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Blood Bank - JD > Cumulative Blood Bank Questions > Flashcards

Cumulative Blood Bank Questions Flashcards

1
Q

Which metabolic pathway is responsible for generating 90% of the ATP for RBCs?

a. pentose phosphate shunt
b. Luebering-Rapaport shunt
c. glycolysis
d. methemoglobin reductase

A

c. glycolysis

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2
Q

Which of the following best describes “integral” membrane proteins?

a) resides at the cytoplasmic surface of membrane
b) spans the entire membrane surface
c) forms the red cell cytoskeleton
d) none of the above

A

b) spans the entire membrane surface

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3
Q

The RBC membrane is relatively permeable to all of the following except:

a) chloride
b) sodium
c) bicarbonate
d) water

A

b) sodium

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4
Q

Which metabolic pathway permits the accumulation of 2,3 DPG?

a) glycolysis
b) Luebering-Rapoport shunt
c) pentose phosphate shunt
d) methemoglobin reductase

A

b) Luebering-Rapoport shunt

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5
Q

The rate of globin synthesis is directly related to:

a) iron synthesis
b) oxygen synthesis
c) porphyrin synthesis
d) 2,3 DPG synthesis

A

c) porphyrin synthesis

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6
Q

All of the following are consistent with a “shift to the right” of the hemoglobin-oxygen dissociation curve except:

a) increased 2,3 DPG
b) 50% O2 saturation to tissues
c) decreased 2,3 DPG
d) decreased hemoglobin affinity for

A

c) decreased 2,3 DPG

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7
Q

What cryoprotective agent is added to the red cells upon freezing?

a) dextrose
b) adsol
c) glycerol
d) all of the above

A

c) glycerol

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8
Q

What is the major biochemical consideration in platelet storage?

a) glucose metabolism
b) oxygen supply
c) production of carbon dioxide
d) regulation of pH

A

d) regulation of pH

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9
Q

How many chromosomes do somatic cells of humans have?

a) 46
b) 50
c) 23
d) 100

A

a) 46

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10
Q

Which of the following must be true when using the Hardy-Weinberg equation?

a) the population must be large
b) mutations cannot occur
c) mating must occur randomly
d) all of the above

A

d) all of the above

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11
Q

Which of the following best describes the structure of human chromosomes?

a) linear strands of DNA wound around histones
b) linear strands of RNA wrapped around histones
c) tertiary structure of DNA wound around histones
d) quaternary structure of DNA wound around histones

A

a) linear strands of DNA wound around histones

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12
Q

In a pedigree analysis, what do vertical lines indicate?

a) consanguineous mating
b) offspring
c) stillbirth
d) deceased sibling

A

b) offspring

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13
Q

Which type of genetic change (mutation)is incapable of reverting back to the original phenotype?

a) duplication
b) deletion
c) recombinations
d) insertion

A

b) deletion

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14
Q

Alternate forms of a gene that can occur at a single chromosome locus are referred to as:

a) amorph
b) trait
c) alleles
d) recessive

A

c) alleles

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15
Q

A gene, such as the O gene, that produces no detectable product is called:

a) an amorph
b) a trait
c) an allele
d) recessive

A

a) an amorph

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16
Q

When an individual is said to have blood group A, it refers to the individual’s:

a) alleles on the chromosome
b) genotype
c) phenotype
d) haplotype

A

c) phenotype

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17
Q

Name a lymphoid organ in which cells of the immune system can be found?

a) thymus
b) bone marrow
c) spleen
d) all of the above

A

d) all of the above

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18
Q

What are the principle receptors for the Fc portion of immunoglobulin and the CR1 complement component, respectively?

a) IgM, C3b
b) IgG, C3b
c) IgG, C3d
d) IgM, C3d

A

b) IgG, C3b

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19
Q

How can T cells be differentiated from B cells?

a) secretion of interleukin-2
b) CD2 marker
c) agglutination of sheep erythrocytes
d) all of the above

A

d) all of the above

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20
Q

What is the definition of an immunoglobulin?

a) a protein molecule produced in response to an antigen
b) a protein molecule produced in response to an antibody
c) a substance that aids in the primary immune response
d) a substance that aids in the growth and proliferation of leukocytes

A

a) a protein molecule produced in response to an antigen

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21
Q

Which IgG subclass primarily comprises antibodies to the Rh blood group system?

a) IgG1, IgG2
b) IgG2, IgG4
c) IgG3, IgG4
d) IgG1, IgG3

A

d) IgG1, IgG3

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22
Q

IgG-coated red cells will be phagocytized by what effector cells?

a) monocytes/macrophages
b) T cells
c) eosinophils
d) basophils

A

a) monocytes/macrophages

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23
Q

Why is EDTA not conducive to complement activation?

a) Antigens are destroyed
b) Antibodies are neutralized
c) Calcium is inactivated
d) It dilutes plasma

A

c) Calcium is inactivated

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24
Q

All of the following are factors of antigens that affect the type and extent of immune response except:

a) solubility
b) charge
c) molecular weight
d) genetic locus

A

d) genetic locus

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25
Q

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

a) alloantibodies
b) autoantibodies
c) drug-induced antibodies
d) all of the above

A

a) alloantibodies

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26
Q

What Rh type does a mother have to be to produce antibodies to Rh (D) from an Rh positive infant?

a) O positive
b) Rh positive
c) Rh negative
d) Kell negative

A

c) Rh negative

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27
Q

In an immune response, _________ antibodes are formed before ________.

a) IgG, IgA
b) IgM, IgG
c) IgG, IgM
d) IgM, IgA

A

b) IgM, IgG

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28
Q

All of the following techniques are methods used in the laboratory to detect blood group antigens or antibodies except:

a) agglutination
b) precipitation
c) ELISA
d) hemolysis

A

c) ELISA

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29
Q

At what temperature do IgM antibodies react?

a) 22˚ C
b) 37˚ C
c) 56˚ C
d) 42˚ C

A

a) 22˚ C

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30
Q

What does the term “zeta potential” mean?

a) the ability of antigen to react with antibody
b) the attraction of positive charges on the red cell surface to negative charges in an ionic cloud
c) the attraction of negative charges on the surface of red cells to postive charges in an ionic cloud
d) the repulsion between red cells cased by noncovalent forces

A

c) the attraction of negative charges on the surface of red cells to postive charges in an ionic cloud

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31
Q

What is the purpose of the antihuman globulin (AHG) test in blood banking?

a) It detects red cells coated with antibody by bridging the gap between red cells
b) It detects white cells coated with antibody by bridging the gap between red cells
c) It detects red cells coated with antigen
d) all of the above

A

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

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32
Q

What function does chemically modified IgG serve?

a) It creates a pentameric structure to enhance binding
b) Dilsulfide bonds are reduced in the hinge region of IgG, which promotes flexibility of Fab portions
c) It alters the light chain variability portion of molecules
d) It dissociates the IgG molecules from surface of sensitized red cells

A

b) Dilsulfide bonds are reduced in the hinge region of IgG, which promotes flexibility of Fab portions

