Rh AND KELL ANTIGENS Flashcards
______ is a phenomenon where red cells from a DCe/Ce (R1/r’) individudal express significantly fewer D antigen sites than red cells from a DCe/ce (R1r) individual
Cepelleni Effect
-D expression is reduced due to the presence of C antigens in trans ( in opposite haplotype) to the D antigen
True / false: The Rh haplotype can influence the expression of D antigen
True
Less D antigen expressed when C antigen is present (Cepellini effect?)
True / false: Weak D phenotypes are a result of amino acid changes predicted to be located within the exofacial/ surface membrane of the red cells
False
The changes are located intracellularly or in the transmembrane region of the protein (aka area of the D protein located within cell membrane)
True / false: weak D phenotypes are further weakened in the presence of C in trans to the weak D
True
Which of the ff altered D phenotypes have altered proteins / amino acids that are located on the cells exterior membrane surfaces? A. D(el) B. Weak D C. Partial D D. Elevated D
C. Partial D
Which of the ff altered D phenotypes has an enhanced expression of D antigen in the reduced expression or absence of C/c and E/e antigens? A. D(el) B. Weak D C. Partial D D. Elevated D
D. Elevated D
In which ethnicity is the D-negative phenotype most common? A. European B. Asian C. African-Am D. Hispanics
A. European (15-17%)
B. Asian (<0.1%)
C. African-Am (~8%)
D. Hispanics (???)
Which of the d scenarios can cause false-negative Rh typing results?
A. A neonate with severe HDFN caused by anti-D
B. IgG coating of red cells by warm or cold agglutinins
C. Washing and retesting a patient sample that showed rouleaux at initial spin
D. Patient red cells are non-specifically aggregating
A. A neonate with severe HDFN caused by anti-D
- will be strongly DAT positive; antigen sites are blocked by maternal Anti-D
B - this will show false pos; treat red cells with glycine or chloroquine
C - false pos by rouleaux; saline replacement should resolve this
D - false pos; may be due to reagent component
Which of the ff Rh antibodies, aside from anti-D, can most likely cause severe HDFN? A. Anti-C B. Anti-E C. Anti-e D. Anti-c
D. Anti-c
Although the rest can also cause HDFN, but milder
How should a female of child bearing age with partial D be considered as (Rh+ or Rh neg) when they come in as a blood donor vs as a patient? A. D+ as donor; D+ as patient B. D- as donor; D+ as patient C. D+ as donor; D- as patient D. D- as donor; D- as patient
C. D+ as donor; D- as patient
Patients with partial D (in general) can make allo anti-D
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
R1R2
DCe/DcE
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
R0R0
Dce/Dce
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
Rzr’
DCE/DCe
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
R2Rz
DcE/DCE
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
r’r”
Ce/cE
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
rr
ce/ce
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
r”r
cE/ce
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
R1r’
DCe/Ce
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
R2R0
DcE/Dce
Convert the Fisher-Race nomenclature into Weiner’s nomenclature:
Rzr^y
DCE/CE
Which of the ff Rh phenotype is the compound antigen f will more likely be expressed in? A. DCe/ce (R1r) B. DCe/CE (R1Rz) C. DcE/DCe (R2R1) D. DCE/DCE (RzRz)
A. DCe/ce (R1r)
expressed on RBCs with c and e on the same protein (RhCe)
ex. DCe/ce or Dce/Dce
Which of the ff Rh phenotypes will the compound antigen Ce more likely be expressed in? A. DCE/ce (Rzr) B. DcE/DCE (R2Rz) C. DCe/Ce (R1r') D. DcE/DcE (R2R2)
C. DCe/Ce (R1r’)
expressed when C and e are on the same protein
ex. Ce/ce or Dce/Ce
The Rh26 antigen was identified in 1964 and antigen negative phenotype Rh26- has been found in Italians and Dutch. Which of the ff Rh antigens is Rh26 more likely to be expressed in? A. c- B. c+ C. C- D. C+
B. c+
antigen is expressed in majority of c pos RBCs. anti-Rh26 is known as anti-c - like;
found in c+,Rh26 - phenotypes found in Italians and Dutch
The Rh29 antigen can be found in nearly all populations (100%). Which of the ff Rh phenotypes was the Rh29- antigen been reported on?
