BB FINAL KBK

What is the basis of Rosenfield Rh terminology?

(+) or (-) sign demonstrates the presence or absence of antigen on a red cell.

When 1000 donors were tested, 75% were positive for C and 25% were negative for C; the gene frequency of C is:

0.5

The Rh gene is located on which chromosome?

1

Reverse grouping procedure

1 drop of A cells or B cells 2 drops of patients serum centrifuge grade

Forward grouping procedure

1 drop of anti-A or anti-B 1 drop of 4% RBC centrifuge grade

Four applications as to why a DAT would be performed?

1. Hemolytic Disease of Fetus/Newborn 2. Hemolytic Transfusion Reaction 3. Drug-Induced Transfusion Reaction 4. Autoimmune Hemolytic Anemia

DAT Procedure:

1. One drop of patient red cell suspension in tube 2. Wash 3-4 times (1 min centrifuge) 3. Add AHG and centrifuge (30sec) 4. Read. Agglutination= positive 5. If negative, let sit for 10 minutes, centrifuge again and read 6. Still negative, add check cells, centrifuge and read. Agglutination = negative, no agglutination = repeat DAT

Procedure for Antibody Screen:

1. one drop of patient serum + one drop of appropriate screen cells (I, II, III) 2. Centrifuge (30 sec) and read. (Immediate Spin) 3. Add potentiator and incubate at 37C for designated time 4. Centrifuge and read (if 37C required) 5. Wash cells 3-4 times 6. Add AHG and centrifuge 30 sec, read. Agglutination = positive 7. No agglutination, add check cells, spin, read. Agglutination= negative no agglutination= repeat screen

Once frozen, red blood cells are good for?

10 years at -65 degrees Celsius

How many IgG molecules must be present on the red cell for a positive IAT to occur?

100

At what age does I antigen become detectable on infant cells?

18 months

How is a 40:1 ratio of serum to cells prepared for the AHG test?

2 drops serum + 1 drop of a 5% v/v red cell suspension

What is the commonly used cell suspension percentage used for ABORh and DAT?

2-5% suspension

H glycosyltransferase H sugar

2-L-fucosyltransferase L-fuctose

At what temperature do IgM antibodies react?

22 C

What is the optimal temperature for ABO testing?

22C

A human gamete (egg or sperm) contains how many chromosomes?

23 chromosomes

In the normal hemoglobin oxygen dissociation curve, what percentage of oxygen is released to the tissues when PO2 averages 40 mmHg?

25%

Gene B glycosyltransferase Gene B sugar

3-D-galactosyltransferase D-galactose

Gene A glycosyltransferase Gene A sugar

3-N-acetylgalactosaminyltransferase N-acetyl-D-galactosamine

What is the incubation time for the IAT when saline is used instead of LISS?

30 minutes

At what temperature do IgG antibodies react optimally?

37 C

What is the optimal temperature for Rh antigen-antibody reaction?

37C

What is the optimal temperature for the AHG phase?

37C

What techniques are necessary for D^u testing

37degrees Celsius incubation & IAT

At what temperature is the incubation phase of the AHG test?

37°C

The diploid chromosomes number in humans is:

46

What percentage of A2 individuals produce anti-A1?

5%

ISBT nomenclature

6 digit machine readable number System has 3 digit code --oo4= Rh system

Saline used for blood banking tests should have a pH of _________.

7.2 to 7.4

What percentage of the type A population are A1?

80%

The Rh antibody agglutinates what percentage of red cells.

85%

Supressed A

A ag is weakened in some leukemias

What substances are found in a group A secretor?

A,H

A sub groups

A1-80% A2-20%

What ABO group contains the least amount of H substance?

A1B

What reagent should be used to resolve an A subgroup with anti-A1

A2 cells; anti-A1 lectin; anti-H; anti-A,B; O cells

What blood type is not possible for an offspring of AO and BO persons?

AB, A or B, & O

Which blood group antibodies are known to activate complement leading to intravascular hemolysis?

ABO

Carbohydrate antigens

ABO H Le P

Why is testing for Rh antigens and antibodies different from ABO testing?

ABO reactions are primarily due to IgM antibodies and usually occur at room temperature; Rh antibodies are IgG , and agglutination usually requires incubation and enhancement media

What reactant or procedure is used to distinguish Kidd and Kell antibodies?

AET

If check cells do not work (false negative)

AHG not added Inadequate washing of rbcs Under centrifugation Shaking tubes too hard Incorrect incubation time and temp

A woman with blood group A marries a man with blood group O. Their first bone child has blood group O. The mother's most probable genotype is:

AO

Immunogenicity

Ability of the D antigen to stimulate production of anti-D

IgM

Activated complement 4C-RT Saline 10 Fab 5 Fc

Potentiators examples

Albumin LISS PEG Enzymes (end in ases)

H lectin

Alex eurpaeus

Donors of Weak D

All Rh negative blood donors must be typed for weak D Weak D are labeled Rh positive

Why is determination of Rh status crucial for obstetric patients?

All Rh negative mothers are possible candidates for Rh immune globulin.

Why was U antigen included in the MNSs blood group system?

All U-negative red cells were also S-s-

Kidd blood group system

Alleles= italics Antigens=normal Phenotypes= JK (a+b+)

Which genetic event most commonly affects the expression of genes within the ABO blood group system?

Amorphs that cause expression of an undetectable group such as group O

Which of the following distinguishes between the blood groups A1 and A2

An A2 person may form anti-A1; an A2 person will not form anti-A

Which antibody would not be detected by group O screen cells?

Anti-A

Which typing results are most likely to occur when a patient has an "acquired B" antigen?

Anti-A, 4+ Anti-B, 1+ A1 cells, neg B cells, 4+

What antibodies are formed by a bombay individual?

Anti-A, Anti-B and anti-H

Rh interpretation

Anti-D Rh con Interp + 0 Rh pos 0 0 Rh neg + + invalid

What antibodies could R'R' individuals make of exposed to R2R2 blood?

Anti-E and anti-C

An antibody shows high tittered reactions in all test phases. all screen and panel cells are positive. the serum is then tested with a cord cell and the reaction is negative. what antibody is suspected?

Anti-I

Why is it strongly recommended to use only homozygous cells when ruling out Kidd antibodies?

Anti-Jka may appear compatible with heterozygous cells Jk(a+b+).

which group of antibodies are commonly found as cold agglutinns?

