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'\  `Roman PShX' 3. ABO and Rh TypingLab3(Carolyn Ragland 0 .  Z Detection of Cold Agglutinins ; Task To determine the presence of cold agglutinins by performing the cold agglutinin titration. ; Aim To determine within  1 tube the titer of cold agglutinins in a patient specimen. Principle Cold agglutinins are commonly found in the serum of approximately 55% of the patients with primary atypical pneumonia, a respiratory disease caused by Mycoplasma pneumonia .Xc6Non-ProfitNon-Profit Stampc#$RB>z  0 @X<<<<@c d'dxd Level 1 Level 2 Level 3 Level 4 Level 5(?2gv$ fY!       ($     (?2gv$ fY!       " !C<< c  ""  XX%M@<< NonProfitOrg.  @xx U.S.Postage@00 PAID@ Permit2757  @nn Austin,Texas0D4`P,BoardBoard of TrusteesC'/D4A`ArialTTC BoardofTrustees |||-%0D4`-Dr.BruceM.Murray,ChairmanDellaMayMoore,ViceChairmanRooseveltLeaks,SecretaryJanAlbersPeteFosterLindaGrayMackRayHernandezLawrenceE.JenkinsMurrayShawDr.DanAngel,President/D4A`ArialTTT{0HeadingFancy ACC Heading    xxxU)64 (Times NewRomanTTU@.. 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A~?????!C A~???~???#~???~???#<?x???#???? $??? $!C??? *?&? *?&??*?&? # ?G*?&? #??G*?&? #?G*?&?? #GS?? q?S?? q?S?? q?S?? ?S??? ?S??? ?-#?? ?-#?? ?-#?? ~?-#? ~?-# ~?-# ~?-#?K#?G?!?G? ?G? ???G>? ??G!?G?!?G!?G!?G ??G? ?G? ??G? ???G|? ?G? ?G? ?G?!??q?q?q?q??q??q?qqqq?q?q?q?q? qqq?q??q?q?q?q??r??rqqq?q?qq?qq?q?qq?qqrrrrrrrrrrrrrrrr?r?rrrr?r?r?r??r??r??r??r?rrr r?r r?rrr r rrrr rr? r??r? rr%r%r?&r?%r?&r?%r?%r%r&r&r&r%r%r %r &r%r&r%r&r<%rddd Xdd Xdd XX%X%,dd ,dd ,dd ,dd ,dd ,dd ,Xdd ,dd ,dd ,Tdd +  $ #$   Clot  2%X!$  Pt_RBCs_  2%X!% antiA  2%X!& antiB  2%X!' anti_A,B_  2%X!( antiD  2%X!)   2%X!*  PtSerum   2%X!+ A1cells  2%X!, Bcells 2%X!- "3"  32uh  5  .3  0 &   Decantthesalinefromthecellsuspension completely by @  @ invertingthetubeoverthewastebucket,allowing :'`#. allsalinetodrainout,shaketheinvertedtube3times.DONOTshaketubewhilesalineisdrainingout,you &(L$/ willcausethe_rbcs_Ԁtoberinsedoutofthetubeintothewastebucket.3@݌)8%0&%&% Ќ  "3"  3k2uh  6  .3  0 &   Addenoughsalinetothepatientscellstoobtaina46%cellsuspension(comparecolorwiththatofthe *'2 reagentredcellsinthedropper).3k݌+'3&%&% Ќ  "3"  3ރ2uh  7  .3  0 &   Addone(1)dropofreagentantiserumintheforwardtypingtubes(antiAinantiAtube,antiBinantiBtube, -)5 etc.)3ރ ݌.*6&%&% Ќ  __ /+7 "3"  3f2uh  8  .3  0 &   Addthree(3)dropspatientserumtotheAcellandBcell @F  @F reversetypingtubes. 3f݌&%&% Ќ  NOTE: Visuallyinspect all tubesatthistimetomakecertainthatalltubeshaveserumorantiseruminthem.  "3"  302uh  9  .3  0 &   Addone(1)dropofpatientcellstoeachforwardtyping @  @ tube.30]݌&%&% Ќ  "3 "  3P2uh  10  .3  0 &   Addone(1)dropofwellmixedreagentreversecellstoeachappropriatetube.3P}݌f &%&% Ќ  "3 "  3i2uh  11  .3  0 &   Mixtubesthoroughlybygentlyshaking.3i݌> d&%&% Ќ  "3 "  3[2uh  12  .3  0 &   Spinalltubesfor15seconds.NOTE:SerofugeMUSTbebalanced.3[݌ < &%&% Ќ  "3 "  3e2uh  13  .3  0 &   Readand immediately recordgradedresultsastheyareread.3e݌ &%&% Ќ  #gXXXhXʽ|#hXXXgXNOTE: Themannerinwhichthe_RBCs_Ԁaredislodgedfromthebottomofthetubeis critical .Shakethetube gently    untilallcellsaredislodged.Thisismosteasilyaccomplishedbyholdingthetubebetweenthumbandforefinger   andgentlyagitating,thentiltingthetube.Avoidovershakingwhichbreaksupfragileagglutinates(falsenegative  reaction)whileinadequatemixingmayresultinafalsepositiveinterpretation.Ifyougetreactionsoflessthan34+  intheDorreversetypingtubesyouareshakingtoohardwhichcouldresultinafalsenegativeresult.#gXXXhXʘ#hXXXgX ~ "3 "  32uh  14  .3  0 &   ݀IfantiDispositiveandpatientisnotGroupABpositive,stophere.3݌V|&%&% Ќ   & a.0 p IftubecontainingantiDisnegative,continuetostep15.#gXXXhXʬ#hXXXgXBhp%p%  & b.0 p IfpatientappearstobeABposgotostep23..Tp%p% "3"  32uh  15  .3  0 &   Setupatubelabeledwithpatientinitialsand Dctrl.PlaceonedropofRhcontrolinthetubefollowedby , 1dropofthepatientswashed_rbc_Ԁsuspension.Spin,readandrecordtheDctrltube.Placeboththenegative  DtubeandDctrltubeinthe37$heatblockfor15minutes.3J݌&%&% Ќ  "3"  3[2uh  16  .3  0 &   After15minutes,removetheDandDctrltubes,washthree(3)timeswithsalineasfollows:3[݌&%&% Ќ  #gXXXhXp#hXXXgX &  p a.0  Filltubesthreefourthsfullwithsaline.%%  &  p b.0  Spininserofugeforone(1)minute.%%  &  p c.0  Completelydecantsalinebyturningupsidedownandallowingallsalinetodrainoutofthetube,then z  shakethreetimes. NOTE: do NOT shakeasthesalineisdrainingoutoryouwillLOSEyour_rbcs_ f!  andwillneedtorepeatthetest.V"|!%%  &  p d.0  Resuspendcellbuttonbyvigoroustappingwithyourfinger.B#h"%%  &  p e.0  Addsalinewithsufficientforcetoresuspendcellbutton..$T #%%  &  p f.0  Repeataetwo(2)additionaltimes,foratotalofthreewashes.#gXXXhXʥ#hXXXgX%@!$%% "3"  32uh  17  .3  0 &   Afterdecantingsalineafterlastwashcontinuetoholdthetubesupsidedownandblotendsoftubeswith &#& biowipetoobtainadrycellbutton.3݌'$'&%&% Ќ  "3"  3]2uh  18  .3  0 &   Addtwo(2)dropsofantihumanglobulinserumtoeachtube.Mixwellandcentrifugefor15seconds.3]݌)%)&%&% Ќ  "3"  32uh  19  .3  0 &   Gentlyresuspendcellbutton,lookingforagglutinationasinstep15above.3݌+'+&%&% Ќ  "3"  32uh  20  .3  0 &   Ifnegativemacroscopically,observemicroscopicallyalso. Recordresultsnow. 3ם݌f-)-&%&% Ќ  "3"  3О2uh  21  .3  0 &   Toalltestsshowinganegativereaction,addone(1)dropof_coombs_Ԁcontrolcells.3О݌>/d+/&%&% Ќ  "3"  3 2uh  22  .3  0 &   Centrifugefor15seconds.Shouldget1to3+reaction.Ifnegativereactionisobtained,testisinvalidand  mustberepeated.3 :݌&%&% Ќ  "3"  3m2uh  23  .3  0 &   Ifalltubesintheforwardtypearepositive(patientappears @  @ tobeABpositive)anegativecontroltubemust  berun.3m݌&%&% Ќ   &  p a.  