IMMUNOHEMA EE Flashcards
(133 cards)
1
Q
Donors who have received blood or blood
products within 12 months of when they
desire to donate are deferred to protect the
recipient because the
A
A. Blood could have transmitted hepatitis
(HBVorHCV)orHIV
2
Q
Which of the following conditions would
contraindicate autologous presurgical
donation?
A
D. Mild bacteremia
3
Q
Which of the following donors would be
deferred indefinitely?
A
D. Recipient of human growth hormone
4
Q
Which of the following viruses resides
exclusively in leukocytes?
A
A. CMV
5
Q
A donor indicates that he has taken
two aspirin tablets per day for the last
36 hours. The unit of bloo
A
C. May be used for pooled platelet
concentrate preparation
6
Q
Which of the following best describes
what must be done with a unit of blood
drawn from a donor who is found to be at
high risk of contracting acquired immune
deficiency syndrome (AIDS)?
A
C. Properly dispose of unit by autoclaving or incineration.
6
Q
Which of the following is least likely to
transmit hepatitis?
A
C. Plasma protein fraction (PPF)
7
Q
A pooled sera product from 16 donors has
a repeatedly positive nucleic acid test
(NAT) for HCV. The next action that
should be taken is to
A
B. Test each donor in the pool for HCV
8
Q
Although Cryoprecipitate has primarily
been used for treatment of hypofibrinogenemia and hemophilia A, it contains
other blood proteins useful in the
treatment of coagulopathies. Which of the
following is not found in Cryoprecipitate?
A
D. Antithrombin III
9
Q
Even though it is properly collected and
stored, which of the following will freshfrozen plasma (FFP) not provide?
A
D. Platelets
10
Q
Blood needs to be prepared for intrauterine transfusion of a fetus with severe
HDN. The red blood cell unit selected is
compatible with the mother’s serum and
has been leuko-depleted. An additional
step that must be taken before transfusion
is to
A
C. Irradiate the RBCs before infusion
11
Q
The addition of adenine in an anticoagulant-preservative formulation aids in
A
A. Maintaining ATP levels for red cell viability
12
Q
The pilot tubes for donor unit #3276 break
in the centrifuge. You should
A
D. Remove sufficient segments to
complete donor processing procedures
13
Q
What is the percent yield of factor VIII in
the final cryoprecipitate?
A
C. 36%
14
Q
Does this product meet AABB Standards
for cryoprecipitate production?
A
A. Yes
15
Q
What is the percent yield of platelets in the
PRP from this unit?
A
D. 83%
16
Q
What is the percent yield of platelets in the
final product from the PRP?
A
D. 60%
17
Q
Does this product meet AABB Standards
for platelet concentrate production?
A
B. No; the count on the final product is
too low
18
Q
The final product was prepared with a
PRP spin time of 2 minutes at 2500 rpm.
To increase the percent platelet yield in the
final product, one would
A
B. Increase the time and/or rpm for the
second spin
19
Q
When 2,3-BPG levels drop in stored
blood, which of the following occurs as a
result?
A
B. Red blood cell ability to release O2
decreases.
20
Q
The last unit of autologous blood for an
elective surgery patient should be
collected no later than
hours before surgery.
A
D. 72
21
Q
For which of the following patients would
autologous donation not be advisable?
A
B. Patients with uncompensated anemia
22
Q
It is generally asymptomatic but has a very
high carrier rate (70-80% have chronic
infections). About 10% of the carriers
develop cirrhosis or hepatocellular
carcinoma. These statements are most
typical of which of the following
transfusion-transmitted infections?
A
C. HCV
23
Q
Biochemical changes occur during the
shelf life of stored blood. Which of the
following is a result of this “storage
lesion”?
A
B. Increase in plasma K+
24
It has been determined that a patient has
posttransfusion hepatitis and received
blood from eight donors. There is nothing
to indicate that these donors may have
been likely to transmit hepatitis. What
action must be taken initially?
C. Notify the donor center that collected
the blood.
25
The temperature range for maintaining red
blood cells and whole blood during
shipping is
C. 1-10°C
26
Platelets play an important role in
maintaining hemostasis. One unit of donor
platelets derived from whole blood should
yield platelets.
C. 5.5 X 1010
27
The pH of four platelet concentrates is
measured on the day of expiration. The pH
and plasma volumes of the four units are
as follows: pH 6.0, 45 mL; pH 5.5, 38 mL;
pH 5.8, 40 mL; pH 5.7, 41 mL. What
corrective action is needed in product
preparation to meet AABB Standards for
platelet production?
