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Questions and Answers

Which cellular process is most directly inhibited by a drug that prevents the expression of MHC II molecules in macrophages?

  • Enzyme production for pathogen breakdown
  • Antigen presentation to T lymphocytes (correct)
  • Migration of macrophages to sites of inflammation
  • Phagocytosis of pathogens

A researcher discovers a novel pathogen that primarily targets and disables dendritic cells. What immunological consequence would be most likely to occur as a result of this infection?

  • Uncontrolled B lymphocyte proliferation and antibody production
  • Compromised activation of T lymphocytes and adaptive immune responses (correct)
  • Immediate and widespread apoptosis of macrophages
  • Overstimulation of the innate immune system, leading to septic shock

A patient with a genetic defect lacks functional mucus-secreting cells. This condition would most directly impair which aspect of the immune system?

  • Activation of T lymphocytes
  • Antigen presentation by macrophages
  • The first line of defense against pathogens (correct)
  • Monocyte differentiation into macrophages

If a disease specifically impairs the ability of monocytes to differentiate into macrophages, which immunological function would be most significantly affected?

<p>Antigen presentation to T lymphocytes and phagocytosis (D)</p> Signup and view all the answers

How would the absence of T lymphocytes affect the function of B lymphocytes?

<p>B lymphocytes would not undergo somatic hypermutation and affinity maturation. (B)</p> Signup and view all the answers

How does the adaptive immune response differ from the innate immune response in terms of its reaction to repeated exposures to the same antigen?

<p>The magnitude of the adaptive immune response increases with each exposure due to immunologic memory, whereas the innate response remains constant. (C)</p> Signup and view all the answers

Which aspect of the adaptive immune response allows it to differentiate between self and non-self antigens?

<p>The presence of recognition receptors on cells involved in the adaptive immune response. (D)</p> Signup and view all the answers

In the context of the adaptive immune response, what is the primary role of B lymphocytes upon encountering a specific antigen?

<p>To transform into plasma cells and produce antibodies specific to the antigen. (C)</p> Signup and view all the answers

How does the specificity of antibodies produced during the adaptive immune response contribute to its effectiveness?

<p>Antibodies bind only to the specific antigen that triggered their production, ensuring a targeted response. (C)</p> Signup and view all the answers

What is the key distinction between humoral and cell-mediated immunity within the adaptive immune response?

<p>Humoral immunity involves antibodies produced by B lymphocytes, while cell-mediated immunity involves the action of T cells. (B)</p> Signup and view all the answers

Why is immunohematology primarily concerned with humoral immunity?

<p>Because intravenous administration of antigens primarily leads to the production of antibodies. (D)</p> Signup and view all the answers

What characteristic of the innate immune response distinguishes it from the adaptive immune response?

<p>The innate immune response lacks immunological memory and responds with the same magnitude upon each exposure. (A)</p> Signup and view all the answers

How does the interaction between humoral and cell-mediated immunity contribute to overall immune function?

<p>They collaborate and influence each other, enhancing the overall ability to recognize and respond to threats. (B)</p> Signup and view all the answers

In the context of immunohematology, what is the most critical distinction the immune system must make to prevent harmful reactions during transfusions?

<p>Recognizing the difference between self and non-self antigens on blood cells. (C)</p> Signup and view all the answers

Which of the following scenarios would MOST directly exemplify a failure in the immune system's ability to differentiate self from non-self, leading to complications in immunohematology?

<p>Transfusion leading to the destruction of the recipient's own red blood cells. (A)</p> Signup and view all the answers

If a patient exhibits an adverse reaction to a blood transfusion, characterized by the destruction of transfused cells, which immunological process is MOST likely responsible?

<p>A previously sensitized recipient attacks the transfused cells due to recognition of non-self antigens. (D)</p> Signup and view all the answers

How does the role of neutrophils in bacterial infections directly relate to the principles of immunohematology in transfusion medicine?

<p>Neutrophils in the recipient's blood can be activated by antibodies against transfused red blood cells, exacerbating transfusion reactions. (D)</p> Signup and view all the answers

Which aspect of myeloid progenitor cell differentiation is of GREATEST significance in immunohematology, considering the potential for transfusion reactions?

<p>The expression of blood group antigens on the surface of cells derived from myeloid progenitors. (D)</p> Signup and view all the answers

In what way does an understanding of basic immunology MOST significantly contribute to safe practices in blood banking and transfusion medicine?

<p>It allows for the precise matching of blood components to prevent alloimmunization and minimize transfusion reactions. (B)</p> Signup and view all the answers

How do mechanical barriers and secreted molecules work alongside cellular components to prevent infectious agents from causing complications during blood transfusions?

<p>They prevent the entry of infectious agents into the donor during the donation process, minimizing the risk of contamination. (B)</p> Signup and view all the answers

Why is comprehending immune responses crucial for dealing with cellular element transfusions?

<p>Helps predict and prevent potential problems. (C)</p> Signup and view all the answers

In a scenario where both parents have the genotype AB, what is the probability that their offspring will have blood type O?

<p>0% (A)</p> Signup and view all the answers

Considering the complexity of HLA genes and their role in organ transplantation, which of the following statements is most accurate?

<p>The complexity of HLA genes makes finding a perfect match for organ transplantation difficult, even among twins. (B)</p> Signup and view all the answers

If two individuals, one with genotype AA and the other with genotype BB, have offspring, what is the expected phenotypic ratio in their children?

<p>100% Blood Type AB (B)</p> Signup and view all the answers

What is the likelihood of a parent with blood type BO and a parent with blood type AB having a child with blood type B?

