Blood Banking 1 (review for BB2)

Review exam for blood banking 2 from everything learned from blood banking 1.

Can a person who is weak D form an anti-D antibody?

Yes. If a person has inherited a weak D by the mosaic model, the D antigen is missing a piece. The person can develop an antibody to the pieces of D antigen that is missing.

Transfusion medicine

Medical field dealing with transfusion of blood and blood products.

Blood banking

storing or “banking” of blood for later use

Factors influencing sensitivity of antibody detection test

cell to serum ratio, temp, length of incubation and pH

Factors that influence the second stage of agglutination?

ZETA POTENTIAL; the class of antibody involved; quantity and location of antigens on the surface of the RBC;

Factors that influence the sesitization process?

Temp of rx; pH of the medium; incubation time; ionic strength; antigen-antibody ratio;

FDA

United states Food and Drug Administration

Heterozygosity

When one chromosome of a pair carrier one allele and the other has a different allele

AABB

American Association of Blood Banks

Agglutination

Clumping of RBC in an antigen-antibody rx

Alleles

At each locus there may be various forms of the same gene called alleles

Allo

other; meaning coming from another person besides yourself ( alloantibody is an antibody a person’s immune system produces in response to exposure from a foreign antigen.

Antibody

another name for immunoglobin; a substance produced by B-call lymphocytes in response to exposure to a foreign antigen.

Antigen system that demonstrates dosage?

Rh, Kiss, MNA, Duffy and Lutheran

Antigens

Foreign substance that have the ability to elicit an immune response; also called immunogens

Antigens destroyed by use of enzymes?

MN and Duffy

Antigens enhanced by the use of enzymes?

Lewis, P, Rh and Kidd (variable)

Antigens present in person with genotype DCe/dce

D+, C+,c+,e+; No E. (d doesn’t matter)

Auto

self (autoantibody is an antibody that a persons immune system produces in response to his own antigens.)

Autosomes

twenty-two of the paired chromosomes that are not the sex chromosomes

Blood group systems with antibodies that cause HDN ?

Kidd, Ss, Rh, Kell, Duffy, Lu(b) but mild.

Blood group systems with antibodies that cause HTR?

Kidd, MN-IF in IAT, Ss, Rh, Duffy, Le(a)- if in IAT, Lu(b)

Blood group systems with immune (RBC stimulated) antibodies?

Kidd, SS, Rh, Kell, Duffy and Lu(b)

Blood group systems with naturally-occuring antibodies

ABO, Lewis, P, MN, I sometimes E of Rh system and Lu(a)

CAP

College of American Pathologist

cGMP

Current Good Manufacturing Practices- federal regulations that when followed, assures the product manufactured meets quality standards.

Check cells ( control cells)

Added at the end of an AHG procedure to make sure that washing was adequate and the procedures was performed correctly. Should always be POSITIVE.

Chromosomes

Substance on which genes are carried

Codominant

Share equal strength in expression of the trait.

DAT - Direct antiglobulin test

detects IN VIVO antibody sensitization of the RBCs

DNA

Deoxyribonucleic acid; Chromosomes are made up of DNA

Dolichos Biflorus

Anti-A1 lectin; Agglutinates A1 cells but not A2 cells.

Dosage

When an antibody reacts more strongly with an antigen resulting from a homozygous gene expression vs heterozygous expression. (double dose of gene expression vs single dose of gene expression)

Enhancement solutions for antigen-antibody reactions?

22% bovine albumin, LISS and PEG

Expected antibodies in Group A

Anti-B

Expected antibodies in group AB

NONE

Expected antibodies in group B

anti-A

Expected antibodies in group O

anti-A and anti-B

Factors influencing sensitivity of antibody detection test

cell to serum ratio, temperature, length of incubation, pH

Fisher-Race theroy of inheritance

D/d, C/c, E/e

Fisher-Race nomenclature for R2r gentotype?

DcE/dce

Gene linkage

when two genes are located close together on a chromosome and “travel” together (inherited together)

Heavy chain

the part of the immunoglobulin that classifies the type of immunoglobulin ( IgG, IgM, IgD, IgE, IgA)

Homozygosity

when both chromosomes of a pair have the same gene

Immune response

the ability of an indivdual to respond to a foreign substance that may enter or invade the body.

