Pre Assessment 1

Question 1

What do you call the blood group when there is an agglutination of RBC with anti-B serum but does not agglutinate with anti-A serum:

A
AB
O
B

Answer 1

B– Agglutination with anti-B indicates that that patient has B antigen. Non agglutination with anti-A indicates that the patient does not have A antigen. The patient therefore is blood group B.

Question 2

Dolichos biflorus is the source of this antibody

Anti A
Anti A1
Anti A3
Anti A2

Answer 2

Anti A1 – Dolichos biflorus is known as the anti-A1 lectin.

Question 2

Results if reverse typing: negative agglutinations with A cells and B cells

Type A
Type Ab
Type B
Type O

Answer 2

Type AB – Reverse typing detects for the presence of antibodies. Negative agglutination with A and B cells indicate that the patient does not have anti-A and anti-B in the serum. Absence of anti-A and anti-B in the serum indicates that the patient has A and B antigen on his/her red blood cells and would therefore be categorized as a blood group AB individual.

Question 3

Reverse typing is also knowns as:

Serum typing
cell typing
direct typing
forward typing

Answer 3

Serum typing – Forward typing is also known as cell typing or direct typing. Reverse typing is also known as back typing, serum typing or indirect typing.

Question 3

Oh RBCs are not agglutinated by:

Anti A, B
Anti B
Any of the choices
Anti A

Answer 3

Any of the choices – Oh RBCs (Bombay) does not contain A, B or H antigens. They are therefore NOT agglutinated by anti-A, anti-B, anti-AB and anti H.

Question 4

Saline phase of compatibility test detects the presence of these antibodies

Anti M, Anti N
Both choices
Ante Le a, Anti Le b
Neither choices

Answer 4

Both choices - Anti-M, anti-N, anti-Lea and anti-Leb mostly exist as cold-reactive, IgM antibodies. They can be detected in the saline phase or immediate spin phase of the compatibility testing.

Question 5

Anti - H lectin (Ulex europeaus) agglutinates these cells:

Group Oh cells
Neither
Group O cells
Both

Answer 5

Group O cells – Group O cells contains H antigen; these cells therefore would be agglutinated by anti-H lectin. Group Oh cells are those that are of the Bombay phenotype, who inherited the hh gene. They do not posses H antigens and would therefore not agglutinated by anti H lectin.

Question 6

Which of the following might cause a false-negative indirect antiglobulin test (IAT)?

Over reading
Too heavy a cell suspension
Over centrifuge
IgG-coated screening cells

Answer 6

Too heavy a cell suspension

False positive:
 improper specimen (refrigerated, clotted) may cause
in-vitro complement attachment
 Autoagglutinable cells
 Bacterial contamination of cells or saline used in
washing
 Cells with a positive direct AHG test used for the IAT
 Saline contaminated by heavy metals or colloidal
silica
 Dirty glasswares
 Overcentrifugation and overreading
 Polyagglutinable cells
 Preservative-dependent antibody in LISS reagents
(IAT)
 Contaminating antibodies in the AHG reagents
 Centrifugation of test with polyethylene glycol prior
to washing

False Negative:
 inadequate or improper washing of cells
 AHG reagent non reactive because of deterioration or
neutralization
 AHG reagent not added
 Serum not added in the indirect test
 Serum non reactive because of deterioration of
complement
 Inadequate incubation conditions in the IAT
 Cell suspension either too heavy or too weak
 Undercentrifuged or overcentrifuged
 Poor reading technique
 Low pH of saline

Question 7

It is the acronym for the duffy system:

K
Se
Fy
Le

Answer 7

Fy – Duffy blood group system is represented by the abbreviation “Fy”.

Question 8

Shelf life of Packed RBC obtained through open system with ACD anticoagulant:

30 days
35 days
21 days
none of the given choices

Answer 8

none of the given choices – RBCs prepared under open system should be transfused within 24 hours.

Question 9

What is the only solution that can be added to blood or blood components before or during transfusion?

A. Normal saline C. Sterile distilled water
B. Heparin D. Dextrose in water

Answer 9

A. Normal saline - Normal saline solution (NSS) or 5% albumin are the only solutions that can be used as IV infusions during blood transfusion.

