Blood Banking Final Flashcards Preview

Med Lab Tech Fall 2016 > Blood Banking Final > Flashcards

Flashcards in Blood Banking Final Deck (160):
1

All blood banks in the United States are regulated by what agency?

FDA

2

Software __________ is the establishment of documented evidence that provides a high degree of assurance that the information system will consistently function as expected.

Validation

3

What information might be found in a blood bank computer system? a. Inventory of blood components b. Antibodies identified in a patient c. The last date of donation for a blood donor d. All of the above

d. All of the above

4

Many accreditation agencies have checklist items that emphasize the responsibilities of operating an information system. Which of the following is NOT a volunteer accreditation agency? a. CAP b. AABB c. FDA d. Joint Commission

c. FDA

5

Which of the following is responsible for overseeing the safety of the blood supply? a. CAP b. AABB c. FDA d. Joint Commission

c. FDA

6

Fatalities related to blood transfusion are reported to ________

CBER

7

Which of the following is a peer voluntary accreditation and inspection agency? a. CAP b. CBER c. FDA d. OSHA

a. CAP

8

The temperature of a refrigerator must be between ______ and ______.

1-6C

9

Refrigerators must: a. Have an audible alarm b. Have a continuous recording device c. Have temps taken daily d. All of the above

d. All of the above

10

A standard operating procedure (SOP) is: a. A statement of intent or course of action b. A description of resources and activities that transform inputs into outputs c. A set of directions for how to perform a particular task d. A form on which to record results

c. A set of directions for how to perform a particular task

11

Which of the following is used to determine if reagents and equipment are functioning prior to testing? a. critical control points b. control charts c. quality assurance d. quality control

d. quality control

12

According to federal law, what organization must be contacted when a biological deviation occurs in a blood bank and the error has the potential to affect the safety of the product or patient?

CBER

13

What is the primary focus of quality assurance?

To amend the system, procedure, or standard operating procedures, if deemed faulty

14

Which part of quality assurance ensures that products are consistently manufactured according to, and controlled by, the quality standards appropriate for their intended use?

Good manufacturing practices

15

Heat blocks for antibody screening are maintained at _______.

37C

16

Which of the following might lead to unacceptable QC results? a. A technician who has not worked in the area for several months b. Deteriorated anti-A c. Uncalibrated serofuge d. All of the above

D. all of the above

17

The major focus of transfusion medicine is a. donor disease diagnosis b. recipient disease diagnosis c. donor/recipient blood group types d. donor/recipient compatibility

d. donor/recipient compatibility

18

The temperature of a freezer for plasma and cryoprecipitate must be maintained at _____

-18C

19

What blood component requires gentle agitation at room temperature during storage?

Platelets

20

What testing must be repeated on donor units at the receiving facility when blood is shipped from a blood supplier?

ABO

21

True or False: The patient's room number is an acceptable unique identifier for use when labeling a tube of blood.

FALSE

22

True or False: It is acceptable to omit date and time of collection on a specimen as long as this information is captured in the LIS

TRUE

23

True or False: Measurement of compliance is on-going while quality management is only done at a point in time.

FALSE

24

True or False: Reagent quality control must include both a positive and negative control.

TRUE

25

True or False: Competency of personnel is assessed annually

TRUE

26

What are the 3 components of Quality Management?

Quality control Quality assurance Quality maintenance systems

27

What temperature are platelet incubators set at?

20-24C

28

True or False: Blood bank SOPs only need to address those tasks which are performed most often

FALSE

29

Polyspecific AHG contains: a. Anti-IgG and Anti-IgM b. Anti-IgG and Anti-C3d c. Anti-IgG and Anti-IgA d. Anti-IgM and Anti-C3d

b. Anti-IgG and Anti-C3d

30

RBCs must be washed in saline at least three times before the addition of AHG reagent to: a. wash away any hemolyzed cells b. remove traces of free serum globulins c. neutralize any excess AHG reagent d. increase the antibody binding to antigen

b. remove traces of free serum globulins

31

False-positive DAT results are most often associated with: a. use of refrigerated, clotted blood samples in which complement components coat RBCs in vitro b. a recipient of a recent transfusion manifesting an immune response to recently transfused RBCs c. presence of heterophile antibodies from administration of globulin d. a positive autocontrol caused by polyagglutination

a. use of refrigerated, clotted blood samples in which complement components coat RBCs in vitro

