Blood Banking & Immunology

The primary purpose of neutrophil granules is to:

Provide microbicidal action

What is the first step of the PCR reaction? Select one: a. Hybridization b. Extension c. Annealing d. Denaturation

D. Denaturation. The double stranded DNA must be made into single stranded DNA before it can be used in any way, so denaturation is the first step.

The term TITER (as it applies to the measurement of antibodies) is best defined as: Select one: a. Concentration of antibody in the serum b. Maximum reactive dilution X 100 c. Maximum reactive dilution / 100 d. Reciprocal of maximum reactive dilution

D. Reciprocal of maximum reactive dilution A specimen with a 1:100 dilution would be said to have a titer of 100.

Which of the following immunoglobulins is capable of fixing complement by the classical pathway:

IgG1, IgG3, and IgM fix complement via the classical pathway. IgA fixes complement through the alternative pathway. Only IgG crossed the placental barrier.

How many micrograms (ug) of IgG anti-D are in a 1500 IU vial of Rhlg? Select one: a. 100 b. 150 c. 200 d. 250 e. 300

e. 300 Calculation: Number of vials of 300 µg RhIG = Volume of fetal bleed/30 mL In the interests of safety some American organizations recommend the following to deal with decimal points: If the number to the right of the decimal point is <5, round down and add 1 vial(e.g., 1.4 = 1 +1 = 2 vials) If the number to the right of the decimal point is greater than or equal to 5, round up and add 1 vial(e.g., 1.7 = 2 +1 = 3 vials) Sub-calculations: Volume of fetal bleed: % fetal cells x maternal blood volume Maternal blood volume: 70 mL/kg x weight (kg) (assume 5,000 mL if maternal information is unknown)

The serum hemolytic complement level (CH50): Select one: a. Is a measure of total complement activity b. Provides the same information as a serum factor B level c. Is detectable when any component of the classical system is congenitally absent d. Can be calculated from the serum concentrations of the individual components

a. Is a measure of total complement activity

Which of the following contains all the possible phenotypes that could be the result of parents who are type O and type A:

a. Type A or type O only

The vast MAJORITY of would-be invaders are killed or inactivated primarily by which part of the immune system? Select one: a. Cell Mediated b. Specific c. Humoral d. Innate

d. Innate The innate immunity system is inherent and nonspecific; meaning that all pathogens are attacked similarly.

The prozone effect can be described by all of the following EXCEPT: Select one: a. Results in a false negative reaction b. The result of antibody excess c. Dilution of antibody can help prevent its occurrence d. Results in a false positive reaction

d. Results in a false positive reaction. Prozone is the result of antibody excess; it appears as a false negative, which becomes positive as the patient's serum is diluted.

A 2 month old infant presented with history of chronic diarrhea and failure to thrive. The child's mother also revealed that the baby has suffered from thrush (Candida infections) since birth. Preliminary finding showed lymphopenia (<2,000), hypogammaglobulinemia, and physical findings showed a small thymus, no tonsils or lymph nodes. Which of the following immune deficiencies DOES the patient present. Select one: a. T-cell activation deficiency b. MCH deficiency c. Deficiency in immunoglobulin production d. Severe combined immunodeficiency syndrome

d. Severe combined immunodeficiency syndrome

Which method remains the "gold standard" for ANA detection? Select one: a. Radioimmunoassay (RIA) b. Lateral Flow Immunoassay c. Enzyme Immunoasay (ELISA) d. Slide- based immunofluorescent assay (IFA) or Colorzyme

d. Slide- based immunofluorescent assay (IFA) or Colorzyme

What is the first step a transfusionist should take when a transfusion reaction is suspected? Select one: a. Slow the transfusion and notify the physician. b. Administer medication to stop the reaction. c. Notify the laboratory of the reaction d. Stop the transfusion, but keep the intravenous line open with saline.

d. Stop the transfusion, but keep the intravenous line open with saline.

