Rh

Question 1

4 terminologies that deals with Rh blood group

Answer 1

1. “Fisher-Race” or “DCE term”
2. Dr. Alexander Weiner - “Rh-hr” Terminology
3. “Alphanumeric Terminology”
4. International Society of Blood Transfusion Committee

Question 2

Who discovered “Fisher-Race” or “DCE term”

Answer 2

Sir Ronald Aylmer Fisher and Dr. Robert Russell Race

Question 3

1941: “Fisher-Race”’ or “DCE term”

Answer 3

• fisher named C and c antigens (on the basis of the reactivity of two antibodies that recognized antithetical antigens)
• D& E (define the antigens recognized by two additional antibodies)

Question 4

1943 “Fisher-Race” or “DCE term”

Answer 4

Sir Fisher proposed that “Antigens of the system were produced by 3 closely linked set of alleles. Each gene was responsible for producing an antigen on the RBC surface.”

Question 5

Gene frequencies of D and d in caucasians

Answer 5

D - 85%
d - 15%

Question 6

Gene frequencies of C and c in caucasians

Answer 6

C = 70%
c = 80%

Question 7

gene frequencies of e and E in caucasians

Answer 7

E = 30%
e = 98%

Question 8

year when rh phenotype was reported in order of DCE

Answer 8

1946

Question 9

what does “d” represent

Answer 9

absence of the D antigen

Question 10

what does parenthesis indicate

Answer 10

weakened antigen expression

Question 11

Believed that there was one gene responsible for detining Rh that produced an agglutinogen containing a series of blood factors

Answer 11

Dr. Weiner

Question 12

who discovered the “rh-hr” terminology

Answer 12

Dr. Alexander Weiner

Question 13

May be considered the phenotypic expression of the haplotype

Answer 13

“Rh-hr” Terminology

Question 14

indicates presence of D

Answer 14

R

Question 15

indicates “d” (absence of D antigen)

Answer 15

r

Question 16

presence of C (ex. R1)

Answer 16

1 or single prime

Question 17

presence of E

Answer 17

2 or double prime

Question 18

presence of CE (with D)

Answer 18

Z

Question 19

for presence of ce

Answer 19

0

Question 20

presence of Ce without D (ex. r’)

Answer 20

‘

Question 21

presence of cE without D (ex. r”)

Answer 21

“

Question 22

presence of CE without D (ex. rAy

Answer 22

y

Question 23

introduced a new terminologies for Rh group in 1962

Answer 23

Richard Rosenfield and Coworkers

Question 24

created to more accurately represent the serologic data and to be
more compatible with computer use.

Answer 24

“Alphanumeric Terminology”

Question 25

Simply demonstrates the presence of absence of the antigen on the RBC

Answer 25

"Alphanumeric Terminology"

Question 26

A "minus sign" preceding the number designates?

Answer 26

absence

Question 27

formed a committee on terminology for Red Cell surface antigens which establishes a **uniform nomenclature** that is both **eye and machine readable** and is in keeping with the genetic basis of blood groups.

Answer 27

International society of blood transfusion therapy

Question 28

ISBT has __ digit number for each antigen

Answer 28

6 digit number

Question 29

First 3 digits represents the _____ & the remaining 3 represents ____

Answer 29

First 3 digits represents the system and remaining 3 represent the antigenic specificity

Question 30

3 digit no. assigned to Rh blood group

Answer 30

"004"

Question 31

About __% of D-positive individuals type as weak D

Answer 31

1%

Question 32

Weak D is formerly known as

Answer 32

"Du"

Question 33

Some people's RBC possess D antigen that requires what test?

Answer 33

IAT

Question 34

type of expression where the D positive RBCs fail to agglutinate directly with anti-D typing reagents

Answer 34

Weak D

Question 35

Red Cells fails to react or reacts weakly agglutination tests (but will react in lAT)

Answer 35

Weak D (Quantitative)

Question 36

From the inheritance of RHD genes that code for weakened expression of the D antigen

Answer 36

Weak D

Question 37

Mutations in the RHD gene occur causing changes in amino acids present in the transmembrane region of the RHD protein, causing conformational changes in the protein

Answer 37

Weak D

Question 38

Production of anti-rh is not possible

Answer 38

Weak D

Question 39

less immunogenic than the normal D positive blood

Answer 39

weak d

Question 40

weak d is commonly seen in?

Answer 40

blacks

Question 41

One or more D epitopes within the entire D protein is missing or altered

Answer 41

Partial D (D Mosaic or D variant)

Question 42

individuals who were type D-positive but produced an anti-D that reacted with all D-positive samples except their own

Answer 42

Partial D (1950s)

Question 43

postulated that the D antigen is made of antigenic subparts, genetically determined, that could be absent in rare instances

Answer 43

Wiener and Unger

Question 44

Classified D variants using **monoclonal (MAb-Dantibodies into 7 categories (I–VII)

Answer 44

Patricia Tippett and Ruth Sanger

Question 45

cause of partial d genes

Answer 45

Hybrid genes — part of RHD gene is replaced by part of RHCE gene

Question 46

resulting protein of partial d gene

Answer 46

portion of RhD and RhCE in various combinations

Question 47

exposure risk of partial d gene

Answer 47

• Partial D people can form anti-D if exposed to normal RhD RBCs. • Anti-D can cause HDFN (Hemolytic Disease of the Fetus and Newborn) or HTR (Hemolytic Transfusion Reaction)

Question 48

Use __ blood for Partial D patients.

Answer 48

Rh-negative blood

Question 49

cause of weak d

Answer 49

Mutation in RHD gene (alters structure but keeps all D epitopes)

Question 50

cause of partial d

Answer 50

Some D epitopes are missing or altered

Question 51

weak d reaction with anti d

Answer 51

Weak or no direct agglutination, reacts in IAT

Question 52

partial d Reaction with Anti-D

Answer 52

Some react normally, others weakly or not at all

Question 53

anti d production in weak d?

Answer 53

No (D epitopes are still present)

Question 54

Anti-D Production in Partial D?

Answer 54

Yes, if exposed to full D antigen

Question 55

clinical significance of Weak D

Answer 55

Less immunogenic, can still be considered D+

Question 56

clinical significance of partial d

Answer 56

Can develop anti-D, need Rh- negative transfusions

Question 57

very rare d antigen expression

Answer 57

Rh Negative

Question 58

with deletion of the RHD gene No RHD, but with inherited 2 RHCE genes

Answer 58

European

Question 59

-An "RHD-negative allele" -Person with this gene does not produce RhD proteins (sequence is identical)

Answer 59

African - with RHD pseudogene (RHD w)

Question 60

mutations in RHD pseudogene

Answer 60

1. missense mutations in exon 5 and exon 6 2. A nonsense mutation in exon 6 3. 37 base pair insertion at the intron 3/exon 4 boundary

Question 61

steps for D negative VS. Weak D

Answer 61

1. Incubate cells with Anti-D typing sera at 37C for 30 minutes 2. Centrifuge 3. Check for agglutination 4. If there is no agglutination, proceed to Anti-Human Globulin Test 5. Add Coomb's reagent and centrifuge

Question 62

Donor units that are Weak D → must be labeled as ?

Answer 62

Rh-positive

Question 63

Agglutination

Answer 63

Weak D positive

Question 64

No agglutination

Answer 64

Truly D negative