Blood Bank Rh Groups

Front 1

hypolobated megakaryocytes

Back 1

5q minus syndrome

Front 3

R Weiner

Back 3

D (i.e. Rh positive) Fisher-Race

Front 4

r Weiner

Back 4

no D (i.e. Rh negative) Fisher-Race

Front 5

1 or '

Back 5

C (alphabetically comes before E) the numeral is used on R the prime is used on r

Front 6

2 or ''

Back 6

E (alpha betically comes after C) the numeral is used on R the prime is used on r

Front 7

0 or blank

Back 7

neither C nor E

Front 8

R' most common in...

Back 8

Whites

Front 9

R most common in...

Back 9

African Americans

Front 10

r second most common in...

Back 10

Whites and African Americans

Front 11

R'>R'' in...

Back 11

whites or African Americans

Front 12

Du

Back 12

weak D decreased quantity of D expression no anti-D!! no HTR/HDN D neg by direct agglutination D pos by IAT intracellular (or trnsmembrane) mutation

Front 13

D partial

Back 13

Partial D decreased quality of D expression positive allo-anti-D!! risk for HTR/HDN D pos by direct agglut extracellular mutation

Front 14

Rh null has what feature of RBC's?

Back 14

stomatocytosis also spherocytosis compensated hemolytic anemia

Front 15

anti-G

Back 15

anti-C and D can't be separated into anti-C and anti-D all D-C- RBCs are G-

Front 16

f antigen

Back 16

ce together on same chromosome ex: R0 or Dce; r or ce

Front 17

Rz

Back 17

DCE R=D z=CE

Front 18

ry

Back 18

CE r = no D y = CE

Front 19

R1

Back 19

DCe R=D 1=C e because no 2 or z

Front 20

R2

Back 20

DcE R=D 2=E c bc no 1 or z

Front 21

R0

Back 21

Dce R=D 0=no C or E

Front 22

Rz

Back 22

DCE R=D z=CE

Front 23

r

Back 23

ce r = no D blank = no C or E

Front 24

r'

Back 24

Ce r=no D '=C e bc no '' or y

Front 25

r''

Back 25

cE r=no D ''= E c bc no ' or y

Front 26

ry

Back 26

CE r=no D y= CE

Front 27

Most common Rh in Asians? Weiner and Fisher-Race

Back 27

R1 or DCe 70% incidence

Front 28

Most common Rh in whites? Weiner and Fisher-Race

Back 28

R1 or DCe 42% incidence

Front 29

Most common Rh in African Americans? Weiner and Fisher-Race

Back 29

R0 or Dce 44% incidence

Front 30

Second most common Rh in whites and african americans? Weiner and Fisher-Race

Back 30

r or ce Wh: 37% incidence AA: 26% incidence

Front 31

Rarest Rh combo? Weiner and Fisher-Race

Back 31

ry or CE

Front 32

Order of incidence for top 4 Rh's in Whites? Weiner

Back 32

R1>r>R2>R0

Front 33

Order of incidence for top 4 Rh's in African Americans? Weiner

Back 33

R0>r>R1>R2

Front 34

Order of incidence for top 4 Rh's in Asians? Weiner

Back 34

R1>R2>r=R0

Front 35

Rh Complex consists of...

Back 35

RhD, RhCE, and RhAG

Front 36

RhD and RhCE require what for expression?

Back 36

RhAG if no RhAG = Rh null

Front 37

Rh null what gene is mutated?

Back 37

RhAG gene complete absence of Rh complex no Rh expression

Front 38

G antigen

Back 38

present on all RBC's with D OR C

Front 39

D- person given C-D+ RBC's. Now has anti-C and anti-D. What's going on?

Back 39

Donor RBC's with D also always have G. Patient made anti-G, which types as anti-C and anti-D (but not actually separable)

Front 40

D neg person given C+D- RBCs. Now has anti-D. What's going on?

Back 40

Donor C+ cells also have G. Patient made anti-G, which types as anti-C and anti-D (but not actually separable)

Front 41

Is D a strong or weak immunogen?

Back 41

D is a strong immunogen 80% of D- make anti-D after 1 unit of D+ RBCs

Front 42

What percentage of D- pts will make anti-D after one unit of D+ RBCs?

Back 42

80% of D- pts will make anti-D after one unit of D+ RBCs (range 30-85%)

Front 43

How many units of D+ RBCs will cause 80% of D- pts to make anti-D?

Back 43

ONE unit of D+ RBC's will cause 80% of D- pts to make anti-D, bc D is a strong immunogen

Front 44

Where can D antigen be found?

Back 44

D ag is only on RBCs

Front 45

Rh antibodies are of what Ig type?

Back 45

Rh Ab's are IgG extravascular hemolysis/don't fix complement do cause HTR/HDN

Front 46

What are the 2 most common settings for developing Rh Abs?

Back 46

pregnancy or transfusion note: anti-E can be naturally occurring

Front 47

What percentage of donor units are D-?

Back 47

About 15% of donor units are D-

Front 48

Do platelets express D antigen?

Back 48

No D ag on platelets, only on RBCs

Front 49

Why can a D- pt receiving platelet transfusion develop anti-D?

Back 49

D ag is not present on platelets, but platelet transfusions contain up to 5 ml of RBC's which can alloimmunize and cause anti-D to be made by pt.

Front 50

Can you transfuse a D- pt with D+ platelets?

Back 50

Yes, but give Rhogam (RhIg) to bind the D+ RBC's in the platelet bag.

Front 51

One vial (300ug) of RhIg can neutralize how many ml D+ RBC's?

Back 51

one vial Rhogam neutralizes up to 15ml D+ RBCs

Front 52

How many RANDOM D+ platelet units can you give after one vial of RhIg?

Back 52

one vial Rhogam can neutralize up to 30 D+ random platelet units, or 15 ml D+ RBCs.

Front 53

How many APHERESIS D+ platelet units can be neutralized by one unit of RhIg?

Back 53

One unit of Rhogam can neutralize up to 7 D+ apheresis platelet units, or 15ml D+ RBCs

Front 54

Is the D status of a plasma unit important?

Back 54

No, D is ony present on RBC's. Plasma from a D+ donor doesn't contain cellular or soluble material capable of inducing anti-D.

Front 55

What are two types of lab tests for detecting D+ RBC's in D- pt?

Back 55

Rosette Test and Kleihauer Betke test

Front 56

How does the Rosette test work?

Back 56

anti-D added to maternal Rh- blood coats any Rh+ fetal RBC's; then add Rh+ test cells, which form rosettes around fetal cells (mixed field agglut)

Front 57

How much fetal-maternal hemorrhage will the Rosette Test detect?

Back 57

10ml

Front 58

Is the Rosette Test for FMH qualitative or quantitative?

Back 58

Qualitative - only shows that fetal Rh+ cells are present, not how many.

Front 59

How does the Kleihauer-Betke test work?

Back 59

Acid-elution test in which fetal Hb resists elution from RBC's under acid conditions, while adult/maternal Hb does elute. Fetal Hb is acid-fast. Count 2000 cells: fetal are pink, maternal are ghosts; calc % fetal cells.

Front 60

Is the Kleihauer-Betke test qualitative or quantitative?

Back 60

QUANTITATIVE - percentage of fetal cells can be determined based on 2000 cell count.

Front 61

What is the relationship between K-B test and Rhogam dosing?

Back 61

K-B test is quantitative test for FMH so dose of RhIg can be calculated based on it.

Front 62

How do you calculate Rhogam dose?

Back 62

maternal bld vol=5000ml OR body wt in kg x 70ml/kg maternal bld vol x %HbF cells= # Rh vials needed round down or up (0.5 cutoff) add one vial

Front 63

short way to calculate vials of RhIg when given %HbF

Back 63

%HbF x 5/3; round down or up; add one vial note: %HbF is just the number, don't divide by 100.

Front 64

1 vial Rhogam neutralizes how much fetal whole blood? fetal RBC's?

Back 64

30ml whole blood 15ml RBCs

Front 65

What dose of RhIg is in one vial of Rhogam?

Back 65

300ug, enough to neutralize 15 ml of D+ RBC's

Front 66

0.3-0.8% fetal cells how many vials Rhogam?

Back 66

2 vials (600ug)

Front 67

0.9-1.4% fetal cells how much Rhogam?

Back 67

3 vials or 900ug

Front 68

1.5-2.0% fetal RBC's how much Rhogam?

Back 68

4 vials or 1200ug

Front 69

2.1-2.5% fetal RBCs How much Rhogam?

Back 69

5 vials or 1500 ug

Front 70

1.4% HbF cells Calculate how much rhogam.

Back 70

1.4/100x5000=70ml one vial covers 30ml: 70/30=2.3 round down to 2 and add one=== 3 vials shorter way: 1.4 x 5/3 = 2.3 etc

Front 71

%HbF = 2.1 how much Rhogam?

Back 71

2.1 x 5/3 = 3.5, round to 4, add one== 5 vials

Front 72

%HbF = 1.7% how much Rhogam?

Back 72

1.7 x 5/3 = 2.8, round up to 3, add one== 4 vials or 1200ug