Rh G Flashcards

1
Q

G antigen is present on most ___ and all ___ RBCs

A

most D-positive and all C-positive

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2
Q

G antigen results from the amino acid serine at position 103 on the __

A

RhD, RhCe, and RhCE

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3
Q

all ___ and ___ cells are G positive

A

C positive and D positive

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4
Q

G antigen are originally found in an rr person who received ____ RBCs

A

D+
C-
E-
c+
e+

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5
Q

t or f: amino acids encoded by exon 2 of RHC are identical to those encoded by exon 2 of RHCe

A

false, identical to those encoded by exon of RHD

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6
Q

t or f: there are some cases where Rh negative individual who received Rh negative blood still reacted

A

TRUE.

the donor was C positive and thus G+ and the antibody produced is actually anti-G not anti D and anti-C.

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7
Q

G antigen is important for ___ patients because production of anti-G also is a candidate for RhIG

A

obstetric patients

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8
Q

if the obstetric patient has produced anti-G and not anti-D, then she is considered a candidate for?

A

RhIG

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9
Q

ability of a particular substance (antigen or epitope) to provoke an immune response to the body of a human or animal

A

immunogenecity

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10
Q

immunogenecity of Rh

A

D > c > E > C > e

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11
Q

enumerate the Rh functions

A
  • structural integrity of red cells
  • ammonia and CO2 transporters
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12
Q

about 1% of D-positive individuals type as ___

A

weak D

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13
Q

weak D is formerly known as?

A

Du

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14
Q

test requirement for people with RBC that possess D antigen

A

indirect antiglobulin test

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15
Q

serologic weak D is noted when initial anti-D testing is ___

A

negative or less than or equal to 2+ strong

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16
Q

t or f: D positive RBCs fail to agglutinate directly with anti-D typing reagents

A

true

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17
Q

not a new antigen because people did not produce anti-Du but anti-D

A

weak D (Du type)

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18
Q

t or f: individuals with RBCs carrying partial D antigen cannot produce anti-D if they are missing epitopes of the D antigen

A

false, it can produce

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19
Q

enumerate the weak D types

A
  • position effect
  • quantitative
  • partial-D antigen
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20
Q

this mechanism of D antigen is that the Rh antigen on RBC is normal (D antigen is structurally complete), 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 - C in trans to RHD

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21
Q

people with this blood type can receive D positive RBCs

A

position effect - C in trans to RHD

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22
Q

in this mechanism, red cells fails to react or reacts weakly to agglutination tests (but will react in IAT)

A

weak D quantitative

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23
Q

this is from the inheritance of RHD genes that code for weakened expression of the D antigen

A

weak D quantitative

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24
Q

mutations in the RHD gene occur causing changes in ___ present in transmembrane region of the RHD protein, causing conformational changes in the protein

A

changes in amino acids

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25
Q

mutation in RHD gene causing conformation changes in the?

A

protein

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26
Q

T or F: in position effect, the changes does not alter or remove any D epitopes, therefore, production of anti-Rh is not possible

A

false, quantitative

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27
Q

production of anti-Rh is not possible in what category of weak D?

A

quantitative

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28
Q

changes of amino acids are observed “inside” the red cells, therefore, antibody production is less likely

what category/type of weak D?

A

quantitative

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29
Q

weak forms of D antigen is less immunogenic than the ___

A

normal D positive blood

30
Q

weak D quantitative is common in?

A

blacks

31
Q

in this mechanism/type, one or more D epitopes within the entire D protein is missing or altered

A

partial D / D mosaic / D variant

32
Q

partial D is also called ___

A

D mosaic or D variant

33
Q

weaker or may not react at all (but some have normal reaction)

identify the type.