<p>50% (A)</p> Signup and view all the answers

In the context of codominance, how are two different dominant genes expressed in an individual's phenotype?

<p>Both genes are expressed fully and independently. (D)</p> Signup and view all the answers

Considering a scenario of blood type inheritance, if one parent has blood type AB and the other has blood type O, what blood types are impossible in their offspring?

<p>B and AB (A)</p> Signup and view all the answers

In the context of dominant inheritance, what is the most likely outcome when a dominant gene is paired with a recessive gene?

<p>The dominant gene will be expressed, masking the recessive gene. (C)</p> Signup and view all the answers

With the understanding that 'double dose' of a dominant gene/allele results in increased expression, contrast this with co-dominance. Which is the most accurate statement?

<p>In co-dominance, both alleles are expressed <strong>equally</strong>; a double dose of a single dominant allele increases the level of expression of <strong>only that allele</strong>. (D)</p> Signup and view all the answers

In a paternity case, direct exclusion definitively disproves paternity, whereas indirect exclusion:

<p>Indicates a possible, but not definitive, exclusion due to factors like suppressor genes. (C)</p> Signup and view all the answers

Why is the Hardy-Weinberg equation limited in applicability to urban populations?

<p>High migration rates in urban areas disrupt the genetic equilibrium assumed by the equation. (B)</p> Signup and view all the answers

How has the advent of DNA testing impacted the role of traditional blood typing in paternity testing?

<p>Blood typing is primarily used as a screening tool, while DNA testing provides more definitive results. (C)</p> Signup and view all the answers

What is the significance of the 'obligatory gene' in paternity testing?

<p>It is a gene that is expected to be passed on from the alleged father to the child. (C)</p> Signup and view all the answers

In the context of indirect exclusion in paternity testing, what is a 'suppressor gene'?

<p>A gene that prevents the expression of another gene, potentially masking the presence of an 'obligatory gene'. (B)</p> Signup and view all the answers

What is a key distinction in the interpretation of results between direct and indirect exclusion in paternity testing?

<p>Direct exclusion definitively rules out paternity, while indirect exclusion suggests a possibility but is not conclusive on its own. (B)</p> Signup and view all the answers

Why is relying solely on the absence of the Jka antigen on a potential father considered indirect exclusion?

<p>A suppressor gene could be preventing the expression of Jka, and the father could still be the biological parent. (C)</p> Signup and view all the answers

In cases where a potential father does not express an expected 'obligatory gene', what additional information would be most useful to definitively exclude paternity?

<p>Analysis of other independent genetic markers to confirm or refute the biological relationship. (B)</p> Signup and view all the answers

Which characteristic of the constant region of an antibody is MOST critical in determining its functional role, such as complement activation or cell attachment?

<p>Its unique amino acid sequence, specific to each antibody class. (C)</p> Signup and view all the answers

If a patient's red blood cells strongly react with anti-Rh antibodies, posing a risk for a transfusion reaction, which type of molecule MOST likely caused the sensitization?

<p>Proteins, as they are the primary component of Rh blood group antigens and strong immunogens. (A)</p> Signup and view all the answers

In forensic testing, if a blood sample is suspected to have a mixed origin, which red cell antigen system would be MOST informative for distinguishing between different individuals' contributions?

<p>MNSs system, as it consists of multiple, independently inherited alleles, offering high variability. (D)</p> Signup and view all the answers

A researcher aims to develop a highly specific diagnostic test to identify a rare blood group antigen. Which molecular property of antibodies should they PRIMARILY focus on manipulating to achieve the highest specificity?

<p>Engineering the variable region to precisely match the unique epitope of the rare antigen. (D)</p> Signup and view all the answers

Which of the following is the MOST accurate explanation for why intravenous administration is often favored over other routes when inducing an immune response with red cell antigens?

<p>Intravenous routes allow direct delivery of the antigen into the circulation, promoting systemic exposure and immune cell interaction. (A)</p> Signup and view all the answers

A newborn presents with hemolytic disease due to maternal antibodies targeting fetal red blood cells. Which antibody isotype is MOST likely responsible for crossing the placenta and causing this condition?

<p>IgG, as it is the only isotype capable of significant placental transfer. (A)</p> Signup and view all the answers

In a patient with selective IgA deficiency, which compensatory mechanism is MOST likely to maintain immune protection at mucosal surfaces?

<p>Upregulation of IgG transport into mucosal secretions. (B)</p> Signup and view all the answers

Which scenario BEST illustrates how the hinge region of an antibody facilitates its function in response to complex antigens?

<p>Enabling the antibody to bind simultaneously to multiple antigens with varying spatial arrangements. (A)</p> Signup and view all the answers

A researcher discovers a novel red cell antigen expressed in a unique ethnic population. What approach would BEST determine the biochemical nature (glycolipid, glycoprotein, or protein) of this new antigen?

<p>Performing enzymatic digestion with specific enzymes to selectively degrade lipid, carbohydrate, or protein components followed by serological testing. (D)</p> Signup and view all the answers

During a blood transfusion, a patient experiences a severe hemolytic reaction due to incompatibility in a minor blood group system. Which aspect of the recipient’s immune system MOST directly mediates the rapid destruction of the transfused red blood cells?

<p>Pre-existing antibodies in the recipient’s serum bind to the donor's red cells and activate the complement system. (D)</p> Signup and view all the answers

A patient’s red blood cells are treated with enzymes that cleave sialic acid residues, resulting in altered reactivity with certain antibodies. Which blood group system is MOST likely affected by this treatment?