Labelatubewithpatientinitialsand"Dctrl"belowit. v  &  p b.0  Place1dropofthepatientredbloodcellsuspensionin @   @   @  thetube.b %% 0 & 0p&%&%c.0p%p%AddonedropofRhcontrolreagenttotheDctrltube,mixwell.N t%%  &  p d.  Centrifugefor15seconds. : `  &  p e.  Shakegentlytoresuspend. & L   &  p f.0  Iftubeisnegative,itconfirmspatientisABpositive,if @(  @(  @( itispositiveadditionaltestingmustbedone. 8 %%  GradingSerologicalReactions#gXXXhXʱ#hXXXgXԀinTubeTesting   0 & GradeAppearance  &%&% 4+0 & Completeagglutination!no_unagglutinated_Ԁ_RBCs_ &%&% 3+s0 & Intermediatebetween3+and4+&%&% 3+0 & Strongreaction!afewdetachedmassesofagglutinated_RBCs_;no_unagglutinated_Ԁ_RBCs_&%&% 3+w0 & Intermediatebetween2+and3+r&%&% 2+s0 & Intermediatebetween2+and3+^&%&% 2+0 & Moderatereaction!largeagglutinatesinaseaofsmalleragglutinates;few_unagglutinated_Ԁ_RBCs_Jp&%&% 2+w0 & Intermediatebetween1+and2+6\&%&% 1+s0 & Intermediatebetween1+and2+"H&%&% 1+0 & Weakreaction!manyagglutinatesofupto20_RBCs_Ԁwithsomesmalleragglutinatesand_unagglutinated_ 4 _RBCs_ &%&% 1+w0 & Intermediatebetweenand1+ &%&% 0 & Granularreaction!scatteredagglutinatesof68_RBCs_Ԁwithmany_unagglutinated_Ԁ_RBCs_Ԁseenmicroscopically&%&% 0r0 & Roughreaction!RBCbuttondoesnotdispersesmoothly;edgeofbuttonappears rough(characteristicof  some_HTLA_Ԁantibodies)&%&% 00 & Noreaction&%&% _MFs_0 & Mixedfieldstrong!largecompleteagglutinateswithasmallnumberof_unagglutinated_Ԁ_RBCs_&%&% MF0 & Mixedfield!moderatesizedagglutinatestogetherwith_unagglutinated_Ԁ_RBCs_n &%&% _MFw_0 & Mixedfieldweak!fewclumpsofagglutinated_RBCs_,butmajorityofRBC_unagglutinated_Z! &%&% _Hs_0 & Stronghemolysis!fewornointact_RBCs_ԀseenF"l!&%&% H0 & Moderatehemolysis!someintact_RBCs_Ԁpresent2#X"&%&% _Hw_0 & Tracehemolysis!manyintact_RBCs_Ԁpresent$D #&%&% Marsh,W.L.,Scoringof_hemagglutination_Ԁreactions.Transfusion1972,12:3523. %"% #gXXXhXO#hXXXgX B.h*.  #gXXXhXM#hXXXgXInterpretation #gXXXhXʧ#hXXXgX  *N d ddd dd dd dd dd dd ydd Xdd (dd dd T=>X%X%,@0 ,@0 ,@0 ,@0 ,@0 ,F@@ +  6' @6 Forward  , antiA ;,!" ;antiB ;,!," ;anti_A,B_ ;,!," ; Reverse  , Acells ;,!" ;Bcells ?,!," ?BloodGroup ,  Interpretation SD, " @   )@SO ;,! " ;O ;,! " ;O ;,! " ;+ ;,!" ;+ ?,!" ?O SD," @ )  )@S+ ;,! " ;O ;,! " ;+ ;,! " ;O ;,! " ;+ ?,! " ?A SD, " @ )  )@SO ;,! 8" ;+ ;,! 8" ;+ ;,! 8" ;+ ;,! 8" ;O ?,! 8" ?B UD, 8" @ )  9@U+ =,!> d" =+ =,!> d" =+ =,!> d" =O =,!> d " =O ?,!> d!" ?_A,B_<20> d"" @ 9   <*N dN d@0 @0 @0 @0 @0 F@@ FX%X%,( ,( ,( ,F(( ,'(( +  6'& L#& L @6ЀantiD ;,!f $" ;Dctrl ;,!f %" ;Du ?,!f &" ?D(Du)ctrl ?,!f '" ?Interpretation SD,f (" @   )@S3+ ;,!` )" ; ;,!` *" ; ?,!` +" ? ?,!