Blood Bank - Blood group systems
48. Which of the following types of whole blood is the only one to be transfused to a type AB patient? A. Group O B. Group A C. Group B D. Group AB
D
85. If an Rh negative patient is administered a unit of R1R1 packed red cells, which one of the following antibodies would be most likely to develop: A. Anti-c B. Anti-E C. Anti-e D. Anti-D
D
118. If Jka is showing dosage, how might reactions on an antibody panel appear? A. Weaker if homozygous for Jka B. Stronger if heterozygous for Jka and Jkb C. Weaker if heterozygous for Jka and Jkb D. Both heterozygous and homozygous reactions would always be of equal strength
C
120. Of the following blood group antibodies, which has been most frequently associated with severe cases of hemolytic disease of the fetus and newborn (HDFN)? A. Anti-A,B B. Anti-Lea C. Anti-K D. Anti-M
C
144. HLA antibodies are responsible for which of the following transfusion reactions? A. Allergic transfusion reactions B. Transfusion-associated sepsis C. Transfusion-associated circulatory overload D. Transfusion-related acute lung injury (TRALI)
D
217. Which of the following blood group antigens are most susceptible to destruction by the action of enzymes? A. D B. Jka C. Lea D. Fya
D
45. Which of the following blood groups reacts least strongly with anti-H? A. O B. A2 C. A1 D. A1B
D
62. Why is it dangerous to transfuse a blood group O person with a unit of blood group A? A. The patient will make antibodies to the type A blood. B. The group A blood may become the prominent blood group. C. The patient's Anti-O would destroy the donor's cells with severe consequences to the patient. D. The patient's anti-A would destroy the donor's cells with severe consequences to the patient.
D
7. If the parents are group A and B respectively, what are the possible blood groups of their children? A. A and B only B. A and B and AB only C. A and B and O only D. A and B and AB and O
D
70. Which one of the following blood group antigens is not expressed, or only weakly expressed on cord blood cells? A. K B. ABO C. M D. Leb
D
25. Which of the following genotypes is found with the highest frequency in the Caucasian population? A. CDe/cDe B. cDE/ce C. cDE/cE D. CDe/ce
D
41. If a patient is determined to have type AB blood, what antibody would be found in his/her serum? A. Anti-A B. Anti-B C. Anti-A and Anti-B D. No Anti-A, no Anti-B antibodies
D
42. Which blood group is most frequently associated with Cold Agglutinin Disease (CAD)? A. Kell B. Kidd C. Duffy D. I
D
43. What is the MOST likely cause of the ABO discrepancy when the following results were obtained from a first-time 29-year old, blood donor? Forward Group Anti-A = Negative Anti-B= Negative Reverse Group A1 Cells = Negative B Cells = 3+ A. Loss of antigen due to disease B. Acquired B C. Low immunoglobulin levels D. Weak subgroup of A
D
47. Which of the following statements are true about anti-H? A. Anti-H does not react with group O cells B. Anti-H reacts more strongly with A1 cells than with O cells C. Anti-H never reacts with group A cells D. Anti-H reacts more strongly with group A2 cells than with group A1 cells
D
51. Which best describes an A1 individual? A. A antigens on RBCs and anti-B antibodies in serum, which may also contain anti-A1 antibodies. B. A, A1, and B antigens on RBCs and no antibodies in serum. C. B antigens on RBCs and anti-A antibodies in serum. D. A and A1 antigens on RBCs and anti-B antibodies in serum.
D
20. What are the possible ABO genotypes of offspring of parents whose genotype is AA and BB? A. AB B. AO C. BO D. OO
A
24. In the ABO blood group system, the A antigen is inherited in what relation to the B antigen? A. Codominant B. Dominant C. Recessive D. Amorphic
A
29. What blood system is often tested to either establish or dispute paternity? A. HLA B. ABO C. Rh D. Duffy
A
10. The McLeod phenotype is associated with which of the following antigen systems? A. Rh B. P C. Kell D. MNSs
C
100. What would be considered a common characteristic of anti-Jka and anti-Jkb? A. The immunoglobulin class is IgM. B. Agglutination reactions are best observed by DAT. C. The antibodies show dosage of Kidd antigens on red cells. D. The antibodies are naturally occurring.
