Final Exam Flashcards by Jessica Hawkins

What red cell morphology is indicative of globin denaturation caused by increased intracellular oxidants?

a) bite cells
b) spherocytes
c) Heinz bodies
d) target cells

C) Heinz bodies

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What would the hemoglobin (oxygen dissociation curve depict in a patient exhibiting clinical signs of alkalosis?
Question 2 options:

a) normal
b) shift to the left
c) shift to the right
d) none of the above

B) Shift to the left

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Which of the following best describes the process of mitosis?
Question 3 options:

a) cell division by which only half of the daughter cells produced are identical to the parent cell
b) cell division of germ cells by which two successive divisions of the nucleus produce cells that contain half the number of chromosomes of somatic cells
c) cell division that produces four daughter cells (4n)
d) cell division that produces two daughter cells having the same number of chromosomes as the parent

D) Cell division that produces two daughter cells having the same number of chromosomes as the parent

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Which of the following best describes the principle of polymerase chain reaction (PCR)?
Question 4 options:

a) migration of proteins in an electrical field
b) amplification of RNA using two oligonucleotide primers that hybridize to opposite DNA strands
c) amplification of DNA using two oligonucleotide primers that hybridize to opposite DNA strands, isolating a particular segment
d) enzymatic cleavage of proteins for DNA sequencing

C) Amplification of DNA using two oligonucleotide primers that hybridize to opposite DNA strands, isolating a particular segment

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Gel electrophoresis is a useful tool in DNA cloning. At a neutral pH when voltage is applied DNA fragments will migrate toward the anode because:
Question 6 options:

a) DNA is positively charged due to its phosphate backbone.
b) DNA is positively charged due to its glycine backbone.
c) DNA is negatively charged due to its glycine backbone.
d) DNA is negatively charged due to its phosphate backbone.

D) DNA is negatively charged due to its phosphate backbone

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These are described as bacterial circular genetic elements that replicate independently from the chromosome and are capable of conferring bacterial resistance to certain antibiotics in DNA cloning.
Question 7 options:

a) extrons
b) plasmids
c) codons
d) introns

B) Plasmids

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All of the following are examples of recombinant proteins used in transfusion medicine, except:
Question 8 options:

a) G-CSF
b) Stem cell factor
c) Epoetin-alpha
d) Factor VIII

B) Stem cell factor

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Extravascular hemolysis occurs when red cells are coated with antibody; what organ sequesters these cells?
Question 9 options:

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

B) Reticuloendothelial system

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Which IgG subclass primarily comprises antibodies to the Rh blood group system?
Question 10 options:

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

B) IgG1, IgG3

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What does hemolysis represent in an antigen-antibody reaction?

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

b) a positive result

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

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

a.) genetic locus

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How is the classical pathway of complement activated?

a) by binding of antigen with antibody
b) by polysaccharides on the surface of bacteria
c) by enzyme catalysis
d) by lipopolysaccharides on surface of red cells

a) by binding of antigen with antibody

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Which metabolic pathway permits the accumulation of 2,3 DPG?
Question 4 options:

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

b) Luebering-Rapoport shunt

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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 growth and proliferation of leukocytes
d) a substance that aids in the primary immune response

a) a protein molecule produced in response to an antigen

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How would a negative IAT be demonstrated in solid phase methodology?

a) cells form a monolayer
b) pellet at bottom of well
c) small agglutinins at bottom of well
d) well turns orange

b) pellet at bottom of well

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Why is the 37øC reading omitted when using PEG additive?

a) Antibodies detected by PEG do not react at 37°C.
b) PEG may cause aggregation of RBCs at 37°C
c) Unwanted reactions due to C3b will be detected at 37°C.
d) Warm-reacting antibodies are not clinically significant.

b) PEG may cause aggregation of RBCs at 37°C

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a) recentrifuge tubes
b) addition of one drop of AHG
c) repeat the antibody screen
d) addition of one drop of control cells

c) repeat the antibody screen

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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

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

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What percentage of the type A population are A1?

a) 20%
b) 80%
c) 10%
d) 50%

b) 80%

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All of the following are tests performed in the blood bank to classify subgroups of A except:

a) elution
b) anti-H Lectin reactivity
c) absorption
d) LISS enhancement

d) LISS enhancement

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

a) AB
b) AA
c) BB
d) all of the above

d) all of the above

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Forward grouping is defined as:

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

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

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What does the term “exalted D” refer to?

a) deletion of the D antigen
b) stronger expression of Ee antigens when D is missing
c) stronger expression of D antigens when Cc and Ee are missing
d) stronger expression of Cc antigens when D is missing

c) stronger expression of D antigens when Cc and Ee are missing

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All of the following are true regarding Rh antibodies except:

a) An individual with a low titer Rh antibody may experience a secondary immune response on antigen exposure.
b) Rh antibodies can bind complement on the red cell membrane.
c) Red cell destruction is usually extravascular.
d) Rh antibodies may cause a delayed hemolytic transfusion reaction.

b) Rh antibodies can bind complement on the red cell membrane.

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A gene, such as the O gene, that produces no detectable product is called: a) an amorph b) an allele c) recessive d) a trait

a) an amorph

Which red cell preservative has a storage time of 35 days? a) CPDA-1 b) ACD c) CPD d) AS-1

a) CPDA-1

What would the hemoglobin (oxygen dissociation curve depict in a patient exhibiting clinical signs of alkalosis? a) normal b) shift to the left c) shift to the right d) none of the above

b) shift to the left

Alternate forms of a gene that can occur at a single chromosome locus are referred to as: a) amorph b) alleles c) recessive d) trait

b) alleles

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

d) all of the above

When an individual is said to have blood group A, it refers to the individual's: a) haplotype b) genotype c) phenotype d) alleles on the chromosome

c) phenotype

What is responsible for recognition of the antibody-binding site to homologous antigen? a) variable region of light/heavy chain b) complementarity c) solubility of antigen d) phenotype

a) variable region of light/heavy chain

Which metabolic pathway is responsible for generating 90% of the ATP for the RBC? a) pentose phosphate shunt b) Luebering-Rapoport shunt c) methemoglobin reductase d) glycolysis

d) glycolysis

Which of the following metabolic pathways is responsible for maintaining heme iron in the ferrous (Fe) state? a) methemoglobin reductase b) glycolysis c) Luebering-Rapoport shunt d) pentose phosphate shunt

a) methemoglobin reductase

Which of the following statements are false concerning the structure of immunoglobulins? a) The enzyme papain splits the antibody molecule at the hinge region to give three fragments (2 Fab + 1Fc). b) The Fc portion is responsible for complement fixation, monocyte binding, and placental transfer. c) The Fab portion is the region responsible for antigen binding. d) IgM participates in placental transfer.

d) IgM participates in placental transfer

What is the function of helicases and gyrases in the polymerase chain reaction? a) to anneal to cDNA sequences b) to unwind the DNA c) to generate blunt-ended double-stranded products d) to extend the primer sequence

b) to unwind the DNA

What MHC Class encodes complement components? a) Class I b) Class II c) Class III d) all of the above

c) Class III

The portion of the immunoglobulin molecule which determine class: a) light chain b) heavy chain c) kappa chain d) lambda chain

b) heavy chain

When 1000 donors were tested, 75% were positive for C and 25% were negative for C; the gene frequency of C is: a) 25 b) 10 c) 1 d) 0.5

d) 0.5

A woman with blood group A marries a man with blood group O. Their first born child has blood group O. The mother's most probable genotype is: a) AO b) OO c) AB d) AA

a) AO

In an immune response, what is the time called in which no antibody is detected in test serum? a) latency period b) amnestic response c) secondary response d) primary response

a) latency period

In an immune response, __________ antibodies are formed before _______. a) IgM, IgA b) IgM, IgG c) IgG, IgM d) IgG, IgA

b) IgM, IgG

A human gamete (egg or sperm) contains how many chromosomes? a) 23 pairs b) 46 pairs c) 46 chromosomes d) 23 chromosomes

d) 23 chromosomes

In the MN blood group system, a person who inherits an "M" allele and "N" allele expresses both M and N antigens on the red blood cells. Which of the following is true? a) M and N are located on the same chromosome b) N is dominant to M c) M an N are codominant alleles d) M is dominant to N

c) M an N are codominant alleles

In Mendel's law of separation, the first-filial generation is: a) autologous b) homozygous c) recessive d) heterozygous

d) heterozygous

Which of the following is representative of the “central dogma” of molecular biology? a) The basic information of life flows from proteins to genes. b) The basic information of life flows from DNA through RNA to proteins. c) The basic information of life flows from RNA through DNA to proteins. d) The basic information of life flows from amino acids to proteins.

b) The basic information of life flows from DNA through RNA to proteins

A father carries the Xga trait and passes it on to all of his daughters, but none of his sons. What type of inheritance does this represent? a) autosomal dominant b) X-linked recessive c) autosomal recessive d) X-linked dominant

d) X-linked dominant

All of the following are functions performed by the complement system except: a) decreased vascular permeability b) direct lysis of bacteria c) promoter of phagocytosis d) smooth muscle contraction

a) decreased vascular permeability

What is a vector? a) extrachromosomal genetic element that can carry a recombinant DNA molecule into a host bacterial cell b) substance that can carry an electric current in solution c) substance capable of catalyzing a reaction d) sequence of three bases in a strand of DNA

a) extrachromosomal genetic element that can carry a recombinant DNA molecule into a host bacterial cell

IgG-coated red cells will be phagocytized by what effector cells? a) monocytes/macrophages b) basophils c) eosinophils d) T cells

a) monocytes/macrophages

What is the function of mononuclear phagocytes? a) produce antibody b) present processed antigen to lymphocytes c) release histamine released d) present processed antibody to lymphocytes

b) present processed antigen to lymphocytes

All of the following biochemical changes are associated with loss of red cell viability upon storage except: a) loss of red cell function b) increased ATP level c) decreased pH d) decreased glucose consumption

b) increased ATP level

All of the following are consistent with a "shift to the right" of the hemoglobin (oxygen dissociation curve except: a) decreased 2,3 DPG b) 50% O2 saturation to tissues c) decreased hemoglobin affinity for O2 d) increased 2,3 DPG

a) decreased 2,3 DPG

How is RNA different from DNA? a) RNA usually exists as one strand b) Ribose is substituted for deoxyribose. c) RNA incorporates uracil. d) all of the above

d) all of the above

How do restriction endonucleases function? a) disrupt hydrogen bonding in DNA structure b) cut DNA into smaller fragments c) promote digestion of RNA d) terminate translation of mRNA

b) cut DNA into smaller fragments

Which of the following corresponds to the basic structure of immunoglobulin? a) two light chains held together with an interlink disulfide bond b) two light chains and two heavy chains held together by covalent disulfide bonds c) one light chain and one heavy chain held together by covalent disulfide bonds d) two heavy chains held together with an interlink disulfide bond

b) two light chains and two heavy chains held together by covalent disulfide bonds

The diploid chromosomes number in humans is: a) 23 b) 12 c) 92 d) 46

d) 46

Only 5% of Kell-negative individuals will develop antibodies to Kell if exposed to the Kell antigen, whereas 50% to 70% of Rh (D) negative individuals would produce antibodies to D upon exposure. What is the reason for this? a) difference in ABO type b) difference in immunogenicity c) phenotype d) all of the above

b) difference in immunogenicity

How is it genetically possible for a child to type Rh negative? a) both parents are (DD) b) mom is DD and Dad is Dd c) both parents are (Dd) d) sibling is Rh positive

c) both parents are (Dd)

In the normal hemoglobin--oxygen dissociation curve, what percentage of oxygen is released to the tissues when PO2 averages 40 mmHg? a) 25% b) 75% c) 100% d) 50%

a) 25%

Which immunoglobulin is found in greatest concentration in serum? a) IgA b) IgE c) IgG d) IgM

c) IgG

At what temperature do IgM antibodies react? a) 22°C b) 37°C c) 42°C d) 56°C

a) 22°C

Which blood group antibodies are known to activate complement leading to intravascular hemolysis? a) Lewis b) ABO c) Duffy d) Rh

b) ABO

What does polyspecific AHG contain? a) IgG b) C3b c) C3d d) all of the above

d) all of the above

At what temperature do IgG antibodies react optimally? a) 22°C b) 56°C c) 4°C d) 37°C

d) 37°C

What class of immunoglobulin is capable of crossing the placenta? a) IgE b) IgG c) IgM d) IgD

b) IgG

Which immunoglobulin exists in a pentameric configuration? a) IgG b) IgM c) IgA d) IgE

b) IgM

What is meant by the term "autosomal"? a) Organism possesses different alleles for a given characteristic. b) Trait is not expressed in the parents. c) Trait is not carried on the sex chromosomes. d) Trait is carried on sex chromosomes.

c) Trait is not carried on the sex chromosomes.

If not labeled "gamma heavy chain specific," monospecific anti-IgG may contain antibodies to: a) alpha heavy chains b) C3d c) immunoglobulin light chains d) mu heavy chains

c) immunoglobulin light chains

How is a 40:1 ratio of serum to cells prepared for the AHG test? a) 1 drop serum + 5 drops of a 5% v/v red cell suspension b) 2 drops serum + 1 drop of a 5% v/v red cell suspension c) 1 drop of serum + 1 drop of a 5%v/v red cell suspension d) 5 drops of serum + 1 drop of a 5% v/v red cell suspension

b) 2 drops serum + 1 drop of a 5% v/v red cell suspension

Why is incubation omitted in the direct AHG test? a) Incubation will cause lysis of red cells. b) In vivo antigen (antibody complex is already formed. c) Polyspecific AHG contains a higher dose of anti-IgG. d) Incubation elutes complement components from red cells.

b) In vivo antigen (antibody complex is already formed.

