Download HASPI Blood Types and Transfusions

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Blood Types and Transfusions
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HASPI Medical Biology Lab 19
Background/Introduction
Phenotype, Genotype, and Alleles
The observable or physical characteristics, such as
eye and hair color, are called an individual’s
phenotype. Think phenotype = physical. The genes
that an individual carries are called an individual’s
genotype. Think genotype = genes. The genotype
influences and creates the phenotype. For example,
an individual who has a gene for brown eye color
(genotype) will have brown eyes (phenotype).
For every gene, there at least two versions, or alleles.
One copy comes from the mother and one copy
from the father. Alleles are for the same gene, but
http://learnscape.org/blog/wp-content/uploads/2008/12/picture-2.png
may be different variations of the gene. For example, the gene for eye color has alleles for
brown eyes, blue eyes, or green eyes. To make it easier to predict how alleles interact, they
are represented with letters. Normally a capital letter represents the dominant allele. As a
reminder, alleles can interact in a variety of ways including dominant/recessive, incomplete,
codominance, or through multiple alleles.
http://media.omedix.com/Healthwise/nr55552056.jpg
The Environment and Phenotypes
It is important to note that environmental factors can also
affect the phenotype, particularly during development. For
example, there are genes that control the normal
development of the spine and spinal cord. A mutation in
these genes can cause abnormal development of the spine
and spinal cord, causing a condition known as spina bifida. If
a mother consumes enough folic acid through vitamins or
food choices, spina bifida can be prevented in more than
70% of children that would normally develop the disease.
Probability and Punnett Squares
Statistics and probability play a key role in genetics.
The random separation of alleles during meiosis and
the combination of sperm and egg during fertilization
can result in a variety of outcomes depending on the
alleles present. Probability can be used to predict the
arrangement of alleles and can be used in combination
with collected data to produce statistically valuable information.
http://www.webquest.hawaii.edu/kahihi/mathdictionary/images/probability.png
Probability is the prediction of the chances that a certain event will occur. For example,
there is a 50% chance that a child will be male or female based on the fact that 50% of
sperm will contain an X chromosome, and 50% of sperm will contain a Y chromosome. All
eggs contain X chromosomes. With this information, it would be assumed that if a family had
4 children they would have 2 boys and 2 girls (50% and 50%). This is only a prediction, and as
you can observe in actual families is not what always occurs.
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In genetics, Punnett squares are used to calculate the probability of genotypes in children.
Predicting the genotype involves predicting the probability that a child will receive specific
alleles from the parents. It predicts the chances that the alleles will combine to produce a
specific genotype, and therefore phenotype. Punnett squares are only capable of
predicting the outcome. The actual results may be very different.
Monohybrid Cross
Dihybrid Cross
A = brown hair
a = blonde hair
Mother = Aa
Father = Aa
Mother = brown hair
Father = brown hair
B = brown eyes
A = brown hair
b = blue eyes
a = blonde hair
Mother = AaBb
Father = AaBb
Mother = brown hair, brown eyes
Father = brown hair, brown eyes
Offspring Genotype
Probability
AA = 0.25 (1/4)
Aa = 0.50 (1/2)
Aa = 0.25 (1/4)
Offspring Phenotype
Probability
Brown hair = 0.75 (3/4)
Blonde hair = 0.25 (1/4)
AABB = 0.0625
AABb = 0.125
AaBB = 0.125
AaBb = 0.25
AAbb = 0.0625
Aabb = 0.125
aaBB = 0.0625
aaBb = 0.125
aabb = 0.0625
Brown hair, brown eyes = 0.5625 (9/16)
Brown hair, blue eyes = 0.1875 (3/16)
Blonde hair, brown eyes = 0.1875 (3/16)
Blonde hair, blue eyes = 0.0625 (1/16)
Allele(s)
Parent Genotypes
Parent Phenotypes
Punnett Square
Human Blood Types
Blood is responsible for transporting materials to and from every cell in the body. These
materials include oxygen, carbon dioxide, nutrients, proteins, and medications, as a few
examples. An adult has anywhere from 4-6 Liters of total blood circulating throughout the
body. Blood contains several types of cells circulating in a liquid called plasma. Red blood
cells contain a protein called hemoglobin that is responsible for transporting oxygen. Red
blood cells also function to remove carbon dioxide from the body. White blood cells are
also present in the plasma, and are responsible for fighting infections. Platelets are present in
the plasma. Platelets assist the blood to clot, and therefore stop any bleeding when an
injury or cut occurs.
