Rh Blood System 8.5

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corbin19
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Rh Blood System 8.5
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2010-09-22 09:48:45
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Rh Blood System Blood Banking NSHS MLT
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Blood Banking Unit 8.5 Rh Blood System
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  1. A substance that stimulates production of an agglutinin
    agllutinogen
  2. a substance that will agglutinate an agglutinogen
    agglutinin
  3. this term is synonymous with agglutinogen
    immunogen
  4. the ability of an antigen to stimulate an antibody.
    immunogenicity
  5. a rare Rh phenotype in which no Rh antigens are expressed on the RBC.
    Rhnull
  6. an antigen composed of several subunits.
    mosaic
  7. a reagent source of antibody
    anitserum
  8. thought to prevent another gene from functioning.
    modifying gene
  9. a phenomenon whereby an antibody reacts more strongly with red cells carrying a double dose of antigens (homozygous genes) than with red cells carrying a single dose of antigen (heterozygous).
    dosage
  10. the location of two or more genes on the same chromosome of a homologous pair.
    Cis position
  11. the location of two or more genes on opposite chromosomes of a homologous pair.
    trans position
  12. condition in which an antibody from the mother's serum crosses the placental barrier and attacks fetal cells.
    Hemolytic Disease of the Newborn (HDN)
  13. commercially produced and purified IgG class Anti-D.
    Rh immune globulin
  14. listing of antigens observed on RBC surface.
    phenotype
  15. listing of the genes present on the person's chromosome.
    genotype
  16. broad term applied to D antigens that give weak reactions with anti-D
    weak D
  17. antibody formed after exposure to a foreign antigen.
    • immune stimulated antibody
    • allo-antibody
  18. this system is second in importance to ABO system.
    Rh
  19. this is when D antigen present on red blood cell
    Rh positive
  20. this is when D antigen is not present on red blood cell
    Rh negative
  21. RBC's lacking what antigen does not have anti-D in serum.
    D antigen
  22. what are two means of formation of antibody through exposure.
    • transfusion
    • pregnancy
  23. what percent of Rh = people if transfused with Rh + blood can develop anti-D.
    80%
  24. what percent of Rh = women who are pregnant with Rh + fetus will develop anti-D if not protected with RhIg.
    8%
  25. hemolytic transfusion reaction and death can occur if exposed to what antigen a second time?
    D antigen
  26. patients and donors are tested for what Rh antigen?
    D
  27. Rh negative patients should receive what type of blood?
    Rh negative blood
  28. Rh antibodies are first identified by what type of test?
    saline
  29. Rh antibodies are what class and react at what temperature?
    • IgG
    • 37oC
  30. after exposure to Rh, antibodies are initially ____ and transition to ____.
    • IgM
    • IgG
  31. Rh system is known to contain nearly ___ antigens.
    50
  32. how many Rh antigens are of major importance?
    five
  33. the five major Rh antigens account for what percent of clinical work?
    99%
  34. Normal D antigen that occurs in Rh positive people is thought to be composed of how many subunits forming a mosaic?
    four
  35. what are the subunits of D?
    • RhA
    • RhB
    • RhC
    • RhD
  36. this is when all subunits of D are absent from RBC.
    Rh negative
  37. how is a missing D subunit indicated?
    lower case letter (RhaBCD)
  38. a person lacking a subunit of the D mosaic may for ______ against the missing subunit.
    antibody
  39. what are the five Rh antigens?
    • D
    • C
    • c
    • E
    • e
  40. what are the two means of immunization to Rh antigens?
    • pregnancy
    • Transfusion
  41. this Rh antibody is rarely encountered as a single antibody.
    Anti-C
  42. what is the second most frequently encountered antibody in the Rh system?
    Anti-c
  43. what is the most common antibody in the Rh system?
    Anti-E
  44. which Rh antibody is rare because the majority of the population has the e antigen?
    Anti-e
  45. which type of nomenclature is referred to as CDE notation?
    Fischer-Race notation
  46. Fischer-Race notation describes _____ and _______.
    • genes
    • antigens
  47. this Rh nomenclautre uses numbers to describe antigens.
    rosenfield notation
  48. this Rh nomenclature uses a six diget number for each authenticated blood group specificity.
    International Society of Blood Transfusions (ISBT)
  49. convert 'D' from fisher race to rosenfield and ISBT.
    • Rosenfield: Rh: 1
    • ISBT: 004001
  50. convert 'C' from fisher race to rosenfield and ISBT.