a. Rzr
b. Rh (mod)
c. Rh (null)
d. D neg red cells
c. Rh (null)
the only Rh29- are Rh(null). Anti-Rh29 is the immune response of some Rh(null) individuals
Which Rh antigen is associated with the partial D, subcategory DIVa phenotype?
a. Hr
b. CE
c. Rh32
d. Go(a)
d. Go(a)
Anti - Goa is found frequently with anti-Rh32 and anti-Evans, specificity NOT separable by absorption
A patient has made an antibody against a rare Lutheran antigen (ex. Anti- Lu4, -5). Which of the ff family members would show the most compatibility for pRBCs in case transfusion is needed? A. paternal grandfather B. parents C. siblings D. maternal grandfather
C. siblings
Which of the ff Kell phenotypes will anti-Ku be most likely found in? A. K-, k-, Kpa+, Kpb- B. K+, k-, Kpa-, Kpb- C. K+, k+, Kpa+, Kpb- D. K-, k-, Kpa-, Kpb-
D. K-, k-, Kpa-, Kpb-
this is a phenotype from a K0 individual (null); Kell null individuals can make anti-Ku
True / false - Patients who have anti-Kpa also usually has anti-K
True
Anti-Km can only be made by which particular individuals?
A. A female with McLeod syndrome, plus CGD
B. A female with McLeod syndrome, without CGD
C. A male with McLeod syndrome, plus CGD
D. A male with McLeod syndrome, without CGD
D. A male with McLeod syndrome, without CGD
McLeod syndrome is a recessive X-linked inherited mutation of the XK gene
A male with McLeod syndrome, plus CGD = can make anti-Km and -Kx
Rank the level of immunogenicity of these Rh antigens from most to least immunogenic A. D > E > c > C > e B. D > c > E > C > e C. D > C > E > c > e D. D > c > e > C > E
B. D > c > E > C > e
Which of the ff is considered as a coexpressor and must be present for successful expression of the Rh antigens? A. Glycophorin A B. Type 1 chains C. RHAG D. LW
C. RHAG
An individual’s Rh type is D+, C+, c+, E+, e+, f-. Which of the ff is his the most probable genotype? A. R0r’’ B. R2R0 C. R1r’’ D. Rzry
C. R1r’’
This individual is DCe, dcE
An f+ individual must inherit c+e+ on the same allele
Ex. dcE/Dce ( R2R0) or Dce/ dcE (R0, r’) or DCE/dce (Rzr)
The antibody to Hr0 is directed to the entire protein resulting fromthe RHCE genes. Which of thr ff phenotype will moce likeley produce anti-Hr0? A. D(mod) B. Weak D C. Partial D D. D —
D. D –
Anti- Hr0 will react with most cells except D - -
Which of the ff low prevalence Rh antigens is NOT associated with any of the categories of Partial D phenotype? A. Rh23 B. Rh 30 C. Rh 40 D. Rh33
D. Rh33
Shows reduced amounts of Some Rh antigens
Anti-LW is best distinguished from Anti-D by which of the ff serologic reactions?
A. Anti-LW will react with cord cells regardless of their Rh type, and is non reactive with 0.2M DTT treated cells
B. Anti-LW is reactive with O+ cord cells, non reactive with O- cord cells, and is non reactive with 0.2M DTT treated cells
C. Anti-LW will react with cord cells regardless of their Rh type, and reactive with 0.2M DTT treated cells
D. Anti-LW is reactive with O+ cord cells, non reactive with O- cord cells, and is reactive with 0.2M DTT treated cells
A. Anti-LW will react with cord cells regardless of their Rh type, and is non reactive with 0.2M DTT treated cells
anti-LW reacts with cord cells regardless of Rh type; LW is a high prevalence antigen that is denatured by DTT treatment