Proteins, called antigens, are attached to the surface
of red blood cells. There are two different types
of antigens, Type A and Type B. Each type is slightly
different in shape. There are 4 human blood types
depending on the combination of Type A or Type B
http://learn.genetics.utah.edu/content/begin/traits/blood/
antigens on the red blood cells. Type A has only Type A antigens, Type B has
only Type B
antigens, Type AB has both Type A and B, and Type O has neither Type A nor B.
Many people also have an additional antigen on the surface of their red blood cells called
the Rh factor. Those who have this antigen are called Rh+. Those who do not have it are
called Rh-. For this reason, you will sometimes see blood types represented as A+ or AB-,
depending on whether they have the Rh antigen or not.
Blood Types and Transfusion, HASPI Medical Biology Lab 19
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Inheritance of Blood Types
Whether an individual has the A and/or B antigens on the
surface of red blood cells depends on what was inherited
from the parents. Blood types are determined by multiple
alleles for the same gene: A and B. Two copies of the allele
are inherited, one from each parent. There are six possible
combinations of alleles to produce the 4 blood types. The
diagram to the left shows those combinations. As you can
see, there are actually 3 possible alleles: iA, iB, or i. Your blood
type is dependent on the combination of 2 of these 3 alleles
that you receive from your parents.
http://www.biologycorner.com/resources/bloodtype_chart.gif
Blood Transfusions
Some of the proteins that blood plasma contain
are called antibodies. There are many different
antibodies, and each one is responsible for
recognizing a specific antigen that may enter the
body. For example, if you have ever had the
chicken pox, caused by a virus that has antigens on
it’s surface, your body now contains antibodies made
to recognize the antigens on the virus. This makes it
easier for your body to recognize the chicken pox
virus if it ever infects you again, and start to attack
the virus faster. So fast in fact, that you will not even
have any symptoms to know you were infected with
the chicken pox again.
If a patient needs a blood transfusion, it is crucial to
match the blood types of the donor and patient. If
the donor red blood cells have antigens that are
different from those of the patient, antibodies in the
patient's blood recognize the donor blood as a
foreign. This causes an immune reaction as the body
attacks the donor red blood cells, resulting in blood
clotting. For example, if a patient with Type A blood
is given Type B blood, the patient’s body will attack
the new blood cells. The massive blood clotting that
http://learn.genetics.utah.edu/content/begin/traits/blood/
occurs throughout the body can cause shock, kidney failure, circulatory collapse, and death. On the other hand, if the donor blood cells have
antigens that are the same as those of the patient, Type B given Type B for example, the
patient's body will not see them as foreign, and no attack will occur. There are two special
blood types when it comes to blood transfusions. People with Type O blood are universal
donors because there are no molecules on the surface of the red blood cells that can
trigger an immune response. People with Type AB blood are universal recipients because
they do not have any antibodies that will recognize Type A or B surface molecules.
Blood Types and Transfusion, HASPI Medical Biology Lab 19
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Review Questions – answer questions on a separate sheet of paper
1.
2.
3.
4.
List 3 materials that blood is responsible for transporting through the body.
How much blood does an adult have circulating the body?
What is the function of red blood cells, white blood cells, and platelets?
What is the difference in antigens between Type A, Type B, Type AB, and Type O
blood types? (you may draw a picture to illustrate the difference)
5. What is the difference between Type A+ and Type A-?
6. What genotype(s) could a person with Type AB blood have? What about Type B?
7. What are antibodies, and how do they interact with antigens?
8. Why is it important to match the blood types of donors and patients during blood
transfusions?
9. Why are Type O and Type AB “special” when it comes to blood transfusions? Use
the terms antigen and antibody in your explanation.
10. Could a person with Type B blood safely receive Type A blood? Explain.
11. Could a person with Type A blood safely receive Type O blood? Explain.
12. Why is it important to have a blood transfusion of the exact type match?
13. Could a man with Type O be the father of a Type AB child? Explain.
14. Could a Type B child with a Type A mother have a Type A father? Explain.
15. Look at Diagram A below. What continent has the lowest percentage of the A
allele? The highest percentage? How and why could this have occurred?
