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Csmls Review Transfusion Questions And Answers With Verified Solutions Already Graded A+ Latest Updated 2024

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  • September 29, 2024
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  • 2024/2025
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Csmls Review Transfusion Questions
And Answers With Verified Solutions
Already Graded A+ Latest Updated 2024
ABO Blood Group - ANSWER✔✔ Landsteiner
- we have Ab against Ag we lack


ABO Ab are naturally occurring, stimulated by nature
- low # until 3-6 months


Ag are codominant
one locus Chr 9 has ⅓ A,B,O
each person has 2 Chr 9 with one allele


Genes at 3 loci control presence and location of the A,B,H Ag = ABO, Hh, Se


A and B genes encode glycosyltransferases which transfers immunodominant
sugar specificity of A and B Ag
Group O = silent allele (no gene product)


Hh and Se on CHr 19 closely links
h and se = amorph (no detectable product = no glycosyl tranferase)
H makes glycosyltransferase acting on 2 chains on H Ag on RBCs (H on RBC)
Se = glycosyltransferase acts on 1 chains H Ag in secretions ( H in secretions)


Bombay Phenotype - ANSWER✔✔ hh

,no H Ag bc no transferase


will not react with Anti-A, Anti-B or Anti-H lectin


their serum will have anti-A, anti-B, anti-A,B and Anti-H
reacts strongly at 37˚C


only can be transfused by other Bombay phenotypes


O has most H substance then A then AB


A Subgroups - ANSWER✔✔ A subgroups
80% A1
20% A2


differentiating A1 and A2 based on Anti-A1 lectin Dolichos biflorus


A1 react with anti-A1
A2 cells do not


Weak A subgroups (<A2)
A3 = mix field agglutination with Anti-A
Ax = stronger reaction with anti-A,B then anti-A
weaker ones only detected by elution and adsorption of anti-A

,Antibodies to A and B Ag - ANSWER✔✔ People A and B make IgM Ab (a little
IgG)
People who are O make IgG (anti-A,B)


ABO sugars - ANSWER✔✔ H Ag L-fucose


A Ag N-acetylgalactosamine


B Ag D-galactose


ABO testing - ANSWER✔✔ Forward
reagent = monoclonal Anti-A and Anti-B
give strong reactions (>/= 3+)


Reverse grouping
A1 cells and B cells (Rh neg)
(>/= 2+)-> weaker = serum problem


other reagents
Anti-A,B = subgroups classification or confirm group O units
A2 cells (resolve discrepancies)


Lectins
Anti-A1 D. biflorus
Anti-H Ulex europaeus

, 1/4 Discrepancy resolution (weak or missing Ag reactivity)-> cell grouping tests -
ANSWER✔✔ Subgroups of A and B =
- A3 subgroup mixed field pattern with
anti -A (from group O or B donors)
- Ax subgroup No agglutination with
anti-A from group B but agglutinate with anti-A,B from group O donors
- Ael subgroup not agglutinated by anti-A or anti-A,B -> Ag only shown with
elution
- B subgroups very rare
leukemia and new borns may have weak expression of A / B Ag


Chimera = transfusion Hx


2/4 Discrepancy resolution (Extra Ag reactivity)
cell grouping tests - ANSWER✔✔ Acquired B
- type as AB, but serum has anti-B
*assoc with GI tract disorder (transient)
Strength of reactivity weakened with decreased pH weakens reactivity (test at pH
6.0 acidified) -> missing fwd group?
* test cells with monoclonal anti-B reagent (doesn't detect acquired B), autocontrol
will also be negative


Pos DAT
- cells agglutinate spontaneously (Rh)
- can be ABO reagents if cold reactive Ab causing pos DAT

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