C
12. Which specific immunodominant sugar is responsible for A (blood group A) antigenic specificity? A. L-fucose B. D-galactose C. N-acetyl-D-galactosamine D. Glucose
C
13. In which group is Type B blood found in higher frequency? A. African Americans B. Caucasians C. Asians D. Hispanics
C
14. Which genotype(s) is/are possible for a mating of an AB mother and an AB father? A. AB only B. AA and BB C. AB, AA, and BB D. All genotypes are possible
C
16. Lewis Blood Group System is a human blood group unlike most others. The antigen is produced and secreted by exocrine glands, eventually adsorbing to the surface of red blood cells. Its expression is based on the genetic expression of the Lewis and Secretor genes. Based on the following genotype (Le) (sese), what would you predict the Lewis antigen phenotypic expression to be? A. Le(a- b-) B. Le(a+ b+) C. Le(a+ b-) D. Le(a- b+)
C
4. Which of the following is the most prevalent blood type found in the United States? A. O positive B. A positive C. B positive D. O negative
A
50. ABO blood groups were discovered by: A. Drew B. Lindemann C. Hicks D. Landsteiner
D
9. Phenotype refers to: A. The genes inherited from each parent B. Opposing antigens produced by genes C. The presence of two or more alleles at a locus D. The expression of traits
D
86. All of the following serological test results may occur in a patient experiencing a hemolytic transfusion reaction due to the presence of a clinically significant Rh antibody such as anti-c EXCEPT: A. Optimal reaction at 37°C or AHG phase. B. Preference to react with RBCs possessing a double-dose of Rh antigen. C. Binding complement. D. Positive DAT result.
C
94. Based on the following results obtained against a patient's red cells, what will the genotype look like in this example? Anti-C = 4+ Anti-c = 4+ Anti-E = 0 Anti-e = 4+ Anti-D = 0 A. R0R0 B. rr C. r'r D. R1R2
C
57. If a patient is determined to have type O blood, what antibody would be found in his/her serum? A. Anti-A B. Anti-B C. Anti-O D. Anti-A and Anti-B
D
88. Which of the following is considered an indication for Rh immune globulin (RhIG) administration in postpartum women? A. Long term protection B. Antibody blocking C. Passive protection D. Active immunity
C
93. Which of the following may result in a false negative reaction when performing Rh typing? A. Rouleaux B. Centrifuging too long C. Cold agglutinins D. Failure to follow manufacturer's directions precisely
D
76. Which of the following D variants has the best likelihood to receive D-positive RBCs without any adverse effects? A. Del B. Partial D C. Partial weak D D. C in Trans to RHD
D
53. A2B is suspected when a patient's ABO typing has the following results: A. Patient's red cells forward types as AB with anti-A1 present in the patient's serum. B. Patient's red cells forward types as A with anti-A1 and anti-B present in the patient's serum. C. Patient's red cells do not react with either Anti-A nor Anti-B, and anti-A1 and anti-B are present in the patient's serum. D. Patient's red cells forward types as A with a mixed field reaction of the patient's red cells with Anti-A, and anti-B detected in the patient's serum.
