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Liz's Blood Bank Module 1 > Rh System > Flashcards

Rh System Flashcards

1
Q

State frequency of D, C, E, c, and e Ags in the US Caucasian population

A 
e+ → 98%
D+ → 85%
c+ → 80%
C+ → 70%
E+ → 30%
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2
Q

Rh Ag

- Development on newborn RBCs

A

Fully developed at birth

- Reasono why HDFN is so severe

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3
Q

Rh Ag

- Location in the body

A

RBC membrane ONLY, as lipoproteins (← carries antigenic specificity)

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4
Q

T/F, Rh Ags are found in secretions

A

False

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5
Q

T/F, Rh Ags are not located on WBCs, plts, or other tissues

A

True

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6
Q

What is the most important Rh Ag?

A

D

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7
Q

T/F, testing for D Ag is part of every blood type

A

True

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8
Q

3 undertermined D Ags

A
  • Genetic
  • Position effect
  • Partial D (D Mosaic)
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9
Q

Genetic weak D

- Mechanism of production

A

Inheritance of D genes that code for weakened expression of D Ag (detected at AHG phase)

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10
Q

Genetic weak D

- Ability oproduce anti-D

A

No

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11
Q

Position effect weak D

- Mechanism of production

A

D Ag is weakened when C is “trans” to D (usually w/ r’)

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12
Q

Position effect weak D

- Ability to produce anti-D

A

No

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13
Q 
Partial D (D Mosaic)
- Mechanism of production
A

Incomplete D Ag

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14
Q 
Partial D (D Mosaic)
- Ability to produce anti-D
A

Yes

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15
Q

Clincial significance of Weak D phenotype

- Donors

A

Donor blood must be tested for weak D AND labeled as D+ if tested as weak D+
- D Ag, even if incomplete, can cause immune production of anti-D

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16
Q

Clinical significance of Weak D phenotype

- Transfusion recipients

A

If weak D is not tested at IS, just call patient D= adn transfuse w/ D= blood

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17
Q

Rhnull

- Laboratory findings

A

Lacks all Rh Ags

18
Q

What happens to RBC membranes if an individual lacks all Rh Ags?

A

RBC membrane becomes leaky allowing Na and K in and out

19
Q

Rhnull transfusion recipient can accept what blood type?

A

Rhnull RBCs only

- Often develop Abs to one or more of the Rh Ags

20
Q

Rare Rh Ags

A
  • G
  • Compound Ags
  • Deletions/enhanced D
21
Q

G Ag

- Found where?

A

Present on most D+ and C+ RBCs

- Anti-G reacts as a combination of anti-C and anti-D adn will react when either C or D is present

22
Q

G Ag

- Who makes anti-G?

A

Individuals who are negative for both C and D (r”, r)

23
Q

Compound Ags

A

f (ce), rhi (Ce), rhii (cE)

- Abs produced will only react when BOTH Ags are in “cis” position; useful in determining MPG

24
Q

Deletions/enhanced D

A
  • Lack Cc and/or Ee
  • Strong D Ags (all that’s being expressed)
  • Consanguineous marriage
25
Q

Rh Abs

- Ig class

A

IgG

26
Q

Rh Abs

- Stimulus for production

A

RBC stimulated (unexpected Abs)

27
Q

Rh Abs

- Ability to bind complement

A

No

28
Q

Rh Abs

- Characteristic serologic reactivity

A
  • Reactivity is greatly enhanced when cells have been enzyme-treated (helpful in ABID)
  • Cross placenta (HDFN)
  • Causes HTR
29
Q

Rh Abs

- Clinical significance

A
  • React best at 37C

- React best at AHG

30
Q

Rh Abs

- Transfusion practices

A
  • Try to give type specific when possible
  • Rh= → Rh+
  • Rh+ → Rh= ONLY in emergencies and patient does not already have anti-D (stop right away)
  • Never give Rh+ to Rh= female of child-bearing age
31
Q

Procedure for D Ag Testing

A
  1. 1 drop mfg anti-D + 1 drop 5% patient cells

2. Spin and read; if negative at IS, save tube and run Rh control AND weak D

32
Q

Procedure for Weak D Testing

A
  1. add mfg anti-D or Rh control + 1 drop patient cells (ratio must match)
  2. incubate 15’ @ 37C
  3. Wash 3x
  4. Add 2 drops AHG
  5. Spin and read; if positive and Rh control is negative, stop and report, if negative, continue
  6. Add 1 drop CCs
  7. Spin and read → should be positive
33
Q

Rh control

- Purpose of use

A

Serves as negative control for D testing
- Detects interference fron unexpected Abs coating cells; at IS phase detects cold autoAbs; at AHG phase, detects pos DAT

34
Q

Rh control

- Composition

A

Diluent of anti-D w/o any Ab in it

35
Q

Rh control

- Expected results

A

Rh control must be negative for test to be valid

36
Q

Anti-D (+)
Rh control (=)
Interpret

A

D+

37
Q

Anti-D (=)
Rh control (=)
Interpret

A

D=

38
Q

Anti-D (+)
Rh control (+)
Interpret

A

Inconclusive

39
Q

Anti-D (=)
Rh control (+)
Interpret

A

Should never get this result

40
Q

Causes of invalid D typings at IS and AHG phases of testing

A

?

Liz's Blood Bank Module 1 (10 decks)

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