Learn: UAMS Blood Bank Case Development: Module 2 EXAM Review

Dominant

Trait that is expressed whether allele is homozygous or heterozygous

Amorph

Describes a gene that does not express a detectable product

Dosage

Stronger agglutination when the antibody is reacted with cells demonstrating homozygous expression of antigen

Genotype

Actual genetic makeup; determined by family studies or molecular typing

Homozygous

Two alleles for a given trait are identical

Heterzygous

Two alleles for a given trait are different

Locus

Position of gene on the chromosome

Phenotype

Observable expression of inherited traits

Linked

When two genes are inherited together by being very close on a chromosome

Recessive

Trait expressed only when inherited by both parents

Co-dominant

Equal expression of two different alleles

Sex linked gene

Located on the X chromosome

Identify the corresponding structures of immunoglobulin molecule indicated by each letter.

A: Antigen Binding Region

B: Heavy Chain

C: Location enzyme cleavage

D: Complement Binding Site

E: Macrophage binding region

F: Light Chain

G: Fab region

H: Hinge Region

I: Fc

Which ABO gene is considered an amorph?

O

Which ABO group shows co-dominance?

AB

Which ABO types demonstrate a homozygous genotype?

AA, BB, OO

Which ABO types demonstrate a heterozygous genotype?

AB, AO, BO

Using the diagram, which area demonstrates postzone?

C

Using the diagram below, which area demonstrates prozone?

A

Using the diagram below, which area designates zone of equivalence?

B

Using the diagram below, which area designates the appropriate environment for agglutination?

B

Using the diagram below, which are provides condition for sensitization?

A, C

IgM or IgG?

Primarily involved in primary immune response

IgM

IgM or IgG?

Preferred reaction temperature 4-25 degress Celsius?

IgM

IgM or IgG?

Preferred reaction temperature 37 degrees Celsius?

IgG

IgM or IgG?

More involved in secondary immune response

IgG

IgM or IgG?

Ability to cross the placenta

IgG

IgM or IgG?

Greater ability to fix complement

IgM

IgM or IgG?

Naturally occuring

IgM

IgM or IgG?

Typically requires enhancement media

IgG

IgM or IgG?

Two available binding sites per molecule

IgG

IgM or IgG?

Ten available binding sites per molecule

IgM

IgM or IgG?

Ability to agglutinate in normal saline alone

IgM

IgM or IgG?

Involved in intravascular hemolysis

IgM

Involved in extravascular hemolysis

IgG

Primary or Anamnestic (Secondary) Immune Response?

Usually takes 7-10 days

Primary response

Primary or Anamnestic (Secondary) Immune Response?

Usually takes approximately 48-72 hours

Anamnestic Response

Primary or Anamnestic (Secondary) Immune Response?

Involves higher titer

Anamestic Response

Primary or Anamnestic (Secondary) Immune Response?

Titer is longer lasting

Anamestic Response

Primary or Anamnestic (Secondary) Immune Response?

Associated more with IgM

Primary response

Primary or Anamnestic (Secondary) Immune Response?

Associated more with IgG

Anamnestic Response

Primary or Anamnestic (Secondary) Immune Response?

Involves memory B cells

Anamnestic Response

Primary or Anamnestic (Secondary) Immune Response?

Requires more antigen for stimulation

Primary response

Primary or Anamnestic (Secondary) Immune Response?

Associated with delayed transfusion reactions

Anamnestic response

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

Proteolytic enzymes (such as ficin and papain) cleave sialic acid, removing the negative charge allowing red cells to agglutinate more readily. Will destroy antigens on the same chains as sialic acid (M, N, S, and Duffy), but enhances Rh and Kidd

Enzyme Pretreatment

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

Reduces the zeta potential of RBC's allowing agglutination. At the pH of testing, albumin has net negative change and dissipates the positive ions swarming around sialic acid.

Protein Enhancement

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

Attaches to antibodies which sensitizes a red cell, bridging the gap allowing visibility of agglutination

Anti-Human Globulin

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

Implemented in blood bank testing to enable the activation of various antibodies to attach (IgG antibodies prefer 37 degrees Celsius to attach; IgM antibodies prefer 4-25 degrees Celsius to attach)

Temperature

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

When RBCs are in a low ionic strength solution (LISS) the cloud of a cations around the cell is less than when in saline. This reduced concentration of cations allows the (+) anitbody easier access (=) antigens thereby increasing sensitization.

Ionic Strength of Solution

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

An antibody will react stronger or show greater agglutination when the RBC has a double dose (homozygous) of the single or one antigen because there are more binding sites containing the one antigen.

Antigen Dosage (homozygous versus heterozygous)

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

Antigen must be proper ratio to antibody for optimal sensitization. Sometimes increasing the amount of antibody (adding more serum) will strengthen weaker reactions

Antigen/Antibody Ratio

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

RBCs are kept apart by a cloud of ions. (+) cations surround the (-) charge on cell surface. The (+) charges repel each other.

