Immunohematology quizzes
When 1,000 donors were tested, 75% were positive for C and 25% were negative for C; the gene frequency of - 10. - 1. - 25. - 0.5
0.5
Which antigen(s) are present in type AB blood on the red blood cell? - A and B - A - B - None
A and B
A negative direct antiglobulin test (DAT) is found in all of the following transfusion reactions except: Transfusion-associated sepsis Acute nonimmune hemolytic transfusion reaction Febrile nonhemolytic transfusion reaction Acute immune hemolytic transfusion reaction
Acute immune hemolytic transfusion reaction
In weak D testing, which step does not occur - Decant after washing cells - Adding PEGG - DAT testing if positive - Incubation period
Adding PEGG
What Kidd antibody will react with all panel cells and phenotype as Jk(a-b-)? - Anti-Jkb - None of the above - Anti-Jka - Anti-Jk3
Anti-Jk3
What does the type 1 chain refer to? - Beta linkage of the number 2 carbon of galactose to the number 4 carbon of N-acetylglucosamine residue of precursor structure - Beta linkage of the number 1 carbon of galactose to the number 3 carbon of N-acetylglucosamine residue of precursor structure - Alpha linkage of the number 1 carbon of galactose to the number 4 carbon of N-acetylglucosamine residue to precursor structure - Alpha linkage of the number 1 carbon of galactose to the number 3 carbon of N-acetylglucosamine residue of precursor structure
Beta linkage of the number 1 carbon of galactose to the number 3 carbon of N-acetylglucosamine residue of precursor structure
Most cases of warm autoimmune hemolytic anemia will be DAT-positive with which of the following? Both anti-IgG and Anti-C3d Anti-C3d only None of the above Anti-IgG only
Both anti-IgG and Anti-C3d
How is it genetically possible for a child to type Rh-negative? - Mom is DD and Dad is Dd - Both parents are Dd - Both parents are DD - Sibling is Rh-positive
Both parents are Dd
According to federal law, what organization must be contacted when a biological deviation occurs in a blood bank and the error has the potential to affect the safety of the product or patient? Joint Commission CBER CAP AABB
CBER
In which of the following is the DAT reactive with anti-C3d only? Cold hemagglutinin disease Membrane modification Warm autoimmune hemolytic anemia Drug adsorption mechanism
Cold hemagglutinin disease
A 75-year-old patient who had recently undergone a cornea transplant 6 months ago is suddenly experiencing neurological abnormalities. Which of the following is most likely? - Variant Creutzfeldt-Jakob disease with an accumulation of prion proteins - Creutzfeldt-Jakob disease with no accumulation of prion proteins - Variant Creutzfeldt-Jakob disease with no accumulation of prion proteins - Creutzfeldt-Jakob disease with an accumulation of prion proteins
Creutzfeldt-Jakob disease with no accumulation of prion proteins
All of the following are important in evaluating a positive DAT except: - Transfusion history - Drug Therpay - Donation history - Patient diagnosis
Donation history
Which of the following best describes the principle of the Kleihauer-Betke test? D-positive indicator cells form rosettes around fetal Rh-positive red blood cells. Maternal hemoglobin is resistant to acid (alkali), appearing pink, whereas fetal cells appear as ghost cells. Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells. D-positive indicator cells form rosettes around maternal Rh-positive RBCs.
Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells
A unit of red blood cells has an expiration date of 05/15/21. A patient currently on a fludarabine regimen requires irradiated packed red blood cells. The unit is irradiated for this patient on 05/02/21. What is the correct expiration date post-irradiation? - 05/02/21 - 05/28/21 - 05/30/21 - 05/15/21
05/15/21
What is the minimum hemoglobin level for a potential allogeneic donor? - 12.5 g/dL - 14 g/dL - 12 g/dL - 11 g/dL
12.5 g/dL
Due to a short supply of O-negative packed cells, an Rh-negative patient was transfused with 1 unit of Rh-positive red blood cells. Calculate the number of Rh-immune globulin vials needed to protect against 250 mL of Rh-positive packed cells (note, I am asking about red blood cells, not whole blood). 17 5 23 10
17
At what temperature do IgM antibodies react? - 37C - 22C - 56C - 42C
22C
Fisher-Race postulated that the: - alphanumeric system - 3 genes account for the Rh antigen structure - Agglutinogen theory - Nomenclature is hard
3 genes account for the Rh antigen structure
A 300-µg dose of Rh-immune globulin contains sufficient anti-D to protect against how much whole blood? 15 mL 10 mL 30 mL 50 mL
30 mL
At what temperature do IgG antibodies react optimally? - 56C - 4C - 37C - 22C
37C
After removing a unit of red blood cells (RBC's) from the refrigerator, how quickly must the RBC's be transfused? 2 hours 6 hours 1 hour 4 hours
4 hours
At what age does I antigen become detectable on infant cells? - 7 -14 days - 4 months - 18 months - 1 year
4 months
What is the deferral period for a donor who has received a live attenuated vaccine for rubella? - 8 weeks - 2 weeks - 4 weeks - No deferral period
4 weeks
Methods of preparation of platelet concentrates from single units of whole blood must produce a product that yields a minimum of: - 5.5 x 10¹⁰ platelets per unit in 75% of units tested - 5.5 x 10¹¹ platelets per unit in 75% of units tested. - none of the above - 5.5 x 10¹¹ platelets per unit in 50% of units tested.
5.5 x 10¹⁰ platelets per unit in 75% of units tested
What dose of RhIG would be appropriate for a D-negative woman who has had a miscarriage at 11 weeks' gestation? - None of the above - 50 µg - 120 µg - 300 µg
50 µg
What is the corrected platelet increment for a patient with a body surface area of 2.7 m2, an initial count of 15,000 per µL, and a 1-hour post-transfusion platelet count of 80,000 per µL given one apheresed platelet component? 5,000 per µL 58,500 per µL 31,900 per µL 53,182 per µL
58,500 per µL
What is the minimal pH required for platelets? - 7.2 - 6.2 - 7.0 - 6.0
6.2
Upon the event of an adverse reaction that results in a transfusion-related fatality, the CBER must be notified within what time frame? 24 hours 14 days 7 days Not necessary to contact CBER. but must contact the FDA
7 days
Packed RBCs must have a final hematocrit of less than or equal to: - 70% - 85% - 80% - 38%
80%
What is the purpose of the antihuman globulin (AHG) test in blood banking? - It detects red blood cells coated with antigen. - It detects white blood cells coated with antibody by bridging the gap between red blood cells. - It detects red blood cells coated with antibody by bridging the gap between red blood cells. - All of the above
It detects red blood cells coated with antibody by bridging the gap between red blood cells.
Why is low ionic strength solution (LISS) used in blood banking? - It increases the zeta potential. - It reduces the net negative surface charge on the RBC. - It reduces the incubation time. - It enhances aggregation.
It reduces the incubation time.
Which of the following is not involved in the Kell blood group system? - Jsa - Kpb - K - Jkª
Jkª
An individual from Bombay who has inherited the Le gene will have a phenotype of: - Le(a-b+) - Le(a+b-) - Le(a+b+) - Le(a-b-)
Le(a+b-)
In the MN blood group system, a person who inherits an "M" allele and an "N" allele expresses both M and N antigens on the RBCs. Which of the following is true? - M and N are located on the same chromosome - M is dominant to N - N is dominant to M - M and N are codominant alleles
M and N are codominant alleles
Anti-M will react strongest with which cells? - M+N+ - M-N- - M+N- - M-N+
M+N-
What is done to prevent HDFN caused by maternal anti-Jka antibody formation? No action is necessary, anti-Jka will not cause HDFN. Prevent formation of Jka-positive cells in the fetus. Give Jka immune globulin. Monitor the mother's antibody level.
Monitor the mother's antibody level
Which of the following is not true of monoclonal reagents? - Monoclonal reagents are highly specific - Monoclonal reagents are produced for single antigens with more than one epitope. - Monoclonal reagents are highly characterized and are uniformly reactive - Monoclonal reagents are produced by hybridoma technology
Monoclonal reagents are produced for single antigens with more than one epitope.
