BB LEMAR NOTES (RH) Flashcards
2ND MOST IMPORTANT BLOOD GROUP SYSTEM IN TERMS OF TRANSFUSION
RH BLOOD GROUP
IN RH, IT IS CURRENTLY ACCEPTED THAT 2 CLOSELY LINKED GENES CONTROL THE EXPRESSION OF RH; ________ CODES FOR THE PRESENCE OF RHD AND A SECOND GENE (RHCE) CODES FOR THE EXPRESSION OF _____ ANTIGENS
ONE GENE RHD ; CcEe
IN RH, ANTIGENS ARE CHARACTERIZED AS _________________ THE RBC MEMBRANE
NONGLYCOSYLATED PROTEINS IN
BASED ON THE THEORY THAT ANTIGEN OF THE SYSTEMS WERE PRODUCED BY 3 CLOSELY LINKED SET OF ALLELES, EACH GENE WAS RESPONSIBLE FOR PRODUCING A PRODUCT (OR ANTIGEN ON THE RED CELLS SURFACE)
FISHER-RACE (DCE)
POSTULATED THAT GENE RESPONSIBLE FOR DEFINING RH ACTUALLY PRODUCED AN AGGLUTINOGEN THAT CONTAINED A SERIES OF BLOOD FACTORS, IN WHICH EACH FACTOR IS AN ANTIGEN RECOGNIZED BY AN ANTIBODY
WIENER (Rh-Hr)
NUMBER IS ASSIGNED TO EACH ANTIGEN OF THE RH SYSTEM IN ORDER OF ITS DISCOVERY
ROSENFIELD (ALPHA NUMERIC)
ADOPTED A 6 DIGIT # FOR EACH BLOOD GROUP SPECIFICITY
ISBT: NUMERIC TERMINOLOGY
INTERNATIONAL SOCIETY OF BLOOD TRANSFUSION (ISBT): NUMERIC TERMINOLOGY’S FIRST 3 NUMBERS REPRESENT THE _______ AND THE REMAINING 3 REPRESENT THE ________
SYSTEM ; ANTIGENIC SPECIFICITY
D ANTIGENS EXPRESSED APPEAR TO BE COMPLETE, BUT FEW IN #
GENETIC WEAK D
1 OR MORE PARTS OF THE D ANTIGEN IS MISSING
D MOSAIC OR PARTIAL D
POSITION EFFECT OR GENE INTERACTION EFFECT
C TRANS
ALLELE CARRYING D IS TRANS (OPPOSITE HAPLOTYPE) TO THE ALLELE CARRYING C
C TRANS
MOST ANTIBODIES ARE IGG AND REACTS OPTIMALLY AT 37degC OR AFTER ANTIGLOBULIN TESTING
IMMUNE ANTIBODIES
DO NOT BIND COMPLEMENTS
RBC DESTRUCTION IS EXTRAVASCULAR
CAUSE HDN
RH ANTIBODIES
- MOST COMMON
- CANT BE DIAGNOSED
- CAN AFFECT FIRST CHILD
- WEAK TO NEG DAT
- OCCURS IN TYPE O MOTHERS
- SLIGHT RISE IN BILIRUBIN (TREAT WITH PHOTOTHERAPY)
ABO HDN
- SEVERE
- FOLLOWED WITH TITERS
- IMMUNE EXPOSURE (2ND CHILD)
- VERY STRONG DAT
- CAN AFFECT ANY RH-NEG MOTHER
- HIGH RISH IN BILIRUBIN (MAY NEED TO PERFORM EXCHANGE TRANSFUSION)
RH HDN
Most common HDN
ABO HDN
SEVERE HDN
RH HDN
TYPE OF HDN THAT CANT BE DIAGNOSED
ABO HDN
HDN FOLLOWED WITH TITERS
RH HDN
HDN THAT CAN AFFECT 1ST CHILD
ABO HDN
HDH THAT PRODUCE IMMUNE EXPOSURE TO 2ND CHILD
RH HDN
HDN WITH WEAK TO NEG DAT
ABO HDN
HDN WITH VERY STRONG DAT
RH HDN
ABO HDN OCCURS IN GROUP _____ MOMS
TYPE O
RH HDN CAN AFFECT ANY ______ MOTHER
RH-NEG
SLIGHT RISE IN BILIRUBIN IN ABO HDN CAN BE TREATED WITH ______
PHOTOTHERAPY
HIGH RISE IN BILIRUBIN IN RH HDN MAY NEED TO PERFORM _______
EXCHANGE TRANSFUSION
SOLUTION OF CONCENTRATED ANTI-RHO(D)
RHO(D) IMMUNE GLOBULIN
IT IS PREPARED FROM POOLED HUMAN PLASMA OF PATIENTS WHO HAVE BEEN HYPERIMMUNIZED AND CONTAINS PREDOMINANTLY IGG ANTI-D
RHO(D) IMMUNE GLOBULIN
RhIg 2 PRIMARY USES
TREATMENT OF ITP ; PREVENTION OF RH HDN
IF THE SCREENING TEST IS NEGATIVE FOR THE PRESENCE OF D+ RBCS OF FETAL ORIGIN, THE MOTHER SHOULD RECEIVE A FULL DOSE OF RHIG WITHIN ______ OF DELIVERY
72 HOURS
IF THE SSCREENING TEST IS POSITIVE IN RHIG, THE FMH MUST BE QUANTIFIED USING THE _______
KLEIHAUER-BETKE TEST
_________ OR _________ IS USED TO QUANTITATE THE NUMBER OF FETAL RH-POSITIVE CELLS IN THE MOMS CIRCULATION AS A RESULT OF FETOMATERNAL HEMORRHAGE
KLEIHAUR BETKE TEST OR FLOW CYTOMETRY
BASED ON THE RESISTANCE OF FETAL HEMOGLOBIN TO ACID TREATMENT
KLEIHAUER BETKE TEST
HOW IS KLEIHAUER BETKE TEST IS DONE?
USE: MATERNAL BLOOD
- THIN SMEAR IN SLIDE
- TREAT WITH ACID
- RINSE
- COUNTERSTAIN
- READ MICROSCOPICALLY
IN READING THE SMEAR, MATERNAL CELLS WILL APPEAR ______ AND THE FETAL CELLS WILL BE ______
GHOSTS ; PINK
FETAL CELLS AND METERNAL CELLS ARE COUNTED SEPARATELY FOR A TOTAL OF ______ CELLS
2000 CELLS
IF 2K ERYTHROCYTES ARE COUNTED, THE % OF FETAL CELLS IS MULTIPLIED BY ___ TO ESTIMATE THE AMOUNT OF FETAL WHOLE BLOOD PRESENT IN THE MATERNAL CIRCULATION
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