Essay: Blood – functions, components and structure

All human and animal need blood to stay alive. Blood is a compounded substance that carries different cells and substances to all part of the body. The movement of blood into the artery system depend on the different pressure at which the heart beats.Blood is like a simple thick fluid which is dark red in colour when taken from the vein and bright red when taken from the artery.Average adult has 5-6 litre of blood which is regarded as 8-10% of human body weight.

Blood is alkaline with a PH OF 7.35-7.45.It\’s temperature range is around 100 degree which makes it warmer than average body temperature. It is moderately denser and more sticky than water. Blood is important to lifeas it supplies vital substances and nutrients such as sugar, oxygen and hormones to our cells, and move waste away from those cell, this waste is finally cleanse out of the body in faeces, urine, sweat and lungs.

FUNCTIONS OF BLOOD

Blood performs different functions in the body which are summarised as follow;

1. The digested food products from the villi of the small intestine is transported by blood to different part of the body where they are required for either immediate use or storage.
2. Blood carries food molecules from their storage area to the cell that need them.
3. It also perform the duty of transporting the excretory product from the cells where they composed to the area where they will be excreted.
4. Blood carries chemical messages (hormones) from the endocrine glands to different organs of the body where they are needed.
5. Blood assist in rebuilding a steady body temperature by circulating heat from very active tissues around the body.
6. Blood carry carbondioxide from respiring cells to the lungs.
7. Blood control the concentration of hydrogen ions in the body which is known as PH.
8. Blood protect the body from the threat of infections and disease which give rise to bacteria.

COMPONENTS OF BLOOD AND THEIR FUNCTIONS

Blood is classified as a connective tissue and comprise of two main constituents;

1. Plasma, which is a clear fluid.
2. Formed elements, which consists of the blood cells and platelet.

Formed elements are:

• Erythrocytes, also known as red blood cells (RBCs)
• Leukocytes, also known as white blood cells (WBCs)
• Platelets

PLASMA

Plasma is refer to the fluid component of the blood in which the cells move around. It is made up of water and consist of many significant substances which are dissolved in it.These substances include salts,food substances such as glucose, excretory substances such as urea, hormones and a vital group of substances called plasma protein.this plasma protein is of three different kind and each has an important functions to perform.

• ALBUMEN: These are the smallest and the most generous plasma protein. It can be found in the white of an egg, it contribute to the thickness and the sticky of the blood.Short of plasma albumin content can result in a loss of fluid from the blood .
• GLOBULIN: This type of protein is provided by the lymph cell for destruction of germs. It comprise of antibodies and there are types of globulin which are required for the clotting of blood.
• FIBRINOGEN: This is a soluble messanger of a sticky protein.It play an important role in the coagulation of blood. Fibrinogen can be removed from plasma by enabling it to clot and then remove the clot.

OTHER SOLUTES INCLUDES

AMINO ACIDS

These are formed from the disintegration of tissue protein or from the breaking down of digested proteins.

NITROGENOUS WASTE

This is the toxic end products of the breaking down of substances in the body, they are discharged from the blood stream and are excreted by the kidney at a rate that stabilizes their production.

NUTRIENTS

Nutrients such as glucose, amino acids, fats, cholesterol, phospholipids, vitamins and minerals consumed by the digestive tract are carried in the blood plasma.

GASES

Some oxygen and carbon dioxide are transferred by plasma. Plasma also consists of reasonable amount of dissolved nitrogen.

ELECTROLYTES

Sodium ions are the most sufficient electrolytes, which consider for more of the blood\’s osmolarity than any other solute.

RED BLOOD CELLS

Red blood cells(RBC),also known as erythrocytes, are the most largest cells in the bloodstream which composed more than 95% of the formed elements. Red blood cell has a disc shape which look as if it is flatten in on either side which gives it a large surface area so that it can take up more oxygen.

Red blood cells have an uncommon structure which is different to other cells in the human body. It has no nucleus, mitochondria or endoplasmic reticulum . The inside is contain red pigment known as haemoglobin which gives blood its red colour.Haemoglobin is a major part of red blood cell that is responsible for transporting the oxygen.

They live for about four months in the blood stream and are there after destroyed. In order to keep up the full number of red blood cell in our blood stream, new ones are constantly produced .In certain condition red blood cells are produced at a faster rate so that the number in the blood increases and they are restored in the body by cell in the bone marrow.