ABO antibodies are classified as which of the following two immunoglobulin classes? Select all that apply. Select one: a. IgG b. IgM c. IgA d. IgE

(B IS WRONG.) a. and b.? IgG is predominant for type O. IgM is predominant for type A and B

A ficin (enzyme) treated panel can be a useful tool for determining the identity of an antibody. On a ficin-treated panel, reactions with systems are enhanced, while reactions with systems are degraded and reactions with stay the same (unaffected).

(Rh, Lewis, Kidd) (MN, Duffy) (Kell)

Which is the first marker (antigen or antibody) which will become positive after exposure to Hepatitis B: Select one: a. HBsAg b. Anti-HBs c. Anti-HBe d. Anti-HBc

(WRONG) b. Anti-HBs

The purpose of C3a and C5a, the split-products of the complement cascade, is to Select one: a. Bind with specific membrane receptors of lymphocytes and cause release of cytotoxic substance. b. Cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils. c. Bind with membrane receptors of macrophages to facilitate phagocytosis and the removal of debris and foreign substances. d. Regulate and degrade membrane cofactor protein after activation by C3 convertase.

(WRONG:) b. Cause increased vascular permeability, contraction of smooth muscle, and release of histamine from basophils.

The antibody MOST frequently present in systemic lupus erythematosus (SLE) is directed against:

Nuclear antigen

The assay which is most helpful in identifying specific allergens is:

RAST

Which of these nitrogenous bases is present in deoxyribonucleic acid (DNA), but not in ribonucleic acid (RNA)? Select one: a. Guanine b. Cytosine c. Adenine d. Thymine

RNA contains Uracil instead of D. Thymine.

Which blood group is considered the "universal" donor when transfusing Red Blood Cells?

Type O (negative.)

If the mother is a Rh immune globulin (Rhlg) candidate, blood safety standards mandate that a test for weak D is compulsory when initial D typing shows a newborn to be Rh negative. True or False? Select one: True False

Weak D red cells can stimulate production of anti-D. Therefore, infants born to mothers who are RhIg candidates must be tested for weak D.

Which of the following antibody types is chiefly seen in the secondary immune response: Select one: a. IgG b. IgA c. IgM d. IgD

a. IgG IgM is chiefly seen in the primary immune response.

A hapten can BEST be described as:

b. A nonimmunogenic material capable of stimulating an immune response only when bound to a carrier protein

A lymphokine can BEST be described as:

A soluble mediator produced by lymphocytes

Which one of the following statements concerning phagocytosis is FALSE? Select one: a. Cells are only capable of phagocytizing bacteria. b. Membrane "reaches" out and surrounds the material to be internalized. c. Once internalized the material is surrounded by phagosomes. d. Only specialized cells are capable of phagocytosis e. Whole pathogenic organisms can be ingested.

A. Cell are only capable of phagocytizing bacteria. They can also phagocytize other cells (dead or dying).

How does the secondary immune response differ from the primary immune response? a. IgG is the predominant antibody class produced in the secondary immune response b. The antibody levels produced are higher in the secondary immune response c. The lag phase (the time between exposure to antigen and production of antibody) is shorter in the secondary d. All of the above

All of the above.

Which of the following is responsible for humoral response: Select one: a. Neutrophils b. Basophils c. B lymphocytes d. Monocytes

B lymphocytes

This antinuclear antibody (ANA) test pattern is characterized by staining to discrete speckles in the nucleus of the interphase cells (a) and discrete speckling also in the chromosomal area of the metaphase mitotics (b) when viewed using fluorescent microscopy. This image represents which of the following patterns?

Centromere

Which two of the following characteristics are common to both RNA and DNA? Exists primarily as a single-stranded molecule. Consists of a sugar, phosphate residue, and a purine or pyrimidine base. Contains the pyrimidine, uracil. Linked by phosphodiester bonds.

Consists of a sugar phosphate residue and a purine or pyrimidine base. Linked by phosphodiester bonds.

