Blood Bank Final

A child inherited Duffy and Kidd antigens from his parents. It was determined with genetic studies that Fya was present on one chromosome and Fyb was present on the opposite chromosome of the pair. It was determined that Jka was present on the same chromosome as Fyb while the Jkb gene was present on the same chromosome as the Fya gene. The relationships of these genes may be described with which of the following statements? 1. Fya is trans to Fyb 2. Fya is cis to Fyb 3. Fya is trans to Jkb 4. Fya is cis to Jkb 5. Jka is trans to Jkb 6. Jka is cis to Jkb 1, 4, and 5 are correct 2, 4, and 6 are correct 2, 3, and 5 are correct 1, 3, and 6 are correct

1,4,5

Anti-D and C antibodies are found in the plasma of a 25-year-old Rh negative patient who requires a transfusion. These antibodies should be considered: 1. both are clinically significant 2. only anti-D is clinically significant 3. both are not clinically significant 4. both are capable of causing a hemolytic transfusion reaction 5. both are capable of causing hemolytic disease of the fetus and newborn 6. only anti-D is capable of causing hemolytic disease of the fetus and newborn only 2 and 5 are correct only 1 and 5 are correct 1, 4, and 5 are correct 2, 4, and 6 are correct

1,4,5

About how many donors will need to be antigen-typed to find 3 Fy(a-) units for crossmatch? 3 12 5 10

10

What is the minimum hemoglobin level for a potential allogeneic donor? Question options: 11 g/dL 12 g/dL 14 g/dL 12.5 g/dL

12.5

A 0.3% fetal-maternal bleed was determined by a Kleihauer Betke stain of postpartum blood. What is the estimated volume of the fetal-maternal bleed expressed as whole blood? 25 mL. 15 mL. 20 mL. 10 mL.

15

The approximate percentage of persons in the Caucasian population who are Rh negative is: 15 85 25 50

15

The frequency of the D-negative phenotype in the population is: 85%. 35%. 50%. 15%.

15

A technologist must find units for transfusion for a patient who is negative for both E and Jka antigens. If the frequency of these antigens in the local population is E = 30% and Jka = 77%, what percentage of ABO specific units will be negative for both antigens? 2% 23% 4.7% 16%

16

How long must a donor wait to donate red blood cells again following a 2-unit red blood cell apheresis donation? Question options: 10 weeks 4 weeks 56 days 16 weeks

16 weeks

How many units of red blood cells are required to raise the hematocrit of a 70-kg nonbleeding adult man from 24% to 30%? 4 3 2 1

2

Of the following choices, the individual with a potential for a reduced amount of ABO antibody are a (an): 1. blood donor 2. elderly patient 3. recently immunized adult 4. newborn 5. post-surgical patient 1 and 3 are correct 1 and 5 are correct 2 and 3 are correct 2 and 4 are correct 1 and 2 are correct

2 and 4

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: 4+. 3+. 1+. 2+.

2+

If the recipient was transfused within the last 3 months, how long from the time of collection can a sample be used for the crossmatch? 5 days 3 days 7 days 10 days

3 days

A 300-µg dose of Rh immune globulin contains sufficient anti-D to protect against how much whole blood? 25 mL 100 mL 30 mL 50 mL

30

In which phase of reactivity would rouleaux typically be detected in the screen? 4° C 37° C 15° C Antihuman globulin

37° C

After adding antigen and antibody to a test tube, one large agglutinate was observed. How should this reaction be graded? 0 2+ 3+ 4+

4+

If prospective donor has participated in a plasmapheresis program, how long must he or she wait to donate whole blood? Question options: 48 hours 4 weeks 24 hours 56 days

48 hours

How long following transfusion must the recipient's sample be stored? 5 days 7 days 10 days 14 days

7 days

Rh immune globulin should be given within how many hours following delivery? 24 12 48 72

72

Following donation, how long does it take to replace the fluid lost from giving whole blood? Question options: 48 hours 72 hours 3 hours 12 hours

72 hours

How often can a person donate a unit of whole blood for a directed donation? Question options: 24 hours 2 weeks 48 hours 8 weeks

8 weeks

Approximately what is the percentage of individuals who demonstrate H in their saliva? 80% 15% 50% 98%

80

Why is the determination of the D antigen important for women during pregnancy? A D-positive mother can form anti-D during pregnancy that may destroy the D-positive red cells of the fetus. A D-negative mother may form anti-D if the father of the child is also D-negative. A D-positive mother may pass her red cells to the D-negative fetus and cause hemolytic disease of the fetus and newborn. A D-negative mother should be given Rh immune globulin to prevent potential formation of anti-D during delivery of a D-positive infant.

A D-negative mother should be given Rh immune globulin to prevent potential formation of anti-D during delivery of a D-positive infant.

HLA matching between the donor and recipient is important for progenitor cell transplantation to avoid: graft versus host disease (GVHD). graft rejection. transfusion reactions. A and B.

