Part 1 - Get a Lab Appointment and Install Software:
Set up an Account on the Scheduler (FIRST TIME USING NANSLO):
Find the email from your instructor with the URL (link) to sign up at the scheduler.
Set up your scheduling system account and schedule your lab appointment.
NOTE: You cannot make an appointment until two weeks prior to the start date of this lab assignment.
You can get your username and password from your email to schedule within this time frame.
Install the Citrix software: – go to http://receiver.citrix.com and click
download > accept > run > install (FIRST TIME USING NANSLO).
You only have to do this ONCE. Do NOT open it after installing. It will work automatically when you go
to your lab. (more info at
http://www.wiche.edu/info/nanslo/creative_science/Installing_Citrix_Receiver_Program.pdf)
Scheduling Additional Lab Appointments:
Get your scheduler account username and password from your email.
Go to the URL (link) given to you by your instructor and set up your appointment.
(more info at http://www.wiche.edu/nanslo/creative-science-solutions/students-scheduling-labs)
Changing Your Scheduled Lab Appointment:
Get your scheduler account username and password from your email. Go to http://scheduler.nanslo.org
and select the “I am a student” button. Log in to go to the student dashboard and modify your
appointment time. (more info at http://www.wiche.edu/nanslo/creative-science-solutions/studentsscheduling-labs)
Part 2 – Before Lab Day:
Read your lab experiment background and procedure below, pages 1-28.
Submit your completed Pre-Lab 1-4 Questions (pages 7-10) per your faculty’s instructions.
Watch the Microscope Control Panel Video Tutorial
http://www.wiche.edu/nanslo/lab-tutorials#microscope
Part 3 – Lab Day
Log in to your lab session – 2 options:
1)Retrieve your email from the scheduler with your appointment info or
2) Log in to the student dashboard and join your session by going to http://scheduler.nanslo.org
NOTE: You cannot log in to your session before the date and start time of your appointment. Use
Internet Explorer or Firefox.
Click on the yellow button in on the bottom of the screen and follow the instructions to talk to your lab
partners and the lab tech.
Remote Lab Activity
SUBJECT SEMESTER: ____________
TITLE OF LAB: Hematology
Lab format: This lab is a remote lab activity.
Relationship to theory (if appropriate): In this lab you will learn to identify the cellular
components of blood and how perturbations in its structure or composition can cause
physiological problems.
Instructions for Instructors: This protocol is written under an open source CC BY license. You
may use the procedure as is or modify as necessary for your class. Be sure to let your students
know if they should complete optional exercises in this lab procedure as lab technicians will not
know if you want your students to complete optional exercise.
Instructions for Students: Read the complete laboratory procedure before coming to lab.
Under the experimental sections, complete all pre-lab materials before logging on to the
remote lab, complete data collection sections during your on-line period, and answer questions
in analysis sections after your on-line period. Your instructor will let you know if you are
required to complete any optional exercises in this lab.
Remote Resources: Primary - Microscope; Secondary - Mitosis and Meiosis Slide Set.
CONTENTS FOR THIS NANSLO LAB ACTIVITY:
Learning Objectives..............................................................................................................
Background Information .....................................................................................................
Equipment ...........................................................................................................................
Preparing for this NANSLO Lab Activity ..............................................................................
Experimental Procedure .....................................................................................................
Pre-lab Exercise 1: Microscopic Examination of the Formed Elements of Blood ...............
Exercise 1: Microscopic Examination of the Formed Elements of Blood ..........................
Pre-lab Exercise 2: Normal Red Blood Cells and Sickled Cells Slide Observation ..............
Exercise 2: Normal Red Blood Cells and Sickled Cells Slide Observation ..........................
Pre-lab Exercise 3: Normal Red Blood Cells and Thalassemia majors Slide Observation ..
Exercise 3: Normal Red Blood Cells and Thalassemia majors Slide Observation ..............
Pre-lab Exercise 4: Normal and Infectious Mononucleosis Blood Observation ...............
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2
2-8
8
8-9
9
9
10-11
11
11-12
12
12
13
CONTENTS FOR THIS NANSLO LAB ACTIVITY – CONT’d
Exercise 4: Normal and Infectious Mononucleosis Blood Observation ............................
Exercise 5: ABO-RH Blood Typing .......................................................................................