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? Paroxysmal cold hemoglobinuria Cold hemagglutinin disease Secondary cold AIHA Warm autoimmune hemolytic anemia
Paroxysmal cold hemoglobinuria
A blood donor with a history of hepatitis B should be excluded: - Permanently - only if liver function tests are abnormal. - only if the disease has been active for the last 5 years. - only if he or she is jaundiced.
Permanently
Which of the following is not a tech error for ABO discrepancies? - Contaminated reagent - Failure to add reagent - Rouleaux - cell suspension too heavy/light
Rouleaux
What is responsible for recognition of the antibody-binding site to homologous antigen? - Variable region of light/heavy chain - phenotype - Solubility of antigen - Complementarity
Variable region of light/heavy chain
Persons with a documented history of anaphylactic reactions should be transfused with _________ blood products. IgE-Deficient Irradiated leukodepleted Washed
Washed
The following blood donors regularly give blood. Which donor may donate on September 11th? - A 28-year-old man who had plateletpheresis on August 24th - A 23-year-old woman who made a direct donation for her aunt on August 14th - A 52-year-old man who made an autologous donation on September 9th - A 40-year-old woman who last donated on July 25th
A 28-year-old man who had plateletpheresis on August 24th
Which platelet pheresis product should be irradiated? Random stock unit going to a patient with disseminated intravascular coagulation (DIC) Autologous unit collected prior to surgery A directed donation given by a mother to her son A directed donation given by an unrelated family friend
A directed donation given by a mother to her son
Why do false-negative Rh testing results occur in babies with severe hemolytic disease of the newborn due to anti-D? - All D sites are covered by maternal anti-D, which blocks the reagent. - The cord cells may be contaminated with Wharton's jelly. - None of the above - Antigens are not expressed yet.
All D sites are covered by maternal anti-D, which blocks the reagent.
How can T cells be differentiated from B cells? - CD2 marker - Secretion of interleukin-2 - Agglutination of sheep erythrocytes - All of the above
All of the above
In order for an individual to express Leb antigen on their red blood cells, they must have inherited which gene? - Se - Le - H - All of the above
All of the above
What does polyspecific AHG contain? - C3d - C3b - IgG - All of the above
All of the above
Which of the following might lead to unacceptable quality control results? A technician who has not worked in the area for several months A deteriorated "anti-A" All of the above An uncalibrated serofuge
All of the above
Which of the following products may lead to sepsis in a patient when contaminated with Escherichia coli? All of the above Normal Saline Red blood Cells Platelets
All of the above
Why might a laboratory adopt an individualized quality control plan (IQCP)? To eliminate the need to perform daily quality control To demonstrate where costs can be saved To customize its QC program to its specific needs All of the above
All of the above
Which of the following provides just cause for a product recall by the FDA? An autologous unit was found reactive for anti-HBc. A therapeutic whole blood unit had a hematocrit of greater than 80%. The donor blood pressure reading was omitted in donor screening. An A-positive packed red blood cell unit was labeled as an A-negative packed red blood cell unit.
An A-positive packed red blood cell unit was labeled as an A-negative packed red blood cell unit
What is the immunologic principle of RhIG administration? -Anti-D attaches to Rh-negative cells of the infant in maternal circulation and are subsequently removed by cells of the reticuloendothelial system, preventing sensitization. -The principle is still under investigation -Anti-D attaches to Rh-positive cells of mother and are subsequently removed by cells of the reticuloendothelial system, preventing sensitization. -Anti-D attaches to Rh-positive cells of the infant in maternal circulation and are subsequently removed by cells of the reticuloendothelial system, preventing sensitization.
Anti-D attaches to Rh-positive cells of the infant in maternal circulation and are subsequently removed by cells of the reticuloendothelial system, preventing sensitization
A person infected with HIV-1 is diagnosed with AIDS-related condition (ARC). What antibodies will be present in the patient's serum at this stage? - Anti-p24 and anti-gp41 - Anti-gp41 - Anti-p26 - Anti-p24
Anti-p24 and anti-gp41
The MHC class I region encodes for all of the following genes except: - HLA-DR - HLA-C - HLA-A - HLA-B
HLA-DR
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? - He would not be able to donate, because all directed donors must meet the same criteria as allogeneic donors. - Because he is donating to his sister, and she signed consent, he may donate for her. - He meets all the criteria for being a directed donor, so he would be able to donate without any problem. - He could donate, but only with the consent of the medical director and physician.