<p>MNSs system, since some of its antigens, such as M and N, rely on sialic acid for their expression. (C)</p> Signup and view all the answers

A researcher is developing a novel therapeutic antibody that targets a specific receptor on malignant B cells. To enhance its efficacy in eliminating these cells, which modification to the antibody’s constant region would be MOST effective?

<p>Modifying the constant region to enhance complement-dependent cytotoxicity (CDC) or antibody-dependent cell-mediated cytotoxicity (ADCC). (C)</p> Signup and view all the answers

A laboratory is investigating a series of transfusion reactions where standard compatibility testing showed no irregularities. What follow-up action would BEST identify potential rare or novel red cell antigen incompatibilities?

<p>Performing extensive red cell phenotyping to identify rare or variant antigens. (A)</p> Signup and view all the answers

A research team is studying the genetic basis of blood group antigen expression in a remote indigenous population. What genomic approach would MOST comprehensively identify novel variations influencing red cell antigen profiles?

<p>Conducting genome-wide association studies (GWAS) to identify novel loci associated with red cell antigen expression. (D)</p> Signup and view all the answers

A patient with a history of multiple transfusions develops an unexpected antibody against a high-frequency red cell antigen. Which strategy is MOST appropriate for managing future transfusion needs for this patient?

<p>Identifying and transfusing antigen-negative red blood cells from rare, matched donors. (B)</p> Signup and view all the answers

How does the formation of antigen-antibody complexes primarily rely on weak interactions?

<p>Through the exclusion of water, which promotes weak bonds within the antigen-antibody complex. (B)</p> Signup and view all the answers

What determines an antibody's ability to activate the classical complement pathway?

<p>The isotype of the antibody's Fc region. (D)</p> Signup and view all the answers

Which of the following steps is directly mediated by the C1 complex in the classical complement pathway?

<p>Cleavage of C4 and subsequent activation of C2. (B)</p> Signup and view all the answers

What enzymatic activity does the C3 convertase complex (C4b2a) directly exhibit within the classical complement pathway?

<p>It cleaves C3, leading to the opsonization and further complement activation. (C)</p> Signup and view all the answers

Which event MOST directly follows the activation of C5 convertase in the classical complement pathway, leading towards cell lysis?

<p>Cleavage of C5 into C5a and C5b, with C5b binding to the cell membrane. (C)</p> Signup and view all the answers

What critical function does C6 serve in the formation of the membrane attack complex (MAC)?

<p>It stabilizes C5b on the cell membrane, allowing for subsequent binding of other complement proteins. (D)</p> Signup and view all the answers

How does the membrane attack complex (MAC) cause cell lysis?

<p>By disrupting the cell membrane's integrity, leading to osmotic lysis. (B)</p> Signup and view all the answers

What is the significance of achieving an equilibrium in concentrations of antigens and antibodies in immunohematological reactions?

<p>Enhances the avidity of antibody binding, leading to stronger and optimum reactions. (D)</p> Signup and view all the answers

In a scenario where an individual inherits a dominant gene for a specific blood group antigen but fails to express the antigen, which genetic mechanism is MOST likely responsible for this lack of expression?

<p>Inheritance of a suppressor gene that inhibits the expression of the dominant gene. (B)</p> Signup and view all the answers

Which of the following best describes the relationship between allelic genes within a blood group system?

<p>Allelic genes are antithetical, representing different forms of a gene that can occupy the same locus. (D)</p> Signup and view all the answers

How does the presence of a 'silent,' 'amorph,' or 'null' gene typically affect the expression of blood group antigens?

<p>It prevents the production of a specific antigen due to lack of gene product. (B)</p> Signup and view all the answers

If two individuals, both heterozygous for a dominant blood group gene but also carrying a suppressor gene, have offspring, what is the MOST likely outcome regarding the expression of that blood group antigen in their children?

<p>The antigen expression will vary depending on whether the suppressor gene is also inherited, potentially leading to some offspring not expressing the antigen even with the dominant gene present. (D)</p> Signup and view all the answers

In the context of polymorphic genes within blood group systems, what is the PRIMARY implication of having multiple alleles at a particular locus?

<p>Increased diversity in antigen expression, contributing to a wider range of blood types within a population. (C)</p> Signup and view all the answers

Which scenario would MOST likely result in an individual with a blood type that appears to contradict Mendelian inheritance patterns based solely on the parents' blood types?

<p>An individual inherits a rare suppressor gene that prevents the expression of an expected dominant blood group antigen. (A)</p> Signup and view all the answers

How do amorphic genes directly impact the expression of blood group antigens in an individual's phenotype?

<p>They result in the absence of the corresponding antigen because they do not produce a functional gene product. (A)</p> Signup and view all the answers

An individual with the genotype AO, hh will phenotypically express which ABO blood group?

<p>None (B)</p> Signup and view all the answers

Which scenario would MOST likely result in an individual with a seemingly 'O' blood type despite possessing A or B genes?

<p>A rare suppressor gene preventing the expression of A and B transferases. (A)</p> Signup and view all the answers

A mother with blood type A and a father with blood type B have a child with blood type O. What are the MOST probable genotypes of the parents?

<p>Mother AO, Father BO (C)</p> Signup and view all the answers

In a population with a high frequency of the Bombay phenotype (hh), which genetic testing strategy would be MOST effective in accurately determining paternity in cases involving individuals phenotypically typed as blood group O?

<p>Testing for the presence/absence of the FUT1 gene. (C)</p> Signup and view all the answers

An individual is found to have a rare genetic mutation that completely inactivates the FUT1 gene. How would this MOST directly affect their red blood cell antigen expression?