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33
Q

A patient with multiple myeloma exhibits rouleaux formation in an immediate spin crossmatch. What procedure is recommended to distinguish true red cell agglutination from nonspecific agglutination?

a) secretor studies
b) saline dilution
c) enzyme treatment
d) polyethylene glycol enhancement

A

b) saline dilution

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34
Q

At what age do infants begin to produce their own antibodies?

a) 1 week
b) 2 months
c) 6 months
d) 1 year

A

c) 6 months

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35
Q

“Complete” agglutinins that agglutinate red cells in saline are of which immunoglobulin class?

a) IgG
b) IgM
c) IgA
d) IgE

A

b) IgM

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36
Q

What type of globulin does the antiglobulin test detect?

a) IgG alloantibodies
b) IgG autoantibodies
c) C3b complement components
d) all of the above

A

d) all of the above

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37
Q

Why is incubation omitted in the direct AHG test?

a) Polyspecific AHG contains a higher dose of anti-IgG
b) Incubation will cause lysis of red cells
c) Incubation elutes complement components from red cells
d) In vivo antigen-antibody complex is already formed

A

d) In vivo antigen-antibody complex is already formed

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38
Q

What do “check cells” contain?

a) A+ red cell coated with anti-D
b) Rh (D)+ red cells coated with anti-D
c) Rh (D)- red cells coated with anti-D
d) B+ red cells coated with anti-D

A

b) Rh (D)+ red cells coated with anti-D

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39
Q

Why does anti-C3d activity require standardization in AHG reagents?

a) Low activity will fix anti-H and other clinically insignificant antibodies
b) high activity will fix anti-I and other clinically insignificant antibodies
c) It eliminates false negative reactions
d) two of the above

A

b) high activity will fix anti-I and other clinically insignificant antibodies

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40
Q

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

a) patient diagnosis
b) drug therapy
c) transfusion history
d) donation history

A

d) donation history

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41
Q

Saline used for blood banking tests should have a pH of_______.

a) 5.0 to 5.5
b) 6.8 to 7.2
c) 7.2 to 7.4
d) 7.5 to 8.0

A

c) 7.2 to 7.4

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42
Q

Anti-IgG is specific for what part of the IgG molecule?

a) Fc fragment
b) constant region of Fab fragment
c) hypervariable region of Fab fragment
d) kappa light chain

A

a) Fc fragment

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43
Q

An advantage of monoclonal anti-C3 over polyclonal anti-C3 is:

a) The antibody potency can be controlled
b) Contamination with anti-IgG is avoided
c) Antibody to immunoglobulin light chains is eliminated
d) False positives caused by cold agglutinins are avoided

A

a) The antibody potency can be controlled

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44
Q

What is the action of PEG?

a) reduces ionic strength to allow for faster antibody uptake
b) its macromolecules allow for closer contact of antibody-coated RBCs
c) increases the serum:cell ratio
d) removes water molecules, thereby concentrating antibody

A

d) removes water molecules, thereby concentrating antibody

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45
Q

Forward grouping is defined as:

a) detecting antibody on an individual’s red cells via reagent antisera
b) detecting antigen(s) on an individual’s red cells via reagent antisera
c) detecting ABO group antibody via reagent red cells
d) detecting ABO group antigen via reagent red cells

A

b) detecting antigen(s) on an individual’s red cells via reagent antisera

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46
Q

What percentage of the white population has type O blood?

a) 45%
b) 10%
c) 4%
d) 32%

A

a) 45%

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47
Q

Why is reverse grouping not performed on cord blood specimens?

a) Antigens are not present at birth
b) Antibodies are generally not present at birth
c) Antibody titer is too high
d) two of the above

A

b) Antibodies are generally not present at birth

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48
Q

Which of the following is unique to the ABO system when compared with other blood group systems?

a) Individuals have antibodies to antigens they lack without foreign stimulus
b) Antibodies are of IgM class
c) Antibodies are of IgG class
d) two of the above

A

a) Individuals have antibodies to antigens they lack without foreign stimulus

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49
Q

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

a) production of specific glycosyltransferases add sugars to precursor substances

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50
Q

What immunodominant sugar is responsible for H specificity?

a) D-galactose
b) L-fucose
c) N-acetyl-D-galactosamine
d) D-glucose

A

b) L-fucose

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51
Q

What does the hh genotype refer to?

a) Lewis
b) Sid
c) Bombay
d) Kell

A

c) Bombay

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52
Q

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

a) glycolipid
b) glycoprotein
c) sphingolipid
d) ceramide

A

b) glycoprotein

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53
Q

What substances are found in a group A secretor?

a) A, H
b) H
c) B, H
d) A, B, H

A

a) A, H

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54
Q

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

A

c) seed extracts that agglutinate human cells with moderate specificity

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55
Q

What percentage of the blood Type A white population is type A2?

a) 1%
b) 10%
c) 20%
d) 25%

A

c) 20%

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56
Q

What is the source of anti-H lectin?

a) Bandeiraea simplificifolia
b) Ulex europaeus
c) Dolichos biflorus
d) all of the above

A

b) Ulex europaeus

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57
Q

What is the most important use for anti-B lectin?

a) differentiating B1 from B2
b) differentiating secretors from nonsecretors
c) differentiating a true B from an acquired-like B
d) all of the above

A

c) differentiating a true B from an acquired-like B

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58
Q

All of the following are technical errors that could result in ABO discrepancies except:

a) sample misidentified
b) failure to warm reagents
c) failure to add reagents
d) clerical errors

A

b) failure to warm reagents

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59
Q

A patient was previously typed as blood group O. Forward grouping was negative with anti-A and anti-B. Reverse grouping showed reactivity with A1 cells and B cells. The technologist reported this patient’s type as A. What technical error occurred?

a) sample misidentified
b) failure to add reagents
c) clerical error
d) sample mix-up

A

c) clerical error

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60
Q

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

a) incubate patient serum and reagent cells for 15 minutes at room temperature
b) incubate patient serum and reagent cells for 15 minutes at 37˚ C
c) perform an antibody screen
d) incubate patient cells and patient serum for 15 minutes at room temperature

A

a) incubate patient serum and reagent cells for 15 minutes at room temperature

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61
Q

What testing is available that will differentiate between a true B and an acquired “B”?

a) anti-B lectin
b) acidification of anti-B reagent
c) secretor studies
d) all of the above

A

d) all of the above

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62
Q

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 and recentrifuged in an attempt to resolve the discrepancy?

a) serum
b) saline
c) water
d) LISS

A

b) saline

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63
Q

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

a) amorph
b) silent allele
c) absence of D
d) all of the above

A

d) all of the above

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64
Q

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

a) 85%
b) 15%
c) 98%
d) 30%

A

d) 30%

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65
Q

What does hr’ refer to in the Weiner nomenclature?

a) c
b) e
c) C
d) E

A

a) c

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66
Q

All of the following are consistent with International Society of Blood Transfusion (ISBT) terminology except:

a) A six digit number specifies each blood group antigen
b) 004 represents Rh group
c) D is written as “RH 1”
d) All genes are written in bold print

A

d) All genes are written in bold print

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67
Q

Where is the Rh antigen located relative to the red cell membrane?