Anti-M, anti-N

Autosomes

Any chromosome except X or Y sex chromosome

Secretor studies were performed on a person who expressed weak reactions in forward grouping. Only B and H substance were present in saliva. What is this person's ABO group?

B

What type of blood should be given an individual who has an anti-Le^b that reacts 1+ at the IAT phase?

Blood that is negative for the Le^b antigen

What does the hh genotype refer to?

Bombay

G antigen is present on all of which type of red cells?

C positive

Which red cell preservative has a storage time of 35 days?

CPDA-1

What blood group antigens are involved in the regulation of complement because they are located on decoy accelerating factor?

CROM

Acquired B

Cells react weakly with anti-B antisera Colon cancer Found only in group A Bacterial enzyme deacetylates the A ag

D-deletions

Cells that lack C/c or E/e D is still present Caused by alteration off the CE gene Deletions have strong D ag Written as -D-

Which antigen is expressed on C4B complement fragments?

Cha

Rh gene found on

Chromosome 1

LW gene found on

Chromosome 19

What MHC Class encodes complement components?

Class III

Unknown cells: Anti-A, neg Anti-B 4+ Unknown serum: A1 cells 4+ B cells 4+

Cold autoantibody

Check cells

Confirmation of negative antiglobulin test Add IgG presensitized cells to all negative antiglobulin tests

Which of the following Rh antigens is the most immunogenic?

D

Rh ag frequencies

D 85 C 70 c 80 E 30 e 98

What sequence of antigens coincides with strongest immunogen to weakest immunogen?

D, K, Fya, Fyb

Which of the following groups of antigens would always be considered as clinically significant ?

D,E,Fy^a, S,A,B,K

Which genotype usually shows the strongest reaction with anti-D?

D-/D-

What immunodominant sugar is responsible for B specificity?

D-galactose

Is a DAT in vivo or in vitro?

DAT is In Vivo because the patient red cells are used

Fisher-Race a.k.a

DCE terminology

Which genotype would be most likely show dosage effect for both C and e antigens?

DCe/DcE

Which genotype is heterozygous for C?

DCe/dce

DNA replication

DNA is copied before mitosis DNA is transcribed to RNA RNA is made into proteins

Which of the following genotypes is consistent with f antigen expression?

Dce/DCE

A3 subgroup

Deals with "mixed field"

Which characterisits are true of all three of the following antibodies: anti-Fy^a, anti-Jk^a, and anti-K?

Detected at the IAT phase; may cause hemolytic disease of the newborn(HDN) and transfusion reactions.

Antihuman Globulin (AHG)

Detects sensitized cells Reacts with IgG or complement

Which antigen is useful as a genetic marker for Mongolian derivation and anthropologic studies?

Dia

Heterozygous

Different alleles

DAT

Direct antiglobulin test a.k.a Coomb's test Detects red cells coated with antibody in vivo

Weak D

Does to agglutinate with anti-D in DAT, but is detectable by the anti globulin technique

IgG

Doesn't activate complement Crosses placenta 37C Potentiator 2 Fab 1 Fc

What is the source of anti-A1 lectin?

Dolichos biflorus

A1 lectin

Dolichos biflorus Detects anti-A1

Amorphic

Don't produce antigen

Which antigen represents Rh3 in Rosenfield terminology?

E

Explain what results you would expect on a DAT that was was only twice? Why?

False negative result or result that has a weaker than expected agglutination. Improper washing leaves protein on the red cells which neutralizes the reaction,

Anti-IgG is specific for what part of the IgG molecule?

Fc fragment

Persons who phenotype negative for U antigen lack Ss-SGP because of a partial or complete deletion of ______.

GPB

Terminal sugar is always

Galactose

Types of weak D (Du)

Gene interaction --C in trans position to D -- -- Cde/cDe Partial D Genetic weak D ag

DNA composition

Guanine/Cytosine Adenine/Thymine

Which substance must be formed first before A or B specificity is determined?

H

What does an antibody screen on patients determine? Identify reasons why it is important to perform on each specimen before transfusion.

Helps detect unexpected allo- or autoantibodies. Important so patient does not suffer from HTR.

Rhnull syndromes

Hemolytic anemia Stomatocytosis

A technologist performs an antibody study and finds 1+ and weak positive reactions for several of the panel cells. The reactions do not fit a pattern. An enzyme panel, several selected cell panels, and antigen typing of the patients red blood cells do not reveal any additional information. the serum is diluted and retested, but the same reactions persist. what type of antibody may be causing these results?

High- titer low avidity(HTLA)

Bombay phenotype

Homozygous hh Normal ABO genes No A, B, or H on rbc A and B genes still produces normal transferase Serum contain anti-A, anti-B and anti-H

A patient is discovered to have anti-Fya in their serum. The medical technologist needs to phenotype the patient cells for the corresponding antigen. What test is appropriate for phenotyping?

IAT

Anti-M was detected in a 27-year-old man before surgery. Units negative for M antigen were not available; however, the units were approved for transfusion when major crossmatch using M+N+ donor cells and patient serum resulted in:

IS=1+, 37=0, AHG=0

Units that were positive for P2 antigen had to be crossmatched with serum of a patient containing the corresponding antibody because of a short supply of blood. Which of the following crossmatch results would be considered acceptable for transfusion?

IS=1+, 37=0, AHG=0

Most Rh antibodies are of what immunoglobulin class?

IgG

What class of immunoglobulin is capable of crossing the placenta?

IgG

Which immunoglobulin is found in greatest concentration in serum?

IgG

Serological characteristics of Rh

IgG 37, antiglobulin Potentiators No complelemt

Immune antibodies

IgG From pregnancy or transfusion

Polyspecific

IgG and C3d

Monospecific

IgG or C3d

D is an ______ antibody, reacts best at _____, and is known to cause____

IgG, AHG, hemolytic disease of the newborn

Most clinically significant blood group antibodies are of what IgG subclass?

IgG1 and IgG3

Which IgG subclasses carry the most significance with regard to Rh antibodies?

IgG1/IgG3

Anti-A from a group B individual is primarily what class of immunoglobulin?

IgM

Lewis antibodies are of what immunoglobulin class?

IgM

What immunoglobulin exists in a pentameric configuration?

IgM

Non-immune antibodies

IgM Naturally occurring

Which of the following statements are false concerning the structure of immunoglobulins?

IgM participates in placental trasfer

In an immune response, _____ antibodies are formed before ______.

