Elsevier ISBB Flashcards by Karl Dashley Atinen

Natural barriers of the immune system include all except which of the following?

a. pH of secretions
b. Coughing
c. Hair follicles
d. Intestinal bacteria

c. Hair follicles

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The fundamental difference between primary and secondary organs of the lymphatic system is:

a. Antibody production occurs only in the primary lymph organs
b. Complement production occurs only in the primary lymph organs
c. Maturation of lymphocytes occurs in secondary organs, and activation occurs in primary organs
d. Maturation of lymphocytes occurs in primary organs, and activation occurs in secondary organs

d. Maturation of lymphocytes occurs in primary organs, and activation occurs in secondary organs

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Toll-like receptors act in which way?

a. Enhance recognition of bacteria by phagocytic cells
b. Activate B cells to produce antibody
c. Activate helper T cells
d. Aid in processing antigen in the form of an MHC molecule

a. Enhance recognition of bacteria by phagocytic cells

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Neutrophils and monocytes have receptors for which part of the immunoglobulin molecule?

a. Fc
b. Fab
c. Hinge region
d. Variable region

a. Fc

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One B-cell marker of early-stage B-cell development is _____, whereas ____ is a marker for later stages of B-cell development.

a. CD20; CD10
b. CD21; CD10
c. CD10; CD20
d. CD19; CD10

c. CD10; CD20

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A double-positive T cell would express which markers?

a. CD4+CD8+CD3+
b. CD4-CD8+CD3+
c. CD4-CD8-CD3-
d. CD4+CD8-CD3+

a. CD4+CD8+CD3+

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Which cell is considered to be a bridge between the innate and adaptive immune systems?

a. NK cell
b. Mast cell
c. Monocyte-macrophage
d. T cell

a. NK cell

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_______ are involved in cell-mediated immunity, whereas _______ are involved in humoral immunity.

a. T cells; B cells
b. T cells; antibodies
c. B cells; T cells
d. A and B

d. A and B

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Antigens that make very good immunogens include which of the following?

a. Carbohydrates
b. Proteins
c. Both a and b
d. Neither a or b

b. Proteins

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The function of the complement system include(s) which of the following?

a. Clearance of cellular debris
b. Chemotaxis
c. Lysis of bacteria
d. All of the above

d. All of the above

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When C3 is cleaved by C3 convertase, what is the result?

a. C3a is released
b. C3b is used as an opsonin
c. C3b is combined with other complement proteins to form C5 convertase
d. All of the above

d. All of the above

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Characteristics of cytokines include which of the following?

a. They can have a pleomorphic effect
b. Cytokines are redundant
c. Cytokines enhance cellular differentiation of lymphocytes
d. All of the above

d. All of the above

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Immunoglobulin idiotypes are antibodies with variations in the domains of which of the following?

a. CH1 and CH2
b. VH and VL
c. VH and CL
d. CH1, CH2, and CH3

b. VH and VL

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Mannose-binding lectin is similar to which component of the classical pathway?

a. C3
b. C2
c. C1q
d. C5a

c. C1q

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A patient with a viral infection to the ABC virus is found to have a high antibody titer to the ABC virus’s RNA, or anti-ABCr. Which of the following is true?

a. MHC class I molecules presented antigen to CD4+Tcells
b. MHC class II molecules presented antigen to CD8+Tcells
c. MHC class I molecules presented antigen to CD8+ T cells
d. MHC class II molecules presented antigen to CD4+Tcells

c. MHC class I molecules presented antigen to CD8+ T cells

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What is the main difference between agglutination and precipitation reactions?

a. Agglutination occurs between a soluble antigen and antibody
b. Agglutination occurs when the antigen is particulate
c. Precipitation occurs when the antigen is particulate
d. Precipitation occurs when both antigen and anti- body are particulate

b. Agglutination occurs when the antigen is particulate

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Postzone causes false-negative reactions in antibody titers as a result of which of the following?

a. Too much diluent added to test
b. Excess antibody in test
c. Excess antigen in test
d. Incorrect diluent added to test

c. Excess antigen in test

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Antibodies produced against two or more epitopes of specific antigen are considered ____________.

a. Monoclonal
b. Pleomorphic
c. Dimorphic
d. Polyclonal

d. Polyclonal

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In the radial immunodiffusion test, the gel contains which of the following?

a. The antigen to be tested
b. Antibody
c. Patient sample
d. None of the above; the gel is the medium to which the antibody and antigen are applied in equal proportion

b. Antibody

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Which statement is true regarding the radial immunodiffusion test?