A
54. Which of the following is the most common subgroup of A? A. A1 B. A2 C. A3 D. Ax
A
59. A patient is group AB with one copy of the Se gene. What will they have in their secretions? A. A, B, & H B. Only B & H C. Only A & H D. Only H
A
60. What sugar configuration is necessary as a base for attachment of other sugars to produce ABO antigens? A. Galactose plus fucose B. Glucose plus fucose C. N-acetylgalactosamine plus fucose D. D-galactose plus fucose
A
68. In providing crossmatch-compatible blood units, all of the following antibodies are most often clinically insignificant EXCEPT: A. Anti-Jkb B. Anti-P1 C. Anti-M D. Anti-Lea
A
40. All of the following antibodies are detected at immediate spin EXCEPT? A. Anti-P1 B. Anti-Jka C. Anti-A D. Anti-M
B
1. What is the most common Rh haplotype among whites? A. Dce B. DCe C. DcE D. dce
B
21. Approximately how many out of 1,000,000 Caucasians will have the following phenotype?Group 0, K+, Jk(a+) A. 10,000 B. 30,000 C. 100,000 D. 600,000
B
30. Which Lewis antigen(s) would be detected when phenotyping the red cells of an adult who has the Le, Se, and H genes? A. Lea B. Leb C. Both Lea and Leb D. Neither Lea or Leb
B
31. If parents have the blood group genotypes AA and BO, what is the possibility of having a child with a blood type of A? A. 25% B. 50% C. 75% D. 100%
B
5. What is his MOST likely genotype for a white male who has the following Rh antigens C,c,D,E,e? A. R1r B. R1R2 C. Ror D. r'r"
B
11. In immunohematology, an antithetical relationship exists between M antigen and which of these antigens? A. K antigen B. S antigen C. Lu6 antigen D. N antigen
D
26. Which of the following is true of the classic Bombay phenotype? A. Two h genes are inherited at the H locus B. H substance is present C. A antigen is present D. B antigen is present
A
28. Which is in the correct order from the lowest concentration of H antigen to the highest concentration of H antigen? A. Bombay, A1B, A1, A2B, B, A2, O B. A1, O, B, A2, Bombay, A1B, A2B C. Bombay, O, A1B, A2, A1, B, A2B D. A1B, A2B, A2, O, B, A1, Bombay
A
44. A patient with multiple myeloma has the following reactions in the ABO typing: Anti-A= w+ Anti-B = w+ Anti-A,B = w+ Auto control = w+ A1 Cells = 4+ B cells = 4+ What is probably causing these results? A. Rouleaux B. Subgroup of A C. Patient has hypogammaglobulinemia D. Patient has selective IgA deficiency
A
49. Which of the following is the predominant immunoglobulin class for anti-A and anti-B antibodies in group B and group A individuals? A. IgM B. IgG C. IgA D. IgE
A
67. What is the MOST likely explanation for the following results? Anti-A = 1+ Anti-B = negative A1 Cells = 1+ B Cells = 4+ A. Subgroup of A with anti-A1 B. Group A with an acquired B antigen C. Group O with hypogammaglobulinemia D. Group AB with anti-A2 antibody
A
69. The majority of Lewis antibodies are of which immunoglobulin class? A. IgM B. IgG C. IgA D. IgE
A
75. Which one of the Rh genotypes listed below is heterozygous for the C antigen? A. R1r B. R1R1 C. R2r" D. r"r
A
78. What is the minimum volume (milliliters) of Rh positive red blood cells that would be needed to produce anti-D in an Rh negative individual? A. < 0.1 mL B. 1 mL C. 5 mL D. > 10 mL
A
79. A D-positive mother with a D-negative fetus eliminates the possibility of HDFN due to the: A. D antigen B. ABO antigen system C. Lewis antigen system D. Rh antigen system
A
36. If a father carried the Xga allele, to which of his children will he pass it along? A. Only to his sons B. Only to his daughters C. To all of his children D. Each child has the same probability of inheriting it
B
38. A patient front-grouped as AB but back-grouped as O. The screening cells and auto control were positive. If the testing was performed correctly, what is the most likely cause of this discrepancy? A. Patient has two distinct cell populations B. Patient has a cold autoantibody C. Patient has missing or weakly expressed antigens D. Patient has leukemia
B
39. A Bombay individual's blood specimen can be differentiated from a blood specimen of a group O person by which of the following? A. Cells giving a negative reaction with anti-A,B B. Testing with anti-H lectin (Ulex europaeus) C. Reverse typing with A1 and B cells would be give different reactions D. Testing with Dolichos biflorus
B
22. The A1 subgroup represents approximately what percentage of group A individuals? A. 25 - 30% B. 50 - 60% C. 75 - 80% D. 95 - 98%
C
8. What is the most common (highest probability percentage) possible phenotype of the mating between a mother who has an AB genotype and a father who has an AO genotype? A. AB B. B C. A D. O
C
80. If possible, what is the recommended time interval for Rh immune globulin administration to the Rh negative mother following the delivery of an Rh positive or weak-D positive infant? A. 72 hours B. One week C. Two weeks D. Prior to another pregnancy
A
81. Antibodies in the Rh system typically exhibit which one of the following characteristics? A. Reacts best at 37ºC and AHG B. Reacts best at room temperature C. Shows hemolysis better than agglutination D. Reacts best at 4oC
A
84. When is testing for weak D optional (not required)? A. Testing for weak D on potential transfusion recipient samples. B. Testing on donor red blood cells. C. Testing cord blood on infants born to Rh-negative moms D. Testing for Rh immune globulin workups.