Question 10

An enzyme formed from prothrombin that coverts fibrinogen to fibrin:

a. Thrombin
b. Thrombocyte
c. Thrombocytosis
d. Thromboplastin

Answer 10

a. Thrombin – Thrombin, the active form of prothrombin, is the enzyme the converts fibrinogen into fibrin.

Question 11

Individual criteria for excluding the donor EXCEPT:
A. Oral temperature of 39ºC and up
B. Hemoglobin at 125 g/l
C. Individuals received pituitary growth hormone of human origin
D. Person has AIDS

Answer 11

B. Hemoglobin at 125 g/l – Donors with hemoglobin of 125g/L (12.5g/dL) can be accepted for donation. Temperature of greater than 37.5°C may indicate and ongoing infection and must be temporarily deferred. Individuals who received pituitary growth hormone of human origin must be permanently deferred due to possibility of transmission of prions. Persons with AIDS are permanently deferred.

Question 12

Red blood cells which are separated in a closed system shall be stored between 1ºC-6ºC. What is the expiration date of this red blood
cells?
A. One year
B. Same as whole blood
C. 45 days
D. much shorter than whole blood

Answer 12

B – RBCs prepared through closed system will have same shelf life as that of the whole blood unit.

Question 12

16. Washed packed red cells must be used within how many days?
    A. 21 days B. 24 days C. 24 hours D. same as whole blood

Answer 12

C – Washed components should be used within 24 hours.

Question 12

Erythroblastosis fetalis usually occur when:
A. Mother O negative, Father O positive
B. Mother O positive, Father O negative
C. Mother A negative, Father A negative
D. Mother AB, Father O

Answer 12

A – Rh HDN usually occurs when mother is Rh negative and father is Rh positive, and their baby is Rh positive.

Question 13

In afibrinogenemia, the transfusion requirements are, EXCEPT:
A. Packed red cells C. cryoprecipitate
B. fresh frozen plasma D. small pool fibrinogen concentrate

Answer 13

A – For fibrinogen replacements, cryoprecipitate is the component of choice. Fibrinogen concentrate and FFP also contain
fibrinogen but packed red cells do not.

Question 14

Confirmatory test for HIV virus:
A. RIA C. ELISA
B. EIA D. Western blot technique

Answer 14

D – Western blot serves as the confirmatory test for HIV. ELISA serves as a screening test.

Question 15

Human immunoglobulin that cross the placenta

A.   IgG   B. IgM   C. IgA   D. IgE

Answer 15

A – IgG is the only immunoglobulin capable of crossing the placenta, and can therefore, cause hemolytic disease of the newborn (HDN)

Question 16

Besides anti-D and anti-C, the established antibodies of the Rh system are the following EXCEPT:
a. anti-d b. anti-e c. anti-C d. anti-e

Answer 16

A – “d” antigen does not exist and only represents the absence of the D antigen.

Question 17

Dengue fever requires the transfusion of this blood component.
a. Plasma b. Packed RBC c. Platelet concentrate d. Fresh whole blood

Answer 17

C – Patients with dengue infection suffer from platelet decrease.

Question 18

The least antigenic in the Rh system:
a. e b. c c. E d. D

Answer 18

A – Immunogenicity of Rh: D > c > E > C > e

Question 19

Fresh frozen plasma has a shelf life of one year if stored at:
a. -18C b. -10C c. -4C d. 1-6C

Answer 19

A – FFP is stored at -18degC for 1 year.

Question 20

Cryoprecipitate should be used within this period after thawing:
a. 2 hours b. 3 hours c. 4 hours d. 6 hours

Answer 20

D – Cryoprecipitate, after thawing, must be stored at room temperature and must be transfused within 6 hours.

Question 21

Shelf life of packed RBC obtained through closed system with ACD anticoagulant: a. 21 days b. 35 days c. 30 days d. None of the above

Answer 21

A – RBCs obtained through open system must be used within 24 hours. Storage Time for blood for different anticoagulants and preservative solutions (closed system) ACD - 21 days CPD - 21 days CP2D - 21 days CPDA-1 - 35 days CPDA-2 - 42 days

Question 22

In an emergency transfusion where typing and cross-matching can not even be done, it is MOST safe to give: a. “O” red cells b. “O” whole blood c. “AB” plasma d. “O” plasma

Answer 22

A – In cases of emergency transfusion, it would be most safe to transfuse an O group red cell pack since these red cells would not contain A or B antigens.

