Common Blood Groups

A patient with M. pneumonia infection will most likely develop a cold antibody with specificity to which antigen? A) I B) i C) P D) P1

A

Antigen S

Frequency 55%

Antigen N

Frequency 72%

Antigen M

Frequency 78%

Which Fy antigen may result from the commingling of Duffy and Rh genes?

Fy5

Biochemically, Lewis antigens are classified as what in secretions?

Glycoproteins

Phenotype S+ s-

Whites (%) 11 Blacks(%) 3

Phenotype M- N+

Whites (%) 22 Blacks(%) 30

Phenotype M+ N-

Whites (%) 28 Blacks(%) 26

Phenotype M+ N+

Whites (%) 50 Blacks(%) 44

Phenotype K+ k-

Whites% 0.2 Blacks% <0.1

Phenotype K+ k+

Whites% 8.8 Blacks% 3.5

A patient with an M.pneumoniae infection will most likely develop a cold autoantibody with specificity to which antigen? a. I b. i c. P d. P 1

a

Enzyme-treated reagent red cells used in antibody identification enhance all of the following antibodies except: A) anti-M B) anti-Lea C) anti-Jkb D) anti-I

a

Which of the following best describes MN antigens and antibodies? a. Well developed at birth, susceptible to enzymes, generally saline-reactive b. Not well-developed at birth, susceptible to enzymes, generally saline-reactive c. Well-developed at birth, not susceptible to enzymes, generally saline reactive d. Well developed at birth, susceptible to enzymes, generally antiglobulin-reactive

a

Which phenotype is associated with a resistance to Plasmodium vivax? A) Fy(a- b-) B) Jk(a- b-) C) Le(a- b-) D) Lu(a- b-)

a

Which of the following characteristics best describes Lewis antibodies? a. IgM, Naturally occurring, cause HDN b. IgM, naturally occurring, do NOT cause HDN c. IgG, in vitro hemolysis, cause HTRs d. IgG, in vitro hemolysis, do NOT cause HTRs

b

Which blood group has the least amount of H antigen? A) A1B B) A2 C) B D)A1

A) A1B The A1B blood group has the least amount to H antigen. This is due to both A and B epitopes present on red cells comprising the availability of H epitopes. A1B cells will yield weak reactions with anti-H lectin

Which of the following antigen groups is closely related to the ABO antigens on the red cell membrane? A) Rh B) Kell C) I, i D) Duffy

C) I, i The I and i antigens exist on the precursor A, B, and H oligosaccharide chains at a position closer to the red cell membrane. The I antigen is associated with branched chains, and the i antigen is associated with linear chains. The products of RH genes are nonglycosylated proteins. This means no carbohydrates are attached to the protein. Rh antigens reside on transmembrane proteins are an integral part of the RBC membrane. Kell blood group antigens are found only on red blood cells. They have not been found on platelets or on lymphocytes, granulocytes, or monocytes. The Duffy antigens (Fya and Fyb) have been identified on fetal red blood cells as early as 6 weeks gestational age. The antigens have not been found on platelets, lymphocytes, monocytes, or granulocytes, but they have been identified in other body tissues

What antibodies are formed by a Bombay individual? A) Anti-A and Anti-B B) Anti-H C) Anti-A,B D) Anti-A,B, and H

D) Anti-A,B, and H Bombay is the only ABO phenotype incompatible with O cells. The red cells of a Bombay show a negative reaction to anti-H because the cells contain no H substance.

Which of the following characteristics is consistent with the Kidd blood group system? A) Jk(a-b-) red cells are resistant to lysis in 2 M urea B) Kidd antigens are destroyed by ficin C) Antibodies to Kidd antigens react best at immediate spin D) Anti-Jka activity may not react well in a LISS test system

A) Jk(a-b-) red cells are resistant to lysis in 2 M urea Kidd antigens are located on the red cell urea transporter. Red cells that lack Kidd antigens resist lysis by 2M urea. Antibodies to Kidd system antigens are enhanced with ficin treated cells. Most antibodies to Kidd antigens are IgG and prefer to react at AHG phase. Antibodies to the Kidd system may be difficult to detect because they can drop in titer in vivo; however, their detection is aided by the use of potentiators such as LISS and PEG.