The part of the immunoglobulin molecule that may be kappa or lambda chains is: Select one: a. Fc b. Fab c. Heavy chains d. Light chains

D. Light Chains

When performing a transfusion reaction investigation, what is the clerical check used to detect?

Errors that may cause an ABO-incompatibility due to patient or donor unit mix up

The 5' end of a DNA strand ends with a OH group. True or False?

False. 3' has the OH group 5' has the phosphate group.

Which one of the following red blood cell phenotypes will NOT react with Anti-Fy3?

Fy(a-b-)

Which of the following diseases is NOT associated with autoantibodies? Select one: a. Wegener's granulomatosis b. Rheumatoid arthritis c. Lupus erythematosus d. Hemolytic disease of the newborn

HDN is associated with alloantibodies from the mother's bloodstream directed against the baby's red cell antigens

The most recent algorithm for HIV confirmatory testing in patients who are positive by HIV-1/2 antigen/antibody combination immunoassay is the: Select one: a. Latex agglutination for HIV-1/HIV-2 antigen b. HIV-1/HIV-2 antibody differentiation immunoassay c. Thin layer chromatography d. ELISA

I believe it is B.

Why are ANA positive samples titered? Select one or more: a. To determine just how ill the patient is b. To determine how much antibody is present in the sample c. To look for multiple ANA patterns.

I picked B and C, not sure though. Maybe be them all.

Which of the following antibody types is chiefly seen in the primary immune response: Select one: a. IgG b. IgA c. IgM d. IgD

IgM = Primary IgG = Seconcary

Certain clinical conditions such as Hemolytic Disease of the Newborn (HDN), Hemolytic Transfusion Reaction (HTR), and Autoimmune Hemolytic Anemia (AIHA) result from the attachment of antibodies or complement to human RBCs. What is this process called? Select one: a. Desensitization b. Non-sensitization c. In vitro sensitization d. In vivo sensitization

In vivo sensitization.

Which of the following is not a feature of systemic lupus erythematosus (SLE):

Increased serum compliment

While ABO, Rh, Kell, Duffy, Kidd, SsU are clinically significant, which of the following antibodies generally react at ONLY the Coombs phase (also knowns as Antihuman Globulin phase):

Kell, Duffy, Kidd ABO, Rh, and SsU react at both IS and 37 phase as well.

Which of the following is responsible for causing graft-versus-host reactions:

Lymphocytes Graft-versus-Host reactions are caused by the engrafting of immunocompetent T lymphocytes into a severely immunosuppressed recipient. They can be prevented by gamma irradiation of cellular blood components.

Most blood group antibodies belong to which immunoglobulin classes?

Mostly IgM, but some IgG

MOST pathogens enter the body through: Select one: a. Skin abrasions b. GI tract c. Lungs d. Mucous membranes

Mucous Membranes (Eyes, Nose, Mouth, etc.)

An individual with type AB blood will demonstrate the complete absence of which of the following antigen sites?

Not A B or H --> None of the above. H is the precursor to ABO antigens.

The reaction that occurs when a soluble antigen is mixed with its specific antibody is termed:

Precipitation

Which of the following would be considered most significant as it relates to serological testing:

Rise of antibody titers is diagnostic. Serological diagnosis of active of recent infection generally requires the demonstration of IgM antibody, or the demonstration of a fourfold rise in the titer of specific IgG antibody.

Patients with antibody to the following antigen are immune to Hepatitis B:

Surface Antigen

All of the following criteria for donor RBC to be used for an exchange transfusion relate to both ABO hemolytic disease of the fetus and newborn (HDFN) and HDFN due to anti-D:

True

In real-time PCR procedures, fluorescence resonance energy transfer (FRET) is the process that allows for probes to emit fluorescence only after hybridization. True or False?

True

Kernicterus due to high levels of unconjugated bilirubin can cause brain damage in newborns suffering from severe HDFN. True or false?

