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BIOL10005 Lecture Notes - Lecture 12: Hemolytic Disease Of The Newborn, Miscarriage, Rh Blood Group System

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orchidhare159
15 Aug 2018
School
University of Melbourne
Department
Biology
Course
BIOL10005
Professor
Dawn Gleeson

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Document Summary

* 2 systems important to transfusion, abo & rhesus. * differences in blood types occur in other animals. * almost any macromolecule if foreign to the body can induce an immune response. * any molecule which induces an immune response is called an antigen (antibody generator) * the alleles determine the presence or absence of an antigen on the surface on the red blood cell. * the antigen is a glycoprotein (to which sugars are attached) embedded in the red blood cell membrane. * ia & ib are dominant to io. * agglutination of red blood cells when mixed with antibody a or antibody b determines which antigens are present i. e. blood type. * use antisera containing antibodies type a, type ab will have agglutination with anti a. Type b, type ab will have agglutination with anti b. Type o will have no agglutination with anti a or b.

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Related Questions

Define antibody screen and antibody identification.

2. Differentiate between the importance and use of the antibody screen versus antibody identification regarding each of the following:
a. Potential blood recipient
b. Donor unit
c. Prenatal/Postpartum patients
d. Recently transfused patients with positive DAT (Direct Antiglobulin Test)
e. Neonate with positive DAT

3. State the three phases of testing used in the antibody screen or antibody identification and which type of antibody can be detected in each phase.

4. State the significance of a negative antibody screen.

5. State the significance of a positive antibody screen.

6. Explain the importance of obtaining a patient transfusion and medication history when investigating a positive antibody screen.

7. Given the type of antibody identified, determine the necessary procedure for compatibility testing to provide blood for transfusion for the patient.

8. Explain the purpose of the autocontrol and its relationship to the DAT.

9. Define dosage as it relates to antibody-antigen interactions.

10. Given specific red cell antigen expression, determine if the antigen expression is homozygous or heterozygous.

11. Explain the significance of using screening and panel cells with homozygous antigen expression when performing an antibody screen or identification.

12. Explain the “3 cell rule-in” rule with regard to antibody identification for single or multiple antibodies present.

13. Explain the “rule-outs” rule with regard to antibody identification.

14. Given antibody agglutination results for an antibody identification panel, perform the “3 cell rule-in” and all “rule-outs” to identify the antibody(ies) present.

15. State which blood group antigens are destroyed by enzyme treatment and which antibodies have enhanced expression when tested against enzyme treated reagent red blood cells.

16. Define mixed field agglutination.

17. Describe specific occasions when mixed field agglutination may be present and identified.

18. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, interpret the testing results.

19. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, select the appropriate ABO/Rh type of red cell products for transfusion.

20. Given a patient history, current ABO/Rh type, antibody screening and (if applicable) antibody identification results, select the appropriate ABO type of frozen component products for transfusion.

21. Given a patient history, current ABO/Rh type, antibody screening and current or historical antibody identification results, determine the appropriate red blood cell antigen negative blood that would be required for transfusion.

22. For patients in Objective #21, given the antigen frequency of those red blood cell antigens, calculate the number of red blood cell donor units that would need to be screened for transfusion to fulfill the order requested by the physician.

23. Given a patient’s ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the most probable genotype of the patient.

24. Given a patient’s ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the most probable genotype or phenotype of the patient’s parents.

25. Given a patient’s ABO/Rh type and/or other red blood cell antigen phenotyping results, determine the antibody(ies) present in the patient’s serum or plasma.

26. Given donor physical, screening and/or history results, determine if the donor would be accepted, temporarily deferred, or permanently deferred from donating blood products

1-The ABO blood typing system is based on ..

a- Genetic testing of blood samples

b- Cell-surface proteins found on red blood cells.

c- The count of certain cells found within a blood sample.

d- Unique white blood cells found in patients withinfections.

e- A conference of the Allied Blood Organization in 1958.

