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MMSC 409 EXAM 3 WITH COMPLETE SOLUTIONS 100%2023/2024
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MMSC 409 EXAM 3 WITH COMPLETE SOLUTIONS 100%2023/2024
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MMSC 409 EXAM 3 WITH COMPLETE SOLUTIONS 100%2023/2024Lewis blood group - correct answer -antigens: Lea & Leb
-alleles: Le dominant and le recessive
-dominant Le codes for the production of a glycosyltransferase and Lea and Leb antigens
-interacts with the secretor genes (Se and se) -ISBT # 007
Le(a+b-) - correct answer white: 22%
black: 23%
Le(a-b+) - correct answer white: 72%
black: 55%
Le(a-b-) - correct answer white: 6%
*black: 22%*
Le(a+b+) - correct answer rare phenotype that is only seen in the Asian population
-Lewis b antigen usually out-competes Lewis a antigen for a place on the RBC membrane, but in this case
they are both present on the RBC
Lewis and Secretor gene interaction - correct answer -if someone has Le gene they produce Lea and Leb antigens
-if they are a secretor (Se) they will secrete Lea and Leb into their plasma and body fluids, Leb will be detected on RBCs
-if they are not a secretor (se) they will only secrete Lea antigen into plasma and body fluids, Lea antigen will be present on the RBCs Lewis ABO and H interaction - correct answer -H gene codes for fucosyltransferase that adds L fucose onto RBC membrane
-L-fucose sugar allows ABO antigenic sugars to attach to the RBC
-L-fucose allows Lea and Leb antigenic glycolipids to attach to the RBC membrane
-type O individuals have the highest amount of L-fucose attached to the RBC, so they can have the greatest amount of Lewis antigens that attach to the RBC
lewis antigen synthesis - correct answer -Lea and Leb are produced by tissue cells and get secreted into body fluids
-Lea and Leb that are secreted into the plasma are adsorbed onto the RBC membrane and become RBC antigens
-lewis antigens in the body fluids= glycoproteins
-lewis antigens on the RBC membrane= glycolipids
lewis type - correct answer -Le= person produces Lea and Leb
-le= person does not produce lewis antigens
-Se= person secretes lewis antigens, ABO antigens and H antigen into body fluids, RBCs will be type Leb
-se= non secretor, RBCs will be Lea
Le(a-b-) phenotype - correct answer -lele genotype: person is unable to produce Lea or Leb antigens
-Le(w) mutation: mutation in the Lewis gene that makes it impossible to produce the antigens
-pregnancy: short term changes in phenotype can be seen due to anti-Lea or anti-Leb that form in maternal circulation and disappear after the baby is born
lewis HDFN - correct answer NOT a cause of HDFN
-anti-Lea or anti-Leb that form during pregnancy are IgM antibodies that are too large to cross the placenta
-if there were an IgG anti-lewis it would still not be that significant because neonate RBCs have no lewis antigens (Le(a-b-)) until about 10 days of age
lewis HTR (hemolytic transfusion reaction) - correct answer reaction that is really only seen in Le(a-b-) individuals because they are generally the only ones who form Lewis antibodies -IgM antibodies, not usually hemolytic
-IgG component that binds complement and reacts all the way through the AHG phase of testing indicates that there is a high chance of hemolytic transfusion reaction (provide antigen negative blood to
individual)
lewis antibodies - correct answer -anti-Lea and anti-Leb
-IgM antibodies, mainly seen at IS phase of testing
-antibodies that react through the 37C and AHG phases of testing have an IgG component and are likely to cause a HTR
-might not react with every single antigen positive cell -mainly seen in Le(a-b-) individuals
-when they are present it will make the patient's serum react with nearly every cell in a ABSC and ABID panel, making it difficult to determine the other antibodies that are present in the serum
lewis neutralization - correct answer -lewis antigens are very high incidence, so if someone has an antibody it will make ABID and ABSC panels way too reactive -using pure commercial Lewis substance neutralizes the antibodies out of the serum, and then the patient serum can be re-tested against the panel again to see if other clinically significant antibodies are present
anti-lea antibody - correct answer antibody is NOT produced by people of the Le(a-b+) phenotype
-these people with the Le allele produce both Lea and Leb antigens, and will not produce antibodies against self antigens
-these people only have Leb antigen on their RBCs, becuase the Leb antigens compete for a spot to adhere on the RBC membrane more effectively
Duffy blood group - correct answer -antigens: Fya and Fyb
-alleles: codominant Fya, Fyb and Fy (no antigen)
-ISBT # 008
65% - correct answer Fya frequency (duffy)
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