32

Solid phase antibody screening is based on: a. adherence b. agglutination c. hemolysis d. precipitation

a. adherence

33

Which of the following methods requires the use of check cells? a. Gel b. Solid phase c. LISS d. Enzyme linked

c. LISS

34

Which factor can affect AHG testing, yet is uncontrollable in the lab? a. Temperature b. Antibody affinity c. RPM of centrifuge d. Incubation time

b. Antibody affinity

35

Which of the following is produced in the primary immune response? a. Anti-IgA b. Anti-IgE c. Anti-IgG d. Anti-IgM

d. Anti-IgM

36

Which of the following is produced in the anamnestic response? a. Anti-IgA b. Anti-IgE c. Anti-IgG d. Anti-IgM

c. Anti-IgG

37

Which of the following is most efficient at binding complement? a. IgA b. IgE c. IgG d. IgM

d. IgM

38

Which portion of the immunoglobulin molecule contains complement binding sites?

Light chain constant region

39

Which complement pathway is activated by the formation of antigen-antibody complexes?

Classical

40

Which immunoglobulin class is capable of crossing the placenta and causing hemolytic disease of the newborn?

Anti-IgG

41

What refers to the effect of an excess amount of antigen present in a test system?

Postzone

42

What refers to the effect of an excess amount of antibody present in a test system?

Prozone

43

What factor distinguishes the indirect from the direct antiglobulin test?

The use of plasma

44

Which of the following affects the direct antiglobulin test? a. temperature b. enhancement solution c. serum to cell ratio d. washing

d. washing

45

How is RNA different from DNA

  • RNA usually exists as one strand
  • Ribose is substituted for deoxyribose
  • RNA incorporates uracil

46

A triplet of nucleotides is called a _______.

Codon

47

Only 5% of Kell negative individuals will develop antibodies to Kell if exposed to the Kell antigen, whereas 50-70% of Rh(D) negative indiciduals would produce antibodies to D upon exposure. The difference for this is?

The difference in immunogenicity

48

At what temperature do IgM antibodies react?

a. 22

b. 37

c. 56

d. 42

a. 22

49

A person with the genotype MM shows 3+ reaction when red blood cells are mixed with anti-M, whereas a person with the genotype MN shows a 1+ reaction with anti-M. What phenomenon is demonstrated here?

Dosage

50

What is the purpose of the AHG test in blood banking?

It detects red blood cells coated with antibody by bridging the gap between red blood cells

51

Which immunoglobulin exists in a pentameric configuration?

IgM

52

Which antibody is considered the most significant in blood banking because it reacts at body temperatures?

IgG

53

What does hemolysis represent in an antigen-antibody reaction?

a. a negative reaction

b. a positive reaction

c. an inconclusive result

d. none of the above

a. a positive reaction

54

When antigen and antibody combine, they are held together by noncovalent forces. With the abscence of a visible lattice, this stage is called ___________

a. adhesion

b. sensitization

c. agglutination

d. inhibition

b. sensitization

55

Which immunoglobulin is found in greatest concentration in serum?

IgG

56

Hos is the alternative pathway of complement activated?

a. enzymes

b. Polysacharrides

c. Proteins

d. all of the above

b. polysacharrides

57

All of the following are true regarding IgM antibodies except:

a. IgM antibodies form against Kell

b. IgM can bind up to 10 antigens on a red cell

c. IgM is 160 A larger that IgG

D. IgM is a pentamer

a. IgM antibodies form against Kell

58

An advantage of both gel and SPRCA is:

a. no washing

b. standardization

c. use of IgG coated cells

d. special equipment

b. standardization

59

What is the equivalent of Factor D (alternative pathway) in the classic complement pathway?

a. C1q

b. C1s

c. Clr

d. C4

b. C1s

60

Which of the following are produced after exposure to genetically different nonself antigens of the same species?

a. alloantibodies

b. autoantibodies

c. drug-induced antibodes

d. all of the above

a. alloantibodies

61

An immunogenic substance which reacts with an antibody is known as an _________

Antigen

62

What MGC class encodes complement components?