a) integrally
b) peripherally
c) centrally
d) none of the above

A

a) integrally

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68
Q

Why is it acceptable for “C Trans” individuals to receive D-positive red cells?

a) the structure of the D antigen is complete
b) the Du is a result of steric complications
c) the Rh antigen on the red cell is normal
d) all of the above

A

d) all of the above

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69
Q

Why is determination of Rh status crucial for obstetric patients?

a) An Rh positive mother can form anti-D that will destroy D-postive red cells of fetus
b) All Rh positive mothers are possible candidates for Rh immune globulin
c) All Rh negative mothers are possible candidates for Rh immune globulin
d) An Rh negative mother can form anti-D if she gives birth to an Rh negative baby

A

c) All Rh negative mothers are possible candidates for Rh immune globulin

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70
Q

Which IgG subclasses carry the most significance with regard to Rh antibodies?

a) IgG1/IgG4
b) IgG2/IgG4
c) IgG3/IgG4
d) IgG1/IgG

A

d) IgG1/IgG

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71
Q

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 too heavy

A

c) rouleaux

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72
Q

All of the following may occur following an Rh-mediated hemolytic transfusion reaction except:

a) elevated fever
b) increased bilirubin
c) intravascular hemolysis
d) positive DAT

A

c) intravascular hemolysis

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73
Q

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

a) DcE/DCe
b) Dce/DCE
c) DCe/DcE
d) DCe/dCE

A

b) Dce/DCE

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74
Q

G antigen is present on all of which type of red cells?

a) D positive
b) C positive
c) E positive
d) two of the above

A

d) two of the above (D and C positive)

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75
Q

If a person has a genotype of LWa LWb, what is his or her phenotype?

a) LW (a+b-)
b) LW (a-b-)
c) LW (a+b+)
d) LW (a-b+)

A

c) LW (a+b+)

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76
Q

Which enzyme is responsible for Lewis specificity?

a) L-fucosyltransferase
b) N-acetylglycosyltransferase
c) D-galactosyltransferase
d) N-acetylgalactosyltransferase

A

a) L-fucosyltransferase

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77
Q

Lewis cell-bound antigens absorbed from plasma onto the red cell membranes are:

a) glycoproteins
b) glycolipids
c) sphingolipids
d) ceramides

A

b) glycolipids

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78
Q

How is Leb substance formed?

a) L-Fucose is added to subterminal N-acetylglucosamine of type 1 H substance
b) L-Fucose is added to subterminal N-acetylglucosamine of type 2 H substance
c) Lea and Leb are codominant alleles located on chromosome 19
d) Leb is secreted into plasma in the absence of fucosyltransferase

A

a) L-Fucose is added to subterminal N-acetylglucosamine of type 1 H substance

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79
Q

Approximately what percentage of the black population is [Le (a-b-)]?

a) 78%
b) 22%
c) 15%
d) 35%

A

b) 22%

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80
Q

Persons who inherit the Se and Le gene will have ________ A or B glycolipids in plasma than persons who are Se le.

a) more
b) less
c) inactive
d) none of the above

A

b) less

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81
Q

Which of the following may be a possible cause for the lack of expression of Lewis antigens during pregnancy?

a) increased ratio of plasma lipoproteins to red cell mass
b) decreased ratio of plasma lipoproteins to red cell mass
c) antigenic sites are blocked by IgG antibody
d) antigenic sites are blocked by IgM antibody

A

a) increased ratio of plasma lipoproteins to red cell mass

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82
Q

How does anti-Lea differ from anti-Leb?

a) Only anti-Lea will be produced in Le (a-b-) individuals.
b) Anti-Lea can bind complement more efficiently
c) Anti-Leb is an IgG antibody
d) Anti-Lea is an IgM antibody

A

b) Anti-Lea can bind complement more efficiently

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83
Q

Why is the Le system not implicated in hemolytic disease of the newborn (HDN)?

a) Lewis antigens are not well developed at birth
b) Lewis antibodies are IgG and cannot cross the placenta and cause HDN
c) Lewis antigens can readily dissociate from the red cell upon transfusion of Lewis-positive cells
d) Lewis antibodies do not bind complement

A

a) Lewis antigens are not well developed at birth

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84
Q

At which phase are Lewis antibodies usually detected?

a) immediate spin
b) 37˚ C
c) Coombs
d) all of the above

A

a) immediate spin

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85
Q

What substance would be present in the saliva of a person with the LeLe HH SeSe AA genotype?

a) A,H
b) A,B,H
c) H, B, Lea, Leb
d) A, H, Lea, Leb

A

d) A, H, Lea, Leb

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86
Q

Most blood group alleles are:

a) X-linked dominant
b) X-linked recessive
c) codominant
d) none of the above

A

c) codominant

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87
Q

What MN phenotype is found in highest frequency in the white population?

a) M+N+
b) M+N-
c) M-N-
d) M-N+

A

a) M+N+

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88
Q

Why are the M and N antigens important for paternity testing?

a) Antigens are well developed on father’s red cells
b) Antigens are poorly developed on mother’s cells
c) Antigens are well developed at birth
d) Antigens are fully developed at 2 years of age

A

c) Antigens are well developed at birth

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89
Q

What characteristic differentiates Ss antigens from MN antigens?

a) antigens well developed at birth
b) S and s exhibit dosage
c) enzyme degradation
d) biochemical structure rich in sialic acid

A

c) enzyme degradation

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90
Q

What can be done to rule in anti-M when only M+N+ red cells are available?

a) decrease the 37˚ C incubation time
b) use potentiating agents such as LISS
c) decrease the serum-to-cell ratio
d) use plasma anticoagulated in an acidic medium

A

c) decrease the serum-to-cell ratio

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91
Q

What is the etiology of dialysis-associated anti-N?

a) Formaldehyde alters the N antigen so that it is recognized as foreign
b) Most renal patients express the phenotype
c) M+N-S-s- were most potent forms of anti-N are found
d) none of the above

A

b) Most renal patients express the phenotype

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92
Q

The M and N antigens are found in which glycoprotein?

a) glycophorin A
b) glycophorin B
c) glycophorin C
d) band 3

A

a) glycophorin A

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93
Q

What does the “U” in U antigen stand for?

a) unusual
b) universal
c) uniform
d) unique

A

b) universal

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94
Q

All of the following are characteristics of the Ena antigen except:

a) It’s a high frequency antigen
b) It’s a low-frequency antigen
c) Individuals negative for Ena lack MN-SGP
d) Most Ena-negative individuals produce anti-Ena

A

b) It’s a low-frequency antigen

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95
Q

Autoantibodies to U antigen may be found in patients with:

a) paroxysmal cold hemoglobinuria
b) cold autoimmune hemolytic anemia
c) warm autoimmune hemolytic anemia
d) drug-induced hemolytic anemia

A

c) warm autoimmune hemolytic anemia

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96
Q

Persons who are genetically P1 may serologically type as P2 because of:

a) inheritance of the In (Lu) gene
b) inheritance of the p gene
c) presence of anti- P1 in their serum
d) depressed antigen expression

