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Immunohematology > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

is required when testing donor bloods

A

Determining the D status of an RBC sample

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2
Q

All Rh-negative, weak D-negative obstetric patients are candidates for

A

Rh immune globulin (RhIg)

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3
Q

Rh immune globulin (RhIg)

A

a drug injected to prevent Rh-negative individuals exposed to Rh-positive RBC’s from developing anti-D

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4
Q

When can accurate Rh can’t be determined?

A

newborn cells are coated with maternal IgG anti-D in utero, very few D antigens
blocking phenomenon

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5
Q

Blocking phenomenon

A

An overabundance of antibodies is coating the red cell
take up all antigen sites on the cell

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6
Q

Most Rh antibodies are what?

A

IgG and react best at 37oC or after AHG

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7
Q

Rh antibodies are usually produced

A

after exposure, i.e.. Pregnancy or transfusion

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8
Q

greatest clinical significance

A

IgG1 and IgG3

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9
Q

Rh antibodies do not bind to what?

A

Complement

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10
Q

When Rh IgG crosses what, what happens?

A

The placenta
Results in positive DAT

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11
Q

erythroblastosis fetalis

A

Erythroblast released into circulation

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12
Q

Order of most to least Rh antigens

A

D>c>E>C>e

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13
Q

How immunogenic are Rh antigens?

A

highly immunogenic

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14
Q

Antibodies appear

A

120 days of a primary exposure
2 to 7 days of a secondary exposure

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15
Q

Rh-mediated hemolytic transfusion reactions, whether primary or secondary usually result in?

A

extravascular destruction of immunoglobulin coated cells

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16
Q

Reactions signs destruction of immunoglobulin coated cells

A

Fever, mild bilirubin elevation, decreased hemoglobin & haptoglobin

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17
Q

Hemolytic Disease of the Newborn

A

Occurs with D-negative women during pregnancy and following delivery of a D-positive fetus

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18
Q

What is given to pregnant mothers who are at risk of HDN

A

Rh-immune globulin

19
Q

Rhnull syndrome

A

Individuals who lack all Rh antigens on their RBC’s
produced by two different genetic mechanisms: Regular and Amorphic type

20
Q

Rhnull syndrome: Regular type

A

a mutation in the RHAG gene
Results in no Rh polypeptides or RHAG antigen expression

21
Q

Rhnull syndrome: Amorphic type

A

there is a mutation in each of the RHCE genes and a deletion of the RHD gene

22
Q

individuals with Rhnull syndrome can only get

A

only Rhnull blood can be given

23
Q

Rhmod phenotype

A

partial suppression of Rh gene expression and exhibit features similar to those with Rhnull syndrome; clinical symptoms are less severe

24
Q

High-frequency antigen

A

antigen whose frequency in the population is 98% to 99%.
Aka high-incidence antigen

25
Q

Low-frequency antigen

A

antigen whose frequency in a random population is very low - < 0%.
Aka low-incidence antigen

26
Q

Cw Phenotypes

A

antithetical to the high-incidence antigen MAR

27
Q

F phenotype

A

ce genes expressed
expressed on the RBC when both c and e are present on the same haplotype (cis position)

28
Q

Anti-F

A

reported to cause HDN and Transfusion reactions

29
Q

Rhi

A

Expressed as Ce
present when C and e are in the cis configuration (Like F)

30
Q

Parts of D mosaic

A

Rh:13, Rh:14, Rh:15, Rh:16

31
Q

Rh:23, Rh:30, Rh:40

A

all low-frequency antigens associated with a specific category of partial-D

32
Q

Rh0

A

present on all RBCs with common Rh phenotypes (R1R1, R2R2, rr)

33
Q

e Variants

A

Appears especially in the black population
e antigen may exhibit the same mosaic quality described for D
recognized when they make antibodies that behave as anti-e

34
Q

Deletions

A

very uncommon phenotypes that demonstrate no Cc and/or Ee reactivity
often have an unusual strong D

35
Q

LW Antigen is similar to

A

Rh systems

36
Q

LW Antigen reacts

A

strongly with most D-positive RBCs
weakly (sometimes not at all) with Rh-negative RBCs
never with Rhnull cells

37
Q

When was LW antigen discovered?

A

with the beginning of Rh antigen recognition
Experiment with Rhesus monkey

38
Q

Lw Antigen alleles

A

Lwa
LWb
LW ( a silent allele)

39
Q

express no LW on the RBC

A

Persons lacking LW altogether are LW/LW

40
Q

Which LW genes are common and which is rare

A

LWa is very common
LWb is rare

41
Q

When the Rhnull is present

A

Rh and LW genes are not expressed on the RBC

42
Q

Anti-LW usually reacts more strongly

A

with D-positive RBCs than with D-negative adult RBCs

43
Q

weak anti-LW may react only

A

With D-positive RBCs

44
Q

How can weak anti-LW react with D-negative adult RBCs

A

enhanced techniques may be required to demonstrate its reactivity with D-negative cells

Immunohematology (16 decks)

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