` ," ?Dpos SD,` -" @ )  )@SO ;,! ." ;O#gXXXhX#hXXXgX ;,! /" ;3+ ?,! 0" ?O#gXXXhX&#hXXXgX ?,! 1" ?ЀD_posw_ UD, 2" @ )  9@UO =,! 3" =O#gXXXhX#hXXXgX =,! 4" =O ?,! 5" ?O#gXXXhX'#hXXXgX ?,! 6" ?Dneg<20 7" @ 9   <LLIfthecontrolfortheweakDtestgivesapositiveresultthenaDATmustbeperformedtoensurevalidresults.If x: theDATisnegative,thisconfirmsthatthepatientisaweakD,iftheDATispositive,additionaltestingmustbe d; performed. Pv< IfpatientisABpositive,andtheDcontrolispositive,thetestcannotbeinterpretedandadditionaltestingmustbe (N> performed. :?  ReportresultsasABOtypefollowedbyDtype.Example:Apos:Opos;ABneg  A 1  |TRX3' LetterX3' Letter3'Letter PtSerum   2%X!+ A1cells  23'LetterT   Homework   NextweekyoumustturninanindexcardwiththeABOandDtubetestwrittenandcondensedonit.Onlyone  indexcardisneeded.Thisistobewritteninasimplifiedmannertoaidyouinperformingthisprocedure. THIS  ISNOTOPTIONAL. Thiscardwillbeusedduringthesummercourse"IntroductiontoClinical_Practicum_"and  duringyourclinicalrotationatthehospital.       L#gXXXhX#hXXXgX 0 & X B . &  #gXXhX#hXXgXABOSlideTest #gXXXhXʀ#iXXXgX&%&% #gXXXiX# hXXXgX & Procedure #gXXXhX:#iXXXgX t  #gXXXiXʕ#hXXXgXInterpretationofResults #gXXXhX#   Slidetestsshouldbeperformedaccordingtodirectionsforthespecificantiserumused.hXXXgX B s 1.0 & PlaceonedropeachofantiA,antiBandantiDonseparateareasofaproperlylabeledslide. &%&% 2.0 & Toeachantiserum,addone(1)dropofcellsfromthewashedcellsuspensionusedinprocedureA.. &%&% 3.0 & Withaseparatecleanapplicatorstick,mixeachcellantiserummixturethoroughlyovertheentirecircle. ; &%&% 4.0 & Rotateortiletheslideandobserveforagglutinationforaperiodnottoexceedtwo(2)minutes.<m &%&% 5.0 & Recordresults#gXXXhXʽ#.n &%&% *lmFdN d( ( ( F(( F'(( 'X%X%,XH ,XH ,SXX +  6' X6antiA ;,!*[" ;antiB ?,!*[" ?ABOgroup SD,*[" X   XSO ;,!n" ;O ?,!n" ?O SD,n" X   XS+ ;,!" ;O ?,!" ?A SD," X   XSO ;,!'" ;+ ?,!'" ?B UD,'" X   XU+ =,!:k" =+ ?,!:k" ?_A,B_<20:k" X    < hXXXgX *FdFdXH XH SXX SlmX%X%,XH , XH ,XX +  6' AX6antiD ;,!7" ;Dcontrol ?,!7 " ?Interpretation SD,7!" X A  *XS+ ;,!J{"" ;RunifpatienttypesasABpositive ?,!J{#" ?Dpositive SD,J{$" X *  AXSO ;,!%" ;Notnecessary ?,!&" ?Dnegative UD,'" X A  QXU+ =,! (" =+ ?,! )" ?Testinvalid<20 *" X Q   <#gXXXhX#_______ @)q%0   _2%Name_________________________________  %%W% hXXgXExercise3 #gXXXhX#@  & ABOandDTyping 3d @YY&RecordingResults  - Foreachofthefollowingrecordthepatientname(lastnamefirst)andtheidentificationnumberdirectlyfrom  ( thetubeofblood.Recordyourreactionsandinterpretationsasexplainedbelow. ) Z hXXgXA .TubeTest    0 & Recordgradedreactions(04+).Leaveblankiftestwasnotdone.Report interpretationasbloodgroup 1  followedby posifDpos,or neg,forDneg.Example:Opos2c &%&% hzXhX#gzhz#[zgz*P dFdXH  XH XX X%X%,( ,( ,( ,( ,( ,( ,( ,( ,( ,H ,( ,H( +  1'd d @1 !   ! ?0! " ?ForwardType BT3$" BReverseType >T/$"T > N?# @ T @NPatientName >/$ >AntiA ;,!" ;AntiB ;,!" ;AntiAB ;,!" ;AntiD ;,!" ;*D  Control ;,!O" ;Du ;,!" ;*Du  Control ;T,!O" ;ACells ;,!"T ;BCells ?T,!" ?Interpretation N?," @  T X@N1. -^ _  ԍ#_________________________________________________________  6'+ 6 2#-^  2 2#-^! 2 2#-^" 2 2#-^# 2 2#-^$ 2 2#-^% 2 2T#-^& 2 2#-^'T 2 6T#-^( 6 eV#-^) @ X T X @2.@@e2.#gz[zk#[zgz#[XX[z)#[zX[X K<:*  @2. @ K )+ ) ), ) )- ) ). ) )/ ) )0 ) )T1 ) )2T ) -T3 - gV#4 @ X T X @3.@@g_3. 5   ԍ#_________________________________________________________  WF;6  @3. @ W 4#7 4 4#8 4 4#9 4 4#: 4 4#; 4 4#< 4 4T#= 4 4#>T 4 6T#? 63)'@ @ X  T 3#[XX[z#*ThisisperformedonlyifahighproteinantiDreagentisused or thepatientappearstobeABpositive.#gXXX[XZ# "A  B.ABOSlideTest  UC UsethecellsuspensionpreparedinprocedureA, TubeTestforthisprocedure.Theslidetestisqualitative,so  D theresultsofthereactionswitheachtypingseraisrecordedas posor neg.Forthe Interprecordtheblood !$E typefollowedby posforDpositiveor negforDnegative.Example:Apos %#VF *6}~d d( ( ( ( ( ( ( ( ( H ( H( PX%X%6,dd ,dd ,dd ,Fdd ,dd +  $%!H%! $PatientName '%"I" 'antiA '%"J" 'antiB '%"K" 'antiD '%"L" 'Interp %"M" 1. m'#N #  ($O   m'#P   m'#Q   m'#R   m'#S 2. *P&T #  Q+'U   *P&V   *P&W   *P&X   *P&Y hXXXgX3. ,)Z ##gXXXhXʉ#  .4*[   ,)\   ,)]   ,)^  ,)_   e/+_ Ї-X<DX~J-Name_________________________________   hXXgXExercise3 #gXXXhX#@  & ABOandDTyping e @'StudyQuestions  . _ 1.0  Whatisthemostcommoncauseoftransfusionrelatedfatalities?(1point) %% 2.0  StatetheimmunologicalreasonwhyABOtypingisthemostimportanttestperformedinpretransfusion  testing.(1point)%% 3.0  Definetheterms Dpositiveand Dnegative.(1point)H%% 4.  Whatisbeingdetectedintheforwardtypingtest?(O.5) C%t! btB  tBb5  .0    Whatisbeingdetectedinthereversegroupingtest?(0.5)tBbی *<&%% Ќ   .+# _6.0  StatethepurposeforusingantiA,Btypingsera.%% 7.0  ListthethreeABOtypingseras AND statethebloodgroupwhichproduceseach.(1.5points)- ^%% 8.0  Foreachofthebloodgroupslistedbelowstatewhatantibodieswillbedetectedintheserumandfillin  theexpectedreactions(positiveornegative)withtheA1andBcells.(4.5points) %%     *qsdddd dd dd Fdd Fdd }~X%X%,dd , dd ,dd ,dd +   @ BloodGroup -# - g XgXAntibodiesPresentinthe  Serum#gXXg # '" 'gFXgXExpectedreactionofserum  withAcells '" 'Expectedreactionofserum  withBcells#gXXgF?# " a.  0 < 0 (;l< <  ( ';l" ' ';l" ' ;l" b.  0 < A < <        !   " c.  0 < B ; l#< <    ; l$   ; l%   ; l& d.0   < AB !'     !(   !)  !*  9.0  State4conditions/reasonswhichmayresultinanABOdiscrepancy.(2points)%!,%%  /B+4 Ї10.0  List4techniqueswhichmaybeutilizedtoresolveABOdiscrepancies.(2points)%% 11.0  Define immunogenicityasitrelatestotheDantigen?