WHITE BLOOD CELLS

White blood cells are also known as WBCs or leukocytes. All white blood cells comprises of nucleus and colourless cytoplasm but lack haemoglobin. Their major role is to destroy germs in the body and protect us against infectious diseases. White blood cell are more greater than erythrocytes, the majority of them are found in the white bone marrow of the long bones, while some of them are found in the lymph gland and the spleen.

There are two main types of leukocytes in our body,each type look different from another when examine under the microscope.These cells consist of granulocytes and agranulocytes. Granulocyte consist of grain in its cell and perform different functions.Classes of granulocytes are basophils,neutrophils, and eosinophils. While agranulocytes did not have visible grain in its cell when examine under the microscope and they consist of lymphocytes and monocytes.

Neutrophils

Neutrophils account for 60 -70% of the circulating white blood cells. They are the most generous cells that protect the body against bacterial or fungal infection. They have multiple nuclei, they consist of granules that are pale lilac when stained which make their cytoplasm look different.Neutophil die after phagocytosed a few patogens because they are not capable of restoring the lysosome used in digesting microbes. They are the regular cell types which are active in the early stage of acute inflammation. Neutrophil has a life span of 4-5 days.

FUNCTION

Neutrophils are the active cells that stretch out to an area when there is a breach in the body. They destroy germ by a process called phagocytosis or ” cell eating” . They are capable of releasing a super oxides which has the capability of destroying many bacterias. They operate by obstructing the passage way of germ that wanted to gain access to the blood through a cut by connecting to the wall of the blood vessel.

EOSINOPHILS

There are few eosinophils in the blood but greater numbers of them are found in the mucous membrane of the respiratory, digestive, and lower urinary tracts. They comprise about 2-4% of the white blood cells and they are the greatest inflammatory cells in allergic reactions. Eosinophils has bi-lobed nucleus and their cytoplasm consist of granules which accept a pink-orange colour when stained with eosin.

FUNCTION OF EOSINOPHILS

Eosinophi functions by enabling toxin from their granules to eliminate pathogens.They also produce chemicals that eliminate large parasites such as hook worms and tape worms which are too large for any white blood cells to phagocytize. High eosinophils count in the blood stream are linked with allergic reactions.

BASOPHILS

Basophils are the smallest type of white blood cell, with only 0-100cells per mm of blood. Their nucleus is bi-or tri lobed and they have large granules that carry out functions that are not well known. When stained and viewed under the microscope they appear very colourful which make them easy to identify.

FUNCTION OF BASOPHILS

Basophils have the ability to produce anticoagulants and antibodies that have function against hypersensitivity reactions in the bloodstream. They functions as part of the immune system\’s action against foreign attacker. Basophils consist of two chemicals such as histamin and heparin which help in the body defence.Histamine functions by expanding the blood vessels and enlarging the circulation of blood to injured tissue.Histamine also makes blood vessel more absorptive so that neutrophils and clotting proteins can move easily into connective tissues.

LYMPHOCYTES

Lymphocytes are small, round cells that have a large nucleus within a small amount of cytoplasm. They have an important role in the immune system, being main players in the humeral immune system which is the part of the immune system that relates to antibody production. Lymphocytes tend to take up residence in lymphatic tissues, including the spleen, tonsils, and lymph nodes. There are about 1300-4000 lymphocytes per mm of blood.

FUNCTION OF LYMPHOCYTES

B lymphocytes produce antibodies, which is one of the final steps in disease resistance. When B lymphocytes make antibodies, they prime pathogens for destruction and then make memory cells ready that can go into action at any time, recalling a previous infection with a specific pathogen. T lymphocytes are another type of lymphocytes, differentiated in the thymus and important in cell-mediated immunity.

MONOCYTES

Monocytes are the greatest of the type of white blood cells. They consists about 200-800 monocytes per mm of blood. Monocytes are agranulocytes with small granules in the cytoplasm when examined under the microscope. Monocytes turn to macrophages when they leave the blood stream.

FUNCTION OF MONOCYTES

As macrophages, monocytes perform the job of phagocytosis (cell-eating) on any type of dead cell in the body, whether somatic cell or a dead neutrophil. They have the liability to digest large foreign particles in a wound because of their big size compared to other types of white blood cells.

PLATELETS

Platelets are small fragments of bone marrow cells and are therefore not really categorised as cells themselves.