Summary Questions ............................................................................................................
Creative Commons Licensing ..............................................................................................
U.S. Department of Labor Information ...............................................................................
13
13-15
15-16
17
17
LEARNING OBJECTIVES:
After completing this laboratory experiment, you should be able to do the following things:
1.
2.
3.
4.
Know the function of each formed element in the blood.
Identify and distinguish between the different kinds of formed elements in the blood.
Measure the relative size of certain cells.
Identify, distinguish, and measure the size of healthy red blood cells and sickle-celled
ones.
5. Identify, distinguish, and measure the size of healthy red blood cells and Thalassemia
majors ones.
6. Identify, distinguish, and measure the size of healthy white blood cells and infectious
mononucleosis ones.
7. Explain the basis for blood typing and matching for blood donation and identify
appropriate blood donors for a given recipient.
BACKGROUND INFORMATION:
Blood is the fluid that transports oxygen and nutrients to the cells and carries away carbon
dioxide and other waste products. Technically, blood is a transport liquid pumped by the heart
(or an equivalent structure) to all parts of the body after which it is returned to the heart to
repeat the process. Blood is the only tissue whose matrix is a complete fluid. It is a tissue,
because it is a collection of similar specialized cells that serve particular functions. These cells
are suspended in a liquid matrix (plasma) which makes the blood a fluid. If blood flow ceases,
death will occur within minutes because of the effects of an unfavorable environment on highly
susceptible cells.
Blood cells known as formed elements are suspended in the plasma. Often clinical evaluations
of the blood characteristics of the patient are important in assessing the condition of the
patient. Blood characteristics vary according to age, sex, metabolic condition, health
conditions, and genetic variations.
Plasma serves as a transport medium for delivering nutrients to the cells of the body and for
transporting waste products derived from cellular metabolism to the kidneys, liver, and lungs
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for excretion. It is also a transport system for blood cells, and it plays a critical role in
maintaining normal blood pressure. Plasma helps to distribute heat throughout the body and to
maintain homeostasis, or biological stability, including acid-base balance in the blood and body.
Plasma is derived when all the blood cells—red blood cells (erythrocytes), white blood cells
(leukocytes), and platelets (thrombocytes)—are separated from whole blood. The remaining
straw-colored fluid is 90–92 percent water, but it contains critical solutes necessary for
sustaining health and life. Important constituents include electrolytes such as sodium,
potassium, chloride, bicarbonate, magnesium, and calcium. In addition, there are trace
amounts of other substances including amino acids, vitamins, organic acids, pigments, and
enzymes. Hormones such as insulin, corticosteroids, and thyroxin are secreted into the blood
by the endocrine system. Plasma concentrations of hormones must be carefully regulated for
good health.
Figure 1: Blood is made up of multiple
components, including red blood cells,
white blood cells, platelets, and plasma.
Platelet: blood components". Art.
Encyclopædia Britannica Online. Web. 27
Apr. 2014.
http://www.britannica.com/EBchecked/me
dia/113906/Blood-is-made-up-of-multiplecomponents-including-red-blood
Red blood cells, also called erythrocytes, are the cellular component of blood. Millions of red
blood cells in the circulation of vertebrates give the blood its characteristic color and carry
oxygen from the lungs to the tissues. The mature human red blood cell is small, round, and
biconcave. It appears dumbbell-shaped in profile. The cell is flexible and assumes a bell shape
as it passes through extremely small blood vessels. It is covered with a membrane composed of
lipids and proteins, lacks a nucleus, and contains hemoglobin — a red, iron-rich protein that
binds oxygen.
White blood cell, also called leukocytes, are cellular components of the blood that lack
hemoglobin, have nuclei, are capable of motility, and defend the body against infection and
disease by ingesting foreign materials and cellular debris, by destroying infectious agents and
cancer cells, or by producing antibodies (also called immunoglobulins, protective proteins
produced by the immune system in response to the presence of a foreign substance, called an
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antigen. Antibodies recognize and latch onto antigens in order to remove them from the body.)
A healthy adult human has between 4,500 and 11,000 white blood cells per cubic millimeter of
blood. Fluctuations in white cell number occur during the day. Lower values are obtained
during rest and higher values during exercise. White cell count also may increase in response to
convulsions, strong emotional reactions, pain, pregnancy, labor, and certain disease states,
such as infections and intoxication.
