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The technique that uses a small amount of DNA and amplifies it for identification is called... |
PCR |
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