He would not be able to donate, because all directed donors must meet the same criteria as allogeneic donors.
What does "HLA" stand for? - Human leukocyte antigen - Human lymphodenapathy - Human liver antigen - Human lymphocyte antibody
Human leukocyte antigen
In cases of warm autoimmune hemolytic anemia, what subclass of IgG is most efficient in binding complement? IgG4 IgG3 IgG1 IgG2
IgG3
What would be the result of group B blood given to a group O patient? Immediate hemolytic transfusion reaction Nonimmune transfusion reaction Delayed hemolytic transfusion reaction Transfusion associated circulatory overload
Immediate hemolytic transfusion reaction
What is the most common preventable error occurring among the nursing and medical staff that results in a transfusion-related death? Alloantibody misidentified Improper patient identification Incorrect crossmatch procedure Specimen mislabeled
Improper patient identification
The indirect antiglobulin test detects which antigen-antibody reactions? - In vitro - Both in vivo and in vitro - In vivo - None of the above
In vitro
Persons who inherit the In(Lu) gene will exhibit: - Jk(a+b-) red blood cells that can absorb anti-Jk3. - Jk(a-b+) red blood cells that can elute anti-Jk3. - Jk(a+b-) red blood cells that can elute anti-Jkª. - Jk(a-b-) red blood cells that can absorb anti-Jkª
Jk(a-b-) red blood cells that can absorb anti-Jkª
A patient was phenotyped for the presence of Lewis antigens (Leª and Leb). A 3+ reaction was observed when patient cells were incubated with anti-Lea. No reaction was observed with anti-Leb. Based on these results, the patient's phenotype is _____________ and the patient is a ____________ of ABH substances. - Le(a-b+)/nonsecretor - Le(a+b-)/nonsecretor - Le(a-b+)/secretor - Le(a+b-)/secretor
Le(a+b-)/nonsecretor
Which of the following blood group systems is not likely to cause HDN? - MN - ABO - Kell - Rh
MN
HLA proteins are coded by what complex? - Innate immune response - Complement - Major histocompatibility complex - Human leukocyte compatibility complex
Major histocompatibility complex
What cells are responsible for mounting a secondary response when exposure to the same antigen occurs? - Myeloblasts - Neutrophils - Memory T/B cells - Plasma Cells
Memory T/B cells
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? - No, she needs to wait 6 more months - Yes, she can donate at this time. - No, she needs to wait 3 more months - No, she should be on permanent deferral.
No, she needs to wait 6 more months
Which antigen(s) are present in type O blood on the red blood cell? - A and B - B - None - A
None
What is the linkage disequilibrium in reference to the HLA antigens? - Occurrence of HLA genes less frequently in the same haplotype than would be expected by chance alone - Displacement of HLA genes on different chromosomes - Occurrence of HLA genes more frequently in the same haplotype than would be expected by chance alone - Crossover of HLA genes
Occurrence of HLA genes more frequently in the same haplotype than would be expected by chance alone
The surface marker, or antigen, detected in histocompatibility testing of a single individual is referred to as HLA: - Phenotype - Karyotype - Haplotype - Genotype
Phenotype
When an individual is said to have blood group A, it refers to the individual's: - alleles on the chromosome - genotype - Phenotype - haplotype
Phenotype
Which of the following is known to enhance K antigen expression in the antihuman globulin test? - Polyethylene Glycol - LISS - Albumin - DTT
Polyethylene Glycol
Autoanti-I was identified in a patient transfused 1 month ago. Which technique is advocated to detect alloantibodies in this patient? Warm autoabsorption Prewarming Enzyme Treat Cold autoabsorption
Prewarming
Which statement concerning compliance programs is false? Compliance is synonymous with organization-wide quality assurance Programs are designed to evaluate effectiveness of blood bank laboratories. Programs provide an occasional opportunity to expose new and different problems. Compliance inspections are conducted every 1 to 2 years.