2- If a patient who has lost a lot of blood is not given atransfusion of typing blood that is "matched" or compatible, butrather an incompatible transfusion, this result in ...

a- Collapse of the veins due to low blood volume and low bloodpressure.

b- Leakage of the blood out of the vascular system and into thetissues.

c- Too much oxygen in the blood, injuring the brain.

d- Immune-mediated lysis of the RBCs, breaking open the cellsand releasing toxins into the blood.

e- A life-threatening condition known as toxemia that can betreated with injection of antibiotics.

3- A person with Type B blood will have________ antibodies inthier blood?

a- Anti-A.

b- Anti-B.

c- Anti-AB

d- Anto-O

e- Anti-ABO

4- Some patients are known as universal acceptors have bloodtype..

a- A.

b- B.

c- AB.

d- O

e- Rh

5- Someone who has Type O blood is known as a universal donorbecause

a- Their red blood cells (RBC) cannot be damaged.

b- Their RBC only have the A antigen, but not the B antigen.

c- Their RBC have both the A and B antigen.

d- Their RBC have neither A nor B antigens on their surface.

e- Their RBC have the O antigen on their surface.

The A antigen (the protein that makes A blood A blood) is embedded in the red blood cell (RBC) membrane. Blood group A individuals will automatically carry antibodies (proteins that are in the blood plasma-liquid part of blood) that will attack blood group B cells. Blood group B individuals will carry antibodies that will attack blood group A cells. Blood group O individuals, lacking either of the A or B antigens will carry BOTH types of antibodies and will attack either A or B cells. When there is a transfusion with incompatible blood groups, cells can clump creating blockages in arteries throughout the body. Other pathways can lead to the lysing of RBC’s which will release their contents into the bloodstream elevating these component in the blood which can have sever effects on the heart (potassium primarily-in case you are interested).

Remember, the Rh is a typical one gene, two allele scenario. Rh+ blood can accept Rh+ or Rh- blood. A person with Rh- blood can only receive Rh- blood. Unlike ABO where an individual manufactures the antibody to an antigen they lack without prior exposure, the Rh factor requires previous exposure to illicit an immune response. If a Rh- person is exposed to Rh+ blood, the individual will create the antibody against the Rh antigen. Now, if Rh+ blood is introduced into this individual again, the recipient’s blood contains anti-Rh antibodies and will attack the Rh+ cells-Bad news for the recipient. This is the same thing that happens with an Rh- mom who gets pregnant with an Rh+ baby. By the time the first Rh+ baby is born and blood mixing may have occurred during late pregnancy (small breaks in the placenta can cause some of baby’s blood to mix with that of mom), first baby escapes unharmed. Subsequent babies aren’t so lucky.

If there are small tears in the placenta (which are normal), mom’s anti Rh antibodies can go in and attack the Rh+ baby’s blood. This can kill the baby. Now, Rh- moms are given a substance that will coat the baby’s RBC’; kind of like putting them into stealth mode so they can’t be seen by mom’s immune system. Later-poof, out pops unaffected baby.

1. What blood type(s) can be given to an A positive individual?

2. If you have B negative blood, what blood types can you receive?

3. What blood types can an O negative receive? O positive?

4. If a man is blood group B and his wife is blood group A what blood type(s) are you 100% sure they could produce in their children?

5. If you have a blood group O father and a blood group B mother, can they produce an O child? Explain your answer.

6. You have a male friend who is blood group AB. He is successful in business but knows very little about biology. His wife just had an O child. Knowing that you have been studying the genetics of blood groups, he asks you for an education on blood groups. What do you think about this situation?

7. A woman is AB and her husband is A. They have a B child. What are all the blood groups possible in their children if he is heterozygous?

8. A woman is Rh- and her husband is Rh+. Their first baby is Rh-. What is the genotype, with respect to Rh, of the parents? What is the probability their next child will be Rh+? Does the woman have to worry about any issues with future children? Explain!