Zeta Potential

Match each process used in blood bank to the correct impact of the antigen/antibody reactions.

Physically forces red cells closer to each other to overcome zeta potential allowing sensitized red cells to agglutinate.

Centrifugation

Match each antigen with its corresponding oligosaccharide sugar.

A

N-actetygalactosamine

Match each antigen with its corresponding oligosaccharide sugar.

B

D-glucose

Match each antigen with its corresponding oligosaccharide sugar.

H

L-fucose

Which blood group has the greatest amount of H substance (L-fucose)?

O

Which blood group have the least amount of H substance (L-fucose)?

A1B

Which H genotype represents a patient with the Bombay phenotype?

hh

Anti-A,B is an antibody that is produced only in what ABO group of individuals?

O

ABO Blood Group System or Rh Blood Group System?

Optimal reaction at room temperature

ABO

ABO Blood Group System or Rh Blood Group System?

Optimal temperature at 37 degrees

Rh

ABO Blood Group System or Rh Blood Group System?

Enhanced reactivity after incubating at 4 degrees

ABO

ABO Blood Group System or Rh Blood Group System?

Enhanced reactivity with AHG testing

Rh

ABO Blood Group System or Rh Blood Group System?

Described as naturally occurring

ABO

ABO Blood Group System or Rh Blood Group System?

Typically built only after exposure

Rh

ABO Blood Group System or Rh Blood Group System?

Associated with IgG classification

Rh

ABO Blood Group System or Rh Blood Group System?

Associated with IgM classification

ABO

Which of the following scenarios most likely indicate the presence of an A1 anitbody?

The IAT is Negative. A1 lectin reaction is negative with patient red cells, A2 cells reaction is negative in reverse typing.

Which of the following reagents is used in D testing because it contains IgM anti-D for the detection of the D antigen at room temperature and IgG antibodies for weak D detection.

Monoclonal/Polyclonal Blend

Which of the following populations is it more important to detect a weak D phenotype to prevent a Rh positive donor from being transfused into an Rh negative recipient?

Donor

Which of the following is the most common cause of positive weak D control?

patient positive DAT

A previously transfused 24-year old Rh= woman appears to have an Anti E. The patient's mother is R1 /r and her father is Ro/r'. Is it is possible for the patient to build Anti-E?

Yes, based on Rh genotype of mother and father, the patient cannot have the E antigen.

A previously transfused 24-year old Rh= woman appears to have an Anti E. The patient's mother is R1 /r and her father is Ro/r'. Would either of the parents be a suitable directed donor for the patient based on the Rh system?

Neither the mother nor the father are suitable directed donors. Both are Rh+

Match each Weiner nomenclature with the corresponding Fisher Race nomenclature.

R1

DCe

Match each Weiner nomenclature with the corresponding Fisher Race nomenclature.

R2

DcE

Match each Weiner nomenclature with the corresponding Fisher Race nomenclature.

R0

Dce

Match each Weiner nomenclature with the corresponding Fisher Race nomenclature.

Rz

DCE

Match each Weiner nomenclature with the corresponding Fisher Race nomenclature.

r'

dCe

Match each Weiner nomenclature with the corresponding Fisher Race nomenclature.

r"

dcE

Match each Weiner nomenclature with the corresponding Fisher Race nomenclature.

r

dce

Match each Weiner nomenclature with the corresponding Fisher Race nomenclature.

ry

dCE

Using the reactions provided in the table below, provide the ABO and Rh interpretation for the patient labeled as A.

A1

Using the reactions provided in the table below, provide the ABO and Rh interpretation for the patient labeled as B.

A2 with Anti-A1

Using the reactions provided in the table below, provide the ABO and Rh interpretation for the patient labeled as C.

A2B with anti-A1

Using the reactions provided in the table below, provide the ABO and Rh interpretation for the patient labeled as D.

A2B

Using the reactions provided in the table below, provide the ABO and Rh interpretation for the patient labeled as E.

A1B

Using the reactions provided in the table below, provide the ABO and Rh interpretation for the patient labeled as F

O

Using the reactions provided in the table below, provide the ABO and Rh interpretation for the patient labeled as G

B

Using the reactions provided in the table below, provide the ABO and Rh interpretation for the patient labeled as H

possible Bombay

Use the reactions provided in the table to provide the Rh interpretation for Patient 1.

Rh positive

Use the reactions provided in the table to provide the Rh interpretation for Patient 2.

Rh Invalid

Use the reactions provided in the table to provide the Rh interpretation for Patient 3.

Rh Negative.

Use the reactions provided in the table to provide the Rh interpretation for Patient 4

Rh Invalid

Use the reactions provided in the table to provide the Rh interpretation for Patient 5.

Rh Positive

Use the reactions provided in the table to provide the Rh interpretation for Patient 6.

Rh positive

Which of the following option provides the best cause for the Rh results in Patient 2?

Patient has a positive DAT

Which of the following provides the best cause of the Rh results in Patient 4?

Patient cells are demonstrating dosage.