Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SBB > Rh antigen > Flashcards

Rh antigen Flashcards

1
Q

What is the second autosomal linkage in humans?

A

Rh blood group and gene for elliptocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What was the Fisher and Race theory?

A 
3 closely linked genes
Inherited has a haplotype
Crossover was rare
1 gene = 1 antigen 
Did not explain all the low freq
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What was the Weiner theory?

A

1 gene codes for 1 agglutinogen that has 3 factors
Each factor represented an antigen
Thought that R and r could code for unlimited factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the ISBT number for Rh?

A

004

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What was Tippetts theory?

A

Correctly described the 2 gene inheritance

1 RHD gene and 1 RHCE gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What antigen does ISBT 4.6 code for?

A

f

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What antigen does ISBT 4.7 code for?

A

Ce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What antigen does ISBT 4.8 codes for?

A

Cw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Most prevalent Rh phenotypes in whites?

A

R1 (42%) > r (37%) > R2 (14%) > Ro (4%)
68% of whites are C +
80% are c+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most prevalent Rh phenotypes in Blacks?

A

Ro (44%) > r (26%) > R1 (17%) > R2 (11%)
27% are C+
98% are c+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Characteristics of Rh antibodies

A

IgG; rarely IgM
Do not activate complement
- Causes extravascular hemolysis
Enhanced by enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rh most to lease immunogenicity

A

D > c > E > C > e

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is anti-RH17?

A

RH17 = Hro (High freq)
antibody that reacts with all cells except D– and D**
Auto antibody is known as anti-pdl (partial deleted)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is anti-RH29?

A

RH29 = total Rh
antibody that reacts with all cells except Rh null cells
Immune stimulated in Rh null
Some anti-RH29 reacts with Rh mod cells
auto antibody is known as anti-dl (total deleted)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are anti-hr(s) and anti-hr(b)?

A

antibody reacts with all cells but can look anti-e reacting with stronger with e+ cells. Made by people with variant e. Seen in black population.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is anti-LW?

A

Antibody reacts stronger with D+ cells than D- cells
- May need to enhance to show reactivity with D- cell
Negative with Rh null cells
Anti-LW reacts with all cords regardless of Rh type
DTT destroys
Seen as an auto antibody with no clinical significance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cw

A

Found with multiple antibodies

Cw is found in 2% of whites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Goa

A

Goa (RH30) is present in DIVa partial D cells

present in 2% of blacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

V antigen is historically known as

A

ce^s
RH10
occurs in 30% of blacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The VS antigen is historically known as

A

e^s
RH20
occurs in 32% of blacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is anti-Evans antibody?

A

Evans antigen is present on D** cells and not D– cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is anti-f?

A

f is present with c and e are in cis
present on Ro and r cells
Appears to be anti-c and -e, but only reacts to shared determinate on Ro and r cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is anti-G?

A

reacts with all cells carrying D or C or both
Transfuse D- C- blood
Differentiate in pregnant females for RHIG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What amino acid change makes G antigen?

A

Serine at position at 103 on RHD and RHCE gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Anti-Ce

A

Also called RH7 or rhi
Similar to f, reacts with Ce+ cells in cis (R1 or r’)
Most anti-C is Ce in Rh positive people
Ce is present in 68% of White and 27% of blacks
- Most C+ will be e+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What disease show reduced expression of Rh antigens

A 
Hereditary spherocytyosis
Leukemias
Myeloid metaplasia
Myelofibrosis
Polycythemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What causes anemia in Rh null or Rh mod people

A

RHag is required for strong cytoskeleton of RBC
Integrity of membrane is compromised
Increased osmotic fragility - abn cation fluxes
Stomatocytes present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What chromosome is RHD and RHCE located on?

A

Chromosome 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Characteristics of RHD and RHCE genes?

A

Both are 416 amino acids long with 10 exons
92-97% identical
genes run in opposite direction = “hair pin” formation and genetic recombination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What chromosome is RHAG located on?

A

Chromosome 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What chromosome is LW located on?

A

Chromosome 19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What cells have the most D antigens present?

A

D–
D**
R2R2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the amino acid that determines C

A

Serine at 103

Ser103Pro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the amino acid that determines c

A

Proline at 103

Ser103Pro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the amino acid that determines E

A

Proline at 226

Pro226Ala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the amino acid that determines e

A

Alanine at 226

Pro226Ala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the Rh box?

