Blood Bank BOC 201-300
An antibody identification study is performed with a 5 cell panel shown in Figure 9. An antibody against which of the following antigens could not be excluded?
1
In what patient population may we observe the following results: anti-A= 4+ anti-B= 0 anti-D= 4+ A1 cell=0 B cells=1+
2 year old surgical patient
A patient is a subgroup of A, Rh positive with anti-A1 in their serum. How many units would you have to screen to find 1 unit that is compatible with the patient's anti-A1?
5 units
During prenatal studies, a woman is noted to have a positive antibody screen and anti-Kpa is identified. What percentage of units will be compatible for this patient id transfusion is necessary?
>98%
A 29 year old male is hemorrhaging severely. He is AB, Rh-negative. 6 unites of blood are required STAT. Of the following types available in the blood abnk, which would be most preferable for crossmatch: AB, Rh pos A, Rh neg A, Rh pos O, Rh neg
A, Rh neg
Based on the reactions below, what is the patient's ABO type? anti-A=4+ anti=B=0 Ulex europaeus=0 Dolichos biflorus=4+
A1
Mixed field agglutination encountered in ABO grouping with no history of transfusion would most likely be due to:
A3 red cells
Which of the following genes on chromosome 1 is made up of 2 exons, leading to the expression of the Duffy glycoprotein and its antigens?
ACKR1
Plasma neutralization is best used to verify which of the following antibodies?
Anti-Ch/Rg
A person's saliva incubated with the following antibodies and tested with the appropriate A2, O and B indicator cells, gives the following test results: anti-A= reactive anti-B= inhibited anti-H= inhibited The person's red cell ABO phenotype is
B
A patient is A2B, Rh pos and has an antiglobulin-reacting with anti-A1 in his serum. He is in the operating room bleeding profusely and group A2B RBCs are NOT available. Which of the following blood types is first choice for crossmatching?
B, Rh pos
A 56 year old female with cold agglutinin disease has a positive DAT. When the DAT is repeated using monospecific antiglobulin sera, which of the following is most likely to be detected?
C3d
Anti-I in cold agglutinin disease may cause a positive DAT because of
C3d bound to the red cells
The most widely accepted QC test to measure probably Hematopoietic progenitor cell engraftment is
CD34+
Reagent antibody screening cells may not detect antibodies directed against low incidence antigens. Which antibody is most likely to go undetected?
Cw
Which of the following tests is most commonly used to detect antibodies attached to a patient's RBCs in vivo?
DAT
Which of the following blood bank chemicals produce Kell null cells?
DTT
Which of the following antigens gives enhances reactions with its corresponding antibody following treatment of the red cells with proteolytic enzymes?
E
Inheritance of the rare Mk gene results in the deletion of both GYPA and GYPB. Which of the following blood group antigens is not expressed on red cells in the presence of Mk gene?
Ena
Which of the following systems plays an important role in Transfusion-Related Acute Lung Injur, transfusion related graft vs host disease, platelet refractoriness, and Febrile nonhemolytic transfusion reactions as well as in hematopoietic stem and organ transplantation?
HLA
Which HLA genes code for MHC II?
HLA-DR, DP, DQ
Indications for an autologous hematopoietic progenitor cell transplant include patient who have
Hodgkin lymphoma with high dose chemotherapy
Polyspecific reagents used in the DAT should have specificity for?
IgG and C3d
In a group O individual with Le and Se genes, what ABO Lewis antigens are present in secretions?
Lea, Leb, H
A patient's antibody identification panel demonstrated anti-M. The antibody was most reactive with homozygous M+ cells compared to heterozygous M+ cells. Which of the following cells would demonstrate the strongest reaction?
M+N-S-s+
A 5 year old with chronic upper respiratory infections arrives in the ER with chronic anemia. The antibody screen and antibody identification panel are all strongly reactive when tested by solid phase automation. The DAT is negative, and the patient's phenotype is shown below. With these findings, what is suspected: C=4+ E=4+ c=4+ e=4+ K=0 k=1+ Fya=0 Fya=0 Jka=4+ Jkb=4+
McLeod syndrome
A patient has a variable reacting anti-P1 pattern in antibdoy identification studies. What test can be used to verify the specificity of anti-P1?