Question 23

It also known as the Donath-Landsteiner antibody: a. anti-P b. anti-Tja c. anti-K d. anti-P1

Answer 23

A – Anti-P specificity is associated with the cold-reactive IgG autoantibody in patients with paroxysmal cold hemoglobinuria (PCH). ~p172, Modern Blood Banking and Transfusion Medicine by Harmening, 5th ed

Question 24

“Stack of coins” appearance of red cells: a. Polyagglutination b. Weakly positive agglutination c. Mixed field agglutination d. Rouleaux formation

Answer 24

D – Rouleaux formation causes the stacked coin appearance of red cells. They may be mistaken as agglutination and can lead to false positive results. It can be, however, dispersed by saline solution, unlike that of true agglutination.

Question 25

High titer of anti-smooth muscle antibody (SMA) strongly-suggestive of: a. primary biliary cirrhosis c. liver carcinoma b. chronic active hepatitis d. acute hepatitis

Answer 25

B – Anti-smooth muscle antibodies are found in patients with chronic active hepatitis. Anti-mitochondrial antibodies, on the other hand, are found in patients with primary biliary cirrhosis.

Question 26

Carcinoembryonic antigen (CEA) is correlated with: a. colon cancer b. ovarian cancer c. prostate cancer d. hepatoma

Answer 26

A – Carcinoembryonic antigen is correlated well with colorectal carcinoma. Prostate specific antigen (PSA) is associated with prostate cancers; whereas CA125 is associated with ovarian cancer.

Question 27

Anti P is significant in transfusion because: a. it has a wide thermal range of reactivity b. it is a potent IgG hemolysin c. it can bind complement d. all of these

Answer 27

D – Anti-P specificity is associated with the cold-reactive IgG autoantibody in patients with paroxysmal cold hemoglobinuria (PCH). The IgG autoantibody in PCH is described as biphasic hemolysin: in vitro, the antibody binds to RBCs in the cold and via complement activation, the coated RBCs lyse as they are warmed to 37°C. ~p172, Modern Blood Banking and Transfusion Medicine by Harmening, 5th ed

Question 28

The different classes of the immunoglobulins are referred to as: a. idiotypes b. isotypes c. allotypes d. phenotypes

Answer 28

B – Isotpye represents the classes of immunoglobulin. They vary depending on the constant heavy chain region of the immunoglobulin.

Question 29

A unit of whole blood produces an increase in hematocrit in an adult recipient of at least: a. 2% b. 3% c. 4% d. 1.5%

Answer 29

B – For a typical 70-kg adult, each unit of whole blood should increase the hematocrit level 3 to 5 percent or hemoglobin 1 to 1.5g/dL. After the transfusion, the increased may not be apparent until 48 to 72 hours when patient’s blood volume adjusts to normal. ~p305, Modern Blood Banking and Transfusion Medicine by Harmening, 5th ed

Question 30

Acute and convalescent serum samples must show at least how many times increase in antibody titer to be considered significant for a disease a. 2 x b. 5 x c. 10 x d. 4 x

Answer 30

D – Four-fold increase in the titer of antibodies is considered to be significant for a disease.

Question 31

Direct antiglobulin test detects coating of red cells by: a. neither of these b. IgG c. either of these d. C3d

Answer 31

C – Direct antiglobulin test can detect in vivo sensitization of red cells by IgG or C3d.

Question 32

Responsible for production of immunoglobulins: a. B cells b. T cells c. Null cells d. Helper cells

Answer 32

A – B cells are capable of differentiating to become plasma cells, which in turn are capable of producing antibodies (immunoglobulins).

Question 33

Responsible for cell mediated immunity: a. B cells b. T cells c. Null cells d. Helper cells

Answer 33

B – Cell-mediated immunity is for the T cells while humoral mediated immunity is for the B cells.

