Blood Bank Exam 2 #6

The Rh blood group system was named after the ______ monkey.

rhesus

In 1940, ______ and ______ helped lead to the discovery of the Rh factor's role in HDFN.

Philip Levine; Ruffin Stetson

______ and ______ discovered a new blood group antigen after immunizing animals with rhesus monkey RBCs.

Karl Landsteiner; Alexander S. Wiener

The animals immunized with rhesus monkey RBCs produced an antibody called ______.

anti-Rh

The original anti-Rh antibody agglutinated approximately ______% of human RBCs.

85

Approximately ______% of human RBCs did not agglutinate with the original anti-Rh antibody.

15

The rhesus antibody produced in guinea pigs and rabbits was actually directed against the ______ antigen.

LW

LW antigen expression is stronger on ______ cells than on ______ cells.

D+; D-

The current theory states that Rh antigens are controlled by ______ closely linked genes on chromosome ______.

2; 1

The gene responsible for D antigen expression is ______.

RHD

D-negative individuals have no genetic material at the ______ locus.

RHD

A true antithetical ______ allele does not exist.

d

The gene responsible for C, c, E, and e antigens is ______.

RHCE

The RHCE allele RHCE encodes the antigens ______.

CE

The RHCE allele RHCe encodes the antigens ______.

Ce

The RHCE allele RHcE encodes the antigens ______.

cE

The RHCE allele RHce encodes the antigens ______.

ce

Only ______ critical amino acid distinguishes C from c and E from e.

one

According to Fisher-Race theory, Rh antigens are controlled by ______ closely linked loci.

3

The Fisher-Race loci are ______, ______, and ______.

D/d; C/c; E/e

According to Wiener theory, Rh antigens are controlled by alleles at ______ gene locus.

one

In Fisher-Race terminology, each gene expresses an antigen designated by the same ______ as the gene.

letter

In Fisher-Race terminology, absence of the D antigen is written as ______.

d

The usual order of Fisher-Race genes is ______.

DCE

An alternate arrangement of Fisher-Race genes is ______.

CDE

According to Wiener, ______ alleles exist at the single Rh gene locus.

8

The eight Wiener alleles are ______.

R0, R1, R2, Rz, r, r', r'', ry

In Wiener terminology, each gene encodes an ______ composed of factors.

agglutinogen

R1 corresponds to the antigens ______.

D, C, e

Long-hand Wiener notation is ______ and rarely used.

outdated

Rosenfield terminology designates antigens by ______.

number

In Rosenfield terminology, Rh1 corresponds to antigen ______.

D

In Rosenfield terminology, Rh2 corresponds to antigen ______.

C

In Rosenfield terminology, Rh3 corresponds to antigen ______.

E

In Rosenfield terminology, Rh4 corresponds to antigen ______.

c

In Rosenfield terminology, Rh5 corresponds to antigen ______.

e

A phenotype of D+, C+, E−, c+, e+ is written in Rosenfield terminology as ______.

Rh:1,2,-3,4,5

ISBT stands for International Society of ______.

Blood Transfusion

The ISBT system attempts to standardize ______.

nomenclature

ISBT assigns ______-digit numbers to blood group specificities.

6

The ISBT number assigned to the Rh system is ______.

004

The phenotype is determined by the reaction between RBCs and ______.

antisera

The genotype is the individual's genetic ______.

makeup

True Rh genotype can only be determined by family studies or ______ testing.

molecular

The five antisera used to determine Rh phenotype are anti-D, anti-C, anti-E, anti-c, and ______.

anti-e

The most common Rh genes in Caucasians are ______.

R1, r, R2, R0

The most common Rh genes in Blacks are ______.

R0, r, R1, R2

The genes considered rare in both White and Black populations are ______.

r', r'', Rz, ry

The frequency of the Ce (r') gene is ≤ ______%.

2

The frequency of the DCE (Rz) gene is ≤ ______%.

1

The frequency of the CE (ry) gene is ≤ ______%.

1

The genotype Dce/Dce is equivalent to ______.

R0R0

Rh antigens have been detected only on ______ membranes.

red cell

Functions of Rh antigens include cation transport and membrane ______.

integrity

Absence of all Rh antigens is called Rh ______.

null

Rh null causes membrane abnormalities called ______.

stomatocytes

Rh null shortens red cell ______.

survival

The most immunogenic antigen in the Rh system is ______.

D

D-negative individuals should receive ______ blood.

D-negative

D-negative individuals exposed to D-positive blood may form ______.

anti-D

The concentration of D antigen varies with antigens inherited at the ______ gene.

RHCE

Newer monoclonal reagents have enhanced detection of D antigens without the ______.

IAT

RBCs positive only by IAT are interpreted as ______.

D-positive

A weak D test cannot distinguish between weak D and ______ D phenotypes.

partial

A weak D test must always include a ______.

control

A monoclonal control contains all additives except an ______.

antibody

If the weak D control is positive, ______ testing is required.

further

Some RHD genes code for ______ expression of D antigen.

weaker

Weak D results from less than normal amounts of D antigen inserted into the RBC membrane, creating a ______ difference.

quantitative

Weak D is more common in ______.

Blacks

Weak D is more often associated with the ______ haplotype.

Dce (R0)

In weak D, ______ D epitopes are present.

all

Individuals with weak D generally do ______ make anti-D when exposed to normal D antigen.

not

When C is inherited in trans to D, D antigen expression becomes ______.

weaker

The position effect is usually detected at ______.

IS

The occurrence of Ce (r') in Whites is less than ______%.

2

AABB requires weak D testing on donor cells initially nonreactive at ______.

IS

Weak D testing is not required on ______ samples.

recipient

Recipients with apparent weak D are classified as ______.

D-negative

Pregnant females classified as D-negative are candidates for ______ injections.

RhIG

Weak D testing is performed on apparent D-negative infants born to ______ females.

Rh-negative

Individuals with partial D are ______ positive.

D

Partial D individuals are missing parts of the ______ antigen.

D

Partial D represents a ______ defect.

qualitative

Partial D individuals may make ______ when exposed to the whole D antigen.

anti-D

Partial D antigens react ______ with monoclonal reagents.

strongly

Suspect partial D when a D-positive individual makes anti-D that does not react with their own ______.

RBCs

Rh antigens other than D, C, E, c, and e are alternate forms produced by ______ and ______ genes.

RHD; RHCE

Compound antigens are also called ______ products.

cis-product

Compound antigens may form when two genes are inherited on the same ______.

chromosome

Almost all genes coding for C or D also code for the ______ antigen.

G

Anti-G mimics a combination of anti-______ and anti-______.

D; C

A patient negative for D and/or C who receives D-positive and/or C-positive blood may develop ______.

anti-G

If anti-G is present, transfuse ______-negative and ______-negative blood.

D; C

Most Rh antibodies are stimulated by ______ exposure.

RBC

Most Rh antibodies are of the immunoglobulin subclass ______.

IgG1

Rh antibody agglutination is best observed by the ______.

IAT

Potentiators are useful in Rh antibody ______.

identification

Antibodies to C, c, E, and e often demonstrate ______.

dosage

With rare exceptions, Rh antibodies do not activate ______.

complement