Granulocytes, the most numerous of the white cells, rid the body of large pathogenic
organisms such as protozoans or helminths and are also key mediators of allergy and other
forms of inflammation. These cells contain many cytoplasmic granules, or secretory vesicles,
that harbor potent chemicals important in immune responses. They also have multilobed
nuclei, and, because of this, they are often called polymorphonuclear cells. On the basis of how
their granules take up dye in the laboratory, granulocytes are subdivided into three categories:
neutrophils, eosinophils, and basophils.
The most numerous of the granulocytes—making up 50 to 80 percent of all white cells—are
neutrophils. They are often one of the first cell types to arrive at a site of infection where they
engulf and destroy the infectious microorganisms through a process called phagocytosis.
Eosinophils and basophils typically arrive later. The granules of basophils contain a number of
chemicals, including histamine and leukotrienes, that are important in inducing allergic
inflammatory responses.
Eosinophils destroy parasites and also help to modulate inflammatory responses.
Neutrophils are characterized histologically by their ability to be stained by neutral dyes and
functionally by their role in mediating immune responses against infectious microorganisms.
Neutrophils move with amoeboid motion.
Neutrophils are actively phagocytic. They engulf bacteria and other microorganisms and
microscopic particles. The granules of the neutrophil are microscopic packets of potent
enzymes capable of digesting many types of cellular materials.
An abnormally high number of neutrophils circulating in the blood is called neutrophilia. This
condition is typically associated with acute inflammation, though it may result from chronic
myelogenous leukemia, a cancer of the blood-forming tissues. An abnormally low number of
neutrophils is called neutropenia. This condition can be caused by various inherited disorders
that affect the immune system as well as by a number of acquired diseases, including certain
disorders that arise from exposure to harmful chemicals. Neutropenia significantly increases
the risk of life-threatening bacterial infection.
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Figure 2: Two neutrophils among many
red blood cells. The normal functions of
neutrophils are compromised in chronic
granulomatous disease. "Chronic
granulomatous disease". Photograph.
Encyclopædia Britannica Online. Web.
27 Apr. 2014.
http://www.britannica.com/EBchecked
/media/126495/Two-neutrophilsamong-many-red-blood-cells
Eosinophils are characterized histologically by their ability to be stained by acidic dyes (e.g.,
eosin) and functionally by their role in mediating certain types of allergic reactions. Eosinophils
contain large granules, and the nucleus exists as two non-segmented lobes.
Figure 3: White blood cells in a field of
red cells. (Top left) Monocyte, (top
centre) basophil, (top right) platelets,
(bottom left) two neutrophils, (bottom
right) lymphocyte and eosinophil,
respectively.
A. Owczarzak/Taurus Photos, Inc.,
"Eosinophil: white blood cells in field of
red cells". Photograph. Encyclopædia
Britannica Online. Web. 27 Apr. 2014.
http://www.britannica.com/EBchecked/
media/767/White-blood-cells-in-a-fieldof-red-cells-Monocyte
Basophils are characterized histologically by its ability to be stained by basic dyes and
functionally by its role in mediating hypersensitivity reactions of the immune system. Basophils
are the least numerous of the granulocytes and account for less than one percent of all white
blood cells occurring in the human body.
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Agranulocytes do not contain any cytoplasmic granules or secretory vesicles. We distinguish two
types: lymphocytes and monocytes.
Lymphocytes, which are further divided into B and T cells, are responsible for the specific
recognition of foreign agents and their subsequent removal from the host.
o
o
B lymphocytes secrete antibodies.
Typically, T cells recognize virally infected or cancerous cells and destroy them,
or they serve as helper cells to assist the production of antibody by B cells.
Monocytes move from the blood to sites of infection where they differentiate further into
macrophages. These cells are scavengers that phagocytose whole or killed microorganisms and
are therefore effective at direct destruction of pathogens and cleanup of cellular debris from
sites of infection. Neutrophils and macrophages are the main phagocytic cells of the body, but
macrophages are much larger and longer-lived than neutrophils.
Platelets also called thrombocytes, are colorless, non-nucleated blood component that are
important in the formation of blood clots (coagulation). Platelets are found only in the blood of
mammals.