a. The area of the precipitin ring is directly proportional to the concentration of antigen in the sample
b. The area of the precipitin ring is directly proportional to the concentration of antibody in the sample
c. The area of the precipitin ring is directly proportional to the concentration antibody and the antigen in the sample
d. The area of the precipitin ring indicates a partial identity to the antibody in the sample

a. The area of the precipitin ring is directly proportional to the concentration of antigen in the sample

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The indirect antiglobulin test is for ______________, whereas the direct antiglobulin test is for__________.

a. Serum antigen; bound antigen
b. Serum antigen; bound antibody
c. Serum antibody; bound antigen
d. Serum antibody; bound antibody

d. Serum antibody; bound antibody

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In an indirect immunofluorescent antibody test for CMV antibodies, the conjugated antibody used for visualizing is:

a. Antihuman globulin conjugated to a fluorescent dye
b. Anti-CMV antibody conjugated to a fluorescent dye
c. CMV virus conjugated to a fluorescent dye
d. Antihuman globulin conjugated to an enzyme

a. Antihuman globulin conjugated to a fluorescent dye

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What is the difference between nephlometry and turbidimetry?

a. There is no difference between the two assays, only in name
b. Nephlometry is a newer example of turbidimetry
c. Nephlometry measures light transmitted through a solution, and turbidimetry measures light scattered in a solution
d. Nephlometry measures light scattered in a solution, and turbidimetry measures light transmitted through a solution

d. Nephlometry measures light scattered in a solution, and turbidimetry measures light transmitted through a solution

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In an Ouchterlony immunodiffusion, the line of precipitation between the antibody and the antigen wells forms an X. This reaction would be described as which of the following?

a. Nonidentity
b. Partial identity
c. Identity

a. Nonidentity

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An initial titer of 4 followed by a subsequent titer of 16 for the same patient, drawn 2 weeks later, is indicative of which of the following? a. Infection b. Convalescence c. Past exposure d. No exposure

a. Infection

A deficiency of T cells can result in which of the following? a. Low levels of complement b. Dysfunctional macrophages c. Fewer B cells maturing to plasma cells d. Contact dermatitis

c. Fewer B cells maturing to plasma cells

A 2-week-old baby is seen for a possible infection with CMV. Which of the following statements is false? a. A positive anti-CMV result from baby’s specimen is inconclusive b. An initial titer of anti-CMV IgG would need to be established c. A positive result for anti-CMV IgM would indicate infection d. All are false statements

b. An initial titer of anti-CMV IgG would need to be established

What is the basic difference between the RPR and VDRL tests? a. The RPR detects antigen, whereas the VDRL detects antibody b. The RPR test is read macroscopically, where as the VDRL is read microscopically c. The RPR test is a treponemal test, whereas the VDRL is nontreponemal d. There is no difference because they are both specific tests for syphilis

b. The RPR test is read macroscopically, where as the VDRL is read microscopically

A patient has the following hepatitis B serology: HBsAg: Negative Anti-HBc: Positive Anti-HBS: Positive These results are consistent with which of the following? a. Acute hepatitis B b. Chronic hepatitis B c. Recovery from hepatitis B d. Acute hepatitis A

c. Recovery from hepatitis B

The HLA genes are inherited as: a. Diplotypes: Two diplotypes from each parent b. Haplotypes: One haplotype from each parent c. HLAs are not inherited, instead are proteins absorbed onto cells d. Only the HLA-A antigen is an inheritable trait

b. Haplotypes: One haplotype from each parent

Agglutination and precipitation that is visible depends on antigen–antibody ratios ________. a. With antigen in excess b. With antibody in excess c. That are equivalent d. All of the above

c. That are equivalent

Which of the following cell types is implicated in immediate hypersensitivity? a. Neutrophil b. Mast cell c. Macrophage d. Monocyte

b. Mast cell

Anti-dsDNA antibodies are associated with which of the following? a. Syphilis b. CMV infection c. Systemic lupus erythematosus d. Hemolytic anemia

c. Systemic lupus erythematosus

Rheumatoid factor is typically an IgM autoantibody with specificity for which of the following? a. SS-B b. Double-stranded DNA c. Ribonucleoprotein d. Fc portion of IgG

d. Fc portion of IgG

All of the following are auto immune diseases except: a. Rheumatoid arthritis b. Rh disease of the fetus and newborn c. Grave’s disease d. Myasthenia gravis

b. Rh disease of the fetus and newborn

In Grave’s disease, one of the main autoantibodies is: a. Anti-CCP b. Antibody to islet cells of pancreas c. Antibody to thyroid-stimulating hormone receptor d. Anti-dsDNA

c. Antibody to thyroid-stimulating hormone receptor

An auto antibody found in patients with Hashimoto’s thyroiditis reacts with which of the following? a. TSH receptor b. Islet cells c. CRP d. Thyroglobulin