IgM, IgG

A transplant patient was retyped when she was transferred from another hospital. What is the most likely cause of the following results? Patients cells: Anti-A, neg Anti-B, 4+ Patients serum: A1 cells, neg B cells, neg

Immunodeficiency

Paraglobiside type 1

In body fluids only Beta 1-3 linage

Why is incubation omitted in the direct AHG test?

In vivo antigen (antibody complex is already formed.

What should be done if all forward and reverse ABO results are negative?

Incubate ar 22 degrees Celsius or 4 degrees Celsius to enhance weak expression

All of the following is true regarding the AHG test except:

Incubation time with LISS is a minimum of 30 minutes.

Landsteiner's law

Individuals have the ABO abs to the ABO ags on their RBCs A A anti-B B B anti-A O -- anti-A, anti-B AB A&B --

Rhnull phenotype

Inherited condition where rbcs lack all Rh ags

Which of the following is true regarding anti-LW?

It appears frequently as an auto antibody.

When red cells are placed in a solution of 2M urea, the red cells will lyse. However, it has been shown that which red cells are resistant to lysis?

Jk(a-b-)

Which of the following is not involved in the Kell blood group system?

Jk^a

Discoverer of ABO system

Karl Landsteiner

Why is it relatively easy to find compatible units for a patient with anti-K?

Kell is a low-frequency antigen

How is Le^b substance formed?

L-Fucose is added to subterminal N-acetylglucosamine of type 1 H substance

Persons who inherit the h allele do not produce ___________ transferase necessary for formation of the H structure.

L-fucosyl

A Bombay individual who has inherited the Le gene will have a phenotype of:

Le(a+b-)

Pregnant women usually express which phenotype?

Le(a-b-)

Why are Lewis antibodies not generally implicated in hemolytic disease of the newborn (HDN)?

Lewis antibodies are IgM and cannot cross the placenta

Why is the Le system not implicated in hemolytic disease of the newborn (HDN)?

Lewis antigens are not well developed at birth

H antigen formation

Locus on chromosome 19 2 genes: H(FUT1) and h H ag is a precursor for A and B h is amporph- no H ag is produced Gene codes for glycosyltransferase

ABO antigens formation

Locus on chromosome 9 Codominant Genes code for glycosyltransferase

Which metabolic pathway permits the accumulation of 2,3 DPG?

Luebering-Rapoport shunt

In the MN blood group system, a person who inherits and "M" allele and "N" allele expresses both M and N antigens on the red blood cells. Which of the following is true?

M and N are codominant alleles

Anti-N will react stronger with which phenotype?

M-N+

False positive check cells

Material contamination Test cells coated with protein Dirty glassware Over centrifugation

Positive DAT causes

Maternal ab coating baby's cells Ab to drug Autoab coating own cells

Sources of error in blood typing

Mix up patients samples Used wrong reagents RBC too heavy or light

H antigen

Most H antigen is converted to A and B No H antigen converted in O --it has the most H antigen A1 converts the most H --it has the least H antigen

Why does anti-Lua go undetected in routine testing?

Most reagent cells are Lu(a-)

A patient tests positive for weak D , but also appears to have anti-D in his serum. What may be the problem?

Most weak D individuals make anti-D or A D mosaic may make antibodies to missing antigen parts

Anti-I is found in association with what microorganism?

Mycoplasma pneumoniae

Which of the following results is discrepant?

Negative A1 cells

A patient is scheduled to undergo open heart surgery. he has anti-P antibody. How should blood be selected?

Negative for the P1 antigen

how can interferring anti-P antibody be removed from a mixture of antibodies?

Neutralization with hydatid cyst fluid

A technologist is having a great difficulty resolving an antibody mixture. one of the antibodies is anti-Le. This antibody is not clinically significant in this situation , but it needs to be removed to reveal the possible presence of an underlying antibody clinically significance. what can be done?

Neutralize the serum with saliva

ABO antibodies

Non-immune Not present until 3-6 months old Isohemagglutinins=anti-A and anti-B

What would happen if you did not re-suspend the cell button each time between washing?

Not all of the red cells would be properly washed, which could result in a false negative or weakly reactive result.

Rh antibodies

Not naturally occurring

Compatibility equation

Number of units needed/ negative frequency or number of units needed/ neg freq x new freq

Which blood group contains the highest concentration of H antigen?

O

LW antigens

On almost all cells except Rhnull

Paraglobiside type 2

On red cells and in body fluids Beta 1-4 linkage

Blood group inheritance

One from mom and one from dad Codominant- both are expressed 2 genes on X chromosome: Xga and Xk

Rhnull transfusions

Only Rhnull blood can be given

G antigen

Only when C and D are present

A blood bank technologist needed to confirm the presence of anti-P1 in a patient specimen. Fresh cells were not available for use, so an old panel taht contained cells positive for P1 was used. No cells positive for the antigen reacted at any phase of the antiglobulin test, whereas cells from the screening cells showed specificity for the presence of anti-P1. What is a possible explanation for this?

P1 antigen deteriorates rapidly upon storage

Whys is hemolytic disease of the newborn (HDN) not a consideration when the mother possesses anti-P1 in her serum?

P1 antigen is poorly expressed at birth

How does the addition of LISS or PEG affect antigen-antibody binding?

PEG removes water from the reaction. LISS reduces the zeta potential. Both enhance Ag-Ab binding effect.

Weak D testing

Patients RBCs Anti-D incubate 37 wash 4 times

What is tested in an antibody screen?

Patients serum is tested against group O reagent screening cells

Clinical significance of Rh

Patients who have produced Rh abs should receive ag negative blood

Why is it important to match the lot number on the panel sheet with the lot number on the panel cells?

Pattern of reactions will change from lot to lot

What type of routine does the blood bank technologist perform when determining the blood group of a patient?

Phenotyping

Person who phenotype as Fy(a-b-) are resistant to infection by which organism?

Plasmodium vivax

2 genes responsible for Rh protein

RHD RHCE

the k (cellano) antigen is a high-frequency antigen and is found on most red cells. how often would one expect to find the corresponding antibody, anti-k?

Rarely, because most individuals have the antigen and therefore would not develop the antibody.

Anti-LW

Reacts strongly with D positive cells Very weak or negative with D negative cells Reacts strongly with cord blood cells regardless of D type

Anti-LW vs Anti-D

Reagent Anti-LW Anti-D D+adult + + D-adult 0 0 D+cord + + D-cord + 0 Rhnull 0 0

Recipients of weak D

Reception testing for weak D is not required

Complement activation

Requires at least 2 Fc

All of the following are true regarding Rh antibodies except:

Rh antibodies can bind complement on the red cell membrane.