Platelets are formed when cytoplasmic fragments of megakaryocytes, which are very large cells
in the bone marrow, pinch off into the circulation as they age. They are stored in the spleen.
Some evidence suggests platelets may also be produced or stored in the lungs where
megakaryocytes are frequently found.
Platelets play an important role in the formation of a blood clot by aggregating to block a cut
blood vessel and provide a surface on which strands of fibrin form an organized clot by
contracting to pull the fibrin strands together to make the clot firm and permanent and,
perhaps most important, by providing or mediating a series of clotting factors necessary to the
formation of the clot. Platelets also store and transport several chemicals, including serotonin,
epinephrine, histamine, and thromboxane. Upon activation, these molecules are released and
initiate local blood vessel constriction which facilitates clot formation.
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Figure 4: A micrograph of a round
aggregation of platelets (magnified
1000x).
Dr. F. Gilbert/Centers for Disease
Control and Prevention (CDC) (Image
Number: 6645)
"Platelet". Photograph. Encyclopædia
Britannica Online. Web. 27 Apr. 2014.
http://www.britannica.com/EBchecke
d/media/116860/A-micrograph-of-around-aggregation-of-platelets
Blood is a germ-free or axenic fluid; however, it is susceptible to infections by eukaryotic
parasites, bacteria or viruses, and some of these infections range from mild to fatal. For
example:
Thalassemia is group of blood disorders characterized by a deficiency of hemoglobin,
the blood protein that transports oxygen to the tissues. Thalassemia (Greek: “sea
blood”) is so called because it was first discovered among peoples around the
Mediterranean Sea among whom its incidence is high.
In the mild form of the disease, Thalassemia minor, there is usually only slight or no
anemia and life expectancy is normal. Occasionally, complications occur involving slight
enlargement of the spleen.
Thalassemia major is characterized by severe anemia, enlargement of the spleen, and
body deformities associated with expansion of the bone marrow.
Mononucleosis is a viral infection causing fever, sore throat, and swollen lymph glands,
especially in the neck. Mononucleosis, or mono, is often spread by saliva and close
contact. It is known as "the kissing disease" and occurs most often in those ages 15 to
17. However, the infection may develop at any age. Mono is usually linked to the
Epstein-Barr virus (EBV), but can also be caused by other organisms such as
cytomegalovirus (CMV). Mono may begin slowly with fatigue, a general ill feeling,
headache, and sore throat. The sore throat slowly gets worse. Your tonsils become
swollen and develop a whitish-yellow covering. The lymph nodes in the neck are
frequently swollen and painful.
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References:
1. "blood." Encyclopedia Britannica. David H. Yawn, M.D. Last updated 6/27/2013.
http://www.britannica.com/EBchecked/topic/463483/plasma
2. "plasma." Encyclopedia Brintannica. David H. Yawn, M.D. Last updated 6/27/2013.
http://www.britannica.com/EBchecked/topic/463483/plasma
3. MedlinePlus, US Library of Medicine.
http://www.nlm.nih.gov/medlineplus/ency/article/000591.htm
4. "thalassemia." Encyclopedia Britannica. The Editor of the Encyclopedia Britannica. Last.
Updated 10/27/2013.
http://www.britannica.com/EBchecked/topic/589769/thalassemia
EQUIPMENT:




Paper
Pencil/pen
Slides
o Human blood smear
o Human sickle cell anemia
o Thalassemia majors smear
o Infectious mononucleosis
Computer with Internet access (for the remote laboratory and for data analysis)
PREPARING FOR THIS NANSLO LAB ACTIVITY:
Read and understand the information below before you proceed with the lab!
Scheduling an Appointment Using the NANSLO Scheduling System
Your instructor has reserved a block of time through the NANSLO Scheduling System for you to
complete this activity. For more information on how to set up a time to access this NANSLO lab
activity, see www.wiche.edu/nanslo/scheduling-software.
Students Accessing a NANSLO Lab Activity for the First Time
For those accessing a NANSLO laboratory for the first time, you may need to install software on
your computer to access the NANSLO lab activity. Use this link for detailed instructions on
steps to complete prior to accessing your assigned NANSLO lab activity –
www.wiche.edu/nanslo/lab-tutorials.
