APPLIED CONCEPTS OF BLOOD
BANKING AND TRANSFUSION
PRACTICES 4THTH EDITION BY
HOWARD EXAM WITH ACTUAL
NGN QUESTIONS AND VERIFIED
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Chapter 01: Quality Assurance and Regulation of the Blood Industry and Safety Issues in the
Blood Bank
,Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 4th Edition
MULTIPLE CHOICE
High frequency antigen. most people are homozygous dominant
h allele
* Amorph
* Behaves as recessive
* No Gene product
* heterozygous recessive is referred to as Bombay phenotype.
Chromosome 9
Genetic antigen occurs on the long arm of this chromsome. A,B, and O
Allele
Alternate form of a gene (ABO)
Genotype
The allelic combinations in an individual that cause a particular trait.
Phenotype
The expression of a gene or the observable trait
RBC antigens
Multiple Alleles
* 2 alleles for a single gene
* Increases genetic variation
Polymorphism
Several Phenotypes associated with alleles of one gene
* occuring in > 1% of the population
Amorph
No expression of a detectable gene product (Blood type O)
H allele
L-Fucosyltransferase
A allele
N-Acetylgalactosaminyltransferase
B allele
D-Galactosyltransferase
Immunodominant sugars
Immunohematology
The study of blood group antigens and antibodies
Antibodies
Immunoglobulins that are Y-shaped proteins that are produced by the immune system to help
stop intruders from harming the body
Antigens
Large molecular-weight proteins that bind to an antibody or T-cell receptor.
Location of Antigens
RBC's surface
Location of Antibodies
Plasma or serum
, Red Cell Antigens
Molecules that bind specifically to an antibody or T-cell receptor.
Location of Rh(D) antigen
Integral part of RBC membrane
Cells I&II
Expresses D antigen (D Pos)
Cells III
Lacks D antigen (D Neg)
Antihuman Globulin (AHG)
Antibodies directed against human antibodies
Used for human testing to detect IgG coating RBC's
IgG coated RBC's (Coombs check cells)
Commercially prepared RBC's coated with igG
Control for negative IAT tests.
Blood Group
A group of antigens that are part of the red cell membrane.
The number of blood group systems
34
The number of antigens
339
A, B and H antigens
Carbohydrate chains composed of hexose suars that are attached to the surface of RBCs
H allele
*Dominant
*Gene product - L-Fucosyltransferase
Terminal sugar molecule attached to glycolipids and glycoproteins.
H Antigen
Blood Group type O
* Lack A and B antigens
* Express H antigen
Forward type
Detects antigens on the RBCs
Antibodies are detectable
3-6 months of age
ABO Antigens are detectable
5-6 weeks in utero
Landsteiner's rule
Co-dominant alleles in Rh Blood group system
D
indicate D antigen
d
indicate no D antigen
Antigen Structure
Imbedded protein surrounded by plasma membrane lipids
Proteins
Crosses the RBC membrane 12 times
, the number of recognized antigens in Rh system
61
Percentage of RhD Pos
85%
the presence of D antigen
determines Rh pos and Rh neg
Healthy individuals posses ABO antibodies directed against the ABO blood group antigens not
expressed on their own RBC's
Test sample
Patient or donor's plasma or serum
Reagents
Commercially prepared RBCs A1 cells B cells
Antisera
A blood serum containing antibodies against specific antigens, injected to treat or protect against
specific diseases.
Forward Type
Patient RBCs (antigen) combined with reagent antisera (antibody) to determine which antigens
are present on the RBC
Reverse Type
Tests antibodies
Rh Blood Group System
Related to immunogenicity of D antigen
Immunogenicity
The ability to induce an immune response
C,c, and E,e
1.
Which of the following is true regarding good manufacturing practices (GMPs)?
GMPs are legal requirements established by the Food and Drug Administration.
GMPs are optional guidelines written by the AABB.
GMPs are required only by pharmaceutical companies.
GMPs are part of the quality control requirements for blood products.
ANS: A
Good manufacturing practices are requirements established by the Food and Drug
Administration.
DIF: Level 1 REF: p. 5
Which of the following is an example of an unacceptable record-keeping procedure?
Using dittos in columns to save time
Recording the date and initials next to a correction
Not deleting the original entry when making a correction
Always using permanent ink on all records
ANS: A
All records must be clearly written. Dittos are unacceptable.
DIF: Level 1 REF: p. 7