BLD 435 EXAM 2 QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
potential causes of Rh and ABO discrepancies
-weak/missing antigens
-additional antigens
-unexpected agglutinins in reverse typing
-missing agglutinins in reverse typing
Subgroups of A antigens
A1= 80% of type A people
A2= 20% of type A people
-all other A subgroups are very rare (less than 1%)
causes of weak or missing antigens
-ABO subgroup
-leukemia/malignancy
-transfusion
-intrauterine fetal transfusion
-transplantation
-excessive soluble blood group substance
causes of additional antigens
,-poly agglutinable cells: cells that agglutinate everything
-high level of soluble antigens in sera can neutralize reagents
-may have an antibody to the dyes and preservatives in the reagents
causes of unexpected agglutinins in reverse grouping
-antibodies to diluents used in the preparation of the reagent cells
-pt could be immunodeficient either age (young or old) or because of pharmaceuticals
(pt will not reverse type)
-all sites for antibody interaction blocked by mass C1 binding
-mismatch forward and reverse if recent bone marrow transplant
-recent plasma transfusion
missing agglutinins in reverse typing
causes of mixed field reactions in ABO and Rh testing
-recent transfusion: most common, ex: A person gets O cells in transfusion, those donor
cells will show up in ABO testing after transfusion
-bone marrow transplant: dont follow ABO during bone marrow transplant, only look for
HLA so there could be other donor cells seen in ABO testing prior to transplant
-true chimera: can only happen if someone had a fraternal twin (even if you dont know,
embryo can absorb other embryo during gestation and get mixed ABO type from twin
-A3: uncommon, A3 subgroup does not agglutinate all cells at once
how does rouleaux affect ABO and Rh testing results
-causes false positive
-caused by extra protein
-looks like stacked coins
, -see the problem when reverse typing
-poly agglutinate cell
resolve using saline replacement technique
Evaluate given discrepant serological results and propose plausible
mechanisms/explanations for them.
For patients with given disease states or genotypes which are known to produce
discrepant serological reactions, construct expected serological results.
· Leukemia/ malignancy: weak/missing antigens
· Immunodeficient: reverse typing issue
Utilize and construct algorithms as tools in ABO and Rh investigations.
resolving problems with absence of antigens
-incubate longer at lower temp
-use enzymes
-check saliva
resolving when you have extra reactions in the forward typing
-could be acquired B
-acquired A (Tn activated)
-mixed field
-sensitized RBCs
resolving problems with back typing
-immunodeficient
-prozone (too many antibodies)
-Asub with anti-A1
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
potential causes of Rh and ABO discrepancies
-weak/missing antigens
-additional antigens
-unexpected agglutinins in reverse typing
-missing agglutinins in reverse typing
Subgroups of A antigens
A1= 80% of type A people
A2= 20% of type A people
-all other A subgroups are very rare (less than 1%)
causes of weak or missing antigens
-ABO subgroup
-leukemia/malignancy
-transfusion
-intrauterine fetal transfusion
-transplantation
-excessive soluble blood group substance
causes of additional antigens
,-poly agglutinable cells: cells that agglutinate everything
-high level of soluble antigens in sera can neutralize reagents
-may have an antibody to the dyes and preservatives in the reagents
causes of unexpected agglutinins in reverse grouping
-antibodies to diluents used in the preparation of the reagent cells
-pt could be immunodeficient either age (young or old) or because of pharmaceuticals
(pt will not reverse type)
-all sites for antibody interaction blocked by mass C1 binding
-mismatch forward and reverse if recent bone marrow transplant
-recent plasma transfusion
missing agglutinins in reverse typing
causes of mixed field reactions in ABO and Rh testing
-recent transfusion: most common, ex: A person gets O cells in transfusion, those donor
cells will show up in ABO testing after transfusion
-bone marrow transplant: dont follow ABO during bone marrow transplant, only look for
HLA so there could be other donor cells seen in ABO testing prior to transplant
-true chimera: can only happen if someone had a fraternal twin (even if you dont know,
embryo can absorb other embryo during gestation and get mixed ABO type from twin
-A3: uncommon, A3 subgroup does not agglutinate all cells at once
how does rouleaux affect ABO and Rh testing results
-causes false positive
-caused by extra protein
-looks like stacked coins
, -see the problem when reverse typing
-poly agglutinate cell
resolve using saline replacement technique
Evaluate given discrepant serological results and propose plausible
mechanisms/explanations for them.
For patients with given disease states or genotypes which are known to produce
discrepant serological reactions, construct expected serological results.
· Leukemia/ malignancy: weak/missing antigens
· Immunodeficient: reverse typing issue
Utilize and construct algorithms as tools in ABO and Rh investigations.
resolving problems with absence of antigens
-incubate longer at lower temp
-use enzymes
-check saliva
resolving when you have extra reactions in the forward typing
-could be acquired B
-acquired A (Tn activated)
-mixed field
-sensitized RBCs
resolving problems with back typing
-immunodeficient
-prozone (too many antibodies)
-Asub with anti-A1