d. Thyroglobulin

Skin testing for exposure to tuberculosis is an example of which type of hypersensitivity? a. Type I b. Type II c. Type III d. Type IV

d. Type IV

Which of the following is a test for specific treponemal antibody? a. VDRL b. RPR c. FTA-ABS d. All of the above

c. FTA-ABS

Serum tested positive for HBsAg and anti-HBc IgM. The patient most likely has which of the following? a. Acute hepatitis C b. Chronic hepatitis B c. Acute hepatitis B d. Acute hepatitis A

c. Acute hepatitis B

The main difference between leukemias and lymphomas is which of the following? a. Leukemias are malignancies of cells in the bone marrow b. Lymphomas are maligniancies of cells in the bone marrow c. Lymphomas are classified as either acute or chronic d. Leukemias are malignancies in lymphoid tissue

a. Leukemias are malignancies of cells in the bone marrow

A 1-year-old boy is seen for having many recurrent infections with Streptococcus pneumoniae. Laboratory tests revealed a normal quantity of T cells, but no B cells and no immunglobulins were seen on electrophoresis. Which of the following would most likely be the cause? a. Chronic granulotomatous disease b. Bruton’s agammaglobulinemia c. DiGeorge’s syndrome d. Wiskott-Aldrich syndrome

b. Bruton’s agammaglobulinemia

A patient with hereditary angiodema has which of the following deficiencies? a. C5-9 b. Phagocytic cell function c. Mature B cells d. C1 Inhibitor

d. C1 Inhibitor

A radiograph of a1-year-old boy indicates the lack of a thymus. Complete blood count and flow cytometry confirm a below-normal lymphocyte count and a lack of T cells. Which of the following would most likely be the cause? a. DiGeorge’s syndrome b. Wiskott-Aldrich syndrome c. Bare lymphocyte syndrome d. Bruton’s agammaglobulinemia

a. DiGeorge’s syndrome

Severe combined immunodeficiency is characterized by which of the following? a. Diagnosed in infancy b. Shortened life span c. No antibody production d. All of the above

d. All of the above

A 3-year-old boy is seen by his physican because of many recent bacterial infections. Flow cytometery indicates normal levels of T and B cells. The nitroblue tetrazolium test for oxidative reduction is negative. The most likely cause is: a. Wegener’s syndrome b. Chronic granulomatous disease c. Bruton’s agammaglobulinemia d. Diabetes mellitus

b. Chronic granulomatous disease

A 25-year-old man was seen by his physican for recurrent infections. Immunoelectrophoresis revealed hypogammaglobulinemia. This man most likely has which of the following? a. Bruton’s agammaglobulinemia b. Common variable immunodeficiency c. X-linked agammaglobulinemia d. DiGeorge’s syndrome

b. Common variable immunodeficiency

In which disease would you expect to see an IgM spike on electrophoresis? a. Transient hypogammaglobulinemia of infancy b. Wiskott-Aldrich syndrome c. Leukocyte adhesion disease d. Waldenstro ̈m’s macroglobulinemia

d. Waldenstro ̈m’s macroglobulinemia

A person has an infected bug bite with pain, swelling, and redness. What is the cause of these physical symptoms of inflammation? a. Production of antibody b. Secondary immune response c. Increased blood flow and neutrophils to site d. Activation of NK cells

c. Increased blood flow and neutrophils to site

The type of graft rejection that occurs within minutes of a tissue transplant is ____________. a. Acute b. Chronic c. Hyperacute d. Accelerated

c. Hyperacute

Which immunodominant sugar confers A antigen specificity? a. D-Galactose b. L-Fucose c. N-Acetylgalactosamine d. Both A and C

c. N-Acetylgalactosamine

If a patient has an A2 ABO type, which of the follow- ing statements is true? a. The patient’s red cells will react with anti-A1 lectin b. The patient’s serum will react with A2 cells c. The patient’s red cells will react with anti-A2 lectin d. The patient’s serum will react with A1 cells if anti-A1 is present

d. The patient’s serum will react with A1 cells if anti-A1 is present

Which genotype confers the Bombay blood type? a. Hh b. hh c. Sese d. Lele

b. hh

Which genes encode for Rh antigens? a. RHDCE b. RHD c. RHCE d. Both b and c

d. Both b and c

Testing for the D antigen was conducted at the IAT phase. A control was included in the testing. Both the patient’s red cells and the control tube reacted at 4+. How would you interpret this test? a. The test is invalid because the control tube was positive b. The patient is D positive c. The patient is D negative d. The test should be repeated and the control tube omitted