A

a) inheritance of the In (Lu) gene

97
Q

All of the following are characteristic of anti-P1 except:

a) Antibody is IgG
b) Antibody reacts strongly at room temperature
c) Antibody is not neutralized by soluble P1 substance
d) Antibody may be detected in AHG phase of antiglobulin test if polyspecific antiserum is used

A

c) Antibody is not neutralized by soluble P1 substance

98
Q

Why is hemolytic disease of the newborn (HDN) not a consideration when the mother possesses anti-P1 in her serum?

a) Anti-P1 is an IgM antibody
b) P1 antigen is poorly expressed at birth
c) Anti-P1 does not react at 37 degrees C
d) Anti-P1 is a naturally occurring antibody

A

b) P1 antigen is poorly expressed at birth

99
Q

The structures that carry the P antigens also carry which determinants?

a) A
b) I
c) B
d) all of the above

A

d) all of the above

100
Q

How is the Luke (LKE) system related to the P blood group system?

a) Anti-LKE reacts with all p individuals
b) Anti-LKE reacts with all P1 and P2 individuals
c) Persons who do not express the Luke antigen lack neuraminic acid
d) Luke-positive individuals occur more in persons who are group O

A

b) Anti-LKE reacts with all P1 and P2 individuals

101
Q

At birth, infant cells are rich in _______, and ________ is nearly undetectable.

a) I/i
b) I/H
c) i/I
d) none of the above

A

c) i/I

102
Q

All of the following is consistent with Benign anti-I except:

a) naturally occurring
b) IgM
c) do not bind complement
d) reactive at 4 degrees C

A

c) do not bind complement

103
Q

How can pathologic anti-I be differentiated from benign anti-I?

a) immunoglobulin class
b) binding of complement
c) broad thermal range of reactivity
d) all of the above

A

c) broad thermal range of reactivity

104
Q

A patient who has a pathologic autoanti-I must be transfused with a:

a) leukocyte filter
b) cold pack
c) blood warmer
d) none of the above

A

c) blood warmer

105
Q

Anti-i is found in association with what disease?

a) pneumonia
b) infectious mononucleosis
c) syphyllis
d) gonorrhea

A

b) infectious mononucleosis

106
Q

What will happen to I antigen expression when ABH sugars are removed from red cells?

a) increased expression
b) decreased expression
c) no effect
d) none of the above

A

a) increased expression

107
Q

The Ii antigens are found on the membranes of which structures?

a) platelets
b) leukocytes
c) red cells
d) all of the above

A

d) all of the above

108
Q

What is Kell’s antithetical partner?

a) Penney
b) Cellano
c) Sutter
d) Rautenberg

A

b) Cellano

109
Q

All of the following is true regarding the Kell antigen except:

a) well developed at birth
b) exhibits dosage
c) destroyed by ficin treatment
d) strongly immunogenic

A

c) destroyed by ficin treatment

110
Q

Why is it relatively easy to find compatible units for a patient with anti-K?

a) Kell is a low-frequency antigen
b) Kell is a high-frequency antigen
c) anti-K does not react at 37 degrees C
d) anti-K has a low avidity for its respective antigen

A

a) Kell is a low-frequency antigen

111
Q

At what phase of the antihuman globulin test will anti-Kell be detected?

a) IS
b) 37 degrees C
c) AHG
d) all of the above

A

c) AHG

112
Q

What biochemical observations signify a protein composition to the Kell antigens?

a) degradation with formaldehyde
b) inactivation at 56 degrees C
c) cell-membrane orientation
d) two of the above

A

b) inactivation at 56 degrees C

113
Q

What is the most common genetic combination in the Kell blood group system?

a) k K Kpb Jsb
b) k Kpb Jsa K11
c) k Kpb Jsb K11
d) K Kpb Jsb K11

A

c) k Kpb Jsb K11

114
Q

All of the following are grouped with the para-Kell antigens except:

a) K18
b) K11
c) K22
d) K14

A

b) K11

115
Q

What fatal disease is associated with the McLeod phenotype?

a) Graves’ disease
b) chronic granulomatous disease
c) lymphoma
d) Fanconi’s syndrome

A

b) chronic granulomatous disease

116
Q

What is the etiology of chronic granulomatous disease (CGD)?

a) muscular degeneration caused by a mutated X gene
b) phagocytes unable to generate hydrogen peroxide, which kills invading bacteria
c) alteration in red cell membrane allowing passage by bacteria
d) inability to generate leukocytes from the bone marrow

A

b) phagocytes unable to generate hydrogen peroxide, which kills invading bacteria

117
Q

Most Kell autoantibodies are directed against which antigens that are usually undefined?

a) low frequency
b) high frequency
c) soluble
d) leukocyte

A

b) high frequency

118
Q

Which population has the greatest frequency of the Fy(a-b-) phenotype?

a) white
b) black
c) Asian
d) Native American

A

b) black

119
Q

The homozygous phenotype Fy(a+b-) has _______ antigenic Fya sites than heterozygous cells, Fy(a+b+).

a) more
b) fewer
c) about the same
d) none of the above

A

a) more

120
Q

Duffy antigens are destroyed by:

a) AET
b) ficin
c) neuraminidase
d) two of the above

A

b) ficin

121
Q

What sequence of antigens coincides with strongest immunogen to weakest immunogen?

a) D, Fya, Fyb, K
b) D, K, Fya, Fyb
c) Fya, Fyb, D, K
d) K, Fya, Fyb, D

A

b) D, K, Fya, Fyb

122
Q

Why is dosage inconsistent in the Duffy blood group?

a) The genotype could be inherited as Fya Fybor FyaFy for Fy(a+b-) red cells
b) Antigens expression is depressed in low ionic strength media
c) The genotype could be inherited as FyaFya or FyaFy for Fy(a+b-) red cells
d) all of the above

A

c) The genotype could be inherited as FyaFya or FyaFy for Fy(a+b-) red cells

123
Q

Black persons who genotype as Fy5Fy5 will phenotype as:

a) Fy(a+b+)
b) Fy(a+b-)
c) Fy(a-b-)
d) Fy(a-b+)

A

c) Fy(a-b-)

124
Q

What are the antibody characteristics of Fy3, Fy4, and Fy5?

a) immunogenic
b) IgG
c) reactive at AHG
d) all of the above

A

d) all of the above

125
Q

In vitro studies using Plasmodium knowlesi showed the malaria merozoits failed to invade red cells when:

a) Fya antigen sites were blocked by antibody
b) Fyb antigen sites were blocked by antibody
c) antigenic sites were denatured by enzymes
d) all of the above

A

d) all of the above

126
Q

All of the following are characteristics of Kidd antibodies except:

a) IgG immunoglobulins
b) ability to bind complement
c) naturallly occurring
d) exhibit dosage

A

c) naturallly occurring

127
Q

Why is it strongly recommended to use only homozygous cells when ruling out Kidd antibodies?

a) Anti-Jka may appear compatible with homozygous cells [Jk(a+b-)]
b) Anti-Jka may appear compatible with heterozygous cells [Jk(a+b+)]
c) It will reduce the number of false positive results
d) two of the above

A

b) Anti-Jka may appear compatible with heterozygous cells [Jk(a+b+)]