A
87. If an R1r patient received R2R2 blood, which of these antibodies could be produced? A. Anti-c B. Anti-D C. Anti-E D. Anti-ce
C
92. A ficin (enzyme) treated panel can be a useful tool for determining the identity of an antibody. On a ficin-treated panel, reactions with which system would be enhanced? A. Rh B. Duffy C. MNS D. Kell
A
95. all of the following offsprings are possible from a mother who is R0R1 and a father who is R1r EXCEPT? A. DcE/DcE B. DCe/DCe C. DCe/dce D. Dce/dce
A
The serum of which of the following individuals may agglutinate group A1 cells? A. A2 individual B. A1B individual C. A1 individual D. Newborn
A
Which type of antibody can cause HDFN in any pregnancy (first or subsequent), but is usually limited to less severe symptoms? A. Anti-A,B B. Anti-D C. Anti-E D. Anti-K
A
72. The following statements are true regarding the Lewis blood group EXCEPT: A. Antigen expression is influenced by secretor status B. Antigens are adsorbed onto the red cells from the plasma C. Antigens are a structural component of the red cell membrane D. ABO group affects antigen expression
C
73. Which one of the following blood group systems may show a cell typing change during pregnancy? A. Rh B. MNS C. Lewis D. Duffy
C
74. Lewis Blood Group System is a human blood group unlike most others. The antigen is produced and secreted by exocrine glands, eventually adsorbing to the surface of red blood cells. Its expression is based on the genetic expression of the Lewis and Secretor genes. Based on the following genotype (Le) (Se), what would you predict the Lewis antigen phenotypic expression to be? A. Le(a- b-) B. Le(a+ b+) C. Le(a- b+) D. Le(a+ b-)
C
46. You perform a gel ABO/Rh test on a 94-year-old woman and receive the following results. Anti-A - 0 Anti-B - 0 Anti-D - 4+ A1 cells - 0 B cells - 0 You recognize a discrepancy between the front and back types. Which one of the following reasons is most likely for this discrepancy? A. The patient has both a weak subgroup of A and a weak subgroup of B B. The patient is O POS with depressed ABO antibody production C. The patient has a Bombay phenotype D. Rouleaux
B
55. Which of the following is the most common reagent source for anti-A1? A. Group A1 plasma B. Dolichos biflorous seed extracts (lectins) C. Bandeiraea simplicifolia seed extracts (lectins) D. Ulex europaeus seed extracts (lectins)
B
58. Which of the following statements regarding the ABO phenotype A2 is true? A. A2 cells contain more antigens per RBC than A1 cells. B. A2 antigens are linear while A1 antigens are branched. C. A2 RBCs will agglutinate with anti-A1 lectin (Dolichos biflorus). D. A2 cells will not agglutinate with anti-A antisera used for ABO blood typing.