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Video Tutorial for RWSL: A short video demonstrating how to use the Remote Web-based
Science Lab (RWSL) control panel for the air track can be viewed at
http://www.wiche.edu/nanslo/lab-tutorials#microscope.
NOTE: Disregard the conference number in this video tutorial.
AS SOON AS YOU CONNECT TO THE RWSL CONTROL PANEL: Click on the yellow button at the
bottom of the screen (you may need to scroll down to see it). Follow the directions on the pop
up window to join the voice conference and talk to your group and the Lab Technician.
EXPERIMENTAL PROCEDURE:
Once you have logged on to the remote lab system, you will perform the following laboratory
procedures. See Preparing for the Microscope NANSLO Lab Activity below.
PRE-LAB EXERCISE 1: Microscopic Examination of the Formed Elements of Blood
In this exercise you will:




Use the microscope to distinguish between the different types of formed elements in
blood.
Identify the red blood cells from different white blood on images you have taken.
Measure and compare the relative size of red blood cells and the monocytes.
Compare the nucleus shape of the different white blood cells.
Pre-Lab Questions:
1. Using what you know about the formed elements in blood, do you think the size and
shape of the red blood cells will be bigger, smaller, or the same as the ones of the
monocytes?
2. Rewrite your answer to question #1 in the form of an If . . . Then . . . hypothesis.
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EXERCISE 1: Microscopic Examination of the Formed Elements of Blood
Data Collection:
3. Select the human blood smear slide (Slide Cassette 3: #21) from the slide loader. Using
the 10X objective, identify the blood cells and bring them in to focus.
4. Carefully working your way through all the objectives focusing with each one until you
reach the 60X objective, capture an image. Insert your images of normal red blood cells,
neutrophils, eosinophils, basophils, lymphocytes and monocytes below.
5. Label the three different parts of a cell (nucleus, cytoplasm and cell membrane) and the
granules of the white blood cells.
6. Describe the shape of the red blood cells and the different white blood cells and their
nuclei.
7. Were you able to see the nucleus of the red blood cells? Explain your answer.
8. Next we are going to measure the size of the red blood cells and the monocytes. To
determine the size of the cells, we are going to use the ratio method. In order to do
this, you will need one piece of information which is the width of your field of view. On
our microscopes, the field of view is 205µm.
9. Now if we use the image in figure 1 we can see that the total width of the field of view is
13.6 cm or 136 mm (Image A). The cell (Gray) is 3.7 cm or 37mm (Image B).
Figure 5: Measurements
10. Now if we divide 37mm/136mm = 0.272 which we multiply the total length of the field
of view by so 0.272 * 205µm = 55.77 µm rounded for significant figures gives us a cell
size of 56µm.
11. Measure the difference in the size of the red blood cells and compare that to the size of
the monocytes.
12. Are your results in correlation with what you have predicted earlier?
13. Rewrite your hypothesis in light of our new information you collected in this exercise.
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Analysis:
14. Describe the function of each cell type in the table blow.
Cell Type
Erythrocytes
Neutrophils
Eosinophils
Basophils
Monocytes
Platelets
Function
PRE-LAB EXERCISE 2: Normal Red Blood Cells and Sickled Cells Slide
Observations
In this lab exercise you will measure and compare the relative size and shape of normal red
blood cells with the sickled celled ones.
Pre-lab 2 Questions:
1. Do you predict the size of normal red blood cells to be smaller, bigger, or the same as
the sickled celled ones?
2. Rewrite your answer to question one in the form of an If … Than … hypothesis.
EXERCISE 2: Normal Red Blood Cells and Sickled Cells Slide Observations
Data Collection:
3. Select the Sickle Cell Anemia slide (Slide Cassette 3: #22) from the slide loader. Using
the 10X objective, identify the blood cells and bring them in to focus.
4. Carefully working your way through all the objectives focusing with each one until you
reach the 60X objective, capture an image. Insert your picture of sickled cells below.
Analysis:
5. Utilizing your normal blood image form exercise 1 and the method from exercise 1
determine the length of the normal and sickle red blood cells.
6. Based on your observation, describe the difference between the shape of normal red
blood cells versus sickled cells.
7. Are your results in correlation with what you have predicted earlier?
8. Rewrite your hypothesis to take into account the new information you have learned in
this exercise.
