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BLOOD BANK > RH BLOOD GROUP SYSTEM > Flashcards

RH BLOOD GROUP SYSTEM Flashcards

1
Q

Second most important blood group system in terms of transfusion ; 2nd most immunogenic

A

Rh D / Rh blood group

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2
Q

Described a hemolytic transfusion in an obstetrical patient

A

Levine & Stetson

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3
Q

A blood group PHENOTYPICALLY RELATED to Rh blood group ; Guinea pigs and rabbits + Rhesus macaque monkey’s blood —> (anti Rhesus) antibody agglutinated 85% human RBCs

A

Landsteiner and Wiener (LW)

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4
Q

Rh system nomenclature ; most to least immunogenic

A

D > c > E > C > e

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5
Q

ISBT : 004001
Rosenfield (numerical): Rh1

Fisher-Race : ____

A

D

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6
Q

ISBT : 004002
Rosenfield (numerical): Rh2

Fisher-Race : ____

A

C

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7
Q

ISBT : 004003
Rosenfield (numerical): Rh3

Fisher-Race : ____

A

E

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8
Q

ISBT: 004004
Rosenfield (numerical): Rh4

Fisher-Race : ____

A

c

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9
Q

ISBT: 004005
Rosenfield (numerical): Rh5

Fisher-Race : ____

A

e

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10
Q

Wiener : Rh0

Fisher-Race : ____

A

D

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11
Q

Wiener : rh’

Fisher-Race : ____

A

C

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12
Q

Wiener : rh’’

Fisher-Race : ____

A

E

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13
Q

Wiener : hr’

Fisher-Race : ____

A

c

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14
Q

Wiener : hr”

Fisher-Race : ____

A

e

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15
Q

Placing _____ around (D), (C), and (e) indicates weakened antigen expression

A

Parenthesis

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16
Q

Agglutinates is described by a letter and symbol assigned based on the factors present

A

Modified Wiener Nomenclature

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17
Q

MODIFIED WIENER NOMENCLATURE : Presence of the D antigen

A

R

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18
Q

MODIFIED WIENER NOMENCLATURE : Absence of D antigen

A

r

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19
Q

MODIFIED WIENER NOMENCLATURE : C antigen

A

1 / ‘

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20
Q

MODIFIED WIENER NOMENCLATURE : c antigen

A

NO 1 / ‘

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21
Q

MODIFIED WIENER NOMENCLATURE : E antigen

A

2 / “

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22
Q

MODIFIED WIENER NOMENCLATURE : e antigen

A

NO 2 / “

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23
Q

MODIFIED WIENER NOMENCLATURE : When both C and E are present

A

z / y

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24
Q

Wiener to Fisher : R1

A

DCe

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25
Q

Wiener to Fisher : r’

A

_Ce or dCe

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26
Q

Wiener to Fisher : R0

A

Dce

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27
Q

system that assigned a NUMBER to each antigen of the Rh system in order of its discovery or recognized relationship to the Rh system ; demonstrates the presence or absence of the antigen on the RBC

A

Rosenfield nomenclature

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28
Q

Rosenfield nomenclature : A ______ preceding a number designates the absence of the antigen

A

Minus

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29
Q

Rosenfield nomenclature : if an antigen has not been phenotypes, its number will ______ in the sequence

A

Not appear

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30
Q

Fisher-Race : DCe/dCe
Rosenfield : _____

A

Rh : 1, 2, -3, 4, 5

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31
Q

Fisher-Race : Dce/dce
Rosenfield : _____

A

Rh: 1, -2, -3, 4, 5

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32
Q

Fisher-Race : Dce/dce
Rosenfield : _____

A

Rh: 1, -2, -3, 4, 5

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33
Q

Fisher-Race :dcE/dcE
Rosenfield : _____

A

Rh : -1, -2, 3, 4, -5

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34
Q

Fisher-Race : DCe/dCe
Rosenfield : _____

A

Rh : 1, 2, -3, -4, 5

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35
Q

Establish a UNIFORM NOMENCLATURE that is both eye- and machine-readable and is in keeping with the genetic basis of blood groups ; adopted a SIX DIGIT-NUMBER for each authenticated antigen belonging to a blood group system