What is the incubation time for the IAT when saline is used instead of LISS? a) 10 minutes b) 1 hour c) 15 minutes d) 30 minutes

d) 30 minutes

A patient came in for a routine type and screen prior to surgery. The antibody screen was negative at 37°C and AHG phase. Check cells did not produce agglutination often. What is a possible explanation for this result? a) inadequate washing b) dirty glassware c) overcentrifugation d) use of positive DAT cells

a) inadequate washing

At what temperature is the incubation phase of the AHG test? a) 22°C b) 56°C c) 37°C d) 4°C

c) 37°C

What is a possible consequence of incubating tubes too long with LISS when performing the IAT? a) increased sensitivity b) hemolysis c) elution of antibody from red cell d) all of the above

c) elution of antibody from red cell

Most clinically significant blood group antibodies are of what IgG subclass? a) IgG1 and IgG2 b) IgG2 and IgG3 c) IgG2 and IgG4 d) IgG1 and IgG3

d) IgG1 and IgG3

Polyspecific AHG contains: a) anti-IgG and anti-C3b-C3d b) anti-IgG c) anti-IgG and anti-IgM d) anti-C3b-C3d

a) anti-IgG and anti-C3b-C3d

What do "check cells" contain? a) Rh(D)- red cells coated with anti-D b) A+ red cell coated with anti-D c) Rh(D)+ red cells coated with anti-D d) B+ red cells coated with anti-D

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

All of the following are important in evaluating a positive DAT except: a) drug therapy b) transfusion history c) patient diagnosis d) donation history

d) donation history

The indirect antiglobulin test detects which antigen-antibody reactions? a) in vivo b) in vitro c) both in vivo and in vitro d) none of the above

b) in vitro

Why was anticomplement introduced into AHG sera? a) Certain clinically significant antibodies demonstrate complement activity. b) Complement components enhance Kell antibodies. c) It provides additional information into transfusion reaction work-ups. d) all of the above

d) all of the above

How many IgG molecules must be present on the red cell for a positive IAT to occur? a) 50 b) 500 c) 10 d) 100

d) 100

All of the following conditions may produce a positive DAT except: a) drug-induced hemolytic anemia b) hemolytic transfusion reaction c) hemolytic disease of the newborn d) lymphoma

d) lymphoma

A patient is discovered to have anti-Fya in their serum. The medical technologist needs to phenotype the patient cells for the corresponding antigen. What test is appropriate for phenotyping? a) IAT b) absorption c) DAT d) elution

a) IAT

Why are "check cells" added to all negative reactions in the AHG test? a) to increase the cell-to-serum ratio b) to wash away any unbound antibody c) to ensure AHG was not neutralized by free globulin molecules d) to bring the antibody closer to the antigen in the test system

c) to ensure AHG was not neutralized by free globulin molecules

What type of globulin does the antiglobulin test detect? a) IgG alloantibodies b) IgG autoantibodies c) C3b complement components d) all of the above

d) all of the above

All of the following is true regarding the AHG test except: a) Centrifugation should provide a firm pellet. b) Coombs control cells should be added to all negative tubes. c) When washing cells, all saline should be removed completely. d) Incubation time with LISS is a minimum of 30 minutes.

d) Incubation time with LISS is a minimum of 30 minutes.

An antibody screen is performed, and all three tubes are negative after adding AHG. Check cells are added, and the tubes are centrifuged. No agglutination occurs after the addition of check cells. What is the next course of action? a) recentrifuge tubes b) addition of one drop of AHG c) repeat the antibody screen d) addition of one drop of control cells

c) repeat the antibody screen

Anti-IgG is specific for what part of the IgG molecule? a) Fc fragment b) kappa light chain c) constant region of Fab fragment d) hypervariable region of Fab fragment

a) Fc fragment

What is the purpose of washing cells in the AHG test? a) to dilute serum b) to remove all bound protein c) to remove all unbound protein d) to exclude a low affinity antibody

c) to remove all unbound protein

Saline used for blood banking tests should have a pH of _________. a) 5.0 to 5.5 b) 7.5 to 8.0 c) 6.8 to 7.2 d) 7.2 to 7.4

d) 7.2 to 7.4

How would a negative IAT be demonstrated in solid phase methodology? a) well turns orange b) cells form a monolayer c) pellet at bottom of well d) small agglutinins at bottom of well

c) pellet at bottom of well

Anti-A from a group B individual is primarily what class of immunoglobulin? a) IgM b) IgG c) IgA d) all of the above

a) IgM

Which of the following criteria is used to classify the B subgroups? a) agglutination patterns with anti-B, anti-AB, and anti-H b) presence of ABH isoagglutinins in serum c) absorption studies with anti-B d) all of the above

d) all of the above

What substances are found in a group A secretor? a) H b) A,B,H c) A,H d) B,H

c) A,H

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) a substance that will agglutinate sensitized cells in the presence of complement d) seed extracts that agglutinate human cells with moderate specificity

d) seed extracts that agglutinate human cells with moderate specificity

What ABO group contains the least amount of H substance? a) A1 b) A2 c) A2B d) A1B

d) A1B

What is the source of anti-A1 lectin? a) Bandeiraea simplicifolia b) Dolichos biflorus c) Ulex europaeus d) all of the above

b) Dolichos biflorus

Secretor studies were performed on a person who expressed weak reactions in forward grouping. Only B and H substance were present in saliva. What is this person's ABO group? a) AB b) B c) O d) A

b) B

Why can anti-H sometimes be found in an A1B individual? a) H gene is not inherited. b) The specific immunodominant sugar blocks the presence of H antigen. c) The individual does not secrete H substance in secretions. d) L-Fucose does not attach to precursor substance.

b) The specific immunodominant sugar blocks the presence of H antigen.

All of the following may result in weak or missing antigens except: a) hypogammaglobulinemia b) Hodgkin's disease c) intestinal infection with Escherichia coli d) presence of blood group specific substances (BGSS)

a) hypogammaglobulinemia

What is the biochemical structure of secreted A,B, and H substances? a) glycoprotein b) glycolipid c) sphingolipid d) ceramide

a) glycoprotein

All of the following statements are true concerning ABH soluble substances except: a) The precursor chain is type 2 (beta 1-4 linkage). b) The first sugar in the precursor substance is N-acetylgalactosamine. c) ABH structures are glycoproteins. d) L-Fucosyltransferase production is regulated by the Se system.

a) The precursor chain is type 2 (beta 1-4 linkage).

All of the following may result in rouleaux formation except: a) Waldenstrom's macroglobulinemia b) leukemia c) Wharton's jelly in cord blood d) dextran

b) leukemia

What percentage of the type A population are A1? a) 20% b) 80% c) 50% d) 10%

b) 80%

Persons who inherit the h allele do not produce ___________ transferase necessary for formation of the H structure. a) N-acetylgalactosaminyl b) D-glucosyl c) L-fucosyl d) D-galactosyl

c) L-fucosyl

All of the following may depress antigen expression except: a) Hodgkin's disease b) leukemia c) lymphoma d) coronary heart disease

d) coronary heart disease

What immunodominant sugar is responsible for B specificity? a) D-glucose b) D-galactose c) L-fucose d) N-acetyl-D-galactosamine

b) D-galactose

What percentage of A2 individuals produce anti-A1? a) 5% b) 80% c) 20% d) 50%

a) 5%

How are ABH antigens formed? a) production of specific glycosyltransferases add sugars to precursor substances b) recombinant gene technology c) ABO genes code for production of antigens d) all of the above

a) production of specific glycosyltransferases add sugars to precursor substances

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) saline b) LISS c) serum d) water

a) saline

Which substance must be formed first before A or B specificity is determined? a) O b) H c) Bombay d) I

b) H

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

c) clerical error

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

a) acquired "B"

What does the hh genotype refer to? a) Bombay b) Kell c) Lewis d) Sid

a) Bombay

Which blood group contains the highest concentration of H antigen? a) B b) AB c) A2 d) O

d) O

What are the advantages of using chemically modified anti-D? a) few false negative results obtained b) Rh control not necessary c) Du testing eliminated d) provides a low-protein medium

d) provides a low-protein medium

The Rh antibody agglutinates what percentage of red cells. a) 35% b) 50% c) 15% d) 85%

d) 85%

Why is determination of Rh status crucial for obstetric patients? a) All Rh positive mothers are possible candidates for Rh immune globulin. b) All Rh negative mothers are possible candidates for Rh immune globulin. c) An Rh negative mother can form anti-D if she gives birth to an Rh negative baby. d) An Rh positive mother can form anti-D that will destroy D-positive red cells of fetus.

b) All Rh negative mothers are possible candidates for Rh immune globulin.

Which antigen represents Rh3 in Rosenfield terminology? a) e b) D c) C d) E

d) E

G antigen is present on all of which type of red cells? a) e positive b) C positive c) E positive d) D positive

b) C positive

Where is the Rh antigen located relative to the red cell membrane? a) integrally b) peripherally c) centrally d) none of the above

a) integrally

Which of the following is true regarding anti-LW? a) It reacts poorly with cord cells. b) It appears frequently as an auto antibody. c) It reacts stronger with D-negative cells than D-positive cells. d) Alloanti-LW is occasionally seen in autoimmune hemolytic anemia.

b) It appears frequently as an auto antibody.

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

d) all of the above

A cord blood sample was sent to the blood bank for a type and DAT. Cells were washed six times with saline before testing. The forward grouping typed as an O. There was no agglutination with anti-D and washed cord cells. The DAT was 3+ with polyspecific AHG. What is the Rh type of the baby? a) Rh negative b) Rh positive c) Rh type cannot be determined d) none of the above

c) Rh type cannot be determined

Which of the following genotypes is consistent with f antigen expression? a) DCe/DcE b) DcE/DCe c) Dce/DCE d) DCe/dCE

c) Dce/DCE

How are the Rh antigens inherited? a) X-linked recessive b) codominant alleles c) X-linked dominant d) none of the above

b) codominant alleles

Most Rh antibodies are of what immunoglobulin class? a) IgG b) IgA c) IgE d) IgM

a) IgG

Which IgG subclasses carry the most significance with regard to Rh antibodies? a) IgG1/IgG4 b) IgG2/IgG4 c) IgG3/IgG4 d) IgG1/IgG3

d) IgG1/IgG3

All of the following are true regarding Rh antibodies except: a) Rh antibodies can bind complement on the red cell membrane. b) Rh antibodies may cause a delayed hemolytic transfusion reaction. c) An individual with a low titer Rh antibody may experience a secondary immune response on antigen exposure. d) Red cell destruction is usually extravascular.

a) Rh antibodies can bind complement on the red cell membrane.

What is the principle of the Rh-Hr (Weiner) terminology? a) The Rh gene produces at least 3 factors within an agglutinin. b) The Rh gene produces at least 3 factors within an agglutinogen. c) Each gene (D,C,c,E,e) produces one product or antigen. d) Each gene is independent of the other.

b) The Rh gene produces at least 3 factors within an agglutinogen.

The Rh gene is located on which chromosome? a) 11 b) 7 c) 9 d) 1

d) 1

Which of the following Rh antigens is the most immunogenic? a) E b) C c) D d) e

c) D

What is the basis of Rosenfield Rh terminology? a) Each gene produces one product or antigen. b) The Rh gene produces at least five factors within an agglutinogen. c) The Rh gene produces at least three factors within an agglutinogen. d) (+) or (–) sign demonstrates the presence or absence of antigen on a red cell.

d) (+) or (–) sign demonstrates the presence or absence of antigen on a red cell.

What class of antibody is found in AHG? a) IgG b) IgM c) IgA d) all of the above

d) all of the above

Red blood cells that phenotyped as [Le(a-b-)] are incubated with plasma containing Lea substance. The red blood cells convert to the phenotype [Le(a+b-)]. Whereas the same red blood cells incubated with saliva containing Lea substance do not convert. Why? a) Other enzymes found in the saliva interfere with the conversion from Le(a-b-) to Le (a+b-). b) Only Leb substance in saliva can convert phenotypes. c) Biochemically, Lewis substances in saliva are glycolipids. d) Glycoproteins are not absorbed onto red blood cell membranes.

d) Glycoproteins are not absorbed onto red blood cell membranes.

What is the most critical step in blood transfusion? a) Phenotyping units to ensure compatibility with alloantibody b) Following quality control procedures c) Checking patient identification and compatibility of donor unit d) Monitoring the temperature control of donor units

c) Checking patient identification and compatibility of donor unit

Recipient serum that 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.

b) an alloantibody directed against a low-frequency antigen.

Lewis cell-bound antigens absorbed from plasma onto the red cell membranes are: a) ceramides b) glycolipids c) sphingolipids d) glycoproteins

b) glycolipids

Why is anti-i implicated in hemolytic disease of the newborn? a) The i antigen is well expressed on cord cells. b) Anti-i can be either IgM or IgG. c) The i antigen has weak antigen expression in adults. d) two of the above

d) two of the above

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 of the above

d) None of the above

Why are the M and N antigens important for paternity testing? a) Antigens are well developed at birth. b) Antigens are well developed on father's red cells. c) Antigens are fully developed at 2 years of age. d) Antigens are poorly developed on mother's cells.

a) Antigens are well developed at birth.

Autoantibodies to U antigen may be found in patients with: a) cold autoimmune hemolytic anemia b) warm autoimmune hemolytic anemia c) drug-induced hemolytic anemia d) paroxysmal cold hemoglobinuria

b) warm autoimmune hemolytic anemia

Antigens in the CH/RG blood group system are described as: a) well developed on cord cells b) resistant to ficin treatment c) adsorbed on to the red cell membrane d) antithetical partners

c) adsorbed on to the red cell membrane

Which antigen is expressed on C4B complement fragments? a) Kna b) Gya c) Yka d) Cha

d) Cha

Why are Lewis antibodies not generally implicated in hemolytic disease of the newborn (HDN)? a) Lewis antigens can readily dissociate from the red cell upon transfusion of Lewis-positive cells. b) Lewis antigens are well developed at birth. c) Lewis antibodies do not bind complement. d) Lewis antibodies are IgM and cannot cross the placenta.

d) Lewis antibodies are IgM and cannot cross the placenta.

