WPCO x-K 4#M)8w&3u u7:'\H.v{ҏJ8T8-bFjSP7G uP*NNot+V2?sO̢sCQ;sE{{&z$*j6;h~w9za aӏ&W7"LI 5lxՊE8x4KK1%0qyf x  0@ 0)U 0<~ 0N 0a 0i 0C 0 0 0o 06 0 0 0U0< %l 0r BR D3o 0Oh 0C 0O AQI3U 0 U." 0"UB$E$ 0$Q& 0O:( 0( 0%) 0)* 0z0 0A1 1 0= 2 0FH2 0h2 12 03 174 0<55 0O9f9f9a9 0O9UBK:U: C:f:a: B *:f:a;a;U>);U>g;U>; i; 1<<n< 04eCNCwC4CC mC 0LC!D 0+eDfCEEE[EaqEEU:F i7F#G^ I 1uIiNJU:K 72Kf#La%Lf9La;LU>OL 0cL 0 LuN 0PN 0NV& 8Document[8]Document Style0..8` ..`   Vy8Document[4]Document Style.. .   V 9{8Document[6]Document Style8...  V 9w8Document[5]Document Style0...  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'\  `Roman PSXXU6Non-ProfitNon-Profit Stamp"#RB>z  0 @X<<<<@ExLLx d'dxd Level 1 Level 2 Level 3 Level 4 Level 5('2XT$ QU!   ($     ('2XT$ QU!   ! C<< c ) !XT"   cXX$ c@ NonProfitOrg.  @PP U.S.Postage@ PAID@uu Permit2757  @EE Austin,Texas.D4`P,BoardBoard of TrusteesC&.D4A`ArialTTC BoardofTrustees -$.D4`-Dr.BruceM.Murray,ChairmanDellaMayMoore,ViceChairmanRooseveltLeaks,SecretaryJanAlbersPeteFosterLindaGrayMackRayHernandezLawrenceE.JenkinsMurrayShawDr.DanAngel,President.D4A`ArialTTT}0HeadingFancy ACC Heading    xxxW(64 *Times New RomanTTW@.. AustinCommunityCollege  6)'Fd66)'Fd66)'t"Fd664 *Times New RomanTTP':FTFA MinutesFirst Pages%Xf$ hN p x (#%'0*,.8135@8:<H?AXX8H"Xdd8  @  FULLTIMEFACULTYASSOCIATION  @+Minutes   + G ,XT'   H"XXXs%Xf$ hN p x (#%'0*,.8135@8:<H?AX J(# Minutes   ?)' xdEx?('2XT$ QU!   ^>8ACC AddressACC Return AddressAustinCommunityCollegeP.O.Box140526Austin,Texas78714dC,EqualEqual Opportunity Statement@.. ACCisanequalopportunityinstitution. N24 labels4 line labels ,  , ,       \RA'*ty CollegeInternal Audit Department\ X X '  4. Rh Phenotyping 2lab4 (Carolyn Ragland 0 .  . Rh Phenotyping ; Task To type three (3) cell samples for the following Rh antigens: D, C, E, c ! , o ; Aim To determine the Rh phenotype and probable genotype of three (3) cell samples. ; Introduction In this procedure, commonly tested antigens of the Rh system will be studied. Normally the only Rh antigen identified in routine pretransfusion testing is the D antigen.R& 8BibliogrphyBibliography0....fE2Doc InitInitialize Document Style3( 7   (456($0 ($0 0 (@$0  0` (#(#0 ` (#` (# `   A_ekqwDocumentDocument StyleI.1.A.a.(1)(a)i)a)jD4Tech InitInitialize Technical Style( 9 ( CuyTechnicalTechnical Document Style11.11.1.11.1.1.11.1.1.1.11.1.1.1.1.11.1.1.1.1.1.11.1.1.1.1.1.1.1x?;u2PleadingHeader for numbered pleading paper ;  <XT(   H"XXXXX?)'*dE*??)'*dE*?\\1\\2\\3\\4\\5\\6\\7\\8\\910111213141516171819202122232425262728  .+('2XT$ QU!   ,5TABLE B('2XT$ QU!   34 `*Times New RomanTT'\ ` dTable_A&0 d dTable_BTABLE Ax9 Z&Times New Romanx9 Z&Times New Romanx9 Z&Times New Roman  CRight ParRight-Aligned Paragraph NumbersI.A.1.a.(1)(a)i)a)3|n'\  `Roman PSXn\  Ps: XP.D4`n PSRD4PkCP.D4A`ArialTT[D4PkCP.D4`lTT|ID4PkCP64 *Times New RomanTTxx/4 pTCxp'6X'A`"Sans Serif PSTTXn6XPT} XP34 `*Times New RomanTT&o4 PC&P'\ `s New RomanTTS\  PCP.4`n PSmanTT]4 PCP'\ `n PSmanTT]\  PCP( U$  2E/0"3U>c$"Small Circle"0 1, 2, 3,Level 1Level 2Level 3Level 4Level 54#?>2Quick 1.X  .0 X(  \   f TABLE C  ,XT'   _X_XZoXXX EXERCISE4nn<%LaboratoryProcedureManual X  ?)'  xdEC!?'6X'A`"Sans Serif PSC-%HP LaserJet 6L,..,040 3#37=CIQYag1.a.i.(1)(a)(i)1)a) _ @XT)   _XeXZoXXXA)) xdEEW!A X 0?g4 4 I% e&$%XeXZoMLAB2431  40  #eXZoX%e&$#'6X'A`"Sans Serif PSci)Table_CTable_DyC Z&Times New Roman(;3$2#  0  .3  0  <rr@:QuickFormat1XXXXXXXXXXXcb   XXXXXXXXXXXcb    k o^*   _ Rh_Phenotyping _((3^$ QU!   <PP@:QuickFormat2AJ&J  cb  AJ&J  cb  QU!   _X(  X,^dH4X<0f>tXH $JX\'Exercise4#XMX8$J# @) Rh_Phenotyping_  S  Textbook: _Quinley_,Chapter8   Skills: 20Points <  d %%W% Objectives:   6  c(#33c"l3"  l322#  1  .3  0    StatetheantigensoftheRhbloodgroupsystem.l32_݌[ %% Ќ  "l3"  l3+2#  2  .3  0    Definetheterms dominant, _codominant_, heterozygous,and homozygousastheyrelatetoinheritance A   oftheRhantigens.l3+X݌' %% Ќ  "l3"  l32#  3  .3  0    Definetheterms phenotypeand genotypeastheyrelatetobloodgroupantigens.l3݌  %% Ќ  "l3"  l32#  4  .3  0    BrieflystatetheprocedurewherebyanindividualsRhphenotypeisdetermined.l3݌ %% Ќ  "l3"  l32#  5  .3  0    Recalleachofthe8RhgenesinbothFisherRaceandWienernotation.l3-݌ %% Ќ  "l3"  l3 2#  6  .3  0    GivenanRhphenotypelistthemostprobablegenotypesinbothWienerandFisherRacenotations.l3 < ݌l %% Ќ  "l3"  l38 2#  7  .3  0    DeterminetheRhphenotypeandprobablegenotypeofthree(3)patientsamples.l38 e ݌R%% Ќ   Discussion  q Inthisprocedure,commonlytestedantigensoftheRhsystemwillbestudied.NormallytheonlyRhantigen o identifiedinroutine_pretransfusion_ԀtestingistheDantigen.FouradditionalRhantigensare:C,E,c!! U!HU ,and_o_. U Informationobtainedthroughtheidentificationoftheseantigensmaybeusedin:familystudies,resolutionof ; antibodyproblems,populationstudies,casesofdisputedparentage,andtopredictwhetherthesexualpartnerof ! awomanwithRhantibodiesislikelytotransmitgenesthatwillresultinoffspringnegativefortheparticular  antigen.  TheRhsysteminitiallyappearssimpleandstraightforwardsinceitinvolvesonlyfive(5)antigens_(C_,c""qf!Hfq,E,_o_,and f D),butisinfactoneofthemorecomplicatedhumanbloodgroupsystemsknown.Thegenecomplexisinherited L andindividualsmaybeanalyzedintermsofseparateantigens:Doritsabsence(d),Corc=2!H2=,andEor_o_.GeneD 2 is dominant toits allele d,becausegenedisan _amorph_Ԁ whichmakesnodetectableantigenicproduct.The k allelesCandcW!HW,andEand_o_Ԁare _codominant_Ԁ andifbothallelesarepresent,bothwillbeexpressed. W WienertheorizedthattheRhantigensdisplayedbyanindividualaretheresultofonlyapairofgenes,one %!  