Blood Bank Test 1
Process of standardizing an instrument against a known value
calibration
System to plan and implement changes to prevent problems
change control
Which class of HLA antigens would be typed when matching patient and donors for platelet transfusion?
class 1 only
Equal expression of two different inherited genes as in most blood group systems
codominant genes
Evaluation of an employee's stability to perform a specific skill
competency assessment
Select the portion of the antibody molecule that imparts the antibody's unique class function.
constant region of the heavy chain
Plans that provide the framework for establishing quality assurance in an organization are:
continuous quality improvement plan
Select the substance that regulates the activity of other cells by binding to specific receptors.
cytokines
Detects IgG or complement-coated red cells
direct and indirect
Requires washing the cells several times before the addition of antihuman globulin reagent
direct and indirect anti globulin test
Tests for certain clinical conditions such as hemolytic disease of the newborn and autoimmune hemolytic anemia
direct antiglobulin test
Part of the antigen that the immunoglobulin binds to
epitope
Parents who are both phenotyped as group A cannot have a group O child.
false
Quality control is the same as quality assurance.
false
What is the potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used?
false negatives
Select the method that uses a dextran-acrylamide matrix.
gel technology
The linked HLA genes on each chromosome are inherited as a:
haplotype
When two genes are close together on the same chromosome and are inherited as a group or bundle, they are inherited as this
haplotypes
The major histocompatibility complex is located on chromosome 6 and is important in all the following immune functions except:
hemolysis
Imparts flexibility to the immunoglobulin molecule
hinge region
Select the term that is associated with the B-cell response to antigens.
humoral immunity
Variable region of an immunoglobulin
idiotype
In order to enhance the reaction of an antibody in vitro, it may be necessary to adjust which of the following?
increase the incubation time in the incubator
In a routine audit of a facilities blood collection area, the quality assurance department found that the blood bags being used on that particular day had expired. What is the appropriate course of action?
initiate a root cause analysis and quarantine the blood collected in the expired bags
The type of immunoglobulins determined by the heavy chain
isotope
All of the following are true regarding competency testing except:
it is required only if the technologist has no experience
One of the two types of light chains
kappa
Reagent derived from plants used to distinguish group A1from group A2 red cells
lectins
The gel technology method uses a concentration of red cells that is
lower than tube techniques
Crossing over occurs during:
meiosis
The antiglobulin test was performed using gel technology. A button of cells was observed at the bottom of the microtube following centrifugation. This result indicates a:
negative reaction
Reagent to identify the specificity of a red cell antibody antisera
panel cells
All of the following are responsibilities of the quality assurance department of a blood bank except:
performing quality control
When an individual is said to be group A, it refers to the individual's:
phenotype
Reagent antibodies prepared from human sources are:
polyclonal in specificity
What reagent contains antibodies to multiple antigenic epitopes?
polyclonal-based
Having two or more alleles at a given gene locus
polymorphic
Which red cells are used to screen for antibodies in donor samples?
pooled screening cells
Maximizes the duration of equipment and increases the reliability of the equipment
preventive maintenance
Marks the sequence to be amplified during PCR
primer
In the PCR reaction, short pieces of single-stranded DNA that are complementary and mark the sequence to be amplified are called:
primers
Short sergment of DNA with a known sequence that can be labeled with a marker
probe
Product limitations and technical considerations for each reagent can be found in the:
product insert
The CAP survey is an example
proficiency test
Testing to determine the accuracy and precision of reagents and equipment
quality control
Removal of products from the market that might compromise the safety of the recipient
recall
When a gene product is expressed only when it is inherited by both parents
recessive
A poor response to platelet transfusion that can be caused by antibodies to human leukocyte antigens is known as:
refractoriness
Investigation and identification of the factors that contributed to an error
root cause analysis
Personal protective equipment includes:
safety glasses mask splash barriers
Reagent to detect the presence of red cell antibodies and B cells
screening cells
Which of the following will cause an antigen to elicit a greater immune response?
size greater than 10,000 daltons
Extravascular destruction of blood cells occurs in the:
spleen
Biosafety levels determine:
the degree of risk for certain areas of a health care facility to exposure to infectious diseases.
