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Questions and Answers
In which of the following scenarios can anti-D immunoglobulin administration prevent Rh D immunization?
In which of the following scenarios can anti-D immunoglobulin administration prevent Rh D immunization?
- A D-positive mother immediately after delivering a D-negative baby.
- A D-positive mother carrying a D-negative fetus.
- A D-negative mother immediately after delivering a D-positive baby. (correct)
- A D-negative mother who has already developed anti-D antibodies.
A D-negative pregnant woman is identified as having a weak D antigen expression. According to the content, what is the recommended course of action regarding Anti-D prophylaxis?
A D-negative pregnant woman is identified as having a weak D antigen expression. According to the content, what is the recommended course of action regarding Anti-D prophylaxis?
- Withhold Anti-D immunoglobulin as the weak D antigen offers sufficient protection.
- Administer Anti-D immunoglobulin prophylactically, as if she were D-negative. (correct)
- Administer Anti-D immunoglobulin only after confirmation of fetal Rh status.
- Monitor Anti-D antibody levels monthly rather than administering Anti-D immunoglobulin.
A patient with Dce/dCe genotype exhibits weak expression of the D antigen. Which of the following explains this observation?
A patient with Dce/dCe genotype exhibits weak expression of the D antigen. Which of the following explains this observation?
- The individual is homozygous for the d allele.
- The individual inherited a D allele in _cis_ to a C allele.
- The C antigen is dominant and suppresses D antigen expression.
- The D allele is inherited in _trans_ to the allele carrying the C gene. (correct)
Which characteristic of Anti-D antibodies is correct?
Which characteristic of Anti-D antibodies is correct?
Which type of anti-D reagent is most likely to produce a false positive reaction, especially in standard slide and rapid tube tests?
Which type of anti-D reagent is most likely to produce a false positive reaction, especially in standard slide and rapid tube tests?
What distinguishes genetic weak D from partial D variants in RhD antigen expression?
What distinguishes genetic weak D from partial D variants in RhD antigen expression?
How does the Rh-associated glycoprotein (RhAG) influence Rh antigen expression, and where is the gene encoding RhAG located?
How does the Rh-associated glycoprotein (RhAG) influence Rh antigen expression, and where is the gene encoding RhAG located?
What is the primary molecular mechanism leading to the D negative phenotype in individuals?
What is the primary molecular mechanism leading to the D negative phenotype in individuals?
If an individual with a partial D phenotype is exposed to a complete D antigen, what immunological response is most likely to occur?
If an individual with a partial D phenotype is exposed to a complete D antigen, what immunological response is most likely to occur?
How many times does the Rh protein cross the red blood cell membrane, and where are its N- and C-termini located?
How many times does the Rh protein cross the red blood cell membrane, and where are its N- and C-termini located?
How does the Tippet theory explain the genetic control of Rh antigens, and how does it differ from earlier models?
How does the Tippet theory explain the genetic control of Rh antigens, and how does it differ from earlier models?
If an individual's red blood cells type as D+, C+, E-, c+, and e+, how would this be represented using the ISBT numerical terminology?
If an individual's red blood cells type as D+, C+, E-, c+, and e+, how would this be represented using the ISBT numerical terminology?
What is a key distinction between the Fisher-Race and Wiener theories regarding the genetic inheritance of Rh antigens?
What is a key distinction between the Fisher-Race and Wiener theories regarding the genetic inheritance of Rh antigens?
Why is determining the weak-D status of an individual clinically important in blood banking?
Why is determining the weak-D status of an individual clinically important in blood banking?
How many different genotypes are theoretically possible in the Rh system, considering the inheritance patterns of RHD and RHCE?
How many different genotypes are theoretically possible in the Rh system, considering the inheritance patterns of RHD and RHCE?
Which of the following statements accurately describes a key difference between the Fisher-Race and Wiener nomenclatures for Rh blood groups?
Which of the following statements accurately describes a key difference between the Fisher-Race and Wiener nomenclatures for Rh blood groups?
An individual is typed as Rh:1,-2,3,4,5 using the Rosenfield nomenclature. How would this be represented using the Wiener nomenclature?
An individual is typed as Rh:1,-2,3,4,5 using the Rosenfield nomenclature. How would this be represented using the Wiener nomenclature?
According to the Fisher-Race nomenclature, the absence of the 'D' antigen is denoted by 'd'. Which statement accurately explains the genetic basis of this notation?
According to the Fisher-Race nomenclature, the absence of the 'D' antigen is denoted by 'd'. Which statement accurately explains the genetic basis of this notation?
An individual's red blood cells are typed as CDe using Fisher-Race nomenclature. What is the equivalent representation using Rosenfield nomenclature?
An individual's red blood cells are typed as CDe using Fisher-Race nomenclature. What is the equivalent representation using Rosenfield nomenclature?
If a patient is documented as 'r' in Wiener nomenclature, what antigens are present on their red blood cells?
If a patient is documented as 'r' in Wiener nomenclature, what antigens are present on their red blood cells?
The Rh system was first recognized in a case report of:
The Rh system was first recognized in a case report of:
What antigen is found in 85% of the white population and is always significant for transfusion purposes?
