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BB guy 1 b

bb guy section 1 notes from Lewis through end

QuestionAnswer
percentage of people who are Lewis (a+B+) zero. not possible
isotype of most Lewis antibodies. significance? IgM; usually not significant
What antigen does H. pylori use to attach to gastic mucosa? Lewis B antigen
Cold agglutinin disease is associated with this RBC auto-antibody Auto-anti-I
infection with this organism is associated with auto-anti-I Mycoplasma pneumoniae
Auto-anti-i is associated with this infectious agent infectious mononucleosis; EBV
This antigen is the parvovirus B19 receptor P
paroxysmal cold hemoglobinuria is associated with auto-antibodies with this specificity auto-anti-P
Is the "d" antigen a carbohydrate, lipid or a protein? No. There is no such antigen. "d" is used as a placeholder noting the absence of D antigen
Name the 4 Weiner haplotypes that account for 97% of people Only four of the above combinations occur with significant frequency: R1, R2, R0 and r. (~97% of blacks and whites use only these four).
describe racial difference in Rh haplotype differences and why that matters “The Big Four” Whites: R1 > r > R2 > R0 Blacks: R0 > r > R1 > R2
briefly outline Rh genetics/structure 2 genes on chromosome 1; RHD,RHCE
outline different mechanisms of D-negative phenotype 1) caused by mutations and deletions rather than by synthetic actions of a gene product 2) Caucasians: D-negatives= deletion of RHD gene 3) African-Americans: Point mutations in RHD gene (“pseudogene”) 4) Asians: Usually have inactive RHD gene
A 26 yo g2p2 woman has a baby. Her Rh type was "weak D". How much Rhogam should you give her? Most Weak D moms do not need RhIG prophylaxis
What are the most common partial D antigens by race? Most common: DVI (say D “six”) in whites, DIIIa (D “three A”) in African-Americans
Why does partial D vs. weak D matter for moms? Partial D moms need HDFN prophylaxis (RHIG), while weak D‟s commonly do not (type 1,2,3)
Why does partial D vs. weak D matter for donor center testing? Partial D OR weak D donor RBCs may induce anti-D in a D-negative recipient
Why does partial D vs. weak D matter for recipients? Partial D recipients may make anti-D when receiving D+ RBCs, weak D recipients generally do not (type 1,2,3)
Describe DEL (“D-E-L”, formerly “Del”) antigen a) Appear D-neg but have tiny amounts of D seen after elution of reagent anti-D from RBCs b) Primarily seen in Asian populations (up to 1/3 of D-negative Asians)
What is the G antigen? G = Antigen present when either C or D is present Anti-G reacts against (D+C-), (D-C+), or (D+C+) RBCs (rarely against D-C-G+)
What is the f antigen? f = Present when RHce is inherited (r and R0) Anti-f is often seen with anti-e or anti-c Can cause mild HDFN and HTR
Describe the dosage effect in regards to antibodies to Kidd antigens Marked dosage effect 1) Antibodies may not react at all against cells with genetic single dose (heterozygous) Kidd antigens (Jka+,Jkb+)
Vicea graminea lectin reacts against N antigen
Antibodies to the this blood group are famous for developing and then disappearing Antibodies to the Kidd blood group are famous for developing and then disappearing (evanescence)
Glycophorin A (GPA) carries these RBC antigens M and N
Glycophorin B (GPA) carries these RBC antigens S,s, U
Glycophorin A (GPA) and Glycophorin B (GPB) are receptors for this organism P. falciparum
M antigen frequency is? N antigen frequncy is? a. M frequency equals N (each ~75%)
s antigen frequency? S antigen frequency? s (~90%) is more frequent than S (~50%W, ~30%B)
What high frequency antigen can be negative in S-s-? If S-s- (as seen in 2% of African-Americans), may also be U-negative (U is extremely high frequency).
isotype of anti-M? significance? IgM. usually not significant
isotype of anti-N? significance? IgM. usually not significant
isotype of anti-S? significance? IgG. Significant
isotype of anti-s? significance? IgG. Significant
isotype of anti-U? significance? IgG. Significant
describe the N-like antigen („N‟) GPB terminal 5 AA sequence; matches N version of GPA; known as „N‟. Close enough to prevent most M+N- from making anti-N. Seen in all except those who lack glycophorin B.
Anti-N nearly exclusive to this race Anti-N nearly exclusive to African-Americans
Auto-antibody to this antigen induced by hemodialysis because of formaldehyde sterilization of machine N
most common Fy phenotype in African Americans Fy(a-b-); 68%; Due to inheritance of two copies of Fy gene, which gives no functioning Duffy glycoprotein; 2) Fy is an Fyb gene variant, and gives Fyb antigen in non-RBC tissues
Duffy antibodies: isotype and significance IgG; significant; HTR and HDFN; anti-Fya>>anti-Fyb
Fy(a-b-) humans are resistant to these organisms Plasmodium vivax and P. knowlesi infection
K antigen frequency: ?% whites, ?% blacks K: 9% whites, 2% blacks
k antigen frequency: ?% whites, ?% blacks k: 99.8% whites, 100% blacks
patients with Kell null phenotype (“K0”) develop this antibody with exposure to Kell antigens 1) All Kell antigens decreased, Kx increased 2) Significant anti-Ku (“universal”) with exposure
In McLeod phenotype this is absent 1) Kx absent, all Kell antigens markedly decreased 2) No anti-Ku, can form anti-Kx and anti-Km (Kell “McLeod”); only McLeod RBCs compatible 3) part of McLeod “syndrome”
Which is the more frequent Diego antigen a. Dia b. Dib Dia very low frequency except in some South Americans and Asians Dib very high frequency in all populations
Of these Diego antigens which is more frequent A. Wra B. Wrb Wra very low frequency Wrb very high frequency
Antibody to this high frequency antigen may interfere with ABO typing due to reaction at room temperatures Vel Antigen Extremely high frequency antigen (>99% in all populations)
This high frequency antigen can cause cells to agglutinate with Dilochus biflorus Sda(“Sid”) antigen High frequency (96%) Lectin of Dolichos biflorus agglutinates Sda positive RBCs (like A1) Neutralize with guinea pig or human Sda+ urine
The 2 most common Antibodies with “high titer, low avidity” (HTLA) features (HTLA-like antibodies) Chido, Rodgers most frequent; High frequency antigens that are generally clinically benign (no HTRs or HDN)
Created by: jfshikle