RH Blood Group Part 1 Flashcards

1
Q

History

1609: what was discovered by a French midwife in a set of twins

A

Hemolytic Disease of the Newborn

one was hydropic and stillborn, while the twin was jaundiced and died of kernicterus

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2
Q

History

1930s (before 1939): the concern on blood types were limited to — only

  • despite the correct ABO match, people were wondering there are still mortalitiy and morbidity problems
  • there are reports about Hemolytic Transfusion Reactions (HTR) and Hemolytic Disease of the Fetus and Newborn (HDN)
A

ABO

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3
Q

History

1939: who described an HTR (hemolytic transfusion reaction) on an obstetrical patient after delivering a stillborn infant which then required transfusion and had her husband be the donor because they have the same ABO blood type

A

Dr. Philip Levine
Rufus Stetson

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4
Q

History

in what year was an antibody was isolated from the mother’s serum that reacts on both 37C and 20C with the father’s RBC

described by Dr. Philip Levine and Rufus Stetson

the mother’s serum also reacted from 80 out of 104 ABO-compatible donors, that’s whi it was then thought that the fetus and the father had something in common that the mother lacked

A

1939

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5
Q

History

In what year and who reported that an antibody made by a guinea pigs and rabbits when transfused with Rhesus macaque monkeys RBCs

A

1940- Dr. Karl Landsteiner and Dr. Alexander S. Wiener

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6
Q

History

in 1940, the antibody produced by guinea pigs and rabbits when transfused with Rhesus macaque monkey RBCs reacted on how many percent of human RBCs

reprorted by Landsteiner and Wiener

A

85%

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7
Q

where was “Rh” antibody named from

what animal

A

Rhesus macaque monkey

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8
Q

History

in 1941, he found over 90% of erythroblastosis fetalis cases is when the mother is Rh-negative and the father was Rh-positive

it was also this time when they concluded that the mother had been immunized by the fetus (inherited the antigen from the father)

A

Dr. Levine

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9
Q

History

what caused the erythroblastosis fetalis from the patient of Dr. Levine

A

the maternal antibody

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10
Q

History

the agglutinin causing the HTR and the antibody described by Landsteiner defines —

Levine and coworkers

years later, it was proven different (human anti-Rh and animal anti-Rh are not the same)

A

defines the same blood group

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11
Q

History

the name “Rh” was retained for human-made anti-Rhesus antibody, while the anti-Rh for animals was renamed — in honor of two scientists (who were they)

A

renamed “anti-LW” in honor of Dr. Karl Landsteiner and Dr. Alexander S. Wiener

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12
Q

Terminologies

who were the people behind “Fisher-Race” or “DCE term”

both were investigating blood groups including the newly discovered Rh antigen

A

Sir Ronald Aylmer Fisher
Dr. Robert Russell Race

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13
Q

Terminologies

in 1941, Sir Ronald Aylmer Fisher named — on the basis of the reactivity of two antibodies that recognized — antigens

A

C and c antigens; antithetical antigens

he then used the next letters of the alphabet (D and E) to define the antigens recognized by two additional antibodies

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14
Q

Terminologies

in 1943, Sir Ronald Aylmer Fisher proposed that “antigens of the system were produced by —; each gene was responsible for producing an antigen on the RBC surface”

A

3 closely linked set of alleles

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15
Q

Terminologies

the phenotype of a given RBC is defined by the presence of these expressions

each antigen and corresponding gene were given the same letter

A

C or c
D or d
E or e

each person inherits a set of Rh gene from each parents (D or d; C or c; E or e) because it was thought to be codominant

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16
Q

Terminologies

C=
c=
D=
d=
E=
e=

gene frequencies of common Rh antigens in Caucasians

A

C= 70%
c= 80%
D= 85%
d= 15%
E= 30%
e= 98%

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17
Q

Terminologies

in 1946, Rh phenotype was reported in order of — because Sir Ronald Aylmer Fisher thought of C/c locus lies betweed D/d and E/e loci

A

DCE

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18
Q

Terminologies

in DCE phenotype, the small letter does not represent an antigen but simply the — of the antigen

