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Rh Flashcards

1
Q

most important antigen in Rh system

A

Rho/D

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2
Q

most important antibody in Rh system

A

anti-D

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3
Q

Rh positive frequency

A

85%

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4
Q

Rh negative frequency

A

15%

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5
Q

frequency of Rh negative people who will make anti-D if exposed to D antigen

A

50-75%

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6
Q

most immunogenic Rh antigen

A

D > c > E

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7
Q

Fisher Race theory

A

3 genes closely linked on chromosome give rise to 5 antigens with each gene resulting in one antigenic determinant site with no crossing over
genes inherited as one group of 3
D, C, c, E, e

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8
Q

Wiener theory

A

1 gene gives rise to 3 antigenic sites (5 antigens)
1 gene gives rise to antigens responsible for numerous blood factors on red cells
R, r, Rh, hr

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9
Q

Fisher Race nomenclature

A

D, C, c, E, e

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10
Q

Wiener nomenclature

A

R, r, Rh, hr

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11
Q

Tippett theory

A 
2 genes (RHD and RHCE) give rise to major Rh antigens
variations in RHCE genes give rise to C, E, c, e antigens
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12
Q

Rosenfield terminology

A

Rh1, Rh2, Rh3, Rh3, Rh4, Rh5, Rh12, Rh7, Rh22

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13
Q

Rh1

A

D

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14
Q

Rh2

A

C

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15
Q

Rh3

A

E

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16
Q

Rh4

A

little c

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17
Q

Rh5

A

little e

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18
Q

Rh12

A

G

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19
Q

Rh7

A

Ce

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20
Q

Rh22

A

CE

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21
Q

Rh32

A

low frequency found primarily in black population, associated with weak C, e

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22
Q

2 Rh genes

A

RHD

RHCE

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23
Q

serine at position 103 RHD

A

D protein

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24
Q

serine at position 103 RHCE

A

big C

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25
Q

proline at position 103 RHCE

A

little c

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26
Q

proline at position 226 RHCE

A

big E

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27
Q

alanine at position 226 RHCE

A

little e

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28
Q

RHAG gene

A

co-expressor required to be present in order for Rh antigens to successfully express

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29
Q

Weiner frequencies in white population

A

R1 > r > R2 > R0

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30
Q

Weiner frequencies in black population

A

R0 > r > R1 > R2

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31
Q

Weiner frequencies in asian population

A

R1 > R2 > r > R0

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32
Q

R1

33
Q

R2

34
Q

R0

35
Q

Rz

36
Q

r’

37
Q

r’’

38
Q

r

39
Q

ry

40
Q

serve as transporter potential for ammonia and CO2

A

Rh antigens

41
Q

Rh antigen enzyme treatment

A

resistant/increased reactivity

42
Q

position effect/gene interaction effect/Ceppellini effect

A

C in trans position weakens expression of D (ex: Dce/dCe)

43
Q

partial D antigen

A

missing epitopes of D antigen

44
Q

can partial D make anti-D?

A

yes if transfused with red cells that carry all the epitopes

45
Q

partial D variants, European ancestry

A

DNB, DVI, DVII

46
Q

partial D variants, African American ancestry

A

DIIIa, DIVa

47
Q

can weak D people make anti D?

48
Q

definition of weak D positive

A

testing results are negative at IS but strongly positive at AHG

49
Q

when is weak D testing required?

A

before initial labeling

cord bloods of babies born to Rh negative moms

50
Q

Rh compound (cis) antigens

A

f(ce), Ce, cE, CE

51
Q

f antigen

A

single entity that results from conformational change within Rhce protein
little c, little e in cis position

52
Q

anti-f reacts with:

A

Dce, dce (ce in cis position)

53
Q

transfusion requirements for patients with anti-f

A

little c OR little e negative (both have to be present for f to be present so only have to be negative for one)

54
Q

Rhi (RH7)

A

C and e inherited in cis position (R1, r’)

55
Q

G (Rh12)

A

present when C or D antigen present

56
Q

anti-G

A

will react with C positive and/or D positive

may be mistaken for combo anti-C, anti-D

57
Q

how to differentiate anti-G from combination anti-C, anti-D?

A

elution and adsorption studies

58
Q

V antigen frequency

A

30% of black populatio

59
Q

VS antigen frequency

A

32% of black population

60
Q

exalted D gene deletion

A

when all of Ee or Ee and Cc is missing and D gene is present, D antigen is unusually strong

61
Q

D– (D dash dash)

A

deletion that results in no CE expression
negative for Rh37
can make anti-Rh17

62
Q

D.. (D dot dot)

A

partial loss of RHCE protein and increased dose of RHD protein
positive for Rh37
can make anti-Rh17

63
Q

Rh null phenotype

A

lack all Rh antigens and LW antigens, rarest blood type in the world, can make anti-Rh29 (total Rh)

64
Q

amorphic Rhnull

A

inheritance of silent alleles at the Rh locus from both parents (—/—)
deletion in RHD and RHCE gene with normal RHAG

65
Q

regulator Rhnull

A

normal RHD and RHCE genes but inheritance of rare suppressor or regulator genes from both parents, no RHAG gene

66
Q

Rhnull clinical presentation

A 
compensated anemia
stomatocytes
retics
low hgb
increase hgb F
decrease serum haptoglobin
possible increased bilirubin
67
Q

Rhmod

A

Rh antigens present but have weakened expression

68
Q

anti-anti-e

A

present with anti-e, positive for e antigen, positive autocontrol

69
Q

e variants

A

hrB and hrS

70
Q

anti-hrB

A

reacts with ce (f) cells, stronger reaction with e positive cells

71
Q

anti-hrS

A

reacts with Ce (Rhi) positive cells

72
Q

Rh17 (Hr0)

A

antigen seen on red cells of all common Rh phenotypes (R1R1, R2R2, rr)

73
Q

Rh32

A

variant of R1[D(C)(e)]

C and e antigens weakly expressed, D antigen exalted

74
Q

Rh33 ceHAR

A

(D)c(e) hybrid gene results in reduced amounts of e, f, Hr0, D antigens and normal amounts of c

75
Q

Rh43

A

Crawford (ceCF) phenotype

76
Q

Rh antibody class

A

IgG

IgG1 and IgG3 most clinically significant

77
Q

LW antigen

A

strong reactivity on Rh positive adult cells
weak or no reaction on Rh negative adult cells
strong reactivity on Rh positive and Rh negative cord cells

78
Q

anti-LWa

A

may be mistaken for anti-D occurring in Rh positive person

79
Q

differentiate between anti-D and anti-LWa

A

panel cells treated with DTT: LW antigens denatured, D antigens are not
react patient’s plasma with Rh+ and Rh- cord cells: anti-D will not react with Rh- cord cells, anti-LWa will react with both

CCHS SBB (40 decks)

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