Immunohema Flashcards
(29 cards)
- What protocol is followed when screening whole blood donors for HIV-1 RNA?
A. Pools of 10 are tested; if the pool is nonreactive, donors are accepted
B. Pools of 20 are tested; if the pool is reactive, samples are tested individually
C. Pools of up to 16 donors are tested; if pool is reactive, individual samples are screened
D. All donors are screened individually; if samples are reactive, blood is discarded
C. Pools of up to 16 donors are tested; if pool is reactive, individual samples are screened
- Currently, nucleic acid testing (NAT) testing is performed to detect which viruses?
A. HIV and Human T-cell lymphotropic virus (HTLV-1)
B. HTLV I/II
C. HIV, HCV, HBV, Zika, and West Nile virus (WNV)
D. HIV, HBV, and WNV
C. HIV, HCV, HBV, Zika, and West Nile virus (WNV)
- John comes in to donate a unit of whole blood at the collection center of the community blood supplier. The enzyme immunoassay assay (EIA) screen for anti-HIV-1,2 is nonreactive; however, the NAT HIV is reactive. After 8 weeks John is tested again and found to be NAT nonreactive and EIA anti-HIV-1,2 nonreactive:
A. This renders him eligible for donation
B. Donation is deferred for 6 months
C. Status is dependent on further confirmatory testing
D. Donation is deferred for 12 months
A. This renders him eligible for donation
- What marker is the first to appear in HBV infection?
A. Hepatitis B core antibody (anti-HBc) IgM
B. HbsAg
C. Hepatitis B surface antibody (anti-HBs)
D. Anti-HBc IgG
B. HbsAg
- What marker indicates immunity to hepatitis B infection?
A. Anti-HBc IgM
B. HBsAg
C. Anti-HBs
D. Anti-HBc IgG
C. Anti-HBs
- A patient with multiple myeloma is placed on daratumumab (Darzalex). What tests are affected by this drug, and what are typical recommendations for transfusion?
A. Antibody screen/least incompatible RBCs
B. ABO/washed RBCs
C. Rh/leukocyte-poor RBCs
D. All of the above
A. Antibody screen/least incompatible RBCs
- A unit tests positive for syphilis with use of the rapid plasma reagin (RPR) test. The Treponema pallidum particle agglutination (TP-PA) test on the same unit is negative. What is the disposition of the unit?
A. The unit may be used to prepare components
B. The donor must be contacted and questioned further; if the RPR test result is most likely a
false positive, then the unit may be used
C. The unit must be discarded
D. Cellular components may be prepared but must be irradiated before issue
A. The unit may be used to prepare components
- SITUATION: John Smith donated a unit of whole blood in May. RBCs made from whole blood were transfused to a recipient at a community hospital in June, with no apparent complications. The blood supplier notified the medical director of the hospital that the donor had reported engaging in high-risk behavior with another male in April, although viral tests remain negative and the donor is healthy. What course of action should be taken?
A. No action should be taken
B. The recipient’s physician should be notified
C. The recipient’s physician and the recipient should be notified
D. The recipient should be notified
B. The recipient’s physician should be notified
- All of the following are required tests on donor blood, except:
A. HBsAg
B. Anti-CMV
C. HIV-1
D. Anti-HTLV I/II
B. Anti-CMV
- Which of the following bands would constitute a positive Western Blot result for HIV?
A. p24, gp41, p17
B. p55, gp120, p51
C. gp160, p31, p56
D. p24, p30, p55
A. p24, gp41, p17
- All of the following are reasons for a positive DAT on cord blood cells of a newborn except:
A. High concentrations of Wharton jelly on cord blood cells
B. Immune anti-A from an O mother on the cells of an A baby
C. Immune anti-D from an Rh negative mother on the cells of an Rh-positive baby
D. Immune anti-K from a K-negative mother on the cells of a K-negative baby
D. Immune anti-K from a K-negative mother on the cells of a K-negative baby
- A fetal screen yielded negative results on a mother who is O negative and infant who is O positive. What course of action should be taken?
A. Perform a Kleihauer-Betke test
B. Issue one full dose of RhIg
C. Perform a DAT on the infant
D. Perform an antibody screen on the mother
B. Issue one full dose of RhIg
- What should be done when a woman who is 24 weeks pregnant has a positive antibody screen?