<p>Suppression of A, B, and H antigen expression, resulting in the Bombay phenotype. (A)</p> Signup and view all the answers

A researcher discovers a new glycosyltransferase enzyme that modifies the H antigen, creating a novel red blood cell antigen. If this enzyme is controlled by a single dominant gene, what is the probability that an offspring will inherit this novel antigen if one parent is heterozygous for the gene and the other parent does not carry the gene?

<p>50% (A)</p> Signup and view all the answers

A patient with the Bombay phenotype (hh) requires a blood transfusion. Which type of blood is MOST suitable for this patient?

<p>Bombay phenotype (hh) blood (B)</p> Signup and view all the answers

In a scenario where a person who is a 'SeSe' secretor also inherits the 'H' gene, how would this influence their expression of ABO blood group antigens?

<p>It would lead to the presence of soluble A, B, and H antigens found in secretions (A)</p> Signup and view all the answers

A researcher is studying the genetic inheritance patterns of a rare blood group antigen in a family. They observe that the antigen is present in every generation, and affected individuals always have at least one affected parent. This pattern is MOST consistent with which mode of inheritance?

<p>Autosomal dominant (B)</p> Signup and view all the answers

If two individuals, both heterozygous for the Se gene (Se/se), have offspring, what is the probability that their child will be a non-secretor (se/se)?

<p>25% (C)</p> Signup and view all the answers

How does the molecular structure of IgM antibodies directly contribute to their characteristic reactivity at lower temperatures?

<p>The pentameric structure promotes increased avidity at lower temperatures, enhancing agglutination. (A)</p> Signup and view all the answers

Why does the IgG isotype's ability to cross the placenta present a complex challenge in immunohematology regarding hemolytic disease of the fetus and newborn (HDFN)?

<p>Maternal IgG antibodies, if specific to fetal red cell antigens, can cross the placenta and cause hemolysis. (D)</p> Signup and view all the answers

How does the use of Low Ionic Strength Solution (LISS) in immunohematological testing enhance antibody-antigen reactions?

<p>LISS reduces the electrical repulsive forces between red blood cells, promoting agglutination. (A)</p> Signup and view all the answers

If both parents are phenotypically blood type B, but genotypically heterozygous (BO), what is the theoretical probability that their offspring will phenotypically express blood type O?

<p>25% (C)</p> Signup and view all the answers

What is the central genetic principle that explains why individuals with both A and B genes express both A and B antigens on their red blood cells?

<p>Codominance (C)</p> Signup and view all the answers

In a scenario where accurate red cell antigen phenotyping is crucial, which quality control measure would MOST effectively ensure the reliability of test results?

<p>Employing a multi-tiered validation process utilizing multiple methodologies and independent interpretation. (C)</p> Signup and view all the answers

How does the concentration gradient of immunoglobulin isotypes in serum, generally ordered as GAMDE (IgG, IgA, IgM, IgD, IgE) from highest to lowest, influence the choice of diagnostic tests in immunohematology for detecting specific antibodies?

<p>More sensitive techniques are typically required for detecting lower concentration isotypes to ensure clinical relevance. (B)</p> Signup and view all the answers

How would the genetic phenomenon of 'suppressor genes' impact the expected inheritance patterns and phenotypic expression of ABO blood group antigens?

<p>Suppressor genes could prevent the expression of the ABO gene, potentially mimicking the Bombay phenotype even if the individual possesses A, B, or O alleles. (D)</p> Signup and view all the answers

In complex cases of disputed parentage, what is the role of statistical analysis, such as calculating the probability of paternity, after genetic testing has identified potential matches and exclusions?

<p>To quantify the strength of the genetic evidence supporting paternity, especially when a direct exclusion is not present, by comparing the likelihood of the alleged father being the true father versus a random, unrelated individual. (B)</p> Signup and view all the answers

How do advancements in molecular techniques, like next-generation sequencing, enhance the accuracy and scope of red cell antigen genotyping compared to traditional serological methods?

<p>Molecular techniques provide increased accuracy and scope by directly identifying genetic variations responsible for antigen expression, surpassing the limitations of serological methods which infer genotypes from antigen presence. (C)</p> Signup and view all the answers

If an individual inherits a gene for blood group antigen A from chromosome 9 and a gene for Kell antigen K from chromosome 7, how will these antigens be expressed according to the principle of independent assortment?

<p>Both A and K antigens will be expressed independently on the red cell surface without influencing each other's expression. (A)</p> Signup and view all the answers

In a scenario where an individual has the phenotype Jk(a+b-), which of the following statements MOST accurately describes their genotype and antigen expression?

<p>The individual has a double dose of the Jka antigen, indicating a homozygous condition for the Jka allele. (B)</p> Signup and view all the answers

When testing for the Jka antigen using anti-Jka antibodies, a strong three-plus reaction is observed. What is the MOST likely reason for this strong reaction?

<p>There are numerous Jka antigen sites on the red cell surface, allowing many anti-Jka antibodies to bind. (C)</p> Signup and view all the answers

Given that the M and N genes are located closely to the Ss genes, what is the significance of this proximity in terms of inheritance?

<p>Crossing over occurs frequently, leading to new combinations; however, because of the close proximity, the likelihood of inheriting the M/N and S/s genes together is higher than if they were on separate chromosomes. (B)</p> Signup and view all the answers

If two parents, both with blood type AB, have multiple children, what blood types are definitively possible in their offspring according to Mendelian inheritance?

<p>Blood types A, B, and AB are possible in their offspring. (B)</p> Signup and view all the answers

What is the fundamental principle behind the use of genograms in illustrating the law of independent assortment?

<p>Genograms illustrate how different blood group genes, located on separate chromosomes, segregate independently during inheritance. (B)</p> Signup and view all the answers

How does the understanding of independent assortment specifically inform transfusion practices in immunohematology?