A cord blood sample was sent to the blood bank for a type and DAT. Cells were washed six times with saline before testing. The forward grouping typed as an O. There was no agglutination with anti-D and washed cord cells. The DAT was 3+ with polyspecific AHG. What is the Rh type of the baby?

Rh type cannot be determined

What do "check cells" contain?

Rh(D)+ red cells coated with anti-D

Wiener a.k.a

Rh-Hr terminology

A complete Rh typing for antigens C,c,D,E and e revealed negative results for C,D and E. How is this individual designated?

Rh-negative

How is an individual classified with genotype DCe/dce?

Rh-positive

Testing reveals a weak D(D) that reacts 1+ after indirect antiglobulin testing(IAT). How is this result classified?

Rh-positive

Interpret this Rh phenotype: -/-

Rhnull

Which procedure would help to distinguish an anti-e and anti-Fy^a in an antibody mixture?

Run an enzyme panel

Homozygous

Same alleles

D testing procedure

Same as forward are reverse

_______ incidence is an antigen in the high-incidence series (901) that is found in saliva and urine. The corresponding antibody typically reacts at the AHG phase and produces a characteristic refractile, mixed field reaction.

Sda

Secreter genes

Se (FUT2) and se SeSe ot Sese 80% of population sese 20% of population

Lectins

Seed extracts that react with human cells Used in determining A sub groups

The M and N antigens exhibit dosage. Therefore, if a person inherits the homozygous genotype MM their red cells will react ____ with anti-M than a person with heterozygous genotype of MN.

Stronger

An Rh typing revealed all Rh antigens as negative. What could be the problem with this typing?

Test performance error, problems with reagents, patient Rh null

Forward grouping

Tests patients red cells Reagents= anti-A and anti-B

Reverse grouping

Tests patients serum Reagents= A cells and B cells

Partial D

The D antigen is very complex. One or more of the D epitaph within the entire D protein is missing

What is the principle of the Rh-Hr (Weiner) terminology?

The Rh gene produces at least 3 factors within an agglutinogen

Which of the following is representative of the "central dogma" of molecular biology?

The basic information of life flows from DNA through RNA to proteins

Inherited weak D

The full D antigen is expressed but there are fewer ads per cells

Anti-A, 1+ Anti-B, Neg A1 cells, 1+ B cells, 4+

The patient may be A2 with anti-A1

All of the following statements are true concerning ABH soluble substances except:

The precursor chain is type 2 (beta 1-4 linkage).

A patients serum is incompatible with O cells. The patient's RBCs give a negative reaction to anti-H lectin. What is the most likely cause of these results?

The pt may be bombay

Why can anti-H sometimes be found in an A1B individual?

The specific immunodominant sugar blocks the presence of H antigen.

What is the reasoning behind using a Rh control tube?

To ensure anti-D is actually negative, ensure reagent is good, and to ensure there is not spontaneous aggregation.

Why do screening tests incorporate multiple phases for reactions to take place?

To ensure negative reactions are true negatives, to ensure there are not any clinically significant antibodies, and to bring out any weakly reacting antibodies.

What is the purpose of adding antibody-antigen coated red cells to all negative AHG tubes?

To ensure proper cell washing and addition of AHG reagent

What is meant by the term "autosomal"?

Trait is not carried on the sex chromosomes

What is the method of choice when performing an ABO type?

Tube

Why is anti-i implicated in hemolytic diseases of the newborn?

Two of the above

Potentiator purpose

Used to decrease zeta potential

What should be done if all forward and reverse ABO results and the auto control are positive?

Wash the cells with warm saline; autoadsorb the serum at 4 degrees Celsius

ABO frequencies

White Black O 45 49 A 40 27 B 11 20 AB 4 4

Blood components include all of the following EXCEPT:

Whole blood

A father carries the Xga trait and passes it on to all of his daughters, but none of his sons. What type of inheritance does this represents?

X-linked dominant

The gene for which blood group antigen is located on the petite arm of the X chromosome?

Xga

A woman undergoing a hysterectomy requires 2 units of blood. The antibody screen was negative. One unit was incompatible in the Coombs phase (2+), the other unit was compatible. Give a reason why this antibody was not detected in the antibody screen.

a low-frequency antigen

What does hemolysis represent in an antigen-antibody reaction?

a positive result

What is the definition of an immunoglobulin?

a protein molecule produced in response to an antigen

What is an elution?

a technique used to dissociate IgG antibodies from sensitized red blood cells

Infection with which organism is associated with naturally occurring IgM anti-K. a. E. coli b. Mycobacteirum sp. c. Campylobacter coli d. All of the above

a. E. coli

What is the etiology of dialysis-associated anti-N? a. Formaldehyde alters the N antigen so that it is recognized as foreign b. Most renal patients express the phenotype M+N-S-s- where most potent form of anti-N are found c. Treatment of renal patients depresses N-antigen expression d. None of the above

a. Formaldehyde alters the N antigen so that it is recognized as foreign

Lewis antibodies are of what immunoglobulin class? a. IgM b. IgG c. IgA d. IgE

a. IgM

Which of the following may be a cause for the lack of expression of Lewis antigens during pregnancy? a. Increased ratio of plasma lipoproteins to RBC mass b. Decreased ratio of plasma lipoproteins to RBC mass c. Antigenic sites blocked by IgG antibody d. Antigenic sites blocked by IgM antibody

a. Increased ratio of plasma lipoproteins to RBC mass

What is the most common Kidd phenotype in the black population? a. Jk(a+b-) b. Jk(a+b+) c. Jk(a-b+) d. Jk(a-b-)

a. Jk(a+b-)