Which of the following may be a possible cause for the lack of expression of Lewis antigens during pregnancy: a) antigenic sites are blocked by IgG antibody b) decreased ratio of plasma lipoproteins to red cell mass c) increased ratio of plasma lipoproteins to red cell mass d) antigenic sites are blocked by IgM antibody

c) increased ratio of plasma lipoproteins to red cell mass

At which phase are Lewis antibodies usually detected? a) immediate spin b) 37°C c) Coombs d) all of the above

a) immediate spin

Why is the Le system not implicated in hemolytic disease of the newborn (HDN)? a) Lewis antibodies do not bind complement. b) HDN Lewis antibodies are IgG and cannot cross the placenta and cause. c) Lewis antigens are not well developed at birth. d) Lewis antigens can readily dissociate from the red cell upon transfusion of Lewis-positive cells.

c) Lewis antigens are not well developed at birth.

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

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

Where are Lewis antigens found? a) plasma b) saliva c) milk d) all of the above

d) all of the above

Lewis antibodies are of what immunoglobulin class? a) IgM b) IgA c) IgG d) IgE

a) IgM

Lewis cell-bound antigens absorbed from plasma onto the red cell membranes are: a) sphingolipids b) glycoproteins c) ceramides d) glycolipids

d) glycolipids

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

b) less

Pregnant women usually express which phenotype? a) Le(a-b+) b) Le(a+b-) c) Le(a+b+) d) Le(a-b-)

d) Le(a-b-)

In order for an individual to express Leb antigen on their red cells, they must have inherited which gene? a) Le b) Se c) H d) all of the above

d) all of the above

A Bombay individual who has inherited the Le gene will have a phenotype of: a) Le(a-b-) b) Le(a+b+) c) Le(a+b-) d) Le(a-b+)

Le(a+b-)

d) two of the above

Which of the following is not involved in the Kell blood group system? a) Jka b) Jsa c) Kpb d) K

a) Jka

Where are the Duffy antigens found? a) red cells b) platelets c) lymphocytes d) all of the above

a) red cells

Why is it relatively easy to find compatible units for a patient with anti-K? a) Kell is a low-frequency antigen b) anti-K has a low avidity for its respective antigen c) anti-K does not react at 37°C d) Kell is a high-frequency antigen

a) Kell is a low-frequency antigen

Red cells were ficin treated to help rule in anti-M from a panel study. Cells not treated reacted at 2+ at immediate spin and 1+ at 37°C. There was no reactivity in the Coombs phase. Ficin-treated cells demonstrated a _______ reaction with patient serum containing anti-M. a) 4+ b) negative c) 2+ d) 3+

b) negative

A blood bank technologist needed to confirm the presence of anti-P1 in a patient specimen. Fresh cells were not available for use, so an old panel that contained cells positive for P1 was used. No cells positive for the antigen reacted at any phase of the antiglobulin test, whereas cells from the screening cells showed specificity for the presence of anti-P1. What is a possible explanation for this? a) Patient expresses the p phenotype. b) P1 antigen deteriorates rapidly upon storage. c) Technician omitted LISS. d) Technician forgot to add AHG.

b) P1 antigen deteriorates rapidly upon storage.

Anti-M was detected in a 27-year-old man before surgery. Units negative for M antigen were not available; however, the units were approved for transfusion when major crossmatch using M+N+ donor cells and patient serum resulted in: a) IS = 1+, 37 = 0, AHG = 0 b) IS = 3+, 37 = 2+, AHG = 1+ c) IS = 2+, 37 = 1+, AHG = 0 d) IS = 1+, 37 = 1+, AHG = 0

a) IS = 1+, 37 = 0, AHG = 0

Anti-Lua reacts at what temperature? a) room temperature b) 37°C c) AHG d) all of the above

a) room temperature

Persons who phenotype negative for U antigen lack Ss-SGP because of a partial or complete deletion of __________________. a) GPB b) N-acetylgalactosamine c) GPA d) N-acetylneuraminic acid

a) GPB

The M and N antigens are found in which glycoprotein? a) band 3 b) glycophorin A c) glycophorin B d) glycophorin C

b) glycophorin A

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

c) broad thermal range of reactivity

Which of the following distinguishes the recessive LuLu gene from the dominant In(Lu) gene? a) expression of trace amounts of i antigen b) abnormal expression of P1 c) expression of the Lu(a-b-) phenotype d) normal expression of P1

d) normal expression of P1

All of the following are characteristics of Kidd antibodies except: a) IgG immunoglobulins b) ability to bind complement c) exhibit dosage d) naturally occurring

d) naturally occurring

When red cells are placed in a solution of 2M urea, the red cells will lyse. However, it has been shown that which red cells are resistant to lysis? a) Jk(a-b+) b) Jk(a+b+) c) Jk(a-b-) d) Jk(a+b-)

c) Jk(a-b-)

The M and N antigens exhibit dosage. Therefore, if a person inherits the homozygous genotype MM their red cells will react _______ with anti-M than a person with a heterozygous genotype of MN. a) stronger b) weaker c) mixed field d) none of the above

a) stronger

The homozygous phenotype Fy(a+b-) has _______ antigenic Fy“ sites than heterozygous cells, Fy(a+b+). a) more b) less c) weaker d) none of the above

a) more

At what age does I antigen become detectable on infant cells? a) 1 year b) 4 years c) 18 months d) 1 month

c) 18 months

What characteristic differentiates Ss antigens from MN antigens? a) antigens well developed at birth b) enzyme degradation c) biochemical structure rich in sialic acid d) S and s exhibit dosage

b) enzyme degradation

Persons who express the phenotype P2 are at risk for developing anti-P1 when handling what animal species? a) dogs b) pigeons c) mice d) cats

b) pigeons

What abnormal blood cell morphology is associated with the McLeod phenotype? a) acanthocytes b) sickle cells c) spherocytes d) ovalocytes

a) acanthocytes

What type of hemolytic transfusion reaction occurs more frequently in patients with Jk antibodies? a) bacterial b) delayed c) febrile d) immediate

b) delayed

Anti-I is found in association with what microorganism? a) Proteus vulgaris b) Treponema pallidum c) Mycoplasma pneumoniae d) Escherichia coli

c) Mycoplasma pneumoniae

Units that were positive for P² antigen had to be crossmatched with serum of a patient containing the corresponding antibody because of a short supply of blood. Which of the following crossmatch results would be considered acceptable for transfusion? a) IS=0, 37=2+, AHG=3+ b) IS=1+, 37=0, AHG=0 c) IS=2+, 37=1+, AHG=0 d) IS=0, 37=2+, AHG=1+

b) IS=1+, 37=0, AHG=0

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

c) anti-Jk3

All of the following are characteristics of Duffy antibodies except: a) destroyed by enzymes b) may or may not show dosage c) not implicated in hemolytic disease of the newborn (HDN) d) IgG

c) not implicated in hemolytic disease of the newborn (HDN)

Anti-Jka was identified in a previously transfused patient. Five cells that were homozygous for Jka yielded 2+ reactions in the AHG phase. The same cells were treated with ficin and yielded 3+ reactions in AHG. Therefore, Jka is _________ by enzyme treatment. a) destroyed b) enhanced c) unaffected d) none of the above

b) enhanced

What sequence of antigens coincides with strongest immunogen to weakest immunogen? a) D, K, Fya, Fyb b) Fya, Fyb, D, K c) D, Fya, Fyb, K d) K, Fya, Fyb, D

a) D, K, Fya, Fyb

Anti-N will react stronger with which phenotype? a) M-N- b) M+N+ c) M+N- d) M-N+

d) M-N+

Anti-N is known to occur in ___________ patients undergoing dialysis with equipment sterilized by formaldehyde? a) thyroid b) immunocompromised c) renal d) cancer

c) renal

What fatal disease is associated with the McLeod phenotype? a) chronic granulomatous disease b) Fanconi's syndrome c) Graves' disease d) lymphoma

a) chronic granulomatous disease

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

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

A woman undergoing a hysterectomy requires 2 units of blood. The antibody screen was negative. One unit was incompatible in the Coombs phase (2+), the other unit was compatible. Give a reason why this antibody was not detected in the antibody screen. a) a high-frequency antigen b) a low-frequency antigen c) antibody has low avidity to cell receptor d) two of the above

b) a low-frequency antigen

Persons who are genetically P1 may serologically type as P2 because of: a) presence of anti-P1 in their serum b) depressed antigen expression c) inheritance of the In(Lu) gene d) inheritance of the p gene

c) inheritance of the In(Lu) gene

Persons who phenotype as Fy(a-b-) are resistant to infection by which organism? a) Plasmodium malariae b) Plasmodium falciparum c) Plasmodium vivax d) Plasmodium ovale

c) Plasmodium vivax

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

c) i/I

Why is hemolytic disease of the newborn (HDN) not a consideration when the mother possesses anti-P1 in her serum? a) Anti-P1 is a naturally occurring antibody. b) Anti-P1 is an IgM antibody. c) Anti-P1 does not react at 37°C. d) P1 antigen is poorly expressed at birth.

d) P1 antigen is poorly expressed at birth.

All of the following is true regarding the Kell antigen except: a) strongly immunogenic b) exhibits dosage c) destroyed by ficin treatment d) well developed at birth

c) destroyed by ficin treatment

What amino acid is specific for S antigen? a) methionine b) glycine c) threonine d) aspartic acid

a) methionine

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

c) Most reagent cells are Lu(a-).

Why was U antigen included in the MNSs blood group system? a) All U-negative red cells were also S-s-. b) All U-positive red cells were also S+s+. c) All U-negative red cells were also M-N-. d) U is enhanced by enzyme treatment.

a) All U-negative red cells were also S-s-.

Duffy antigens are destroyed by: a) AET b) ficin c) neuraminidase d) two of the above

b) ficin

All of the following is consistent with Benign anti-I except: a) do not bind complement b) naturally occurring c) IgM d) reactive at 4°C

a) do not bind complement

What effect do enzyme treated cells have on anti-I detection? a) enhances reactivity b) destroys reactivity c) no effect d) none of the above

a) enhances reactivity

A woman came in for a cesarean section. The antibody screen was positive with a 3+ reaction in the AHG phase using screening cell I. Screening cells II and III were negative in all phases. An 8-cell panel was performed that paralleled the antibody screen where 3 cells reacted 3+ at AHG and 5 cells were negative at all phases of reactivity. The antibody identified was anti-Kell. What procedure might be helpful in predicting the infant's susceptibility to hemolytic disease of the newborn (HDN)? a) a fetal screen (rosette test) on the mother b) determination of the father's phenotype c) plasmapherese of the mother's plasma d) determination of the mother's phenotype

b) determination of the father's phenotype

Antigens in the CH/RG blood group system are described as: a) resistant to ficin treatment b) well developed on cord cells c) antithetical partners d) adsorbed on to the red cell membrane

d) adsorbed on to the red cell membrane

Which antigen is expressed on C4B complement fragments? a) Cha b) Kna c) Gya d) Yka

a) Cha

The Dia and Dib antigens are located on: a) erythrocyte acetylcholinesterase b) complement receptor one (CRI) c) the anion exchange molecule (AE-1) d) channel-forming integral protein (CHIP)

c) the anion exchange molecule (AE-1)

The gene for which blood group antigen is located on the petite arm of the X chromosome. a) Doa b) Sc1 c) Coa d) Xga

d) Xga

The seven Gerbich antigens are located on: a) glycophorins A and B b) glycophorins C and D c) glycophorins A and D d) glycophorins B and C

b) glycophorins C and D

What blood group antigens are involved in the regulation of complement because they are located on decoy accelerating factor? a) IN b) CROM c) DO d) CO

b) CROM

Bg antibodies are primarily directed toward antigenic determinants present on: a) white blood cells b) red blood cells c) meso cells d) platelets

a) white blood cells

What criteria must be met for an antigen to be assigned to a blood group system? a) must be a red cell antigen b) must be assigned to a unique chromosomal locus c) must be controlled by a single gene or two closely linked genes d) all of the above

d) all of the above

_________ incidence is an antigen in the high-incidence series (901) that is found in saliva and urine. The corresponding antibody typically reacts at the AHG phase and produces a characteristic refractile, mixed field reaction. a) Sda b) Vel c) Lan d) JMH

a) Sda

Which antigen is useful as a genetic marker for Mongolian derivation and anthropologic studies? a) Xga b) Dia c) Doa d) Yta

b) Dia

What is an antigen profile? a) a statistical comparison of 200 blood banks' results of antigenic reactions with various antisera b) an insert listing the antigenic make-up of check cells c) an insert listing the antigenic make-up of screening cells d) an insert listing the antibodies present on screening cells

c) an insert listing the antigenic make-up of screening cells

What would be a realistic source of finding compatible units for a person with an antibody to a high-frequency antigen? a) a donor of similar ethnic background b) random donor units c) siblings d) apheresis donors

c) siblings

What is tested in an antibody screen? a) Patient serum is tested against group AB reagent screening cells. b) Patient serum is tested against group O reagent screening cells. c) Patient serum is tested against group A reagent screening cells. d) Patient red cells are tested against group O reagent screening cells.

b) Patient serum is tested against group O reagent screening cells.

What is a possible explanation for a nonreactive eluate? a) hemolytic disease of the newborn (HDN) b) positive DAT due to drugs c) a warm autoantibody d) all of the above

b) positive DAT due to drugs

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

b) positive DAT

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

b) Pattern of reactions will change from lot to lot.