    • Rosenfield: Rh:2
    • ISBT: 004002
  51. convert 'E' from fisher race to rosenfield and ISBT.
    • Rosenfield: Rh: 3
    • ISBT: 004003
  52. convert 'c' from fisher race to rosenfield and ISBT.
    • Rosenfield: Rh: 4
    • ISBT: 004004
  53. convert 'e' from fisher race to rosenfield and ISBT.
    • Rosenfield: Rh:5
    • ISBT: 004005
  54. this is the theory that Rh antigens are produced by three sets allelic genes.
    fisher-race theory
  55. how many sets of three alleles are inherited from each parent?
    one
  56. Rh is inherited as ___ genetic alleles closely linked.
    three
  57. the C gene is allelic to what gene?
    c gene
  58. the E gene is allelic to what gene?
    e
  59. allelic Rh pairs exhibit what dominance?
    co dominant
  60. what antigens are prsent on the RBC from the genotype CDE/cde?
    • C
    • c
    • D
    • E
    • e
  61. write R1 in agglutinogen and fischer-race notation.
    • agglutinogen: rh' Rho hr''
    • Fischer-Race: CDe
  62. write R2 in agglutinogen and fischer-race notation.
    • agglutinogen: hr' Rho rh"
    • Fischer-Race: cDE
  63. write Ro in agglutinogen and fischer-race notation.
    • Agglutinogen: hr' Rho hr"
    • Fischer-Race: cDe
  64. write Rz in agglutinogen and fischer-race notation.
    • Agglutinogen: rh' Rho rh"
    • Fischer-Race: CDE
  65. write r in agglutinogen and fischer-race notation.
    • agglutinogen: hr' hr''
    • Fischer-Race: ce
  66. write r' in agglutinogen and fischer-race notation.
    • agglutinogen: hr' hr"
    • Fischer-Race: Ce
  67. write r' in agglutinogen and fischer-race notation.
    • agglutinogen: rh' hr"
    • Fischer-Race: Ce
  68. write r" in agglutinogen and fischer-race notation.
    • agglutinogen: hr' rh"
    • Fischer-Race: cE
  69. write ry in agglutinogen and fischer-race notation.
    • agglutinogen: rh' rh"
    • Fischer-Race: CE
  70. these are the Rh system antigens on a person's RBC.
    Rh phenotype
  71. how is Rh phenotype determined?
    specific antisera
  72. what does a positive reaction with antisera indicate?
    presence of antigen
  73. what does a negative reaction with antisera indicate?
    absence of antigen
  74. true or false.
    phenotype does not always indicate the exact Rh genotype.
    true
  75. this aides in the statistical guess of possible genotype.
    phenotypes
  76. what are the four applications of Rh phenotype/genotype?
    • population studies
    • paternity studies
    • antibody studies
    • HDN
  77. what percents of the white and black population have the D antigen (Rh1)?
    • white: 85%
    • black: 92%
  78. what percents of the white and black population have the C antigen (Rh2)?
    • white: 70%
    • black: 34%
  79. what percents of the white and black population have the E antigen (Rh3)?
    • white: 30%
    • black: 21%
  80. what percents of the white and black population have the c antigen (Rh4)?
    • white: 80%
    • black: 97%
  81. what percents of the white and black population have the e antigen (Rh5)?
    • white: 98%
    • black: 99%
  82. what are the four variants of the Rh system?
    • weak D
    • G antigen
    • compound/hybrid antigens
    • deletions of Rh genes/antigens
  83. this is an inherited condition where D antigen is present but few in number.
    Genetic weak D
  84. 50% of weak D people have this type of weak D, making it the most common form.
    partial D (D mosaic)
  85. when is weak D detected?
    AHG phase
  86. this is when the normal D gene is not fully express causing less D antigen.
    position effect weak D (C trans)
  87. position effect weak D is caused why what?
    C trans
  88. G antigen is caused by a gene complex of what two genes?
    D and C
  89. anti-G may be produced by _________.
    transfusion
  90. what are the four compound/hybrid antigens?
    • Ce
    • ce (f)
    • cE
    • CE
  91. this is four antigens that are produced when corresponding gense present in same gene complex.
    compound/hybrid antigens
  92. R1 gene complex produces what antigens?
    • C
    • D
    • e
    • Ce
  93. each 3-gene complex produces ____ compound Rh antigen.
    one
  94. true or false
    Anti-Ce will react with C and e antigen
    • false
    • Anti-Ce will react only with Ce
  95. this is when RBC's lack only have D antigen present in increased quantity.
    super D
  96. this is when RBC lacks C, c, E, and e antigens.
    deletion of Rh genes and antigens
  97. what is the genotype notation of super D?