Phenotype little p

Antigens Present None Possible Antibodies Anti-PP1Pk Frequency Whites Rare Blacks Rare

Phenotype P2

Antigens Present P, P^k Possible Antibodies Anti-P1 Frequency Whites 21% Blacks 6%

Phenotype P1

Antigens Present P1, P, P^k Possible Antibodies None Frequency Whites 79% Blacks 94%

The Del phenotype is associated with what ethnicity?

Asians?

Which antibody does NOT fit with the others with respect to optimum phase of reactivity? A) Anti-S B) Anti-P1 C) Anti-Fy^a D) Anti -Jk^b

B

A 5-year old with chronic upper respiratory infections arrives in the Emergency Room with chronic anemia. The antibody screen and antibody identification panel are all strongly reactive when tested by solid phase automation. The DAT is NEGative, and the patient's phenotype is shown below. With these initial findings, what is suspected? C: 4+ E: 4+ c: 4+ e: 4+ K: 0 k: 1+ Fya: 0 Fyb: 0 Jka: 4+ Jkb: 4+ A) PCH B) Mcleod sydnrome C) WAIHA D) CHD

B) Mcleod sydnrome The Mcleod phenotype demonstrates weakened Kell system antigens and the antigens Km and Kx are absent. Mcleod syndrome is an X-linked disease state associated with acanthocytosis, muscular, neurologic and psychiatric symptoms. Many also have chronic granulomatous disease and recurrent infections [AABB Tech Manual 2017, p330]

An antibody commonly associated with delayed transfusion reactions is: A) anti-Lu^a B) anti-S C) anti-Jk^b D) anti-M

C

Which autoantibody specificity is found in patients with paroxysmal cold hemoglobinuria? A) Big Eye B) Little Eye C) Big Pee D) P1

C

Which of the following blood group systems is known for showing dosage? A) I B) P C) Kidd D) Lutheran

C

Which blood group system is under control of a gene located on the short arm of the X chromosome? A) GE B) DI C) YT D) XG

D

What antigen system is closely associated phenotypically with Rh?

LW

The Lewis phenotype that is most commonly associated with H.pylori infections...

Le(a-b+)

An individual with the Bombay phenotype (hh) cannot express which antigen?

Le^b

Glycophorin A and glycophorin B possess antigen sites for which blood group system?

MNS

T/F I and i are NOT antithetical antigens

True

True/False Both Lu^a and Lu^b are poorly developed at birth and are antigens produced by allelic codominant genes

True

True/False Excluding ABO, the K antigen is rated second only to D antigen in regards to immunogenicity

True

True/False Fy^a and Fy^b antigens are well developed at birth and can be destroyed by enzymes and ZZAP

True

True/False The Lu(a- b-) phenotype is rare and may result from three different genetic backgrounds

True

True/False The lele genotype is more common among blacks than in whites and will phenotype as Le(a- b-)

True

The Le gene codes for a specific glycosyltransferase that transfers an L-fucose to the N-acetylglucosamine on...

Type 1 precursor chain

What is Neutralization?

an antibody identification technique that combines a soluble antigen with antibody in vitro. If the patient's serum contains the antibody, the soluble antigen makes the antibody inactive

Fill in The Blank Outside of the ABO and Rh antibodies ___________ is the most common antibody seen in the blood bank

anti-K

Antibody detection cells will NOT routinely detect which antibody specificity? A) Anti-M B) Anti-Kp^a C) Anti-Fy^a D) Anti-Lu^b

b

Antibody detection cells will NOT routinely detect which antibody specificity? a. Anti-M b. Anti-Kpa c. Anti-Fya d. Anti-Lub

b

Select the disease most commonly associated with the Mcleod phenotype? A) infectious mononucleosis B) chronic granulomatous disease C) Hodgkin's disease D) PCH

b

What is the cell morphology seen with the Mcleod Phenotype?

