Final Exam: Old Exam Questions Flashcards
(167 cards)
1
Q
What blood type is the universal donor of plasma?
A
AB
2
Q
What blood type is universal recipient of red cells
A
AB
3
Q
What do Landsteiner’s laws state
A
If you have the antigen, you do not have the antibody
If you have the antibody, you do not have the antigen
You can not have both
3
Q
Why is the ABO blood type the most significant
A
It has naturally occurring antibodies that are primarily IgM that react at body temperature
4
Q
Donor has the phenotype hh AB. What is the red cell phenotype in forward type?
A
O
4
Q
What lectin is used to determine A subgroups?
A
Dolichos biflorus
5
Q
What immune globulin levels characterize a secondary immune response
A
higher total antibody, slower decline
6
Q
What do we call the net negative charge on the surface of the RBCs
A
Zeta potential
7
Q
What are immunoglobulin functions
A
Binding to antigens, facilitates phagocytosis, fix complement.
8
Q
Phenotype is
A
the physical expression produced by the genotype
9
Q
LISS reagent is used to
A
reduce the zeta potential
10
Q
Which immunoglobulin class has 10 antigen binding sites and can’t cross placenta
A
IgM
11
Q
Which of the following sugars must be present on the precursor chain for the A and B immunodominant sugars to be added
A
L-fucose
12
Q
Acquired B may occur in patients with which disorders?
A
Disorder of the lower intestinal tract
13
Q
If a person as the genotype SeSe, AA what antigens would be in their secretions
A
A and H
14
Q
Phenomenon in which a false-negative result is obtained in an agglutination based assay because of an excessively increased ration of antigen to antibody
A
Postzone
15
Q
Which of the following ABO blood groups contains the most amount of H antigen
A
A2
16
Q
An example of a technical error that could result in ABO discrepancy
A
Reagent was not added in correct amounts
17
Q
What is the best definition of avidity when talking about antigen-antibody interaction
A
sum of all attractive forces
18
Q
What is the first step in agglutination reactions
A
sensitization
19
Q
What corrective action should be taken when rouleaux causes positive test results
A
Perform a saline replacement technique
20
Q
Which immunodominant sugar is for the B blood type
A
D-galactose
21
Q
What is in the adaptive immune response that is not in the acquired?
A
Memory
22
Q
What does reverse typing tell you?
A
The antibodies in the patient’s plasma
23
Lattice formation of antigen and antibody...
will not occur in prozone and postzone
24
Genetic material in the order from largest to smallest
Chromosomes, genes, DNA, nucleic acids
25
The most common blood type in the US is
type O
26
The class of antibody is usually clinically significant in the blood banking lab usually at 37 degrees and is small enough to cross the placenta
IgG
27
Which is the immunodominant sugar confers A antigens
N-Acetylgalactosamine
28
The lectin Ulex europeaus agglutinates what RBC
Most cells except Bombays
29
What is the inheritance pattern for the ABO and Rh blood groups
Autosomal co-dominant
30
The O gene has no detectable product and is termed...
Amorph
31
The products of genes inherited at the ABO locus are
transferases
32
Processes of the adaptive immune system include...
production of antibody on exposure to foreign antigens
33
What is not part of the innate immune system
memory B-cells
34
What is true about prozone and postzone
they both result in a false negative
35
What cells are involved in the production of antibodies
B lymphocytes
36
A person who has the A2 phenotype will have which antigens on their red cells
A antigens only
37
What antibody is present when patient serum agglutinates with a panel of adult red cells
Anti-I
38
What groups of antigens are destroyed by enzymes?
M, N, S and Duffy
39
Which antibody disappears rapidly in vivo, making it difficult to detect in vitro
Kidd
40
What test method is most efficient for a short staff lab
Solid phase or gel testing
41
What can proteolytic enzymes do to red cell antigens
Enhance, destroy or not affect reactivity
42
A patient is suspected of having PCH. Which pattern of reactivity is characteristic of the antibody that causes the condition?
Attaches to RBCs at 4C, and causes hemolysis at 37C
43
Which antigen is notorious for deteriorating rapidly in storage
P1 antigen
44
Polyspecific AHG reagent contains
Anti-IgG and Anti C3d
45
Anti-N like antibodies may be formed in individuals...
requiring renal dialysis
46
How is the principle of the antiglobulin test best described
AHG reacts with human globulin molecules that can be bound to RBCs or free in serum
47
CAD is associated with antibody specificity towards which of the following
I
48
If there is no agglutination when check cells are added then the results are...
invalid
49
What is the substance that prevents the allogeneic production of anti-D in pregnant women
Rh-immune globulin (RhIg)
50
Where does antihuman globulin AHG bind
To the Fc receptor of IgG molecule
51
What type of RBCs do Rhnull individuals have on a peripheral blood smear
Stomatocytes
52
What antigen is the 3rd most immunogenic after the D antigen and well developed at birth
K
53
The endpoint reaction of gel testing technology is
agglutination
54
The indirect antiglobulin test detects...