Platelets have the following functions;

1. Produce vasoconstrictors which constrict blood vessels, causing vascular spasms in broken blood vessels.
2. They enlarge into temporary platelets plugs to stop bleeding
3. Produce procoagulants (clotting factors) to encourage blood clotting.
4. It disperse blood clots when they are no longer needed.
5. Platelet destroy and dissolve bacteria
6. It produce chemicals that introduce neutrophils and monocytes to sites of inflammation.
7. Platelet produce growth factors to retain the linings of blood vessels.

TASK 3

The three leucocytes identify and label on the diagram above are:

• Basophils
• Neutrophils
• Lymphocyte

BASOPHIL

STRUCTURE OF BASOPHILES

1. Basophil will look dark purple in colour when it is stained by a basic dye such as wright stain or Leishman’s stain.
2. Its Nucleus is round and the cytoplasm form a thin rim around the nucleus
3. Basophil contain large cytoplasm which is mainly, made of many large, rough –looking, grain – like particles.
4. These grain – like particles make the cell nucleus invisible under the microscope when stained. However, the nucleus can be visible under the microscope when unstained and it usually has two lobes.
5. Basophils grain – like particles are made up of the following substances; histamine , Leukotrienes, and heparin. Histamine can be found in the cell that is released during allergic and inflammatory reactions, Leukotrienes are homogenous to histamine because they are substances in the body that make allergic and inflammatory reaction. While heparin is a substance in the body that stop clotting
6. Three quarter of basophiles granulated cell are taken up by the nucleus.
7. Basophils are the least common type of Leukocytes which is appropriately 0.40% – 1% of white blood cells.

FUNCTIONS OF BASOPHIL IN RELATION TO THE IMMUNE SYSTEM

Different types of white blood cells are used by the immune system to depend on the human body against foreign invaders. Basophils are purposed to release histamine. Histamine is usually linked with allergic reactions, its main objective is to increase blood flow to an area of the body which the immune system reckon under attack from foreign substances. These Leukocytes also function as an attractor for other cells required to fight off invading bacteria and other threats.

Basophils are part of the body’s innate immune system that will be available at birth. The primary purpose of basophil is to release histamine in response to allergens. Histamine also causes neutrophils and eosinophils to quit the blood stream and eliminate the threatening cells.

This scenario demonstrate how the immune system uses basophils when presented with a perceived threat. A young man, who is allergic to roses, coincidentally scrapes his arm on the thorns of a rose bush. As his skin breaks, microscopic rose bush cells, together with any bacteria or parasites settled on the thorns, rush into the body. Closely basophils, confronted with the allergen and release histamine.

This histamine causes inflammation and increased blood flow to collect enough white cell, and also to attract eosinophils and Neutrophils.

NEUTROHIL

STRUCTURE OF NEUTROPHILS

1. Neutrophils are usually produced in the bone marrow

2. Neutrophil has a segmented nucleus when mature, while an immature Neutrophil has a band –shaped nucleus

3. This Leukocytes naturally live for about three days on average.

4. Neutrophils plasma membrane comprise of several membrane channels, adhesive proteins, receptors for various ligands, pumps and ectoenzyme. It comprise a large amount of glycogen in the cytoplasm which supply Neutrophils with energy.

5. When Neutrophils is fully developed, they are not able to grow or divide.

8. Neutrophils are made up of 70% of all Leukocytes.

FUNCTIONS OF NEUTROPHILS IN RELATION TO THE IMMUNE SYSTEM

Neutrophils are a type of white blood cells which play a vital role in the immune system of the body. They are one of the first blood cells to be released to the site of infection and are generally responsible for the whitish colour of pus, as they constitute most of it. Neutrophils are used by the immune system as a defence against attacking cell to fight any infection that come into the body. Because of their granular appearance they are also called Neutrophil granulocytes. They can travel through the blood stream, but when infection occurs, they are directed towards the site of the infection by cytokines, which are spread at the site of the infection .

Neutrophils can absorb pathogens. When pathogens are ingested, they form a phagosome where reactive oxygen species are supplied which in turn will kill the offending bacteria. Increase in white cell especially Neutrophils may indicate an infection in the body while a low level known as neutropenia may signify a restrain in the immune system.