acanthocytes

About how many donors will need to be antigen-typed to find 3 Fy(a-) units for crossmatch? A) 3 B) 5 C) 10 D) 12

c

Anti LW will not react with which of the following? a. Rh-pos RBCs b. Rh-neg RBCs c. Rhnull RBCs d. Rh:33 RBCs

c

What antigen is found in 85% of the white population and is always clinically significant for transfusion purposes? a. d b. c c. D d. E e. e

c

What do Rhnull cells lack? a. Lewis antigens b. Normal oxygen-carrying capacity c. Rh antigens d. MNSs antigens

c

What is the most likely Lewis phenotype of a nonsecretor? A) Le(a- b-) B) Le(a+ b+) C) Le(a+ b-) D) Le(a- b+)

c

Which autoantibody specificity is found in patients with paroxysmal cold hemoglobinuria? A) I B) i C) P D) P1

c

Which blood group system is associated with resistance to P. vivax malaria? A) P B) Kell C) Duffy D) Kidd

c

Which blood group system is associated with resistance to P. vivax malaria? a. P b. Kell c. Duffy d. Kidd

c

Which blood group system possesses the Js b and Kp a antigens a. Duffy b. Lutheran c. Kell d. Kidd

c

Which blood group system possesses the Js^b and Kp^a antigens? A) Duffy B) Lutheran C) Kell D) Kidd

c

Which of the following Duffy phenotypes is prevalent in blacks but virtually nonexistent in whiteys? A) Fy(a+ b+) B) Fy(a- b+) C) Fy(a- b-) D) Fy(a+ b-)

c

Which of the following blood group systems is known for showing dosage? A) M B) S C) Kidd D) Lutheran

c

Chronic Granulatomous disease is associated with a depression of the antigens in the ______ blood group system. a. Duffy b. Kidd c. P d. Kell

d

The McLeod phenotype is associated with: a. Rhnull phenotype b. K zero phenotype c. U-negative phenotype d. absence of Kx antigens

d

The Rhnull phenotype is associated with: a. elevated D antigen expression b. Increased LW antigen expression c. the Bombay phenotype d. red cell membrane abnormalities

d

Which antibody is most commonly associated with delayed hemolytic transfusion reactions? A) Anti-s B) Anti-k C) Anti-Lu^a D) Anti-Jk^a

d

Which of the following is the most common antibody seen in transfusion medicine after ABO and Rh antibodies? A) Anti-Fy^b B) Anti-k C) Anti-Js^a D) Anti-K

d

Which of the following reagents destroys Kell system antigens a. ficin b. albumin c. PEG d. DTT

d

The M and N antigens are found on what well-characterized glycoprotein?

glycophorin A

At birth infant RBCs are rich in what antigen?

i

What high frequency antibodies are expressed more vigorously on cord RBCs?

i LW

Where are Lewis antigens produced?

tissue cells

The qualitative differences between A1 and A2 phenotypes includes all of the following EXCEPT: A) The formation of anti-A1 in A subgroups. B) The amount of transferase enzymes. C) The length of the precursor oligosaccharide chains. D) The lack of agglutination of patient red cells with anti-A reagent.

D) The lack of agglutination of patient red cells with anti-A reagent. Qualitative differences for A1 and A2 phenotypes includes the following: differences in the precursor oligosaccharide chains (in length and complexity of branching), small differences in transferase enzymes (decreased in A2 subgroup), and the formation of anti-A1 in the serum of A2 phenotype individuals. Both A1 and A2 patient red cells react with anti-A reagent. Dolichos biflorus or anti-A1 lectin reagent is used to differentiate between A1 and A2 phenotypes. This lectin reagent agglutinates with A1 patient red cells but does NOT agglutinate with A2 patient red cells.

Which genotype(s) will give rise to the Bombay phenotype? A) HH only B) HH and hh C) Hh and hh D) hh only

D) hh only The Bombay phenotype will only be expressed when no H substance is present. The Oh type is expressed by the genotype hh. Bombays produce naturally occurring anti-H, and their serum agglutinates group O red cells in addition to red cells from groups A, B, and AB persons.

Phenotype K- k+

Whites% 91.0 Blacks% 96.5