Programs are designed to evaluate effectiveness of blood bank laboratories.
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? - Adding one drop of control cells - Adding one drop of AHG - Repeating the antibody screen - Recentrifuging the tubes
Repeating the antibody screen
Which of the following is a characteristic red blood cell morphology seen on a peripheral blood smear from a patient with warm autoimmune hemolytic anemia? target cells stomatocytes Teardrop cells Spherocytes
Spherocytes
The M and N antigens exhibit dosage. Therefore, if a person inherits the homozygous genotype MM, their red blood cells will react _______ with anti-M than/as those of a person with a heterozygous genotype of MN. - The same - Stronger - None of the above. - Weaker
Stronger
P1 antigens - are fully developed at 6 months - Take up to 6-7 years to develop - none of the above. - Are fully developed at birth
Take up to 6-7 years to develop
What is the principle of the Rh-Hr (Weiner) terminology? - Each gene (D, C, c, E, e) produces one product or antigen. - The Rh gene produces at least three factors within an agglutinogen. - Each gene is independent of the others. - The Rh gene produces at least three factors within an agglutinin.
The Rh gene produces at least three factors within an agglutinogen.
How would the hematocrit of a patient with chronic anemia be affected by transfusion of 2 units of whole blood versus transfusion with 3 units of packed RBCs? Patient's hematocrit would be equally affected The hematocrit would not change at all with the whole blood because of the plasma in the unit. The whole blood would increase the hematocrit more than the packed RBCs. The packed RBCs would increase the hematocrit more than the whole blood.
The packed RBCs would increase the hematocrit more than the whole blood.
A male patient was seen in the emergency room with an acute bleed. The recommendation from the blood supplier is to give O-positive RBCs as uncrossmatched blood. This patient has already been exposed to Rh-positive blood after a previous accident. What is a possible outcome? - The patient may have a hemolytic transfusion reaction from an allo-immunized anti-D. - The anti-D would activate complement, and a strong intravascular transfusion reaction would occur. - Anti-D is not hemolytic, and even with the circulating antibody there would be no danger to the patient. - Anti-D is not immunogenic, and the patient probably would not have formed an anti-D.
The patient may have a hemolytic transfusion reaction from an allo-immunized anti-D.
Which of the following characterizes an alloimmune response in immune hemolytic anemia? None of the above The patient produces an antibody to a prescribed antibiotic. The patient produces anti-K to transfused red blood cells. The patient produces an antibody reactive with her own red blood cells.
The patient produces anti-K to transfused red blood cells
What are the dangers of transfusing donor Rh-negative RBCs to an Rh-positive patient? - There are no dangers. - A hemolytic transfusion reaction will occur. - A patient will be sensitized and will develop an Anti-D. - Most Rh-negative blood is c- and e-positive, and because of their immunogenicity the patient may form an antibody to those antigens.
There are no dangers
Why are fresh blood units (less than 7 days old) preferred for a neonate transfusion? They minimize 2,3 DPG levels. They reduce the risk of hypernatremia. They reduce the risk of hypokalemia They reduce the risk of hyperkalemia.
They reduce the risk of hyperkalemia.