C. Increase final plasma volume of
platelet concentrates
28
During preparation of platelet concentrate,
the hermetic seal of the primary bag is
broken. The red blood cells
C. Must be labeled with a 24-hour
expiration date
29
The blood bank procedures manual must be
D. Reviewed annually by an authorized
individual
30
Previous records of patients' ABO and Rh
types must be immediately available for
comparison with current test results
B. For 12 months
31
Which of the following weak D donor
units should be labeled Rh-positive?
D. All the above
32
In order to meet the current A ABB
Standards for leukocyte reduction to
prevent HLA alloimmunization or CMV
transmission, the donor unit must retain at
least of the original red
cells and leukocytes must be reduced to
less than .
B. 80%, 5 X 106
33
Which of the following tests is/are not
performed during donor processing?
D. HBsAb
34
A 70-kg man has a platelet count of
15,000/uL, and there are no complicating
factors such as fever or HLA sensitization.
If he is given a platelet pool of 6 units,
what would you expect his posttransfusion
count to be?
C. 45,000-75,000/uL
35
Which of the following tests on donor
red blood cells must be repeated by the
transfusing facility when the blood was
collected and processed by a different
facility?
A. Confirmation of ABO group and Rh
type of blood labeled D-negative
36
required storage temp: Red blood cells (RBCs), liquid
A. 1-6°C
37
required storage temp: red blood cells, frozen
D. -65°C or colder
38
required storage temp: fresh frozen plasma
C. -18°C or colder
39
required storage temp: cryoprecipitate
C. -18°C or colder
40
required storage temp: platelet concentrate
B. 20-24°C
41
shelf life: Red blood cells in CPDA-1
C. 35 days
42
shelf life: fresh frozen plasma
D. 1 year
43
shelf life: cryoprecipitate
D. 1 year
44
shelf life: fresh frozen plasma, thawed
A. 24 hours
45
shelf life: Platelet concentrate in PL-732 (with agitation)
B. 5 days
46
allowable shelf
life for blood for transfusion therapy: CPD (citrate phosphate dextrose)
A. 21 days
47
allowable shelf
life for blood for transfusion therapy: CPDA-1 (citrate phosphate dextrose
adenine)
B. 35 days
48
allowable shelf
life for blood for transfusion therapy: AS-l(Adsol®)
C. 42 days
49
allowable shelf
life for blood for transfusion therapy: EDTA
D. Not an approved anticoagulant
50
indicate whether the individual volunteering to
donate blood for allogeneic transfusion should be
accepted or deferred: A 65-year-old man whose birthday is
tomorrow
D. Accept
51
indicate whether the individual volunteering to
donate blood for allogeneic transfusion should be
accepted or deferred: A 45-year-old woman who donated a unit
during a holiday appeal 54 days ago
A. Defer temporarily
52
indicate whether the individual volunteering to
donate blood for allogeneic transfusion should be
accepted or deferred: A 50-year-old man who had sex with
another man in 1980
C. Defer indefinitely
53
indicate whether the individual volunteering to
donate blood for allogeneic transfusion should be
accepted or deferred: A 25-year-old man who says he had
yellow jaundice right after he was born
D. Accept
54
indicate whether the individual volunteering to
donate blood for allogeneic transfusion should be
accepted or deferred: An 18-year-old with poison ivy on his
hands and face
D. Accept
55
indicate whether the individual volunteering to
donate blood for allogeneic transfusion should be
accepted or deferred: A woman who had a baby 2 months ago
D. Accept
56
indicate whether the individual volunteering to
donate blood for allogeneic transfusion should be
accepted or deferred: A 35-year-old runner (pulse 46 bpm)
D. Accept
57
indicate the component of choice for transfusion
therapy: Patients with warm autoimmune
hemolytic anemia (AIHA) due to
a-methyldopa (Aldomet®) with
hemoglobins of 8.5 g/dL or above
D. Transfusion not indicated
58
indicate the component of choice for transfusion
therapy: Patients requiring transfusion with RBC
that will not transmit cytomegalovirus
(CMV)
C. Leukocyte-reduced RBC
59
indicate the component of choice for transfusion
therapy: Patients with normovolemic anemia
B. RBC
60
indicate the component of choice for transfusion
therapy: Patients who are thrombocytopenic
secondary to the treatment of acute
leukemia
A. Platelet concentrate
61
Most blood group antibodies are of what
immunoglobulin classes?
D. IgGandlgM
62
The following family study is performed:
Mother = K + k +
Father = K - k +
Child 1 = K + k -
Child 2 = K - k +
B. Father has one k gene and one K° gene
63
Which of the following blood groups
reacts least strongly with an anti-H
produced in an AjB individual?