What is an elution? a) a technique used to dissociate IgM antibodies from sensitized red blood cells b) a technique used to dissociate IgG antibodies from sensitized red blood cells c) a technique used to reduce the zeta potential enhancing antigen binding d) none of the above

b) a technique used to dissociate IgG antibodies from sensitized red blood cells

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) Fy(a+), C–, Fy(b-)

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

A doctor has ordered 4 units of red blood cells for a patient with anti-E in his serum. How many units would have to be screened to yield 4 E-negative units? a) 10 b) 6 c) 12 d) 15

b) 6

hat is the final step in antibody identification? a) phenotype patient's RBCs for corresponding antigen b) phenotype donor's red blood cell (RBC) units for corresponding antigen c) phenotype patient's RBCs for corresponding antibody d) phenotype RBC units for corresponding antibody

a) phenotype patient's RBCs for corresponding antigen

In which scenario can an antibody be ruled out? a) Patient serum does not react with a cell known to carry the corresponding antigen. b) Patient cells do not react with a cell known to carry the corresponding antibody. c) Patient cells do react with a cell known to carry the corresponding antibody. d) Patient serum does react with a cell known to carry the corresponding antigen.

a) Patient serum does not react with a cell known to carry the corresponding antigen.

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) Rh b) Duffy c) Kell d) Kidd

d) Kidd

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

b) Weakly reacting antibody may not react with heterozygous cells.

Which of the following is known as the "sensitization phase" in the antibody screen? a) immediate spin b) AHG c) 37°C incubation d) none of the above

c) 37°C incubation

All of the following antigens are interacted by proteolytic enzymes except: a) S b) M c) Fya d) C

d) C

ow 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 with patient's sera followed by phenotyping compatible units of red blood cells c) your blood supplier d) b & c

d) b & c

What is the first step in reading hemagglutination reactions? a) resuspension of red blood cells b) checking supernatant for hemolysis c) grading agglutination d) none of the above

b) checking supernatant for hemolysis

A 2-unit crossmatch was ordered on a patient in the emergency room. The patient's antibody screen was negative. One unit was compatible and the other was incompatible at AHG. If the patient's antibody screen was negative and the donor had no history of antibodies, what could be the reason for this reaction? a) The patient's sera has an antibody to a low-frequency antigen not present on screening cells. b) Donor has a positive DAT. c) The patient's sera has an HTLA antibody. d) a & b

d) a & b

One drop of Coombs control cells was added to a negative antibody screen. No agglutination was observed after centrifugation. What course of action is taken? a) repeat the test b) add one more drop of check cells and recentrifuge c) report negative result d) report inconclusive result

a) repeat the test

What is an abbreviated crossmatch? a) a type and screen plus an immediate spin crossmatch b) a type and screen plus a minor crossmatch c) a minor crossmatch d) a type and screen plus an immediate spin crossmatch using pooled screening cells

a) a type and screen plus an immediate spin crossmatch

Which phlebotomy site is unacceptable for compatibility testing? a) blood drawn from vein above the intravenous line b) blood drawn from vein below an intravenous line c) antecubital fossa d) vein from the hand

a) blood drawn from vein above the intravenous line

Given the following results, what is the probable cause of a positive reaction in the major crossmatch? IS = 0 37 = 0 AHG = 2+ CC = ND Autocontrol was negative a) autoantibody in patient serum reacting with antigen on donor cells b) rouleaux c) alloantibody in patient serum reacting with antigen on donor cells d) incorrect ABO grouping of patient or donor

c) alloantibody in patient serum reacting with antigen on donor cells

In what circumstance 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

c) in an elderly woman

What is the most critical step in blood transfusion? Incorrect Response a) following quality control procedures b) phenotyping units to ensure compatibility with alloantibody c) monitoring the temperature control of donor units d) checking patient identification and compatibility of donor unit

d) checking patient identification and compatibility of donor unit

n an intrauterine transfusion, whose serum is used for compatibility testing? a) infant's b) mother's c) father's d) none of the above

b) mother's

What is the optimal time interval for compatibility testing if the patient was transfused in the past 3 months? a) 2 weeks b) less than 24 hours after collection c) 5 days d) less than 72 hours after collection

d) less than 72 hours after collection

An ABO antibody will cause a more severe hemolytic transfusion reaction in a patient who has received mismatched blood than an alloantibody. a) true b) false

a) true

Which statement best describes the relation between a crossmatch and a compatibility test? Incorrect Response a) They are identical. b) If a crossmatch was a house, a compatibility test would be a room. c) If a compatibility test was a pie, a crossmatch would be a slice. d) A crossmatch is a confirmation of the compatibility test.

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

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) none d) AB packed cells

c) none

A 4-unit crossmatch is ordered on a patient for emergency surgery. The patient's blood type is group B positive. The blood bank inventory only contains 2 B positive packed cells. What other type is ABO compatible with this patient? a) A negative b) AB positive c) O negative d) A positive

c) O negative

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

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

What criterion governs the use of the electronic crossmatch? a) Patients Rh group must have been done on two separate occasions. b) Patients antibody screen must have been done on two separate occasions. c) Patients ABO group must have been determined on two separate occasions. d) Patients DAT must have been done on two separate occasions.

c) Patients ABO group must have been determined on two separate occasions.

Name a disease in which your positive D control might be positive. Multiple myeloma PCH Huntington's disease Epstein-Barr virus

Multiple myeloma

A male patient of average size has a hemoglobin count of 8.1 g/dl. The surgeon wants a hemoglobin count of 10 g/dl before doing surgery. How many units of RBCs need to be given before the surgeon will accept the patient into surgery? 2 1 3 4

While performing an antibody screen, a test reaction is observed that is suspected to be rouleaux. A saline replacement test is done, and the reaction remains. What is the best interpretation? The original reaction was rouleaux and may be ignored. The replacement test is invalid and should be repeated. The original reaction was due to true agglutination. The antibody screen is negative.

The original reaction was due to true agglutination.

Why is dosage inconsistent in the Duffy blood group? The genotype could be inherited as FyaFyb or FyaFy for Fy(a+b-) red blood cells Antigen expression is depressed in low ionic strength media. The genotype could be inherited as FyaFya or FyaFy for Fy(a+b-) red blood cells. All of the above

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

A whole blood donation contains a volume of 350 mL. Which of the following is true regarding this unit? a) Platelets cannot be made from this unit. b) Packed red cells cannot be made from this unit. c) FFP cannot be made from this unit. d) Cryoprecipitate can be made from this unit.

c) FFP cannot be made from this unit.

A potential donor diagnosed with West Nile Virus infection should be deferred until ______ days after the condition is resolved and at least _____ days from the onset of febrile illness or diagnosis of West Nile Virus, whichever date is later. a) 14/7 b) 28/14 c) 14/28 d) 7/14

c) 14/28

A patient has a baseline platelet count of 30,000/µL. Upon receiving a platelet pool of 4 random platelets, what would you expect the post-transfusion platelet count to be? a) 100,000/µL b) 80,000/µL c) 50,000/µL d) 35,000/µL

c) 50,000/µL

To maximize the number of components made from whole blood, processing must occur within how many hours of collection. a) 10 hours b) 24 hours c) 6 hours d) 1 hour

c) 6 hours

The gel system has all of the following advantages over the traditional tube procedure except: a) replicability of the test results b) different grading system c) standardization in reading technique d) stability of the test reaction

b) different grading system

Which of the following may be a serious manifestation of fresh frozen plasma (FFP) transfusion in congenital factor deficiencies? a) pleurisy b) tachycardia c) hypogammaglobulinemia d) pulmonary edema

d) pulmonary edema

Which patient is most likely to require irradiated products? Patients undergoing a bone marrow transplant patients undergoing open heart surgery Newborn Geriatric patients

Patients undergoing a bone marrow transplant

Coating reaction chambers with protein A applies to which of the following? Solid phase technology Gel technology Tube method None of the above

Solid phase technology

A stable reaction end point of 2-3 days can be observed with which of the following? Gel Solid phase Tube Two of the above

Two of the above

Which autologous blood collection involves collecting and reinfusing blood during surgery Intraoperative Interoperation Normovolemic Preopearative

Intraoperative

A positive DAT may be seen in: a) warm autoimmune hemolytic anemia b) cold agglutinin syndrome c) hemolytic transfusion reaction d) all of the above

d) all of the above

Why would A2 cells be used in the reverse group in donor processing? a) to differentiate an A subgroup from a group AB b) to differentiate an A subgroup from a group B c) to differentiate an A subgroup from a group O d) none of the above

c) to differentiate an A subgroup from a group O

What is the main concern for obstetric patients in prenatal testing? a) antibody that causes hemolytic transfusion reaction b) autoantibodies c) antibody that causes hemolytic disease of the newborn (HDN) d) drug-induced antibody

c) antibody that causes hemolytic disease of the newborn (HDN)

To maximize the number of components made from whole blood, processing must occur within how many hours of collection. a) 6 hours b) 10 hours c) 24 hours d) 1 hour

a) 6 hours

The gel system has all of the following advantages over the traditional tube procedure except: a) replicability of the test results b) standardization in reading technique c) different grading system d) stability of the test reaction

c) different grading system

Which of the following may be a serious manifestation of fresh frozen plasma (FFP) transfusion in congenital factor deficiencies? a) hypogammaglobulinemia b) tachycardia c) pleurisy d) pulmonary edema

d) pulmonary edema

Why is the infusion of serum albumin looked upon more favorably for protein replacement than fresh frozen plasma (FFP)? a) FFP can transmit disease. b) FFP does not contain protein. c) Serum albumin will not cause an allergic reaction. d) two of the above

d) two of the above

Compatibility testing is required for granulocyte concentration if the red blood cell contamination is greater than: a) 5 mL b) 10 mL c) 15 mL d) 20 mL

a) 5 mL

The method in which a specific ligand is bound to a insoluble matrix in a column and plasma is perfused over the column with select removal of pathogenic substance and return of patient's plasma is known as: a) immunoadsorption b) plasma exchange c) immunoinhibition d) elution

a) immunoadsorption

How is hydroxyethyl starch (HES) used in apheresis procedures? a) a chelation agent to bind calcium b) a primer to keep infusion lines open c) a hemolysin to lyse red blood cells d) a sedimenting agent to separate white blood cells from red blood cells

d) a sedimenting agent to separate white blood cells from red blood cells

Photopheresis is effective against what malignant disorder? a) cutaneous T-cell lymphoma b) Hodgkin's lymphoma c) acute lymphocytic leukemia d) hairy cell leukemia

a) cutaneous T-cell lymphoma

The specific cell product used for treating sepsis is the: a) granulocyte b) lymphocyte c) monocyte d) plasmacyte

a) granulocyte

Plasma exchange is most effective when ________ is considered the pathologic substance. a) IgG b) IgE c) IgM d) IgA

c) IgM

What is the definition of apheresis? a) the extraction of plasma from a whole blood unit b) the process of freezing red blood cells in liquid nitrogen c) separation or removal of a blood component from whole blood d) the addition of EPO to red blood cells to increase 2,3 DPG levels

c) separation or removal of a blood component from whole blood

Platelets collected using an open apheresis system have a _______ outdate. a) 5-day b) 24-hour c) 48-hour d) 72-hour

b) 24-hour

A child undergoing apheresis may require continuous flow centrifugation (CFC) to minimize: a) extramedullary volume b) intracorporeal volume c) extracorporeal volume d) extravascular volume

c) extracorporeal volume

A normal healthy donor undergoes a procedure to obtain platelets that will be transfused to a patient is representative of: a) therapeutic apheresis collection b) component apheresis collection c) whole blood donation d) none of the above

b) component apheresis collection

In what circumstance is a plasmapheresis donor rejected from donation? a) serum protein = 5.0 g/dL b) blood pressure = 140/95 c) temperature = 99.5°F d) hematocrit = 40%

a) serum protein = 5.0 g/dL

Which of the following is an indication for therapeutic apheresis? a) Collection of neocytes to reduce the number of transfusions in Thalassemia Major patients. b) A pathogenic substance exists in the blood that contributes to a disease process. c) A substance can be more effectively removed by apheresis than the body's own homeostatic mechanisms. d) two of the above

d) two of the above

Which of the following is defined as the removal of white blood cells with the return of red blood cells, plasma, and platelets. a) erythrocytapheresis b) plateletpheresis c) leukopheresis d) plasmapheresis

c) leukopheresis

All of the following is consistent with photopheresis except: a) Collected white blood cells are exposed to ultraviolet light, which activates psoralen preventing replication. b) The patient is given an oral dose of psoralen, which binds to DNA of all nucleated cells. c) Treated cells are returned to patient, inducing a immune response against the abnormal lymphocyte clone. d) The patient is given an oral dose of piroxicam, which binds to RNA of all nucleated cells.

d) The patient is given an oral dose of piroxicam, which binds to RNA of all nucleated cells.

What is the physiologic cause of citrate toxicity in cytapheresis procedures? a) The extracorporeal blood volume leaks citrate into the reinfusion site of donor. b) The anticoagulant in plasma contains citrate, which binds calcium, lowering the body's ionized calcium. c) The anticoagulant in plasma contains citrate, which binds chloride lowering the anion gap. d) none of the above

b) The anticoagulant in plasma contains citrate, which binds calcium, lowering the body's ionized calcium.

What is a complication of chronic transfusion therapy in patients with thalassemia major? a) hyperkalemia b) iron deposition in tissues c) blockage of the reticuloendothelial system d) hypervolemia

b) iron deposition in tissues

All of the following is consistent with continuous flow centrifugation (CFC) except: a) The process of phlebotomy, separation, and reinfusion is uninterrupted. b) Separation of components is achieved thru centrifugation. c) Reinfusion to patient completes one cycle. d) Blood is drawn from one phlebotomy site and returned thru another.

c) Reinfusion to patient completes one cycle.