<p>It stresses the importance of testing for a wide array of independently assorted blood group antigens to ensure compatibility and prevent adverse reactions. (B)</p> Signup and view all the answers

What is the MOST significant implication of understanding that the ABO blood group originates from chromosome 9 and the Kell blood group from chromosome 7?

<p>It underscores the independent inheritance of ABO and Kell blood group antigens, necessitating separate testing for each system to ensure compatibility. (C)</p> Signup and view all the answers

An individual has a genotype that results in the expression of both M and N antigens, but lacks the expression of big S antigen on their red blood cells. Considering the relationship between M/N and S/s genes, what can be definitively concluded about their S antigen status?

<p>The individual likely inherited an M/N allele linked to the <em>s</em> allele, resulting in the absence of <em>S</em> expression. (D)</p> Signup and view all the answers

If a patient requires a blood transfusion and possesses a rare combination of Kidd and MNS blood group antigens, how might the principle of independent assortment complicate the selection of compatible blood?

<p>It increases the complexity of finding compatible blood, as the rare combination requires screening for specific alleles across multiple independently assorted blood group systems. (B)</p> Signup and view all the answers

An antigen with multiple epitopes elicits the production of various antibodies. How does the specificity of these antibodies correlate with the epitopes?

<p>Antibodies produced for different epitopes tend to cross-react if they share a common determinant. (C)</p> Signup and view all the answers

If a novel antigen is introduced into a host, what properties would classify it as a potent immunogen relative to other antigens?

<p>Molecular weight exceeding 10,000 Daltons and a complex protein structure. (A)</p> Signup and view all the answers

In the context of antigen recognition, how are allogeneic and autologous antigens differentiated by the immune system, and what is the outcome of each interaction?

<p>Allogeneic antigens are recognized as foreign and elicit an immune response, while autologous antigens are tolerated as 'self'. (A)</p> Signup and view all the answers

An experimental drug is designed to selectively inhibit the presentation of a specific alloantigen. What cellular mechanism would this drug MOST likely target?

<p>Interference with MHC molecule loading and presentation by antigen-presenting cells (B)</p> Signup and view all the answers

How would an absence or deficiency in T helper cells specifically affect the ability of B lymphocytes to respond to complex protein antigens, such as those found on viral surfaces?

<p>B lymphocytes would be unable to undergo somatic hypermutation, resulting in antibodies with low affinity for the antigen. (D)</p> Signup and view all the answers

Flashcards

First Line of Defense

The body's initial defense against pathogens, preventing their entry.

Components of First Defense

Includes skin and mucus-secreting cells.

Monocyte-Macrophage Role

Phagocytic cells that present antigens to T cells.

Antigen Presentation

Dendritic cells and macrophages are crucial in this process.

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T Lymphocytes (T cells)

White blood cells that mature in the thymus and are key in cell-mediated immunity.

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Immunohematology

The science encompassing blood group antigens and antibodies, focusing on immune responses to transfused cellular elements.

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Immune System

An integrated network of cells, tissues, organs, and molecules that defends the body.

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Immune System Functions

Defense against infectious agents, recognition of self vs. non-self, and elimination of foreign substances.

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Location of Immune Responses

Immune responses occur in the blood and lymphoid organs.

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Myeloid Progenitor Cell

A type of progenitor cell that differentiates into granulocytes.

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Polymorphonuclear cells (PMN)

Granulocytes, including neutrophils, eosinophils, and basophils.

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Neutrophil

The most numerous type of granulocyte, very active during bacterial infections.

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Site of Immune Cell Production

The bone marrow.

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Innate Immunity

The body's first line of defense against pathogens.

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Innate Physical Barriers

Physical barriers like skin and mucous membranes.

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Characteristics of Innate Response

Produces the same magnitude response each time and lacks memory.

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Adaptive Immunity

Involves antibodies (humoral) or T-cell actions (cell-mediated).

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Adaptive Response Properties

Immunologic memory and specificity to recognize self from non-self.

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Adaptive Immunity - Repeated Exposure

Repeated exposure leads to a stronger response.

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Antibody Specificity

Antibodies are highly specific to a particular agent.

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B Lymphocytes

They are activated to become plasma cells and produce antibodies.

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Blood Type AB

A blood type where both A and B alleles are expressed equally.

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Codominant Inheritance

A type of inheritance where both alleles are expressed if different.

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Dominant Gene

An allele that expresses its trait even when paired with a recessive allele.

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Dominant Inheritance

If inherited two dominant genes, although different, both of their gene products will be expressed.

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Pairing with Recessive Gene

If paired with a recessive gene, it will still be expressed

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Organ Transplantation Matching

Organ rejection, but due to the complexity of HLA gene, finding match for organ transplantation is quite difficult; even for the case of twins.

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Genotype Present in Blood Type

AA, AB, BB

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Percentage Distribution

AA → ¹⁄ or 25%, AB → ¹⁄ or 50%, BB → ¹⁄ or 25%

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Homozygous Population Proportion

The proportion of individuals with either two identical dominant alleles or two identical recessive alleles for a specific gene.

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Gene Frequency Equation Applicability

Applies to communities with stable populations and no migration; not typically applicable in urban areas due to population movement.

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DNA Paternity Testing

A type of relationship testing that involves DNA analysis to establish or disprove paternity.

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Blood Typing in Paternity

A screening method used in paternity testing, but not a confirmatory test.

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Obligatory Gene

Testing that relies on the expected inheritance of a gene from the father to the child.

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Indirect Exclusion

Paternity exclusion based on the absence of an expected gene in the child; absence could be due to a suppressor gene.