D. Group A1
64
How many genes encode the following Rh
antigens: D, C, E, c, e
B. Two
65
68. The test results could be due to
C. Inheritance of hh genes
66
If the patient's RBCs were tested against
anti-H lectin and did not react, this person
would be identified as a(an)
B. Oh phenotype
67
If a person has the genetic makeup Hh,
AO, LeLe, sese, what substance will be
found in the secretions
C. Lea substance
68
The tech suspects that this is a case of an
acquired B antigen. Which of the
following would support this suspicion?
D. The patient's red cells give a negative
result, with a monoclonal anti-B
reagent lacking the ES-4 clone.
69
Lectins are useful in determining the
cause of abnormal reactions in blood bank
serology. These lectins are frequently
labeled as anti-H, anti-Ap etc. The nature
of these lectins is explained by which of
the following?
B. A plant substance that chemically
reacts with certain RBC antigens
70
Which of the following sugars must be
present on a precursor substance for A
and B antigenic activity to be expressed?
D. L-Fucose
71
An antigen-antibody reaction alone
does not cause hemolysis. Which of the
following is required for red blood cell
lysis?
B. Complement
72
A white female's red blood cells gave the
following reactions upon phenotyping:
D+ C+ E- c+ e+. Which of the
following is the most probable Rh
genotype?
B. DCe/dce
73
A black patient has the following Rh
phenotype: D+ C+ E+ c+ e+. Which of
the following genotypes is the least
probable?
C. DCe/dcE
74
An individual of the dee/dee genotype
given dCe/dce blood has an antibody
response that appears to be anti-C plus
anti-D. What is the most likely explanation for this?
A. The antibody is anti-G.
75
If a patient has the Rh genotype DCe/DCe
and receives a unit of red blood cells from
a DCe/dce individual, what Rh antibody
might the patient develop?
B. Anti-c
76
What percentage of this couple's offspring
can be expected to be D-negative?
C. 50%
77
Which of the following conclusions
regarding the family typing is most likely?
C. The husband cannot be excluded from
being the infant's father.
78
Which, if any, of these three individuals
can make anti-D
C. Wife
79
If a D-positive person makes an anti-D,
this person is probably
A. Partial D
80
A victim of an auto accident arrives in the
emergency department (ED) as a transfer
from a hospital in a rural area. The patient
has been in that facility for several weeks
and has received several units of red blood
cells during that time. The ED resident
orders 2 units of RBCs for transfusion.
The sample sent to the blood bank is
centrifuged and the cell-serum interface
is not discernable. A subsequent sample
produces the same appearance. You would
suspect that the patient has
C. Anti-Jka
80
A serum containing anti-k is not frequently encountered. This is because
A. People who lack the k antigen are rare
81
Which of the following is a characteristic
of the Xga blood group system?
A. The Xga antigen has a higher
frequency in women than in men.
82
Testing needs to be done with an antiserum that is rarely used. The appropriate
steps to take in using this antiserum
include following the manufacturer's
procedure and
D. Testing a cell that is negative for the
antigen and one that is heterozygous
for the antigen
83
Which of the following is a characteristic
of Kidd system antibodies?
D. Often implicated in delayed hemolytic
transfusion reactions
84
Which of the following statements is not
true of anti-Fya and anti-Fyb?
B. React well with enzyme-treated panel
cells
85
Which of the following antibodies can be
neutralized with pooled human plasma?
B. Anti-Cha and anti-Rga
86
Which of the following statements is not
true about anti-U?
D. Only occurs in Fy(a-b-) individuals
87
A patient had an anti-E identified in his
serum 5 years ago. His antibody screening
test is now negative. To obtain suitable
blood for transfusion, what is the best
procedure to use?
B. Type the donor units for the E antigen
and crossmatch the E-negative units.
88
A patient's red blood cells are being typed
for the Fya antigen. Which of the following is the proper cell type of choice for a
positive control of the anti-Fya reagent?
B. Fy(a+b+)
89
Which of the following antibodies has been
clearly implicated in transfusion reactions
and hemolytic disease of the newborn?
B. Anti-K
90
Which of the following antibodies would
require additional testing in order to be
ruled out?
A. Anti-E, -K, -Kpa, -Jsa, -Jkb
91
The most likely antibody(ies) in the
patient's serum is(are)
B. Anti-E and anti-K
92
From the cells in red cell panel chart 2,
choose a selected cell panel to help
identify the antibody(ies) in the patient
described in question 95.
C. 1,4,7
92
Often when trying to identify a mixture of
antibodies, it is useful to neutralize one of
the known antibodies. Which one of the
following antibodies is neutralizable?
C. Anti-Lea
93
Which of the following antibodies does
not match the others in terms of optimal
reactive temperature?