inheritedfromeachparent.Iftheseareidentical,theindividualis homozygous forthatgeneandalltheproducts  "! ofthegenewillbeexpressedinadoubledoseontheperson'sredcell.Whenthegenesinheritedfromeachparent "" arenotidentical,thepersonis heterozygous fortwodifferentgenesand,sincetheRhgenesare_codominant_,the # # productsofbothwillbeexpressedontheperson'sredcells.Antigensthatareproductsofbothgeneswillbe $n!$ presentindoubledose,whilethoseproducedbyonlyoneofthepairofgeneswillbepresentinsingledose. %T"%  0  EXAMPLE :u'"$'%% 0  0<%%   <%<% 0  _DCe_/DCE(slashseparatesthegene)transmittedfromeachparentC)%)%% 0  antigenD=homozygous,presentonbothsides)*&*%% 0  antigenC=homozygous,presentonbothsides00%%0f0%0%+'+f%f% n0  antigens_o_ԀandE=heterozygous,presentinone00%%  sideonly00%0%0%%0%%0>%%+(,>%>%  /:,0 ЇA phenotype istheassortmentofantigensactuallydetectableonanindividual'sredcellsusingselected S antiserums.Inmanybloodgroupsystems,thephenotypeisanexactexpressionofthe genotype. Unfortunately, ? thisisnotthecaseintheRhsystem.Sinceanyoneantigenmayderivefromanyofseveralgenes,identifying ' antigensdoesnotalwaysallowthegenotypetobededucedwithcertainty.Presumptionsregardingthe most     probable genotyperestonknowledgeofthefrequencywithwhichparticularantigeniccombinationsderivefrom  asinglegenecomplex.Todeterminethegenotypewithmorecertainty,itisnecessarytodofamilystudieswhich  arenotalwayspossible.Thefollowingisanexampleofaphenotypeandthepossiblegenotypeswhichcouldbe x present.  ^ Ѐ   EXAMPLE:  } *  0  Phenotype(antigensdetectedontheredcells)is:D,C,c,e  O %% 0   %% 0  PossibleGenotypes < 0%%PossibleGenotypes %% 0  (FisherRace) < 0%%0%%(Wiener)V %% 0  _DCo_/dcG < !H< G _o_ < 0%%0%%0%%R1/r< %% 0  _DCo_/Dc- u"!Hu"- _o_ < 0%%0%%0%%R1/Rou"%% 0  Dc22[!H[e/_dCo_ < 0%%0%%0%%Ro/r'[%% AXfXXXM]4X<0f>t X<66]Inthegeneralpopulation,the mostcommonDpositivemXMXXAXfXMXXXMcb    genotypeism" AXfXXXMAXfXXAXfcb    ݀mXMXXAXfXMXXXMcb    R1/rm# AXfXXXMAXfXXAXfcb      .The mostcommonDnegative - genotypeis_rr_.   \' \f \   Principle  S TheRhphenotypeisdeterminedbytestingthepatientredbloodcellswiththefivestandardantiserums:anti-D, W anti-C,anti-c~~C!HC,anti-E,andanti-_o_.Iftheantigentowhichtheantiserumisdirectedispresent,agglutinationof C the_rbcs_Ԁwilloccur.Noagglutinationofthe_rbcs_Ԁindicatestheabsenceoftheantigen.Basedonthereactions / withtheseserums,certainstatisticalassumptionsaremade,notalwayscorrectly.Forinstance,ifacellreacts  withanti-Cbutnotwithanti-c l !H l,theantigenCisassumedtobepresentinadoubledose(homozygousforC).   