Which group of antigens below best represents the definition of high-frequency antigens? a. Jsb, Kpb b. K, k c. Kpa, Jsa d. Jka, K

a. Jsb, Kpb

Why is it relatively easy to find compatible units for a patient with anti-K? a. Kell is a low-frequency antigen b. Kell is a high-frequency antigen c. Anti-K does not react at 37C d. Anti-K has a low avidity for its respective antigen

a. Kell is a low-frequency antigen

How is Leb substance formed? a. L-fucose is added to subterminal N-acetylglucosamine of type I H substance b. L-fucose is added to subterminal N-acetylglucosamine of type II H substance c. Lea & Led are codominant alleles located on chromosome 19 d. Leb is secreted into plasma in the absence of fucosyltransferase

a. L-fucose is added to subterminal N-acetylglucosamine of type I H substance

What MN phenotype is found in highest frequency in the white population? a. M+N+ b. M+N- c. M-N- d. M-N+

a. M+N+

Anti-M will react strongest with which cells? a. M+N- b. M+N+ c. M-N- d. M-N+

a. M+N-

The homozygous phenotype Fy(a+b-) has ______ antigenic Fy sites than heterozygous cells, Fy(a+b+). a. More b. Fewer c. Weaker d. None of the above

a. More

Anti-I is found in association with what microorganism? a. Mycoplasma pneumoniae b. Treonema pallidum c. E. coli d. Proteus vulgaris

a. Mycoplasma pneumoniae

RBCs were treated with ficin to help rule in anti-M from a panel study. Cells not treated reacted at 2+ at immediate spin and 1+ at 37C. There was no reactivity in the Coombs phase. Ficin-treated cells demonstrated a _____ reaction with patient serum containing anti-M. a. Negative b. 2+ c. 3+ d. 4+

a. Negative

Where are the Kell blood group antigens found? a. RBCs b. Platelets c. Lymphocytes d. All of the above

a. RBCs

Where are the Kidd antigens found? a. RBCs b. Platelets c. Lymphocytes d. Monocytes

a. RBCs

Where are the Duffy antigens found? a. Red blood cells b. Platelets c. Lymphocytes d. All of the above

a. Red blood cells

Anti-Lua reacts at what temperature? a. Room temp. b. 37C c. AHG d. All of the above

a. Room temp.

The M and N antigens exhibit dosage. Therefore, if a person inherits the homozygous genotype MM, their RBCs will react ______ with anti-M than/as those of a person with a heterozygous genotype of MN. a. Stronger b. Weaker c. The same d. None of the above

a. Stronger

Which of the following statements regarding individuals who are Fy(a-b-) is true? a. The presence of Fyb in the tissues of individuals who are black who are Fy(a-b-) prevents those individuals from forming Anti-Fyb b. The presence of Fya substance in individuals who are white who are Fy(a-b-) prevents those individuals from forming Anti-Fya c. All individuals that are Fy(a-b-) are likely to form anti-Fyb if exposed to the Fyb antigen d. Anti-Fyb can only be produced from individuals that have inherited the Duffy gene

a. The presence of Fyb in the tissues of individuals who are black who are Fy(a-b-) prevents those individuals from forming Anti-Fyb

What RBC antigens do McLeod individuals express? a. TracekKpbJsbK11 b. KmKx c. None d. KkKpbJsa

a. TracekKpbJsbK11

Indirect antiglobulin test

a.k.a. antibody screen Detects ab circulating free in serum in vitro

Antigens in the CH/RG blood group system are described as:

absorbed onto the red cell membrane

What abnormal blood cell morphology is associated with the McLeod phenotype?

acanthocytes

A patient who was recently diagnosed with an obstructed bowel became septic from Proteus vulgaris. Prior to surgery, a routine type and screen was performed. Though this person typed as an A two years ago, his forward type is consistent with an AB individual, albeit weaker in strength with anti-B. What is the reason for this discrepancy?

acquired "B"

How is RNA different from DNA?

all of the above

In order for an individual to express Le^b antigen on their red cells, they must have inherited which gene?

all of the above

What class of antibody is found in AHG?

all of the above

What criteria must be met for an antigen to be assigned to a blood group system?

all of the above

What does polyspecific AHG contain?

all of the above

What type of globulin does the antiglobulin test detect?

all of the above

Where are Lewis antigens found?

all of the above

Which of the following criteria is used to classify the B subgroups?

all of the above

Which of the following must be true when using the Hardy-Weinberg equation?

all of the above

Why is it acceptable for "C Trans" individuals to receive D-positive red cells?

all of the above

Why was anticomplement introduced into AHG sera?

all of the above

Alternate forms of a gene that can occur at a single chromosome locus are referred to as:

alleles

Rosenfield a.k.a

alpha numeric terminology

Secreter gene product

alpha-2-L-fucosyltransferase Adds fucose to type I structures

A gene, such as the O gene, that produces no detectable product is called:

an amorph

What is an antigen profile?

an insert listing the antigentic make-up of screening cells

This antibody is produced in people with pneumonia caused by Mycoplasma pneumonia

anti-I

Polyspecific AHG contains:

anti-IgG and anti-C3b-C3d

What Kidd antibody will react with all panel cells and phenotype as Jk(a-b-)?

anti-Jk3

Rh genes are

autosomal codominant

At what age does I antigen become detectable on infant cells? a. 1 year b. 18 months c. 4 years d. 1 month

b. 18 months

What is the definition of a blood group system? a. A group of antibodies produced by alleles at a single gene locus b. A group of antigens produced by alleles at a single gene locus c. A group of antibodies produced by alleles at multiple genetic loci d. A group of antigens produced by alleles at multiple genetic loci

b. A group of antigens produced by alleles at a single gene locus

Why is it strongly recommended that only homozygous cells be used when ruling out kidd antibodies? a. Anti-Jka may appear compatible with homozygous cells Jk(a+b-) b. Anti-Jka may appear compatible with heterozygous cells Jk(a+b+) c. It will reduce the number of false-positive results d. Options a & c

b. Anti-Jka may appear compatible with heterozygous cells Jk(a+b+)