P1 neutralization
A 10 year old girl was hospitalized because her urine has a distinct red color. The patient had recently recovered from an URT infection and appeared very pale and lethargic. Tests were performed with the following results in figure 15. The patient probably has:
Paroxysmal cold hemoglobinuria
Using the antigen typing results below, what is the patient's likely phenotype: D=+ C=0 E=+ c=+ e=+ f=+ G=+
R2r
Whic of the following genes on chromosome 1 encodes for the 4 common antigen combinations ce, cE, Ce, and CE?
RHCE
The Rh-negative phenotype results from the complete deletion of what gene?
RHD
Autoantibodies demonstrating blood group specificity in warm autoimmune hemolytic anemia are associated with which blood group system?
Rh
A patient's serum sample was reactive with all cells except the autocontrol when tested by PEG-AHG. The patient's phenotype was confirmed as C-R+c+e+; K-k+, Kp(a-b+); Js(a-b+); Fy(a-b+); Jk(a-b-); M+N+S+s+. Phenotypically similar cells were tested and found to be nonreactive. In what population of donors are we most likely to find a compatible donor for the patient?
Tahitian
An antibody screen performed using solid phase technology revealed a diffuse layer of RBC's on the bottom of the well. these results indicate:
a positive reaction
The following results were obtained in pretransfusion testing in Figure 7. The most probable cause of these results is
a warm autoantibody
What ABO type is found in group A1 individual following deacetylation of their A antigen?
acquired B
Refer to the cell panel in figure 13. Based on these results, which of the following antibodies is most likely present?
anti-C
A patient's serum reacted weakly positive with 16 of 16 group O panel cells at the AHG phase. The autocontrol was negative. Tests with ficin-treated panel cells demonstrated no reactivity at the AHG phase. Which antibody is most likely responsible for these results?
anti-Ch
The test for weak D is performed by incubating patient's red cells with
anti-D antisera
The sample from a 45 year old Asian omen, gravida 2, para 2 demonstrated a positive antibody screen. The results are in Figure 11. Which common antibody has not been ruled out by the panel?
anti-E
Refer to Figure 12. Based on the results of the above panel, the most likely antibodies are
anti-E, anti-Jka, and anti-K
An antibody that causes in vitro hemolysis and reacts with red blood cells of 3 out of 10 AHG-crossmatched donor units is most likely
anti-Lea
In the process of identifying an antibody, the technologist observed 2+ reactions with 3 of the 10 cells in a panel after the IS phase. There was no reactivity after incubation at 37'C and after the AHG test phase. The antibody most likely is
anti-Lea
In the process of identifying and antibody, the technologist observes 2+ reaction with 3 out of the 10 cells at IS and RT. There were no reactions at 37'C or AHG. What is the most likely antibody?
anti-Lea
To confirm the specificity of anti-Leb, an inhibition study using Lewis substance was performed with the following resutls: patients serum+Lewis substance=0 patient serum+saline control=+ What conclusion can be made from these results?
anti-Leb is confirmed because the tubes with Lewis substance are negative
A patient demonstrates 4+ reactivity with all red cells tested and the autocontrol is nonreactive. This high incidence antibody was suspected to be related to the P1PK blood group system as the patient is the rare p phenotype. What antibody specificity should be suspected?
anti-PP1Pk
A patient's serum reacts with 2 of the 3 antibody screening cells at AHG phase. 8 of 10 units crossmatched were incompatible at the AHG phase. All reactions are markedly enhanced by enzymes. These results are most consistent with
anti-c
A 25 year old Caucasian women, gravida 3, para 2 required 2 units of RBC. The antibody screen was positive and the results are in Figure 10. Which of the following antibodies may be the cause of the positive antibody screen?
anti-c and anti-E
A patient's serum was reactive 2+ in the AHG phase of testing with all cells on a routine panel including their own. Transfusion was performed 6 months previously. The optimal adsorption method to remove the autoantibody is
autoadsorption using the patient's ZZAP-treated cells
The patient's results are listed in figure 18. What is the most likely specificity based on the reaction pattern?
autoantibody
The following blood typing results were noted on a patient's sample: anti-A= 0 anti-B=3+ anti-D=4+ A1 cells- 4+ B cells=0 Rh typing: C-E-c+e+ What is the patient's likely ethnicity?