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Indirect Exclusion Cause

Paternity exclusion based on the father not having the factor/antigen but is present in baby (not mother). The absence of the gene in the father could be due to the presence of a suppressor gene.

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Suppressor Gene

A factor that prevents the expression of or suppresses the antigen found on the gene.

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Intravenous Administration

Introducing a substance directly into a vein. This route is often the most effective for triggering an immune response.

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Blood Group Systems

A comprehensive classification system for blood, encompassing 29 recognized systems and over 250 unique red cell antigens.

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Inheritance of RBC Antigens

Red blood cell antigens are determined by inherited genes, leading to a unique antigen profile for each individual.

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Three Forms of RBC Antigens

Glycoproteins, glycolipids, and proteins constitute the three primary forms of red blood cell antigens.

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Glycolipid Antigens

ABO, Lewis, Li, and P blood group systems are examples of antigens formed from a combination of proteins and lipids.

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Protein Antigens

Rh, M, and N blood group systems are very effective at inducing an immune response.

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Antibodies

Antibodies are proteins produced by plasma cells (activated B cells) that specifically recognize and bind to antigens.

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Antibody Variable Region

The variable region is critical for binding to specific antigens.

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Antibody Constant Region

The constant region determines the antibody class and its effector functions, such as complement activation.

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IgE and IgD Location

IgE is typically found on the surface of basophils and mast cells, while IgD resides on the surface of B lymphocytes.

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IgG and IgM Location

IgG is mainly found in the serum, and IgM is primarily located on the surface of B cells.

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IgA Location

IgA is predominantly found in secretions such as mucus, saliva, and tears.

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Antibody Hinge Region

The hinge region is a flexible area in the antibody molecule that allows for movement and adjustment during antigen binding.

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Papain Action on Antibodies

The enzyme papain cleaves antibodies into three fragments.

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Glycoproteins

Glycoproteins are a combination of carbohydrates and proteins.

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Activation (Ag-Ab)

Weak bonds formed due to water exclusion in antigen-antibody complexes.

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Affinity (antibody)

The strength of attraction between an epitope and an antibody's binding site.

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Classical Complement Pathway Initiation

Initiated by antigen-antibody interaction. C1qrs cleaves C4 into C4a (lost) and C4b (retained).

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C3 Convertase Formation

C4b binds C2, which is cleaved into C2a (retained) and C2b (lost). C4b2a forms C3 convertase.

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C5 Convertase Formation

C4b2a cleaves C3. C3b joins C4b2a to form C4b2a3b, now the C5 convertase.

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C5b Attachment

C5 convertase cleaves C5 into C5a and C5b. C5b attaches to the cell membrane and is rapidly inactivated unless bound with C6.

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Membrane Attack Complex (MAC)

C5b joins with C6, C7, C8, and C9 to form C5b6789, the membrane attack complex (MAC).

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MAC Function

The MAC induces cell lysis by creating pores in the cell membrane.

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IgM Antibody

Cold reacting; Monomer; Not reactive at body temperature (22-24°C or lower).

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IgG Antibody

Warm reacting; Pentamer; Reactive at body temperature; Can cross the placenta.

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Potentiators

Increase rate of reaction by reducing the electrical potential between red cells.

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22% albumin

A solution containing protein derived from human blood; Enhances antibody reactions

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Low Ionic Strength Solution (LISS)

A solution containing protein derived from human blood; Enhances antibody reactions by increasing ionic strength.

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Genotype

The genetic makeup of an individual, including both expressed and unexpressed genes.

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Phenotype

The observable traits or characteristics of an individual, based on their genetic makeup.

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Codominance in Blood Type

If parents have A and B genes, both antigens will be expressed.

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Nitrogenous Bases

The building blocks of DNA, including adenine, thymine, guanine, and cytosine.

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Possible Offspring Blood Types

Parent AO and B, offspring can have AB, AO, BO or OO (OO as homozygous while rest is heterozygous)

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Independent Assortment

The independent inheritance of genes on different chromosomes. Genes are expressed separately.

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Genogram

Illustrates the law of independent assortment.

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Phenotype “A”

Presence of A antigen implies genotype AO or AA.

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Jk (a+ B-) Phenotype

Presence of Jka antigens on red cells; absence of Jkb antigen.

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ABO Blood Group Location

These antigens come from chromosome 9.

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Kell Blood Group Location

K and k antigens come from chromosome 7.

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Anti-Jka Antibodies

Antibodies attach to all red cells with Jka antigens.

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Jka Antigen Testing

The antibody used to test is anti-Jka antibodies and it gives a 3+ reaction

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M/N Gene Relationship

M and N genes cannot be both present on the red cell.

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S and s Gene Location

Big S and Small s.

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HLA

Human Leukocyte Antigen; important in tissue typing for organ transplants.

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Organ Transplant Match

Matching HLA types between donor and recipient to minimize rejection.

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HLA Complexity

A complex blood group system with numerous possible antigen combinations.

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Lu Antigens

Antigens of the Lutheran blood group system.

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Lu(a-b-)

Absence of both Lu(a) and Lu(b) antigens.

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Lu(a-b-) Inheritance

A recessive inheritance pattern in the Lutheran blood group system.

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Separate Expression

While being on separate chromosomes, their genes are expressed separately.

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Separately Expressed Genes

Both genes, though from separate chromosomes, express separately.

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Independent Inheritance

Genes for separate blood groups are inherited independently.

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Allelic Genes

Genes located at the same locus on a chromosome which determine a particular trait.

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Antithetical Genes

Having only one form of a gene present at a particular locus on a chromosome.

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Polymorphic Genes

Genes with more than one allele occupying a particular locus on a chromosome.