128
Q

What sample requirement is essential for identification of a Kidd antibody?

a) fresh plasma
b) fresh serum
c) fasting sample
d) sample on ice

A

b) fresh serum

129
Q

When red cells are placed in a solution of 2M urea, the red cells will lyse. However, it has been showed that which red cells are resistant to lysis?

a) Jk(a+b-)
b) Jk(a+b+)
c) Jk(a-b-)
d) Jk(a-b+)

A

c) Jk(a-b-)

130
Q

What Kidd antibody will react with all panel cells and phenotype as Jk(a-b-)?

a) anti-Jka
b) anti-Jkb
c) anti-Jk3
d) none of the above

A

c) anti-Jk3

131
Q

What organism is capable of converting Jk(b-) red cells to Jk(b+)?

a) Escherichia coli
b) Micrococcus species
c) Proteus vulgaris
d) Streptococcus pneumoniae

A

b) Micrococcus species

132
Q

Why does anti-Lua go undetected in routine testing?

a) Anti-Lua demonstrates low avidity
b) Most reagent cells are Lu(a+)
c) Most reagent cells are Lu(a-)
d) two of the above

A

c) Most reagent cells are Lu(a-)

133
Q

The Lu3 antigen is present whenever:

a) Lua is present
b) Lua is absent
c) Lub is present
d) two of the above

A

d) two of the above

134
Q

Which of the following distinguishes the recessive LuLu gene from the dominant In(Lu) gene?

a) normal expression of P1
b) abnormal expression of P1
c) expression of the Lu(a-b-) phenotype
d) expression of trace amounts of i antigen

A

a) normal expression of P1

135
Q

All of the following is consistent with Xga antibody characteristics:

a) reactive at the IAT phase
b) IgM immunoglobulins
c) resistant to enzymes
d) always clinically significant

A

a) reactive at the IAT phase

136
Q

The Wright blood group antigens belong to which blood group system?

a) Wr
b) DI
c) DO
d) SC

A

b) DI

137
Q

Which statement is true concerning the Cartwright antigens?

a) The Ytb antigen is a strong immunogen
b) Cord blood tests as Yta negative
c) The Yta is inherited as a dominant allele
d) Ytb is a high-frequency antigen

A

b) Cord blood tests as Yta negative

138
Q

Which antigen is useful as a genetic marker for Mongolian derivation and anthropologic studies?

a) Yta
b) Dia
c) Xga
d) Doa

A

b) Dia

139
Q

The rarely encountered Scianna antibodies react in which phase of the antibody screen?

a) immediate spin
b) 37 degrees C
c) IgG
d) all of the above

A

c) IgG

140
Q

Which of the following is true concerning Colton antibodies?

a) encountered frequently
b) destroyed by enzymes
c) react at immediate spin
d) stimulated by red cell exposure

A

d) stimulated by red cell exposure

141
Q

Which antigen is expressed on C4B complement fragments?

a) Cha
b) Kna
c) Yka
d) Gya

A

a) Cha

142
Q

How does complement aid in the identification of alloantibodies masked by anti-Cha?

a) C4d in plasma will absorb anti-Cha
b) C3b in serum will absorb anti-Cha
c) C3d in plasma will absorb anti-Cha
d) C4a in plasma will absorb anti-Cha

A

a) C4d in plasma will absorb anti-Cha

143
Q

Bg antibodies are primarily directed toward antigenic determinants present on:

a) white blood cells
b) red blood cells
c) platelets
d) meso cells

A

a) white blood cells

144
Q

Absorption with commercial human platelet concentrate is effective for removing which antibodies?

a) anti-Ge
b) anti-Kn
c) anti-Di
d) anti-Bg

A

d) anti-Bg

145
Q

Antigens in the CH/RG blood group systems are described as:

a) resistant to ficin treatment
b) antithetical partners
c) well developed on cord cells
d) absorbed on to the red cell membrane

A

d) absorbed on to the red cell membrane

146
Q

What blood group antigens are involved in the regulation of complement because they are located on decoy accelerating factor?

a) CO
b) DO
c) CROM
d) IN

A

c) CROM

147
Q

What determines if a red blood cell antibody is clinically significant?

a) class of antibody (IgG or IgM)
b) shortened red blood cell survival
c) shortened white blood cell survival
d) shortened platelet survival

A

b) shortened red blood cell survival

148
Q

What is tested in an antibody screen?

a) Patient red cells are tested against group O reagent screening cells
b) Patient serum is tested against group AB reagent screening cells
c) Patient serum is tested against group O reagent screening cells
d) Patient serum is tested against group A reagent screening cells

A

c) Patient serum is tested against group O reagent screening cells

149
Q

Why are screening cells group O?

a) to prevent interference with anti-A and anti-B in patient serum
b) to prevent interference with A and B antigens on patient cells
c) because group O cells are easier to acquire in random populations
d) because group O cells contain antigens to clinically significant antibodies

A

a) to prevent interference with anti-A and anti-B in patient serum

150
Q

Antibodies in which of the following blood group systems are “notorious” for escaping detection on an antibody screen and cause a severe delayed hemolytic transfusion reaction when antigen positive red blood cells are transfused to a patient?

a) Kell
b) Rh
c) Duffy
d) Kidd

A

d) Kidd

151
Q

What screening cells are used primarily for testing donor units for unexpected antibodies?

a) pooled
b) 2-vial
c) 3-vial
d) 4-vial

A

a) pooled

152
Q

Why might some blood banking facilities prefer the use of monospecific IgG over polyspecific antihuman globulin (AHG) in their antibody screens?

a) Interference from naturally occurring warm antibodies in patient sera is reduced
b) Interference from naturally occurring cold antibodies in patient sera is reduced
c) There is more IgG in monospecific antisera than polyspecific reagents
d) Monospecific IgG has been standardized

A

b) Interference from naturally occurring cold antibodies in patient sera is reduced

153
Q

Which of the following is known as the “sensitization phase” in the antibody screen?

a) immediate spin
b) AHG
c) 37 degrees C incubation
d) none of the above

A

c) 37 degrees C incubation

154
Q

What makes up an autologous control?

a) patient serum and patient cells
b) patient serum and screening cells
c) patient cells and Rh control
d) none of the above

A

a) patient serum and patient cells

155
Q

A positive autocontrol in antibody detection procedures is usually indicative of:

a) inadequate washing
b) positive DAT
c) positive IAT
d) two of the above

A

b) positive DAT

156
Q

What might a positive antibody screen and a negative autocontrol indicate?

a) An alloantibody is coating donor cells after a transfusion
b) An autoantibody has been detected
c) An alloantibody has been detected
d) Drug-induced antibody reacting with patient cells

A

c) An alloantibody has been detected

157
Q

When should multiple antibodies be suspected in a positive antibody screen?

a) The autocontrol was positive
b) Cells react at different phases and strengths
c) Only the AHG phase is reactive
d) none of the above

A

b) Cells react at different phases and strengths

158
Q

In what test might rouleaux cause an interference?