LYMPHOCYTE

STRUCTURE OF LYMPHOCYTES

1. Lymphocytes are leukocytes that are identifiable by their large, darkly staining nuclei.

2. They are small cells with a very little cytoplasm.

3. They have no granules in their cytoplasm

4. Lymphocytes make up roughly 20 – 40 percent of the total white blood cells in human adults.

5. There are two types of lymphocytes, the B cell and T cell.

FUNCTION OF LYMPHOCYTES IN RELATION TO THE IMMUNE SYSTEM

During our daily movement we come into contact with different types of extraneous molecules in our body which have the possibility to make us sick. The immune system is important for recognising irrelevant material in our bodies. When this foreign material are recognised, our immune ststem perform the role of killing the material in our body. An antigen is a substance that recollect a response from our immune system. when Lymphocytes found an antigens, an immune response is triggered to protect our bodies.

Lymphocytes, such as T cells and blood cells, have their separate binding sites that allow them to recognised and attach to antigens that have distrupt the body. T cells function in the immune system,by helping other white blood cells during immune response and supporting immunological balance in the body.

TASK 4

BLOOD CLOTTING

Blood clotting reduces blood loss when injury happened.The blood coagulate to constitute a solid plug ( clot) which are made up of cell that are caught in a fibrous network.This solid plug prevent further blood loss, minimise the risk of harmful micro organism invading the body and supply a structure for the adjustment of damaged tissue.

Blood clotting involves a elaborated series of biochemical reactions which can be analysed in the flow chart below.

Step 1: INJURY TO BLOOD VESSELS

If a blood vessel is damaged, the collagen fibre in the vessel wall will be revealed to blood

Step 2: Platelet adhesion

Platelet attached quickly to the exposed collagen fibres.The connection between the platelet and the collagen fibres generate the breaking up of platelets into large numbers.

STEP 3:Platelet Activation.

Platelets discharge different substances which include serotonin and thromboplastins that are exceptionally important.

Serotonin allow the smooth muscle of the arterioles to become smaller and then narrow the vessels,stopping the blood flow to the affected area. While thromboplastins is an enzymes that set out a cascade of events which bring about the accummulation of a clot.

STEP 4:

In the presence of adequate level of calcium ions and vitamin k, thromboplastin catalyses a large conversion of plasma protein prothrombin.

STEP 5:

Prothrombin which is an inactive plasma protein convert to thrombin an active plasma protein.

STEP 6:

Thrombin an active plasm protein acts as an enzymes that catalyse the conversion of soluble fibrinogen.

STEP 7:

The soluble fibrinogen is now converted into insoluble fibrin.

STEP 8:

Insoluble fibrin which is made up of fibrous strand develop into a network of fibres which get stuck with blood cell and debris to form the clot.

1 WHERE IS PROTHROMBIN PRODUCED

Prothrombin is a plasma protein that is process in the liver in the presence of vitamin k and convert into thrombin by the action of different activators (as thromboplastin) in the clotting of blood. Prothrombin is processed in the liver and is adjusted in a vitamin k-dependent reaction that change ten glutamic acids on prothrombin to (Gla). In the presence of calcium, the Gla residues help in the binding of prothrombin to phospholipid bilayers. Abesence of vitamin K or the provision of the anticoagulant warfarin delay the production of gamma-carboxyglutamic acid.

2. Within the clotting cascade what is required for each reaction to occur?

VASCULAR PHASE

When a blood vessel wall is injured, contraction will occur in that specific area of the blood vessel. This vaso constriction can last from 30minutes to a few hourswhich can totally block the vessel which can happen as a result of injury to the endothelia cells.This injury give rise to different factors such as endothelins, tissue factors and ADP.

2. THE PLATELET PHASE

Minor injury to the blood vessel can be stopped by a platelet plug. The platelet phase starts immediately the platelet are about to connect themselves to the injured area of the endothelium.This process starts within 15 seconds of injury.As more platelets are connected to the injured surface, platelet aggregation is formed and the connection of platelets to the injured surface is known as platelet adhesion. Once a particular mass of platelet is achieved a process called platelet plug formation is formed.

3.FIBRIN

Insoluble fibrin is the initiated form of fibrinogen which is processed by the liver and the platelets.Fibrin makes up a large number of fibrin threads when it is initiated in the clotting process which assist in adjusting and separating a platelet plug from the normal circulation.