Question 34

Which of the following substances is not immunogenic: a. lipopolysaccharides b. glycoproteins c. pure lipids PRETEST 1 d. nucleoproteins

Answer 34

C – Immunogenicity can be determined by a substance’s chemical composition and molecular complexity. Proteins and polysaccharides are the best immunogens. Proteins are powerful immunogens, because they are made up of a variety of units known as amino acids. Carbohydrates are somewhat less immunogenic than protein, because the units of sugars are more limited than the number of amino acids in protein. Pure nucleic acids and lipids are not immunogenic by themselves, although a response can be generated when they are attached to a suitable carrier molecule.4 This is the case for autoantibodies to DNA that are formed in systemic lupus erythematosus. These autoantibodies are actually stimulated by a DNA protein complex rather than by DNA itself. –p40-41, Clinical Immunology and Serology by Stevens.

Question 35

The T4 cells are the: a. T Memory b. T helpers-inducers c. T cytotoxic Killers d. T suppressors

Answer 35

B – T4 cells are known as T helper or T inducer cells; whereas T8 cells are known as cytotoxic T cells.

Question 36

Hydroxythyl starch (HES) is used in: a. platelet pheresis b. leukapheresis c. red cell pheresis d. plasmapheresis

Answer 36

B – Hydroxyethyl starch (HES) is used as an RBC sedimenting agent during leukapheresis in order to separate WBCs from RBCs effectively. – p328, Modern Blood Banking and Transfusion Medicine by Harmening.

Question 37

The oral temperature of blood donor should not be more than: a. 37.5°C b. 39°C c. 36°C d. 37°C

Answer 37

A – Blood temperature of blood donor should not be more than 37.5°C or 99.5°F.

Question 38

Donation of blood is deferred for this period if prospective donor had polio vaccination: a. Ten weeks b. 8 weeks c. Four weeks d. Two weeks

Answer 38

D – Donor who received polio vaccination is deferred for two weeks.

Question 39

Transfusion of which of the following is needed to help correct hypofibrinogenemia due to DIC? a. Cryoprecipitated AHF c. Fresh Frozen Plasma b. Whole Blood d. Platelets

Answer 39

A – Cryoprecipitate (cryoprecipitated anti-hemophilic factor) is used primarily for fibrinogen replacement. Fibrinogen replacement may be required in patients with liver failure, DIC or massive transfusion and in rare patients with congenital fibrinogen deficiency.

Question 40

The Weil-Felix reaction is: a. Neutralization test b. Agglutination test c. Hemagglutination test d. Precipitation test

Answer 40

B – Weil-Felix and Widal test are examples of febrile agglutinin tests that utilizes the principle of direct agglutination.

Question 41

The H-antigen preparation of Salmonella species for Widal test utilizes: a. both choices b. somatic antigens c. Flagellar antigens d. neither choices

Answer 41

C – In the Widal test for Salmonella antibodies, H antigen is prepared from flagellar antigens; O antigen is prepared from somatic antigen and K or Vi antigens are prepared from capsular antigen.

Question 42

Anti-streptolysin O is an antibody produced against streptococci of: a. Group D b. Group B c. Group H d. Group A

Answer 42

D – Anti-streptolysin O antibodies are produced against the agent of strep throat, Streptococcus pyogenes. Streptococcus pyogenes is classified under the group of beta hemolytic group A Streptococcus.

Question 43

The ABO blood type of the least incidence among the Filipino children: a. Type O b. Type B c. Type A d. Type AB

Answer 43

D – Frequency of ABO blood groups: O > A > B > AB

Question 44

Apheresis is applicable to: a. Plasma b. Platelet c. Both d. Neither

Answer 44

C – Apheresis can be applied to any blood component such as RBCs, WBCs, platelets and plasma.

Question 45

Jk stands for this blood group: a. Duffy b. Kidd c. Kell d. Lewis

Answer 45

B – Jk is the shorthand term for Kidd.

Question 46

Massive hemorrhage secondary to trauma requires this blood: a. Plasma b. Packed RBC c. Platelet concentrate d. Fresh whole blood

Answer 46

D – Whole blood is given to individuals who have symptomatic anemia with blood volume deficit, such as in cases of acute hemorrhage.