Theexceptionstothisarerare,butmaybesignificantinpaternitytesting.   Inthepastthereagentantiserumsaremadefromindividualswhohavedevelopedanantibodyagainstaspecific  x  bloodgroupantigen.Althoughhumansourceantiserumsarestillavailable,themoveistoprovidethese  d  reagentsfromclones.Agglutinationofanindividual'sredcellsbyaspecificantiserumindicatesthepresence  P  ofthecorrespondingantigen.Noagglutinationindicatesitsabsence. <   +  Reagents  S 1.0  BloodBankReagentRack(SeeProcedure3)W%% 2.0  AntiC,AntiE,Antien n C!HC,Anti-c C!HC,RhcontrolC%% 3.0  CanofBloodBankplasticpipets/%% 4.0  Blottingsquares(_biowipes_)%% 5.0  12x75testtubes %% 6.0  _Serofuge_ %% 7.0  HeatBlock %% 8.0  Agglutinationviewer x %% 9.0  Squirtbottleof0.85%saline d %% 10.Sharpie  P   Procedure  g  1.0  Placeseruminaproperlylabeledtube(ifnotalreadydone)andpreparea4-6%redcellsuspensionforeach , patientinanappropriatelylabeledtube(refertoprocedure3).k%% 2.0  SetuptubesforABOandDtypeandanadditionaltubeforeachRhtypingsera(remember,antiDispart W oftheforwardtype).C%% 3.0  LabelatubefortheotherRhantigenswiththepatient'sfirstandlastinitialandtheRhantigentobetested./%% 4.0  Add1dropofeachreagentforwardtypingseratoeachappropriatetube.%% 5.0  Placetwo(2)dropsoftheappropriateRhanti-serumintoitsappropriatelylabeledtube.%% 6.0  Add3dropsofpatientserumtotheA1andBreversecelltypingtubes.%% 7.0  Place1dropappropriatereagentreversecellintotheproperlylabeledreversetypetube.%% 8.0  Placeone(1)dropofthe4-6%patientcellsuspensiontoeachforwardtypetube.x%% 9.0  Centrifugefor1520seconds.d%% 10.Gentlyresuspendcellbuttonandexamineformacroscopicagglutination. P 11.Gradetheagglutinationreactionandimmediatelyrecordtheresults. < 12.IncubateallnegativeRhtypingtestsandtheircontrolsfor15minutesat37$C. {( 13.Repeatsteps5-7exeptforD.IfpatientappearsDnegative,performtheDutest(refertoABO/Dtubetest). g X 14.Duringincubationrecordtheresultsofthepositiveandnegativecontroltubesforthe otherRhtyping S seras. ?   RecordingResults  #" Recordthereactionsoftheindividual'scellswitheachappropriateantiserum.Thendeterminetheindividual's %!$ phenotypeand mostprobable genotypeintheappropriatespaces.Seeexampleprovided.Usetheattached %"% chartforassistance. &#& ЇA?2XAXf [&InterpretationofResults0 < #AXfXA?28#S<%<% A&h=%XAXfOncetheresultsofantigen_typings_Ԁhavebeenobtained,themostprobablegenotypemustbedetermined.Atfirstthis ? willbeconfusinganddifficult,butinterpretationwillgeteasierwithpractice.Thefollowingexamplemayhelp.  