B
63. How are antibodies to the ABO blood group antigens unique? A. Laboratory tests are available for their identification B. The antibodies are naturally occurring to antigens that are absent from the red cell membrane C. The antibodies are formed after the individual has been immunized D. The antibodies are IgM
B
71. If detected in antibody screen testing, which of the following antibodies is NOT considered clinically significant in prenatal patients? A. Anti-M B. Anti-N C. Anti-Leb D. Anti-Fya
C
18. 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. 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 group 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 cross-matched 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? 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
19. A patient, who recently received a transfusion of three units of red cells, is DAT-positive with an IgG specificity. What would be the best method to identify the patient's phenotype? A. Adsorption and elution B. Type and Screen C. Polymerase chain reaction-based assay D. Antigen typing
C
23. Which of the following represents the approximate percentage of the Caucasian population that is Rh positive? A. 35 % B. 65 % C. 85 % D. 95 %
C
27. What does the hh genotype gives rise to? A. H substance B. H secretors C. Bombay phenotype D. h antibodies
C
3. What ABO phenotype will exist in an individual that inherits an A gene from one parent and a B gene from the other? A. A B. B C. AB D. O
C
32. The Rh nomenclature which uses the letters DCE is found in which of the following genetic models? A. Wiener B. Shorthand C. Fisher -Race D. Rosenfield
C
33. What is the most frequent genotype among Rho (D) negative persons? A. r'r B. r'r" C. rr D. r"r
C
35. If an individual has blood type O, which of the following are possible genotypes? A. AO and OO B. BO and OO C. OO only D. AO, BO, and OO
C
52. When a group O patient's serum is not compatible with donor O red blood cells and the auto control is negative, what is the MOST likely cause? A. Warm autoantibodies B. Cold autoantibodies C. Bombay phenotype D. A2 phenotype
C
89. Which of the following antibodies causes the MOST severe cases of hemolytic disease of the fetus and newborn (HDFN)? A. Anti-I B. Anti-N C. Anti-A,B D. Anti-D
D
96. If a recipient has anti-c, which donor unit should be selected? A. r'r B. R0R1 C. R2ry D. r'ry
D
15. Which one of these Lewis blood group system phenotypes usually produces anti-Lea? A. Le(a+b+) B. Le(a+b-) C. Le(a-b+) D. Le(a-b-)
D
17. A specimen from a 23-year-old female patient who is a Bombay phenotype arrives in the blood bank. You observe the following reactions upon tube testing. Anti-A - 0 Anti-B - 0 A cells - 4+ B cells - 4+ Which of the following statements is true? A. Type AB red blood cells can be transfused to this patient B. Type O red blood cells can be transfused to this patient in an emergency C. Type O NEG blood can be transfused to this patient D. Patient can receive only Bombay phenotype blood
D
2. The qualitative differences between A1 and A2 phenotypes includes all of the following EXCEPT: A. The formation of anti-A1 in A subgroups. B. The amount of transferase enzymes. C. The length of the precursor oligosaccharide chains. D. The lack of agglutination of patient red cells with anti-A reagent.
D
107. Which of the following blood group antigen-antibody reactions is enhanced by using enzymes: A. Fya B. Fyb C. M D. Jka
D
111. Which of the following antibodies is most often implicated as a cause of a delayed hemolytic transfusion reaction (DHTR)? A. Anti-S B. Anti-M C. Anti-Fya D. Anti-Jka
D
114. Anti-U antibodies can be produced by which of the following genotypes? A. M-N- B. S+s+ C. S+s- D. S-s-
D
116. A patient demonstrates an antibody that reacts at the immediate spin phase, shows variable dosage, and has increased reactivity after treatment with enzymes. Which antibody does the patient most likely have? A. Anti-M B. Anti-Fya C. Anti-e D. Anti-P2
D
123. Which of the following is considered a high-incidence antigen? A. K (big K) B. C (big C) C. c (little c) D. k (little k)
D
128. All of the following red blood cell phenotypes will react with Anti-Fy3, EXCEPT? A. Fy(a+b+) B. Fy(a+b-) C. Fy(a-b+) D. Fy(a-b-)
D
129. A low-incidence antigen is one that occurs in less than 10% of the population. Which of the following is a low-incidence antigen? A. D B. c (little c) C. Fyb D. Cw
D
133. Which of the following is true regarding the Lutheran blood group system? A. Anti-Lua most often is IgG B. Anti-Lub is always IgM C. Lua is a high frequency antigen D. Lub is a high frequency antigen
D
138. Which of the following antigens is classified as a Major Histocompatibility Complex Class II antigen (MHCII)? A. HLA-A B. HLA-B C. HLA-C D. HLA-DR
D
141. The Major Histocompatibility Complex (MHC) codes for which antigens? A. ABO B. Kell C. Rhesus D. Human Leukocyte Antigens
D
90. A Rh negative individual has produced an anti-D antibody. Which situation has the ability to stimulate this production of anti-D? A. Delivering a Rh negative baby. B. Delivering a Rh positive baby. C. Receiving Rh negative packed red blood cells. D. Receiving Rh positive fresh frozen plasma.