What fatal disease is associated with McLeod phenotype? a. Grave's disease b. Chronic granulomatous disease c. Lymphoma d. Fanconi's syndrome

b. Chronic granulomatous disease

What sequence of antigens coincides with strongest immunogen to weakest immunogen? a. D, Fya, Fyb, K b. D, K, Fya, Fyb c. Fya, Fyb, D, K d. K, Fya, Fyb, D

b. D, K, Fya, Fyb

What type of hemolytic transfusion reaction occurs more frequently in patients with Jk antibodies? a. Febrile b. Delayed c. Immediate d. Bacterial

b. Delayed

A women undergoing a hysterectomy requires 2 units of blood. The antibody screen was negative. 1 unit was incompatible in the Coombs phase (2+), the other unit was compatible. Give a reason why this antibody was not detected in the antibody screen. a. Existence of a high-frequency antigen b. Existence of a low-frequency antigen c. Antibody has low avidity to cell receptor d. Options a & c

b. Existence of a low-frequency antigen

What sample requirement is essential for identification of a Kidd antibody? a. Fresh whole blood b. Fresh serum or plasma c. Fasting sample d. Sample on ice

b. Fresh serum or plasma

Anti-M was detected in a 27 year old man before surgery. Units negative for M antigen were not available; however, the units were approved for transfusion when major crossmatch using M+N+ donor cells and patient serum resulted in: a. IS=1+, 37=1+, AHG=0 b. IS=1+, 37=0, AHG=0 c. IS=3+, 37=2+, AHG=1+ d. IS=2+, 37=1+, AHG=0

b. IS=1+, 37=0, AHG=0

Anti-i is found in association with what disease? a. Pneumonia b. Infectious mono c. Syphilis d. Gonorrhea

b. Infectious mono

Anti-N will react stronger with which phenotype? a. M+N+ b. M-N+ c. M+N- d. M-N-

b. M-N+

Persons who phenotype as Fy(a-b-) are resistant to infection by which organism? a. P. falciparum b. P. vivax c. P. ovale d. P. malariae

b. P. vivax

Why is HDN not a consideration when the mother possesses anti-P1 in her serum? a. anti-P1 is an IgG antibody b. P1 antigen is poorly expressed at birth c. Anti-P1 does not react at 37C d. Anti-P1 is a naturally occurring antibody

b. P1 antigen is poorly expressed at birth

What finding may protect individuals from making alloanti-Lub in dominant In(Lu) genotype? a. The ability to neutralized anti-Lub b. The ability to absorb & elute anti-Lub c. Trace amounts of Lua on RBCs d. The ability to secret Lub substance in plasma

b. The ability to absorb & elute anti-Lub

Duffy antigens are destroyed by: a. AET b. ficin c. Neuraminidase d. Neuraminidase & AET

b. ficin

What does the U in U antigen stand for? a. unusual b. universal c. uniform d. unique

b. universal

How is it genetically possible for a child to type Rh negative?

both parents are (Dd)

How can pathologic anti-I be differentiated from benign anti-I?

broad thermal range of reactivity

How is the classical pathway of complement activated?

by binding of antigen with antibody

The true Lewis phenotype will normally be detected at what age? a. Birth b. 10 days c. 6 years d. not necessarily ever

c. 6 years

A patient who has a pathologic auto anti-I must be transfused with: a. A leukocyte filter b. A cold pack c. A blood warmer d. None of the above

c. A blood warmer

At what phase of the antihuman globulin test will anti-Kell be detected? a. IS b. 37C c. AHG d. All of the above

c. AHG

What Kidd antibody will react with all panel cells and phenotype as Jk(a-b-)? a. Anti-Jka b. Anti-Jkb c. Anti-Jk3 d. None of the above

c. Anti-Jk3

A person who inherits alleles Fya and Fyb will carry which antigens on their RBCs? a. Only Fya antigen b. Only Fyb antigen c. Both Fya and Fyb antigen d. Neither Fya or Fyb antigen

c. Both Fya and Fyb antigen

How can pathologic anti-I be differentiated from benign anti-I? a. Immunoglobulin class b. Binding of complement c. Broad thermal range of reactivity d. All of the above

c. Broad thermal range of reactivity

What characteristic differentiates Ss antigens from MN antigens? a. Antigens well developed at birth b. S and s exhibit dosage c. Enzyme degradation d. Biochemical structure rich in sialic acid

c. Enzyme degradation

Black persons who genotype as FyFy will phenotype as: a. Fy(a+b+) b. Fy(a+b-) c. Fy(a-b-) d. Fy(a-b+)

c. Fy(a-b-)

When RBCs are placed in a solution of 2M urea, the RBCs will lyse. However, it has been shown that which RBCs are resistant to lysis? a. Jk(a+b-) b. Jk(a+b+) c. Jk(a-b-) d. Jk(a-b+)

c. Jk(a-b-)

A panel suggests that the patient has an anti-K antibody. All other clinically significant antibodies have been ruled out with the exception of anti-E. Which of the following cells would be best to rule out the presence of the anti-E? a. K+, k+, E-, e- b. K-, k+, E+, e+ c. K-, k+, E+, e- d. K+, k-, E-, e+

c. K-, k+, E+, e-

What Cell phenotype is found is highest frequency in the white population? a. K+k+ b. K+k- c. K-k+ d. K0

c. K-k+

An individual from Bombay who has inherited the Le gene will have a phenotype of: a. Le(a-b-) b. Le(a+b+) c. Le (a+b-) d. Le(a-b+)

c. Le(a+b-)

A patient was phenotyped for the presence of Lewis antigens (Lea & Led). A 3+ reaction was observed when patient cells were incubated with anti-Lea. No reaction was observed with anti-len. Based on these results, the patient's phenotype is_________ and the patient is a ______ of ABH substances. a. Le(a+b-)/secretor b. Le(a-b+)/secretor c. Le(a+b-)/nonsecretor d. Le(a-b+)/nonsecretor

c. Le(a+b-)/nonsecretor

What is the most common Lutheran phenotype in the white population? a. Lu(a+b-) b. Lu(a-b-) c. Lu(a-b+) d. Lu(a+b+)

c. Lu(a-b+)

Persons who are negative for Duffy antigens are less likely to contract which of the following diseases? a. Chicken pox b. Influenza c. Malaria d. Polio

c. Malaria

Why does anti-Lua go undetected in routine testing? a. Anti-Lua demonstrates low avidity b. Most reagent cells are Lu(a+) c. Most reagent cells are Lu(a-) d. None of the above

c. Most reagent cells are Lu(a-)