True

The DNA strand ending with a phosphate group is the 5' end. True or False

True

Tiny volumes of D+ red cells (e.g., as little as 0.1 mL) can stimulate production of anti-D in some individuals. True or false?

True

Gamma irradiation of cellular blood components is required in which of the following situations: Select one: a. Prevent post-transfusion purpura b. Prevent Graft-Versus-Host (GVH) disease c. Sterile components d. Prevent non-cardiogenic pulmonary edema

b. Prevent GVH disease

A 300 ug dose of Rhlg can suppress immunization to how many mL of D-positive whole blood? Select one: a. 15 mL b. 20 mL c. 25 mL d. 30 mL e. 35 mL

d. 30 mL

The immunoglobulin molecule is made up of both heavy and light chains-the light chains can be comprised of which of the following:

Kappa or Lambda

Given the following results, what is the immune status for the patient? HbsAg: positive HbeAg: positive Anti-HBc IgM: positive Anti-HBs: negative

Acute Infection.

During which stage in real-time PCR can the fluorescent signal start to be recorded? Select one: a. Plateau stage b. Exponential stage c. Leveling stage

B. Exponential Stage In real-time PCR the fluorescent signal is generally too low to detect until after the first couple of cycles. However, detection usually occurs before the end of the exponential stage.

Which of the following would NOT be included in a hemolytic transfusion reaction investigation? Select one: a. ABO/Rh check of post transfusion sample b. Leukocyte antigen studies c. Direct antiglobulin test (DAT) on post-transfusion sample d. Clerical check

B. Leukocyte Antigen Studies

What is the MOST likely cause when clinical signs indicated HIV infections, but antibody tests are negative? Select one: a. probably not HIV infection b. patient is in the "window phase" before antibody production c. tests were performed incorrectly

B. Patient is in the 'window phase' before antibody production.

A hapten is only antigenic when it is coupled with which of the following: Select one: a. Enzymes b. Proteins c. Lymphocytes d. Thrombocyte

B. Proteins The molecular weight of a hapten is by itself not sufficient to elicit an antibody response.

Which immune elements are involved in a POSITIVE TB skin test? Select one: a. IgE b. T cells and macrophages c. Nk cells and IgG antibodies d. B cells and IgM antibodies

B. T cells and macrophages

Why would a unit of group O blood never be administered to a Bombay patient: Select one: a. Anti-A in donor b. Anti-B in donor c. Anti-H in donor d. Anti-H in recipient

D. Anti-H in the recipient. The classic Bombay phenotype (Oh) is characterized by the absence of A, B and H antigens, and the presence of anti-H, which will react from 4o to 37o C. Bombay patients must therefore be transfused only with blood from donors of the Bombay phenotype.

When a unit of packed RBC's is split using the open system, each half-unit must be issued within: Select one: a. 24 hours b. 48 hours c. 30 days d. the original expiration date e. 72 hours

If a unit is entered without use of a sterile connection device (open system) it must be used within 24 hours of entry. Closed systems retain the same expiration date as the original whole blood unit.

Match each letter in this image of a tissue cell that is used as a substrate in ANA testing to the structure that it is indicating.

b.

The Kidd antibody is MOST commonly associated with: Select one: a. Delayed hemolytic transfusion reactions b. Postpartum depression c. Hives and rashes with shingles d. Immediate spin, cold antibody reactions

a. Delayed Hemolytic Transfusion Reactions (As well as Hemolytic Disease of the Newborn HDN)

When performing an antibody panel, which one of the following antigens will be rendered inactive by enzyme treatment? Select one: a. Fya b. Jka c. E d. Lua

a. Fya (Fya--Duffy antigens are rendered inactive by enzyme treatments since the enzyme will remove the sialic acid from the RBC membrane. This process destroys: M, N, S, s, and Duffy antigens. The process enhances the reactions for Rh, Kidd, Lewis, I, and P antigens.)