    -D-/-D- or -D-/-d-
  98. this is the genotype of cell which lack E and e antigens.
    Cd-/cd-
  99. the Rhnull phenotype occurs in 1 out of how many people?
    1 in 6,000,000
  100. what is the Rhnull Genotype?
    ---/---
  101. this is a very rare condition where RBCs lack all Rh antigen.
    Rhnull
  102. what are the two causes of Rhnull?
    • inheritance of rare suppressor gene
    • inheritance of silent alleles
  103. Rh antibodies are normally what class?
    IgG
  104. Rh antibodies are detected durring what IAT phase?
    37oC/LISS phase
  105. agglutinated RBC's in 37oC/LISS phase show what reaction in AHG?
    same or stronger
  106. antibody to antigen reactivity in Rh can be enhanced by _______ treatment.
    enzyme
  107. Rh antibodies are capable of what two disease states?
    • transfusion reactions
    • HDN
  108. what is the most immunogenic antigen outside of the ABO system?
    D antigen
  109. circulating antibodies in the Rh system appear within ____ days after initial exposure, ____ days after secondary exposure
    • 120
    • 2-7
  110. presence or absence of D antigen is determined by testing the RBC with what?
    Anti-D sera
  111. agglutination on Rh testing indicates what?
    RBC have D antigen
  112. No agglutination indicates what on Rh testing?
    RBC do not have D antigen
  113. D negative cells are subject to what?
    IAT for weak D
  114. what are the four common reagents used in Rh testing?
    • Anit-D
    • Rh control
    • AHG
    • Check cells
  115. what size test tubes should be used for Rh testing?
    12x75mm
  116. what is the ratio for anti-D and Rh control to cell suspension?
    1:1
  117. a + anti-D and = Rh control indicates what Rh type?
    Rh pos
  118. a = anti-D and = Rh contol indicates what Rh type?
    weak D testing needs to be performed
  119. a = anti-D and + Rh control indicates what Rh type?
    invalid
  120. a + anti-D and + Rh control indicates what Rh type?
    invalid
  121. true or false
    for weak D testing two negative tubes from Rh testing should be incubated for 15 min without LISS
    true
  122. for weak D testing what should be added to the tubes?
    AHG
  123. if Weak D testing is negative macrosopically how should it be confirmed?
    • microscopically
    • check cells
  124. a positive reaction on weak D testing indicates what?
    D antigen present
  125. negative reaction macro and micro with positive check cells indicates what?
    D antigen not present
  126. a positive reaction on any Rh control tube indicates what?
    test is invalid
  127. what is the expected result on Rh control?
    negative
  128. this is used to enhance lab processing?
    blood bank cell washers
  129. a cell suspension that is too heavy will cause what type of false result in Rh testing?
    false positive
  130. cold agglutinins will cause what type of false result in Rh testing?
    false positve
  131. test incubated too long will cause what type of false result in Rh testing?
    false positive
  132. rouleaux will cause what type of false result in Rh testing?
    false positive
  133. fibrin interference will cause what type of false result in Rh testing?
    false positive
  134. contaminating low-incidence antibody in reagent will cause what type of false result in Rh testing?
    false-positive
  135. polyagglutination will cause what type of false result in Rh testing?
    false positive
  136. bacterial contamination of reagent vial will cause what type of false result in Rh testing?
    false positive
  137. incorrect reagent selected will cause what type of false result in Rh testing?
    false positive
  138. immunoglobulin coated cells (in-vivo) will cause what type of false result in Rh testing?
    false negative
  139. saline-suspended cells will cause what type of false result in Rh testing?
    false negative
  140. failrue to follow manufacturer's directions precisely will cause what type of false result in Rh testing?
    negative
  141. omission of reagent will cause what type of false result in Rh testing?
    false negative
  142. resuspension too vigorous will cause what type of false result in Rh testing?
    false negative
  143. incorrect reagent selected will cause what type of false result in Rh testing?
    false negative
  144. variant antigens will cause what type of false result in Rh testing?
    false negative
  145. reagent deterioration will cause what type of false result in Rh testing?
    false negative

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