a) DAT
b) forward ABO grouping
c) reverse ABO grouping
d) Rh control

A

c) reverse ABO grouping

159
Q

Why is it important to match the lot number on the panel sheet with the lot number on the panel cells?

a) The ABO group will change from lot to lot
b) Pattern of reactions will change from lot to lot
c) It is a requirement of the FDA
d) all of the above

A

b) Pattern of reactions will change from lot to lot

160
Q

Why should only homozygous cells be used to rule out an antibody?

a) homozygous cells carry a double dose of antibody
b) weakly reacting antibody may not react with heterozygous cells
c) strong reacting antibodies may not react with heterozygous cells
d) all of the above

A

b) weakly reacting antibody may not react with heterozygous cells

161
Q

If you suspect anti-C is present in a patient’s serum, and anti-Fya still has to be ruled out using other reagent cells, what would the phenotype of the rule out cell have to be?

a) Fy (a+), C-, Fy (b+)
b) Fy (a+), C-, Fy (b-)
c) Fy (a+), C+, Fy (b-)
d) Fy (a+), C+, Fy (b-)

A

b) Fy (a+), C-, Fy (b-)

162
Q

How would 4 units of red blood cells be found for a patient with antibodies to C, Fya, and Jkb?

a) chloroquine treat donor units to strip antigenic sites
b) random crossmatching patient’s sera followed by phenotyping compatible units of red blood cells
c) your blood supplier
d) b & c

A

d) b & c

163
Q

Tests with which AHG reagents can determine if IgG, complement, or both are coating red blood cells?

a) monospecific
b) polyspecific
c) standardized
d) irradiated

A

a) monospecific

164
Q

Which of the following is a mechanism of an elution procedure?

a) disruption of structural complementarity of antigen and antibody
b) enhancement of structural complementarity of antigen and antibody
c) exchange of one immunoglobulin class for another
d) denaturation of membrane epitopes by chemical means

A

a) disruption of structural complementarity of antigen and antibody

165
Q

What is the most common use of adsorption?

a) removal of plasma protein from patient serum
b) removal of alloantibody from patient serum
c) removal of autoantibody from patient serum
d) removal of drug-induced antibody from patient serum

A

c) removal of autoantibody from patient serum

166
Q

In what circumstances would an alloadsorption be performed?

a) warm autoantibody in serum
b) hemolytic disease of the newborn (HDN)
c) multiple antibodies in serum
d) hemolytic transfusion reaction

A

c) multiple antibodies in serum

167
Q

How can neutralization aid in the identification of multiple antibodies?

a) Once antibody has been neutralized serum can be further tested in panel studies
b) Neutralization inhibits all warm autoantibodies
c) Neutralized serum can be used to phenotype patient cells
d) all of the above

A

a) Once antibody has been neutralized serum can be further tested in panel studies

168
Q

What test is used to confirm efficacy of chloroquine treatment?

a) IAT
b) DAT
c) ABO grouping
d) neutralization test

A

b) DAT

169
Q

Why are antibodies to high-frequency antigens, such as cellano (k), rarely seen in patient samples?

a) Most persons are not antigenically stimulated to produce the antibody because their red blood cells are negative for the antigen
b) Most persons are not antigenically stimulated to produce the antibody because their red blood cells are positive for the antigen
c) anti-k has low avidity
d) Most reagent cells are heterozygous for cellano

A

b) Most persons are not antigenically stimulated to produce the antibody because their red blood cells are positive for the antigen

170
Q

What would be a realistic source of finding compatible units for a person with an antibody to a high-frequency antigen?

a) random donor units
b) a donor of similar ethnic background
c) siblings
d) apheresis donors

A

c) siblings

171
Q

Which of the following high-frequency antigens do not cause in vivo red blood cell destruction when complexed with corresponding antibody?

a) k
b) Jsb
c) Cha
d) Lub

A

c) Cha

172
Q

Which of the following statements are correct concerning cold antibody screens?

a) patient serum is incubated with group O adult and cord reb blood cells at 4 degrees C
b) patient serum is incubated with group O adult and cord reb blood cells at 37 degrees C
c) patient serum is incubated with check cells at 18 degrees C
d) patient serum is incubated with group A cord cells at room temperature

A

a) patient serum is incubated with group O adult and cord reb blood cells at 4 degrees C

173
Q

A person has developed an antibody to the LISS reagent. What test will not be affected by this circumstance?

a) major ACT crossmatch
b) IAT
c) DAT
d) antibody screen

A

c) DAT

174
Q

Why can’t autoadsorption be performed on a patient who was transfused 1 month before?

a) Only IgM antibody would be present at 1 month
b) Donor cells might adsorb out autoantibody in serum
c) Patient cells might adsorb out alloantibody in serum
d) Donor cells might adsorb out alloantibody in serum

A

d) Donor cells might adsorb out alloantibody in serum

175
Q

What is the purpose of treating serum containing cold autoantibodies with dithiothreitol (DTT) or 2-mercaptoethanol (2-ME)?

a) to denature IgG alloantibody and test serum for presence of IgM autoantibody
b) to denature IgM cold autoantibody and test serum for presence of IgM alloantibody
c) to denature IgM cold autoantibody and test serum for presence of IgG alloantibody
d) to denature IgM drug-induced antibody and test serum for presence of IgG alloantibody

A

c) to denature IgM cold autoantibody and test serum for presence of IgG alloantibody

176
Q

What test must be performed on a patient with a warm autoantibody in their serum before transfusing?

a) prewarming
b) warm autoadsorption
c) elution
d) DAT

A

b) warm autoadsorption

177
Q

In hemolytic disease of the newborn (HDN), the IgG antibodies are directed against which antigen on the fetal red blood cells?

a) maternal
b) paternal
c) bacterial
d) viral

A

b) paternal

178
Q

In hemolytic disease of the newborn (HDN), once D-positive fetal cells become sensitized by maternal anti-D, what system is responsible for their destruction and removal from circulation?

a) maternal reticuloendothelial system
b) fetal complement system
c) fetal reticuloendothelial system
d) maternal complement system

A

c) fetal reticuloendothelial system

179
Q

The D-positive fetal cells in Rh-HDN are _______.

a) homozygous
b) heterozygous
c) amorphic
d) homologous

A

b) heterozygous

180
Q

Besides the Rh antibodies, what other red blood cell antibody is known to cause severe hemolytic disease of the newborn (HDN)?

a) anti-M
b) anti-Lea
c) anti-K
d) anti-Fyb

A

c) anti-K

181
Q

What life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepatomegaly and splenomegaly?

a) Thalassemia
b) Sickle cell anemia
c) Hereditary Persistence of Fetal Hemoglobin
d) Hydrops Fetalis

A

d) Hydrops Fetalis

182
Q

What is the physiologic path of indirect bilirubin produced as a result of red blood cell destruction in hemolytic disease of the newborn (HDN)?

a) Indirect bilirubin is transported across the placenta and excreted via maternal kidneys.
b) Indirect bilirubin is conjugated in the fetal liver to direct bilirubin
c) Indirect bilirubin crosses the placenta and is conjugated in the maternal liver to direct bilirubin
d) none of the above

A

c) Indirect bilirubin crosses the placenta and is conjugated in the maternal liver to direct bilirubin

