Immunology 7

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Immunology 7
2010-02-21 20:31:03
immunology 7 usp james donaldson zinc

Immunology 7
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  1. List some symptoms indicative of a wrongful blood-type transfusion.
    • Symptoms resemble physiological shock.
    • 1.) Delusions (3rd)
    • 2.) Chest pain
    • 3.) Back pain (1st)
    • 4.) Rashes
    • 5.) Shortness of breath (2nd)
    • Same symptoms as PCN allergy.
  2. Type "O" blood - for example - contains anti-A and anti-B antibodies. However, it is safe to give someone with type "A" blood a transfusion of type "O" blood. Why is this?
    An individual with type "O" blood will have many different types of antibodies in their plasma, including anti-A epitopes. However, the number of any one given antibody is extremely small, and overall will not have a noticeable effect.
  3. Anti-B antibodies transfused into a "B"-patient is (deadly/harmless). "A"-type blood cells transfused into a "B"-patient is (deadly/harmless).
    • 1.) Harmless
    • 2.) Deadly
  4. True or False?
    Bombay individuals do not have antibodies against any of the blood types and can therefore receive any transfusion available.
    • False.
    • They have antibodies against all three blood types.
  5. True or False?
    Due to the difficulty of fractioning techniques, most transfusions contain all of the components of blood (ex. plasma, RBC's, WBC's, Platelets).
    • False.
    • People usually do not get whole blood.
  6. What does the "+/-" mean in the ABO epitope system?
    It refers to the Rh epitope system - that is, the Rhesus factor (first seen in Rhesus monkeys).
  7. What two genes exist in the Rh epitope system?
    • 1.) "CcEe" gene
    • 2.) "D" gene
  8. Which of the two Rh system's genes have no known clinical significance?
    The "CcEe" gene has 6 different alleles but no known clinical significance.
  9. What 2 alleles exist for the "D" gene of the Rh system?
    • 1.) "D" allele
    • 2.) amorph allele
  10. If an individual has one or more copies of the "D" allele of the Rh system, they are classified as ________, and comprise __________ of the population.
    • 1.) Rh+ or RhD (expressing the D-epitope)
    • 2.) 85 %
  11. When is the Rh epitope system medically significant?
    When you an Rh- (amorph/amorph) female has become pregnant by an Rh+ male.
  12. If an Rh- female becomes pregnant by an Rh+ male, what are the chances that the child will express the Rh epitope?
    • Depending on the genotype of the father, the chances are:
    • 1.) 50% (if father was heterozygous)
    • 2.) 100% (if father bred true)
  13. True or False?
    Cells present in amniotic fluid are characteristic of the fetus.
    • True.
    • During birth process, contractions of the uterus may cause these cells to enter the mother's blood stream through tiny tears in the birth canal.
  14. True of False?
    If a relatively small amount of fetal Rh+ cells enter the mother's (Rh-) bloodstream, antibodies will be produced against them.
    • False.
    • If its only a small amount, phagocytosis will be sufficient and an immune response will not be initiated. However, if a relatively large amount enter the mother's body, antibodies will be produced.
  15. True or False?
    The Rh epitope can evoke a strong immune response in Rh- individuals.
  16. If an Rh- female is pregnant with an Rh+ child, and it is her first pregnancy, will there be an immune response?
    No, her body has not yet been exposed to the child's Rh epitope.
  17. If an Rh- female is pregnant with an Rh+ child, and it is her second such pregnancy, will there be an immune response?
    No. Since her antibodies against the Rh epitope from her first pregnancy lived only for about 21 days.
  18. Antibodies produced by plasma cells derived from B-cells have a half life of ______. Antibodies produced by plasma cells derived from memory cells have a half life of _______.
    • 1.) About 21 days
    • 2.) Months to years
  19. An Rh- mother is pregnant with an Rh+ child. How long do her antibodies live after her...
    1st pregnancy?
    2nd pregnancy?
    • 1.) About 3 weeks (21 days)
    • 2.) Months to years
  20. If an Rh- female is pregnant with an Rh+ child, and it is her third such pregnancy, will there be an immune response?
    Yes. Her antibodies against the Rh epitope from her second pregnancy were derived from memory cells, and thus are still circulating her body. They can cross the placenta and attack the fetal RBC's.
  21. What is the consequence of maternal Rh-epitope-antibodies entering her fetus?
    The antibodies will attach to the fetal RBC's, causing them to be phagocytized. The baby will suffer from anemia at a point in its development when oxygen is critical to organ growth.
  22. What terms describe a newborn who has suffered anemia from its mother's anti-Rh antibodies?
    • 1.) Historically known as "blue baby"
    • 2.) Scientifically called erythroblastosis fetalis
    • 3.) Recently called "hemolytic disease of the newborn"
  23. True or False?
    Erythroblastosis fetalis is still a prominent problem today.
    • False.
    • It hasn't been a serious medical issue since the 1970's with the introduction of Rhogam.
  24. What is the active ingredient in Rhogam?
    Rh+ (RhD) antibodies.
  25. What is the principle behind the effectiveness of Rhogam?
    The drug is given to the Rh- mother before the Rh+ fetal blood cells enter her body. Upon infiltration, the antibodies bind to the fetal RBC's, flagging them for immediate phagocytosis. If they are 100% eliminated, her body will never need an immune response.
  26. What is the new protocol for administration of Rhogam?
    Injection at 28 weeks of pregnancy and 24 hours after pregnancy.
  27. At _______ weeks of pregnancy, the blood type of the fetus can be determined by a procedure called ________.
    • 1.) 20 weeks
    • 2.) Amniocentesis
  28. True or False?
    At childbirth, some Rh- women already show the presence of Rh+ antibodies.
    • True.
    • Hypothesis: Some fetuses grow faster than placenta and thus cause microscopic tears and an exchange of cells. This is the basis for the new administration of Rhogam.
  29. True or False?
    The fetal immune system begins functioning very early in utero .
    • False.
    • It is non-functional until after birth. Up to that time, they rely on their mother's immune system.