a. The test is invalid because the control tube was positive

Of the red cells listed, which has the most D antigen present? a. Rh null b. D positive c. dce/dce d. D- -

d. D- -

Which is true of the Duffy blood group system? a. Antigens are resistant to enzyme treatment b. Antibodies never show dosage c. Fya and Fyb are codominant alleles d. The majority of whites are Fy(a-b-)

c. Fya and Fyb are codominant alleles

Which antibody is typically considered to be an auto-antibody if found in the serum of an adult? a. Anti-K b. Anti-I c. Anti-D d. Anti-Fya

b. Anti-I

Which reagent destroys all of the Kell blood group system antigens? a. DTT b. Chloroquine diphosphate c. AHG d. LISS

a. DTT

Which is true of antibodies to Kidd blood group system antigens? a. They are enhanced by enzymes b. Titers can quickly drop in patients c. Both A and B d. None of the above

c. Both A and B

Which of the following is true of the Lewis system? a. Lewis antigens are found on type II precursor cells b. Lewis antigens are well developed at birth c. Antibodies to Lewis antigens always cause HTRs d. Antibodies to Lewis antigens rarely cross the placenta

d. Antibodies to Lewis antigens rarely cross the placenta

Which of the following is true of antibodies to MNS blood group system antigens? a. Anti-U is directed at a high-incidence antigen b. Anti-N is commonly found c. Anti-M is always clinically significant d. Anti-S is reactive with enzyme-treated cells

a. Anti-U is directed at a high-incidence antigen

Which of the following antibodies is classified as “biphasic” and an autoantibody? a. Anti-B b. Anti-P c. Anti-H d. Anti-Lea

b. Anti-P

You have performed an antibody screen using the tube method. All three screening cells tested negative. The Coombs check cells in all three tubes are also nonreactive. What should you do? a. Respin the tubes and reread them b. Report the antibody screen as negative c. Repeat the antibody screen d. Perform an antibody identification panel

c. Repeat the antibody screen

An antibody panel has six 2+ reactive cells at AHG phase. Panel testing using enzyme-treated cells showed no reactivity. Which is the most likely anti- body that is present? a. Anti-Fya b. Anti-e c. Anti-k d. Anti-Lua

a. Anti-Fya

A patient has a currently nonreactive antibody screen but has a history of anti-Jka in the patient file. Which type of crossmatch must be performed on this patient? a. Immediate spin crossmatch b. IAT crossmatch c. Electronic crossmatch d. Both a and c

b. IAT crossmatch

A recently transfused patient has a 3+ reactive DAT with anti-IgG. Which procedure should be used to identify the specificity of the IgG antibody attached to the red cells? a. Adsorption b. Neutralization c. Titration d. Elution

d. Elution

An O-negative mother gave birth to an O-positive baby. Her rosette test was positive. Which of the fol- lowing is true? a. The test is invalid because of the mother’s ABO type b. A Kleihauer-Betke test should be performed to quantify the fetal maternal hemorrhage c. The mother should be given a 300-mg dose of RhIG d. A weak D test should be performed on the baby

b. A Kleihauer-Betke test should be performed to quantify the fetal maternal hemorrhage

In which of the following settings are platelet transfusions not indicated? a. Thrombotic thrombocytopenic purpura b. Immune thrombocytopenic purpura with severe intracranial hemorrhage c. Massive transfusion d. Vascular catheter placement, platelet count 24,000/mL e. Brain biopsy, platelet count 62,000/mL

a. Thrombotic thrombocytopenic purpura

An obstetric patient presents to the hospital with marked vaginal bleeding and severe lower abdominal pain. During placement of an intravenous catheter, she was noted to have marked oozing. She is diag- nosed with disseminated intravascular coagulation as a complication of her primary problem. She is given cryoprecipitate and fresh frozen plasma before going to the operating room. What element of cryoprecipitate is important in treating this patient? a. Factor I b. Factor II c. Factor VIII:c d. Factor VIII:vWF e. Factor XIII

a. Factor I

A patient’s ABO blood type is determined by which of the following? a. Genetic inheritance and environmental factors b. Genetic inheritance c. Environmental factors d. Immune function e. Maternal blood type

b. Genetic inheritance

A trauma patient with type AB is seen at a rural hospital. The hospital only has 3 units of type AB RBCs. What blood type of RBCs can the patient receive as an alternative? a. Type O b. Type B c. Type A d. None of the above e. All of the above

e. All of the above

A genetic state in which no detectable trait exists is called: a. Recessive b. Dominant c. Incomplete dominance d. Amorph

d. Amorph

Most blood group antigens are expressed as a result of which of the following? a. Autosomal recessive inheritance b. X-linked dominant inheritance c. Y-linked recessive inheritance d. Autosomal codominant inheritance