The platelet count of the plateletpheresis donor must be ________ prior to procedure. a) >20 x 109 per L b) >50 x 109 per L c) >100 x 109 per L d) >150 x 109 per L

d) >150 x 109 per L

In platelet pheresis, which blood component is returned to the donor? a) red blood cells b) platelets c) white blood cells d) two of the above

d) two of the above

What is the "rebound phenomena" in plasma exchange? a) Reappearance of IgA in plasma occurs more quickly owing to re-equilibrium. b) A two-volume exchange results in total depletion of IgG. c) Removal of IgG with pheresis can lead to increased antibody synthesis. d) Reappearance of IgM in plasma occurs more quickly owing to re-equilibrium

c) Removal of IgG with pheresis can lead to increased antibody synthesis

What is the most common anticoagulant used in pheresis procedures? a) ACD b) EDTA c) CPDA-1 d) Heparin

a) ACD

Leukopheresis may be indicated when the white blood cell count exceeds ________. a) 100,000 per µL b) 50,000 per µL c) 25,000 per µL d) 75,000 per µL

a) 100,000 per µL

Which apheresis method carries the additional risk of returning red cells to the wrong individual and yielding the smallest volume of selected blood component? a) membrane filtration b) continuous flow centrifugation (CFC) c) manual apheresis d) intermittent flow centrifugation (IFC)

c) manual apheresis

All of the following constitute variables of apheresis procedures except: a) length of dwell time of blood in centrifuge b) centrifuge speed c) blood type d) anticoagulant

c) blood type

A person participating in a serial apheresis program would not: a) lose more than 25 mL of red blood cells per week b) be monitored for weight loss c) donate every 72 hours d) donate more frequently than every 4 weeks

a) lose more than 25 mL of red blood cells per week

During a plasmapheresis procedure, the red blood cells must be returned within how many hours of phlebotomy? a) 4 hours b) 8 hours c) 6 hours d) 2 hours

d) 2 hours

What other transfusion component is available and effective for neonates with limited bone marrow reserve aside from granulocyte transfusion? a) deglycerolyzed red blood cells b) washed red blood cells c) buffy coats d) red cell aliquots

c) buffy coats

All coagulation factors are produced in the liver except: a) antihemophilic factor (AHF) b) factor VII c) factor I d) von Willebrand factor (vWF)

d) von Willebrand factor (vWF)

What is the advantage of performing a type and screen for patients scheduled for surgery instead of crossmatching units for possible transfusion? a) increases the amount of crossmatch performed b) decreases the number of panel studies done on positive antibody screens c) increases the availability of donor units in the inventory d) contributes to outdating of blood products

c) increases the availability of donor units in the inventory

How are red blood cell aliquots prepared for a neonate transfusion? a) Blood is withdrawn from collection bag using a syringe and diluted 1:2 with saline. b) Blood is withdrawn from collection bag using a syringe and diluted 1:2 with glycerol. c) Blood is transferred from collection bag to satellite bag and withdrawn using a syringe. d) none of the above

c) Blood is transferred from collection bag to satellite bag and withdrawn using a syringe.

Which of the following is an indication for immunoglobulin administration? a) infectious mononucleosis b) congenital hypergammaglobulinemia c) hepatitis A d) cytomegalovirus (CMV)

c) hepatitis A

Deglycerolyzed red blood cells can be used interchangeably with washed red blood cells because both procedures: a) remove white blood cells b) remove plasma c) have 24-hour outdate d) all of the above

d) all of the above

Why are fresh blood units (younger than one week) preferred for a neonate transfusion? a) reduce the risk of hypokalemia b) reduce the risk of hypernatremia c) reduce the risk of hyperkalemia d) minimize 2,3 DPG levels

c) reduce the risk of hyperkalemia

All of the following are consistent with graft-versus-host disease (GVHD) except: a) an immunocompromised recipient b) HLA incompatibility between graft and recipient c) transplantation of "immunologically naive" T lymphocytes d) transplantation of immunocompetent T lymphocytes

c) transplantation of "immunologically naive" T lymphocytes

Which of the following are not at risk for developing cytomegalovirus (CMV) via CMV-positive blood products? a) CMV-negative premature infants b) CMV-negative bone marrow transplant recipients c) CMV-negative pregnant women d) CMV-positive heart transplant recipients

d) CMV-positive heart transplant recipients

Why do liver transplant patients require plasma? a) most coagulation factors produced in the liver b) to replace lost fluid volume c) to correct a shortened PT d) none of the above

a) most coagulation factors produced in the liver

Why is whole blood contraindicated for patients with severe chronic anemia? a) These patients have a reduced amount of red blood cells. b) These patients have an increased amount of red blood cells. c) The plasma volume of these patients is decreased. d) The plasma volume of these patients is increased.

d) The plasma volume of these patients is increased.

How is donor platelet survival determined in the recipient? a) platelet count increment (1 hour after transfusion) b) radiolabeled metals c) antiplatelet antibody detection d) none of the above

a) platelet count increment (1 hour after transfusion)

Immunoglobulin prepared from pooled plasma is primarily: a) IgE b) IgA c) IgM d) IgG

d) IgG

A blood component should be transfused within: a) 2 hours b) 4 hours c) 3 hours d) 1 hour

b) 4 hours

How is the whole blood that is collected from a donor different from whole blood circulating in someone's blood vessels? a) The pH of whole blood is higher in collected units than in blood vessels. b) Anticoagulant prevents activation of the coagulation system. c) Immunogenicity is diminished in collected units. d) Citrate serves as substrate for red blood cell metabolism.

b) Anticoagulant prevents activation of the coagulation system.

In addition to nonhemolytic febrile transfusion reactions, what other indication exists for washed red blood cells? a) IgM-deficient patients with anti-IgM b) IgE-deficient patients with anti-IgE c) IgG-deficient patients with anti-IgG d) IgA-deficient patients with anti-IgA

d) IgA-deficient patients with anti-IgA

What is the expiration on washed red blood cells? a) 42 days b) 35 days c) 24 hours d) 6 hours

c) 24 hours

What is the storage temperature for granulocyte concentrates? a) below -18°C b) 1° to 6°C c) 35° to 37°C d) 20° to 24°C

d) 20° to 24°C

Why is red blood cell transfusion contraindicated in a stable patient with chronic renal failure who has no symptoms except after climbing three flights of stairs? a) The anemia is compensated. b) The anemia is a "nutritional anemia." c) Whole blood is recommended because the plasma volume is decreased in these patients. d) none of the above

a) The anemia is compensated.

Why is the increase in hemoglobin and hematocrit evident more quickly in red blood cell transfusions than whole blood transfusions? a) Whole blood is usually transfused through a porous filter. b) Whole blood takes longer to mix. c) Blood volume adjustment is greater when red blood cells are transfused. d) Blood volume adjustment is less when red blood cells are transfused.

d) Blood volume adjustment is less when red blood cells are transfused.

What is suspected when the hematocrit has decreased by 4% and the total bilirubin level is increased 5 days after transfusion? a) delayed hemolytic transfusion reaction b) urticarial reaction c) volume overload d) acute hemolytic transfusion reaction

a) delayed hemolytic transfusion reaction

The rejection of platelets in multiply transfused patients is called: a) urticaria b) refractoriness c) stimulation d) platelet satellitism

b) refractoriness

Each cryoprecipitate unit contains at least how much factor VIII? a) 50 units b) 80 units c) 100 units d) 30 units

b) 80 units

What blood component is responsible for most allergic reactions? a) plasma b) white blood cells c) red blood cells d) platelets

a) plasma

What transfusion therapy is indicated for a patient who is found to be refractory to random platelets? a) neutralization of antiplatelet antibodies by type specific platelets b) irradiated random donor platelets c) apheresis platelets from an HLA compatible donor d) random platelets from other donors

c) apheresis platelets from an HLA compatible donor

What hemoglobin level is considered critical and may warrant a red blood cell transfusion? a) 10 g/dL b) 12 g/dL c) 9 g/dL d) 7 g/dL

d) 7 g/dL

Cryoprecipitate antihemophilic factor (AHF) contains how much fibrinogen? a) 50 to 100 mg b) 500 to 750 mg c) 250 to 400 mg d) 150 to 250 mg

d) 150 to 250 mg

A patient with paroxysmal cold hemoglobinuria (PCH) would require_________ in the event of a blood transfusion. a) Hgb S negative units b) cytomegalovirus-negative units c) a blood warmer d) irradiation

c) a blood warmer

Which of the following represents the final clerical check of a transfusion? a) Nurse uses the patient armband to compare patient identification with patient crossmatch report and tags attached to unit. b) Medical technologist compares specimen label with computer information. c) Two individuals verify affixing of proper labels to selected blood products. d) Phlebotomist asks patient to state his name and social security number and compares with patient requisition.

a) Nurse uses the patient armband to compare patient identification with patient crossmatch report and tags attached to unit.

What is the only blood component that provides high concentrations of von Willebrand factor (vWF)? a) whole blood b) cryoprecipitated antihemophilic factor (AHF) c) fresh frozen plasma (FFP) d) platelets

b) cryoprecipitated antihemophilic factor (AHF)

A 160-lb. man was transfused with one unit of whole blood after being rescued from a burning apartment building. His hematocrit was determined to be 27% before transfusion. What would you expect his hematocrit to be in 48 hours? a) 45% b) 28% c) 30% d) 40%

c) 30%

Which of the following Rh-negative patients may permit transfusion of Rh-positive units when few O-negative units are available in an emergency? a) neonate b) middle-aged male c) pregnant women d) 25-year-old female

b) middle-aged male

A patient with severe hemolytic anemia had a pulse of 120 beats per minute and a respiratory rate of 37 breaths per minute. What blood component is indicated for this patient? a) plasma b) platelets c) whole blood d) red blood cells

d) red blood cells

One unit of random platelets should increase the platelet count by: a) 5000 to 10,000 per µL b) 10,000 to 20,000 per µL c) 500 to 1000 per µL d) 1000 to 5000 per µL

a) 5000 to 10,000 per µL

Leuko-depletion or leukopoor filters are used in the transfusion of red blood cells and platelets to prevent: a) febrile nonhemolytic transfusion reactions b) febrile hemolytic transfusion reactions c) nonfebrile nonhemolytic transfusion reactions d) nonfebrile hemolytic transfusion reactions

a) febrile nonhemolytic transfusion reactions

Treatment of post-transfusion purpura (PTP) with _________is not advocated in medical practice. a) plasmapheresis b) platelet transfusions c) exchange transfusions d) prednisone

b) platelet transfusions

A transfusion reaction investigation should include all of the following except: a) washed RBCs b) diagnosis c) neocyte transfusion d) current medication

c) neocyte transfusion

What should be done in the transfusion process when the patient temperature spikes from 37.5°C to 38.5°C within 30 minutes of transfusion? a) Continue the transfusion. b) Affix a leukocyte filter to transfusion line. c) Stop the transfusion and keep the intravenous line open. d) Treat with Benadryl.

c) Stop the transfusion and keep the intravenous line open.

A 41-year-old multiparous woman was rushed to the emergency room after being shot in the chest. She received 8 units of packed red blood cells and 5 units of platelets. The hemoglobin and hematocrit determinations stabilized after 6 hours in surgery, but the platelet counts remained less than 50,000 per µL. She had received additional units of platelets at 48-hour intervals with little efficacy. Her serum was tested for platelet antibodies. She was placed on corticosteroids to control chest wound bleeding. Anti-PLA1 was identified in the patients serum. This case is representative of what type of transfusion reaction? a) post-transfusion purpura b) circulatory overload c) alloimmunization d) graft-versus-host disease

a) post-transfusion purpura

A patient with two or more documented febrile nonhemolytic transfusion reactions (FNHTRs) should receive __________ blood components. a) leukopoor b) irradiated c) hemoglobin S negative d) cytomegalovirus-negative

a) leukopoor

Which of the following questions should be asked when investigating a transfusion reaction? a) How many milliliters of red blood cells were transfused? b) What was the donor unit hematocrit? c) What methodology was used for serologic testing? d) What time of day was the donor unit collected?

a) How many milliliters of red blood cells were transfused?

What measure can be taken to prevent transfusion-associated hypothermia? a) prudent use of platelet concentrates b) close monitoring of patient vital signs c) premedication with calcium gluconate d) transfusion of product using a blood warmer

d) transfusion of product using a blood warmer

Persons with a documented history of anaphylactic reactions should be transfused with _________ blood products. a) leuko-depleted b) IgE deficient c) washed d) irradiated

c) washed

A postpartum woman was crossmatched for 2 units of packed red blood cells. The first unit was issued at 3:15 AM. At 3:45 AM, the nurse called the blood bank and stated the patient was developing red hives and pruritis (itching). The transfusion was stopped and a post-transfusion specimen was drawn. The unit and identification tags were returned to the blood bank. The DAT on the specimen was negative and hemolysis was absent. All visual and clerical checks were satisfactory. The pathologist ordered the treatment of diphenhydramine for all subsequent transfusions. What type of transfusion reaction has occurred in this patient? a) post-transfusion purpura b) alloimmunization c) anaphylactic d) urticarial

d) urticarial

What statement is false regarding the pathophysiology of alloimmunization? a) Upon secondary exposure to foreign antigen large amounts of IgG are produced. b) Lymphocyte memory is invoked after the first exposure to foreign antigen. c) Upon primary exposure to foreign antigen large amounts of IgG are produced. d) Antibody will attach to red cells and activate the complement system.

c) Upon primary exposure to foreign antigen large amounts of IgG are produced.