Class III

63

Why is EDTA not conducive to complement activation?

a. Antigens are destroyed

b. Antibodies are neutralized

c. Calcium is inactivated

d. It dilutes plasma

c. Calcium is inactivated

64

The portion of the immunoglobulin molecule that determines class is the _________

Heavy chain

65

A patient with multiple myeloma exhibits rouleaux formation in an immediate spin crossmatch. What procefure is recommended to distinguish true RBC agglutination from rouleaux?

Saline replacement

66

All of the following are characteristics of antigens that affect the type and extent of immune response EXCEPT:

a. solubility

b. charge

c. molecular weight

d. genetic locus

d. genetic locus

67

Why is LISS used in blood banking?

It reduces incubation time

68

The immune response that consists of physical barriers, biochemical effectors and immune cells is the _________ immune response.

Innate

69

HLA proteins are coded for by what complex?

MHC

70

A patient came in for a routine type and screen for surgery. The antibody screen was negative at 37C and AHG. The check cells did no produce agglutination. What is the possible explanation?

a. Dirty glassware

b. use of DAT positive cells

c. Inadequate washing

d. Overcentrifugation

c. Inadequate washing

71

What is the temperature of the incubation phase of the IAT?

 

37C

72

What do "Check cells" contain?

Rh(D) positive red blood cells coated with anti-D

73

All of the following are important in evaluating a positive DAT EXCEPT:

a. patient diagnosis

b. drug therapy

c. transfusion history

d. donation history

d. donation history

74

The indirect antiglobulin test detects antigen-antibody reactions

a. in vivo

b. in vitro

c. both in vivo and in vitro

d. none of the above

b. in vitro

75

All of the following conditions may produce a positive DAT EXCEPT:

a. HDN

b. HTR

c. Lymphoma

d. Drug induced hemolytic anemia

c. Lymphoma

76

Saline used for blood banking should have a pH of ________

7.2-7.4

77

How would a negative IAT appear in solid phase methodology?

a. the cells form a monolayer

b. there is a pellet at the bottom of the well

c. the well turns orange

d. small agglutinins appear at the bottom of the well

b. there is a pellet at the bottom of the well

78

The principle of gel testing is

a. hemagglutination

b. hemolysis

c. adherence

d. rouleaux

a. hemagglutination

79

True or False:

Both GEL and SPRCA require large amounts of sample

FALSE

80

A disadvantage of both gel and SPRCA is:

a. decreased sensitivity

b. inability to test hemolyzed samples

c. increased sensitivity

d. standardization

c. increased sensitivity

81

A safety featre of SPRCA is:

a. bubble barrier

b. color change of LISS

c. viscous barrier

d. Use of IgG coated cells

b. color change of LISS

82

True or False:

Rouleaux is true agglutination

False- it is not true agglutination

83

True or False:

The button must be completely resuspended before an accurate observation can be made.

TRUE

84

True or False:

After resuspending buttons, tube may be set aside and read later.

FALSE:

the tube must be read right away

85

True or False:

Antigen antibody reactions are not reversible

FALSE:

They are reversible

86

Antigen structures include ________ , _________ , and _________

proteins, glycolipids, and glycoproteins

87

Antigens are produced by _________ gene action or by ___________ production which adds sugars to backbone structures.

direct, enzyme

88

Elution is a technique used to dissoviated which type of antibodies from sensitized RBC's?

IgG

89

Which cells are involved in the production of antibodies?

B cells -- Plasma cells

90

Which MHC class is found on antigen presenting cells?

MHC Class II

91

Which end of an immunoglobulin binds to the antigen?

Fab

92

Which end of an immunoglobulin is responsible for complement fixation?