183
Q

Which of the following antibodies have not been known to cause hemolytic disease of the newborn (HDN)?

a) anti-C
b) anti-S
c) anti-D
d) anti-Lea

A

d) anti-Lea

184
Q

Anti-D in the serum of a third trimester pregnant woman with a titer of 16 is indicative of:

a) RhIg
b) active immunization
c) passive immunization
d) none of the above

A

b) active immunization

185
Q

Anti-Kell was identified in the serum of a woman during prenatal screening. An antibody titer was determined to be 32. At 20 weeks’ gestation, a serum titer was done and determined to be 64. What procedure is now indicated based on these findings?

a) amniocentesis
b) exchange transfusion
c) percutaneous umbilical blood sampling
d) two of the above

A

d) two of the above

186
Q

How is an intrauterine transfusion performed?

a) Red blood cells (RBCs) are injected into the placenta
b) RBCs are injected into the fetal peritoneal cavity
c) RBCs are injected into the maternal peritoneal cavity
d) RBCs are injected into the mother and diffused through the placenta to the fetus

A

b) RBCs are injected into the fetal peritoneal cavity

187
Q

Why is reverse grouping omitted in neonate ABO grouping?

a) Maternal ABO antibody is identical to newborn ABO antibody
b) Maternal antibodies mask the ABO antibodies of the neonate
c) Newborns do not produce isoagglutinins of their own
d) none of the above

A

c) Newborns do not produce isoagglutinins of their own

188
Q

Why are premature newborns more likely to require exchange transfusions, than full-term infants?

a) Premature newborns are deficient in carrier protein (albumin) for bilirubin transport
b) Premture newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin
c) Premature newborn livers are too underdeveloped to conjugate bilirubin
d) none of the above

A

c) Premature newborn livers are too underdeveloped to conjugate bilirubin

189
Q

How are units for exchange transfusion prepared?

a) group O red cells and group O plasma
b) group O red cells and group A plasma
c) group O red cells and group AB plasma
d) group O red cells and group B plasma

A

c) group O red cells and group AB plasma

190
Q

When is the antenatal dose of RhIg given?

a) 20 weeks
b) 13 weeks
c) 28 weeks
d) 36 weeks

A

c) 28 weeks

191
Q

Which of the following best describes the principle of the Kleihauer-Betke test?

a) D-positive indicator cells form rosettes around maternal Rh-positive red cells
b) D-positive indicator cells form rosettes around fetal Rh-positive red cells
c) Maternal hemoglobin is resistant to acid (alkali) appearing pink, where fetal cells appear as ghost cells
d) Fetal hemoglobin is resistant to acid (alkali) and appear pink, where maternal red cells appear as ghost cells

A

d) Fetal hemoglobin is resistant to acid (alkali) and appear pink, where maternal red cells appear as ghost cells

192
Q

Due to a short supply of O-negative packed cells, a Rh-negative patient was transfused with 1 unit of Rh-positive red cells. Calculate the number of RhIg vials needed to protect against 250 mL of Rh-positive packed cells.

a) 5
b) 17
c) 10
d) 23

A

b) 17

193
Q

All of the following are characteristic of ABO hemolytic disease of the newborn (HDN) except:

a) Mother is group O
b) Mother has anti-A, B
c) The antibody is IgM
d) Infant has mild HDN

A

c) The antibody is IgM

194
Q

Which red blood cell morphology is most characteristic of in ABO hemolytic disease of the newborn (HDN), and absent in Rh HDN?

a) target cells
b) tear drop cells
c) microsphereocytes
d) burr cells

A

c) microsphereocytes

195
Q

In which type of hemolytic disease of the newborn (HDN), the first-born is affected?

a) ABO
b) Rh
c) Lewis
d) P

A

a) ABO

196
Q

A cord blood specimen from a jaundiced infant should be tested for which of the following?

a) ABO
b) Rh
c) DAT
d) all of the above

A

d) all of the above

197
Q

Mixing patient serum and donor red cells together and observing for direct cell lysis or agglutination is known as:

a) the Donath-Landsteiner test
b) a minor crossmatch
c) a major crossmatch
d) an autohemolysis test

A

c) a major crossmatch

198
Q

What does compatibility testing include?

a) ABO, Rh, antibody screen, major crossmatch
b) ABO, Rh, DAT, major crossmatch
c) ABO, antibody screen, major crossmatch, elution
d) ABO, Rh, antibody screen, minor crossmatch

A

a) ABO, Rh, antibody screen, major crossmatch

199
Q

Why are hemolyzed samples unacceptable for compatibility testing?

a) agglutination reactions will be undetectable
b) IgG activation by antigen-antibody complexes will be masked
c) Complement activation by antigen-antibody complexes will be masked
d) Hemolyzed samples inhibit antibody binding

A

c) Complement activation by antigen-antibody complexes will be masked

200
Q

How long after a transfusion must donor and recipient samples be stored at 1 to 6 degrees C?

a) 7 days
b) 5 days
c) 10 days
d) 14 days

A

a) 7 days

201
Q

All of the following antibodies are clinically significant except:

a) anti-C
b) anti-K
c) anti-Fya
d) anti-Bga

A

d) anti-Bga

202
Q

Why is it necessary to use single-donor screening cells instead of pooled screening cells for patient samples?

a) Pooled screening cells are devoid of Duffy antigens
b) Single-donor screening cells are free from HIV infection
c) Single-donor screening cells are complementary among each other
d) none of the above

A

c) Single-donor screening cells are complementary among each other

203
Q

What alternative type can be given to an O-positive person when group O blood is not available?

a) A packed cells
b) B packed cells
c) AB packed cells
d) none

A

d) none

204
Q

In what circumstances would it be feasible to transfuse Rh-positive blood to an Rh-negative individual?

a) in a teenager with anti-D in his sera
b) during an emergency cesarean section
c) in an elderly woman
d) none of the above

A

c) in an elderly woman

205
Q

Which statement best describes the relation between a crossmatch and a compatibility test?

a) They are identical
b) If a compatibility test was a pie, a crossmatch would be a slice
c) If a crossmatch was a house, a compatibility test would be a room
d) A crossmatch is a confirmation of the compatibility test

A

b) If a compatibility test was a pie, a crossmatch would be a slice

206
Q

Why was the minor crossmatch discontinued?

a) Too many cold autoantibodies were being detected
b) The only product being made from donors was packed red blood cells, and plasma was residual
c) Donor screening for antibody was incorporated into donor processing
d) none of the above

A

c) Donor screening for antibody was incorporated into donor processing

207
Q

What is an abbreviated crossmatch?

a) a minor crossmatch
b) a type and screen plus an immediated spin crossmatch
c) a type and screen plus a minor crossmatch
d) a type and screen plus an immediate spin crossmatch using pooled screening cells

A

b) a type and screen plus an immediated spin crossmatch

208
Q

What is an “electronic” crossmatch?

a) a data base compiled by the American Red Cross for rare phenotype accessibility
b) comparison of donor and patient ABO groups and serologic data from a computer file
c) a crossmatch performed in microtiter plates and read by a spectrophotometer
d) all of the above