B
91. A D-negative mother gives birth to a baby that tests as D-negative in the immediate spin phase. What step should be performed next? A. Calculate dose for RhIg B. Perform a weak D test C. Administer one dose of RhIg D. Perform a Kleihauer-Betke stain
B
102. Which of the following conditions is MOST frequently associated with anti-I? A. Cold agglutinin disease B. Hemolytic transfusion reaction C. Delayed transfusion reaction D. Infectious mononucleosis
A
106. Antibodies to the Kidd blood group system are MOST commonly associated with: A. Delayed hemolytic transfusion reactions B. Postpartum depression C. Hives and rashes D. Immediate spin, cold antibody reactions
A
109. What antibody is best described as common autoantibody that can be found in virtually all sera? A. Anti-I B. Anti-K C. Anti-Jk D. Anti-M
A
112. Which of the following characteristics is consistent with the Kidd blood group system? A. Jk(a-b-) red cells are resistant to lysis in 2 M urea B. Kidd antigens are destroyed by ficin C. Antibodies to Kidd antigens react best at immediate spin D. Anti-Jka activity may not react well in a LISS test system
A
132. Patients may sometimes develop antibodies to which antigen without having a red cell stimulation? A. Lua B. Fya C. Leb D. N
A
134. An antibody to which platelet antigen is most commonly encountered in blood bank? A. HPA-1a B. HPA-2a C. HPA-3a D. HPA-4a
A
136. Platelet specific antigens, also referred to as human platelet antigens (HPAs), are expressed on which of the following? A. Membrane glycoproteins B. Membrane lipids C. Nucleus surface D. Nucleus nucleolus
A
142. A newborn presents with neonatal alloimmune thrombocytopenia. What is the most likely cause of this condition? A. Maternal antibodies to neonatal platelet antigens B. Maternal antibodies to neonatal ABO antigens C. Maternal antibodies to neonatal white cell antigens D. Maternal antibodies to neonatal D antigen
A
97. What is a characteristic of a person who is weak D? A. Types as D negative and produces anti-D when exposed to D antigen B. Demonstrates a reduced number of D antigen sites on the surface of the red cell C. Types as D positive and produces anti-D when exposed to D antigen D. Someone who is defined as being D negative
B
98. Which Rh antibody might be produced if a unit of blood with Rh genotype DCe/dce is given to a patient with Rh genotype DCe/DCe? A. Anti-C B. Anti-c C. Anti-D D. Anti-Cw
B
108. A 9-year-old male in Alaska presents with hemolysis and hematuria. The patient history reveals that he recently recovered from a flu-like virus. The ABO type is A+, and the DAT reacts at 1+. What blood group antibody should be suspected? A. Autoanti-i B. Anti-M C. Autoanti-P D. Anti-H
C
99. A patient has a probable anti-Fya; however, anti-c and anti-K have not been excluded. Which of the following cells would be the most useful cell to exclude both anti-c and anti-K efficiently in this patient? A. Fya-; Fyb+; C+c+; K+k+ B. Fya-; Fyb+; C-c+; K+k- C. Fya-; Fyb+; C+c+; K+k- D. Fya+; Fyb-; C-c+; K+k-
B
115. Which of the following antigens are well developed on fetal cells? A. Lewis B. ABO C. Kell D. I
C
117. Generally speaking, infant RBCs demonstrate the presence of the ____ antigen, which gradually decreases as one ages. Conversely, the ____ phenotype is not expressed at birth, but the amount of this antigen increases as one ages. A. M; N B. K; k C. i; I D. M; K
C