THE COAGULATION PHASE

This phase involves a complicated series of events,which lead to the activation of fibrin from fibrinogen and this phase start about 30 seconds after the earlier injury.

THE CLOTTING CASCADE

There are two separate clotting pathways which is the intrinsic and extrinsic.

The intrinsic pathways starts in the blood stream and it is initiated when blood is unprotected to collagen surface.While the extrinsic pathway starts in the vessel wall. When the endothelial cell is injured it will liberate tissue factors and the more the amount of damage to the endothelial cell the more tissue factors produced.

Task4(3)

Why does blood clotting does not occur normally? what is required for its initiation.

The process of blood clotting is established by the blood platelets.This platelet develop a substance that merge with calcium ions in the blood to form thromboplastin. Thromboplastin then transform the protein prothrombin into thrombin in a complicated series of reactions. Thrombin, which is a proteolytic enzyme, change fibrinogen, a protein substance, into fibrin. Fibrin is an insoluble protein that produce a thread like structures called fibrils which make blood plasma to clot. The plasma and the blood cell are involved in the structure of fibrils to form the clot. Blood clotting can be established by the extrinsic mechanism, where substances from injured tissues are muddled with the blood, or by the intrinsic mechanism, where the blood is damaged. Different substances are recognised in blood which affect the blood clotting .The coagulation process is determined by a balance between those substances that encourage coagulation (procoagulants) and those substances that hinder it (anticoagulants). Prothrombin, is an important substance in the clotting mechanism, which is supply by the liver in the presence of vitamin K. This vitamin is very important in the body and When the body lack this vitamin , bleeding is very hard to control.

The coagulation of blood within the blood vessels in the absence of injury can cause serious illness or death, especially when a clot forms in the coronary arteries (thrombosis) or cerebral arteries (stroke or apoplexy). Bood clotting can be avoided from an individual with known tendency of clot formation or during blood transfusion by fortifying the body\’s natural anti clotting subatance, heparin, with a supplementary amount of an anticoagulant such as Dicumarol which can be ingested into yhe body.

4. Explain the last stage of the clotting cascade in which Fibrin is made, using your knowledge of proteins.

During the last stage of clotting cascade. Fibrinogen, the blood plasma is transformed into the insoluble protein called fibrin during the clotting process. Fibrinogen is a soluble protein that is supply by the liver and deliver in blood plasma. Platelet aggregation is the property of platelets to clump with each other to form a platelet plug. Two proteins in the platelet membrane namely glycoprotein 11b and glycoprotein 111a play a vital role in platelet aggregation.

Damaged to the vessel lining and contact to the blood with tissues outside the vessel stimulates thrombic production by the activation of the clotting system.

Thrombin is an enzyme which converts the soluble fibrinogen into insoluble fibrin strands. When fibrinogen is converted into cross – linked fibrin, it develop into a mesh which assemble platelets and other blood cells into a solid clot which plug the hole and stops the bleeding. Fibrin is an insoluble protein that is produced in response to bleeding.

Fibrin molecules that merged together to form long fibrin strand which twist platelets, building up a permeable mass that gradually become hard and shorter to form the blood clot.

Fibrin can interact with several cell types including endothelial cells, smooth muscle cells, fibroblasts, leukocytes and keratinocytes. It can also bind to and accumulate the cells required for the inflammatory response and for tissue repair at the site of the damage.

Furthermore, Fibrin can bind to several protein including fibronectin, albumin, thrombospondin, Von Willebrand factor, fibrulin, fibroblast growth factor – 2, vascular endothelial growth factor. Binding of fibrin to these protein usually results in a change to the structure and properties of the blood clot.

Fibronectin is found in blood and connective tissue, and is involved in cell adhesion and wound healing which affect the clot size and density. Albumin is a blood protein it bind to fibrin affects the aggregation of fibrin, altering the thickness of the fibrin fibre. Thrombospondin is released from the alpha- granules of activated platelets. It stabilizes the interactions between fibrin and the integrin receptors on platelets.

TASK 5

ANALYSIS OF BLOOD GROUP COMPATIBILITY

MATERIAL NEEDED

• Anti-A serum (simulated)
• Anti-B serum (simulated)
• Anti-Rh serum (simulated)

1 Blood typing tray paper towels

4 Patient Blood samples (simulated)

1set stirring sticks (blue, green and yellow)

PROCEDURES:

PATIENT 1

STEP 1: 5 drops of patient 1 stimulated sample is put on each well of the blood typing tray.