in vitro sensitation
55
The direct antiglobulin test detects
in vivo sensitation
56
Antibodies to Kpa and Jsa are...
rare because few people are exposed to them
57
What does the RHAG gene do
it must be present for the expression of Rh antigens
58
The D antibody will agglutinate with what percentage of the populations RBCs
85%
59
What does the term exalted D refer to
Stronger expression of D antigens when Cc and Ee are missing
60
What makes up an autocontrol
patient serum and patient cells
61
Which of the following is NOT a reagent used in the lab to enhance the reactions of antibodies
Distilled water
62
Which of the following is an example of weakened expression of a trait due to position effect
Weakened expression of D when C is trans
63
Le(a-b-) individuals may develop Lewis antibodies without exposure to lewis antigens. These antibodies are referred to as being
naturally occuring
64
AHG reagent that is monospecific for IgG contains...
Anti-IgG only
65
Sold-phase antibody testing is based on
adherence
66
When an individual inherits both the lewis gene and the secretor gene which of the following RBC phenotypes will be observed
Le (a-b+)
67
The Fy(a-b-) phenotype is seen largely in what population
African
68
In the indirect antiglobulin test IAT, which phase of testing is IgM antibodies
IS
69
Which of the following would give you a false negative antiglobulin test
incorrect plasma to cell ratio
70
When one or more D epitopes within the entire D protein is missing it is termed
Partial D
71
Most Rh antibodies are of what immunoglobulin class
IgG
72
Which of the following lists the three phases of the IAT in the correct order
IS, 37C, AHG
73
Which microbial disease is associated with the development of an auto-anti-I in older adults
mycoplasma pneumonia
74
Rh system genes are
RHD and RHCE
75
AHG (Coombs) control cells
are coated with IgG antibodies
76
What are weak D donors typed as
Rh positive
77
What liquid is not able to inhibit or neutralize any antibody
PEG
78
The lack of Kx expression of RBCs has been associated with
the McLeod phenotype and CGD
79
Why should specimens be used no more than 3 days after collections in patients who have been recently transfused or pregnant.
Recent pregnancy or transfusion may stimulate antibodies that are not detectable at the time of collection
80
What is being tested in an antibody screen
patient serum against group O reagent cells
81
When would you suspect multiple antibodies in a patients serum?
Patterns of reactions not fitting a single antibody, variation in reactivity phase, and variation in reactivity strength
82
What does the rule of 3 determine
95% confidence that the correct antibody has been detected
83
Which of the following best describes the principle of absorption
The process of removing antibodies from serum by incubating with the corresponding antigen
84
What compatibility testing is preformed on plasma products
No compatibility testing is required
85
Once a donor unit arrives to the transfusion facility, donor units should be observed for
blood clots, correct labeling and abnormal color
86
An autologous donation of blood is
a donation from yourself for future surgery or medical needs
87
For an autologous donation the Hb and Hct must be at least
11g/dl and 33%
88
Which of the following microorganisms poses the greatest risk of infection by transfusion
Bacteria
89
Washed RBCs are particularly important for which patient population
IgA deficient patients
90
After transfusion the donor sample and pre transfusion recipient sample must be kept for
7 days
91
Which is the most appropriate product for a person with multi-coag factor deficiency
FFP
92
Irradiation of donor blood is done to prevent which of the following adverse effects of transfusion
Transfusion associated graft vs host disease
93
Pre-transfusion testing for a patient with a newly detected clinically significant Ab must include
an AHG phase crossmatch
94
Pre-transfusion orders for a type and screen includes
ABO group, Rh type and antibody screen
95
A donor unit shipped to a transfusion facility from a collection facility must be retyped for ABO group and
Rh typed if D neg
96
A patient that has every had a serologic positive test for Hep B would be deferred from donating for how long
permanently
97
In a left shift...
Hb O2 affinity increases, owing to a decrease in 2,3 DPG
98
What is considered a massive transfusion
8-10 units of RBC in less than 24 hours
99
If the collection and transfusion facilities are the same what testing is required before transfusion
ABO/Rh & Ab screen
100
What type of testing has decreased window period
Nucleic acid testing of donated blood products
101
What can donation centers do on the Donor history questionaire
Add additional questions at the end to make criteria more stringent
102
What happens in a computer crossmatch
Compares patients blood type to a database of units to find a match
103
What is part of pre donation screening
Registration, medical history questionnaire, physical exam
104
Antibodies are excluded using RBCs that are homozygous for the antigen because
antibodies may show dosage
105
What is one way to restore 2,3 DPG and ATP levels in a unit of packed RBCs
Rejuvenate the RBCs with rejuvisol
106
How long does someone donating platelets wait after taking aspirin
2 days
107
Directed donation from a first degree relative increases the risk of
transfusion associated graft vs host disease
108
You perform an IS crossmatch and see no Agg. What does that mean
unit is compatible and can be transfused
109
What type of crossmatch is done if there is history of an Ab
AHG crossmatch
110
What is the europe/canada technique to make plts from whole blood
Buffy coat method
111
when performing AHG crossmatch what procedure do we use
IAT
112
The min Hb concentration for male to donate is
13g/dl
113
What is it called when a donor tests positive for a bloodborne pathogen
donor lookback
114
A RBC unit is considered uncross matched when it is issued
prior to lab test completion
115
Therapeutic apheresis can be used to remove pathologic substances from a patients blood. This could include removal of...