Immunogens

another name for Antigen. Foreign substance that have the ability to elicit an immune response.

Immunoglobulin

another name for antibody. a substance produced by B cell lymphocytes in response to exposure to a foreign antigen.

Immunohematology

the study of or the science of blood group antigens and antibodies

In blood banking, the three ways a person may be exposed to antigens?

transfusion, pregnancy and enviorment

IAT - Indirect antiglobulin test

detects in VITRO antibody sensitization of the RBCs

JCAHO

Joint Commission on Accreditation of Healthcare Organization

Who discovered the ABO system?

Karl Landsteiner

Location of blood group antigen?

surface of RBC ( this would be the donor RBC when cross matching)

Locus

A gene is located at a specific point on a chromosome called a locus

Occurrence Management

a process for detecting, reporting, evaluating and correcting deviations and non-conformances with procedures, products or service.

Phenotype

antigens that can be serologically detected in a blood sample (ABO system)

Primary response

the immune response to the initial exposure to a foreign antigen; characterized by a long lag phase, that is the time antigen exposure and antibody production. Additionally, the primary response results in IgM being the initial antibody produced with low levels of IgG production.

Prozone

too much antibody so that all of the antigen binding sites are filled with antibody, resulting in a false-negative reaction.

Quality assurance

set of planned actionsQ to provide confidence that system and elements that influence the quality of the product or service are working as expected.

Quality control

process that validates final results and quantifies variation

Quality systems

a framework for applying quality principles and practices uniformly across all lab operations.

Secondary or anamnetic response

occurs upon subsequent exposure to the same antigen and has a short lag phase and results in elevated production of IgG antibody which remain in circulation for extended periods of time.

Sensitization

first stage of an antigen-antibody reaction. the attachment of the antigen

Sex chromosomes

twenity-third pair of chromosomses. these are not autosomes. XX (female) or XY (male)

Terminal sugar in group O

L-fucose

Terminal sugar in group A

L-fucose + N-acetyl-D-galactosamine

Terminal sugar in group AB

L-fucose + N-acetyl-D-galactosamine+L-fucose+D-galactoseT

Terminal sugar in group B

L-fucose + D-galactose

Three mechanism of weak S formation?

Sterc hindrance, inherited weak expression of D antigen and mosaic model

What are the two types of immune response?

Humoral and cell-mediated

Two-loci theroy of Rh inheritance

two closely linked genes conteol expression of Rh: RHD (code for presence or absent D/d) and RHCE ( codes for Ce, cE, ce or CE)

Type of immunity medication B-cell lymphocytes?

humoral immunity

Type of immunity mediated by T-cell lymphocytes?

cellular immunity

Ulex europeaus

Anti-H lectin; reacts strongly with O cells, will not react with Oh (bombay cells)

Weiner theroy of inheritance

single gene at the Rh locus (on a chromosome) leads to expression of several distinguishable antigens.

What are the four major human blood groups?

O, A, B, and AB

What type of genetics do the blod group systems follow?

mendelian genetics or inheritance

Working cell suppression for ABO/Rh tube type?

2-5%

Cold antibodies

IgM - Lewis, I, P and MNS, ABO

Warm antibodys

IgG - Rh, Kell, Duffy, Kidd and Ss

What antibodies are naturally occurring?

IgM - lewis, I, P, MN and ABO

clinically significant

antibodies associated with transfusion and HDN. Ss, Kell, Kidd, Duffy and Lutheran

clinically insignifacnt

antibodies that so not react with transfusion or fetal health problems. Lewia, I,P,MN and Lu(a). ALL IgM antibodies do not react

Wiener —> shorthand

R0 = Dce

R1 = DCe ( C comes before E so that is why it is a 1 not a 2)

R2 = DcE

Rz = DCE

r = dce

r1=dCe

r” = dcE

ry = dCE (y means all but d is uppercase)

3 phases of IAT testing

IS (immediate spin), 37C and AHG

IS detects what antibodies?

IgM or colder - ABO, Rh, MN, lewis, P and I

37C detects what antibodies

IgM that react at 37C and IgG warm antibodies - Rh, Ss, kell, kidd and duffy

AHG detects what antibodies?

IgG Rh, kell, kidd and duffy (these are clinically significant )

Complement causes what?

Hemolysis