Rh Blood Group Systems

Question 1

Proposed the RHD and RHCE genes

Answer 1

Patricia Tippett

Question 2

Expression of Rh genes

Answer 2

Autosomal codominant

Question 3

Location of RHD and RHCE genes

Answer 3

Chromosome 1

Question 4

Co-expressor but by itself cannot express any Rh antigens

Answer 4

RHAG gene

Question 5

Location of RHAG gene

Answer 5

Chromosome 6

Question 6

Rh system nomenclature involving the presence of 3 separate genes D,C, and E and their alleles c and e—linked on the same chromosome and are inherited as group of 3

Answer 6

Fischer-Race

Question 7

Rh system nomenclature based on the notion that a single locus on a gene carries the entire Rh system

Answer 7

Wiener

Question 8

Most common in blacks

Answer 8

R0r

Question 9

Most common in Asians/Whites

Answer 9

R1r

Question 10

4 most common genotypes

Answer 10

R1, R2, r, R0

Question 11

Rh nomenclature system that assigns a number to each antigen in order of its discovery or recognized relationship to the Rh system

Answer 11

Rosenfield

Question 12

Rh nomenclature system that adopted a 6 digit number for each authenticated antigen

Answer 12

International Society of Blood Transfusion (ISBT)

Question 13

The first 3 numbers of the ISBT represent the

Answer 13

System/collection/series

Question 14

The last 3 numbers of the ISBT represent the

Answer 14

Antigenic specificity

Question 15

These Ags are: polypeptide, reside in transmembrane proteins, not soluble, not expressed in tissues, well developed at birth (can cause HDN), very good immunogens

Answer 15

Rh antigens

Question 16

Most immunogenic antigen after A and B antigens

Answer 16

D antigen

Question 17

Immunogenecity of Rh antigens

Answer 17

D > c > E > C > e

Question 18

Ag common in blacks, no/weak reactions with anti-D, and detected by IAT

Answer 18

Weak D (Du)

Question 19

Causes of weak D

Answer 19

1) positinal D/ C in tans to RHD
2) genetic weak D
3) partial D/ D-mosaic

Question 20

Allele carrying RHD is in trans to allele carrying C

Answer 20

Positional D/ C in trans to RHD

Question 21

D antigen is expressed completely but fewer in number

Answer 21

Genetic weak D

Question 22

One or more epitopes within the D protein is missing/altered; alloantibodies can be formed against the missing/altered epitopes (can cause HDN)

Answer 22

Partial D/D-mosaic

Question 23

C&E are not expressed on RBCs; increased number of D antigens on RBC

Answer 23

Rh deletion (D- -/D- -)

Question 24

No antigen expression on RBCs; abnormalities in transmembrane protein

Answer 24

Rh null

Question 25

Characterized by HA, reticulocytosis, stomatocytosis, decreased: Hb, Hct, haptoglobin, increased: bilirubin, HbF

Answer 25

Rh null

Question 26

Mutated RHAG, normal RHD & RHCE; no RHAG expression; no RHD and RHCE expeessions

Answer 26

Regulator type Rh null

Question 27

Mutated RHCE, deleted RHD, normal RHAG

Answer 27

Amorphic type Rh null

Question 28

Partial suppression of Rh gene; weakened Rh expression

Answer 28

Rh mod

Question 29

Compound antigen; expressed when 'c' and 'e' are in cis position

Answer 29

f(ce)

Question 30

Single amino acid change in RhCe protein

Answer 30

Cw

Question 31

Compound antigen; expressed when 'C' and 'e' are present

Answer 31

rhi(Ce)

Question 32

Present on most D+ and C+ RBCs

Answer 32

G(DC)

Question 33

Strong D expression because of no Cc/Ee expression

Answer 33

Exalted D

Question 34

Not naturally occurring Abs; form upon exposure to corresponding Ags; IgG; warm reacting Abs and react best at 37degC; can cross the placenta; cause HDN

Answer 34

Rh antibodies

Question 35

Most clinically significant Rh Abs

Answer 35

IgG1 and IgG3

Question 36

Rh Abs that cause complement fixation

Answer 36

IgG3 > IgG1 > IgG2

Question 37

Rh Ab that cannot bind complement

Answer 37

IgG4

Question 38

Rh Abs best at crossing the placenta

Answer 38

IgG1 > IgG4 > IgG3

Question 39

Rh Ab that cannot cross the placenta

Answer 39

IgG2

Question 40

Rh Abs with the greatest significance because RBCs coated with these are cleared in the RES

Answer 40

IgG1 and IgG2

Question 41

HTRs due to Rh incompatibility usually result in

Answer 41

Extravascular hemolysis of liver & spleen

Question 42

Amount of Rh Abs that can stimulate Ab prod. in an Rh neg person

Answer 42

Less than 0.1 mL