A sample of cerebrospinal fluid is diluted 1:100 ; the standard 9 squares of a hemocytometer are counted on each side for a total of 18 large squares. Side 1 - 186 nucleated cells counted Side 2 - 184 nucleated cells counted Total nucleated cells = 370 Using the standard hemocytometer formula shown on the right, what is the nucleated cell count per microliter (uL) ?

b. 2.06 X 104 (370 x 100) / (18 x .01)

What are the possible ABO genotypes of offspring from parents whose genotypes are OO and AB:

b. OA and OB

If a child's phenotype is Group O, the phenotype of the mother of the child is Group A and the phenotype of the father is group B what are the possible genotypes of both parents? Select one: a. AA and BO b. AO and BB c. AO and BO d. AA and BB

c. AO and BO

Which one of the following immunoglobulins is MOST likely to be elevated in anaphylactic shock? Select one: a. IgA b. IgD c. IgE d. IgG e. IgM

c. IgE (IgE---"True" anaphylaxis is caused by degranulation of mast cells or basophils mediated by IgE, and pseudo-anaphylaxis occurs without IgE mediation.)

A traveler is being evaluated at a local hospital for gastrointestinal pain, fever and diarrhea. The patient has recently returned from a month-long visit to Southeast Asia. The patient has no recent history of sexual activity or IV drug use but did describe conditions of poor sanitation where they were visiting. If liver function test results were elevated and bilirubinuria was noted, which of the following would be the next logical test to order? Select one: a. ELISA test for the Hepatitis B Surface Antigen (HBsAg) b. Recombinant Immunoblot Assay (RIBA) test for Hepatitis C c. Western Blot test for HIV d. ELISA testing for Hepatitis A antigens in the stool

d. Elisa Testing for Hepatitis A antigen in the stool. Hepatitis B, C and HIV are spread primarily through sexual contact or IV drug use and needle sharing. While it is possible to contract these viruses through other means, the patient history of visiting areas of low sanitation in Asia is more indicative of an enterically (fecal-oral) transmitted organism like Hepatitis A.

A 2 month old infant presented with history of chronic diarrhea and failure to thrive. The child's mother also revealed that the baby has suffered from thrush (Candida infections) since birth. Preliminary findings showed lymphopenia (<2,000), hypogammaglobulinemia, and physical findings showed a small thymus, no tonsils or lymph nodes. Which of the following immune deficiencies DOES the patient present? Select one: a. T-cell activation deficiency b. MCH deficiency c. Deficiency in immunoglobulin production d. Severe combined immunodeficiency syndrome

d. Severe combined immunodeficiency syndrome

The most definite indication that a patient has been sensitized to a specific red cell antigen is: Select one: a. Hives and rash b. A positive posttransfusion DAT in a patient with a previously negative DAT c. A positive posttransfusion DAT in a patient with a previously positive DAT d. Hemoglobinuria

A positive posttransfusion DAT in a patient with a previously negative DAT Hives and rash usually indicate an allergic reaction. Hematuria is due to a variety of causes. Fever and chills usually indicate a febrile reaction. Positive DAT due to conditions other than sensitization to red cell alloantigens is not uncommon. Therefore a positive DAT in the posttransfusion specimen with a negative DAT in the pretransfusion specimen is more likely to indicate alloimmunization.

All of the following are considered benefits of automated isolation and extraction equipment EXCEPT:

Automated isolation equipment is cheaper and more practical Automated isolation is expensive.

Avidity is best described by which of the following statements: Select one: a. The strength with which red cells agglutinate b. The strength with which multivalent antigens and antibodies bind c. The strength wit which univalent antigens and antibodies bind d. The speed with which an antigen-antibody reaction occurs

B. The strength with which multivalent antigens and antibodies bind. The term affinity refers to the strength of attraction between a single antigenic determinant and a corresponding antigen binding site. The term avidity refers to the total strength of the attraction between an antibody and a multivalent antigen. The reaction between an IgM molecule (which has 10 antigen binding sites), and a multivalent antigen is therefore much stronger than that of an IgG antibody (which has only 2 antigen binding sites).