d. Autosomal codominant inheritance

What blood type is not possible for the offspring of AO and BO parents? a. AB b. A or B c. O d. All are possible

d. All are possible

How many molecules of IgM are needed to fix complement? a. 1 b. 2 c. 3 d. 4

a. 1

For lysis of red blood cells to occur after antigen– antibody reaction, which compound is required? a. Albumin b. Glucose-6-phosphate dehydrogenase (G6PD) c. Complement d. Antihuman globulin (AHG)

c. Complement

An end-point of tube testing other than agglutination that must also be considered a positive reaction is called: a. Clumping b. Mixed field c. Hemolysis d. Microscopic

c. Hemolysis

Mixed-field (mf) agglutination can be observed in the: a. DAT on a person undergoing delayed hemolytic transfusion reaction b. IAT result of a patient who has anti-Lea c. DAT on a patient on high doses of penicillin d. Typing result with anti-A of a patient who is A2 subgroup

a. DAT on a person undergoing delayed hemolytic

In which situation(s) may the ABO serum grouping not be valid? a. The patient has hypogammaglobulinemia b. IgM antibodies are present c. Cold autoantibodies are present d. All of the above

d. All of the above

If you knew the DAT is positive, what would you expect the Rh control to be when doing a weak D test through AHG? a. Negative b. Positive c. Mixed field d. Hemolysis at 37C would be seen

b. Positive

How can IgG antibodies be removed from red cells? a. Elution b. Adsorption c. Prewarming d. Neutralization

a. Elution

Testing needs to be done with an antiserum that is rarely used. The appropriate steps to take in using this antiserum include following the manufacturer’s procedure and: a. Performing a cell panel to be sure that the antiserum is performing correctly b. Performing the testing on screen cells c. Testing in duplicate to ensure the repeatability of the results d. Testing a cell that is negative for the antigen and one that is heterozygous for the antigen

d. Testing a cell that is negative for the antigen and one that is heterozygous for the antigen

Based on the following antigram, which cell is heterozygous for M? DCEcEMNSsP1 LeaLebKkFyaFybJkaJkb 1 0+0+++++00+00+0+0+ 2 ++00+0+0++0+0++++0 3 00++++0+++00+++0++ a. Cell 1 b. Cell 2 c. Cell 3 d. None of the above

a. Cell 1

Which antibody can be neutralized with a specific reagent? a. Anti-D b. Anti-Jka c. Anti-M d. Anti-Lea

d. Anti-Lea

Group O red blood cells are used as a source of com- mercial screening cells because: a. Anti-A is detected using group O cells b. Anti-D reacts with most group O cells c. Weak subgroups of A react with group O cells d. ABO antibodies do not react with group O cell

d. ABO antibodies do not react with group O cell

The use of EDTA samples for the direct antiglobulin test prevents activation of the classical complement pathway by: a. Causing rapid decay of complement proteins b. Chelating Mg2+ ions, preventing assembly of C6 c. Chelating Ca2+ ions, preventing assembly of C1 d. Preventing chemotaxis

c. Chelating Ca2+ ions, preventing assembly of C1

Check (Coombs control) cells are: a. Added to every negative antiglobulin test b. Added to negative direct antiglobulin tests only c. Used to confirm a positive Coombs’ reaction d. Coated with both IgM and C3d

a. Added to every negative antiglobulin test

What type(s) of red cells is(are) acceptable to transfuse to an AB-negative patient? a. A negative, B negative, AB negative, O negative b. O negative only c. AB negative only d. AB negative, A negative, B negative only

a. A negative, B negative, AB negative, O negative

A nonbleeding adult of average height and weight with chronic anemia is transfused with 2 units of red blood cells. The pretransfusion Hgb is 7.0 g/dL. What is the expected posttransfusion Hgb? a. 8 g/dL b. 9 g/dL c. 10 g/dL d. 11 g/dL

b. 9 g/dL

An IgA-deficient patient with clinically significant anti-IgA requires which of the following? a. Leukocyte-reduced fresh frozen plasma b. CMV-seronegative RBCs c. Irradiated RBCs and platelets d. Washed RBCs

d. Washed RBCs

Anti-H will react weakest with blood from a person with _____________. a. Group O b. Group A1 c. Group A2 d. Group A2B

b. Group A1

Which of the following antibodies do not match the others in terms of optimal reactive temperature? a. Anti-Fya b. Anti-M c. Anti-K d. Anti-S

b. Anti-M

What antibody can an R1r patient make if transfused with R2R2 blood? a. Anti-D b. Anti-C c. Anti-E d. Anti-c e. Anti-e

