Rh system, weak D, partial D, Rh antibodies, Rh typing, P1PK/GLOB, I/i, and MNS

Which blood group system is considered the most important after ABO due to the highly immunogenic D antigen?

Rh system

How many different antigens are currently included in the Rh blood group system, according to your reviewer?

55 antigens

In transfusion practice, what antigen must every blood donor and recipient be routinely typed for the presence or absence of?

D antigen

What must initial D-negative donors be tested for before being labeled Rh-negative?

Weak D

Do initial D-negative recipients routinely require testing for Weak D?

No

What type of blood should D-positive recipients receive in general transfusion practice?

D-positive

What type of blood should D-negative recipients receive in general transfusion practice?

D-negative

What is the fifth antigen among the five most commonly tested Rh antigens (D, C, E, c)?

e

Which chromosome houses the two closely linked genes that control the Rh blood group system?

Chromosome 1

Which Rh gene is responsible for coding the RhD protein and the D antigen?

RHD

Which Rh gene codes for the C, E, c, and e antigens?

RHCE

What gene do D-positive individuals inherit one or two copies of?

RHD

What gene do D-positive individuals also inherit two copies of?

RHCE

D-negative individuals usually have a complete deletion of which Rh gene?

RHD deletion

D-negative individuals inherit only two copies of which gene?

RHCE

What four common antigen combinations are explained by several alternate alleles of RHCE?

Cc Ee

What Fisher-Race haplotype corresponds to RHCE*Ce paired with RHD in the common Rh haplotype table?

DCe

How is the DCe haplotype written in Wiener notation?

R1

Which three antigens does the R1 haplotype express?

D C e

What Fisher-Race haplotype corresponds to RHCE*cE paired with RHD in the common Rh haplotype table?

DcE

How is the DcE haplotype written in Wiener notation?

R2

Which three antigens does the R2 haplotype express?

D c E

What Fisher-Race haplotype corresponds to RHCE*CE paired with RHD in the common Rh haplotype table?

Dce

How is the Dce haplotype written in Wiener notation?

R0

Which three antigens does the R0 haplotype express?

D C E

What Fisher-Race haplotype corresponds to RHCE*ce paired with RHD in the common Rh haplotype table?

DCE

How is the DCE haplotype written in Wiener notation?

RZ

Which three antigens does the RZ haplotype express?

D c e

What Fisher-Race haplotype is produced when RHD is absent but RHCE*Ce is present?

ce

How is the ce Rh-negative haplotype written in Wiener notation?

r

Which two antigens does the r haplotype express?

C e

What Fisher-Race haplotype is produced when RHD is absent but RHCE*cE is present?

Ce

How is the Ce Rh-negative haplotype written in Wiener notation?

r'.

Which two antigens does the r' haplotype express?

c E

What Fisher-Race haplotype is produced when RHD is absent but RHCE*CE is present?

cE

How is the cE Rh-negative haplotype written in Wiener notation?

r''

Which two antigens does the r'' haplotype express?

C E

What Fisher-Race haplotype is produced when RHD is absent but RHCE*ce is present?

CE.

How is the CE Rh-negative haplotype written in Wiener notation?

rY.

Which two antigens does the rY haplotype express?

C e.

In Rh terminology, what does a haplotype refer to?

The inherited allele from each parent expressed in a single term.

In Rh terminology, what does a genotype refer to?

Inherited haplotypes.

In Rh terminology, from what kind of result is a phenotype derived?

Cell typing.

What additional studies, along with typing results and haplotype frequencies, are necessary to determine the most probable genotype?

Family studies.

Which Rh-positive haplotype is the most common at 42% in White individuals?

R1.

Which Rh-positive haplotype is the most common at 44% in Black individuals?

R0.

Which Rh-positive haplotype is the most common at 70% in Asian individuals?

R1.

Which Rh-negative haplotype is the most common at 37% in White individuals?

r.

Which Rh-negative haplotype is the most common at 26% in Black individuals?

r.

Which Rh-negative haplotype is listed at 3% in Asians?

r.