Fc

93

Anti-A from a group B individual is primarily what class of immunoglobulin?

a. IgM

b. IgG

c. IgA

d. All of the above

a. IgM

94

Approximately how many antigen sites exist on a type-A1 individual's RBC?

1 million

95

What substances are found in a group A secretor?

a. AH

b. H

c. BH

d. ABH

a. AH

96

What is a lectin?

a. a protein produced from immunized rabbits and cloned for specificity

b. a foreign protein that will elicit an immune response in most individuals

c. seed extracts that agglutinate human cells with moderate specificity

d. a substance that will agglutinate sensitized cells in the presence of complement

c. seed extracts that agglutinate human cells with moderate specificity

97

What ABO group contains the least amount of H substance?

a. A1

b. A2

c. A1B

d. A2B

c. A1B

98

What is the source of Anti-A1 lectin?

a. Bandeiraea simplicifolia

b. Dolichos biflorus

c. Ulex europaeus

d. all of the above

b. Dolichos biflorus

99

Secretor studies were performed on a person who expressed weak reactions in forward grouping. Only B and H substances were present in the saliva. What is this person's ABO group?

a. O

b. A

c. B

d. AB

Group B

100

All of the following may result in weak or missing antigens EXCEPT:

a. presence of blood-group-specific soluble substances (BGSS)

b. Hodgkin's disease

c. Hypgammaglobulinemia

d. Intestinal infection with Escherichia coli

c. Hypgammaglobulinemia

101

What is the biochemical structure of secreted A, B, and H substances?

Glycoprotein

102

All of the following statements are true concerning ABH soluble substances EXCEPT:

a. the first sugar in the precursor substance is N-acetylgalactosamine

b. the precursor chain is type 2 (beta 1-4 linkage)

c. ABH structures are glycoproteins

d. L-fucosyltransferase production is regulated by the Se system 

b. the precursor chain is type 2 (beta 1-4 linkage)

103

Two drops of serum are added to one drop of A1 cells, and 2 drops are added to one drop of B cells, th 2 tubes are centrifuged. The tubes shows reactivity when read microscopically. This is an example of:

a. forward grouping

b. reverse grouping

c. antibody screed

d. crossmatch

b. reverse grouping

104

Why is reverse grouping not performed on cord blood specimens?

Antibodies are generally not present at birth

105

What immunodominant sugar is responsible for H specificity?

L-fucose

106

What percentage of the type A population is A2?

 

20%

107

An elderly patient is documented as being type O. The forward grouping is negative with anti-A and anti-B. The reverse grouping shows no reactivity with A1 and B cells. What can be done to correct the discrepancy?

Incubate the patient's serum and reagent cells for 15 minutes at room temperature

108

The ABO group antibodies are primarily ________

Naturally occurring

109

What percentage of the white population has type O blood?

45%

110

Reverse grouping showed negative reactions with A1 and B cells. Forward grouping showed positive reactions with A, B, and AB antisera. What blood type is consistent with these results?

AB

111

Which blood group contains the highest concentration of H antigen?

Group O

112

What is the only possible phenotype of an offspring produced from two group O parents?

O

113

The forward grouping of a patient showed no agglutination of patient cells with anti-A, anti-B, or anti-AB reagent antisera. The reverse grouping showed agglutination with A1 and B cells. What is this person's ABO group?

O

114

Forward grouping is defined as:

a. detecting antibody on an individual's red blood cells via reagent antisera

b. detecting antigen(s) on an individual's red blood cells via reagent antisera

c. detecting ABO group antibody via reagent red blood cells

d. detecting ABO group antigen via reagent red blood cells

b. detecting antigen(s) on an individual's red blood cells via reagent antisera

115

What does the hh genotype refer to?

Bombay

116

Approximately how many antigen sites can be found on A2 cells?

260,000

117

Individuals with group B blood are more common among which populations?

a. Black/Asian

b. White/Black

c. Asian/White

d. Hispanic/White

a. Black/Asian

118

A patient who was recently diagnosed with an obstructed bowel became septic from Proteus vulgaris. Prior to surgery, a routine type and screen was performed. Though this person typed as an A 2 years ago, his forward type is consistent with an AB individual, albeit weaker in strength with anti-B. What is the reason for this discrepancy?

