Chapter 7 The Rh Blood Group System

Question 1

Upper case R (R)

Answer 1

presence of D antigen

Question 2

Lower case r (r)

Answer 2

absence of D antigen

Question 3

Wiener System

indicated by 1 or ‘

Answer 3

upper case C (C)

Question 4

When there is no ‘ or 1

Answer 4

lower case c(c)

Question 5

R^1 =?

Answer 5

DCe

Question 6

r’ =?

Answer 6

Ce

Question 7

R^0 =?

Answer 7

Dce

Question 8

indicated by 2 or “

Answer 8

upper case E (E)

Question 9

When there is no 2 or “

Answer 9

lower case e (e) is implied

Question 10

R^2 =

Answer 10

DcE

Question 11

r” =

Answer 11

cE

Question 12

r =

Answer 12

ce

Question 13

letter z or y is used when both C and E are upper case

Answer 13

R^z = DCE
r^y = CE

Question 14

The Rh system was first recognized in a case report of:

Answer 14

A hemolytic transfusion reaction

Question 15

What antigen is found in 85% of the white population and is always significant for transfusion purposes?

Answer 15

D

Question 16

How are weaker-than-expected reactions with anti-D typing reagents categorized?

Answer 16

Weak D

Question 17

Cells carrying a weak-D antigen require the use of what test to demonstrate its presence?

Answer 17

(IAT) indirect antiglobulin tets

Question 18

How are Rh antigens inherited?

Answer 18

co-dominant alleles

Question 19

Biochemically speaking, what type of molecules are Rh antigens?

Answer 19

Proteins

Question 20

Rh antibodies react best at what temperature (C)?

Answer 20

37 degrees C

Question 21

Rh antibodies are primarily of which immunoglobulin class?

Answer 21

IgG

Question 22

Rh antibodies have been associated with which of the following clinical conditions?

Answer 22

Stomatocytosis

Question 23

What do Rh-null cells lack?

Answer 23

Rh antigens

Question 24

What antigen system is closely associated phenotypically with Rh?

Answer 24

LW or Landsteiner Weiner

Question 25

Anti-LW will not react with what?

Answer 25

Rh null RBC

Question 26

What most commonly causes an individual to type RhD positive yet possess anti-D?

Answer 26

Partial D

Question 27

Convert the following genotypes from Wiener nomenclature to Fisher-Race: 1. R1r 2. R2RO 3. RzR1 4. ryr

Answer 27

1. DCe/dce 2. DcE/Dce 3. DCE/DCe 4. dCE/dce

Question 28

Which RH phenotype has the strongest expression of D?

Answer 28

D-

Question 29

An individual has the following Rh phenotype: D+C+E+c+e+. Using Fisher-Race terminology, what is their most likely Rh genotype?

Answer 29

DCe/DcE

Question 30

What is the most common Rh phenotype in African Americans?

Answer 30

Dce/dce

Question 31

In the Fisher-Race nomenclature what does "d" refer to?

Answer 31

- amorph - silent allele - absence of D

Question 32

What is the frequency of E antigen in the general population?

Answer 32

30%

Question 33

What does hr' refer to in the Weiner nomenclature?

Answer 33

c

Question 34

All of the following are consistent with International Society of Blood Transfusion (ISBT) terminology except: a) A six digit number specifies each blood group antigen b) 004 represents Rh group c) D is written as "RH 1" d) All genes are written in bold print

Answer 34

d) All genes are written in bold print

Question 35

Where is the Rh antigen located relative to the red cell membrane?

Answer 35

integrally

Question 36

Why is it acceptable for "C Trans" individuals to receive D-positive red cells? a) the structure of the D antigen is complete b) the Du is a result of steric complications c) the Rh antigen on the red cell is normal d) all of the above

Answer 36

d) all of the above

Question 37

Why is determination of Rh status crucial for obstetric patients?

Answer 37

All Rh negative mothers are possible candidates for Rh immune globulin

Question 38

Which IgG subclasses carry the most significance with regard to Rh antibodies?

Answer 38

IgG1/IgG3

Question 39

All of the following may cause a false negative reaction in Rh typing except: a) omission of reagent b) immunoglobulin coating cells c) rouleaux d) cell suspension too heavy

Answer 39

c) rouleaux

Question 40

All of the following may occur following an Rh-mediated hemolytic transfusion reaction except:a) elevated fever b) increased bilirubin c) intravascular hemolysis d) positive DAT

Answer 40

c) intravascular hemolysis

Question 41

What genotype is consistent with f antigen expression?

Answer 41

Dce/DCE

Question 42

G antigen is present on all of which type of red cells?

Answer 42

C positive

Question 43

If a person has a genotype of LWa LWb, what is his or her phenotype?

Answer 43

LW (a+b+)