c. Anti-E

What is the probability of finding blood negative for the Jka and Fya antigens (23% of population is Jk [a-] and 34% of population is Fy[a-])? a. 5.1% b. 51% c. 7.8% d. 78%

c. 7.8%

If the following patient’s RBCs were tested against anti-H lectin and did not react, this person would be identified as a(an): Anti-A: 0 Anti-B: 0 A1 cells: 4+ B cells: 4+ SCI: (IS: 4+), (37C LISS: 4+), (AHG:4+) SCII: (IS: 4+), (37C LISS: 4+), (AHG:4+) Autocontrol: (IS: 0), (37C LISS: 0), (AHG:0), (Check cells: 2+) a. Acquired B b. Secretor c. Oh phenotype d. Subgroup of A

c. Oh phenotype

If a person has the genetic makeup Hh, AO, LeLe, sese, what substance will be found in the secretions? a. A substance b. H Substance c. Lea substance d. Leb substance

c. Lea substance

Before A and B antigens can be expressed, the precursor substance must have the terminal sugar _______________. a. d-Galactose b. N-Acetylgalactosamine c. Glucose d. L-Fucose

d. L-Fucose

A white female’s RBCs gave the following reactions: D+, C+, E-, c+, e+. The most probable Rh genotype is: a. DCe/Dce b. DCe/dce c. DCe/DcE d. Dce/dCe

b. DCe/dce

If a D-positive person makes anti-D, this person is most likely: a. Partial D b. D negative c. Weak D as position effect d. Weak D because of transmissible gen

a. Partial D

A serum containing anti-k is not frequently encoun- tered because of which of the following? a. People who lack the k antigen are rare b. People who possess the k antigen are rare c. The k antigen is not a good immunogen d. Kell-null people are rare

a. People who lack the k antigen are rare

A characteristic of the Xga antigen is that the Xga antigen: a. Has a higher frequency in women than in men b. Has a higher frequency in men than in women c. Is enhanced by enzymes d. Is usually a saline reacting an

a. Has a higher frequency in women than in men

Which of the following is a characteristic of the Kidd system antibodies? a. The antibodies are usually IgM b. The corresponding antigens are destroyed by enzymes c. The antibodies are usually strong and stable during storage d. The antibodies are often implicated in delayed hemolytic transfusion reactions

d. The antibodies are often implicated in delayed hemolytic transfusion reactions

Anti-E will react with which of the following cells? a. RoRo b. R1R1 c. R2R2 d. rr

c. R2R2

Which statement is not true concerning anti-Fya and anti-Fyb? a. Are clinically significant b. React well with enzyme-treated panel cells c. Cause hemolytic transfusion reactions d. Cause a generally mild hemolytic disease of the newborn

b. React well with enzyme-treated panel cells

Which of the following antibodies can be neutralized with pooled human plasma? a. Anti-Hy and anti-Ge:1 b. Anti-Cha and anti-Rga c. Anti-Coa and anti-Cob d. Anti-Doa and anti-Jsb

b. Anti-Cha and anti-Rga

Donors who have received RBC transfusion within the last 12 months are deferred because: a. Blood could transmit hepatitis or HIV b. Donor red cell hemoglobin level may be too low c. Donor health would prohibit the donation process d. There will be two cell populations in this donor

a. Blood could transmit hepatitis or HIV

Autologous presurgical donations are not allowed for which of the following patients? a. Weigh less than 100 lb b. Under the age of 14 c. With hemoglobin of 13 g/dL d. With bacteremia

d. With bacteremia

Which of the following viruses resides exclusively in leukocytes? a. HCV b. HBV c. CMV d. HIV

c. CMV

Which product is least likely to transmit hepatitis? a. Cryoprecipitate b. Plasma protein fraction c. RBC d. Platelets

b. Plasma protein fraction

In preparing platelets from a unit of whole blood, the correct order of centrifugation is: a. Hard spin followed by a hard spin b. Light spin followed by a light spin c. Light spin followed by a hard spin d. Hard spin followed by a light spin

c. Light spin followed by a hard spin

Which antibody could cause hemolytic disease of the fetus and newborn? a. Anti-I b. Anti-K c. Anti-Lea d. Anti-N

b. Anti-K

A group A, D-negative obstetric patient with anti-D (titer 256) is carrying a fetus who needs an intrauterine transfusion. The blood needed should be: a. Group A, D-negative RBC b. Group A, D-negative whole blood c. Group O, D-negative RBC d. Group O, D-negative whole blood

c. Group O, D-negative RBC

Which of the following mothers should receive RhIG? a. A-negative mother; O-negative baby; no prenatal care, anti-D in mother b. AB-negative mother; B-positive baby; anti-D in mother c. O-negative mother; A-positive baby; no anti-D in mother d. A-positive mother; A-positive baby; no anti-D in mother