16. Correctly complete the table below.
Blood
Group
A
B
AB
O
Antigens on red
blood cells
A
Antibodies in
plasma
Can receive
blood from
Can give blood
to
A and AB
Anti-A
A and B
O
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Blood Types and Transfusion, HASPI Medical Biology Lab 19
http://s155239215.onlinehome.us/turkic/63_Blood_Types/Blood_TypesEn_files/image003.gif
Diagram A
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HASPI Medical Biology Lab 19
Scenario
You are part of the Surgical Technology Team at HASPI Hope Hospital. The number of
patients that have died during surgery at the hospital in the last year is less than 1%, but the
surgical team lost 50% of its surgery patients on the previous day. The hospital administration
has asked your team for a review of surgical procedures to determine what may have gone
wrong. Blood transfusions were required for all 6 of the surgical patients yesterday, and
blood samples from each patient, as well as their transfusion bag samples, have been
collected for testing. The first step will be to retest the blood types to determine if any
patients may have been given the wrong blood type during the surgical procedure.
Table 1. Patient Medical Information
Patient Name/ID
Condition
Surgical
Procedure
Mr. Stone/ 55991
Mrs. Patrick/ 11180
Mr. Ascot/ 22568
Mr. Thompson/ 44875
Ms. Richards/ 66123
Ms. Johnson/ 33009
Recovery
Recovery
Deceased
Deceased
Deceased
Recovery
Hernia Repair
Tonsillectomy
Cholecystectomy
Hip Replacement
Hysterectomy
Appendectomy
Patient
Blood
Type
AB
A
O
B
O
A
Transfused
Bag/Blood
Type
Bag 1/ AB
Bag 2/ A
Bag 3/ O
Bag 4/ B
Bag 5/ O
Bag 6/ O
According to the original patient medical information given above, the patient blood types
and transfusion blood types match. You will be blood typing each of the patient samples
and transfusion bag samples to double-check. Use Table 2 to interpret your results.
Table 2. Blood Type Results
Type A
Type B
Type AB
Type O
Well A is clumped
together or cloudy
Well B is clumped
together or cloudy
Wells A & B are clumped
together or cloudy
None of the wells are
clumped or cloudy
A
A
A
A
B
B
B
B
Materials
Blood typing tray
Toothpicks (12)
Anti-A serum
Anti-B serum
Pencil
Paper towel
Blood sample - Mr. Stone
Blood sample - Mrs. Patrick
Blood sample - Mr. Ascot
Blood sample - Mr. Thompson
Blood sample - Ms. Richards
Blood sample - Ms. Johnson
Blood sample - Bag 2
Blood sample - Bag 3
Blood sample - Bag 4
Blood sample - Bag 5
Blood sample – Bag 6
Blood sample - Bag 1
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Procedure/Directions
Period:
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Your lab team will be given tasks, or directions, to perform on the left. Record your questions,
observations, or required response to each task on the right.
Task
Response
The patient blood samples and
transfusion bag samples will be
rotated throughout all lab groups
b. What will the results show if the blood type is B?
for testing, so start with whichever
blood sample you receive.
c. What will the results show if the blood type is AB?
Place 2-3 drops of the blood
sample in well A, and 2-3 drops of
the blood sample in well B of your
d. What will the results show if the blood type is O?
blood typing tray (we will not be
using well Rh for this lab).
Place 2-3 drops of Anti-A serum
(blue) in well A. Mix thoroughly
with a clean toothpick.
Place 2-3 drops of Anti-B serum
Table 3. Actual Patient Blood Types
(yellow) in well B. Mix thoroughly
Patient Name/ID
Anti-A
Anti-B
with the opposite side of the
Reaction Reaction
toothpick you used for well A.
Mr. Stone/ 55991
Observe each well for
Mrs. Patrick/ 11180
agglutination (clumping). See
Table 2 for examples.
Mr. Ascot/ 22568
If well A shows agglutination, put a
Mr. Thompson/ 44875
+ in the Anti-A Reaction column. If
it does not show agglutination, put
Ms. Richards/ 66123
a – in the Anti-A Reaction column.
Ms. Johnson/ 33009
a. What will the results show if the blood type is A?
1
2
3
4
5
6
7
8
9
If well B shows agglutination, put a
+ in the Anti-B Reaction column. If
it does not show agglutination, put
a – in the Anti-B Reaction column.
Record your results in Table 3 for
the patient sample, and Table 4
for the transfusion bag sample.
Rinse off and dry the well tray with
a paper towel. Repeat steps 2-8
for all of the patient blood samples
and the transfusion bag samples.
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Blood
Type
Table 4. Actual Transfusion Bag Blood Types
Transfusion
Anti-A
Anti-B
Blood
Bag
Reaction Reaction
Type
Bag 1
Bag 2
Bag 3
Bag 4
Bag 5
Bag 6
Blood Types and Transfusion, HASPI Medical Biology Lab 19
Name(s):
Analysis & Interpretation
Period:
Date:
Analysis Questions – answer questions on a separate sheet of paper
1. Create a combined data table that summarizes the original patient and
transfusion blood types from the Patient Medical Information, and the blood
types you obtained from your testing from Table 3 and Table 4.
2. For each of the patients, summarize the purpose of the surgical procedure
performed as indicated in the Patient Medical Information.
3. Did any of the patients who received Type O have any problems? Explain why
someone who received Type O in surgery might have a problem with
agglutination.
4. Explain on a cellular level why giving someone Type B if he or she is Type A
would be a problem.
5. Why did this day have an abnormally high mortality rate?
6. Do you think this is a case of negligence or malpractice? Explain your answer.
Connections & Applications
Your instructor may assign or allow you to choose any of the following activities. As per
NGSS/CCSS, these extensions allow students to explore outside activities recommended by
the standards.
1. DETERMINING BLOOD TYPES: Human blood types have multiple alleles and are
codominant. The alleles include iA, iB, and i. Different combinations of these alleles
produce the different blood types. An additional gene also affects blood types. The
Rh factor is dominant/recessive with Rh+ being dominant and Rh - being recessive.
Use Punnett squares to answer the following probability problems.
a. A mother has the genotype iAiB and a father has the genotype iAi. What are the
phenotypes of each parent? What are the possible genotypes and phenotypes
of their children?
b. A mother has the genotype iAiA and a father has the genotype iBiB. What are
the phenotypes of each parent? What are the possible genotypes and
phenotypes of their children?
c. A mother has the genotype iBi and is heterozygous Rh +. A father has the
genotype iBiB and is heterozygous Rh+. What are the phenotypes of each
parent? What are the possible genotypes and phenotypes of their children?
d. If a mother is Type AB+ and a father is Type O -, what are the chances their
children will be type O+? Explain your answer.
e. If you are Type O -, can you donate blood to an individual with Type B+?
Explain your answer.
f. If you are Type AB+, can you donate blood to an individual with Type A+?
Explain your answer.
g. When a baby is Rh+ and the mother is Rh -, it is called Rh incompatibility. This
can lead to serious health problems, even death, if the baby and mother’s
blood intermingle. If a mother is Rh - and a father is heterozygous Rh +, what are
the chances their baby will have Rh incompatibility?
Blood Types and Transfusion, HASPI Medical Biology Lab 19
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2. BLOOD TYPE ALLELE PERCENTAGES: Table 5 shows the average percentage of people
in the world that have a specific blood type.
Table 5. Worldwide Blood Type Percentages
Blood Type
O
A
B
AB
%
45
40
12
3
Rh+ Rh85
15
a. Complete Table 6 below using the information provided in Table 5.
Blood
Type
% of Non Rh
Blood Type
% Rh+ or Rh-
Multiplied
Together
Blood Type %
(divide by 100)
O+
OA+
AB+
BAB +
AB b. Using the data from Table 6, create a digital line or bar graph of the results (use
Excel or online format that allows you to print the graph). Include a title, key, and
labels.
3. RESEARCH: Using the internet, research blood type distribution by percentage in the
following countries: United States, Japan, China, Norway, Australia, Africa, Canada,
and South America (Mexico). For each country, provide the following:
a. Percentage of Type O, A, B, and AB.
b. Compare and contrast the percentages to the worldwide percentages
in Table 5.
c. Cite reference of where you found the information.
NOTE: This will take some research, and cross-checking, so rely on the first
website you find!
Resources and References
•
“Blood Groups, Blood Typing and Blood Transfusions". 2011. Nobelprize.org.
http://nobelprize.org/educational/medicine/landsteiner/readmore.html.
•
Genetic Science Learning Center, Genes and Blood Type. 2011. Learn. Genetics.
http://learn.genetics.utah.edu/content/begin/traits/blood/.
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Blood Types and Transfusion, HASPI Medical Biology Lab 19