What antigen is found in 85% of the white population and is always significant for transfusion purposes?
How are weaker-than-expected reactions with anti-D typing reagents categorized?
How are weaker-than-expected reactions with anti-D typing reagents categorized?
Cells carrying a weak-D antigen require the use of what test to demonstrate its presence?
Cells carrying a weak-D antigen require the use of what test to demonstrate its presence?
How are Rh antigens inherited?
How are Rh antigens inherited?
Biochemically speaking, what type of molecules are Rh antigens?
Biochemically speaking, what type of molecules are Rh antigens?
Rh antibodies react best at what temperature (°C)?
Rh antibodies react best at what temperature (°C)?
Rh antibodies are primarily of which immunoglobulin class?
Rh antibodies are primarily of which immunoglobulin class?
Rh antibodies have been associated with which of the following clinical conditions?
Rh antibodies have been associated with which of the following clinical conditions?
What do Rhnull cells lack?
What do Rhnull cells lack?
What antigen system is closely associated phenotypically with Rh?
What antigen system is closely associated phenotypically with Rh?
Anti-LW will not react with which of the following?
Anti-LW will not react with which of the following?
Convert the following genotypes from Wiener nomenclature to Fisher-Race and Rosenfield nomenclatures, and list the antigens present in each haplotype.
Convert the following genotypes from Wiener nomenclature to Fisher-Race and Rosenfield nomenclatures, and list the antigens present in each haplotype.
Which Rh phenotype has the strongest expression of D?
Which Rh phenotype has the strongest expression of D?
Which of the following most commonly causes an individual to type RhD positive yet possess anti-D?
Which of the following most commonly causes an individual to type RhD positive yet possess anti-D?
An individual has the following Rh phenotype: D+C+E+c+e+. Using Fisher-Race terminology, what is their most likely Rh genotype?
An individual has the following Rh phenotype: D+C+E+c+e+. Using Fisher-Race terminology, what is their most likely Rh genotype?
Which of the following is the most common Rh phenotype in African Americans?
Which of the following is the most common Rh phenotype in African Americans?
Flashcards
Anti-Rhesus Antibodies
Anti-Rhesus Antibodies
Original name for antibodies later identified targeting the LW antigen, not Rh.
Rh Inheritance Theories
Rh Inheritance Theories
Fisher-Race: Three linked genes (D/d, C/c, E/e). Wiener: One gene locus with multiple alleles.
Weak D Expression
Weak D Expression
Genetic variations that produce slightly different versions of the D antigen.
Two Rh Gene Loci
Two Rh Gene Loci
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ISBT Numerical Terminology
ISBT Numerical Terminology
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Rh Phenotype Control
Rh Phenotype Control
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Rh Protein Structure
Rh Protein Structure
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RhAG's Role
RhAG's Role
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D Antigen Importance
D Antigen Importance
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D Negative Cause
D Negative Cause
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"C in trans" effect
"C in trans" effect
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Clinical significance of Anti-D
Clinical significance of Anti-D
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Preventing Anti-D immunization
Preventing Anti-D immunization
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Anti-D detection method
Anti-D detection method
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False Positive Anti-D Testing
False Positive Anti-D Testing
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Rh Nomenclature Systems
Rh Nomenclature Systems
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Wiener Nomenclature
Wiener Nomenclature
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Fisher-Race Nomenclature
Fisher-Race Nomenclature
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Rosenfield Nomenclature
Rosenfield Nomenclature
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R1 (Wiener)
R1 (Wiener)
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Study Notes
False Reactions with Rh Typing Reagents
False-Positives
- Heavy cell suspension can cause false positives
- Adjust the suspension to proper concentration, then retype
- Cold agglutinins can cause false positives
- Wash with warm saline, then retype
- Extended incubation or drying of the test slide can cause false positives
- Follow the manufacturer's instructions precisely
- Rouleaux formation can cause false positives
- Use saline-washed cells, then retype
- Fibrin interference can cause false positives
- Use saline-washed cells, then retype
- Contaminating low-incidence antibody in reagent can cause false positives.
- Try another manufacturer's reagent or use a known serum antibody
- Polyagglutination can cause false positives
- See chapter on polyagglutination
- Bacterial contamination of reagent vial can cause false positives
- Open a new vial of reagent, then retype
- Using an incorrect reagent can cause false positives.
- Repeat the test carefully, ensuring to read the vial label carefully
False-Negatives
- Immunoglobulin-coated cells (in vivo) can cause false negatives
- Use saline-active typing reagent
- Saline-suspended cells (slide) can cause false negatives
- Use unwashed cells
- Deviation from manufacturer's directions can cause false negatives
- Review the directions and repeat the test precisely
- Omission of reagent manufacturer's directions
- Always add reagent first and double-check before adding cells
- Over vigorous resuspension can cause false negatives
- Ensure the cells are gently resuspended in all tube test
- Incorrect reagent selection can cause false negatives
- Carefully read the vial label; repeat
- Variant antigen can cause false negatives
- Refer the sample for further investigation if variant antigen is suspected
- Reagent deterioration can cause false negatives
- Open a new vial and retest, if reagent deterioration is suspected </existing_notes>
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