STEP 2:3 drops of Anti-A stimulated serum is placed in well A.

STEP 3: 3 drops of Anti-B stimulated serum is placed in well B.

STEP 4: 3 drops of Anti_Rh simulated serum in well Rh.

STEP 5: A separate stirring stick is used to mix the simulated blood and serum in each well for about 10 seconds.

OBSERVATION: Agglutination occur in stimulated blood sample of patient A which contain antigens that reacted against the antibodies in the Anti A- serum and Anti- Rh serum.

RESULT: The blood type of patient 1 is A-positive. (A+)

PATIENT 2

PROCEDURE:

STEP 1: 5 drops of patient 2 simulated sample is put on each well of the blood typing tray.

STEP 2: 3 drops of Anti-A simulated serum is placed in well A.

STEP 3; 3 drops of Anti_B simulated serum is placed in well B.

STEP 4: 3 drops of Anti_Rh simulated serum is placed in well Rh.

STEP 5: A separate stirring stick is used to mix the simulated blood and serum in each well for about 10 seconds.

OBSERVATION: clumping of the blood in well B indicate that the simulated blood sample of patient 2 contain antigens that reacted against the antibodies in Anti- B serum. While the antigen in the simulated blood sample of patient 2 did not react against the antibodies in the Anti-A serum and Anti Rh- serum.

RESULT: The blood type of patient 2 is B-negative. (B-)

PATIENT 3

PROCEDURE:

STEP 1: 5 drops of patient 3 simulated blood is put on each well of the blood tray.

STEP 2: 3 drops of Anti_ A simulated serum is place in well A.

STEP 3: 3 drops of Anti_ B simulated serum is placed in well B.

STEP 4: 3 drops of Anti-Rh simulated serum is placed in well Rh.

STEP 5 : A separate stirring stick is used to mix the simulated blood and serum in each well for about 10 seconds.

OBSERVATION: Agglutination in well A, B and Rh indicate that the simulated blood sample of patient 3 contain antigen which reacted against the antibodies in the serum A, B and Rh.

RESULT: The blood type of patient 3 is AB- positive (AB+).

PATIENT 4

PROCEDURE:

STEP 1:5 drops of patient 4 simulated blood sample is place in each well of the blood typing tray.

STEP 2: 3 drops of Anti_A simulated serum is placed in well A.

STEP 3: 3 drops of Anti_B simulated serum is placed in well B.

STEP 4: 3 drops 0f Anti-Rh simulated serum is placed in well Rh.

STEP 5: A separate stirring stick is use to mixed the simulated blood and serum in each well for about 10 seconds.

OBSERVATION: No agglutination in well A, B and Rh which indicate that the simulated blood sample has no antigens that can react against the antibodies in the typing serum of Anti_A, B and Rh.

RESULT: The blood type of patient 4 is O-negative (O-).

The table of the result is summarise bellow:

Simulated blood sample Agglutination in well A(+/-) Agglutination in well B(+/-) Agglutination in well Rh(+/) Blood Type Observations

Patient 1 Yes No Yes A+ A and Rh agglutination

Patient 2 No Yes No B- A and Rh no agglutination

Patient 3

Yes Yes Yes AB+ Agglutination in well A,B and Rh

Patient 4 No No No O- No agglutination in well A, B and Rh.

(1)According to the table, patient 4 is considered a universal donor because there is no antigen in his red blood cell so his blood can be transfuse to anyone without causing any antigen antibody reactions.

2) The different blood group which can trigger adverse reaction in patient 2 with blood group B is blood group type A which contain A antigen. When an individual has type A blood with type A antigen, their plasma has type B antibodies, therefore a reaction occurs when the antigen on the red blood cell of the donor blood react with the antibodies in the plasma.

In this scenario, if a unit of blood type A is transfused into patient 2 with type B, a transfusion reaction will occur where an antibody attaches to antigens on several red blood cells. This causes the red blood cell to clump together and plug up vessels, this cell are then destroyed through hemolysis which releases haemoglobin from the red blood into the blood.

3) Patient 4 was offer anti D injection because the anti-D immunoglobulin neutralises and prevent Rh D positive that may have entered patient 4 blood during pregnancy

4) Simulated blood typing activity is similar to actual human blood because there is an antigen-antibody reaction.

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