A

partial D

34
Q

T or F: in 1970s, individuals who were type D-positive but produced an anti-D that reacted with all D-positive samples except their own

A

false, 1950s

35
Q

they postulated that the D antigen is made of antigenic subparts, genetically determined, that could be absent in rare instances

A

Wiener and Unger

36
Q

if an individual lacks one or more epitopes, of the total D antigen, this antibody can be made to the missing epitopes if exposed to the RBCs that possess the complete D antigen

A

alloantibody

37
Q

persons who classified the antigens

A

Patricia Tippett and Ruth Sanger

38
Q

they tested anti-D sera from D positive people with RBCs from other D-positive people who also made anti-D

A

Patricia Tippett and Ruth Sanger

39
Q

Patricia Tippett and Ruth Sanger used this antibodies to classify

A

monoclonal (MAb-D) antibodies

40
Q

this type has 7 categories with assigned roman numerals

A

partial D

41
Q

t or f: serologic typing and molecular analysis are not required to accurately categorize the partial-D types

A

false, required

42
Q

Partial D antigens are classified and are attributed to hybrid genes resulting from portions of the __ being replaced by portions of the ___ gene

A

portions of the RHD gene being replaced by portions of the RHCE gene

43
Q

resulting protein contains a portion of RhD and RhCE in various combinations

A

partial D

44
Q

partial D occurs __ to the RBC membrane

A

external

45
Q

what particular location does partial D occur in the RBC membrane?

A

extracellular loop or portion to the RhD protein

46
Q

if an individual with hybrid RhD-RhCe-RhD protein is exposed to RBCs possessing normal RhD protein, what will they make?

A

antibody to the portion of the RhD protein they are missing

47
Q

anti-D made by individuals expressing partial D can cause?

A
  • hemolytic disease of the fetus and newborn
  • hemolytic transfusion reactions
48
Q

once anti-D is identified, what will blood will you use for transfusion?

A

Rh negative

49
Q

RhCE protein can express ___ detected by some monoclonal anti-D

A

RhD epitopes

50
Q

few individuals possess these unusual proteins

A

RhCE protein

51
Q

t or f: anti-D will show negative reactivity even though the D epitope is on the RhCE protein

A

false, will show positive reactivity

52
Q

examples of unusual phenotypes who possess these unusual proteins and will show positive reactivity even though D epitope is on the RhCE protein

A
  • DHAR
  • CeCF (Crawford)
53
Q

R0Har “DHAR” results from what hybrid gene?

A

RHCE-RHD-RHCE

54
Q

in this phenotype, only a small portion of RHD is inserted into the RHCE gene

A

R0Har “DHAR”

55
Q

R0Har “DHAR”

if paired to a normal RHD gene, the person will have Rh?

A

Rh-positive

56
Q

these individuals should be classified as RhD-negative since they lack RhD protein

what phenotype?

A

R0Har “DHAR”

57
Q

what RH is the Crawford phenotype?

A

RH34

pero RH43 kang sir :>

58
Q

this phenotype are found in individuals of African descent

A

Crawford antigen (ceCF)(Rh34)

59
Q

Crawford antigen (ceCF)(Rh43) is due to ___

a. small portion of RHD is inserted
b. specific amino acid change

A

due to specific amino acid change in the RhCE sequence

60
Q

results for an RhD epitope on the RhCE protein, what phenotype?

A

Crawford antigen (ceCF)(Rh43)

61
Q

this phenotype has very low prevalence

A

Crawford antigen (ceCF)(Rh43)

62
Q

Phenotype in individuals whose RBCs possess an extremely low number of D antigen sites that most reagent anti-D are unable to detect

A

Del (el is naa sa ubos)

63
Q

only way to detect the D antigen in Del phenotype

A

adsorbing and eluting anti-D

64
Q

Mutant, RHD gene that alters expression of the RhD protein

identify what phenotype

A

Del

65
Q

Del is due to splice site mutation or deletion that results in the absence of amino acids encoded by what exon?

A

exon 9 of RHD in Asians (or M295I mutation in whites)

66
Q

this phenotype is common in Asian (10-30% population)

A

Del

67
Q

Del phenotype has high incidence in people?

A
  • Hong kong
  • Chinese
  • Japanes
68
Q

this phenotype may be typed as D negative and can be found only when they stimulate production of anti-D in D negative individuals

A

Del

69
Q

process of gathering/pulling molecules onto the surface

employed in Del phenotype

A

Adsorbing

70
Q

process of removing molecules from a source or cellular entity.

employed in Del phenotype

A

elution

71
Q

in Del phenotype, the Red Cells are incubated with __ at ___.

A

anti-D at 37C

gives time to anti-D to bind the antigens present

72
Q

Del phenotype

what is adsorbed?
what is eluted?

A

adsorbed = red cells
eluted = anti-D