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/students-scheduling-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 ActivitySUBJECT 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............................................................................................................ 2Background Information .................................................................................................... 2-8Equipment ......................................................................................................................... 8Preparing for this NANSLO Lab Activity ............................................................................. 8-9Experimental Procedure .................................................................................................... 9Pre-lab Exercise 1: Microscopic Examination of the Formed Elements of Blood............... 9Exercise 1: Microscopic Examination of the Formed Elements of Blood .......................... 10-11Pre-lab Exercise 2: Normal Red Blood Cells and Sickled Cells Slide Observation .............. 11Exercise 2: Normal Red Blood Cells and Sickled Cells Slide Observation ........................... 11-12Pre-lab Exercise 3: Normal Red Blood Cells and Thalassemia majors Slide Observation . . 12Exercise 3: Normal Red Blood Cells and Thalassemia majors Slide Observation .............. 12

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Pre-lab Exercise 4: Normal and Infectious Mononucleosis Blood Observation ................ 13

CONTENTS FOR THIS NANSLO LAB ACTIVITY – CONT’d

Exercise 4: Normal and Infectious Mononucleosis Blood Observation ............................ 13Exercise 5: ABO-RH Blood Typing ...................................................................................... 13-15Summary Questions ........................................................................................................... 15-16Creative Commons Licensing ............................................................................................. 17U.S. Department of Labor Information .............................................................................. 17

LEARNING OBJECTIVES:

After completing this laboratory experiment, you should be able to do the following things:

1. Know the function of each formed element in the blood.2. Identify and distinguish between the different kinds of formed elements in the blood.3. Measure the relative size of certain cells.4. 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

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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 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/media/113906/Blood-is-made-up-of-multiple-components-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.

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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 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

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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.

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-neutrophils-among-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-field-of-red-cells-Monocyte

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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.

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 B lymphocytes secrete antibodies. o 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/EBchecked/media/116860/A-micrograph-of-a-round-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 smearo Human sickle cell anemiao Thalassemia majors smearo 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 Function Erythrocytes Neutrophils Eosinophils Basophils Monocytes Platelets

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?

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8. Rewrite your hypothesis to take into account the new information you have learned in this exercise.

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

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the recipient and donor must have the same, or compatible, blood groups. Otherwise, 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

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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 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 TypeAgglutination Reaction (Clumping – yes or no)

Anti-A Serum Anti-B Serum Anti-Rh SerumA + A – B + B –

AB + AB – O + O –

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?

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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.

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. An individual with type A blood:b. An individual with type B blood:c. An individual with type O blood: d. 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+ B+ AB+ O+ A B AB 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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For more information about NANSLO, visit www.wiche.edu/nanslo.

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Creative Commons Attribution 3.0 United States License 3

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