What premedication therapy is beneficial for thrombocytopenic patients with a known history of febrile nonhemolytic transfusion reaction (FNHTR) when leukopoor filters are not available? a) dopamine b) acetaminophen c) aspirin d) diphenhydramine (Benadryl)

b) acetaminophen

Which of the following represent the pathophysiology of post-transfusion purpura (PTP)? a) Platelet alloantibody attaches to platelet surface permitting intravascular destruction by RES. b) Platelet autoantibody attaches to platelet surface permitting extravascular destruction by RES. c) Platelet alloantibody attaches to platelet surface permitting extravascular destruction by RES. d) Platelet autoantibody attaches to platelet surface permitting intravascular destruction by RES.

c) Platelet alloantibody attaches to platelet surface permitting extravascular destruction by RES.

In what circumstance would a direct antiglobulin test (DAT) be negative in the presence of a hemolytic process? a) Donor red blood cells have been destroyed. b) Alloantibody in patient serum is reacting with antigen on donor cells. c) Complement proteins are coating red cells. d) Donor white blood cells have been destroyed.

a) Donor red blood cells have been destroyed.

A patient transfused with 2 units of packed cells spiked a fever of 99.5°F and complained of chills 3 days after transfusion. The DAT was positive with polyspecific antisera and anti-IgG, but negative with anti-C3d. Compatibility testing was performed on the pre- and post-transfusion specimens. The latter was incompatible with one of the donor units transfused. An antibody screen was done on both the pre- and post-transfusion specimens. An antibody was detected in the post-transfusion specimen only and identified by panel studies as anti-Jka. This transfusion reaction is most likely caused by: a) a anaphylactic response b) DHTR caused by primary alloimmunization c) delayed hemolytic transfusion reaction (DHTR) caused by anamnestic response d) post-transfusion purpura

c) delayed hemolytic transfusion reaction (DHTR) caused by anamnestic response

Why is a febrile nonhemolytic transfusion reaction (FNHTR) said to be a "diagnosis of exclusion"? a) A spiked fever can only be the result of a blood transfusion. b) FNHTR should not be suspected when fever is the sole symptom exhibited by patient. c) Fever can be the result of many other underlying maladies. d) none of the above

c) Fever can be the result of many other underlying maladies.

All of the following are symptoms of an allergic reaction except: a) pruritus b) anemia c) hives d) local erythema

b) anemia

What postanalytical measure is advocated in the prevention of sepsis? a) use of a blood warmer when transfusing product b) transfusion of blood component with a leukopoor filter c) transfusion of blood component within 4 hours d) all of the above

c) transfusion of blood component within 4 hours

Which of the following represents the pathophysiologic mechanism of a febrile nonhemolytic transfusion reaction (FNHTR)? a) Platelet antibody in patient serum is directed against antigens on donor random platelets. b) Red blood cell alloantibody in patient serum is directed against antigens present on donor erythrocytes. c) HLA antibody in patient serum are directed against antigens present on monocytes, granulocytes, and lymphocytes. d) all of the above

c) HLA antibody in patient serum are directed against antigens present on monocytes, granulocytes, and lymphocytes.

A delayed hemolytic transfusion reaction is most often the result of: a) a unit of packed cells infected with hepatitis B virus b) hemosiderosis in a massively transfused patient c) bacterial contaminated red cells d) an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy

d) an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy

Which of the following may serve as a distinguishing factor in anaphylactic reactions? a) shock b) transfusion of washed red blood cells c) hypotension d) absence of fever

d) absence of fever

A patient undergoing transfusion of packed red cells became hypotensive and cyanotic 30 minutes into the transfusion. The nurse also noted a 0.8°C increase in temperature. The transfusion was stopped and post-blood specimens were sent down to lab for a transfusion reaction investigation. The donor serum was tested against screening cells (3-vial) and was reactive at AHG in all vials. A panel was performed, and anti-Bga was identified. What special blood component should this patient now receive? a) leukopoor b) washed c) deglycerolyzed d) none of the above

d) none of the above

How is a febrile nonhemolytic transfusion reaction (FNHTR) best defined? a) a 2°C temperature rise associated with transfusion and pneumonia b) a 1°C temperature rise associated with transfusion that has no medical explanation other than blood component transfusion c) a 1°C temperature rise associated with transfusion and inflammation of the colon d) a 2°C temperature rise associated with transfusion that has no medical explanation other than component transfusion

b) a 1°C temperature rise associated with transfusion that has no medical explanation other than blood component transfusion

Which of the following is an underlying cause of an immediate hemolytic transfusion reaction (IHTR)? a) A patient with anti-M in serum is transfused with M-positive red cells. b) A patient is transfused with a red cell unit contaminated with Escherichia coli. c) A patient with anti-K in serum is transfused with K-positive red cells. d) Iron overload occurs in a massively transfused patient.

c) A patient with anti-K in serum is transfused with K-positive red cells.

What type of hemolysis is implicated in a delayed hemolytic transfusion reaction (DHTR) caused by primary alloimmunization? a) extravascular b) intravascular c) nonimmune d) none of the above

a) extravascular

Which of the following therapies is not advocated in circulatory overload? a) whole blood units b) transfusing at too fast a rate c) washed red blood cells d) therapeutic phlebotomy

a) whole blood units

What type of hemolysis accompanies an anaphylactic reaction? a) intravascular b) extravascular c) acute d) none of the above

d) none of the above

A severe manifestation of alloimmunization might include: a) platelet refractoriness b) cyanosis c) renal failure d) rising hemoglobin and hematocrit

a) platelet refractoriness

What may be found in the sera of a person who is exhibiting signs of a noncardiogenic pulmonary edema reaction? a) allergen b) red blood cell alloantibody c) antileukocyte antibody d) IgA antibody

c) antileukocyte antibody

All of the following comprise the immediate nonhemolytic transfusion reactions, except: a) febrile b) anaphylaxis c) allergic d) post-transfusion purpura (PTP)

d) post-transfusion purpura (PTP)

Which clinical manifestation is not included in the physically or chemically induced transfusion reactions? a) factor VIII depletion b) hyperkalemia c) hemosiderosis d) citrate toxicity

c) hemosiderosis

What is meant by the term "iatrogenic"? a) generic treatment b) underlying disease c) physician caused d) hospital contracted

c) physician caused

What is the most frequent cause of circulatory overload? a) transfusion of a unit at too fast a rate b) transfusion of a unit at too slow a rate c) transfusion of a unit partially delycerolyzed d) massive transfusion of blood components

a) transfusion of a unit at too fast a rate

A delta check was noted for potassium after a surgical patient was transfused with 2 units of packed red blood cells. The pretransfusion potassium was 3.1 mmol/L and the post-transfusion specimen was 6.2 mmol/L. What could be the reason for this sudden increase? a) Coagulation factors were diluted out of patient plasma. b) Red blood cells were washed prior to infusion. c) Red blood cells spent maximum time in storage. d) none of the above

c) Red blood cells spent maximum time in storage

What is the most common preventable error occurring among the nursing and medical staff that results in a transfusion-related death? a) specimen mislabeled b) alloantibody misidentified c) improper patient identification d) incorrect crossmatch procedure

c) improper patient identification

Which of the following types of blood should be transfused if necessary prior to a patient receiving a hematopoietic progenitor cell transplant? Leuko-reduced CMV - negative Irradiated All of the above

All of the above

When not all of the recipient's hematopoietic progenitor cells are destroyed prior to transplantation, it is called myeloablative conditioning non-myeloablative conditioning syngeneic conditioning chimerism

non-myeloablative conditioning

In which section of the blood bank laboratory would blood be issued for transfusion? a) main laboratory b) component preparation and storage c) donor processing d) reference laboratory

a) main laboratory

What test(s) are involved when a physician orders a 4-unit crossmatch on a patient? a) IS crossmatch b) ABO, Rh, antibody screen, IS crossmatch c) ABO, Rh, DAT, IS crossmatch d) AHG crossmatch

b) ABO, Rh, antibody screen, IS crossmatch

Platelets are stored on a ____________ which provides constant agitation. a) rotator b) refrigerator c) incubator d) cryostat

a) rotator

A positive DAT may be seen in: a) warm autoimmune hemolytic anemia b) cold agglutinin syndrome c) hemolytic transfusion reaction d) all of the above

d) all of the above

Anti-Jka was identified in a donor sample. What blood products can be made from the parent unit? a) fresh frozen plasma (FFP) b) packed red blood cells c) none d) platelets

b) packed red blood cells

A group O whole blood unit collected from an outside facility was needed for a group A recipient. How can packed cells be made in the shortest time frame possible? a) refrigerated centrifugation b) filtration c) vertical rotation d) red blood cell sedimentation

a) refrigerated centrifugation

Which of the following would prolong labeling of the packed red blood cell unit? a) nonreactive RPR b) anti-K in donor plasma c) ALT = 31 U/L d) none of the above

d) none of the above

What one forward-typing reagent can be used to confirm O units collected from another facility? a) anti-H b) anti-A c) anti-B d) anti-A and -B blend

d) anti-A and -B blend

In what department of the blood bank laboratory is knowledge of patient diagnosis, drug history, age, and transfusion history most important? a) reference laboratory b) donor processing c) component preparation and storage d) main laboratory

a) reference laboratory

Which of the following is a representation of an automated cell washer? a) Unit is introduced into sterile bowl, centrifuged, and collected. b) Unit is collected and centrifuged c) Unit is introduced into sterile bowl, saline is added, the mixture is centrifuged, supernate is discarded, and the unit is collected. d) Unit is introduced into sterile bowl, saline is added, and collected.

c) Unit is introduced into sterile bowl, saline is added, the mixture is centrifuged, supernate is discarded, and the unit is collected.

How are 6-8 units of cryoprecipitate usually issued? a) as eight individual units b) as one pooled unit c) as four multiple units of two d) none of the above

b) as one pooled unit

In which department of the blood bank laboratory would an ABO discrepancy be resolved? a) reference laboratory b) donor processing c) main laboratory d) component preparation and storage

a) reference laboratory

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

b) false

Granulocyte concentrates follow the same compatibility protocol as packed red cells. a) true b) false

a) true

Why would an Rh type be ordered on a cord blood sample? a) to determine mother's candidacy for RhIG if she is Rh-negative b) to determine mother's candidacy for RhIG if she is Rh-positive c) because the mother had a spontaneous abortion d) two of the above

a) to determine mother's candidacy for RhIG if she is Rh-negative

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

d) all of the above

Why can the Rh-hr control be eliminated from donor processing? a) An Rh-positive unit of blood typed as an Rh-negative would only be transfused to an Rh-positive patient. b) An Rh-negative unit of blood typed as an Rh positive would only be transfused to an Rh-negative patient. c) An Rh-negative unit of blood typed as an Rh positive would only be transfused to an Rh-positive patient. d) none of the above

c) An Rh-negative unit of blood typed as an Rh positive would only be transfused to an Rh-positive patient.

What additive is used to freeze blood for long-term storage at -65°C? a) glycine b) glutamic acid c) dextran d) glycerol

d) glycerol

To maximize the number of components made from whole blood, processing must occur within how many hours of collection. a) 24 hours b) 6 hours c) 10 hours d) 1 hour

b) 6 hours

A proper blood bank specimen is good for how many days after it is drawn from a patient that has had a prior transfusion within 90 days? a) 3 days b) 14 days c) 7 days d) 24 hours

a) 3 days

It is December 1, 2012, and you irradiate an O-negative packed RBC that you have in inventory, which outdates January 5, 2013. What will the new outdate be for that unit? a) December 3, 2012 b) January 5, 2012 c) December 2, 2012 d) December 29, 2012

d) December 29, 2012

A STAT type and screen comes from surgery. Your institution uses a blood bank band ID bracelet system. The nurse who obtained specimens did not label them with the blood bank number before she handed them to transport to take to the laboratory. What would be the most appropriate action to take? a) Label the specimen yourself and continue with testing. b) Accept the specimen as is. c) Reject the specimen and have it re-collected. d) Call surgery and have the nurse come down and properly label the specimens.

c) Reject the specimen and have it re-collected.

A 40-year-old male presented in the ER with acute bleeding. The technologist received a specimen but was unable to resolve a typing discrepancy between the forward and reverse typings. What blood type should the patient receive for emergency transfusion? a) O-negative crossmatched packed RBCs b) Type specific uncrossmatched packed RBCs c) Electronic crossmatched blood d) O-negative uncrossmatched packed RBCs

d) O-negative uncrossmatched packed RBCs

The indicator cells used to detect antibodies in a solid phase technology are: a) plain red cell suspension b) AHG-coated red cells c) antibody screen cell I d) anti-D coated red cells

b) AHG-coated red cells

Upon centrifugation of an antibody screen procedure done by the gel system, the red cell agglutinates are dispersed through out the gel column with a few agglutinates at the bottom of the micro tubes. This reaction should be graded as a: a) 3+ reaction b) 2+ reaction c) 1+ reaction d) 4+ reaction

b) 2+ reaction

The FDA has approved the following tests for application of the gel technology: a) ABO, antibody screen, and DAT only b) antibody screen, antibody identification, and crossmatching only c) ABO, Rh, DAT, and antibody screen only d) ABO, Rh, DAT, antibody screen and identification, and crossmatching

d) ABO, Rh, DAT, antibody screen and identification, and crossmatching

When performing an antibody screen by gel technology, the following steps are eliminated: a) cells I and II, saline wash b) centrifugation, saline wash c) AHG reagent, control checked cells d) saline wash, control check cells

d) saline wash, control check cells

The gel system has all of the following advantages over the traditional tube procedure except: a) replicability of the test results b) stability of the test reaction c) different grading system d) standardization in reading technique

c) different grading system

What is the expiration time for platelet concentrates that have been pooled? a) 4 hours b) 24 hours c) 6 hours d) 48 hours

a) 4 hours

In a gel-based technology, the solid band at the top of the gel indicates __________, whereas formation of a pellet at the bottom of the micro-tubes indicates _____________. a) 4+ reaction/negative reaction b) negative/4+ reaction c) 3+ reaction/negative reaction d) mixed field reaction/sub groups

a) 4+ reaction/negative reaction

The washing procedure is applicable to which of the following serologic methods: a) solid phase and tube system b) solid phase and affinity column c) gel technology and solid phase d) gel technology and tube system

a) solid phase and tube system

A layer of red cell agglutinates at the top of the gel micro-tubes 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

c) mixed field

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

c) positive

After completing an antibody screen using the gel testing method, results after centrifugation yield a pellet of unagglutinated cells at the bottom of the microtube and a thin layer of cells at the top gel column. This situation commonly indicates: a) a warm autoantibody b) contaminated patient specimen c) fibrin from serum that has not clotted completely d) A cold agglutinin

c) fibrin from serum that has not clotted completely

Which of the following tests is not available for both the gel testing method and solid phase technology? a) AHG b) DAT c) ABO d) None of the above

b) DAT

If you had a lipemic and icteric sample that needed to have an antibody screen done, which of the following would obtain the best results? a) Tube b) Gel c) SPRCA d) None of the above

c) SPRCA

Which of the following statements is the most accurate? A mixed-field in the gel system: a) can be ignored without further workup. b) needs to have further testing performed. c) can be caused by fibrin found in plasma and can be corrected by using fresh serum. d) can be resolved by respinning the gel card.

b) needs to have further testing performed.