In Rh typing practice, what antigens are present in a cell that is Anti-D positive, Anti-C positive, Anti-E negative, Anti-c negative, and Anti-e positive?

D C e.

From the phenotype of D, C, and e present, what is one possible homozygous most probable genotype?

R1R1.

From the phenotype of D, C, and e present, what is one possible heterozygous most probable genotype?

R1r'.

What type of antibodies are Rh antibodies generally considered to be in origin?

Immune-type.

From what exposure do Rh antibodies result, which are genetically absent in the antibody producer?

Antigens.

Which IgG subclasses are Rh antibodies usually classified under, according to your reviewer?

IgG1 IgG3.

What system do Rh antibodies usually not activate?

Complement.

At what phase of testing do Rh antibodies usually react?

AHG phase.

Why are Rh antibodies considered clinically significant?

They can cause HDFN and acute delayed transfusion reactions.

Before the advent of RhIG, which Rh antibody was the most frequent cause of HDFN?

Anti-D.

What type of reagent is the most commonly used for Rh typing today?

Low protein.

Routine low-protein anti-D reagents are usually what source type?

Monoclonal.

What may anti-D typing reagents utilize several clones for?

To enhance reactivity with multiple D epitopes.

At what phase is weak D testing allowed when using low-protein anti-D reagents blended of IgM and IgG?

AHG phase.

When low-protein Rh typing reagents are used, what serves as the negative control for ABO typing?

Negative control.

How is high-protein Rh typing reagent typically described?

Polyspecific reagent.

From what source does high-protein anti-D reagent obtain IgG anti-D?

Immunized persons.

What percentage of protein and additives does high-protein reagent contain?

20–24%.

At what immediate phase of testing can high-protein reagent react?

IS.

What matching control is required from the same manufacturer when using high-protein reagent?

Rh control.

In routine Rh typing, what percentage of red cells react at IS and are identified as D-positive?

85–92%.

In routine Rh typing, what percentage of red cells fail to react at IS and are identified as D-negative?

8–15%.

Weak D testing may be performed on red cells that were initially identified as what?

D-negative.

At what temperature do weak D testing and incubation of red cells with anti-D occur?

37°C.

What reagent is added after incubation in weak D testing?

AHG.

What additional control is required for the proper interpretation of weak D testing and must be negative at the AHG phase?

An appropriate control.

What type of false result in Rh typing can a positive DAT cause, according to your reviewer?

False negative.

What Rh typing problem may a variant or weak form of the antigen lead to?

False negative.

What error in Rh typing may result from using too heavy a cell suspension?

False negative.

What Rh typing error may occur from failure to add or using the wrong reagent?

False negative.

What typing problem can be caused by centrifugation that is either too short or with low rpm?

False negative.

What may produce a false negative Rh typing issue due to deterioration or contamination of reagents?

False negative.

Vigorous shaking of tubes may lead to what Rh typing error?

False negative.

What is a less common cause of false positive Rh typing, especially due to low-protein reagent use?

Positive DAT.

What Rh typing error can rouleaux or fibrin produce?

False positive.

What Rh typing problem can occur from using the wrong or contaminated reagent?

False positive.

Overcentrifugation may lead to what Rh typing issue?

False positive.

What Rh typing problem may polyagglutination cause?

False positive.

How is weak D described in terms of its defect?

Quantitative defect.

In weak D, are all pieces of the D protein present or absent?

All present.

In weak D, D protein exists in reduced what?

Quantities.

Generally, do persons with weak D produce which antibody?

Anti-D.

What is molecular testing increasingly being used for in weak D?

To determine the need for RhIG.

Which weak D types are noted as not producing anti-D?

1 2 3 4.1.

Which weak D type may produce anti-D and therefore requires RhIG?

4.0.

How is partial D described in terms of defect?

Qualitative defect.

Partial D results from unique RHD genes that produce some but not all D what?

Epitopes.

What can individuals with partial D make antibodies against?

Portions of the D antigen they lack.

What type of blood should individuals with partial D receive?

D-negative.

What prophylactic product should individuals with partial D receive during pregnancy?

RhIG.