Blood Bank

Front 1

Name the neutrolizer of ABO Ab's

Back 1

Saliva (secretor)

Front 2

Name the neutrolizer of Lewis Ab's

Back 2

Saliva (secretor for Leb)

Front 3

Name 2 neutrolizers of P1 Ab's

Back 3

1. Hydatid cyst fluid
2. Pigeon egg fluid

Note: Turtle dove egg fluid can apparently do it too.

Front 4

Name the neutrolizer of Sda Ab's

Back 4

Urine

Front 5

Name the neutrolizer of Chido and Rodgers Ab's

Back 5

Serum/Plasma

Front 6

Name a neutralizer of anti-H Ab

Back 6

Saliva

(Also neutralizes anti- Lewis a and anti-AB"O").

Front 7

Name a neutralizer of anti-I Ab

Back 7

Breast milk

Front 8

Name the Ab's that most commonly show dosage

Back 8

Kidd, Rh, Duffy, and MNSs

Mnem: Because of dosage, kidd rides duffy up mountains

Front 9

The lectin Bandeiraea simplicifolia binds what Ag?

Back 9

B Ag

Front 10

What Ab class are most cold reacting Ab's?

Back 10

IgM

Front 11

The lectin Lotus tetragonolobus binds what Ag?

Back 11

H Ag

Front 12

The lectin Arachis hypogaea binds what Ag?

Back 12

T Ag

Front 13

What Ab class are most warm reacting (and clinically significant) Ab's?

Back 13

IgG

Front 14

What bld grp Ab system is the major exception to the general rule that most cold reacting Ab's are IgM and most warm reacting Ab's are IgG?

Back 14

ABO (though often naturally occuring and IgM-except anti-A, anti-B, or anti-A,B in grp O folks which are in fact IgG Ab's-these are indeed clinically significant)

Front 15

Name the enzyme enhanced blood groups

Back 15

1. The ABO FAMILY (ABO, Lewis, I/i, P) Mnem: "ALIP"
2. Rh blood group
3. Kidd blood group

Front 16

Name the enzyme decreased blood groups

Back 16

1. MNSs (mainly MNS-s usu. not affected)
2. Duffy

Front 17

Name the enzyme unaffected blood group(s)

Back 17

Kell

Recall Kell Ag's are destroyed by thiol reagents (e.g. ZZAP, 2ME, DTT) but not by enzymes alone!

Front 18

What is the approx.frequency of the Se gene?

Back 18

About 80%

Front 19

What is the approx. frequency of the H gene?

Back 19

About 100%

So most folks are not Bombays.

Front 20

Where are type 1 chains found and what is the composition of their R group?

Back 20

They are found in secretions and in plasma. Their R grp is composed of glycoproteins.

Front 21

What is the sugar added to type 1 chains in order to make H Ag and where is that sugar added?

Back 21

Fucose is the sugar added. It is added to the terminal galactose of type 1 chains.

Front 22

Where are type 2 chains found and what is the composition of their R group?

Back 22

They are found on RBC's. Their R grp is composed of glycosphingolipids.

Front 23

What is the sugar added to type 2 chains in order to make H Ag and where is that sugar added?

Back 23

Fucose is the sugar added. It is added to the termial galatose of type 2 chains

Front 24

What type of H Ag must be made before A and/or B Ag's can be made on rbc's?

Back 24

Type II H Ag

Front 25

What type of H Ag must be made before A and/or B Ag's can be made in secretions and/or plasma?

Back 25

Type I H Ag

Front 26

What sugar is added to the terminal galactose in order to make an A Ag?

Back 26

N-acetylgalactosamine (Gal-NAc)

Front 27

What sugar is added to the terminal galactose in order to make a B Ag?

Back 27

Galactose

Front 28

On what chromosome are the Se and/or H genes?

Back 28

Chrm 19

Front 29

On what chromosome are the ABO Ag genes?

Back 29

Chrm 9

Front 30

Besides their location (rbc's vs. secretions/plasma) what is the only big difference between type I and type 2 chains?

Back 30

Their R grps. Type I chains have a glycoprotein as the R group. Type 2 chains have a glycosphingolipid as the R group.

Front 31

What are lectins?

Back 31

They are chemicals that cause agglutination of rbc's bearing a certain antigen for which they are specific.

Front 32

For what Ag's is the lectin Dolichos biflorus specifc? Why is this important?

Back 32

1. A1
2. Sda

Is important with regard to A1 b/c it helps differentiate A1 from A2 subgroups. Dolichos biflorus agglutinates A1 subgroup rbc's but not A2 subgroup rbc's.

Front 33

For what Ag is the lectin Ulex europaeus specific?

Back 33

H

Front 34

For what Ag is the lectin Vicea graminea specific?