Resultsobtained: t *=Iddd Xdd Xdd X%%,dd ,dd ,dd ,dd ,dd +  $LL $antiD ' " 'antiC ' " 'antic '  " 'antiE '  " 'antie '  " '4+ 'o  " '4+ 'o  " '4+ ;1o " # ;0 :0%o " #  :4+"o "  "Positivereactionsindicatethepresenceoftheantigen,negativereactionsindicatetheabsenceoftheantigen.The O   phenotype ofthispatient(antigensdetectableonthe_rbc_)is:D,C,c,e. '  AnRhgenecomplexconsistsofaDord,Corc,Eoreantigensisinheritedfromeachparent.WhenapatientisD   positivethephenotypeofthepersoniseitherD/d(heterozygousforD)orD/D(homozygousforD).Makeaseparate ^  columnforeachpossiblegenotype,theotherRhantigenswillbeaddedtothis basetype. 6     < HeterozygousD0 0 0f0%0%HomozygousD9f%f%    <   D/d0  00%%0f0%0%D/Df%f% TheresultsfromtheRhphenotypeindicatesthatthepatientisC+andc+,theindividualisheterozygousfortheC n antigen,soplaceaCorconeithersideoftheDdasfollows.ItiscriticaltoremembertolistALLpossible F combinations. q    < DC/dc0  00%%0f0%0%DC/Dc(onlycombinationpossible)If%f% 0  0<%%Dc/_dC_!<%<% Thenextantigento pluginisE.ThepatientisE=e+indicatingthatthisindividualishomozygousfore,soewillbe ~! presentonbothsides. V"    < _DCe_Ԁ/_dce_0  00%%0f0%0%_DCe_Ԁ/_Dce_Y$f%f% 0  0<%%_Dce_Ԁ/_dCe_1%<%<% YoumustnowconverttheWienernotationstoFisherRaceusingthechartsupplied,alsoindicatethefrequenciesin ' whichthesegenotypesoccur: f( 0  0<%%_DCe_Ԁ/_dce_0<%<%R1r00%%0f0%0%33%i!*f%f% 0  0<%%_Dce_Ԁ/_dCe_0<%<%RJ&h=%JA&h=0#A&h=%JJ&h=H#r f <0.1%A"+%% 0  0<%%_DCe_Ԁ/_Dce_0<%<%RK&h=%JA&h=1#A&h=%JK&h=H#RL&h=%JA&h=0#A&h=%JL&h=FI#0f%%2%#,f%f% Onethingtorememberisthatfrequenciesgivenareforthewhitepopulation.IntheblackpopulationtheR0genotype $v!. isverycommon.Itiscriticaltoknowtheraceoftheindividualwhendeterminingmostprobablegenotypes. %N"/    Q'#1 [& [\f [    InterpretingResults  S Memorizethischart! -  AntigensP <FisherRaceP&Wiener   _D,c,e_P!<Dcmb!HbmoPWW%Ro b _D,C,e_P"<_DCo_ԈPWW%R1 : Dc66 e !He  EP!<Dc e !He  EPWW%R2 e  _D,C,E_P"<DCEP[[%_Rz_ =  c z !H  z,oP!<dc   z !H  zoP&r    _C,o_P"<_dCo_ԈP%r'    c} * r !H r } * ,EP!<dc} * r !H r } * EPkk%r"  r  _C,E_P"<_dCE_ԈPvv%ry  J  ]4X<0f>t X<66]Ininterpretingreactionsforgenotypes,alwaysrememberthatiftheDantigenispresentitdoes not meanthatitis M  homozygous.FigurethegenotypewithDononesideanddontheother(heterozygousforD).Usethechartonthe )  followingpageandselectthegenotypewiththehighestfrequency.Forexample,iftheD,C,cf  !H f Ԁandoantigensare   present,therearethree(3)possiblegenotypes:     < FisherRace 0 PBB.fWiener     > P7t%frequencyfrom 6    <        0  f        > P++8tfollowingtable  a   1.0 < _DCo_/dc9!H9o   0 P/fR1/r       > P>t33%9<%<%   2. < DCo/Dc88v!Hvo   0 P/fR1/Ro      P6>2%  0  3. < DcN!HNe/dCo   0 P/fRo/r'       > P;t0.010.1%%% ThemostprobablegenotypeisR1rsincethishasthehigheststatisticalprobability. q  .6+3      < @  RhGenotypesandTheirSerologicalReactions  S A"%A&h=B""A*gh dddd dd dd dd dd =I%%,00 ,00 ,X00 ,X00 ,X00 ,X00 ,X00 ,00 +  8+[[ @8Genotypes @3$H" @Reactionswithanti D3$H" DCaucasian H Frequency(%) bU=_ " @   @bFisherRace 9,!L 9Wiener 9,!L 9D 9,!L " 9C 9,!L " 9E 9,!L " 9c 9,!L " 9e 1'!L " 1 </_   @   @<DCe/dce 0#P 0R1/r 0#P 0+ 9,!P" 9+ 9,!P" 90 9,!P" 9+ 9,!P" 9+ 9,!P" 933 ND,P" @   0NDCe/Dce  D R1/R0  D + 'D" '+ 'D" '0 'D" '+ 'D" '+ 'D" '2 ?5D" 0 0?Dce/dCe   8 R0/r'   8 + ' 8 " '+ ' 8!" '0 ' 8"" '+ ' 8#" '+ ' 8$" '' ?5 8%" 0 0?DCe/DCe   ,& R1/R1   ,' + ' ,(" '+ ' ,)" '0 ' ,*" '0 ' ,+" '+ ' ,," '18 ?5 ,-" 0 0?DCe/dCe  s . R1/r'  s / + 's 0" '+ 's 1" '0 's 2" '0 's 3" '+ 's 4" '* ?5s 5" 0 0?DcE/dce  g  6 R2/r  g  7 + 'g  8" '0 'g  9" '+ 'g  :" '+ 'g  ;" '+ 'g  <" '11 ?5g  =" 0 0?Dce/dcE  [  > R0/r"  [  ? + '[  @" '0 '[  A" '+ '[  B" '+ '[  C" '+ '[  D" '' ?5[  E" 0 0?DcE/Dce  O F R2/R0  O G + 'O H" '0 'O I" '+ 'O J" '+ 'O K" '+ 'O L" '* ?5O M" 0 0?DcE/DcE  C N R2/R2  C O + 'C P" '0 'C Q" '+ 'C R" '+ 'C S" '0 'C T" '2 ?5C U" 0 0?DcE/dcE  7 V R2/r"  7 W + '7 X" '0 '7 Y" '+ '7 Z" '+ '7 [" '0 '7 \" '* ?57 ]" 0 0?DCe/DcE  + ^ R1/R2  + _ + '+ `" '+ '+ a" '+ '+ b" '+ '+ c" '+ '+ d" '12 ?5+ e" 0 0?DCe/dCE  f R1/ry  g + 'h" '+ 'i" '+ 'j" '0 'k" '+ 'l" '( ?5m" 0 0?DCe/dcE  n R1/r"  o + 'p" '+ 'q" '+ 'r" '+ 's" '+ 't" '1 ?5u" 0 0?DcE/dCE  v R2/ry  w + 'x" '+ 'y" '+ 'z" '+ '{" '0 '|" '( ?5}" 0 0?DcE/dCe  ~ R2/r'   + '" '+ '" '+ '" '+ '" '+ '" '* ?5" 0 0?DCE/DCE   Rz/Rz   + '" '+ '" '+ '" '0 '" '0 '" '( ?5" 0 0?DCE/DCe   Rz/R1   + '" '+ '" '+ '" '0 '" '+ '" '* ?5" 0 0?DCE/DcE   Rz/R2   + '" '+ '" '+ '" '+ '" '0 '" '' ?5" 0 0?DCE/dCe  x Rz/r'  x + 'x" '+ 'x" '+ 'x" '0 'x" '+ 'x" '( ?5x" 0 0?DCE/Dce  l Rz/R0  l + 'l" '+ 'l" '+ 'l" '+ 'l" '+ 'l" '' ?5l" 0 0?DCE/dcE  ` Rz/r"  ` + '`" '+ '`" '+ '`" '+ '`" '0 '`" '( ?5`" 0 0?DCE/dce  T Rz/r  T + 'T" '+ 'T" '+ 'T" '+ 'T" '+ 'T" '* ?5T" 0 0?DCE/dCE  H Rz/ry  H + 'H" '+ 'H" '+ 'H" '0 'H" '0 'H" '( ?5H" 0 0?Dce/dCE  < R0/ry  < + '<" '+ '<" '+ '<" '+ '<" '+ '<" '( ?5<" 0 0?Dce/dce  0 R0/r  0 + '0" '0 '0" '0 '0" '+ '0" '+ '0" '2 ?50" 0 0?Dce/Dce  w$ R0/R0  w$ + 'w$" '0 'w$" '0 'w$" '+ 'w$" '+ 'w$" '' ?5w$" 0 0?dCe/dce  k  r'/r  k  0 'k " '+ 'k " '0 'k " '+ 'k " '+ 'k " '* ?5k " 0 0?dCe/dCe  _!  r'/r'  _!  0 '_! " '+ '_! " '0 '_! " '0 '_! " '+ '_! " '( ?5_! " 0 0?dcE/dce  S" r"/r  S" 0 'S"" '0 'S"" '+ 'S"" '+ 'S"" '+ 'S"" '* ?5S"" 0 0?dcE/dcE  G# r"/r"  G# 0 'G#" '0 'G#" '+ 'G#" '+ 'G#" '0 'G#" '' ?5G#" 0 0?dCe/dcE  ;$  r'/r"  ;$  0 ';$ " '+ ';$ " '+ ';$ " '+ ';$ " '+ ';$ " '' ?5;$ " 0 0?dCE/dce  /%! ry/r  /%! 