A

RHD gene is flanked by 2 Rh boxes
Identity boxes
In whites, Deletion of D gene occurs in RH boxes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the structure of D antigen?

A 
Pass membrane 12x
Has a C and N terminus in cytoplasma of cell
Non-glycosylated = Hydrophobic
Non=phosphorlated
More than 30 epitopes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is X1r?

A

Normal RHAG gene
Makes precursor substance 2 from precursor 1
Must be present to make RH and LW antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is Xor?

A

No RHAG gene
= Rh null regulator
No Rh antigens or LW antigens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is Xqr?

A

Rh mod phenotype

RHAG makes a modified precursor substance 2. DCE and LW antigens are present but weak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is rr (double bar)

A

Amorph Rh null
No DCE or LW antigens
RHAG is normal
D deletion with homozygous inactive RHCE genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

High protein Anti-D

A

Human source = Polyclonal
20-24% protein added to enhance IS of IgG antibody by bringing RBC’s close together
May see spontaneous agglutination with warm auto

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

IgM Saline anti-D

A

Human source

Expensive because hard to find donors with IgM Anti-D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Chemically modified anti-D

A

Human source

DTT breaks the disulfide bonds in the hinge region to allow IgG to crosslink 2 RBC’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Monoclonal anti-D

A

Combonations of IgM and IgG
Can be monoclonal IgM with human IgG
or both monoclonal IgG and IgM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is crawford antigen (ceCF)?

A

RH43 - Found in Africans 0.1%
amino acid substitution in the RHCE gene that results in a D like epitope
D gene is NOT present.
Negative at IS but reacts at AHG phase

48
Q

What causes a false positive with anti-D?

A

Warm or Cold auto antibodies
Rouleaux or spontaneous red cells agglutination
contaminated reagent
Polyagglutination - seen with ortho (human source)

49
Q

What causes a false negative with anti-D?

A

Failure to add reagent
RBC suspension too heavy
Shaking tube to hard
Red cells with positive strong DAT (seen in HDFN)

50
Q

How many D antigen sites are on most normal D+ cells?

A

10-33,000

51
Q

How many D antigen sites are on D– or D** cells?

A

75-300,000

52
Q

How many antigens are on Weak D cells?

A

<100-10,000

53
Q

How many antigens are on Del cells?

A

> 20

54
Q

% of Whites and Blacks that D+?

A

85% of whites

92% of blacks

55
Q

% of Asians and Native Americans that are D+?

A

99%

56
Q

What causes D neg in most Caucasians?

A

D gene is deleted

Chromosome misalignment and unequal crossing over between the Rh boxes

57
Q

What is the pseudogene?

A

Occurs in African populations (66% of Rh-)
There is a premature stop codon which does not allow the D gene to be expressed
D gene is present but inactive

58
Q

What is the Del phenotype?

A

Amino acid change that results in very low D antigens on RBC
Will type D- at IS and AHG phase
Must adsorb and elute to detect D antigen
Found in 10-30% Asians
Exon 9, inside the membrane, is deleted
Most are C+ (Rh negative)

59
Q

Weak D

A 
Quantitative = Less D antigen present
Amino acid change occurs inside the membrane
May need AHG to detect
All D epitopes are present 
Types 1-3 will not make anti-D
60
Q

Partial D

A 
Qualitative 
Missing some D epitopes
Many will react as IS
Most due to hybrid gene with RHCE gene
Amino acid change on external loops of D antigen
Can make allo-anti-D to missing epitopes
Many assoc. with low frequency antigens
61
Q

C in Trans to D

A

Occurs in Ror’
Steric arrangement if C and D interferes with D expression
D antigen is normal = Can rec’v D+ cells

62
Q

What is Ceppellini effect?

