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Blood Bank Test 2 > Rh General Information > Flashcards

Rh General Information Flashcards

1
Q

Who delivered the still borne infant?

A

Levine and Stetson

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2
Q

Which due transfused rhesus monkey blood, and demonstrated the Levin and Stetson baby had an Rh incompatibiliyt?

A

Landteiner and Weiner

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3
Q

What is the primary cause of HDFN?

A

Rh

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4
Q

What percent of Caucasians are D negative?

A

15-17%

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5
Q

What is the Tippett Genetic model?

A

i) Genes RHD and RHCE encode for the Rh proteins (RhD and RhCE)

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6
Q

Rh negative is most likey due to what?

A

A complete deletion of the Rh gene

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7
Q

RhD genes differ from other genes by how many amino acids?

A

32-35; this is why RhD is so antigenic

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8
Q

Protein structures produced by RHD and RHCE are

A

nonglycosylated and are linked to fatty acids in the lipid bilayer of the RBC membrane

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9
Q

RhCE codes for which genes?

A

C and c
E and e
RHCE, RHCe, RHcE, Rhce

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10
Q

The RHAG is responsible for

A

Rh associated glycoprotein (necessary for Rh antigen expression)

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11
Q

Rhnull results from

A

lack of the RHAG gene

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12
Q

Dce/dcE is an example of what nomenclature system?

A

Fisher and Rice

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13
Q

R1r’ is an example of what nomenclature system?

A

Weiner

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14
Q

Rh: 1,2,3,-4,5 is an example of what nomenclature system?

A

Rosenfield

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15
Q

What is the most common genotype?

A 
R1r
DCe/dce
Rh: 1,2,-3,4,5
RHD, RHCe/Rhce
33%
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16
Q

Define Rh immunoglobulin (RhIg

A

concentrated and purified anti-D given to people who are capable of forming an anti-D (Rh negative) if exposure to the D antigen has occurred or may occur, as during pregnancy (HDFN). The RhIg prevent immunization to the D antigen.

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17
Q

What is a Nonglycosylated protein

A

protein with no carbohydrates

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18
Q

Weak D is usually due to

A

persons with a single RHD that has a mutation encoded amino acid change

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19
Q

Are antigens complete in weak D?

A

Yes, but low in number

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20
Q

What is Del?

A

Weak D that is only detectable with adsorption/elution studies

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21
Q

What is the consequence of a Ce allele found trans to RHD?

A

The postitional effect may influence D antigen expression

22
Q

Testing for weak d requires

A

antihuman globulin detection phase

23
Q

Who needs to be typed for weak D?

A

Typing and infant to determine if an Rh neg mother is a candidate for Rh immunoglobulin
Donor blood units (AABB standards)

24
Q

Define partial D (D mosaic)

A

due to inheritance of hybrid genes in which portions of RHD are replaced by the corresponding portions of RHCE, resulting in the loss of some epitopes (called DVI or BARC(Rh52))

25
Q

People with partial D have RBCs that type D+, but they may make…

A

anti-D (following pregnancy or transfusion)

26
Q

Once anti-D has been detected in serum, patients must recieve

A

D neg blood

27
Q

Can most weak D patients recieve D positive blood?

A

Yes

28
Q

Weak D types 11, 15, and 12 have made weak D, suggesting they have

A

altered D epitopes

29
Q

Can patients with partial D recieve D positive blood?

A

No, may make anti-D

30
Q

Cw patients type C, but may make

A

anti-C

31
Q

Low frequency C and c antigens are named ____ and they are caused by ______

A

Cw (Rh8)
Cx (Rh9)
Single amino acid change

32
Q

Altered C antigens which react weakly with polyclonal antibodies, but strongly with monoclonal antibodies in African Americans are caused by

A

Sickle Cell Disease (SCD)

33
Q

What are deleted or partially deleted phenotypes?

A

In rare cases, people may inherit inactive or partially inactive RHCE genes that do not include E or e and may not encode some level of expression of C or c.

34
Q

deleted or partially deleted phenotypes consist of

A

Dc-
DC^w-
D–

35
Q

People with deleted or partially deleted phenotypes from antibodies called _____ and caused the serum of the individual to agglutinate all RBCs except _____

A

anti-Rh17 (Hro)

D– homozygous (Rhnull)

36
Q

RBCs that are D or C positive are also _____ positive

A

G

37
Q

The G antigen is a product of

A

exon 2 of RHD or exon 2 of RHCE*Ce, as these are identical and encode the same amino acids

38
Q

Which phenotype carries no Rh system antigens (D, C, E, c, e)?

A

Rhnull

39
Q

Rhnull cells lack _____, also called ______

A

Rh29, total Rh

40
Q

Rhnull amorph type is caused by

A

inactive RHCE
Deletion of RHD
(reduced amounts of RHAG)

41
Q

Rhnull regulator type is caused by

A

inactive (absent or mutated) RHAG gene

42
Q

Mild, compensated hemolytic anemia, stomatocytosis, and a slight to moderate decrease in Hgb and HCT are symptoms of

A

Rhnull syndrom (suggests the prescence of Rh antigens are necessary for RBC normal function)

43
Q

This Rh abnormality has symptoms similar to Rhnull, but it is less sever.

A

Rh mod (very reduced amounts of Rh antigen)

44
Q

Rh mod is caused by

A

Genetic modification of RHAG

45
Q

What is the order of Rh antigen immunogenicity?

A

D>c>E>C>e

46
Q

Do Rh antibodies bind complement?

A

No

47
Q

Do Rh antigens cross the placenta?

A

No

48
Q

Are Rh antigens fully developed in the fetus?

A

Yes (HDFN)

49
Q

How long does it take for circulating Rh antibodies to form?

A

120 days after primary exposure

50
Q

After a second exposure, How long does it take for circulating Rh antibodies to form?

A

2-7 days

51
Q

Unexplained fever, mild bilirubin elevation, decrease in Hgb/HCT, +DAT are all symptoms of

A

Rh mediated HTR (extravascular RBC destruction)

52
Q

What is givin to Rh negative mothers to prevent HDFN?

A

Rho Immune Globulin

Blood Bank Test 2 (5 decks)

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