All of the following are characteristics of Kidd antibodies except: a. IgG immunoglobulin b. ability to bind complement c. Naturally occurring d. Exhibit dosage

c. Naturally occurring

A blood bank technologist needed to confirm the presence of anti-P1 in a patient specimen. Fresh cells were not available for use, so an old panel that contained cells positive for P1 was used. No cells positive for the antigen reacted at any phase of the anti globulin test, whereas cells from the screening cells showed specificity for the presence of anti-P1. what is a possible explanation for this? a. Tech omitted LISS b. Patient expressed the p phenotype c. P1 antigen deteriorates rapidly upon storage d. Tech forgot to add AHG

c. P1 antigen deteriorates rapidly upon storage

The Fy5 antigen has been shown to be the result of an interaction between Duffy genes and: a. Lewis b. ABO c. Rh d. Kidd

c. Rh

All of the following are characteristic of anti-P1 except: a. The antibody is IgM b. The antibody reacts strongly at room temperature c. The antibody is not neutralized by soluble P1 substance d. The antibody may be detected in AHG phase of antiglobulin testify polysepecific antiserum is used

c. The antibody is not neutralized by soluble P1 substance

Why is dosage inconsistent in the Duffy blood group? a. The genotype could be inherited as FyaFyb or FyaFy for Fy(a+b-) RBCs b. Antigen expression is depressed in low ionic strength media c. The genotype could be inherited as FyaFya or FyaFy of Fy(a+b-) RBCs d. All of the above

c. The genotype could be inherited as FyaFya or FyaFy of Fy(a+b-) RBCs

All of the following are characteristics of anti-M except: a. They are naturally occurring antibodies b. They do not bind complement c. They react stronger with enzyme-treated cells d. Antibodies may exhibit an IgG component

c. They react stronger with enzyme-treated cells

A patient presented in the ER needing to be transfused ASAP. According to the computer, the patient had a Kell antibody 5 years ago. The antibody screen is negative now. Of the following, the best procedure to obtain suitable blood for transfusion is: a. To use immediate spin crossmatch compatible blood b. To take the time to crossmatch the units of blood through the AHG phase c. To antigen type the units for Kell & completely crossmatch the negative ones d. To assume the electronic crossmatch is acceptable

c. To antigen type the units for Kell & completely crossmatch the negative ones

Most blood group alleles are: a. X-linked dominant b. X-linked recessive c. codominant d. None of the above

c. codominant

At birth, infant cells are rich in _____, and ______ is nearly undetectable. a. I/i b. I/H c. i/I d. H/i

c. i/I

What adult phenotype is rich in i antigen and common to the white population? a. I1 b. I2 c. i1 d. i2

c. i1

What is the most common genetic combination in the Cell blood group system? a. kKKpbJsb b. kKpbJsaK11 c. kKpbJsbK11 d. KKpbJsbK11

c. kKpbJsbK11

P1 antigens: a. are fully developed at birth b. are fully developed at 6 months c. take up to 6 or 7 years to develop d. none of the above

c. take up to 6 or 7 years to develop

Which of the following best describes the process of mitosis?

cell division that produces two daughter cells having the same number of chromosomes as the parent

What fatal disease is associated with the McLeod phenotype?

chronic granulomatous disease

A patient was previously typed as blood group O. Forward grouping was negative with anti-A and anti-B. Reverse grouping showed reactivity with A1 cells and B cells. The technologist reported this patient's type as A. What technical error occurred?

clerical error

Agglutination

clumping together of antigen bearing cells

How are the Rh antigens inherited?

codominant alleles

Hemolysis

complement causes RBCs to lyse

What factors influence the physical attachment of antibodies to RBC antigens?

concentrations of antibodies and antigens, temperature, and presence of potentiators.

All of the following may depress antigen expression except:

coronary heart disease

How do restriction endonucleases function?

cut DNA into smaller fragments

Enzymes destroy the antigens of which of the following blood groups? a. N b. Fya c. M d. All of the above

d. All of the above

In order for an individual to express Let antigen on their RBCs, they must have inherited which gene? a. Le b. Se c. H d. All of the above

d. All of the above

Lutheran antibodies are rarely associated with causing hemolytic disease of the newborn for which of the following reasons? a. Lutheran antigens are poorly developed at birth b. Maternal Lutheran antibodies are absorbed onto glycoproteins on the placenta, decreasing the likelihood of HDN c. Lutheran antibodies are generally IgM class & normally do not cross the placenta d. All of the above

d. All of the above

The structures that carry the P antigens also carry which determinants? a. A b. I c. B d. All of the above

d. All of the above

What class of immunoglobulin makes up anti-Lub? a. IgA b. IgM c. IgG d. All of the above

d. All of the above

Which of the following is not involved in the Kell blood group system? a. Jsa b. K c. Kpb d. Jka

d. Jka

Which of the following is known to enhance K antigen expression in the antihuman globulin test? a. LISS b. DTT c. Albumin d. Polyethylene glycol

d. Polyethylene glycol

Which of the following is true concerning Colton antibodies? a. Encountered frequently b. Destroyed by enzymes c. React at immediate spin d. Stimulated by RBC exposure

d. Stimulated by RBC exposure

All of the following are characteristics of Duffy antibodies except: a. They are IgG in nature b. They may or may not show dosage c. They are destroyed by enzymes d. They are not implicated in HDN

d. They are not implicated in HDN

LW has a phenotypic relationship with the ____________ antigen. a. D b. P1 c. M d. Wra

d. Wra

What are the antibody characteristics of Fy3 & Fy5? a. Immunogenic b. IgG c. Reactive at AHG d. all of the above

d. all of the above

What is found in the secretions of Le(a-b-) individuals? a. Lea b. Leb c. Both a and b d. none of the above

d. none of the above

All of the following are consistent with a "shift to the right" of the hemoglobin oxygen dissociation curve except:

decreased 2,3 DPG

All of the following are functions performed by the complement system except:

decreased vascular permeability

What type of hemolytic transfusion reaction occurs more frequently in patients with Jk antibodies?

delayed

All of the following is true regarding the Kell antigen except:

destroyed by ficin treatment

A woman came in for a cesarean section. The antibody screen was positive with a 3+ reaction in the AHG phase using screening cell I. Screening cells II and III were negative in all phases. A 8-cell panel was performed that paralleled the antibody screen where 3 cells reacted 3+ at AHG and 5 cells were negative at all phases of reactivity. The antibody identified was anti-Kell. What procedure might be helpful in predicting the infant's susceptibility to hemolytic disease of the newborn (HDN)?

determination of the father's phenotype

Only 5% OF Kell-negative individuals will develop antibodies to Kell if exposed tot eh Kell antigen, whereas 50% to 70% of Rh (D) negative individuals would produce antibodies to D upon exposure. What is the reason for this?

difference in immunogenicity

All of the following is consistent with Benign anti-I except:

do not bind complement

All of the following are important in evaluating a positive DAT except:

donation history

What is a possible consequence of incubating tubes too long with LISS when performing the IAT?

elution of antibody from red cell

Anti-Jka was identified in a previously transfused patient. Five cells that were homozygous for Jka yielded 2+ reactions in the AHG phase. The same cells were treated with ficin and yielded 3+ reactions in AHG. There fore, Jka is _____ by enzyme treatment.