(1point)& %% 12.0  WhatpercentageofthepopulationisDpositive?Dnegative?(1point)S%% 13.  ForthefollowinginterprettheDtyping.(1.5points) L *|dddd  dd  dd dd qsX%X%,dd ,dd ,dd ,edd ,dd ,'dd +      6,! "M 6AntiD 6,! "M 6Dctrl 6,! "M 6Du 6,! "M 6Ductrl 6,! "M 6Interpretation 2(& "  M 2A. 'c" '4+ 'c" " 'NA 'c"!" 'NA 'c""" 'NA c"#"   c"$ B. ;1# % # ;0 ND%# &" #  # N0 ND%# '" #  # N0 ND%# (" #  # N0 1'%# )" #  1  # * C. ;1c%!+ # ;0 ND%c%!," #  # N0 :0%c%!-" #  :4+ ;1c%!." # ;0 1'%c%!/" #  1 c%!0   #/T+7 btB  tBb14  .0    DcontrolsareunnecessarywhenusingsalineorchemicallymodifiedantiD EXCEPT whenthe @" patient  iswhichABOorDtype.Explainindetailwhyacontrolmustberuninthesesituations.(1.5points)tBbی2%% Ќ  15.  StatethepurposeofperformingtheweakDtest.(1point)   btB  tBb16  .0    Describethetransfusionstatus(Dinterpretation)oftheweakDindividualasadonorandas @! arecipient.tBbیS%% Ќ  0  (1point)%% tB  tB.b17  .0    TheweakDtestispositive.Whattestmustbeperformedtoensurethatthisisnotafalse @ positive " result?0D%%(0.5)tB.Ibی$F D%D% Ќ    -)# YXN XXgX18.0  Accordingtothereportingformatdemonstrated,interpretthefollowingABO/D.Noticethatyouareto   writeyourinterpretationoftheforwardtypeinthe InterpForwardcolumn,thereversetypeinthe Interp 2 Reversecolumn,thencomparethe2determinevalidityoftheresults.Onceyouhavecomparedthe 3d resultswrite yesforvalid(forwardandreversematch)or noforinvalid(forwardandreversedidnot e match).(2pointseach)%% Y XYXN*npdddd dd dd edd edd 'dd '|X%X%,,( , ( , ( ,( ,( ,( ,( ,( ,(( ,(( ,(( +  4* , , @4 ?0!; l" ?ForwardTyping F3$; l" FInterp ; l  Forward TA27 h " TReverseTyping F3$; l " FInterp ; l  Reverse TA27 h " TValid? ; l Yes/No bX=7 h" @   @ b ;,!= n"  ;antiA ;,!= n" ;antiB ;,!= n" ;antiA,B AM,!= n" AantiD AM,!= n"M ADcontrol ?0!= n"M ? 5& . 5A1cells ?,!= n" ?BCells C0!= n" C 4! . 4 M>& . @   @Ma. ;,!A r " ;O ;,!A r " ;O ;,!A r " ;O AM,!A r " AO AM,!A r "M ANA ;,!A r "M ; ;,!A r " ;4+ ?,!A r " ?4+ ?,!A r " ? ?,!A r !" ? SD,A r "" @   @Sb. ;,!!R #" ;O ;,!!R $" ;O ;,!!R %" ;1+ AM,!!R &" A3+ AM,!!R '"M ANA ;,!!R ("M ; ;,!!R )" ;O ?,!!R *" ?4+ ?,!!R +" ? ?,!!R ," ? SD,!R -" @   @Sc. ;,!2 ." ;O ;,!2 /" ;4+ ;,!2 0" ;4+ AM,!2 1" A3+ AM,!2 2"M ANA ;,!2 3"M ; ;,!2 4" ;4+ ?,!2 5" ?O ?,!2 6" ? ?,!2 7" ? SD,2 8" @   @Sd. ;,!9" ;4+ ;,!:" ;4+ ;,!;" ;4+ AM,!<" A3+ AM,!="M A3+ ;,!>"M ; ;,!?" ;O ?,!@" ?O ?,!A" ? ?,!B" ? SD,C" @   @Se. ;,!D" ;4+ ;,!E" ;4+ ;,!F" ;4+ AM,!G" AO AM,!H"M AO#YXN XY/#Y XYXN#g Y#Yg  ;,!I"M ; ;,!J" ;O ?,!K" ?O ?,!L" ? ?,!M" ? UD,N" @   @Uf. =,!O" =3+ =,!P" =4+ =,!Q" =4+ AM,!R" A4+ AM,!S"M AO =,!T"M = =,!U" =1+ ?,!V" ?O ?,!W" ? ?,!X" ?<20Y" @    <  #g Ys/##gXXg 1/#Ifyouanswered Nointhe Valid?columnattempttogiveanexplanation.Extracreditawardedforcorrect w[ problemsolving. \