platelets, plasma, WBC, RBC
116
What crossmatch is equivalent to a computer crossmatch
IS crossmatch
117
What is the expected outcome of a transfusion of 1 unit of packed RBCs
Inc Hb by 1g/dl and Hct by 3%
118
What is the window period
The period between infection and detection of Ab
119
What acute transfusion reaction would be least likely to cause an inc in temperature
Transfusion associated circulatory overload (TACO)
120
What acute transfusion reactions have pulmonary effects
TACO and TRALI
121
What happens in the blood within the first hours of an intravascular hemolytic event
Haptoglobin decreases and free hemoglobin increases
122
T/F is malaria screened for in all donated units of blood int he US
False
123
Which transfusion would likely not exhibit hypotension
Febrile non-hemolytic transfusion reaction
124
Which transfusion reaction would likely have a + DAT
Acute hemolytic
125
What reaction would decrease the most if we only used male donors
TRALI
126
What are the results of someone with a delayed HTR
Dec Hb and inc total bilirubin
127
What component is most frequently involved in transfusion associated sepsis
Platelets
128
Fatal TR are most often caused by
clerical errors
129
Fever, maculopapular rash, watery diarrhea, abnormal liver function, pancytopenia after first degree relative
TA-GVHD
130
How are mild allergic TR with isolated symptoms or hives treated
Transfusion is stopped, anti-histamine is administered, when symptoms improve transfusion is restarted.
131
Patient has respiratory distress, severe hypoxemia and hypotension and fever. What reaction
TRALI
132
What is a characteristic of iron overload
Multi organ damage
133
Hepatosplenomegaly in a fetus with HDFN is caused by...
erythropoiesis in the liver and spleen
134
What is performed at 28 weeks in a Rh neg mother
RhIG dose
135
What is the most important serologic test for HDFN diagnosis
DAT
136
Besides Keilhaur betke test what is another method to determine fetal hemorrhage volume
Flow cytometry
137
What causes fifths disease and enters RBCs via the P antigen
Parvovirus B-19
138
What diseases are caused by mosquito bites
Malaria, West Nile Virus, Dengue Fever
139
Babesiosis is common in what geographical area
Northeastern and midwestern US
140
What is responsible for the decrease in the window period
Nucleic amplification testing
141
What poses the greatest risk of infection by transfusion in an immunocompetent individual
Bacteria due to contaminated skin or septic donor
142
Which disease is not tested in donated units in the US
vCJD
143
Why do we rarely see syphilis transmitted via RBC donation
The organism can not survive at fridge temperatures for very long
144
Antibodies that are common causes of HDFN can be IDed in prenatal specimens include
Rh and Anti-K
145
What is the principle of the kleihauer-betke test
Fetal cells resist acid elution and stain pink. Adult cells are not resistant and will not stain
146
Why is Rh HDFN more severe than ABO
Both involve IgG, but ABO antigens are not well developed at birth
147
Kernicterus is caused by
Unconjugated bilirubin
148
When determining RhIg dosage it is better to under or over estimate
over
149
50% or greater of the adult population has been exposed to which viruses
CMV, EBV, parvovirus
150
HLA antibodies are induced by:
Multiple pregnancies or transfusions
151
Which method of pathogen inactivation can not be used on cellular products
Heat and solvent/detergent
152
Maternal IgG antibodies that enter the fetus can remain in the circulation at significant levels for what length of time after birth
several weeks
153
The most important and easiest step in the safe administration of blood products is
accurate identification of the donor unit and recipient
154
Severe allergic reactions in plasma products are most likely to happen with...
IgA deficient patients
155
Which of the transfusion reactions is not associated with HLA antibodies
TACO
156
Rh immune globulin is administered to mothers to prevent
maternal antibody production
157
Which of the following best describes pathogen inactivation using Psoralen and UV light
Crosslinks the nucleic acid of pathogens so they can not reproduce
158
The prion disease that is most concerning for transfusion transmittance in the US is
vCJD
159
What is the most common treatment for ABO HDFN
UV light
160
300ug dose of RhIg can suppress immunization to how many mls of D-pos whole blood
30
161
The most helpful lab test for early detection of acute HTR is
a visual inspection of plasma for hemolysis
162
Compensated anemia
RBC production > RBC destruction
163
Uncompensated anemia
RBC production < destruction
Decreased Hb, Hct, Haptoglobin
Inc retics, unconjugated bilirubin
164
Conditions that cause secondary AIHA
Lymphoproliferative (CLL) and SLE = warm
Epstein barr, pnemonia, lymphoproliferative=cold
165
What antibodies are commonly seen in warm autos?
Rh, Kell, Kidd