Acquired "B"

119

Which substance must be formed first before A or B specificity is determined?

a. I

b. O

c. Bombay

d. H

d. H

120

Reverse grouping was performed on an AB person. The technologist observed a very weak agglutination macroscopically. The cells appeared as "stacked coins" under a microscope. Which reagent should be added to the tube befor recentrifugation in an attempt to resolve the discrepancy?

Saline

121

How are ABH antigens formed?

a. Production of specific glycosyltransferases add sugars to precursor substances

b. recombinant gene technology

c. ABO genes code for production of antigens

d. all of the above

a. Production of specific glycosyltransferases add sugars to precursor substances

122

What percentage of individuals inherit the secretor gene?

98%

123

What immunodominant sugar is responsible for B specificity?

D-galactose

124

An AB male mates with an AB female. What could be the genotype of the offspring?

a. AB

b. AA

c. BB

d. all of the above

d. all of the above

125

All of the following may depress antigen expression EXCEPT:

a. leukemia

b. lymphoma

c. coronary heart disease

d. Hodgkin's disease

c. coronary heart disease

126

Persons who inherit the h allele do not produce _________ transferase necessary for formation of the H structure.

a. L-fucosyl

b. N-acetylgalactosaminyl

c. D-galactosyl

d. D-glucosyl

a. L-fucosyl

127

All of the following may result in rouleaux formation except

a. Waldenstrom's macroglobulinemia

b. Wharton's jelly in cord blood

c. leukemia

d. dextran

c. leukemia

128

Antibody titers specific to antigens from the ABO system are typically highest:

a. when the patient is a newborn

b. when the patient is around 10 years old

c. when the patient is around 30 years old

d. when the patient is around 60 years old

b. when the patient is around 10 years old

129

A1 lectin agglutinates:

a. all cells except A2

b. all subgroups of A

c. cells not agglutinated by absorbed anti-A

d. only A1 cells

d. only A1 cells

130

The Rh antibody agglutinates what percentage of RBCs?

85%

131

When the presence of the D antigen on the RBC can only be demonstrated in the antiglobulin phase, the term is?

a. Rh null

b. Bombay

c. Weak D

d. Positive DAT

c. Weak D

132

G antigen is present on all of which type of RBCs?

a. D-positive

b. C-positive

c. E-positive

d. e-positive

a. D-positive

133

What does Rh grnotype refer to?

a. antigens detected on a RBC by serologic methods

b. Antibodies detected in serum by serologic methods

c. Rh genes inherited from both parents

d. Rh genes inherited from the mother

c. Rh genes inherited from both parents

134

Where is the Rh antigen located relative to the RBC membrane?

a. integrally

b. peripherally

c. centrally

d. none of the above

a. integrally

135

Which of the following statements regarding anti-LW is true?

a. Anti-LW reacts poorly with cord cells

b. Anti-LW reacts stronger with Rh-positive cells than with Rh-negative cells

c. Rh-null individuals lack the LW gene

d. the gene coding for LW is located on the same chromosome as the Rh genes

b. Anti-LW reacts stronger with Rh-positive cells than with Rh-negative cells

136

Of the 3 following categories of altered D antigen, in which variation of D antigen expression are you more likely to encounter an allo-anti-D?

a. C in trans to RhD

b. Weak D

c. Partial D

d. None of the above

c. Partial D

137

Which of the following genotypes is consistent with f antigen expression?

a. DcE/DCe

b. Dce/DCE

c. DCe/DcE

d. DCe/dCE

c. DCe/DcE

138

How are the Rh antigens inherited?

Codominant alleles

139

All of the following may cause a false-negative reaction in Rh typing except:

a. omission of reagent

b. immunoglobulin coating cells

c. rouleaux

d. cell suspension that is too heavy

c. rouleaux

140

In the Fisher-Race nomenclature what does "d" refer to?

a. amorph

b. silent allele

c. absence of D

d. all of the above

d. all of the above

141

Which of the following genotypes would demonstrate the stronges expression of D antigen?

a. Dce/dCE

b. DCe/dce

c. dce/dce

d. dCe/dcE

b. DCe/dce

142

Most Rh antibodies are of what immunoglobulin class?