A

D is weaker in Presence of C

R1 is weaker than R2 cells

63
Q

Partial DVI

A

Found in Whites 0.02-0.05%
Accounts for 6-10% of all partial D’s that make anti-D
BARC+ (RH52; low freq)
Not detected at IS but variably positive in AHG.
FDA Requires that monoclonal anti-D NOT detect DVI at IS, so females are typed as D neg

64
Q

DVII

A

Found in Whites

Tar+ (RH40; Low freq)

65
Q

DIVa

A

Found in blacks
Goa+ (RH 30; Low freq)
GoDIVa

66
Q

DIIIa

A 
Found in Blacks
Assoc. with Variant RHCE*ce^s
Make anti-D, anti-c, or anti-hr^b
DAK+ (RH54; Low freq)
Consistently strong D epitopes - types D+
67
Q

What partial D’s will type D positive?

A

III, IV, VII

3 + 4 = 7

68
Q

D**

A

Has D, G, RH29 (total Rh) + RH37 (EVANS)
Has less D antigen than other D deletions
Can make anti-Rh17 and anti-RH47 (DAV

69
Q

D–

A

Has D, G, and RH29 Total
D gene is present and homozygous for RHCE null
Most D antigen present
Form anti-e or Ce (Rh 7)
Also, make anti-Rh17 or anti-Hr = Reacts with all common Rh phenotypes

70
Q

RHD*DHAR

A

Formerly called RoHAR but better named ceHAR
Found in 0.01% Germans
FPTT+ and RH33
Hybrid CE-D-CE gene = No D antigen; Only one D epitope insertion
R HAR = Normal c, reduced e, f, Hro and D = (D)c(e)
Most IgM reagents detect; can make anti-D

71
Q

What is Rh null regulator?

A

NO RHAG protein due to inactivating mutations
Xor
NO DCE, LW, GPB (S, s, U) or FY5 antigens
Reduced CD47
Make anti=RH29 (total Rh)

72
Q

What is Rh mod?

A

XQr = RHAG is modified and not expressed normally
Rh antigens are present but weakend
Must adsorb and elute to detect Rh antigens

73
Q

What is Rh null amorph?

A

rr (double bar)
amorph from deleted D gene and homozygous for RHCE containing inactivating mutations
Normal RHAG but no DCE, LW. Normal Ss and weak U
Rare, occurs in whites

74
Q

Frequency of Rh null

A

One in 6,000,000

75
Q

Can an Rh Null pass Rh gene to child?

A

rr and Rh null (R1R1) person can pass one normal RHAG and R1r to child = Rh positive from 2 Rh neg parents

76
Q

What does the FDA require for weak D on instrument?

A

Instrument must detect a weak D of 1+ or greater.

Weaker than 1+ will be labeled as Rh negative

77
Q

What does the RHAG code for?

A

RH-associated glycoprotein

It carries 4 antigens and Rh core complex

78
Q

What is Rh core complex?

A

Interacts with Band 3, GPA, GPB, LW, and CD47 and is associated with the membrane skeleton via Ankyrin and Protein 4.2

79
Q

What is CD47?

A

Part of Ig superfamily
Generates a “survival signal”
-Anti-CD47 drug

80
Q

What is RHAG1?

A

Duclos Antigen
High incidence
Absent Rh null regulator and Rh mod phenotype

81
Q

What is RHAG2?

A

OIa antigen

Low frequency

82
Q

What is RHAG3?

A

DSLK antigen
Stands for Duclos like antigen
Reacts like Duclos but proven unique

83
Q

What is RHAG4?

A

Low freqency
Only one case and caused HDFN
Person was African

84
Q

What is f antigen?

A

RH6
Anti-f reacts with c in cis to e or Ro and r cells
65% of Caucasians
92% of Blacks - R0 and r very common

85
Q

What is Ce antigen?

A

RH7 also known as rhi
most immune anti-C is in Rh positive is really anti-Ce
antibody reacts to C and e in cis position or R1 and r’ cells
68% of whites - R1 is most common
27% of blacks

86
Q

What is Cw antigen?

A 
RH8
weak C
W stands for Willis
Low freq present in 2% of whites, 1% of blacks, 4% finns, and 9% latvans
Antithetical to Cx and Mars
Most Cw cells are C+
87
Q

What is Cx antigen?

A

RH9
Weak C
Very low frequency 0.01% (seen in 1.8% Finns)
Antithetical to Cw

88
Q

What is RH39?

A

C-Like
Antibody reacts stronger C+ cells than C-
Antibody can be absorbed by C+ and C- cells except Rh null cells

89
Q

What is RH51?