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Gene Loci Specificity

Loci that can only contain one specific gene.

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Silent/Amorph/Null Genes

Genes that do not code for any product.

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Action of Suppressor Genes

Suppressor genes inhibit the expression of other genes regardless of dominance.

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Suppressor Gene Impact

Despite inheritance of dominant genes, the suppressor genes inhibit product expression.

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Immunogen

Substances that elicit a specific immune response; all immunogens are antigens.

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Antigen

An antigen that is capable of producing a specific immune response.

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Epitopes

Small, unique regions on an antigen recognized by antibodies.

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Alloantigens

Antigens from the same species but a different individual.

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Autologous Antigens

Antigens that are normally tolerated by the immune system.

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Study Notes

Immunology and Serology

  • The science of Immunohematology embodies blood group antigens and antibodies
  • Immunohematology relies on immunology for understanding immune responses to cellular element transfusions
  • The body's immune system is a network of cells, tissues, organs, barriers, and molecules
  • The immune system has three main functions: defense, homeostasis, and surveillance

Cells of the Immune System

  • Immune responses mainly in blood and lymphoid organs
  • Most immune cells originate in bone marrow from the same stem cells, differentiating into myeloid and lymphoid lineages
  • Myeloid Progenitor Cells differentiate into granulocytes such as:
  • Neutrophils: Active in bacterial infections, migrate to tissues during infection through diapedesis
  • Eosinophils: Contain major basic protein, important for fighting parasites
  • Basophils: Granules contain histamine, mediate hypersensitivity responses
  • Mast Cells: Found in tissues, also trigger hypersensitivity reactions
  • Monocytes:
  • Become dendritic cells or macrophages, antigen-presenting cells
  • Capture and break down antigens through phagocytosis
  • Present antigenic remnants to T lymphocytes
  • Lymphoid Stem Cells give rise to lymphocytes
  • NK cells release chemicals to kill infected, foreign, and tumor cells
  • T lymphocytes/cells: Key immune cells that mature in the thymus

T Cell Classes

  • T-helper cells: (CD4+) Activate macrophages and B cells by secreting cytokines and determine immune responses
  • T-cytotoxic cells: (CD8+) Kill infected/foreign cells and tumors using chemicals such as perforins & granzymes

Lymphocyte Details

  • B Lymphocytes are produced and mature in the bone marrow, differentiating into plasma cells
  • Plasma cells activated by T-helper cells produce antibodies (humoral immunity) to block infections
  • They are Derived from the bone marrow stem cells, and are involved in humoral immunity
  • They transform into plasma cells to produce antibodies

B Lymphocyte Activation

  • There are two ways B Lymphocytes are activated
  • Binding of an antigen to IgD/IgM on B cell surfaces activates B cells; and become plasma cells = antibody secretion
  • Cytokine signaling from T-helper cells activates B cells and become plasma cells, and release antibodies

Innate vs Adaptive Immunity

  • Innate immunity involves the first line of defense against pathogens and physical barriers
  • Including: skin, Mucus, secreting cells, enzyme producing cells
  • Phagocytic cells and chemical mediators also promote inflammatory responses
    • Such as: skin, Mucosal linings, HCl of stomach, Flushing action of the urine, Unsaturated fatty acids, Sweat, tears, saliva
  • Inflammation occurs if pathogens bypass the first line of defense
    • Inflammation signs: pain, heat, redness, and swelling
    • Vasodilation (increased blood vessel diameter) leads to redness and heat
    • Influx of phagocytes via diapedesis into the infected site
  • Adaptive immunity results from immunologic memory and specificity
  • Adaptive immunity involves the ability
  • The adaptive response will be the Production of antibodies specific to an infectious agent

Antigens

  • Key antigen characteristics: foreignness, high molecular weight, complexity
  • Molecular size: Antigens larger than 10,000 daltons are more effective
  • Molecular complexity: Proteins are most effective antigens, followed by carbohydrates and glycolipids
  • The Route of administration affects immune response
  • The Degree of foreign material must be identified as nonself
  • Introduced antigens which often administered intravenously to check for immune response,
  • Intravenous administration is the the best routes for inducing an immune response
  • Immunogen is an antigen that produces an immune response.
  • Epitopes (antigenic determinants) are recognized by corresponding antibodies
  • Allogeneic Antigens: From the same species, but a difference between indivduals = foreign
  • Autologous Antigens: Tolerated and known or recognized as self

Antibodies

  • Antibodies are the counterpart of antigens and are specific to them
  • They Are created by plasma cells that are activated B cells that made proteins
  • Antibodies produce 5 types of antibodies: IgG, IgA, IgM, IgE, IgD
  • Made of monomer units (some with more than one): Monomer IgG, IgE, IgD, Dimer IgA, and Pentamer IgM
  • The heavy chains unique and determine immunoglobulin class, biological function
  • Variable region: Binds to the antigen
  • Constant region: Determines Antibody class functions such as the complement.
  • IgG mainyl in the serum with antigen attachment
  • IgE and IgD antigen attachment to other cells, while IgM attach to surface of B cells
  • The Hinge region is flexible, aids antigen attachment
  • Heavy chains determine Antibody specificity
  • Papain and pepsin enzymes act on antibodies
  • Heavy chains consist IgG, which indicates gamma form

Immunoglobulin Details

  • IgM
  • Accounts for 5-10% of the immunoglobulin pool.
  • Largest antibody, a pentamer
  • Found primarily in the intravascular space, activates the classical complement pathway
  • Does not cross the placenta
  • Saline agglutinins
  • IgG
  • Most abundant in plasma (80% of the total immunoglobulin)
  • Can cross the placental which provides protection for developing fetus and during pregnancy
  • Reactivity at 37°C (body temperature)
    • Can activate the component system, through indirect agglutination and hemolysis
    • There are 4 subclasses w/ minor variations on gamma heavy cahins with slight differences in amino acids