Solid-phase red cell adherence used for antibody detection has an advantage over tube testing because:
the endpoint is more clearly defined
All accidents, even minor ones, must be reported to a supervisor.
true
The Occupation Safety and Health Administration does not require the routine use of gloves by phlebotomists working with healthy prescreened donors or changing gloves between donors.
true
Mitosis results in __________ chromosomes as the original.
two cells with the same number of
How would you interpret the results if both the anti-D reagent and the Rh control were 2+ agglutination reactions?
unable to determine without further testing
Establishing that a specific process produces an expected result
validation
Select the region of the antibody molecule responsible for imparting unique antibody specificity.
variable region
Monoclonal antibodies are prepared in:
vitro
Rouleaux is a false-positive reaction that would not likely be observed during which of the following tests?
weak D test
Following centrifugation of the gel card, red cells are observed to be evenly dispersed throughout one of the microtubes. This reaction could be graded as a:
2+
The indirect antihuman globulin test is incubated at what temperature?
37
After adding antigen and antibody to a test tube, one large agglutinate was observed. How should this reaction be graded?
4+
In the solid-phase red cell adherence test, a negative test would appear as:
A button of cells on the bottom of the well
An advantage of Nucleic Acid Testing (NAT) for viral marker testing is:
A small amount of DNA or RNA can be detected
Reagent used in the identification of ABO antibodies
A1 and B cells
Professional organization that accredits blood banks and transfusion services
AABB
Reagent used to determine the ABO antigenic composition of a patient's red cells
ABO antisera
In a family study, it was determined that all four siblings in the family had a different blood type: A, B, O, and AB. The parents were most likely __________.
AO and BO
A gene that does not express a detectable product
Amorphic genes
Amplified target sequences of DNA produced by polymerase chain reaction
Amplicon DNA sequence
Polyspecific antihuman globulin contains:
Anti-IgG and anti-C3d
Which of the following red cell antigens do proteolytic enzymes destroy?
Antigens Fya and Fyb in the Duffy system
The mixed lymphocyte culture (MLC) is a procedure that has been used in HLA testing to determine:
B and D
Select the cell involved in humoral immunity.
B lymphocytes
In the complement cascade, lysis of the target cell is mediated by which of the following components?
C5 to C9
Provides peer-reviewed accreditation for hospital laboratories
CAP
Makes reccomendations to the Occupational Safety and Health Administration regarding the prevention of disease transmission
CDC
The purpose of adding antibody-sensitized red cells following the antiglobulin test is to:
Check that the wash procedure was sufficient to remove unbound antibodies
Hemolysis was observed at room temperature when testing a patient's serum with reagent red cells used for screening. When this test repeated using the patient's plasma, no hemolysis was observed. What was the most likely explanation for the different reactions?
Complement activation was inhibited by calcium in the plasma sample.
Incubation step is not necessary
Direct antiglobulin test
Ensures the safety and efficacy of biologics, drugs, and devices
FDA
Which of the following organizations are involved in the regulation of blood banks?
FDA
What portion of the antibody molecule binds to receptors on macrophages and assists in the removal of antibody bound to red cells?
Fc fragment
Which of the following is true regarding good manufacturing practices (GMPs)?
GMPs are legal requirements established by the Food and Drug Administration.
HLA matching between the donor and recipient is important for progenitor cell transplantation to avoid:
GVHD and graft rejection
The standard operating procedure is a document that:
Helps achieve consistency of results
In safety training, employees must become familiar with all of the following except:
How to perform cardiopulmonary resuscitation on a donor or other employee
Of the following markers that can be used to test for paternity, which marker provides the most useful statistical value?
Human leukocyte antigen typing
The binding of two complementary pairs of DNA
Hybridization
Found in secretions, such as breast milk:
IgA
Associated with allergic reactions and mast cell activation:
IgE
Able to cross the placenta:
IgG
Has the highest serum concentration:
IgG
What immunoglobulin class is capable of crossing the placenta?
IgG
What immunoglobulin class reacts best by antiglobulin testing?
IgG
Associated with immediate-spin in vitro reactions:
IgM
Associated with intravascular cell destruction:
IgM
Efficient in activation of the complement cascade:
IgM
What immunoglobulin class reacts best at room temperature at immediate spin?