A

b) comparison of donor and patient ABO groups and serologic data from a computer file

209
Q

All of the following may be used as potentiators in the antiglobulin crossmatch except:

a) papain
b) albumin
c) LISS
d) PeG

A

a) papain

210
Q

When performing an Antiglobulin crossmatch, the cells had a jagged edge appearance after the addition of AHG and centrifugation. This indicates a(n) ______ result.

a) positive
b) negative
c) inconclusive
d) none of the above

A

a) positive

211
Q

Recipients serum which reacted with one out of five donor units in the AHG phase and where the antibody screen was negative is probably due to:

a) an alloantibody directed against a high-frequency antigen
b) an alloantibody directed against a low-frequency antigen
c) an alloantibody coating the recipient cells
d) an ABO mismatch

A

b) an alloantibody directed against a low-frequency antigen

212
Q

Passive acquisition of anti-A, B, AB may occur through:

a) RhIG injection
b) bacterial injection
c) bone marrow transplantation
d) hepatitis vaccination

A

c) bone marrow transplantation

213
Q

What causes rouleaux to form?

a) antibody-coated cells
b) abnormal A/G ratio
c) shortened incubation
d) electrolyte imbalance

A

b) abnormal A/G ratio

214
Q

Which of the following is true regarding blood issued on an emergency basis without patient testing?

a) The patient sample is tested for only ABO and Rh at a later time
b) Units are tagged for emergency release and no further testing is done
c) Units are tagged for emergency release and segments are pulled for later testing
d) The medical technician must authorize the emergency transfusion

A

c) Units are tagged for emergency release and segments are pulled for later testing

215
Q

How can the ABO and Rh of the fetus be determined in utero?

a) amniocentesis
b) chorionic villus sampling
c) percutaneous umbilical cord sampling
d) all of the above

A

d) all of the above

216
Q

All of the following may be used for the antibody screen before transfusing an infant except:

a) maternal serum
b) infant serum
c) paternal serum
d) infant eluate

A

c) paternal serum

217
Q

What may be added to samples from patients taking heparin to induce clotting?

a) protamine sulfate
b) antithrombin III
c) reptilase
d) fibrinogen

A

a) protamine sulfate

218
Q

What tests are not required on autologous units transfused within the collecting facility?

a) ABO
b) Rh
c) antibody screen
d) two of the above

A

c) antibody screen

219
Q

Why is the transfusion product tagged before it is issued and transfused?

a) to identify the patient
b) to verify compatibility results
c) to verify the donor number
d) all of the above

A

d) all of the above

220
Q

What blood-banking research product hopes to provide oxygen-carrying capacity without the need for compatibility testing?

a) red blood cell stroma
b) hemoglobin substitutes
c) liquid agglutination
d) solid phase adherence

A

b) hemoglobin substitutes

221
Q

In which department of the blood bank laboratory would blood be issued for transfusion?

a) component preparation and storage
b) donor processing
c) main laboratory
d) reference laboratory

A

c) main laboratory

222
Q

What additive is used to freeze blood for long-term storage at -65 degrees C?

a) glycerol
b) glycine
c) glutamic acid
d) dextran

A

a) glycerol

223
Q

To maximize the number of components made from whole blood, processing must occur within how many hours of collection?

a) 1 hour
b) 8 hours
c) 12 hours
d) 24 hours

A

b) 8 hours

224
Q

Tests performed on donors (ABO, Rh, antibody screen, viral testing) are only performed on first donations.

a) true
b) false

A

b) false

225
Q

The most common procedure for a donor’s antibody screen utilizes:

a) Type O screening cells (2 donors)
b) Type O screening cells (3 donors)
c) Type AB screening cells (3 donors)
d) autologous cells

A

b) Type O screening cells (3 donors)

226
Q

All of the following viral tests are required for donor processing except:

a) HBsAg
b) CMV
c) anti-HIV
d) anti-HTLV-I

A

b) CMV

227
Q

Which of the following would lead to nonacceptance of a blood bank specimen?

a) initials of phlebotomist not on specimen
b) a patient name spelled incorrectly
c) an erroneous social security number
d) all of the above

A

d) all of the above

228
Q

What test (s) are involved when a physician orders a 4-unit crossmatch on a patient?

a) IS crossmatch
b) AHG crossmatch
c) ABO, Rh, antibody screen, IS crossmatch
d) ABO, Rh, DAT, IS crossmatch

A

c) ABO, Rh, antibody screen, IS crossmatch

229
Q

What tests are indicated for cord blood specimens if the mother has made anti-K?

a) ABO, Rh, Antibody screen
b) ABO, Rh, DAT
c) ABO, Rh, cold auto absorption
d) Kleihauer-Betke

A

b) ABO, Rh, DAT

230
Q

All of the following procedures might be done in an investigation of an ABO discrepancy except:

a) increasing incubation time for reverse grouping
b) secretor studies
c) neutralization studies with urine
d) testing with anti-A1 lectin

A

c) neutralization studies with urine

231
Q

When performing an antibody screen by gel technology, the following steps are eliminated:

a) AHG reagent, control checked cells
b) saline wash, control check cells
c) cells I and II, saline wash
d) centrifugation, saline wash

A

b) saline wash, control check cells

232
Q

A layer of red cell agglutinates at the top of the gel microtubes and a pellet of unagglutinated red cells at the bottom. These findings are comparable to which of the following reactions in the test tube?

a) negative
b) weak positive
c) mixed field
d) invalid

A

c) mixed field

233
Q

The gel system has all of the following advantages over the traditional tube procedure except:

a) standardization in reading technique
b) stability of the test reaction
c) replicability of the test results
d) different grading system

A

d) different grading system

234
Q

The washing procedure is applicable to which of the following serologic methods:

a) solid phase and tube system
b) gel technology and solid phase
c) solid phase and affinity column
d) gel technology and tube system

A

a) solid phase and tube system

235
Q

The technology that uses proteins G and A instead of AHG reagent is called:

a) gel test
b) affinity column
c) solid phase
d) none of the above

A

b) affinity column

236
Q

The diluent that is used to make the red cell reagents for the affinity column technology is _______, and the final concentration of the red cell reagents are ________.

a) hypertronic saline/3% to 5%
b) hypotronic saline/3% to 5%
c) high ionic strength/0.8%
d) low ionic strength/0.8%

A

d) low ionic strength/0.8%

237
Q

Adherence of IgG sensitized red cells to an immunologically active matrix is characteristic of:

a) solid phase
b) gel technology
c) affinity column technology
d) tube system

A

c) affinity column technology

238
Q

In performing an antibody screen by solid phase technique, a monolayer of red cells is formed at the top of microplate wells following the addition of indicator cells. This result should be interpreted as:

a) negative
b) mixed field
c) positive
d) weak positive

A

c) positive

239
Q

Which of the following are licensed additive solutions approved for the storage of red cells at 1 to 6˚ C for 42 days?

a) Adsol (AS-1)
b) Nutricel (AS-3)
c) Optisol (AS-5)
d) all of the above

A

d) all of the above

Blood Bank - JD (16 decks)

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