P/GLOB,Rh Flashcards by Filip Garrett | Brainscape

Q

P Blood group Antigen.

- GLOB collection Antigens.

A

P1 Ag - P blood group

- Pk and P Ags - GLOB collection

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Q

The P1 antigen is the receptor for what?

A

Parvovirus B19 (5th disease)

*entry point into RBCs

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Q

What antigen is the target of antibodies in paroxysmal cold hemoglobinuria (PCH).

A

P antigen

-Auto-anti-P antibody

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Q

The P group phenoytes are defined by reactivity with what antibodies?

A

Anti-P1
Anti-P
Anti-Pk
Anti-PP1Pk

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Q

What is the P1 phenotype?

A

P1+, P+, Pk-, PP1Pk+

*80% of white; 95% of blacks

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Q

Individuals with p phenotype (P1-, P-, Pk-, PP1Pk-) make a potent ____ antibody.

A

Anti-PP1Pk

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Q

Anti-PP1Pk antibodies may be associated with what?

A

Delayed Hemolytic transfusion reaction
HDFN
1st trimester spontaneous abortion

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Q

Anti-P1 is agglutinated by what? (3)

A

Hydatid cyst fluid
Pigeon egg whites
Turtledove egg whites

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Q

Anti-P1 titers may be elevated in what conditions/situations?

A

Echinococcal infection (Hydatid cyst)

- Bird Handlers

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Q

P(k) antigen is the receptor for binding what in renal epithelium?

A

Shiga toxin

- E. coli toxins

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Q

Individuals with P2 phenotype make an Anti-P1 25% of the time, describe the antibodies:

Warm/Cold
IgG/IgM
Clinical signficance

A

Cold
IgM
Insignificant

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Q

Auto-anti-P antibody characteristics. (4)

A

Paroxysmal cold hemoglobinuria
Biphasic IgG
Binds in cold temps, hemolyzes at 37
“Donath-Landsteiner biphasic hemolysin”
Seen following viral infection in children (syphilis historically)

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Q

Wiener’s “Haplotype” - Fisher-Race Equivalents:

-R1

A

DCe

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Q

Wiener’s “Haplotype” - Fisher-Race Equivalents:

-R2

A

DcE

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Q

Wiener’s “Haplotype” - Fisher-Race Equivalents:

-R0

A

Dce

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Q

Wiener’s “Haplotype” - Fisher-Race Equivalents:

-r’

A

dCe

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Q

Wiener’s “Haplotype” - Fisher-Race Equivalents:

-r’’

A

dcE

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Q

Wiener’s “Haplotype” - Fisher-Race Equivalents:

-r

A

dce

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Q

Wiener’s “Haplotype” - Fisher-Race Equivalents:

-Rz

A

DCE

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Q

Wiener’s “Haplotype” - Fisher-Race Equivalents:

-r(y)

A

dCE

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Q

What are the frequency of the different Rh combinations in WHITES?

A

R1>r>R2>R0

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Q

What are the frequency of the different Rh combinations in BLACKS?

A

R0>r>R1>R2

Q

Rh antigens are polypeptide antigens encoded by what two closely linked gene loci? (chromosome?)

A

RHD & RHCE

-Chr1

Q

What additional proteins associate with the Rh complex?

A

LW

- Duffy (Fy)

Q

What helps explain the possibility of “partial D” phenotypes?

A

Multitude of extracellular domains

*size and intricacy result in multitude of epitopes and antigens

Q

What is the most common Rh- genotype?

A

r/r (dce/dce)

*Whites 40%; Blacks 30%

Q

Rh null individuals have no Rh antigens, they also have diminished expression of what other antigens? (5)

A

LW
Fy5
S/s
U

Q

Rh null individuals have no Rh antigens, what clinical manifestations are they associated with? (3)

A

Osmotic fragility
Chronic hemolysis
Stomatocytosis

Q

What antibody will form in a Rh null patient who received Rh- RBCs?

A

Anti-Rh29

-Anti-total Rh antibody

Q

Weak D is what type of defect?

A

Quantitative defect in D antigen

-Less D than normal

Q

T/F: Persons with weak D do NOT form an anti-D antibody.

A

True

Q

Weak D is defined historically by weak reactivity with anti-D reagent, typified by the following reactions:

A

Negative at IS with anti-D reagent
Negative after 37 incubation with anti-D reagent
Positive at AHG phase with anti-D (IAT)

Q

What are the possible reasons for weak D?

A

Mutated form of RHD (MC)
-point mutation in membrane or inner part of RHD leading to alteration in antigen expression

RHCe on opposite chromosome to RHD (“C in trans”) inhibits D expression

Q

When do you perform weak D test?

A

All D-negative DONORS

*Weak D RBCs could induce anti-D in a D(-) recipient

Q

What non-donor group needs weak D testing?

A

D(-) babies born to D(-) mothers

Q

T/F: Weak D moms do NOT need RhIG prophylaxis.

A

True

Q

What is the definition of partial D?

A

Alteration in 1 of the epitope sequences of the D gene

Q

What is the result of partial D?

A

D antigen with some, but not all, epitopes

*Persons with partial D may form anti-D antibody

Q

T/F: Transufusion of partial D cells into a D Negative recipient may cause sensitization.

A

True

Q

Partial D women and pregnancy.

A

-At risk for forming anti-D antibodies with D+ preganancy

Q

How should partial D recipient women be treated?

A

D Negative

Q

How is partial D frequently identified?

A

Coexistence of D expression and anti-D antibodies

Q

Rh antibodies are __ antibodies that are _______.

A

IgG

acquired through exposure

Q

What is the most immunogenic of all the non-ABO antigens?

A

D antigen

Q

What is the rate of sensitization, when Rh+ blood is transfused to Rh- recipients in the ER setting?

A

20-30%

Q

All Rh antibodies except what, display dosage?

A

Anti-D

Q

T/F: All Rh antigens are enhanced by enzymes.

A

True

Q

If anti-E is detected in the serum, the additional presence of what antibody should be suspected?
-Why?

A

anti-c

-Anti E individuals have R1R1 phenotype (DCe/DCe), and have likely been transfused with R2 blood (DcE)

Q

anti-c may be undetectable, but is a common cause of what?

A

Delayed hemolytic transfusion reaction

Q

G antigen is found on ALL __ RBCs and most __ RBCs.

A

G antigen is found on all D+ RBCs and most C+ RBCs

Q

Serologically anti-G antibodies can mimic what?

A

anti-D and anti-C

*multiple absorption/elution studies can distinguish anti-G from anti-D and anti-C

Q

Anti-f is an antibody against what?

A

compound antigen ce

Q

T/F: Anti-f is the most common alloantibody directed against compound Rh antigens.

A

True

Q

Anti-f is primarily found in persons with what Rh phenotype?

A

DCe/DcE (R1R2)