Your screen cells are 3+ at immediate spin and weak (W) + at AHG. Your auto control is negative for both phases. Some of your antibody panel cells are 3+ at immediate spin and negative at AHG. What should you suspect? Select one: a. A warm autoantibody is present b. A cold antibody may be present c. Bad specimen draw

B; If your reactions are strong at immediate spin (3+) and then get weaker at AHG (w+), it could mean the presence of a strong cold antibody.

During routine inspection, a unit of unexpired blood was noticed to have a black color with numerous small clots. What is the likely cause for this observation? Select one: a. the unit was frozen b. donor had DIC c. viral contamination d. bacterial contamination

Bacterial Contamination D. D; Bacterial contamination can manifest itself in several ways including: the presence of clots, darker purple-black color of blood unit, unit can appear cloudy, hemolysis may be present.

What has happened in an antibody titer, if tubes # 5-7 show a stronger reaction than tubes #1-4? Select one: a. Poor technique b. Postzone reaction c. Prozone reaction d. Equivalence reaction

C. Prozone reaction

Which of the following mediators is released during T-cell activation? Select one: a. immunoglobulins b. thymosin c. serotonin d. lymphokines e. cytoplasmic granules

D T cells secrete lymphokines, which encourage cell growth, promote cell activation, direct cellular traffic, destroy target cells, and initiate macrophages.

The use of non-specific fluorescent dyes is the most specific method of measuring amplicons in real-time PCR. True or False?

False Non-specific fluorescent dyes can bind to both the product and the primers, resulting in lack of specificity. The use of DNA probes is more specific.

Which of these is NOT considered one of the systemic autoimmune rheumatic diseases? Select one: a. Systemic lupus erythematosus (SLE) b. Systemic sclerosis (SSc) c. Rheumatoid arthritis (RA) d. Hashimoto disease of the thyroidH

Hashimoto disease of the thyroid is not a systemic autoimmune disease; it is an organ-specific autoimmune disease. That is, the autoantibodies are directed at a single target organ (in this case, the thyroid). SLE, SSc, and RA are all considered systemic autoimmune rheumatic diseases because they can effect multiple systems in the body (systemic) including the joints, muscles and bones (rheumatic).

Given the following results, what is the immune status of the patient? HBsAg: negative HBeAg: negative Anti-HBc: positive Anti-HBs: positive Select one: a. acute infection b. chronic infection c. recovery d. immunization

I believe it's recovery. Because having both Anti's mean's that they have been infected but they have overcome the disease. The vaccine only is Anti-HBc, which I'm assuming is an Immunization.

Which of the following immunoglobulin classes is chiefly responsible for the degranulation of mast cells and basophils:

IgE levels are often increased in patients with allergic disease. IgE binds to the membranes of mast cells and basophils, and if specific antigen is present to react with the IgE molecule, degranulation of these cells occurs, releasing histamines, and other substances into the blood or tissues.

A delayed hemolytic transfusion reaction is most likely to be the result of which of the following antibodies:

Jka Blood group antibodies associated with Delayed Transfusion reactions include those of the Kidd, Duffy, Kell and MNS systems, in order of decreasing frequency.

A 40-year-old female receives two units of Red Blood Cells during a surgical procedure. The patient has no prior history of transfusions. Seven days later, she presents with extensive bruising of the extremities and bleeding of the gums, with no additional symptoms. Her platelet count is 5X109/L (reference interval 150-400 X 109 /L). What is the most likely diagnosis?

PTP

Which T cell expresses the CD8 marker and acts specifically to hill tumor or virally infected cells?

T cytotoxic

The best way to evaluate single nucleotide polymorphism (SNP) is by melting curve analysis. True or False?

True The use of real-time PCR can detect differences as small as one base pair in a DNA segment.

Evaluating B-type natriuretic peptide (BNP) levels can be helpful in distinguishing transfusion- related acute lung injuries (TRALI) from cardiopulmonary edemas.