A

MAR antigen
High prevalence to Cw and Cx
100% are positive except 0.2% of Finns are MAR neg

90
Q

What is RH2?

A

C antigen 4.2
Partial C = Cw, Cx, D(C)(e) and (C)ce^s
Anti-C in blacks may be anti-hrB (RH31)
68% Whites and 27% of blacks C +

91
Q

What is RH3?

A

E antigen 4.3
Some examples of Anti-E are naturally occurring
29% of Whites and 22% of Blacks E+

92
Q

What is R11?

A

Ew
Partial antigen detected by some but not all anti-E reagents
0.01% (Germany)

93
Q

What is RH4?

A

c antigen 4.4
Most clinically sig next to D antigen
80% of Whites and 98% of blacks are c+

94
Q

What is RH26?

A

c like antibody
antibody reacted with some c+ but not all cells
c+ RH26- cells found in Italians and Dutch

95
Q

What is RH5

A

e antigen 4.5
Antigen for e has many parts - not full understood
Allo anti-e seen in e variants (missing e epitopes)

96
Q

What are the two categories of partial e?

A

Partial e that make anti-e like antibody

Partial e and partial Hro (RH17) that make antibody that reacts with cells except Rh null

97
Q

What is hr^s?

A 
RH19
Present in 98% 
R2R2 cells are negative
Negative seen in Africans (1% of Bantus)
make anti-Hr
Appears to be anti-e in e positive people
98
Q

What is hr^b?

A

RH31
High frequency
Anti-e antibody in e positive person
Weak anti-hr^b may look like anti-C in blacks. Reacts stronger with C+ cells
Anti-hr^s and anti-hr^b are found in DIII people
Common in sickle cell patients

99
Q

What is V?

A

RH10
ce^s
c is cis to e^s
30% of blacks are postitive

100
Q

What is VS?

A 
RH20
e^s
Found in 32% of blacks
Most V+ are VS+
hr^b neg cells are VS+
101
Q

What is the rG haplotype>

A

rG cells have not DCE antigens but G is present

Assoc with JAHK

102
Q

What is RH18?

A

Hr antigen

High freq present on all except RHCE null, Rh null and Hrs negative

103
Q

What are the high prevalent Rh antigens?

A

Hr^o, Hr, hr^s, RH29 (total), hr^B, Hr^b, NOU, SEC, DAV, MAR

104
Q

What are the low prevalent Rh antigens?

A

Dw, Goa, RH32, RH33 (DHAR), TAR, FPTT, BARC, DAK, Crawford

105
Q

What is LW5?

A

LWa - 97%

106
Q

What is LW6?

A

LWab - 3%

107
Q

What is LW7?

A

LWb - Rare

108
Q

What causes LW(a-b-) phenotype?

A

Rh null will type as LW(a-b-) even if LW gene is present

109
Q

What is the function of LW antigen?

A

It’s an Intercellular adhesion molecule (ICAM)
maker for lymphocyte maturation and differentiation
May help stabilize the erythroblastic islands
Involved in removal of old RBC’s

110
Q

How do you differentiate anti-D and anti-LW?

A

LW will react with all cord cells regardless of D type
LW is destroyed by DTT and pronase
Both are resistant to Ficin/papain

111
Q

How do you transfuse a person with Anti-LW?

A

D neg RBC have less LW and survive well

112
Q

What subclass is Anti-D most commonly?

A

IgG1 and IgG3

113
Q

What does a weak anti-hrb resemble?

A

Anti-hrb will react stronger with C+ cells so may appear to be anti-C. May also appear as anti-Ce Occurs in black population.

114
Q

How do you identify anti-hrs?

A

e like antibody in e+ people

To correctly identify anti-hrs, you must have cells that are cells that are e+ hrs-.

115
Q

DFR

A

Type of partial D that is positive for FPTT (RH50)

116
Q

DBT

A

Type of D-CE hybrid that is found in blacks
R^N (RH32) +
Normal D with weak C and e
Can make anti-SEC (RH46; high freq)

117
Q

What partial/weak D’s will be detected?

A

III, IV, VII will type as D+ (3+4=7)
Variable results with DVI, DBT, DHAR, and Crawford
DVI will type neg at IS per FDA requirements

SBB (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions