Deck 6: Rh Blood Group System

Question 1

Red cells that phenotype as D-negative indicate that:

A) they inherited two D genes.
B) there is no genetic material inherited from the RHD gene from both parents.
C) a suppressor gene was inherited that is turning off the D gene expression.
D) reagents currently in use are not detecting the D antigen.

Answer 1

B
The D-negative phenotype is the absence of genetic material at the RHD gene locus.This lack of genetic material must be inherited from both parents to result in a negative expression.

Question 2

If D-negative red cells are transfused to an R₁R₁ individual,what is the most likely Rh antibody that could develop?

A) Anti-E
B) Anti-d
C) Anti-D
D) Anti-c

Answer 2

D
Anti-c could develop since the recipient is c-negative and the donor is most likely rr or ce/ce.

Question 3

What is the immunoglobulin class of most Rh system antibodies?

A) IgM
B) IgG
C) IgA
D) IgE

Answer 3

B
Rh system antibodies are IgG,requiring the indirect antiglobulin test to detect.

Question 4

A patient phenotypes as D+C+E-c-e+.Predict the most likely genotype.

A) R₁r
B) R₁R₁
C) R₁r'
D) R₁R₀

Question 5

Why is the determination of the D antigen important for women during pregnancy?

A) A D-positive mother can form anti-D during pregnancy that may destroy the D-positive red cells of the fetus.
B) A D-negative mother should be given Rh immune globulin to prevent potential formation of anti-D during delivery of a D-positive infant.
C) A D-negative mother may form anti-D if the father of the child is also D-negative.
D) A D-positive mother may pass her red cells to the D-negative fetus and cause hemolytic disease of the fetus and newborn.

Question 6

Testing for the weak D expression is performed by:

A) using anti-Du antisera with an extended incubation.
B) using monoclonal anti-D.
C) performing the indirect antiglobulin test with anti-D.
D) performing the direct antiglobulin test with anti-D.

Question 7

All of the following can cause the D antigen expression to be weaker except:

A) inheriting the G gene.
B) inheriting the C antigen in trans to the D antigen.
C) an RHD gene that is genetically weaker.
D) partial D expression.

Question 8

The frequency of the D-negative phenotype in the population is:

A) 15%.
B) 85%.
C) 50%.
D) 35%.

Question 9

The numeric Rh4 nomenclature refers to which antigen in the Rosenfield notation?

A) C
B) c
C) e
D) E

Question 10

The inheritance of the Rh antigens are:

A) X-linked recessive.
B) X-linked dominant.
C) autosomal recessive.
D) codominant.

Question 11

Current theory regarding the genetics of the Rh system suggests that:

A) each Rh system antigen is coded by its own gene locus.
B) Rh system antigens are coded by two closely linked genes.
C) one gene locus with multiple alleles codes for the protein antigens.
D) the Rh system genes are a haplotype that codes for three sets of alleles.

Question 12

How would you label a donor who tested negative with anti-D reagent upon immediate-spin and positive in antihuman globulin test?

A) D-positive
B) D-negative
C) Cannot label; more testing needed

Question 13

Each of the following genotypes is possible for an individual whose red cells react as indicated below except:

A) R₁R₂.
B) R₁r".
C) Rᴢr.
D) R₀r'.

Question 14

Which of the following phenotypes will react with anti-f?

A) rr
B) R₁R₁
C) R₂R₂
D) R₁R₂

Question 15

An anti-E was identified in a patient who recently received a transfusion.What other Rh system antibody should be investigated?

A) Anti-G
B) Anti-f
C) Anti-D
D) Anti-c

Question 16

The LW antigen expression is typically stronger on _____________ red cells.

A) D-positive
B) D-negative
C) Rh null
D) D-variant

Question 17

Anti-D reagent and the D control were tested with patient's red cells.Both tests were 2+ agglutination reactions.What is the interpretation of the results?

A) D-positive
B) D-negative
C) Unable to interpret without further testing
D) D-positive if the sample is from a patient

Question 18

An individual's red cells gave the following reactions with antisera:

The most probable genotype is:

A) R₁R₂.
B) R2r.
C) R₀r.
D) R₁r.

Question 19

The weak D test detects:

A) the Du antigen.
B) the missing D mosaic.
C) a weak D antibody.
D) a weak D antigen.

Question 20

How is it genetically possible for a child to phenotype as D-negative?

A) Both parents are heterozygous D-positive.
B) Both parents are homozygous D-positive.
C) Mom is homozygous D-positive, and Dad is heterozygous D-positive.
D) The sibling is D-positive.

Question 21

MATCHING
Match the following phenotypes with the most probable genotype in the Weiner nomenclature.
a.R₁r
b.R₁R₁
c.R₂R₂
d.rr
DCce

Question 22

Which of the following is associated with the Rhnᵤll phenotype?

A) Membrane abnormalities
B) Immunized Rhnull individuals may produce anti-Rh29
C) Mutation of the RhAG regulator gene
D) All of the above

Question 23

Match the Fisher-Race notation with the correct Weiner notation for the following:
a.Ce
b.CE
c.DCE
d.Dce
r'

Question 24

Match the Fisher-Race notation with the correct Weiner notation for the following:
a.Ce
b.CE
c.DCE
d.Dce
R⁰

Question 25

If a D-positive person appears to have anti-D in their serum,what is the most likely explanation?

A) D-deletion phenotype
B) Compound antigen
C) Partial D antigen
D) Transposition effect

Question 26

MATCHING
Match the following phenotypes with the most probable genotype in the Weiner nomenclature.
a.R₁r
b.R₁R₁
c.R₂R₂
d.rr
DcE

Question 27

Match the Fisher-Race notation with the correct Weiner notation for the following:
a.Ce
b.CE
c.DCE
d.Dce
rʸ

Question 28

MATCHING
Match the following phenotypes with the most probable genotype in the Weiner nomenclature.
a.R₁r
b.R₁R₁
c.R₂R₂
d.rr
DCe

Question 29

MATCHING
Match the following phenotypes with the most probable genotype in the Weiner nomenclature.
a.R₁r
b.R₁R₁
c.R₂R₂
d.rr
ce

Question 30

Match the Fisher-Race notation with the correct Weiner notation for the following:
a.Ce
b.CE
c.DCE
d.Dce
Rᴢ