0 '/%!" '+ '/%! " '+ '/%! " '+ '/%! " '+ '/%! " '( ?5/%! " 0 0?dCE/dcE  #&" ry/r"  #&" 0 '#&"" '+ '#&"" '+ '#&"" '+ '#&"" '0 '#&"" '( ?5#&"" 0 0?dCE/dCe  '# ry/r'  '# 0 ''#" '+ ''#" '+ ''#" '0 ''#" '+ ''#" '( ?5'#" 0 0?dCE/dCE   ($ ry/ry   ($ 0 ' ($ " '+ ' ($!" '+ ' ($"" '0 ' ($#" '0 ' ($$" '( F5 ($%" 0 0Fdce/dce 4#(%& 4r/r 4#(%' 40 =,!(%(" =0 =,!(%)" =0 =,!(%*" =+ =,!(%+" =+ =,!(%," =15<20(%-" 0  %  <*=lessthan1percentbutgreaterthan0.1percent [+(/ '=lessthan0.1percentbutgreaterthan0.01percent ,(0 (=lessthan0.01percent  ,)1 #B&h=%"BY#BXfX%B&h=#AXfXXBXfY#XMXXAXf@ ComparisonofWienerandFisherRaceConceptsof S @ $theRhBloodGroupSystem  ` #&P $%XXM'#^%$%&P #A"%^i#B""Ac:X?<0f>t X<66c*ij d&d00 00 X00 XX00 XX00 XX00 XX00 X00 gh%%,HH ,HH ,HH ,XH ,HH ,XH@+  8+ @8WienerConcept B3$9" BFisherRaceConcept D3$9" DApproximate 9 Frequencyin  Caucasoidsof n NewYorkCity  2  (%) bU=I  "   @   @bGene 9,!C   9Agglutinogen 9,!C   9BloodFactors ;,!C   ;GeneComplex 9,!C  9BloodFactors 1'!C  1 </  @   @<R0 0#M  00 Rho :-"M   :Rh0,hr',hr" 0#M  00 8 Dce :-"M 88 :D,c,e 0#M  02.5 ND,M U @   0NR1  A  0 Rh1 (A   (Rh0,rh',hr"  A  0 8 DCe (A 88 (D,C,e  A  51.2 ?5A U 0 0?R2  5  0 Rh2 (5   (Rh0,rh",hr'  5  0 8 DcE (5 88 (D,c,E  5  16.5 ?55 !U 0 0?Rz  ) " 0 Rhz () #  (Rh0,rh',rh"  ) $ 0 8 DCE () %88 (D,C,E  ) & 14.9 ?5) 'U 0 0?r   ( 0 rh ( )  (hr',hr"   * 0 8 dce ( +88 (c,e   , 13.4 ?5 -U 0 0?r'   . 0 rh' ( /  (rh',hr"   0 0 8 dCe ( 188 (C,e   2 1.1 ?5 3U 0 0?r"   4 0 rh" ( 5  (rh",hr'   6 0 8 dcE ( 788 (c,E   8 0.4 F5 9U 0 0Fry 4#: 40 rhy >-";  >hr',hr" 4#< 40 8 dCE >-"=88 >C,E 4#> 40.02<20?U 0   <#A""B##A&h=%"AQ# /,e ЇHH2%Date_________________________________ S  k&h=%6A&h=  RhPhenotyping#A&h=%6k&h=# @@.   RecordingResults  G Note:The#3patientwillbewhereyouwillrecordyourresultsifyouhavedecidedtotestyourownsample. c  A.TypeandRh    AS&%A&h=BS&&AS*DE d dHH HH HH XH HH XH@ij%%, ( ,X( , ( ,X( ,X( , ( , ( ,X( ,XH ,( ,H( +  1' p  p (1 0!   0ForwardType BF3$  " BReverseType >F/$  "F > SD,  " ( F (SPatientName ;,! p  ;AntiA ;,! p " ;AntiB ;,! p " ;AntiAB ;,! p " ;AntiD ;,! p " ;*DCtrl ;,! p " ;Du ;,! p " ;*DuCtrl ;F,! p " ;ACells ;,! p "F ;BCells ?F,! p " ?Interpretation QD, p " (  F (Q1.  H  # 2#K  2 2# H  2 2# H  2 2# H  2 2# H  2 2# H  2 2# H  2 2F# H ! 2 2# H "F 2 6F# H # 6 H;# H $ (  F (H2 d % #. 2#g & 2 2#d ' 2 2#d ( 2 2#d ) 2 2#d * 2 2#d + 2 2#d , 2 2F#d - 2 2#d .F 2 6F#d / 6 L;#d 0 (  F (L3 1 #. 