Antigen-Antibody Complex

  • Binding relies on noncovalent forces that include:
  • Electrostatic Forces: Attraction between opposite charges
  • Hydrogen Bonds: Hydrogen shared between electronegative atoms (N, O)
  • Van Der Waals Forces: Fluctuations between electron clouds
  • Hydrophobic Forces: Exclusion of water molecules. Weak bond formed because it is formed after liquid is excluded.
  • Affinity: The tendency of an epitope for combining with the antigen binding site of antibody molecule.
  • Avidity: Represents the strength of the bond between antigen and antibody.

The Component System

  • Complement: Serum proteins that enhance immunologic processes, trigger antigenic clearance, cell lysis, and vasodilation
  • Components circulate as inactive pro-enzymes, activated during the immune response
  • Functions: opsonization, anaphylaxis, lysis, and chemotaxis
  • Opsonization: clearing of immune complexes
  • Anaphylaxis: increase smooth muscle contraction, induces inflammation
  • Lysis: Foreign antigen destruction by membrane lysis, which requires antibody to bind to antigen of red cells
  • Chemotaxis: the recruitment of platelets and phagocytes induces immune repsosnse
  • There are 3 Methods to activate the components, and include:
  • Classical Pathway, MB-Lectin Pathway, and the Alternative pathways
  • NOTE:, not all antibodies activate components, some are not able to, but can support anitbody process

Cascade Of The Classical Component cascade System:

  • Involve An Ab-Ag Complex - That results from having been introduced in the the antigen stimulus
  • C1 Component - Which recognize's portions of Antibodies which are labeled, these portions are also recognized by C1qr2
  • The combination of 4b2a is known as C3 convertase, and helps cleave your C3
  • C5 convertase will then cleave the C3, which then will lead to the membrane
  • C5 will eventually lead to MAC, a new membrane attack complex, that will induce cell lysis

Isoagglutinins

  • The term isoagglutination refers to agglutination that occurs among members of the same species
  • These are frequently the result of antibodies to the ABO
  • What occurs is that the individual to the individual of the that species

Antiserum

  • Defined as blood serum containing antibodies against a particular antigen
  • Used in tests to determine the antigen in the blood
  • If the antibodies that has to be removed then: Add Reagents Be familiar so it wont have false information, which include testing of antibody
  • Be sure and remember as well that most of the commercial are: anti- sera A/ B commercial reagem

Methods for Testing For antibodies

Forward typing is done when known antiserum or another reagent used to identify antigens on cells surface
•Reverse test- patients serum is reacted against known test cells to determine nature of antibody, is reverse typing

Important Reminders For a test

(1) Use Proper Techniques For Testing (For a valid, Accurate test) (2) Use Quality Control Methods (For a good quality test) (3) Perform All Recommended Calculations: As well, in all steps of the test (4) Note limitations/ interfering substances before doing

ABO and ABO blood groups

(1)Blood group system is based on antigens and antibodies in certain individual which then lead to recognition of blood group: A,B O individuals

    • 2 Individuals can be grouped by the antibodies, And then can be given their A B status
  • -- Individuals that are able to produce AB antigens but there’s certain individuals who can’t due to other factors

(ABO BLOOD GROUPS) A: red cells carry A antigen B red cells carry B antigen Neither: O means neither 4 In serum: Ant- A& Antibody B

Technical tests to perform

  • *Antiglobulin: (AHG) (coombs) phase or test-**
    Used to determine warm- reacting antibodies\
  • Immediate spin phase:*
    Used determine Cold- reacting antibodies
  • *Normal saline Solution ** solution: isotonic with tissue cells , so cells are in appropriate tonicity will not
  • LISS* and or 22 percentalbumin: Used as potentiators to get to react more frequently

The testing and inheritance of genes

  • -- If test is negative, it does not mean what you are testing for is there. A person cannot produce an antibody
  • --If the parents are AB blood type, that does not mean the child will be AB blood type

Technical Problems

  • Can come down to testing and can come down to error

Testing with patient

When the Forward technique and Reverse technique do not the come out the SAME is because that then there is a discrepancy

  • -- In ABO Blood Group Systems If that happens then something wrong!
  • -- When there the 2 techniques DO come out the SAME ! Then ok, there are not any problems
  • -- Forward type test tells the Antigens in the red cell --- While type tests to you the Antibodies in the plasma

The testing and inheritance of genes

O will not agglutinate to any test or type •A1 to test A antigens on red cell with specific type 1 •B will mix type B blood together •If the 2 sides that are performed do not match the 2 testing is done in correctly

Important Info To remember

Remember forward test for Antigen type; Reverse test: helps detects antibodies

Notes

Test result with the known antigens: What to expect

•Type A, then Anti-B antibody = to have Antibodies to have •B group and Ant -A antibody = to have, •Ab antibody = Both have but neither do they have any antibodies
•O types and Anti A& B antibody. That group then has Antibodies towards whatever is negative •So what to remember is that a red blood cell is then not to be produced within serum or you would have problems •One then test does not work you can test the antibody test, one of the great things perform that is is the test to check for blood •If the test doesn’t work the is a false negative as long as it is a true positive

Last Step

When performing Test

  • (1) Do testing for ABO/ Rh compatibility
  • (2) Do you the antibody screen and/ or cell identification?

Note is is most is the red cells with most important and all that are able to get to with O Neg

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