True.

For those facilities that in the interest of safety use a special calculation for Rhlg dosage, regardless if they round up or round down, they always add one vial. True or False?

True. Even if the patient is negative, you still give them one vial.

A centromere that is located at the point where two chromosome arms are roughly EQUAL in length is called metacentric. True or false?

True. Metacentric = Equal in length Telocentric = Different in length

True or False: When antigen typing, mixed-field agglutination (MFA) due to red cell transfusion indicates RECENT transfusion, specifically transfusion within the past three months.

True?

The Hepatitis B virus vaccine was administered to MLS students during Orientation. Which type of immunity is expected and provide long-term protection? Select one: a. Active b. Passive c. Adoptive d. Innate

a. Active Because you're actively getting a vaccine to become immune.

The mediator cells that bind MOST to IgE antibodies are: Select one: a. Basophils b. Eosinophils c. Polymorphonuclear neutrophils d. Macrophages

a. Basophils Basophils are the principal cells that bind IgE antibody while their number of receptor sites is proportional to serum IgE levels. Eosinophils are drawn to the site by the basophil chemotaxis mechanism, but are not the main cell which binds the IgE antibody.

A decrease in which of the following in a AIDS patient are associated with increased susceptibility to infection: Select one: a. CD4 + cells b. CD8 + cells c. HIV antigens d. HIV antibodies

a. CD4 + cells

Which part of the immunoglobulin molecule is responsible for activating complement? Select one: a. Fc b. Fab c. heavy chains d. light chains e. Hinge regions

a. Fc The Fc portion of immunoglobulin can activate the classical complement pathway, where the heavy chains, light chains, hinge regions and Fab portions cannot.

There are two patterns present in this microscopic field from an antinuclear antibody ANA test. The test is viewed using fluorescent microscopy. One pattern can be seen in the interphase cells (a) and the area outside of the chromosomal area of the mitotics (b). The other pattern is recognizable in the chromosomal area of the metaphase mitotic cells (c). What are these two patterns? Select one or more: a. Centromere b. Homogeneous c. Speckled d. Nucleolar

a. Homogeneous, Speckled

Patient 1234 has a positive antinuclear antibody (ANA) test with a centromere pattern at a 1:1280 titer. Surprised by the result, the clinician calls and says the patient is only having mild stiffness of her fingers and asks your opinion of the result. Which is your best reply? Select one: a. You point out that centromere antibodies have been known to occur years prior to the onset of the disease and the patient should be carefully examined and monitored for the development of other symptoms. b. You comment that it's common to over-read ANA results and since the ANA testing is not diagnostic and prone to false results it's unlikely the results are of any concern. c. You state that the ANA results alone are diagnostic of systemic sclerosis and since there is no cure for this disease the clinician is powerless to do anything.

a. You point out that centromere antibodies have been known to occur years prior to the onset of the disease and the patient should be carefully examined and monitored for the development of other symptoms.

Fresh frozen plasma should be used for which of the following: Select one: a. Platelet replacement b. Coagulation deficiencies c. Volume replacement d. Albumin replacement

b. Coagulation Deficiencies. A unit of fresh frozen plasma (FFP) contains all coagulation factors. FFP is indicated for patients with a coagulopathy who are bleeding or at risk of bleeding, and where a specific therapy or factor concentrate is not appropriate or unavailable. FFP may be indicated to replace labile plasma coagulation factors during massive transfusion, cardiac bypass, liver disease or acute disseminated intravascular coagulation in the presence of bleeding and abnormal coagulatio

You are working at a blood donor center; the date is July 1st. A unit of packed RBCs expires on August 4th. If the unit of blood is irradiated, what will be the new expiration date? Select one: a. July 6th - because after irradiation, blood expiration date is always shortened b. July 29th - because after irradiation, the expiration date shortens to 28 days from the date of expirations, or the original expiration date, whichever is first c. August 10th - because following irradiation, the expiration date is extended d. August 4th - because irradiation does not alter the expiration date

b. July 29th - because after irradiation, the expiration date shortens to 28 days from the date of expirations, or the original expiration date, whichever is first.

