Warm Reacting Ag System.txt

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moses1424
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89858
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Warm Reacting Ag System.txt
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2011-06-08 20:22:03
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Warm Reacting Ag System
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Warm Reacting Ag System
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  1. Discover of the Kidd System
    Discovered in pregnant woman in 1951 & 1953 because of HDN.
  2. Clinical Significance of Kidd System
    • IgG Antibody
    • Causes delayed HTRxn and HDN
    • Transfusion reaction sever as well as delayed.
  3. Pacific Islanders have what, Kidd?
    Jk Silent Allele
  4. Kidd Antigen Structure
    • 389 Amino Acids
    • Multipass 10 membrane passes
  5. Kidd Antigen responsible for the transport of what?
    • Urea
    • People with null phenotype do not concentrate urine well.
  6. Jka and Jkb are what dominant?
    Co-Dominant
  7. Kidd has how many genes and where?
    4 Allelic genes on Ch#18
  8. What is the Kidd Null phenotype?
    • Jk
    • Silent Allele
    • Discovered in 1959
  9. JK (a- b+)
    What is genotype?
    And percent in population
    • Jkb+ Jkb+ or Jkb+ Jk
    • Whites: 23
    • Blacks: 8
    • Asians: 27
  10. Inhibitor gene for Kidd
    In (JK)
  11. JK (a+ b-)
    What is genotype?
    and percent in population?
    • Jka+ Jka or Jka+ Jk
    • Whites: 26
    • Blacks: 51
    • Asians: 23
  12. JK (a+b+)
    What is genotype?
    • Jka+ Jkb+
    • Whites: 50
    • Blacks: 41
    • Asians: 49
  13. JK (a-b-)
    What is genotype?
    Percent in population?
    • Jk Jk or In (Jk)
    • Polynesians: 0.9
    • Blacks whites and asians: Extremely Rare
  14. Kidd Antibodies
    • Anti Jka
    • Anti Jkb
    • IgG
    • React best in AHG Phase
    • Complement dependant.
    • Storage Weakens Ag
  15. Anti Jka and Jkb react best in what phase?
    • AHG
    • Complement Dependant
  16. What Kidd Ab is most common?
    What percent lack antigen?
    • Jka
    • 25% of whites negative for Jka
    • 9-10% of blacks negative for Jka
  17. Enzymes do what to Jka and Jkb reaction?
    Enhance
  18. Reminder
    Jka and Jkb BINDS COMPLEMENT
    • Reminder
    • Jka and Jkb BINDS COMPLEMENT
  19. Severity of HDN due to Kidd.
    Mild
  20. Duffy history
    Discovered 1950 in a hemophiliac patient named Duffy.
  21. What type of Ab is Duffy?
    IgG
  22. Duffy is what gene on what chromosome?
    DARC gene on CH 6
  23. FYA Codes for?
    What substitutes?
    • Fy(a) antigen.
    • Glycine substitution
  24. FYB codes for?
    What substitutes?
    • Fy(b) antigen.
    • Aspartic acid substitution.
  25. What is dominant between Fy(b) and Fy(a)?
    Codominant
  26. What is a variant of Fy(b)?
    What substitution?
    • Fx
    • Aginine substitution for cystine @AA 89
  27. Fy what type of Allele?
    What percent in populations?
    • Amorphic
    • 70% in blacks.
    • 100% gambianese
  28. Darc gene is what?
    • Duffy antigen receptor gene.
    • Functions as a cytokin and plasmodium vivax (malaria) receptor.
  29. The Darcy gene is transmembrenous and passes how many times?
    • 7 passes.
    • Glycoprotein with 63 amino acids.
  30. Darc carrier molecule converts to antigen how?
    Making a single amino acid substitution.
  31. Fy3 incidence?
    • High Incidence
    • Found on all RBCs except the null phenotype.
    • 100% whites and asians.
    • 32% blacks.
  32. Fy4 incidence?
    • High
    • Found on all RBCs except whites with null phenotype.
  33. Fy5 incidence?
    Absent from all null phenotype RBCs including Rh nullphenotype.
  34. Fy6 incidence?
    • High
    • All rbcs except null phenotype.
  35. Fy (a+b-)
    Genotype?
    • Homozygous Fy(a) Fy(a)
    • Heterozygous Fy(a) Fy
  36. Fy (a+b+)
    genotype?
    • Heterozygous Fy(a) Fy(b)
    • Heterozygous Fy(a) Fx
  37. Fy(a-b+)
    Genotype?
    • Homozygous Fy(b) Fy(b)
    • Heterozygous Fy(b) Fx
  38. Fy (a-b-)
    Genotype?
    • Null phenotype.
    • More common among blacks.
  39. 2 types of null Duffy phenotype?
    • Fy allele
    • Nonsense mutation.
  40. Fy Allele
    • Fyb gene with single neucleotide substitution that disrupts binding site.
    • Duffy antigen present on tissue but not RBCs.
  41. Nonsense mutation (Duffy)
    • Premature stop codon.
    • Duffy glycoprotein is truncated.
    • No duffy antigen on tissues or Rbcs
  42. Fy(a+b-) frequency?
    • Whites 17%
    • blacks 9%
  43. Fy(a+b+) frequency
    • Whites 49%
    • blacks 1%
  44. Fy(a-b+) frequency
    • Whites. 34%
    • blacks. 22%
  45. Fy(a-b-) frequency
    • Whites: very rare
    • Blacks: 68%
  46. Duffy antigen reaction characteristics.
    • Well developed at birth
    • Shows dosage effect with homozygous.
