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rh group Flashcards

1
Q

who described a hemolytic transfusion reaction in an obstetrical patient.

A

Levine and Stetson

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2
Q

two tests under HEMOGLOBIN F DETERMINATION

A
  • Alkali denaturation test
    > Betke test (sodium hydroxide)
    > Singer test (potassium hydroxide)
  • Acid Elution test
    > Kleihauer-betke test
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3
Q

Given to pregnant women that is capable of
producing anti-D when exposed to D positive
RBCs.

A

Rh IMMUNE GLOBULIN (rhogam)

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4
Q

what is the principle of rhogam

A

to prevent immunization to D antigen by the use of high titer RhIg

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5
Q

if POSITIVE: FMH

A

must be quantified using the Kleihauer-Betke test

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6
Q

If NEGATIVE in PH

A

the mother should
receive a full dose of RhIg within 72
hours of delivery.

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7
Q

used during
pregnancy to quantify the amount of
fetal blood found in the maternal
circulation

A

kleihauer-betke test

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8
Q

a postpartum blood sample is drawn from the
mother

A

postpartum dosage

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9
Q

Should be given to nonimmunized D-negative
females at 28th weeks’ gestation

A

ANTEPARTUM DOSE (300 μg anti-D IM or IV)

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10
Q

is advised after 34th weeks’ gestation when
amniocentesis is performed or in the event of
obstetric complication or following termination of
pregnancy

A

120 ug dose rhogam

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11
Q

FULL DOSE RHOGAM

A

protect 30 ml of WB and 15 ml RBC

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12
Q

MINI OR MICRODOSE RHOGAM

A

protects up to 5 ml D + WB 2.5 ml D + RBC

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13
Q

Given after 12 weeks of pregnancy (Rh negative) to
avoid abortions and ectopic pregnancies,
miscarriage.

A

full dose rhogam

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14
Q

given to the first 12 weeks of pregnancy (Rh
negative) for abortions and ectopic pregnancies,
miscarriage

A

mini or microdose rhogam

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15
Q

five antigens made up the Rh
system.

A

D > c > E > C > e

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16
Q

HDN will lead to

A

death, spontaneous abortion, ectopic pregnancy, miscarriage

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17
Q

Reported on an antibody made by guinea
pigs and rabbits when they were transfused
with rhesus monkey RBCs

A

Landsteiner and Wiener

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18
Q

anti-rhesus antibody formed by the
animals was renamed

A

anti-LW

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19
Q

Based on the theory that the antigen of the
systems were produced by the three closely
linked set of alleles, each gene was responsible
for producing a product (or an antigen) on the red cell membrane.

A

FISCHER-RACE (DCE)

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20
Q

Postulated that the gene responsible for defining
Rh are actually produced an agglutinogen that
contains a series of blood factors, in which each
factor is an antigen recognized by an antibody

A

WIENER (Rh-Hr)

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21
Q

Number is assigned to each antigen of the Rh
system in order of its discovery

A

ROSENFIELD (ALPHA NUMERIC)

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22
Q

The two most important nomenclature are

A

Fischer/Race and Wiener nomenclature

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23
Q

only describes the presence or
absence of a given antigen

A

Rosenfield

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24
Q

absence of the capital D antigen

A

small d

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25
Q

small is also known as

A

silent gene or amorph gene

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26
Q

each person inherits a set of Rh genes from each
parent.

A

Fischer-race

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27
Q

What is the normal inheritance pattern

A

Codominant

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28
Q

inherit 3 genes

A

FISCHER-RACE (DCE)

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29
Q

R
r
1
‘
2
“

A

D
d
C
c
E
e

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30
Q

Inherit 1 gene

A

Wiener (Rh-hr)

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31
Q

C/E

A

z or y

32
Q

codes for agglutinogen

A

Wiener

33
Q

No genetic basis

A

Rosenfield nomenclature

34
Q

Rosenfield guideline
o Rh1
Rh2
Rh3
Rh4
Rh5

A

D
C
E
c
e

35
Q

minus sign preceding a number designates

A

absence of the antigen

36
Q

When Rh-positive RBC samples are typed for the D antigen, they are expected to

A

react strongly with anti-D reagents

37
Q

RBCs carrying the weaker D antigen have
historically been referred to as having the

A

Du type

38
Q

Du type is now referred to as

A

expressing weak D

39
Q

Weak D result is considered as

A

Rh positive

40
Q

Weak D variation

A

▪ Weak D patient = Rh negative
▪ Weak D Donor = Rh positive
▪ GENERALLY WEAK D = Rh positive

41
Q

Three different mechanisms of weak D

A

o Genetic Weak D
o C trans
o Partial D (D mosaic)

42
Q

D antigens expressed appear to be complete,
but few in number.

