Blood Bank and Immunology Lecture Review

These flashcards cover key concepts in Blood Bank and Immunology, including innate/adaptive immunity, blood group antigens and antibodies, agglutination principles, common lab procedures, and specific Rh and ABO blood group characteristics.

Which of the following is NOT an example of innate immunity?

B cells are primarily involved in adaptive immunity, though T cells can have both innate and adaptive roles.

What is the most immunogenic blood group antigen?

D

What is the second most immunogenic blood group antigen, also known as 'killer'?

K (Kell)

What characteristic defines naturally occurring antibodies?

Produced without prior exposure to a foreign antigen

What immunoglobulin class are most naturally occurring antibodies, such as ABO antibodies?

IgM

Which antibody class reacts best at room temperature and activates complement?

IgM

Which antibody class reacts best at 37°C (body temperature)?

IgG

What are the two unchanging light chains found in IgG and IgM immunoglobulins?

Kappa lambda

Which region of the immunoglobulin molecule binds complement?

FC region

Which region of the red cell-bound immunoglobulin does the FAB region of anti-human globulin (AHG) bind to?

FC region

How many antigen-binding sites (FAB regions) does an IgM molecule have?

10

How many FC regions does an IgM molecule have?

5

How many molecules of IgG are needed to activate complement?

Two

How many IgM molecules are needed to activate complement?

One

Which immunoglobulin class can cross the placenta?

IgG

Which two blood group systems are most important to induce complement-mediated intravascular hemolysis?

ABO and Lewis

Which step of agglutination is affected by temperature, incubation time, pH, and ionic strength?

Sensitization

Which step of agglutination is affected by zeta potential, zone of equivalence, and centrifugation?

Lattice formation

Is hemolysis considered a positive reaction in blood banking?

True

What causes hemolysis?

Complement activation

What type of media is added to a test system to decrease the incubation time?

Enhancement media (potentiators)

Which potentiator can reduce incubation time to 10-15 minutes and is favored by most labs in America?

LISS (Low Ionic Strength Solution)

What are possible sources for the antibody in a blood bank test system?

Serum, plasma, or reagent antiserum

What is the primary source of antigens in routine blood bank testing?

Red cell membrane

When setting up a blood bank test, which source (antibody or antigen) should be added first?

Antibody source

What does anti-human globulin (AHG) detect?

Human antibodies (anti-IgG, anti-C3, or both)

Which blood bank test detects in vivo sensitization?

Direct Antiglobulin Test (DAT)

Which blood bank test detects in vitro sensitization?

Indirect Antiglobulin Test (IAT)

Which step in the IAT removes free globulin molecules?

Washing

Which step in the IAT allows for antibody to attach to the antigen (sensitization)?

Incubation

What type of error can dirty glassware cause in blood bank testing?

False positives

What type of error can an ideal serum-to-cell ratio (not enough or too much antibody/antigen) cause?

False negatives

What is one of the most common Rh haplotypes in the white population?

R1

What is one of the most common Rh haplotypes in the black population?

R0

Patients whose red cells type negative with Ulex Europaeus (anti-H lectin) are phenotypically O, but what is their true blood group?

Bombay

What substances would be found in the secretions of a group AB non-secretor?

Nothing

What color tube is most commonly used for blood bank specimens?

Pink

When does a blood bank specimen typically expire?

The third day at midnight (e.g., drawn Monday, expires Thursday midnight)

What does the term 'murine' mean in the context of reagents?

Derived from a rodent

What portion of the antibody molecule imparts its unique class function?

The constant region of the heavy chain

What is the minimum strength required for a forward type (ABO) reaction to be considered positive?

3+ or greater

What is the minimum strength required for a reverse type (ABO) reaction to be considered positive?

2+ or greater

What immunodominant sugar must be present (making up the H antigen) before A and B sugars can be added to the oligosaccharide chain?

L-fucose (which was referred to as L-glucose in the lecture)

If an error is found on a blood bank label, what is the correct action to take?

Redraw the specimen

What additive is typically found in blood bank specimen tubes to prevent clotting?

EDTA

What percentage of the population is compatible with type O red blood cells (as a recipient)?

100%

Which human blood group has the least amount of H antigen and is therefore most likely to create the Bombay phenotype?

AB blood group

Which ABO subgroups can typically cause mixed field reactions?

A3 and B3

What is the least common ABO type?

AB

A donor blood sample tested negative at immediate spin with anti-D, but positive at the AHG phase. How is this blood labeled?

Rh positive

How is a patient with a negative immediate spin anti-D reaction but a positive AHG phase reaction categorized?

Weak D positive