A

International Society of Blood Transfusion Committee: Updated Numeric Terminology

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36
Q

Wiener : R1r
Fisher-Race : ___
Rosenfield : ____

A

DCe/dce
Rh : 1, 2, -3, 4, 5

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37
Q

Wiener : R0r
Fisher-Race : ___
Rosenfield : ____

A

Dce/ce
Rh : 1, -2, -3, 4, 5

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38
Q

Wiener : r”r”
Fisher-Race : ___
Rosenfield : ____

A

dcE/dcE
Rh : -1, -2, 3, 4, -5

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39
Q

Rh gene responsible for making antigen D

A

RHD gene

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40
Q

Rh gene responsible for making antigen Cc and Ee

41
Q

D antigen is present while Cc and Ee antigens are absent ; greatest concentration of D antigen

42
Q

D antigen is present while Cc and Ee antigens are absent ; greatest concentration of D antigen

43
Q

Gene important to RH ANTIGEN EXPRESSION ; termed a COEXPRESSOR and must be preset for successful expression of the Rh antigens

A

Rh-associated glycoprotein (RHAG)

44
Q

RH BIOCHEMISTRY : important in determining C or c antigen

A

Amino acid position 103

45
Q

RH BIOCHEMISTRY : Differentiates E from e

A

Amino acid position 226

46
Q

Variations in the quantity of D antigen or the specificity of D antigen epitopes ; variations of D antigen expression

47
Q

The Rh antigen on the RBC is normal but the steric arrangement of the C antigen in relationship to the D antigen appears to interfere with the EXPRESSION OF D ANTIGEN

A

POSITION EFFECT

48
Q

Inheritance of RHD genes that code for WEAKENED EXPRESSION of the D antigen ;antigens expressed appear to be COMPLETE but FEWER in number ; low concentration of D antigen

A

Quantitative

49
Q

Extremely low number of D antigen sites that most reagent anti-D are unable to detect

50
Q

Most significant ; associated with anti-D formation ; Wiener and Unger postulated that the D antigen is made of antigenic subparts, genetically determined, that could be ABSENT in rare instances ; individual LACKS 1 or more pieces or epitopes of the total antigen, alloantibody can be made to the missing epitope(s) if exposed to RBCs that possessed the complete D antigen

A

Partial D-antigen

51
Q

Weak D categories that can receive Rh positive blood

A

Position Effect and Quantitative weak D

52
Q

Weak D category that cannot receive Rh positive blood as it can induce anti-D formation

A

Partial-D / D-mosaic

53
Q

General rule for weak D

A

Donor must be Rh positive ; patient must be Rh negative

54
Q

React best at 37C (IgG in nature) ; immune antibodies ; do not bind compliment ; show dosage

A

RH antibodies

55
Q

Clinical consideration for Rh antibodies

A

HTR and HDFN

56
Q

Fail to express any Rh antigens on the RBC surface ; completely negative

57
Q

Rh null genotype

A

little r double bar

58
Q

Rh antibodies can be detected through

A

Antibody screening and identification

59
Q

Rh antibodies demonstrate dosage except

60
Q

Severely reduced expression of all Rh antigens ; weakened

61
Q

Rh typing : Rh view box with a temp of 45C

A

SLIDE TEST

62
Q

Rh typing : incubated a 37C

63
Q

Rare / unusual phenotypes

A

C^w
f(ce)
rhi (Ce)
G
Exalted D (D-)

64
Q

Rare antigen phenotype that is present on most D-positive and all C-positive RBCs

A

G phenotype

65
Q

The destruction of the red blood cells of a fetus and neonate by antibodies produced by the antibodies of the mother ; mother can be stimulated to form RBC antibodies naturally (ABO), by previous pregnancy, or transfusion (RBC alloimmunization)

A

HDFN - hemolytic disease of the fetus and newborn

66
Q

3 important factors for HDFN to occur

1) the red cell antibody produced by the mother must of the _______
2) the fetus must possess an antigen that is _______
3) the antigen must be ______ at birth