103. What is the rare phenotype found exclusively in male patients that is caused by X-linked inheritance from a carrier mother, often demonstrating a chronic but well-compensated anemia as well as muscle and nerve disorders? a. Fy (a- b-) b. McLeod c. Jk (a- b-) d. U-
B
110. Which one of the following antibodies has been implicated in hemolytic disease of the fetus and newborn (HDFN)? A. Anti-I B. Anti-K C. Anti-Lea D. Anti-Leb
B
119. Which antibody is associated with Mycoplasma pneumoniae infection and cold hemagglutinin disease? A. Anti-P B. Anti-I C. Anti-M D. Anti-i
B
121. A 27-year-old female presents to her physician after suffering a spontaneous abortion. Though rare, which antibody may be the etiological agent? A. Anti-P1 B. Anti-P C. Anti-PP1Pk D. Anti-P2
B
122. All of the following RBC antigens are high-frequency EXCEPT: A. k (little k) B. E (big E) C. Lub D. Kpb
B
124. An antibody screen demonstrates a mixed field agglutination pattern. To which blood group system will this antibody most likely belong? A. Lewis B. Lutheran C. Kell D. Kidd
B
126. Which of the following genotypes are known to be resistant to P. vivax (malaria) merozoites? A. Fy(a+b+) B. Fy(a-b-) C. Jk(a-b-) D. Jk(a+b+)
B
131. Which of the following statements about high-frequency antigens is correct? A. High-frequency antigens are common and it is easy to identify their corresponding antibodies. B. High-frequency antigens are common, but it is difficult to identify their corresponding antibodies. C. High-frequency antigens are rare and it is difficult to identify their corresponding antibodies. D. High-frequency antigens are rare, but it is east to identify their corresponding antibodies.
B
135. Which patient population benefits from HLA matching to provide patients with the best outcomes? A. Transfusion recipients B. Organ transplant recipients C. Neonates D. Patients with high-incidence antibodies
B
137. A patient presents with platelet refractoriness, or poor response to platelet transfusions. What can be performed to help ensure platelet transfusions will be therapeutic? A. ABO matching B. HLA typing C. Transfusing the platelets with a warmer D. Administering an antihistamine before the transfusion
B
139. In which system are DR antigens are found? A. Kell system B. HLA system C. Duffy system D. ABO system
B
140. Antibodies directed against granulocyte antigens have been implicated for all of the following EXCEPT? A. Febrile transfusion reactions B. Acute hemolytic transfusion reactions C. Transfusion-related acute lung injury (TRALI) D. Neonatal alloimmune neutropenia (NAN)
B
61. As a student in a blood bank laboratory, you are tasked with determining the identification of an antibody as part of your practical exam. You are asked to use an enzyme treated red cell panel during the process of antibody identification. Which of the following antibodies is enhanced by enzyme treatment of red cells? A. MN and Duffy antibodies B. Rh, Lewis, and Kidd antibodies C. Rh, A, B, and S antibodies D. Duffy, A, and B antibodies
B
66. Which of the following is the MOST likely discrepancy seen when a person demonstrates an "acquired B-antigen" phenomenon? A. Forward typing appears to be B, but reverse group type is O. B. Forward typing appears to be AB, but reverse group type is A. C. Forward typing appears to be AB, but reverse group type is B. D. Forward typing appears to be B, but reverse group type is AB.