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9. What is the impact of sickle cell anemia on oxygen transport?
PRE-LAB EXERCISE 3: Normal Red Blood Cells and Thalassemia majors Slide
Observations
In this lab exercise you will measure and compare the relative size and shape of normal red
blood cells with Thalassemia major ones.
Pre-lab 3 Questions:
1. Do you predict the size of normal red blood cells to be smaller, bigger or the same as
Thalassemia majors ones?
2. Rewrite your answer to question one in the form of an If … Than … hypothesis.
EXERCISE 3: Normal Red Blood Cells and Thalassemia majors Slide Observations
Data Collection:
3. Select the Thalassemia majors slide (Slide Cassette 3: #32) from the slide loader. Using
the 10X objective, identify the blood cells and bring them in to focus.
4. Carefully working your way through all the objectives focusing with each one until you
reach the 60X objective, capture an image. Insert your picture of Thalassemia major
cells below.
Analysis:
5. Utilizing your normal blood image form exercise 1 and the method from exercise 1 to
determine the diameter of the normal red blood cells and the Thalassemia majors ones.
6. Based on your observation, describe the difference between the size of normal red
blood cells versus the Thalassemia majors cells.
7. Are your results in correlation with what you have predicted earlier?
8. Rewrite your hypothesis to take into account the new information you have learned in
this exercise.
9. What is the impact of large pale red blood cells on the blood circulation and the overall
body health? Explain your answer.
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PRE-LAB EXERCISE 4: Normal and Infectious Mononucleosis Blood Observations
In this lab exercise you will measure and compare the relative size and shape of normal white
blood cells with infectious mononucleosis ones.
Pre-lab 4 Questions:
1. Do you predict the size of normal white blood cells to be smaller, bigger or the same as
the infectious monocudeosis ones?
2. Rewrite your answer to question one in the form of an If … Than … hypothesis.
EXERCISE 4: Normal and Infectious Mononucleosis Blood Observations
Data Collection:
Select the infectious mononucleosis slide (Slide Cassette 3: #25) from the slide loader. Using
the 10X objective, identify the blood cells and bring them in to focus.
3. Carefully working your way through all the objectives focusing with each one until you
reach the 60X objective, capture an image. Insert your picture of infected white blood
cells below.
Analysis:
5. Utilizing your normal blood image form exercise 1 and the method from exercise 1,
determine the diameter of the normal white blood cells and the infectious
mononucleosis ones.
6. Based on your observation, describe the difference between the size of these cells.
7. Are your results in correlation with what you have predicted earlier?
8. Rewrite your hypothesis to take into account the new information you have learned in
this exercise.
9. What is the impact of the infectious mononucleosis on the overall function of the
immune system? Explain your answer.
EXERCISE 5: ABO-RH Blood Typing
Blood typing is the classification of blood in terms of distinctive inherited characteristics that
are associated with the antigens located on the surface of red blood cells (erythrocytes). The
ABO and the Rh blood groups are among those most commonly considered. Identification of
these determinants has become indispensable in connection with blood transfusion, because
the recipient and donor must have the same, or compatible, blood groups. Otherwise,
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hemolysis (destruction) or coagulation (clotting) results from interaction of an antigen on the
red blood cells of one with an antibody in the serum of the other.
ABO blood group system is the classification of human blood based on the inherited properties
of red blood cells (erythrocytes) as determined by the presence or absence of the antigens A
and B which are carried on the surface of the red cells. Persons may thus have type A, type B,
type O, or type AB blood. The A, B, and O blood groups were first identified by Austrian
immunologist Karl Landsteiner in 1901.
Blood containing red cells with type A antigen on their surface has in its serum (fluid) antibodies
against type B red cells. If, in transfusion, type B blood is injected into persons with type A
blood, the red cells in the injected blood will be destroyed by the antibodies in the recipient’s
blood. In the same way, type A red cells will be destroyed by anti-A antibodies in type B blood.
Type O blood can be injected into persons with type A, B, or O blood unless there is
incompatibility with respect to some other blood group system also present.
To perform a blood typing test, anti-A and anti-B sera are each separately mixed with a drop of
sample blood and observed for agglutination (or clumping).