enhanced

What effect do enzyme treated cells have on anti-I detection?

enhances reactivity

What characteristic differentiates Ss antigens from MN antigens?

enzyme degradation

What is a vector?

extrachromosomal genetic element that can carry a recombinant DNA molecule into a host bacterial cell

Duffy antigens are destroyed by:

ficin

All of the following are factors of antigens that affect the type and extent of immune response except:

genetic locus

Lewis cell-bound antigens absorbed from plasma on to the red cell membranes are:

glycolipids

which metabolic pathway is responsible for generating 90% of the ATP for the RBC?

glycolysis

The M and N antigens are found in which glycoprotein?

glycophorin A

The seven Gerbich antigens are located on:

glycophorins C and D

What is the biochemical structure of secreted A,B, and H substances?

glycoprotein

The portion of the immunoglobulin molecule which determine class:

heavy chain

In Mendel's law of separation, the first-filial generation is:

heterozygous

Which genotype(s) will give rise to the Bombay phenotype?

hh only

All of the following may result in weak or missing antigens except:

hypogammaglobulinemia

At birth, infant cells are rich in _____, and ______ is nearly undetectable.

i/I

At which phase are Lewis antibodies usually detected?

immediate spin

If not labeled "gamma heavy chain specific," monospecific anti-IgG may contain antibodies to:

immunoglobulin light chains

The indirect antiglobulin test detects which antigen-antibody reactions?

in vitro

A patient came in for a routine type and screen prior to surgery. The antibody screen was negative at 37°C and AHG phase. Check cells did not produce agglutination often. What is a possible explanation for this result?

inadequate washing

All of the following biochemical changes are associated with loss of red cell viability upon storage except:

increased ATP level

Which of the following may be a possible cause for the lack of expression of Lewis antigens during pregnancy?

increased ration of plasma lipoproteins to red cell mass

Persons who are genetically P1 may serologically type as P2 because of:

inheritance of the In(Lu) gene

Where is the Rh antigen located relative to the red cell membrane?

integrally

In an immune response, what is the time called in which no antibody is detected in test serum?

latency period

Person who inherit the Se and Le gene will have _____ A or B glyolipids in plasma than persons who are Se le.

less

All of the following may result in rouleaux formation except:

leukemia

All of the following conditions may produce a positive DAT except:

lymphoma

Which of the following metabolic pathway is responsible for maintaining heme iron in the ferrous (Fe) state?

methemoglobin reductase

What amino acid is specific for S antigen?

methionine

IgG-coated red cells will be phagocytized by what effector cells?

monocytes/macrophages

The homozygous phenotype Fy(a+b-) has _____ antigentic Fy" sites than heterozygous cells, Fy(a+b+).

more

All of the following are characteristics of Kidd antibodies except:

naturally occuring

Red cells were ficin treated to help rule in anti-M from a panel study. Cells not treated reacted at 2+ at immediate spin and 1+ at 37C. There was no reactivity in the Coombs phase. Ficin-treated cells demostrated a ______ reaction with patient serum containing anti-M.

negative

Which of the following distinguishes the recessive LuLu gene for the dominant In(Lu) gene?

normal expression of P1

All of the following are characteristics of Duffy antibodies except:

not implicated in hemolytic disease of the newborn

f antigen

only when ce are produced by same gene

How would a negative IAT be demonstrated in solid phase methodology?

pellet at bottom of well

When an individual is said to have blood group A, it refers to the individual's:

phenotype

Persons who express the phenotype P2 are at risk for developing anti-P1 when handling what animal species?

pigeons

Rh is highly

polymorphic

A positive autocontrol in antibody detection procedures is usually indicative of:

positive DAT

What is a possible explanation for a nonreactive eluate?

positive DAT due to drugs

What is the function of mononuclear phagocytes?

present processed antigen to lymphocytes

How are ABH antigens formed?

production of specific glycosyltransferases add sugars to precursor substances

What are the advantages of using chemically modified anti-D?

provides a low-protein medium

Which donor is not selected for a recipient with anti-D?

r'r^y

Where are the Duffy antigens found?

red cells

Anti-N is known to occur in _____ patients undergoing dialysis with equipment sterilized by formaldehyde?

renal

An antibody screen is performed, and all three tubes are negative after adding AHG. Check cells are added, and the tubes are centrifuged. No agglutination occurs after the addition of check cells. What is the next course of action?

repeat the antibody screen

Anti-Lu^a reacts at what temperature?

room temperature

What is one possible genotype for a patient who develops anti-C antibodies?

rr

A patient developed a combination of Rh antibodies: anti-C, and anti-E, and anti-D. Can compatible blood be found for this patient?

rr blood could be used without causing a problem

Reverse grouping was performed on an AB person. The technologist observed a very weak agglutination macroscopically. The cells appeared as "stacked coins" under a microscope. Which reagent should be added to the tube and recentrifuged in an attempt to resolve the discrepancy?

saline

A patient with multiple myeloma exhibits rouleaux formation in an immediate spin crossmatch. What procedure is recommended to distinguish true red cell agglutination from nonspecific agglutination?

saline dilution

What is a "lectin"?

seed extracts that agglutinate human cells with moderate specificity

What would the hemoglobin oxygen dissociation curve depict in a patient exhibiting clinical signs of alkalosis?

shift to the left

What would be a realistic source of finding compatible units for a person with an antibody to a high-frequency antigen?

sibilings

The Dia and Dib antigens are located on:

the anion exchange molecule (AE-1)

A patient is suspected of having paroxysmal cold hemoglobinuria. Which pattern of reactivity is characteristic of the Donath-Landsteriner antibody, which cause this condition?

the antibody attaches to RBCs at 4 degrees Celsius and causes hemolysis at 37 degrees Celsius.

Why are "check cells" added to all negative reactions in the AHG test?

to ensure AHG was not neutralized by free globulin molecules

What is the purpose of washing cells in the AHG test?

to remove all unbound protein

What is the function of helicases and gyrases in the polymerase chain reaction?

to unwind the DNA

Which of the following corresponds to the basic structure of immunoglobulin?

two light chains and two heavy chains held together by covalent disulfide bonds

What is responsible for recognition of the antibody-binding sit to homologous antigen?

variable region of light/heavy chain

Bg antibodies are primarily directed toward antigenic determinants present on:

white blood cells