What is the primary focus of quality assurance? To analyze postmarket stability To amend the system, procedure, or standard operating procedures, if deemed faulty To rewrite employee job descriptions as needed To place blame on employees who make recurring errors
To amend the system, procedure, or standard operating procedures, if deemed faulty
Why is the Center for Biologics Evaluation and Research (CBER) notified in the case of a transfusion-related fatality? To disclose the name of the deceased To report all reagent lot numbers used in typing deceased patient To determine if appropriate corrective action has been taken to prevent recurrence To recall all banked units
To determine if appropriate corrective action has been taken to prevent recurrence
What is the main purpose of crossmatching before transplantation? - To identify antigen in the recipient cells to antibody present in donor serum - To identify antibody in the potential donor to antigen present on recipient cells - To identify antigen present on donor tissues to antibody present in recipient serum -To identify antibody in the serum of the potential recipient to antigens present on donor tissues
To identify antibody in the serum of the potential recipient to antigens present on donor tissues
Why are donors deferred for 6 months following receipt of blood products? - To allow donor recovery from the condition that required transfusion - To allow clearance of all transfused cells in the donor - To permit adequate screening for transfusion-acquired viral infections - Because donation may cause recurrence of the condition that required transfusion
To permit adequate screening for transfusion-acquired viral infections
What is the most frequent cause of circulatory overload? Transfusion of a partially deglycerolized unit Massive transfusion of blood components Transfusion of a unit at too fast a rate Transfusion of a unit at too slow a rate
Transfusion of a unit at too fast a rate
Rh-immune globulin is of no benefit after a person has been actively immunized and formed anti-D. True False
True
A blood donor's serologic tests were reactive for HIV-1/2 antibodies. The test was repeated, and both were reactive. A Western blot confirmatory test was done and was negative. What is the protocol for this donor? - Donor is permanently deferred - Unit is discarded - Health department is notified - Unit is acceptable to use
Unit is discarded
A postpartum woman was crossmatched for 2 units of packed red blood cells. The first unit was issued at 3:15 a.m. At 3:45 a.m., the nurse called the blood bank and stated the patient was developing red hives and pruritus (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 (Benadryl) for all subsequent transfusions. What type of transfusion reaction has occurred in this patient? Anaphylactic TRALI Urticarial Alloimmunization
Uticarial
Liquid plasma is not indicated for factor ___________ deficiency. XI II X V
V
A 25-year-old patient who had travelled to Ireland in the last year has been experiencing neurological abnormalities since returning to the United States several months ago. Which of the following is most likely? - Creutzfeldt-Jakob disease with an accumulation of prion proteins - Variant Creutzfeldt-Jakob disease with an accumulation of prion proteins - Creutzfeldt-Jakob disease with no accumulation of prion proteins - Variant Creutzfeldt-Jakob disease with no accumulation of prion proteins
Variant Creutzfeldt-Jakob disease with an accumulation of prion 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? - Autosomal recessive - X-linked dominant - X-linked recessive - Autosomal dominant
X-linked dominant
RHAG is considered: - a coexpressor - antibody - antigen - dominant
a coexpressor
Recipient lymphocytotoxic HLA-antibody to donor antigens is associated with: - accelerated graft rejection - respiratory distress. - accelerated graft rejection & platelet refractoriness. - platelet refractoriness.
accelerated graft rejection & platelet refractoriness.
In a patient who has been recently transfused, a positive DAT may be due to: alloantibody coating patient cells. antibodies to a drug coating donor cells. Eating too many cookies alloantibody coating transfused donor cells.
alloantibody coating transfused donor cells
An O-positive mother gave birth to an A- negative baby. After 24 hours the newborn's bilirubin level rose to 18 mg/dL (elevated value). A DAT performed on the cord blood specimen was positive with polyspecific AHG and anti-IgG reagents. It is probable that _______ from maternal circulation is coating the newborn's red blood cells. anti-A anti-D anti-B anti-A,B
anti-A,B
Persons diagnosed with pneumonia caused by Mycoplasma pneumoniae may produce a cold autoantibody with ____________ specificity. anti-I anit-P anti-H anti-i
anti-I
HBsAg is what part of the hepatitis B virus - coat Protein - Capsid Protein - Dane Particle - Core Protein
coat Protein
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: an anaphylactic response. DHTR caused by primary alloimmunization delayed hemolytic transfusion reaction (DHTR) caused by anamnestic response. post-transfusion purpura
delayed hemolytic transfusion reaction (DHTR) caused by anamnestic response.
Blood collected in a red-top tube and a lavender tube was sent through a tube system to the STAT laboratory. The blood specimens were not labeled with any type of patient identification. The medical technologist called the emergency room (ER) to notify them of the problem. The ER nurse stated she wanted the tubes sent back to the ER and that she would label them. The stat laboratory technologist related the laboratory's policy on unlabeled specimens, saying that they would be discarded. At that point the disgruntled nurse said she would write up a(n) _______________ for the laboratory's refusal to analyze blood on an emergency patient. patient report employee evaluation flow chart incident report
incident report
A patient with two or more documented febrile nonhemolytic transfusion reactions (FNHTRs) should receive __________ blood components. irradiated leukoreduced CMV negative Hemoglobin S negative
leukoreduced
All of the following conditions may produce a positive DAT except: - lymphoma - hemolytic transfusion reaction - hemolytic disease of the newborn. - drug-induced hemolytic anemia
lymphoma
Individuals who are Le(a-b-) and can develop Lewis antibodies without exposure to Lewis antigens are called - naturally occurring - immune mediated - biphasic - autoantibodies
naturally occurring
All of the following are transfusion service quality assurance indicators used to monitor patient care except: number of therapeutic units drawn. labeling errors on specimens sent to the blood bank. reason for return of blood products. turnaround time on antibody identification.