black
Use of EDTA plasma prevents activation of the classical complement pathway by:
chelating Ca ions which prevent the assembly of C1
Which of the chemical is useful for removing IgG from red cells with a positive DAT to perform a phenotype?
chloroquine
Consider the results in Figure 16. What is the most likely cause of this discrepancy?
cold autoantibody
What method may be used to resolve the patient's ABO serum typing in Figure 17?
cold-autoadsorption
the atoantibody most often implicated in paroxysmal cold hemoglobinuria is
cold-reactive, IgG, anti-P
Samples from the same patient were received on 2 consecutive days. Thest results are summarized in figure 6. How should the request for crossmatch be handled?
collect a new sample and repeat the tests
Some blood group antibodies characteristically hemolyze appropriate antigen-positive red cells in presence of
complement
To confirm a serum antibody specificity identified a anti-P1 a neutralization study was performed and the following results obtained: serum + P1 substance serum + saline both negative with P1 + RBC's What conclusion can be made from these results. a. anti-P1 is confirmed b. anti-P1 is ruled out c. a second antibody is suspected due to the results of the neg ative control d. anti-P1 cannot be confirmed due to the results of the negative control,
d. anti-P1 cannot be confirmed due to the results of the negative control,
In the DAT, the antiglobulin reagent is used to
detect preexisting antibodies on erythrocytes
Which characteristics are true of all of the three following antibodies: anti-Fya, anti-Jka, and anti-K?
detected at IAT phase an may cause HDFN and transfusion reactsion
A sample is given the following results: anti-A= 3+ anti-B=4+ A1 cells=2+ B cells=0 Which lectin should be used first to resolve this discrepancy?
dolichos biflorus
Which of the following would most likely be responsible for an incompatible antiglobulin crossmatch
donor red cells have a positive DAT
The mechanism that best describes hemolytic anemia due to penicillin is
drug-dependent antibdoies reacting with drug treated cells
The separation of antibody from its antigens is known as
elution
A patient's serum contains a mixture of antibodies. One of the antibodies is identified as anti-D. Anti-Jka, anti-Fya, and possibly another antibody are present. What techniques may be helpful to identify the other antibodies?
enyzme panel; select cell panel
A 10% red cell suspension in saline is used in a compatibility test. Which of the following would most likely occur?
false-negative due to antigen excess
In a cold autoadsorption proceudre, pretreatment of the patient's red cells with which of the following reagents i helpful?
ficin
A male patient's sample demonstrates a pattern most consistent with anti-D. The patient is Rh negative, and was transfused with Rh positive blood emergently after a motor vehicle accident 2 years previously. The anti-D shows variable reactivity when tested with D positive cells. What test would be appropriate to enhance the anti-D reactivity and verify specificity?
ficin-AHG
Which of the following is the correct interpretation of the saliva neutralization test in Figure 21.
group O secretor
Review the following schematic diagram: 1. patient serum+reagent group O cells 2. incubate and read for agglutination 3. wash, add AHG, agglutination is observed The next step would be to
identify the cause of agglutination
A patient in the immediate post BM transplant period has a hematocrit of 21%. The red cell product of choice for this patient would be:
irradiated
A group O, Rh negative pregnant female has anti-Vel in her serum. If needed, how might blood be provided to her infant?
maternal donation
A pregnant women has a positive antibody screen and the panel results are in figure 14. What is the assocaited of the antibodies with HDFN?
may cause HDFN
Which DAT results are assocaited with an anamnestic antibody response in a recently transfused patient?
mixed field
A patient is group A, Rh-positive but is receiving Group O, BMT on friday. After the transplant, what hemagglutination pattern will the patient demonstrate when teh patient's red cells are tested with Anti-A?