Rh blood group system is a system for classifying blood groups according to the presence or
absence of the Rh antigen, often called the Rh factor, on the cell membranes of the red blood
cells (erythrocytes). The designation Rh is derived from the use of the blood of rhesus monkeys
in the basic test for determining the presence of the Rh antigen in human blood. The Rh blood
group system was discovered in 1940 by Karl Landsteiner and A.S. Weiner. Since that time, a
number of distinct Rh antigens have been identified, but the first and most common one, called
RhD, causes the most severe immune reaction and is the primary determinant of the Rh trait.
The Rh antigen poses a danger for the Rh-negative person, who lacks the antigen, if Rh-positive
blood is given in transfusion. Adverse effects may not occur the first time Rh-incompatible
blood is given, but the immune system responds to the foreign Rh antigen by producing anti-Rh
antibodies. If Rh-positive blood is given again after the antibodies form, they will attack the
foreign red blood cells, causing them to clump together, or agglutinate. The resulting hemolysis,
or destruction of the red blood cells, causes serious illness and sometimes death.
A similar hazard exists during pregnancy for the Rh-positive offspring of Rh-incompatible
parents when the mother is Rh-negative and the father is Rh-positive. The first child of such
parents is usually in no danger unless the mother has acquired anti-Rh antibodies by virtue of
incompatible blood transfusion. During labor, however, a small amount of the fetus’s blood
may enter the mother’s bloodstream. The mother will then produce anti-Rh antibodies which
will attack any Rh-incompatible fetus in subsequent pregnancies. This process produces
erythroblastosis fetalis, or hemolytic disease of the newborn, which can be fatal to the fetus or
to the infant shortly after birth. Treatment of erythroblastosis fetalis usually entails one or
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more exchange transfusions. The disease can be avoided by vaccinating the mother with Rh
immunoglobulin after delivery of her firstborn if there is Rh-incompatibility. The Rh vaccine
destroys any fetal blood cells before the mother’s immune system can develop antibodies.
Reference: http://www.britannica.com/EBchecked/topic/69880/blood-typing
In the table below, predict the agglutination reactions for each of the following blood types.
Blood Type
A+
A–
B+
B–
AB +
AB –
O+
O–
Agglutination Reaction (Clumping – yes or no)
Anti-A Serum
Anti-B Serum
Anti-Rh Serum
SUMMARY QUESTIONS:
Answer the following questions.
1. Which of the formed elements are referred to collectively as granulocytes?
2. Which of the formed elements are referred to collectively as agranulocytes?
3. When a patient is admitted to the hospital, one of the first procedures that health
professionals perform is a blood draw. One lab value that is checked is a white blood cell
(WBC) count. If the WBC count is elevated, this could indicate the presence of
inflammation. Further analysis (called a differential) is performed to determine the
relative prevalence of different types of white blood cells and the potential cause of the
inflammation. What might be causing the inflammation if (use your textbook for
reference:)
a. Neutrophils were elevated? Explain your reasoning.
b. Lymphocytes were elevated? Explain your reasoning.
c. Eosinophils were elevated? Explain your reasoning.
4. If someone is diagnosed with "microcytic, hypochronic anemia," how would you
describe the hemoglobin content and size of his or her red blood cells?
5. Iron is necessary to produce hemoglobin. In iron-deficiency anemia, would you expect
the red blood cells to be hyperchronic, normochronic, or hypochronic? Explain.
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6. What is the difference between antigen and antibody?
7. If your blood type is A-, which antigens are present on your red blood cells? What if
your blood type is AB+?
8. With the ABO blood types, individuals will have circulating antibodies to antigens that
are not present in their own blood. Identify the antibodies (A, B, both A and B, or none)
produced by the following individuals:
a.
b.
c.
d.
An individual with type A blood:
An individual with type B blood:
An individual with type O blood:
An individual with type AB blood:
9. Based on your results for each patient, identify the blood types he/she could receive
using the following choices. Note: Some patients may be able to receive several types
of blood.
A+
A
B+
B
AB+
AB
O+
O
Patient 1 could receive _____________________________
Patient 2 could receive _____________________________
Patient 3 could receive _____________________________
10. Patient 4 could receive _____________________________
11. What is a universal donor? Which of these patients would be considered universal
donor?
12. What would happen to a type O patient if he receives type A or B blood?
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