IgG

143

What clinical manifestation may be associated with the Rh-null syndrome?

a. Reticulocytosis

b. stomatocytosis

c. low hemoglobin

d. all of the above

d. all of the above

144

Which of the following is most likely the genotype of the given patient:

C antigen POS; D antigen POS; E antigen NEG; c antigen POS; e antigen POS

a. DCe/Dce

b. DCE/dce

c. DCe/dcE

d. Dce/dce

a. DCe/Dce

145

The Rh testing on a blood donor was negative at immediate sprin. The tube was incubated at 37C for 15 minutes. The tube was centrifuged and read macroscopically. The test was negative at 37C. The tube was washed 3 times with saline, and 2 drops of AHG were added. After centrifugation, the tube yielded a 2+ reaction/ How is this Rh type reported on the donor unit?

Rh-positive

146

What does the "R" represent in Rh-Hr terminology?

The presence of the D antigen

147

What is the basis of Rosenfield Rh terminology?

a. Each gene produces one product or antigen

b. the positive or negative sign demonstrates the presence or absence of antigen on a RBC

c. The Rh gene produces at least 3 factors within agglutinogen

d. The Rh gene produces at least 5 factors within an agglutinogen

b. the positive or negative sign demonstrates the presence or absence of antigen on a RBC

148

Which of the following Rh antigens is the most immunogenic?

a. D

b. C

c. e

d. E

a. D

149

What protocol is put in place to validate Rh testing when high-protein reagents are used, especially when the patient types as an AB-positive?

a. wash cells before testing

b. run a control with Rh test

c. add LISS to test system

d. use only saline reactive anti-D

b. run a control with Rh test

150

What is the frequency of E antigen in the general population?

 

15%

151

The Rh antigen is located on which chromosome?

1

152

What is the principle of the Rh-Hr (Weiner) terminology?

a. the Rh gene produces at least 3 factors within an agglutinogen

b. each gene (D,C,E,c,e) produces one product or antigen

c. The Rh gene produces at least 3 factors within an agglutinin

d. Each gene is independent of the others

a. the Rh gene produces at least 3 factors within an agglutinogen

153

All of the following are true regarding Rh antibodies except:

a. Rh antibodies can bind complement on the RBC membrane

b. An individual with a low titer Rh antibody may experience a secondary immune response on antigen exposure

c. Rh antibodies may cause a delayed hemolytic transfusion reaction

d. RBC destruction is usually extravascularf

a. Rh antibodies can bind complement on the RBC membrane

154

When the C antigen is on the opposite chromosome to D and the D is weakened, this is called _______

C in trans to Rh(D)

155

Given the following results, what is the likely explanation,

Anti-A: 2+

Anti-B: 0

Anti-D: 3+

A1C: 2+

BC: 4+

a. patient has colon cancer

b. patient has anti-Fya

c. patient is A2 with anti-A1

d. patient is demonstrating polyagglutination

c. patient is A2 with anti-A1

156

Anti-LW will react most strongly with:

a. adult Rh-positive RBCs

b. Rh-negative RBCs

c. Rh-null RBCs

d. Rh-negative cord blood

a. adult Rh-positive RBCs

157

Which of the following statements is FALSE:

a. anti-D usually stimulates complement

b. anti-D is mostly IgG

c. anti-D can cause hemolytic disease of the newborn

d. None of the above

a. anti-D usually stimulates complement

158

When a patient has Rh-null syndrome, what kind of packed RBCs need to be transfused?

ABO compatible Rh-null blood

159

An individual of the dce/dce genotype is given dCe/dce blood and has an antibody response that appears to be anti-C and anti-D. The most likely explanation for this is:

a. the antibody is anti-G

b. the anitbody is anti-partial D

c. the antibody is anti-Cw

d. there was an incorrect reading of the agglutination reactions

a. the antibody is anti-G

160