A

absence

for example the “d” does not indicate an antigen, but rather its absence

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19
Q

Terminologies

placing a phenotype inside a parenthesis indicates a —

placing parenthesis around “D” = (D)

A

weakened antigen

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20
Q

Terminologies

the Fisher-Race terminology was followed for —

by Sir Arnold Aylmer Fisher and Dr. Robert Russell Race

A

written communication

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21
Q

Terminologies

who was responsible for “Rh-hr” terminology

A

Dr. Alexander Wiener

he believed that there was one gene responsible for defining Rh that produced an agglutinogen containing a series of blood factors

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22
Q

Terminologies

Rh gene produce at least — factors within an agglutinogen

“Rh-hr” terminology by Dr. Alexander Wiener

A

3 factors

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23
Q

Terminologies

Rh-hr terminology may be considered the phenotypic expression of the —

by Dr. Alexander Wiener

A

haplotype

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24
Q

Terminologies

R=
r=
1 or single prime=
2 or double prime=
Z=
0=
‘=
“=
y=

Rh-hr terminology by Dr. Alexander Wiener

A

R= indicates presence of D
r= indicated “d” (absence of D antigen)
1 or single prime= presence of C (ex. R1)
2 or double prime= presence of E
Z= presence of CE (with D)
0= presence of ce
‘= presence of Ce without D (ex. r’)
“= presence of cE without D (ex. r”)
y= presence of CE wihout D (ex. r^)