Back 34

N

Front 35

What is the pathogenesis behind an acquired B phenotype?

Back 35

Bacteria deacetelyate the grp A sugar (GalNac) and the remaining (now exposed) terminal galactose cross reacts with reagent anti-B to give an AB fwd grping (with weak fwd reactions with reagent anti-B).

Front 36

Name 4 "treatments" that can be used to deal with an acquired B phenotype.

Back 36

1. Acidify the serum (acidified human anti-B does not react with acquired B Ag)
2. Acetic anhydride (re-acetylates)
3. Autoincubation
4. BS-1 lectin

Front 37

What is the difference between a bombay and a para-bombay?

Back 37

Bombays totally lack H, A, and B Ag's due to lack of H AND Se genes. Parabombays are similar but have Se gene to partially comensate for their lack of H. Thus their secretions/serum testing may show H and A or B Ag (unless they are grp O) but their rbc's may type like a Bombay(i.e. no H, A or B).

Front 38

On what chain (type 1 vs. 2) only can Lewis Ag be made?

Back 38

Type 1

Front 39

Can you make Lewis b Ag if you are a non-secretor?

Back 39

No. The reason is because H Ag is required to make Lewis b. And since Lewis Ag (regardless of Lewis A or Lewis B) is only made on type 1 chains, only those who make type 1H (i.e. secretors can make Lewis b Ag). Note that H Ag is not required to make Lewis A Ag. All you need is a type 1 chain (H Ag on it is not required).

Front 40

If Lewis Ag's are only made on type I chains, then how is it that Lewis Ag's are rbc Ag's? Because recall, type I chains are found only in secretions and/or plasma, not on rbc surfaces.

Back 40

They are absorbed onto the rbc surface (and Lewis B more so than A).

Front 41

Is there an inverse relationship between the amount of H Ag present and the amount of Lewis Ag (e.g. Lewis B Ag) present on rbc's like there is with H Ag and ABO Ag?

Back 41

No

Front 42

With the exception of the ABO blood group, when Ab's are naturally occuring, are they clinically significant?

Back 42

No

Front 43

Name 2 "diseases" associated with the production of an auto-anti I.

Back 43

1. Mycoplasma pna infection.
2. Cold agglutinin dz

Front 44

Name a disease associated with the production of an auto-anti i.

Back 44

Infectious mono.

Front 45

Unlike most anti-P Ab's, the Donath-Landsteiner Ab (which is the anti-P Ab associated with PCH) is of what Ab class?

Back 45

IgG.

Front 46

Most of the Rh Ab's are immune mediated. But if one is naturally occuring, what is it MC to be?

Back 46

Anti-E.

Front 47

What is the other name for each of the following genes (i.e. FUT 1, 2, or 3)?
1. Se gene
2. H gene
3. Lewis gene

Back 47

Se gene= FUT2
H gene=FUT1
Lewis gene=FUT3

Front 48

What is the significance of LW Ag and anti-LW Ab?

Back 48

The LW Ag is expressed more strongly on D+ cells than D- cells. If anti-LW Ab's are present, they may appear to be reacting with only D+ cells, thus simulating anti-D Ab's. Thus they can make it seem like an O+ person has an anti-D Ab.

Front 49

What effect can Hodgkin lymphoma and/or leukemia have on A and B Ag's on rbcs'?

Back 49

It can give decreased/weakened expression of them leading to mixed-field agglutination.

Front 50

What effect can gastric CA have on A and B Ag's on rbc's?

Back 50

It can give increased free serum A or B Ag's which may have the effect of binding your REAGENT anti-A and anti-B thereby rendering them unable to bind to A and B Ag's on rbc's thus giving the false impression that the patient has type O cells.

Front 51

What 4 drugs are classically known to give a positive DAT/autocontrol?

Back 51

1. PCN
2. Cephs
3. Procainamide
4. Aldomet

Front 52

Name 2 relatively uncommon causes of a positive DAT/autocontrol that must be excluded (along with more common causes such as recent transfusion and drugs) before a primary autoimmunity is considered.

Back 52

1. Post-bone marrow txplant
2. Pt taking anti-lymphocyte globulin (ALG)

Front 53

The warm-reacting auto-Ab's in WAIHA are usu of what Ig class?

Back 53

IgG

Front 54

What is the only reliable CBC index in a pt with cold agglutinins?

Back 54

The hgb.

Front 55

What Ig class are most cold agglutinins?

Back 55

IgM. Thus they can activate complement in vitro and rxns can thus be seen at the AHG phase using polyspecific antisera. If monospec. reagents are used, the cells are agglutinated by anti-C3d but not anti-IgG.

Front 56

What are the Ab's in cold agglutin dz usu. against?

Back 56

Anti-I is MC.
Anti-i.
Anti-H.