4#02 4 4#3 4 4#4 4 4#5 4 4#6 4 4#7 4 4#8 4 4F#9 4 4#:F 4 6F#; 63)'< (   F 3BXfX&BSXMXXBXf*ThisisperformedonlyifahighproteinantiDreagentisused or thepatientappearstobeABpositiveorforD w$= negativepatients. c>  B.RhPhenotypecirclethemostprobablegenotype  A *#GHXd d ( X( X ( X( XX( X (  ( X( XXH X( H( DE%%#, @0 ,w@0 ,w@0 ,w@0 ,w@0 ,w@0 ,X@0 ,@0 ,'@0 ,@@ +  1'C @1 0!'D" 0Reactionswithanti >/$'E" > C0!'F" CMostprobablegenotype VG/'G" @   @VName ;,!!H" ;D ;,!!I" ;C ;,!!J" ;E ;,!!K" ;c!!H! ;,!!L" ;e33!!H! ;,!!M" ;Rhctrl ;,!!N" ;Phenotype ;,!!O" ;FisherRace ?,!!P" ?Wiener SD,!Q" @   @SExample ;,!R" ;3+ ;,!S" ;3+ ;,!T" ;O ;,!U" ;3+ ;,!V" ;3+ ;,!W" ;O ;,!X" ;D,C,c00!Hehh!H ;,!Y" ;DCe!H/dc!He ?,!Z" ?R1r QD,[" @   @Q1. \ # ;,!] ; ;,!^ ; ;,!_ ; ;,!` ; ;,!a ; ;,!b ; ;,!c ; ;,!d ; ?,!e ? QD,f @   @Q2.  Fg # ;,!!,h ; ;,! Fi ; ;,! Fj ; ;,! Fk ; ;,! Fl ; ;,! Fm ; ;,! Fn ; ;,! Fo ; ?,! Fp ? UD, Fq @   @U3. $ r # =,!%!s = =,!$ t = =,!$ u = =,!$ v = =,!$ w = =,!$ x = =,!$ y = =,!$ z = ?,!$ { ?<20$ | @    <  G($} BX<D X?<66B%%W%Name_________________________________ 9 %%W%@) Rh_Phenotyping_Ԉ  @)StudyQuestions  K    > X Y?>  Y?>X1  .0    ListtheantigensoftheRhsystem.(2.5points)Y?>Xی} *%% Ќ  Y?>  Y?>{X2  .0    StatethreesituationsinwhichtestingfortheRhantigensprovidesusefulinformation.(1.5points).Y?>{XیI %% Ќ  Y?>  Y?>X3  .0    IsthealleletoDactuallydetected?Explain.(1point)Y?>Xی_ %% Ќ  Y?>  Y?>X4  .0    WhatdoesitmeantosaythattheRhantigensCandcorEandeare _codominant_.(1point)Y?>XیV%% Ќ  Y?>  Y?>X5  .0    Whatismeantbythetermshomozygousandheterozygous?(2_pts_)Y?>Xی""%% Ќ  Y?>  Y?>X6  .0    Definephenotype.(1point)Y?> Xی#)%)%% Ќ   m/,0 Y?>  Y?>X7  .0    Definegenotype.(1point)Y?>XیS%% Ќ  Y?>  Y?>X8  .0    StatethemostcommonDpositivegenotypeinbothFisherRaceandWienernotations.Providethesamefor d themostcommonDnegativegenotype.(2points)Y?>Xی J%% Ќ  *>?Md Xd @0 w@0 ww@0 ww@0 ww@0 ww@0 wX@0 X@0 '@0 '@@ GH%%,dd , dd ,rdd +  i  i     z  FisherRace ' z " 'Wiener # z "  #Dpositive  M    M    M  Dnegative  t    t   t   Y?>  Y?>X9  .0    Howarepresumptionsregardingthemostprobablegenotypedetermined?(1point)Y?>X یV%% Ќ  Y?>  Y?>X10  .0 <   Fillinthefollowingchartandmemorize!Y?>X ی<%<% Ќ  *Z]`4dddd  dd  rdd r>?%%,m dd ,dd +  )RR )FisherRace 6,! "C 6Wiener 2(&  "  C 2a. 6!   R1 6"    _DcE_ #  b.  $ c. }*%   _Rz_ }*&    _dce_  '  d.   ( e. q")   R2 q"*    _dcE_ # +  #f.  # , g. e%"-   r"e%".   "  .>+7 Forthefollowingphenotypes,list all possiblegenotypes.Stateeachones'statisticalprobabilityasgivenfor S  Caucasians.(UseFisherRaceandWiener.) Circle themostprobablegenotype.Pointvaluesvary. ? Y?>  Y?>&X11  .0 <   D,C,E,_o_ԀY?>&AX ی<%<% Ќ  0   %% Y?>  Y?>:X12  .0 <   d,c ' !H' ,_o_Y?>:UX ی' <%<% Ќ  Y?>  Y?>iX13  .0 <   D,E,c)q!Hq),_o_Y?>iX یq<%<% Ќ  Y?>  Y?>X14  .0 <   State2situationsinwhichaDcontrol must berun.(1point.Y?>Xی  <%<% Ќ  @0