number of therapeutic units drawn.
A physician complains that she has not received a test report from the blood bank. The remedial action is to: prepare a copy of the report for the physician. Determine why the report was not delivered complete the occurrence report form. None of the above.
prepare a copy of the report for the physician
All of the following are goals of an exchange transfusion except: to correct anemia to remove high levels of conjugated bilirubin. to remove high levels of unconjugated bilirubin. to remove high levels of maternal antibody.
to remove high levels of conjugated bilirubin
All of the following are consistent with graft-versus-host disease (GVHD) except: HLA incompatibility between graft and recipient. transplantation of immunocompetent T lymphocytes. an immunocompromised recipient. transplantation of "immunologically naive" T lymphocytes.
transplantation of "immunologically naive" T lymphocytes.
Platelets prepared from ______ are referred to as random donor platelets. red blood cells pheresis products whole blood units recovered plasma
whole blood units
Why is reverse grouping not performed on cord blood specimens? - Antibodies are generally not present at birth. - Antigens are not present at birth - Antibody titer is too high. - Antigens are too weak.
Antibodies are generally not present at birth.
What life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepatomegaly and splenomegaly? Sickle cell anemia Thalassemia Hydrops fetalis Hereditary persistence of fetal hemoglobin
Hydrops fetalis
In addition to nonhemolytic febrile transfusion reactions, what other indication exists for washed red blood cells? IgE-deficient patients with anti-IgE IgM-deficient patients with anti-IgM IgG-deficient patients with anti-IgG IgA-deficient patients with anti-IgA
IgA-deficient patients with anti-IgA
What class of immunoglobulin is capable of crossing the placenta? - IgE - IgM - IgG - IgD
IgG
What blood group is the best example of codominantly inherited blood group genes? - Lewis - Rh - MN - ABO
MN
Persons who are negative for Duffy antigens are less likely to contract which of the following diseases? - COVID-19 - Malaria - Influenza - Polio
Malaria
How could a potential alloimmunizaton due to anti-K be prevented? Use of third-generation bedside leukocyte filters Use of washed red blood cells Use of apheresed platelets Matching of donor and recipient red blood cell phenotype
Matching of donor and recipient red blood cell phenotype
The laboratory is presented with a case of HDFN due to ABO incompatibility. The mother is Group O and the infant is Group B. The most appropriate type of blood to use for an exchange transfusion for this infant is: A B O AB
O
What is the action of PEG? - Reduces ionic strength to allow for faster antibody uptake - Its macromolecules allow for closer contact of antibody-coated RBCs - Increases the serum-to-cell ratio - Removes water molecules, thereby concentrating antibody
Removes water molecules, thereby concentrating antibody
You are performing an IAT, and you are suspicious of the results. It appears there may be a weak alloantibody present. You decide to repeat the test, and at the LISS stage you decide to add an extra two drops of serum to each tube being tested. What can you expect to happen? - There would be no effect. - You lowered the zeta potential, thus enhancing your results. - Sensitivity of the test decreases, because you increased the ionic strength of the mixture. - The additional serum increases reaction strengths, because more possible antibody is added to the reaction.
Sensitivity of the test decreases, because you increased the ionic strength of the mixture.
Polyspecific AHG contains: - anti-IgG and anti-IgM. - anti-IgG and anti- C3d - anti-C3b-C3d. - anti-IgG
anti-IgG and anti- C3d
Which red blood cell morphology is most characteristic in ABO HDFN and absent in Rh HDFN? tear drop cells Burr cells spherocytes Target cells
spherocytes