C. Anti-N
94
A recently transfused patient's serum has
a positive antibody screen. The panel
performed at IS, in LISS at 37°C, and at
AHG shows a strong anti-Fya and a weak
possible anti-C. To confirm the anti-C, you
would perform an
D. Enzyme panel
95
The antiglobulin test does not require
washing or the addition of IgG-coated
cells in which of the following antibody
detection methods?
B. Gel test
96
Which set of antibodies could you
possibly find in a patient with no history
of transfusion or pregnancy?
D. Anti-Pr anti-Lea, anti-I
97
Lymphocytotoxicity testing can be used to
detect the presence of antibodies to
B. HLA antigens
98
In which of the following instances may
mixed-field (mf) agglutination be
observed?
A. Direct antiglobulin test (DAT) result of
patient undergoing delayed hemolytic
transfusion reaction
99
The antibody produced during the
secondary response to a foreign antigen is
usually
D. Present at a higher titer than after a
primary response
100
In which situation(s) may the ABO serum
grouping not be valid?
D. All the above
101
The method of serogrouping Shigella used
in the clinical laboratory is based on
D. O antigens
102
The symptom of diffuse, watery diarrhea
that produces a relatively clear stool
containing mucus flecks is suggestive of
an infection caused by
C. Vibrio cholerae
103
An example of a halophilic microorganism is
C. Vibrio parahaemolyticus
104
Which of the following statements is not
true of Brucella?
C. The risk of accidental laboratory
infection is no greater than with any
other organism.
105
Infection of the gastric mucosa leading to
gastritis or peptic ulcers is most commonly associated with
B. Helicobacterpylori
106
Which of the the following does not
describe Acinetobacter sp.?
A. Commonly susceptible to most
antimicrobials
107
An unheated suspension of Salmonella
Typhi typically produces agglutination
of Vi antisera. After heating the same
suspension, agglutination will occur in
which grouping sera?
D. D
107
Explosive watery diarrhea with severe
abdominal pain after eating raw shellfish is
most characteristic of infection caused by
D. Vibrio parahemolyticus
108
The species of Campylobacter noted to
produce septicemia, septic arthritis,
meningitis, jaundice with hepatomegaly,
and thrombophlebitis in debilitated
patients is
B. C. fetus
109
Shigella sonnet is differentiated from
other Shigella sp. by
A. A positive ONPG
110
A positive Voges-Proskauer reaction is
characteristic of
A. Enterobacter aerogenes
111
Which of the following is not true
regarding virulent strains of Vibrio
cholerae?
C. Nonmotile
112
The classic toxigenic strains of which
serogroup are implicated in epidemic
infections of Vibrio cholerae?
A. Ol
113
Brucella spp. are
D. Intracellular pathogens
114
Which of the following reactions is typical
for Escherichia coli?
A. Beta-hemolytic on sheep blood agar
115
Yersinia pestis is characteristically
A. Urease negative
116
Lack of motility is characteristic of
B. Klebsiella oxytoca
117
In cases of legionellosis
C. Patients can present with a self-limited
nonpneumonic febrile illness
118
Which of the following is not a characteristic of Klebsiella (Calymmatobacteriuni)
granulomatis?
B. Is isolated on chocolate agar
119
A positive DNase would be seen with
D. Serratia marcescens
120
A negative citrate reaction is
characteristic of
D. Shigella boydii
121
Isolation ofNeisseria gonorrhoeae
B. Requires incubation under increased
CO2
122
A positive indole reaction is
characteristic of
A. Escherichia coli
123
Which one of the following organisms
would produce a yellow slant and a yellow
butt on TSI agar after incubating 18
hours?
A. Escherichia coli
124
Pyocyanin is characteristically
produced by
A. Pseudomonas aeruginosa
125
Color Plate 28 * shows the Gram stain of
cerebrospinal fluid from a 1-year-old girl
suspected of having meningitis. After 24
hours of growth, small tan colonies were
isolated on chocolate agar incubated in
CO2. Sheep blood agar also incubated
in CO2 had no growth. Which of the
following organisms should be suspected?
C. Haemophilus influenzae
126
Which of the following is true concerning
Campy lobacter jejuni ?
D. A leading cause of bacterial diarrhea
worldwide
127
Of the following microorganisms, which
one will turn a dark purple when tetramethyl-p-phenylenediaminehydrochloride
is applied?
C. Moraxella catarrhalis
127
Cardiobacterium hominis, an inhabitant of
the upper respiratory tract of humans, has
been recovered as the etiologic agent from
cases of endocarditis. An identifying
characteristic of the organism is
C. Indole negative
128
Vibrio vulnificus is a well-established
human pathogen that is known to cause
D. Wound infections