  47. Duffy HDN and HTRs.
    • Anti-Fy(a) causes hdn and htr.
    • Anti-Fy(b) not been found to cause hdn but causes fatal transfusion reactions.
  48. Duffy Ab works best in what phase?
    • IGG
    • works best in AHG
    • SHOWs dosage.
  49. What effect does enzymes have on anti Duffy?
    • Destroys.
    • Binds some complement.
  50. Kell history
    Found in mother named Kellaher in 1946 with HDN.
  51. Kell causes what type of transfusion reaction?
    Acute and delayed
  52. Kell accounts for what percent of detected allo antibodies?
    • 67%
    • 3rd most common cause of HDN.
  53. Anti K causes what in the fetus?
    Fetal anemia by suppresing RBC synthesis.
  54. Kell antigen structure.
    • Transmembrenous single pass Ag.
    • 732 amino acids glycosylated at 5 different site.
  55. Difference between Kell and Cellano?
    • Single amino acid substitution.
    • Methionine for Kell.
    • Threonine for Cellano.
  56. Kell is anchored to RBC by what?
    And what is it's structure?
    • XK protein
    • Multipass glycoprotein with 10 passes.
  57. Absence of XK Protein results in what?
    • McLeod phenotype.
    • Weak expression of Kell antigen.
    • Causes acanthocytes.
  58. Kel gene is found where?
    What is it's structure?
    • Found on chromosome #7
    • Highly polymorphic resulting in 25 antigens in system.
  59. What are the 2 major Kell antigens?
    • K (Kell)
    • k (cellano)
  60. What is null Kell phenotype and what can it produce?
    • Null phenotype is Ko.
    • Can produce Anti-Ku
  61. Kell inheritance
    • 3 sets of linked genes
    • Kell (K) and Cellano (k)
    • Kp(a), Kp(b), Js(b)
    • Js(a) and Js(b)
    • Inherit one set from each Parent.
    • Each pair made of one high incedence and one low incidence.
  62. What are high incidence Kell antigens?
    • Cellano (k)
    • Kp (b)
    • Js (b)
  63. Low incidence Kell genes?
    • Kell
    • Kp (a)
    • Js (a)
    • Inherate only one low incidence gene per chromosome.
  64. Most common gene complex for Kell?
    • k, Kp(b), Js(b)
    • Kp(a) rarely found in african americans.
    • Js(a) rarely found in caucasians.
  65. K+k- frequency.
    • 0.2 whites.
    • Rare in blacks.
  66. K+k+ frequency.
    • 8.8 whites.
    • Rare in blacks.
  67. K-k+
    • 91 in whites.
    • 98 in blacks.
  68. Kp(a+b-) frequency.
    • Rare in whites.
    • 0 in blacks.
  69. Kp(a+b+) frequency.
    • 2.3 whites.
    • Rare in blacks.
  70. Kp(a-b+) frequency
    • 97.7 whites.
    • 100 blacks.
  71. Js(a+b-) frequency
    • 0 in whites.
    • 1 in blacks.
  72. Js(a+b+) frequency.
    • Rare in whites.
    • 19 in blacks.
  73. Js(a-b+) frequency
    • 100 in whites
    • 80 in blacks
  74. Ko frequency
    Extremely rare blacks and whites
  75. How well is Kell developed at birth.
    Kell well developed at birth.
  76. Second only to Rho(D) in immunogenicity.
    Kell 2nd to D
  77. Kell reacts best at what stage?
    AHG
  78. Which Kell antibody shows dosage?
    Anti-Cellano (k)
  79. How well does Kell bind compliment?
    Some of the Ab bind complement?
  80. Which Kell, Duffy and Kidd Ab are clinically significant?
    All are and cause HDNs and HTRs.
  81. How well does Kell, Duffy and Kidd store?
    Labile on storage.
  82. Kell reacts how to enzymes?
    No change.
  83. S+s- frequncy
    • Whites 11%
    • Blacks 3%
  84. S+s+ Frequency
    • 44 Whites
    • 28 Blacks
  85. S-s+ Frequency
    • Whites 45%
    • Blacks 69%
  86. S-s- frequency
    • Null phenotype
    • Whites 0%
    • Blacks 1.5%
  87. s+ How frequent occurs in blacks?
    97% high incidence.
  88. What is the precursor substance for S, s, U antigens?
    Glycophorin B
  89. Ss antigen structure?
    • Single pass.
    • 72 Amino acids.
  90. S gene substitutes for what and where?
    Methionine is the substituted amino acids on the 29th position of the on the glycophorin B molecule.
  91. What substitutes for the s antigen and where?
    Threonine is the substituted amino acids on the 29th position on the glycophorin B molecule.
  92. U antigen is found on what cells?
    All RBCs with S+ or s+ cells (S+s+U+)
  93. U antigen frequency?
    • high
    • 100% of whites
    • 98.5% of blacks
  94. Anti-S formation and frequency?
    • Forms in homozygous ss genotype. (S-s+)
    • Rare anitbody
  95. Anti-s cause and frequency?
    • Forms in homozygous SS genotype (S+s-)
    • Extremely Rare anitbody.
  96. Does MNSU cause in vitro hemolysis.
    NO
  97. What effect does enzymes have on Ss?
    Variable Effect
  98. What effect does enzymes have on U?
    No Change
  99. Is SsU clinically significant?
    • Yes
    • Causes mild to severe HDNs and HTRs.
  100. What type of Alleles are Ss?
    Co-dominant
  101. What years were SsU discovered?
    47, 51, 53

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