A. Perform an antibody identification panel; titer, if necessary
B. No need to do anything until 30 weeks’ gestation
C. Administer RhIg
D. Adsorb the antibody onto antigen-positive cells
A. Perform an antibody identification panel; titer, if necessary
- All of the following are interventions for fetal distress caused by maternal antibodies attacking fetal cells except:
A. Intrauterine transfusion
B. Plasmapheresis on the mother
C. Transfusion of antigen-positive cells to the mother
D. Middle cerebral artery peak systolic velocity (MCA-PSV)
C. Transfusion of antigen-positive cells to the mother
- Cord blood cells are washed six times with saline, and the DAT result and negative control are still positive. What should be done next?
A. Obtain a heelstick sample
B. Record the DAT result as positive
C. Obtain another cord blood sample
D. Perform elution on the cord blood cells
A. Obtain a heelstick sample
- What can be done if HDFN is caused by maternal anti-K?
A. Give Kell immune globulin
B. Monitor the mother’s antibody level
C. Prevent formation of K-positive cells in the fetus
D. Not a problem; anti-K is not known to cause HDFN
B. Monitor the mother’s antibody level
- Should an O-negative mother receive RhIg if a positive DAT on the newborn is caused by immune anti-A?
A. No, the mother is not a candidate for RhIg because of the positive DAT result
B. Yes, if the baby’s type is Rh negative
C. Yes, if the baby’s type is Rh positive
D. No, the baby’s problem is unrelated to Rh blood group antibodies
C. Yes, if the baby’s type is Rh positive
- Should an A-negative woman who has just had a miscarriage receive RhIg?
A. Yes, but only if she does not have evidence of active anti-D
B. No, the type of the baby is unknown
C. Yes, but only a minidose regardless of trimester
D. No, RhIg is given to women at full-term pregnancies only
A. Yes, but only if she does not have evidence of active anti-D
- SITUATION: The automated blood bank analyzer reports a type of O negative on a woman who is 6 weeks pregnant with vaginal bleeding. The woman tells the emergency department physician she is O positive and presents a blood donor card. The MLS performs a test for weak D and observes a 1+ reaction in the AHG phase. The Kleihauer-Betke test result is negative. Is this woman a candidate for RhIg?
A. Molecular testing is indicated to a certain the type of weak D
B. Yes, she is Rh positive
C. No, there is no evidence of a fetal bleed
D. Yes, based on the automated typing results
A. Molecular testing is indicated to a certain the type of weak D
- Which of the following patients would be a candidate for RhIg?
A. B-positive mother; B-negative baby; first pregnancy; no anti-D in mother
B. O-negative mother; A-positive baby; second pregnancy; no anti-D in mother
C. A-negative mother; O-negative baby; fourth pregnancy; anti-D in mother
D. AB-negative mother; B-positive baby; second pregnancy; anti-D in mother
B. O-negative mother; A-positive baby; second pregnancy; no anti-D in mother
- The Kleihauer-Betke acid elution test identifies 40 fetal cells in 2,000 maternal RBCs. How many full doses of RhIg are indicated?
A. 1
B. 2
C. 3
D. 4
D. 4
- Kernicterus is caused by the effects of:
A. Anemia
B. Unconjugated bilirubin
C. Antibody specificity
D. Antibody titer
B. Unconjugated bilirubin
- Anti-E is detected in the serum of a woman in the first trimester of pregnancy. The first titer for anti-E is 32. Two weeks later, the antibody titer is 64 and then 128 after another 2 weeks. Clinically, there are beginning signs of fetal distress. What may be done?
A. Induce labor for early delivery
B. Perform plasmapheresis to remove anti-E from the mother
C. Administer RhIg to the mother
D. Perform an intrauterine transfusion using E-negative cells
B. Perform plasmapheresis to remove anti-E from the mother
- What testing is done for exchange transfusion when the mother’s serum contains an alloantibody?
A. Crossmatching and antibody screen
B. ABO, Rh, antibody screen, and crossmatching
C. ABO, Rh, antibody screen
D. ABO and Rh only
B. ABO, Rh, antibody screen, and crossmatching