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25
# Terminologies introduced the "alphanumeric terminology" in 1962 | new terminology for Rh group ## Footnote created to more accurately represent the serologic data and to be more compatible with computer use
Richard Rosenfield and coworkers ## Footnote assigns a number to each antigen of the Rh system in order of its discovery or recognized relationship to the Rh system
26
# Terminologies this terminology have no genetic basis and does not involve theory of Rh inheritance | by Richard Rosenfield and coworkers ## Footnote simply demonstrates the presence or absence of the antigen on the RBC
Alphanumeric terminology
27
# Terminologies D= C= E= e= | alphanumeric terminology by Richard Rosenfield and coworkers
D= 1 C= 2 E= 3 c= 4 e= 5
28
# Terminologies what sign is used in alphanumeric terminology that designates the absence of an antigen | by Richard Rosenfield and coworkers
minus sign
29
# Terminologies the number is --- if the antigen was not tested | in alphanumeric terminology by Richard Rosenfield and corworkers
omitted
30
# Terminologies this committee created a terminology for Red Cell surface antigens which establishes a uniform nomenclature that is both eye and machine readable and is keeping with the genetic basis of blood groups
International Society of Blood Transfusion (ISBT) Committee
31
# Terminologies the International Society of Blood Transfusion Committee assigned a --- digit number for each antigen; and what does these numbers represents
6 digit number for each antigen; the **first three digits** represents the system and the remaining **three represents** the antigenic specificity
32
# Terminologies what number was assigned to Rh blood group by the International Society of Blood Transfusion (ISBT) Committee
"004"
33
this is the basis for Rh antigens
Molecular Biology and Genetics
34
# Molecular biology and Genetics what are the two theories of Rh genetic control that were initially given
Wiener Fisher-Race
35
# Molecular biology and Genetics this theory states that a single gene produces a single product that contains separately recognizable factors
Wiener
36
# Molecular biology and Genetics this theory states that the Rh locus contains 3 distinct genes that control production of their respective antigen
Fisher-Race
37
# Molecular biology and Genetics Patricia Tippett (1997) said that Rh was based on two Rh genes, which are
"RHD" and "RHCE"
38
# Molecular biology and Genetics "RHD" and "RHCE" are closely linked genes that are on chromosome --- that spans --- | Patricia Tippett
chromosome 1 that spans 65 kb
39
# Molecular biology and Genetics "RHD" and "RHCE" are ---% identical and --- each other at their --- ends | Patricia Tippett
97% identical and faces each other at their 3' ends
40
# Molecular biology and Genetics how many exons do "RHD" and "RHCE" genes have | Patricia Tippett
10 exons each
41
# Molecular biology and Genetics "RHD" and "RHCE" is inherited as --- | Patricia Tippett
codominant alleles
42
# Molecular biology and Genetics RHD gene codes for --- protein and is flanked by --- | Patricia Tippett
RhD protein and is flanked by Rhesus boxes
43
# Molecular biology and Genetics RHCE gene codes for --- | Patricia Tippett
RhCe Rhce RCE ## Footnote most Rh negative white people have RHCE gene
44
# Molecular biology and Genetics it is a gene important for Rh antigen expression
RHAG
45
# Molecular biology and Genetics
46
RHAG gene can be found at chromosome --- and is ---% identical to the RH genes
chromosome 6 and is 47% identical to the RH genes
47
# Molecular biology and Genetics how many exons do RHAG genes have ## Footnote same as RHD and RHCE
10 exons
48
# Molecular biology and Genetics RHAG gene codes for
Rh-associated glycoprotein (Rh50 glycoprotein
49
# Molecular biology and Genetics 1. similar in structure to --- except it has --- 2. forms a complex with --- for a successful expression of Rh antigens (coexpressor) 3. by itself, it --- 4. if mutated, --- | Rh-associated glycoprotein (Rh50 glycoprotein)
1. similar in structure to Rh proteins except it has a glycoprotein 2. forms a complex with Rh proteins for a successful expression of Rh antigens (coexpressors) 3. by itself, *does not express Rh antigen* 4. if mutated, Rh proteins will be **missing or altered**
50
# Molecular biology and Genetics it was believed that the RHAG and Rh genes came from --- 250-350 million years ago
gene duplication
51
# Molecular biology and Genetics RH and RHAG mRNAs are restricted to cells of --- lineages
erythroid
52
# Molecular biology and Genetics in erythropoiesis, RHAG appears early on --- progenitors and Rh proteins appear later (RhCE and then RhD)
CD34+
53
# Rh antigens - "D" well developed early in ---
fetal life
54
# Rh antigens - "D" resides at the --- of the RBC membrane
transmembranous (integral) protein
55
# Rh antigens - "D" Rh complex is linked to the membrane skeleton via --- and --- | since RhD can be found at the transmembranous protein of the RBC
Rh/RhAG-ankyrin interaction and CD47-protein 4.2 association
56
this Rh antigen provides conformational requirements for many serological differences between Rh groups
Rh anitgen - D
57
this Rh antigen maintains structural integrity for the RBC
Rh antigen - D
58
# Rh antigens - "D" composed of how many amino acids that traverses the cell membrane how many times | 2 questions
416 amino acids; traverses the cell membrane 12 times
59
what Rh antigen where only small loops of Rh proteins are exposed on RBC surface
Rh antigen - D
60
# Rh antigens - "D" differs only about how many amino acids
32-35 amino acid
61
# Rh antigens - "D" what positions: 1. important in determining C or c 2. differentiates E from e
1. position 103 2. position- 226
62
# Rh antigens - C/c and E/e antigens the four major allelic forms of RHCE
CE Ce cE ce
63
# Rh antigens - C/c and E/e antigens C and c differs how many amino acids
4 amino acids
64
# Rh antigens - C/c and E/e antigens 1. cysteine at residue --- replaced by --- 2. isoleucine at residue --- replace by --- 3. serine at residue --- replaced by --- 4. serine at residue --- replaced by --- | C and c ## Footnote follow ups: 1. number (1) is encoded by what exon? 2. RHCe have arisen from trasfer of --- from --- into ---
1. cysteine ate residue 16 is replaced by tryptophan 2. isoleucine at residue 60 is replaced bby leucine 3. serine at residue 68 is replaced by asparagine 4. serine at residue 103 is replaced by proline ## Footnote 1. exon 1 2. RHCe have arisen from transfer of exon 2 from RHD into RHce
65
# Rh antigens - C/c and E/e antigens E and e differs by how many amino acids
1 amino acid
66
# Rh antigens - C/c and E/e antigens proline at residue --- replaced by --- | E and e
proline at residue 226 replaced by alanine
67
# Rh antigens - C/c and E/e antigens resides on the --- of the protein and encoded by what exon? | E and e
4th extracellular loop of the protein encoded by exon 5
68
# Rh antigens - C/c and E/e antigens what mutation caused the E and e antigen
single point mutation in Rhce resulted in RHcE