19a Blood Types - Ascent...

Blood Types and Transfusion, HASPI Medical Biology Lab 19 491

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Blood Types and TransfusionsHASPI 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 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.

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

Allele(s) A = brown hair a = blonde hair

B = brown eyes A = brown hair b = blue eyes a = blonde hair

Parent Genotypes Mother = Aa Father = Aa

Mother = AaBb Father = AaBb

Parent Phenotypes Mother = brown hair Father = brown hair

Mother = brown hair, brown eyes Father = brown hair, brown eyes

Punnett Square

Offspring Genotype Probability

AA = 0.25 (1/4) Aa = 0.50 (1/2) Aa = 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

Offspring Phenotype Probability

Brown hair = 0.75 (3/4) Blonde hair = 0.25 (1/4)

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)

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 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.

http://learn.genetics.utah.edu/content/begin/traits/blood/



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.

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 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.

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http://learn.genetics.utah.edu/content/begin/traits/blood/



Blood Group

Antigens on red blood cells

Antibodies in plasma

Can receive blood from

Can give blood to

A A A and AB B Anti-A

AB A and B O O

Diagram A

Review Questions – answer questions on a separate sheet of paper 1. List 3 materials that blood is responsible for transporting through the body. 2. How much blood does an adult have circulating the body? 3. What is the function of red blood cells, white blood cells, and platelets? 4. 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.

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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

Patient Blood Type

Transfused Bag/Blood

Type Mr. Stone/ 55991 Recovery Hernia Repair AB Bag 1/ AB Mrs. Patrick/ 11180 Recovery Tonsillectomy A Bag 2/ A Mr. Ascot/ 22568 Deceased Cholecystectomy O Bag 3/ O Mr. Thompson/ 44875 Deceased Hip Replacement B Bag 4/ B Ms. Richards/ 66123 Deceased Hysterectomy O Bag 5/ O Ms. Johnson/ 33009 Recovery Appendectomy A 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

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 1

Blood sample - Bag 2 Blood sample - Bag 3 Blood sample - Bag 4 Blood sample - Bag 5 Blood sample – Bag 6

A

B

A A A

B B B



Procedure/Directions 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

1

The patient blood samples and transfusion bag samples will be rotated throughout all lab groups for testing, so start with whichever blood sample you receive.

a. What will the results show if the blood type is A? b. What will the results show if the blood type is B? c. What will the results show if the blood type is AB? d. What will the results show if the blood type is O?

2

Place 2-3 drops of the blood sample in well A, and 2-3 drops of the blood sample in well B of your blood typing tray (we will not be using well Rh for this lab).

3

Place 2-3 drops of Anti-A serum (blue) in well A. Mix thoroughly with a clean toothpick.

4

Place 2-3 drops of Anti-B serum (yellow) in well B. Mix thoroughly with the opposite side of the toothpick you used for well A.

Table 3. Actual Patient Blood Types Patient Name/ID Anti-A

Reaction Anti-B Reaction

Blood Type

Mr. Stone/ 55991

Mrs. Patrick/ 11180

Mr. Ascot/ 22568

Mr. Thompson/ 44875

Ms. Richards/ 66123

Ms. Johnson/ 33009

5

Observe each well for agglutination (clumping). See Table 2 for examples.

6

If well A shows agglutination, put a + in the Anti-A Reaction column. If it does not show agglutination, put a – in the Anti-A Reaction column.

7

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.

Table 4. Actual Transfusion Bag Blood Types Transfusion

Bag Anti-A Reaction

Anti-B Reaction

Blood Type

Bag 1

Bag 2

Bag 3

Bag 4

Bag 5

Bag 6

8

Record your results in Table 3 for the patient sample, and Table 4 for the transfusion bag sample.

9

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.



Analysis & Interpretation 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?

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.



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 Rh+ Rh-

%

45

40

12

3

85

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 +

O -

A +

A -

B +

B -

AB +

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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