A

IgG class ; lacking in the mother ; well-developed

67
Q

ABO antigens develop after ____ to ___ years of age

A

2 to 4 years of age

68
Q

ABO HDFN occur if the mother is blood type ____ and the baby is blood type _____

A

O ; A or B or AB

69
Q

Occurs when maternal IgG attaches to specific antigens of the fetal RBCs

70
Q

Destruction of red cells

71
Q

Increased production of red cells

A

Erythropoiesis

72
Q

Fetal hemolysis of the newborn ; swollen liver

A

Hydrops fetalis

73
Q

Hemolysis releases hemoglobin which is then metabolized further into bilirubin (b1/indirect/unconjugated). If left untreated, this can cause _____ or permanent damage to parts of the brain

A

Kernicterus

74
Q

Highly specialized prenatal test in which a sample of the baby’s blood is removed from the umbilical cod for testing

A

Cordocentesis (percutaneos umbilical cord testing)

75
Q

Collecting amniotic fluid from the mother - determine the severity of HDFN - test for fetal lung maturity

A

Amniocentesis

76
Q

Used to correct anemia which maintains hemoglobin >10g/dL ; Performed by accessing the fetal umbilical vein (cordocentesis) and injecting donor RBCs directly into the vein

A

Intrauterine transfusion

77
Q

blood group commonly used to treat HDFN for intrauterine and neonatal transfusions

A

Group O RBCs

78
Q

Neonatal transfusion requirements

A

Blood should less than 7 days old
CMV negative
ORh negative blood

79
Q

In neonatal transfusion, the blood must be less than 7 days old in order to prevent _____ and maximize _____

A

Hyperkalemia ; 2,3-DPG

80
Q

Used to remove toxic elements in the neonate’s blood ; use of whole blood or equivalent to replace the neonate’s circulating blood

A

Exchange transfusion

81
Q

Used to remove bilirubin (light sensitive) from the neonate

A

Phototherapy

82
Q

Prevents hemolysis ; Competes with the mother’s antibodies for the FC receptors on the macrophages in the infant’s spleen

A

Intravenous immunoglobulin

83
Q

Prevents immunization to D antigen ; prevents HDFN by preventing formation of anti-D

84
Q

Rhogam mechanism of action:

Rhogam attaches to the fetal Rh ____ RBC in the maternal circulation

A

Rh positive

85
Q

Regular -dose vial : sufficient anti-D to protect against _____ mL of packed RBCs or ____ mL of whole blood (most commonly used)

A

15 mL ; 30 mL

86
Q

Rhogam is given during ____ week of gestation or ____ hours after death

A

28th-week ; 72 hours

87
Q

Rhogam : Always add ___ vial to correct mistakes in the computation

88
Q

A screening test for Rhogam ; used to determine if there is fetal bleed of fetal-maternal hemorrhage

A

Rosette testing

89
Q

Rosette testing : Reagent that is added to maternal blood ; attaches to fetal blood

A

Reagent 1 : anti-D

90
Q

Rosette testing : after the addition of reagent 1 or anti-D (reaction will not occur, since the maternal blood is more concentrated than the fetal blood), you now then add the reagent 2 or ____, concentrating the fetal blood

A

Rh (+) cells

91
Q

If positive for rosette testing, this test is performed next

A

Quantitative test : Kleihauer-Betke acid elution

92
Q

Kleihauer-Betke Acid Elution

A

Quantitative test

93
Q

Kleihauer-Betke acid elution : Hemoglobin A of the mother is ______ to acid elution whereas the Hemoglobin F of the infant is _____ to acid elution

A

Not resistant ; resistant

94
Q

Kleihauer-Betke acid elution

ghost cell : ____

A

Mother cell

95
Q

Kleihauer-Betke acid elution

Intact cell : ____

A

Infant cell

96
Q

% Fetal Red cell formula

A

of FRC / 2000 cells x 100

97
Q

% Fetal Red cell formula

A

of FRC / 2000 cells x 100

98
Q

FHM (fetal-maternal hemorrhage) formula

A

FMH = %FRC X 50

99
Q

Rhogam is indicated in

A

Rh (-) without anti-D
Rh (-) with complicated pregnancy
Rh (-) with Rh (+) baby

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