IgM
has the highest number of antigen binding sites:
IgM
Polyethylene glycol is a reagent that can be added to the screen or panel in order to:
Increase the avidity of IgG antibodies
A laboratory technologist decided she would like to bring her lab coat home for laundering because it had too many wrinkles when it was returned by the laboratory's laundry service. Is this acceptable?
No because the lab is a biosafety level 2, and lab coats may not be removed
A technologist was being trained in a different area of the blood bank and noticed that the person training her had not recorded the results of a test. To be helpful, she carefully recorded the results she saw at a later time, using the technologist's initials. Is this acceptable procedure?
No; she should have brought the error to the technologist's attention.
The children of an AB mother and a B father could phenotype as all of the following except:
O
Ensures safe and healthful working conditions
OSHA
Technique used to replicate a specific targeted
PCR
In relationship testing, a "direct exclusion" is established when a genetic marker is:
Present in the child but absent in both the mother and alleged father
The evidence for reagent red cell deterioration may include which of the following?
Significant hemolysis, loss of agglutination strength over time, spontaneous agglutination
Hematopoietic progenitor cell engraftment evaluation following a transplant evaluates which specific markers in the recipient?
Similarities and differences of short tandem repeats of DNA
Blood irradiators require all of the following safety procedures except:
That the user have a degree in radiology
Why is incubation omitted in the direct antihuman globulin test?
The antigen-antibody complex has already formed in vivo
Several units were released to a hospital by mistake before all viral marker testing was completed. What is the appropriate course of action?
The error is reportable and the FDA must be contacted
A facility does not validate a refrigerator before use. What is a potential outcome?
The facility is in violation of current good manufacturing practices and could be cited by the FDA
If two traits were found to occur higher in a population together than each occurs separately, they may be linked. This would suggest that:
The genes are close together on the same chromosome
A patient's record indicated that he had a history of an antibody to HPA-1a. What is the significance of this antibody if this patient requires a platelet transfusion?
The patient would require HPA-1a negative platelets, which are relatively rare
How is RNA different from DNA?
The sugar ribose is substituted for deoxyribose, the base uracil exists only in RNA, RNA usually exists as a single strand
Unacceptable quality control results for the antiglobulin test performed in test tubes may be noticed if:
The technologist performing the test was never trained, preventive maintenance has not been performed on the cell washer, the reagents used were improperly stored
Which of the following statements is true regarding high-protein anti-D reagents?
They may increase the possibility of a false-positive reaction, requiring the use of a control, they contain approximately 20% bovine albumin, they have been largely replaced with low-protein monoclonal reagents
Which of the following statements is true regarding IgG-sensitized red cells?
They must be used to confirm negative antiglobulin tube test
Which of the following is an example of an unacceptable record-keeping procedure?
Using dittos in columns to save time
A father carries the Xga blood group trait and passes it on to all of his daughters but to none of his sons. What type of inheritance pattern does this demonstrate?
X-linked dominant
A person whose red cells type as M+N+ with antisera would be:
a heterozygote
What is meant by the term autosomal?
a trait that is not carried on the sex chromosomes
Degree to which a measurement represents the true value
accuracy
It was observed that an antibody identified in the transfusion service appeared to be reacting stronger following the second exposure to an antigen from a transfusion. The most likely explanation of this is:
affinity maturation of the immunoglobulin molecule anamnestic response isotope switching
Employee training takes place:
after hiring and following implementation of new procedures.
Which of the following is not an advantage of using a monoclonal antibody over a polyclonal antibody?
all variations of the antigen can be detected
Which of the following is responsible for the activation of the classic pathway of complement?
antibody bound to antigen
In a serologic test, the term prozone is also known as:
antibody excess
Select the test that uses IgG-sensitized red cells (check cells).
antiglobulin test
In a lymphocytotoxicity test, cells that take on the dye
are recognized by a specific antibody
Systematic evaluations to determine whether procedures are being followed
audit
An antigen that originates from the individual is termed:
autologous
Most blood group systems are inherited as:
autosomal codominant
At what point in the employment process should safety training take place?
before independent work is permitted and annually thereafter
Opsonozation is a term to describe what process?
binding to cells or antigens