mixed-field
The following reactions were obtained: anti-A= 4+ anti-B= 3+ anti-A,B= 4+ A1 cells= 2+ B cells=4+ The technologist washed the patients cells with saline, and repeated the forward typing. A saline replacement technique was used with the reverse typing. The following results were obtained: anti-A= 4+ anti-B= 0 anti-A,B= 4+ A1 cells= 0 B cells=4+ Based on these results, a likely diagnosis of this patient may be:
multiple myeloma
Transfusion of Ch+ red cells to a patient with anti-Ch has been reported to cause
no clinically significant red cell destruction
The drug cephalosporin can cause of positive DAT due to modification of the RBC membrane by the drug which is independent of antibody production. This mechanism related to the drug cephalosporin is best described as
nonimmunologic protein adsorption
The following test results are noted for a unit of blood labeled group A, Rh-negative: anti-A= 4+ anti-B= 0 anti-D= 3+ What should be done next?
notify the collection facility
While performing an antibody screen, a test reaction is suspected to be rouleaux. A saline replacement test is performed and the reaction remains. What is the best explanation?
original reaction was due to true agglutination
A patient received 2 units of RBS and has a delayed transfusion reaction. Pretransfusion antibody screening records indicate no agglutination except after the addition of IgG snesitized cells. Repeat testing of the pretransfusion specimen detected an antibody at the AHG phase. What is the most likely explanation for the original result?
patient's serum was omitted form the original testing
A 26 year old female is admitted with anemia of undetermined origin. Blood samples are received with a crossmatch request for 1 unit of RBCs. THe patient is group A, Rh negative and has no history of transfusion or pregnancy. The following results were obtained in the pretransfusion testing: all screening cells and auto control were 3+ at IAT The next step to continue this investigation would be
perform a warm autoadsorption
The following results were obtained on a patient's blood sample during routine ABO and Rh testing: anti-A= 0 anti-B=4+ anti-D= 0 autocontrol=0 A1 cells= 4+ B cells=2+ Select the course of action to resolve this problem.
perform antibody screening procedure at immediate spin and AHG using group O cells
A patient received 4 unites of blood 2 year previously and now has multiple antibodies. He has not been transfused since that time. It would be most helpful to
phenotype his cells to determine which additional alloantibodies may be produced
A drug induced immune hemolytic anemia caused by a drug-independent antibody would have which of the following restuls?
positive DAT with IgG; positive antibody screen
Refer to the panel in figure 20. Based on the results of the above panel, which technique would be most helpful in determining antibody specificity?
proteolytic enzyme treatment
A patient is typed as group O, Rh positive and crossmatched with 6 units of blood. At the IAT phase of testing, both antibody screening cells and 2 crossmatched units are incompatible. What is the most likely cause of the incompatibility?
recipient alloantibody
The major crossmatch will detect
recipient antibody directed against antigens on the donor red cells
During an emergency situation, with no time to determine ABO group and Rh type on a current sample for transfusion, it is noted that previous records state the patient is known to be A, Rh negative. The technologist should
release O, Rh negative RBCS
Based on the results below, what is the next step in determination of the patient's ABO/Rh type: anti-A= 4+ anti-B= 3+ anti-D= 4+ A1 cells=0 B cells=0
repeat the ABO red cell typing and include a control
Results of a serum sample tested against a panel of reagent red cells gives presumptive evidence of an alloantibody directed against a high incidence antigen. Further investigation to confirm the specificity should include which of the following?
serum testing against red cells known to lack high incidence antigens
Which of the following statements is correct about HPC transplantation
sources for HPC collection include BM, UCB, and mobilized peripheral blood
The purpose of testing with anti-A,B is to detect
subgroups of A
A mother is Rh-negative and the father Rh-positive. Their baby is Rh-negative. It may be concluded that:
the father is heterozygous for D
A group B, Rh negative patient has a positive DAT. Which of the following situations would occur?
the weak D test and control would be positive
Which of the following will cause a false-negative IAT?
too heavy a cell suspension
Refer to the following data in Figure8. Which clinical condition is consistent with the lab results shown above?
warm autoimmune hemolytic anemia
In a prenatal workup, the following results were obtained: anti-A= 4+ anti-B=2+ anti-D=4+ Rh control=0 A1 cells=0 B cells=3+ DAT= negative Ab screen=negative ABO discrepancy was thought to be due to an antibody directed against a component of the typing sera. What test would resolve this discrepancy?
wash the patient red cells and repeat the testing
The following results were obtained when testing a sample from a 20 year old, first time blood donor: Anti-A=0 Anti-B=0 A1 cells=0 B cells=3_ What is the most likely cause of ABO discrepancy?
weak subgroup of A