A

Genetic weak D

43
Q

Position effect or gene interaction effect

A

C trans

44
Q

Cis

A

on the same side

45
Q

Trans

A

opposite side

46
Q

Expression of D antigen
is Normal.

A

C is in cis position to D

47
Q

expression of D antigen
is Weakened.

A

C is trans position to D

48
Q

One or more parts of the D antigen is missing

A

Partial D or D mosaic

49
Q

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

A

HDN or HTR (transfusion reaction)

50
Q

WEAK D DETERMINATION

A
  • Incubate cells with anti-D at 37°C, coating of D
    antigens will occur if present.
  • Wash using the AHG
  • Wash 3X add AHG on the 3rd wash
    AHG will bind to anti-D coating cells if present.
51
Q

No C/c and E/e Ag’s
o designated as D–/D–

A

Rh deleted

52
Q

no Rh ag
o designated as —/—

A

Rhnull

53
Q

What inclusion body can you seen in Rhnull

A

Stomatocytes

54
Q

phenotype have a partial surpression of Rh
gene expression

A

Rhmod

55
Q

blood sample that is typed Rh0 (D)-
negative by the slide or tube method must be subjected to

A

Indirect
Antiglobulin test/technique

56
Q

For C trans weak D and Genetic weak D

A

Rh positive blood may be transfused

57
Q

For Partial D (D mosaic) recipients

A

Rh negative blood should be used for
transfusion

58
Q

Most Rh antibodies are

A

IgG and reacts optimally at
37°C or after antiglobulin testing

59
Q

Immune antibodies produced either by

A

transfusion or pregnancy

60
Q

RBC destruction is

A

extravascular hemolysis

61
Q

ABO antibodies

A

Intravascular hemolysis

62
Q

Extravascular hemolysis happens in the

A

spleen and liver

63
Q

CLINICAL CONSIDERATIONS

A
  • Transfusion Reactions
  • HDN
64
Q

CLINICAL CONSIDERATIONS for HDN

A

o Rh negative female
o Rh positive father
o Rh positive infants

65
Q

Rh ANTIGEN TYPING
Reagent:
If in Rh typing the result is negative

A

Anti-D
TEST FOR
PRESENCE OF WEAKLY ANTIGEN. (IAT)

66
Q

IN EMERGENCY CASES: If the patient is Rh (-)

A

transfuse Rh (+) if no past immunization.

67
Q

COOMBS’ TEST

A
  • Direct anti globulin test
  • Indirect anti globulin test -
68
Q

Direct Antiglobulin test:

A

o HDN (Hemolytic Disease of the Newborn)
o HTR (Hemolytic Transfusion Reactions)
o AIHA (Autoimmune Hemolytic Anemia)
o Drug induced hemolytic Anemia

69
Q

Indirect Antiglobulin test:

A

o Cross-matching
o Antibody detection
o Antibody identification
o RBC Antigen phenotyping

70
Q

AHG REAGENTS

A

sensitization of the RBC

71
Q

Licensed Monospecific AHG

A

Anti-IgG and Anti-C3b-C3d

72
Q

FOR TEST TO BE VALID FOR NEGATIVE AHG TEST

A

perform Coombs check cell

73
Q

Coombs check cell concentration

A

GRoup O RBC sensitized with IgG are added

74
Q

is a reagent where
in it is used to test for the validity of a negative AHG
test

A

Coombs check cell

75
Q

As little as _____ it can elicit a response

A

1mL

76
Q

Before delivery, the risk of sensitization is

A

1.5 - 1.9%

77
Q

THE GREATEST RISK OF
IMMUNIZATION To RH is at

A

delivery

IMHM (10 decks)

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