If a prospective blood donor has participated in a pheresis donation (platelets, plasma, granulocytes) at least how many hours must pass before donating whole blood? a) 48 hours b) 24 hours c) 56 days d) 4 weeks

a) 48 hours

A whole blood donor who has taken Tegison should be: a) deferred for 6 months b) deferred for 3 months c) permanently deferred d) accepted

c) permanently deferred

What is the deferral period for a donor who has received a live attenuated vaccine for rubella? a) 2 weeks b) 8 weeks c) no deferral period d) 4 weeks

d) 4 weeks

c) 14/28

What is the minimum hemoglobin level for a potential allogeneic donor? a) 11 g/dL b) 12 g/dL c) 12.5 g/dL d) 14 g/dL

c) 12.5 g/dL

What is the minimum hemoglobin level for a potential autologous donor? a) 12.5 g/dL b) 11 g/dL c) 14 g/dL d) 12 g/dL

b) 11 g/dL

A whole blood donation contains a volume of 350 mL. Which of the following is true regarding this unit? a) FFP cannot be made from this unit. b) Packed red cells cannot be made from this unit. c) Platelets cannot be made from this unit. d) Cryoprecipitate can be made from this unit.

a) FFP cannot be made from this unit.

In acute normovolemic hemodilution: a) Shed blood is normally reinfused to the patient within 24 hours of collection. b) Blood units are reinfused in the reverse order of collection. c) The last blood collection should occur no sooner than 72 hours before scheduled surgery. d) Blood units are reinfused in the order of collection.

b) Blood units are reinfused in the reverse order of collection.

Which of the following is the only pheresis procedure that requires administration of a growth factor to the donor? a) plasmapheresis b) erythrocytapheresis c) plateletpheresis d) leukopheresis

d) leukopheresis

A unit of red cells has an expiration date of 11/15/04. A patient currently on a fludarabine regimen requires irradiated packed red cells. The unit is irradiated for this patient on 11/02/04. What is the correct expiration date post-irradiation? a) 11/28/04 b) 11/02/04 c) 11/30/04 d) 11/15/04

d) 11/15/04

Packed RBCs must have a final hematocrit of less than or equal to: a) 38% b) 80% c) 85% d) 70%

b) 80%

Packed RBCs leukoreduced must have an absolute white cell count of less than and contain at least what percent of original RBC mass? a) 5 x 10(8)/85 b) 5 x 10 (8)/80 c) 5 x 10(6)/85 d) 5 x 10(6)/80

c) 5 x 10(6)/85

All of the following is characteristic of a penetrating cryoprotective agent, except: a) Large molecules form a shell around the cell preventing loss of water and dehydration. b) Osmotic force prevents migration of water outside of cell preventing dehydration. c) Two of the above. d) It consists of generally small molecules.

a) Large molecules form a shell around the cell preventing loss of water and dehydration.

What is the minimal pH required for platelets? a) 7.0 b) 6.0 c) 7.2 d) 6.2

d) 6.2

Cryoprecipitate is indicated for all of the following disorder, except: a) hemophilia A b) hemophilia B c) hypofibrinogenemia d) Von Willebrand's disease

a) hemophilia A

A woman received a transfusion of packed RBCs while delivering her baby. Six months later she wanted to donate a unit of blood back to the American Red Cross. If the woman meets all other criteria for donation, is she allowed to donate at this time? a) No, she should be on permanent deferral. b) No, she needs to wait 6 more months. c) No, she needs to wait 3 more months. d) Yes, she can donate at this time.

b) No, she needs to wait 6 more months.

A blood donor with a history of hepatitis B should be excluded: a) only if liver function tests are abnormal. b) only if they are jaundiced. c) permanently d) only if the disease has been active for the last 5 years.

c) permanently

Methods of preparation of platelet concentrates from single units of whole blood must produce a product that yields a minimum of: a) 5.5 × 1011 platelets per unit in 50% of units tested. b) 5.5 × 1011 platelets per unit in 75% of units tested. c) 5.5 × 1010 platelets per unit in 75% of units tested. d) 5.5 × 1012 platelets per unit in 75% of units tested.

c) 5.5 × 1010 platelets per unit in 75% of units tested.

An autologous unit should be donated what time period prior to the patients surgery/need? a) 24 hours b) 72 hours c) 48 hours d) 1 week

b) 72 hours

The following blood donors regularly give blood. Which donor may donate on September 11th? a) A 23-year-old woman who made a direct donation for her aunt on August 14th b) A 52-year-old man who made an autologous donation on September 9th c) A 28-year-old man who had plateletpheresis on August 24th d) A 40-year-old woman who last donated on July 25th

c) A 28-year-old man who had plateletpheresis on August 24th

How many times can a person meeting all the optimal criteria donate an apheresis unit of platelets per year? a) 24 times b) 48 times c) 56 times d) 100 times

a) 24 times

A world traveler came in to do a directed donation for his sister when he found out she needed surgery for her hip. After spending 5 weeks in Europe, he traveled extensively throughout Africa. How should his case be handled? a) Because he is donating to his sister, and she signed consent, he may donate for her. b) He would not be able to donate, because all directed donors must meet the same criteria as allogeneic donors c) He meets all the criteria for being a directed donor, so would be able to donate without any problem. d) He could donate, but only with the consent of the medical direct and physician.

b) He would not be able to donate, because all directed donors must meet the same criteria as allogeneic donors

The new international bar code system that most blood banks are converting to is a) Codabar 128 b) Eian 12 c) ISBT 128 d) Codabar

c) ISBT 128

Why is transmission of cytomegalovirus (CMV) through blood components not a significant risk to most recipients? a) most recipients are CMV positive b) most recipients are CMV negative c) the CMV cannot tolerate cold storage temperatures d) two of the above

a) most recipients are CMV positive

All of the following viruses have been associated with transfusion-associated hepatitis (TAH) except: a) hepatitis E b) hepatitis D c) hepatitis B d) hepatitis A

a) hepatitis E

Which of the following best describes the principle of the Kleihauer-Betke test? a) Maternal hemoglobin is resistant to acid (alkali) appearing pink, where fetal cells appear as ghost cells. b) Fetal hemoglobin is resistant to acid (alkali) and appear pink, where maternal red cells appear as ghost cells. c) D-positive indicator cells form rosettes around fetal Rh-positive red cells. d) D-positive indicator cells form rosettes around maternal Rh-positive red cells.

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

In which of the following, the DAT is reactive with anti-C3d only? a) drug adsorption mechanism b) cold hemagglutinin disease c) warm autoimmune hemolytic anemia d) membrane modification

b) cold hemagglutinin disease

In warm autoimmune hemolytic anemia, the autoantibody will frequently demonstrate _________ -like specificity. a) Fya b) Rh c) Jkb d) K

b) Rh

HLA testing is useful in what other area of study? a) paternity testing b) disease correlation c) anthropology d) all of the above

d) all of the above

How is complement detected in HLA testing? a) uptake of trypan blue dye b) agglutination c) uptake of mitomycin-C d) hemolysis

a) uptake of trypan blue dye

How many cells are required for HLA antibody screening? a) 40 b) 10 c) 20 d) 30

d) 30

A 300-µg dose of RhIg contains sufficient anti-D to protect against how much whole blood? a) 50 mL b) 100 mL c) 15 mL d) 30 mL

d) 30 mL

Which of the following describes a cold autologous absorption procedure? a) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 37°C; autoantibody is removed and alloantibody remains in serum. b) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 37°C; alloantibody is removed while autoantibody remains in serum. c) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; alloantibody is removed while autoantibody remains in serum. d) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; autoantibody is removed while alloantibody remains in serum.

d) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; autoantibody is removed while alloantibody remains in serum.

All of the following are characteristics of benign cold autoagglutinins except: a) Autoantibodies are of the IgM class. b) Antibodies react best with ficin-treated cells. c) Autoantibodies can activate complement in vitro. d) Antibodies have a titer greater than 64 at 4°C

d) Antibodies have a titer greater than 64 at 4°C

All of the following are goals of an exchange transfusion except: a) to correct anemia b) to remove high levels of unconjugated bilirubin c) to remove high levels of conjugated bilirubin d) to remove high levels of maternal antibody

c) to remove high levels of conjugated bilirubin

HBsAg is what part of the hepatitis B virus? a) capsid protein b) core protein c) coat protein d) Dane particle

c) coat protein

Why are T cells unacceptable for cytotoxicity testing using fluorescent labeling? a) T cells do not adhere to nylon wool. b) T cells are not involved in cytotoxicity testing. c) The suppressor activity of T cells renders membrane protein inaccessible to label antibody. d) T cells lack immunoglobulin on their surface.

d) T cells lack immunoglobulin on their surface.

All of the following are characteristic of ABO hemolytic disease of the newborn (HDN) except: a) Mother is group O. b) Infant has mild HDN. c) The antibody is IgM. d) Mother has anti-A, B.

c) The antibody is IgM.

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

c) Newborns do not produce isoagglutinins of their own.

The hepatitis A virus belongs to which family of viruses? a) Hepadnaviridae b) Retroviridae c) Flaviviridae d) Picornaviridae

d) Picornaviridae

Kidney transplants are used to treat which disease? a) Di Guglielmo's syndrome b) Graves' disease c) end-stage renal disease d) erythropoietin deficiency

c) end-stage renal disease

When might a benign cold autoagglutinin cause interference in antibody screening procedures? a) when polyspecific AHG reagents are used in test procedure b) when the immediate spin phase is omitted c) when anti-IgG AHG reagents are used in test procedure d) when LISS is used as a potentiator at 37°C incubation

a) when polyspecific AHG reagents are used in test procedure

Which red blood cell morphology is most characteristic of in ABO hemolytic disease of the newborn (HDN), and absent in Rh HDN? a) burr cells b) tear drop cells c) target cells d) microspherocytes

d) microspherocytes

Which of the following changes in blood donation practices significantly decreased the risk of hepatitis B virus infection in recipients? a) addition of cholesterol screening for blood donors b) elimination of vein-to-vein transfusions via multiple syringes c) availability of autologous predeposit donations d) elimination of cash payments for blood donations

d) elimination of cash payments for blood donations

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) viral d) bacterial

b) paternal

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

d) all of the above

In HLA testing, what is the purpose of mineral oil contained in the testing well? a) to create a viscous microenvironment b) to act as an antigen-antibody complex potentiator c) to prevent evaporation of antisera during incubation d) to provide height to the testing well

c) to prevent evaporation of antisera during incubation

How might a technologist detect a patient with drug-induced hemolytic anemia? a) an ABO discrepancy b) a positive antibody screen c) a positive DAT d) a positive rosette test

c) a positive DAT

the most sensitive test for the detection of HIV infection is the: a) immunofluorescence b) western blot c) southern blot d) polymerase chain reaction

d) polymerase chain reaction

Which of the following products have been known to transmit HIV infection to a recipient? a) whole blood b) albumin c) recombinant factor VIII d) two of the above

d) two of the above

Why is the immediate spin eliminated in the prenatal antibody screen? a) to reduce the detection of auto-antibodies b) to reduce the detection of IgG antibodies c) to reduce the detection of IgM antibodies d) two of the above

c) to reduce the detection of IgM antibodies

Which of the following is indicated when a recipient of blood or blood components develops a viral disease. a) donor look-back b) transfusion-reaction investigation c) type and screen d) incident report

a) donor look-back

What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen? a) Chance of maternal sensitization to Rh antigen is increased. b) Chance of maternal sensitization to Rh antigen is decreased. c) It has no effect. d) none of the above

b) Chance of maternal sensitization to Rh antigen is decreased.

Immunization of the mother can be caused by as little as ____________ D-positive fetal cells. a) 50 mL b) 20 mL c) 1 mL d) 10 mL

c) 1 mL

What physiologic phenomenon associates erythroblastosis fetalis with hemolytic disease of the newborn (HDN)? a) release of nucleated red blood cell (RBC) into circulation of mother inflicted with HDN b) release of mature RBC into circulation of neonate inflicted with HDN c) release of nucleated RBC into circulation of neonate inflicted with HDN d) none of the above

c) release of nucleated RBC into circulation of neonate inflicted with HDN

How is an intrauterine transfusion performed? a) RBCs are injected into the maternal peritoneal cavity. b) RBCs are injected into the fetal peritoneal cavity. c) RBCs are injected into the mother and diffused through the placenta to the fetus. d) Red blood cells (RBCs) are injected into the placenta.

b) RBCs are injected into the fetal peritoneal cavity.

