Rh Flashcards
(79 cards)
1
Q
most important antigen in Rh system
A
Rho/D
2
Q
most important antibody in Rh system
A
anti-D
3
Q
Rh positive frequency
A
85%
4
Q
Rh negative frequency
A
15%
5
Q
frequency of Rh negative people who will make anti-D if exposed to D antigen
A
50-75%
6
Q
most immunogenic Rh antigen
A
D > c > E
7
Q
Fisher Race theory
A
3 genes closely linked on chromosome give rise to 5 antigens with each gene resulting in one antigenic determinant site with no crossing over
genes inherited as one group of 3
D, C, c, E, e
8
Q
Wiener theory
A
1 gene gives rise to 3 antigenic sites (5 antigens)
1 gene gives rise to antigens responsible for numerous blood factors on red cells
R, r, Rh, hr
9
Q
Fisher Race nomenclature
A
D, C, c, E, e
10
Q
Wiener nomenclature
A
R, r, Rh, hr
11
Q
Tippett theory
A
2 genes (RHD and RHCE) give rise to major Rh antigens variations in RHCE genes give rise to C, E, c, e antigens
12
Q
Rosenfield terminology
A
Rh1, Rh2, Rh3, Rh3, Rh4, Rh5, Rh12, Rh7, Rh22
13
Q
Rh1
A
D
14
Q
Rh2
A
C
15
Q
Rh3
A
E
16
Q
Rh4
A
little c
17
Q
Rh5
A
little e
18
Q
Rh12
A
G
19
Q
Rh7
A
Ce
20
Q
Rh22
A
CE
21
Q
Rh32
A
low frequency found primarily in black population, associated with weak C, e
22
Q
2 Rh genes
A
RHD
RHCE
23
Q
serine at position 103 RHD
A
D protein
24
Q
serine at position 103 RHCE
A
big C
25
proline at position 103 RHCE
little c
26
proline at position 226 RHCE
big E
27
alanine at position 226 RHCE
little e
28
RHAG gene
co-expressor required to be present in order for Rh antigens to successfully express
29
Weiner frequencies in white population
R1 > r > R2 > R0
30
Weiner frequencies in black population
R0 > r > R1 > R2
31
Weiner frequencies in asian population
R1 > R2 > r > R0
32
R1
DCe
33
R2
DcE
34
R0
Dce
35
Rz
DCE
36
r'
dCe
37
r''
dcE
38
r
dce
39
ry
dCE
40
serve as transporter potential for ammonia and CO2
Rh antigens
41
Rh antigen enzyme treatment
resistant/increased reactivity
42
position effect/gene interaction effect/Ceppellini effect
C in trans position weakens expression of D (ex: Dce/dCe)
43
partial D antigen
missing epitopes of D antigen
44
can partial D make anti-D?
yes if transfused with red cells that carry all the epitopes
45
partial D variants, European ancestry
DNB, DVI, DVII
46
partial D variants, African American ancestry
DIIIa, DIVa
47
can weak D people make anti D?
no
48
definition of weak D positive
testing results are negative at IS but strongly positive at AHG
49
when is weak D testing required?
before initial labeling
| cord bloods of babies born to Rh negative moms
50
Rh compound (cis) antigens
f(ce), Ce, cE, CE
51
f antigen
single entity that results from conformational change within Rhce protein
little c, little e in cis position
52
anti-f reacts with:
Dce, dce (ce in cis position)
53
transfusion requirements for patients with anti-f
little c OR little e negative (both have to be present for f to be present so only have to be negative for one)
54
Rhi (RH7)
C and e inherited in cis position (R1, r')
55
G (Rh12)
present when C or D antigen present
56
anti-G
will react with C positive and/or D positive
| may be mistaken for combo anti-C, anti-D
57
how to differentiate anti-G from combination anti-C, anti-D?
elution and adsorption studies
58
V antigen frequency
30% of black populatio
59
VS antigen frequency
32% of black population
60
exalted D gene deletion
when all of Ee or Ee and Cc is missing and D gene is present, D antigen is unusually strong
61
D-- (D dash dash)
deletion that results in no CE expression
negative for Rh37
can make anti-Rh17
62
D.. (D dot dot)
partial loss of RHCE protein and increased dose of RHD protein
positive for Rh37
can make anti-Rh17
63
Rh null phenotype
lack all Rh antigens and LW antigens, rarest blood type in the world, can make anti-Rh29 (total Rh)
64
amorphic Rhnull
inheritance of silent alleles at the Rh locus from both parents (---/---)
deletion in RHD and RHCE gene with normal RHAG
65
regulator Rhnull
normal RHD and RHCE genes but inheritance of rare suppressor or regulator genes from both parents, no RHAG gene
66
Rhnull clinical presentation
```
compensated anemia
stomatocytes
retics
low hgb
increase hgb F
decrease serum haptoglobin
possible increased bilirubin
```
67
Rhmod
Rh antigens present but have weakened expression
68
anti-anti-e
present with anti-e, positive for e antigen, positive autocontrol
69
e variants
hrB and hrS
70
anti-hrB
reacts with ce (f) cells, stronger reaction with e positive cells
71
anti-hrS
reacts with Ce (Rhi) positive cells
72
Rh17 (Hr0)
antigen seen on red cells of all common Rh phenotypes (R1R1, R2R2, rr)
73
Rh32
variant of R1[D(C)(e)]
| C and e antigens weakly expressed, D antigen exalted
74
Rh33 ceHAR
(D)c(e) hybrid gene results in reduced amounts of e, f, Hr0, D antigens and normal amounts of c
75
Rh43
Crawford (ceCF) phenotype
76
Rh antibody class
IgG
| IgG1 and IgG3 most clinically significant
77
LW antigen
strong reactivity on Rh positive adult cells
weak or no reaction on Rh negative adult cells
strong reactivity on Rh positive and Rh negative cord cells
78
anti-LWa
may be mistaken for anti-D occurring in Rh positive person
79
differentiate between anti-D and anti-LWa
panel cells treated with DTT: LW antigens denatured, D antigens are not
react patient's plasma with Rh+ and Rh- cord cells: anti-D will not react with Rh- cord cells, anti-LWa will react with both