c. O-negative mother; A-positive baby; no anti-D in mother

How many doses of RhIG are indicated for a Kleihauer-Betke reading of 0.6%? a. 1 b. 2 c. 3 d. 4

b. 2

What should be done first if a mother types as O and the baby types as AB? a. Report the results with no further testing b. Try to get a sample from the father c. Recheck all labels, get new samples, if necessary, and retest d. Retype using all new reagents

c. Recheck all labels, get new samples, if necessary, and retest

A newborn has a positive DAT. What is the best procedure to determine the antibody causing a positive DAT in this newborn? a. An antibody titer on the mother’s serum b. An antibody panel on the mother’s serum c. An antibody panel performed on the eluate of the mother’s cells d. An antibody panel performed on the eluate of the baby’s cells

b. An antibody panel on the mother’s serum

Which of the following is(are) an example(s) of a record-keeping error? a. Use of correction fluid or tape b. Using pencil c. Documentation after the fact d. All of the above

d. All of the above

Which of the antigens below is considered low incidence? a. Fya b. S c. C d. Kpa

d. Kpa

Which of the antigens below is considered high incidence? a. Fyb b. Vel c. E d. S

b. Vel

In performing tube testing, you see many medium- sized agglutinates in a clear background. How would you grade this reaction? a. 2+ b. 1+ c. 4+ d. 3+

a. 2+

Of the following, which genotypes would result in the B phenotype? a. BB b. AB c. BO d. a and b e. a and c

e. a and c

How would you interpret the following reactions? Forward Type Anti-A: 0 Anti-B: 0 Reverse Type A1 cells: 4+ B cells: 4+ a. Blood type A b. Blood type O c. Blood type B d. Blood type AB

b. Blood type O

Noting these reactions, if they patient needed blood now, what type of blood should be transfused? Forward Type Anti-A: 4+ Anti-B: 0 Reverse Type A1 cells: 1+ B cells: 4+ a. Blood type A b. Blood type O c. Blood type A2 d. Blood type A

b. Blood type O

Blood group antibodies made by type A and type B people are predominantly which class? a. IgE b. IgA c. IgG d. IgM

d. IgM

Based on these reactions, what should be the next step? Forward Type Anti-A: 4+ Anti-B: 0 Reverse Type A1 cells: 1+ B cells: 4+ a. Test the serum with A2 cells b. Report the patient as type A c. Test the cells with anti-A1 lectin d. Both a and c e. Request a new specimen

d. Both a and c

A “directed donor” unit of blood is defined as a unit of blood from a person who gives blood for: a. Relief of polycythemia or other blood disorder b. His or her specific use only c. First-degree blood relative d. Another person he or she has specified

d. Another person he or she has specified

Before the patient can receive a directed donation unit, the patient requires which of the following tests to be completed? a. Type and screen only b. Type and screen and compatibility testing c. Retype of patient and donor unit d. No additional testing is required

b. Type and screen and compatibility testing

An 18-year-old female with a hematocrit of 38%, temperature of 37C, and blood pressure of 175/ 90 mm Hg presents for whole blood donation. Based on this information, would you accept, permanently defer (PD), or temporarily defer (TD) the donor? a. Accept b. TD, blood pressure is too high for a person of her age c. TD, temperature is too high d. PD, for all values listed

a. Accept

A 63-year-old man with a hemoglobin value of 130 g/dL and pulse of 80 beats/min, who received human pituitary growth hormone (PGH) when he was 10 years old, presents for whole blood donation. Based on this information, would you accept, permanently defer (PD,) or temporarily defer (TD) the donor? a. Accept the donor b. TD, because of the human PGH c. PD, because of the human PGH d. PD, because of the high hemoglobin value

c. PD, because of the human PGH

A 38-year-old female weighing 153 lb, who received the rubella vaccine 2 months previously, presents to donate whole blood. She also received 2 units of packed cells after the delivery of her eighth child 8 weeks ago. Based on this information, would you accept, permanently defer (PD), or temporarily defer (TD) the donor? a. Accept the donor b. TD because of the packed cells 8 weeks ago c. PD because of receiving blood products d. TD because of the rubella vaccine

b. TD because of the packed cells 8 weeks ago

A 22-year-old female with a cousin with AIDS who had taken aspirin the day before and with needle marks on both arms presents to donate whole blood. Based on this information, would you accept, permanently defer (PD), or temporarily defer (TD) the donor? a. PD, needle marks on both arms b. TD, needle marks on both arms c. PD, cousin with AIDS d. TD, because of the aspirin