In the event of a clinically significant antibody found in the mother's serum, which of the following must be performed to determine its concentration? a) elution b) antibody titer c) fetal screen d) antibody screen

b) antibody titer

A patient who has been exposed to the hepatitis A virus will have _____________ after just 5 days. a) IgM antibodies b) IgG antibodies c) virus in stool d) elevated ALT

c) virus in stool

Which of the following is a proposed theory for methyldopa-induced mechanism of immune hemolytic anemia? a) The drug modifies the red cells so that plasma proteins bind to the membrane. b) The drug produces aberrations in the proliferation of normal lymphocytes, producing clones of normal immunologically competent cells which produces antibody against foreign red cell antigens. c) Normal red cell antigens are altered by the drug and are no longer recognized as "self," resulting in production of alloantibody to these red cell antigens. d) The drug affects the synthesis of IgG, exerting a direct effect on T lymphocytes, which results in a loss of suppressor function and subsequent proliferation of autoantibodies by B lymphocytes.

d) The drug affects the synthesis of IgG, exerting a direct effect on T lymphocytes, which results in a loss of suppressor function and subsequent proliferation of autoantibodies by B lymphocytes.

Which of the following describes the drug- adsorption (Hapten) mechanism? a) The drug induces production of autoantibody that recognize red cell antigens. b) Drugs bind firmly to proteins of the rbc membrane. c) Drugs alter the red cell membrane so that plasma proteins then bind to membrane. d) A soluble drug-antidrug complex absorbs nonspecifically to red cell membrane.

b) Drugs bind firmly to proteins of the rbc membrane.

What technique can be used to identify an alloantibody in the presence of a cold autoagglutinin? a) polyethylene glycol b) prewarming c) chloroquine treatment d) enzyme treatment

b) prewarming

What life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepatomegaly and splenomegaly? a) Thalassemia b) Hydrops Fetalis c) Hereditary Persistence of Fetal Hemoglobin d) Sickle cell anemia

b) Hydrops Fetalis

What technique is used for lymphocyte-defined compatibility? a) flow cytometry b) mixed lymphocyte reaction (MLR) c) major crossmatch d) minor crossmatch

b) mixed lymphocyte reaction (MLR)

Immune hemolytic anemia is defined as: a) increased RBC destruction caused by enzyme defects b) shortened RBC survival mediated thru humoral antibody production c) shortened RBC survival caused by defective DNA synthesis d) increased red blood cell (RBC) destruction caused by radiation exposure

b) shortened RBC survival mediated thru humoral antibody production

Which of the following is a characteristic of autoantibodies? a) The DAT is only reactive with anti-C3d. b) Antibody reacts with high-incidence antigens. c) Antibody reacts with low-incidence antigens. d) Antibody consist of IgM immunoglobulin

b) Antibody reacts with high-incidence antigens.

How is a donor's eligibility status affected when Western blot results are indeterminate over a period of 6 months and deemed as false positives? a) Donor is placed on a re-entry list. b) Donor is eligible for donation. c) Donor is not eligible to donate. d) none of the above

c) Donor is not eligible to donate

All Rh-negative recipients who are transfused with as little as 1 ml of Rh-positive cells will develop anti-D. a) true b) false

b) false

How can persons with cold hemagglutinin disease (CHD) avoid hemolytic episodes? a) corticosteroid therapy b) move to the North Pole c) have a splenectomy d) move to a warm climate

d) move to a warm climate

Which of the following treatments use ultraviolet light to treat hyperbilirubinemia after the infant is delivered? a) plasma exchange b) electrophoresis c) amniocentesis d) phototherapy

d) phototherapy

Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn infant? a) kernicterus b) bilirubinemia c) hydrops fetalis d) bilirubinuria

a) kernicterus

Which of the following antibodies have not been known to cause hemolytic disease of the newborn (HDN)? a) anti-S b) anti-D c) anti-C d) anti-Lea

d) anti-Lea

A double-lung transplant is indicated in which of the following disorders? a) primary hypertension b) pneumonia c) pulmonary fibrosis d) cystic fibrosis

d) cystic fibrosis

The majority of cross-reactive alloantibodies detect HLA specificities of allelic molecules coded by the same locus. a) true b) false

a) true

Anti-K was identified in absorbed serum of a patient with warm autoimmune hemolytic anemia. If a red blood cell phenotype was performed using an indirect antiglobulin test to ensure the patient was negative for K antigen, what would the technologist find? a) a negative result after cells were treated with ficin b) a patient would type negative for K antigen c) a positive result due to IgM coating cells d) a positive result due to IgG coating cells

d) a positive result due to IgG coating cells

Which IgG subclass carries more potency in red blood cell hemolysis? a) IgG2 b) IgG3 c) IgG4 d) two of the above

b) IgG3

Rhogam should be given within how many hours after delivery? a) 36 b) 24 c) 72 d) 48

c) 72

What does the "R" signify in the HLA-DR locus? a) recessive gene b) red cell predominance c) RNA d) subregion of D

d) subregion of D

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

b) fetal reticuloendothelial system

Rh immune globulin is of no benefit once a person has been actively immunized and formed anti-D. a) false b) true

b) true

A patient who has been presensitized to foreign HLA antigens will demonstrate _________ if the donor tissue expresses the same antigens. a) chimerism b) graft rejection c) ABO conversion d) graft survival

b) graft rejection

Autoanti-I was identified in a patient transfused 1 month ago. Which technique is advocated to detect alloantibodies in this patient? a) prewarming b) enzyme treatment c) cold autoabsorption d) warm autoabsorption

a) prewarming

The reactions of a warm autoantibody will be the same in the serum and in the eluate. a) true b) false

b) false

Cold autoanti-H is more prevalent in which blood group? a) A2 b) A1B c) B d) O

b) A1B

MHC class II molecules are expressed on all of the following except: a) endothelial cells b) monocytes c) platelets d) B lymphocytes

c) platelets

A 5-year-old boy suffering from the measles complained of back pain, chills, and stomach pain. A visit to the doctor revealed hemoglobinuria, bilirubinemia, and hemoglobinemia. The child's hemoglobin level had fallen to 6 g/dL. A Donath- Landsteiner test was performed and showed the following: control sample = no hemolysis test sample = hemolysis The results are consistent with what disorder? a) secondary cold autoimmune hemolytic anemia (AIHA) b) cold hemagglutinin disease c) warm autoimmune hemolytic anemia d) paroxysmal cold hemoglobinuria

d) paroxysmal cold hemoglobinuria

Which theory supports production of autoantibodies? a) Loss of T-cell suppressor activity upon self- antigens leads to production of autoantibody. b) Loss of T helper cell activity upon self-antigens leads to production of autoantibodies. c) T suppressor cells prevent overproduction of antibody by B cells. d) Helper T cells assist immunocompetent B cells in making antibody against foreign antigens.

a) Loss of T-cell suppressor activity upon self- antigens leads to production of autoantibody.

Patients who have been presensitized to HLA antigens have a much higher graft survival rate in liver transplantation than non-sensitized patients. a) true b) false

b) false

Which of the following best describes the principle of the Kleihauer-Betke test? a) D-positive indicator cells form rosettes around fetal Rh-positive red cells. b) D-positive indicator cells form rosettes around maternal Rh-positive red cells. c) Fetal hemoglobin is resistant to acid (alkali) and appear pink, where maternal red cells appear as ghost cells. d) Maternal hemoglobin is resistant to acid (alkali) appearing pink, where fetal cells appear as ghost cells.

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

In order for the mother to be considered for RhIg, her Rh type must be and her newborn must be __________. a) Rh positive/Rh negative b) Du positive/Rh positive c) Du negative/Du negative d) Rh negative/Rh positive

d) Rh negative/Rh positive

What is the primary goal for treatment in patients with warm autoimmune hemolytic anemia? a) reduction in neoplastic tumors b) treat for coexisting anemia c) treat the underlying disease d) none of the above

c) treat the underlying disease

When is the antenatal dose of RhIg given? a) 13 weeks b) 20 weeks c) 28 weeks d) 36 weeks

c) 28 weeks

What is the physiologic mechanism of RhIg? a) attachment of fetal Rh-positive red cells in maternal circulation inhibiting production of anti-D b) attachment of maternal Rh-negative red cells in maternal circulation inhibiting production of anti-D c) attachment of fetal Rh-positive red cells in fetal circulation inhibiting production of anti-D d) attachment of fetal Rh-negative red cells in maternal circulation inhibiting production of anti-D

a) attachment of fetal Rh-positive red cells in maternal circulation inhibiting production of anti-D

Transfusion-associated AIDS (TAA) accounts for approximately what percentage of all AIDS cases. a) 2% b) 50% c) 35% d) 10%

a) 2%

In which type of hemolytic disease of the newborn (HDN), the first-born is affected? a) Lewis b) ABO c) P d) Rh

b) ABO

A patient with a warm reacting autoantibody needs 2 units of compatible, or least incompatible, packed cells. Medical history reveals a blood transfusion 2 months ago. A homologous absorption is performed using the following red blood cell phenotype: R2R2, ss, Fy(a-b+), Jk(a+b-), kk. What alloantibody would remain in serum after absorption? a) anti-Fyb b) anti-S c) anti-Jka d) anti-E

b) anti-S

Which statement is true regarding hepatitis delta virus (HDV)? a) The HDV is a DNA virus. b) Most HDV infections occur via blood transfusion. c) The HDV can occur simultaneously with hepatitis B virus. d) A carrier of hepatitis B virus cannot contract HDV infection.

c) The HDV can occur simultaneously with hepatitis B virus.

How are units for exchange transfusion prepared? a) group O red cells and group B plasma b) group O red cells and group AB plasma c) group O red cells and group O plasma d) group O red cells and group A plasma

b) group O red cells and group AB plasma

Which MHC region encodes for complement proteins? a) class I b) class II c) class III d) none of the above

c) class III

Persons infected with the hepatitis C virus may develop what disease? a) chronic liver disease b) cirrhosis c) hepatocellular carcinoma d) all of the above

d) all of the above

which of the following, the DAT is reactive with anti-C3d only? a) warm autoimmune hemolytic anemia b) drug adsorption mechanism c) membrane modification d) cold hemagglutinin disease

d) cold hemagglutinin disease

What is the most important pretransplant test performed on the recipient in heart transplantation? a) red blood cell antibody screen b) HLA-antibody screen c) HLA-crossmatch d) red blood cell-crossmatch

b) HLA-antibody screen

The antibody titer of maternal antibody is directly proportional to severity of hemolytic disease of the newborn (HDN). a) true b) false

b) false

What is the most common clinical manifestation of ABO hemolytic disease of the newborn (HDN)? a) hyperbilirubinemia b) hypotension c) hyperkalemia d) severe anemia

a) hyperbilirubinemia

A newborn hemoglobin level of 7 g/dL is indicative of severe anemia and corresponds to which zone of the Liley graph? a) zone I b) zone II c) zone III d) none of the above

c) zone III

The most important serologic test for the diagnosis of hemolytic disease of the newborn (HDN) is the ________ with anti-IgG reagents. a) DAT b) IAT c) fetal screen d) elution

a) DAT

Which of the following statements is false regarding the Western blot confirmation test for HIV infection? a) Most persons with AIDS show bands to p24 and gp41. b) A purified viral lysate is dissolved in SDS and separated by PAGE electrophoresis. c) Viral components are distributed according to molecular weights. d) Interpretation of test depends upon degree of immunofluorescence.

d) Interpretation of test depends upon degree of immunofluorescence.

Which of the following describes a cold autologous absorption procedure? a) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 37°C; autoantibody is removed and alloantibody remains in serum. b) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; autoantibody is removed while alloantibody remains in serum. c) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; alloantibody is removed while autoantibody remains in serum. d) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 37°C; alloantibody is removed while autoantibody remains in serum.

b) An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; autoantibody is removed while alloantibody remains in serum.

Why is suppression of erythropoiesis an advantage of exchange transfusions? a) reduction in the production of compatible red blood cells (RBCs) b) clearance of nucleated RBCs from circulation c) decreased the risk of iron overload d) reduction in the production of incompatible RBCs

d) reduction in the production of incompatible RBCs

Which of the following assays is used to detect fetomaternal hemorrhage in a postpartum specimen? a) Kleihauer-Betke b) rosette test c) antibody screen d) DAT

b) rosette test

Most cases of warm autoimmune hemolytic anemia will be DAT positive with which of the following? a) anti-IgG only b) anti-C3d only c) both anti-IgG and C3d d) none of the above

c) both anti-IgG and C3d

Persons diagnosed with pneumonia caused by Mycoplasma pneumoniae may produce a cold autoantibody with ____________ specificity. a) anti-P b) anti-H c) anti-i d) anti-I

d) anti-I

Which of the following patients would be at a greater risk for cytomegalovirus (CMV) infection? a) an autologous transplant recipient b) a low birth weight infant transfused with CMV- negative blood c) an allogenic bone marrow transplant recipient d) none of the above

c) an allogenic bone marrow transplant recipient

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) 23 c) 17 d) 10

c) 17

How is the serology work-up for an autoantibody produced by a drug-induced hemolytic anemia different from other autoantibody workups? a) Eluate is detectable when drug-coated red cells are present. b) Antibody is not detected in presence of drug. c) The antibody will only be reactive with red cells in the presence of the drug. d) Complement will be detected on red cells.

c) The antibody will only be reactive with red cells in the presence of the drug

In a patient who has been recently transfused, a positive DAT may be due to: a) alloantibody coating patient cells b) alloantibody coating transfused donor cells c) antibodies to a drug coating donor cells d) none of the above

b) alloantibody coating transfused donor cells

What is the recommended treatment for drug-induced hemolytic anemia caused by the immune complex mechanism? a) cessation of drug administration b) transfusion c) splenectomy d) immunosuppressive therapy

a) cessation of drug administration

Final Exam Flashcards

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