What is the first line treatment for moderate to severe hemophilia A? Select one: a. Platelets b. Lyophilized Factor VIII concentrate c. Factor IX complex d. Cryoprecipitate AHF

b. Lyophilized Factor VIII concentrate

In blood bank agglutination reactions, the zeta potential (a force exerted by ions in the saline solution that causes repulsion between red blood cells in the saline suspension) can be reduced by treating the sensitized cells with:

b. Polyethylene glycol (PEG), albumin, or proteolytic enzymes

Jane Doe is a 39-year-old female who felt tired for several months, had pain in the joints of her fingers, and recently developed a dermatitis following exposure to the sun. The following test results were obtained on a blood sample drawn during the initial evaluation: Total Protein = 8.4 gm/dL (N = 6.0-8.0 gm/dL) ANA > 1:2560; speckled pattern CRP = positive C3 = 40 mg/dL (N = 80-180 mg/dL) C4 = 5 mg/dL (N=15-45 mg/dL) Based on the clinical and laboratory findings, what disease should be suspected?

b. Systemic Lupus Erythematosus (SLE)

What type of the follow - up testing is recommended for a Speckled ANA pattern ? Select one: a. None b. Testing for antibodies to the extractable nuclear antigens (ENA) c. Testing for antibodies to dsDNA

b. Testing for antibodies to the extractable nuclear antigens (ENA)

Which of the following kappa / lambda ratios is found in normal serum: Select one: a. 4:1 b. 3:1 c. 2:1 d. 1:1

c. 2:1

It's a busy Friday evening in the blood bank and you have been receiving a steady stream of Type & Screen specimens from the emergency room and several of them have positive antibody screens which require further workup. One of these patients is a 46-year-old male whose hemoglobin has dropped from 8.4 g/dL to 4.6 g/dL in the previous 8 hours (normal Hgb for this patient demographic would be ̴ 14 g/dL). Your workup reveals a Type O patient with the following antibodies: Anti - K , anti Fya. The prevalence of K negative donors in your donor population is 91% while the prevalence of Fya negative donors is 37%. Two units of crossmatched RBCs are requested by the physician. How many units of group O RBC units should you phenotype, in order to fulfill the request for two cross matched units? Select one: a. 2 units of type O RBC units b. 3 units of type O RBC units c. 6 units of type O RBC units d. 12 units of type O RBC units

c. 6 units of type O RBC units

Which of the following is responsible for humoral response: Select one: a. Neutrophils b. Basophils c. B lymphocytes d. Monocytes

c. B lymphocytes

Which of the following is the "activation unit" in the classical complement pathway? Select one: a. C1 b. C2 c. C4, C2, C3 d. C5, C6, C7, C8, C9 e. C1, C2, C9

c. C4, C2, C3

Transfusion- associated graft versus host disease (TA-GVHD) may be prevented by which of the following? Select one: a. Washing blood components b. Leukoreduction of blood components c. Irradiation of cellular products d. None of the above

c. Irradiation of cellular products

In HDN which of the following antigen-antibody reactions is occurring: Select one: a. Maternal antibody against fetal antibody b. Maternal antigen against fetal antibody c. Maternal antibody against fetal antigen d. Maternal antigen against fetal antigen

c. Maternal antibody against fetal antigen

IgM antibodies produced against red blood cells generally: Select one: a. Are the only immunoglobulin involved in hypersensitivity reactions b. Can be identified using the AHG test c. React best at room temperature d. React best at 37 degrees Celsius

c. React best at room temperature

Which T cell expresses the CD8 marker and acts specifically to kill tumor or virally infected cells? Select one: a. Helper T b. T suppressor c. T inducer/suppressor d. T cytotoxic e. Natural killer

c. T cytotoxic