a. PD, needle marks on both arms

Each unit of blood must be tested for all of the following except: a. Anti-HIV 1/2 b. HBsAg c. Anti-HCV d. Antigen to HCV

d. Antigen to HCV

The principle of the HBsAg test is to detect which of the following? a. Antigen in patient’s plasma b. Antigen on the patient’s RBCs c. Antibody in patient’s serum d. Antigen and antibody in patient’s serum

a. Antigen in patient’s plasma

Cryoprecipitate is prepared by first thawing: a. Fresh frozen plasma at 1to 6C, and then doing a cold centrifugation to pack the cryoprecipitate to the bottom so the plasma may be removed b. Fresh frozen plasma at room temperature, then placing in the freezer for 2 hours, then centrifuging and removing the cryoprecipitate c. Cryoprecipitate at 1to 6C, then pooling the thawed cryoprecipitate in batches of 10 units, then quickly refreezing d. Cryoprecipitate at room temperature, then centrifugation in the cold to concentrate the cryoprecipitate to the bottom before adding more plasma to reconstitute

a. Fresh frozen plasma at 1to 6C, and then doing a cold centrifugation to pack the cryoprecipitate to the bottom so the plasma may be removed

Platelets must be kept in constant motion for which of the following reasons? a. Maintain the pH so the platelets will be alive before transfusion b. Keep the platelets in suspension and prevent clumping of the platelets c. Mimic what is going on in the blood vessels d. Preserve the coagulation factors and platelet viability

a. Maintain the pH so the platelets will be alive before transfusion

After thawing and pooling cryoprecipitate for transfusion to a patient, the product should be stored at: a. Room temperature b. 1 to 6C c. 37C d. 0C

a. Room temperature

Fresh frozen plasma must be thawed at which temperature? a. 1 to 6C b. Room temperature c. 37C d. 40C or higher

c. 37C

Frozen red blood cells are prepared for transfusion by thawing at: a. Room temperature and then washing with saline b. 37C in a water bath and then washing with different concentrations of saline c. 37C control incubator and then mixing well before transfusion d. 1 to 6C for 2 days and then washing with different concentrations of dextrose

b. 37C in a water bath and then washing with different concentrations of saline

Which is the most likely reason frozen deglycerolized red blood cells would be used? a. A patient with antibodies to a high-frequency antigen b. Pregnant women requiring intrauterine transfusions c. Emergency transfusion situations d. Group AB Rh-negative patients

a. A patient with antibodies to a high-frequency antigen

One indication for transfusion of thawed/pooled cryoprecipitate would be replacement of which of the following? a. Factor X in hemophiliacs b. Factor VIII in massively transfused patients c. Fibrinogen d. Volume

c. Fibrinogen

A contraindication for transfusing red blood cells to a patient is if the patient: a. Is massively bleeding b. Has well-compensated anemia c. Has bone marrow failure d. Has decreased red blood cell survival

b. Has well-compensated anemia

Concerning the component and the required quality control results, which of the following is a true statement? a. FFP must have 80 international units of fibrinogen in 7 units tested b. Cryoprecipitate must have 80 international units of factor VIII c. Leukocyte-reduced red blood cells must have fewer than 3.3x10^11 WBCs in each unit d. Platelets must have no red blood cells

b. Cryoprecipitate must have 80 international units of factor VIII

Fresh frozen plasma must be stored at: a. Colder than -18C for no longer than 1 year from donation b. Colder than -38C for no longer than 1 year from donation c. Exactly -18C for no longer than 1 year from donation d. -18C to-38C for up to10 years from donation

a. Colder than -18C for no longer than 1 year from donation

The storage temperature for packed red blood cells is a. 1 to 10C b. 1 to 4C c. 1 to 6C d. 20 to 25F

c. 1 to 6C

Platelets made from a single whole blood donation should contain which of the following? a. 3x10^11 platelets in 90% of samples b. 3.3x10^9 platelets in 75% of samples c. 5.5x10^10 platelets in 90% of samples d. 10x10^10 platelets in 75% of samples

c. 5.5x10^10 platelets in 90% of samples

Frozen red blood cells must be stored at __________________. a. 180C or less b. 18C or less c. 32C or less d. 65C or less

d. 65C or less

The temperature for incubation of the indirect anti- globulin test (IAT) should be ____________. a. 24C b. 6C c. 37C d. 37+/- 10C

c. 37C

The temperature of a blood refrigerator without a continuous recording device should be recorded: a. Daily b. Every 4 hours c. Once every 24 hours d. Every 30 minutes

b. Every 4 hours

When should quality control be performed on routine blood typing reagents? a. At the beginning of each shift b. Once daily c. Weekly d. Only when opening a new vial

b. Once daily