B
77. The term used to describe patients with absence of Rh antigens is: A. Rhmod B. Rhnull C. Partial D D. Del
B
101. Which antibody identified in prenatal specimens is never a cause of hemolytic disease of the fetus and newborn? A. Anti-D B. Anti-c C. Anti-E D. Anti-I
D
125. In theory, how difficult is it to find a compatible blood unit and to identify the antibody in a patient with an antibody to a low-frequency antigen, such as Kpa or Jsa? A. It is difficult to find compatible blood and difficult to identify the antibody B. It is difficult to find compatible blood but not difficult to identify the antibody C. It is not difficult to find compatible blood but difficult to identify the antibody D. It is not difficult to identify the antibody and not difficult to find compatible blood
C
130. Almost all individuals possess which Lutheran antigen profile? A. Lu(a-b-) B. Lu(a+b-) C. Lu(a-b+) D. Lu(a+b+)
C
143. A patient is experiencing prolonged bleeding following a transfusion. The complete blood count indicates that the patient's platelet count has decreased following the transfusion. What is the most likely cause of this issue? A. Transfusion-associated circulatory overload B. Transfusion reaction to red cell antigens C. Posttransfusion purpura D. Transfusion related acute lung injury
C
6. The serum from a patient of African-American descent is reactive with all screening and panel cells. Which antibody directed to a high incidence antigen is most likely to be present? A. Anti-Lub B. Anti-Jk3 C. Anti-U D. Anti-Ku
C
65. Which of the following antigen groups is closely related to the ABO antigens on the red cell membrane? A. Rh B. Kell C. I, i D. Duffy
C
104. Antibodies within which of the following blood group systems are known to result in severe hemolytic transfusion reactions, but are not always detected during pre-transfusion testing in the blood bank? A. Duffy B. Kell C. Lewis D. Kidd
D
105. Which adsorption technique removes cold (IgM) antibodies, particularly anti-I specificities? A. Cold autoadsorption B. Warm autoadsorption C. Differential (allogeneic) D. Rabbit erythrocyte stroma (RESt)
D
113. A 54-year-old woman has just braved a winter snow storm in North Dakota to see her doctor for a general checkup. She indicates no complaints but does mention how difficult the cold weather is for her. The doctor notices bluish coloring of her ears and fingers. She states that this has been happening for years whenever it is cold and that the problem subsides during the warm summer months. What abnormal test results might be noted in this patient's blood tests? Choose the BEST answer. A. Negative Donath-Landsteiner test B. Agglutination on blood smear C. Positive direct antiglobulin test (DAT) D. Agglutination on blood smear and positive DAT
D Feedback The patient demonstrates symptoms of cold agglutinin disease (CAD), which is associated with the presence of a cold autoantibody. The cold autoantibody is typically autoanti-I and it agglutinates red cells in peripheral areas of the body exposed to cold temperatures. The problem will thus occur seasonally. The mechanism is as follows: When blood reaches the periphery and cools, the autoantibody attaches to RBCs (thus the positive DAT result). This also causes agglutination of RBCs and complement fixation (leading to a mild degree of hemolysis). The patient typically remains stable as this is a chronic condition. The Donath-Landsteiner test helps to diagnose Paroxysmal Cold Hemoglobinuria, which causes symptoms like those noted in this patient. However, note that while the question asks for the "abnormal test results", the answer choice indicates a Negative Donath-Landsteiner test, which is normal.
34. Approximately what percent of the Caucasian population is Rh negative? A. 10 % B. 15 % C. 25 % D. 35 %
B
82. Why is Weak D testing not performed on pregnant women? A. Weak D testing should be performed on pregnant women. B. Weak D testing is not required as part of a prenatal evaluation, as it is not possible to differentiate weak D from partial D serologically. C. Weak D testing is no longer used in blood banking. D. Weak D testing is not reliable in pregnant women.
B
83. Which of the following statements best describes Rh antibodies? A. Naturally occurring, IgM B. Immune, IgG C. Naturally occurring, IgG D. Immune, IgM
B
56. While ABO, Rh, Kell, Duffy, Kidd, SsU are clinically significant, which of the following antibodies generally react at only the Coombs phase (also known as Antihuman Globulin phase)? A. Rh and Kell antibodies B. ABO antibodies C. Kell, Duffy and Kidd antibodies D. SsU and Kidd antibodies
C