A and B

What ABO phenotype would agglutinate in the presence of anti-A1B produced by group O individuals? A only O only B only A and B

A and B

What is meant by the term autosomal? A trait that is expressed only in the parents A trait that is not carried on the sex chromosomes A gene that does not express a characteristic A trait that is carried on the sex chromosome

A trait that is not carried on the sex chromosomes

A 29-year-old female was admitted to the emergency room with severe bleeding. The blood type was tested and determined to be AB, D negative. Six units of RBCs are ordered STAT. Of the following types available in the blood bank, which would be the most preferable for crossmatch? A, D negative AB, D positive O, D negative A, D positive

A, D negative

What substances are found in the saliva of a group A person who also inherited the secretor gene? A, H A, B, H A, Se H

A,H

Reagent used in the identification of ABO antibodies

A1 and B cells

Professional organization that accredits blood banks and transfusion services

AABB

Ch 5: A recipient with a group A phenotype requires a transfusion of 2 units of frozen plasma. Which of the following types are appropriate to select for transfusion?

AB and A

In which type of hemolytic disease of the fetus and newborn is the first-born affected? M D E ABO

ABO

An infant less than 4 months old requires which procedures for compatibility testing? Immediate spin crossmatch with each unit released Antibody screen with each unit released in a 48-hour period ABO and D typing and antibody screen initially only; units released without additional testing if the screen is negative Group O, D-negative unit; no testing is necessary

ABO and D typing and antibody screen initially only; units released without additional testing if the screen is negative

Reagent used to determine the ABO antigenic composition of a patient's red cells

ABO antisera

he test procedure that combines patient's serum with commercial A1 and B reagent red cells is called: ABO forward grouping. antibody screen. ABO reverse grouping. antibody panel.

ABO reverse grouping.

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 __________. AA AND BB AO AND BO OO AND AB AO AND BB

AO AND BO

19-year-old woman who recently finished the three-part vaccination for hepatitis B surface antigen after starting a volunteer position at the hospital

Acceptable donors

53-year-old woman taking a beta-blocker for hypertension and over-the-counter low-dose aspirin for blood-clot prevention

Acceptable donors

65-year-old woman taking sleep medication at night

Acceptable donors

Associated with ABO incompatibilities

Acute hemolytic

The subgroup of A with the least amount of A antigen is: A2. A3. Ael. Ax.

Ael.

Before implementing new automation technology into the transfusion service setting, which of the following is required? Training All of the above Written procedures Validation

All of the above

To identify the cause of suspected hemolytic disease of the fetus and newborn, which tests are performed? ABO group D testing Direct antiglobulin test All of the above

All of the above

Which of the following is associated with the Rhnull phenotype? Membrane abnormalities Immunized Rhnull individuals may produce anti-Rh29 Mutation of the RhAG regulator gene All of the above

All of the above

To increase the sensitivity of the antibody screen in a compatibility test, what can be done? Use an enhancement such as polyethylene glycol. Increase the serum-to-cell ratio. Extend the incubation time. All of the above are correct.

All of the above are correct.

Amplified target sequences of DNA produced by polymerase chain reaction

Amplicon DNA sequence

: Amniotic fluid analysis showed a marked increase into zone III of the Liley graph. Lecithin-sphingomyelin ratios indicated that the fetal lungs were not mature. Select the most appropriate decision regarding medical intervention. No immediate need for intervention An intrauterine transfusion Delivery be cesarean section None of the above

An intrauterine transfusion

What forward typing reagent can be used to confirm group O units before placing them in inventory? Anti-A,B Anti-H Anti-A Anti-B

Anti-A,B

According to Landsteiner's rule, what ABO antibody will be detected in a group A individual's serum? Anti-A Anti-A,B None Anti-B

Anti-B

The blood bank supervisor is asked to consult with a staff technologist who is identifying an antibody. The technologist has performed a standard panel and an enzyme panel. The standard panel has reactivity with all panel cells at some phase/temperature. The enzyme panel has three specific antibodies that cannot be ruled out based on the enzyme panel alone. These antibodies are: Anti-c Anti-Fya Anti-E The supervisor was able to rule out one antibody that could not be excluded on the enzyme panel by using the following piece of information: Anti-Fya would be destroyed by the enzymes Anti-E is not positive on as many cells as anti-Fya and anti-c the supervisor made an error and cannot rule out any of the antibodies in this list based on the information provided Anti-c is a high incidence antigen that would mask any other antibodies

Anti-Fya would be destroyed by the enzymes

Given the following red cell antigen frequencies: K 10% E 30% K 90% P1 80% Which of the following red cell alloantibodies would be responsible for incomplete crossmatches with one 1 of 10 random donor units? Anti-P1 Anti-k Anti-K Anti-E

Anti-K

Which of the following antibodies has been clearly implicated in transfusion reactions and hemolytic disease of the newborn? Anti-I Anti-N Anti-K Anti-Lea

Anti-K

Which of the following is the most common antibody seen in the blood bank after ABO and Rh antibodies? Anti-k Anti-Jsa Anti-Fyb Anti-K

Anti-K

All of the following antibodies may cause Hemolytic Disease of the Fetus and Newborn except: Anti-Lea Anti-E Anti-A Anti-Jka

Anti-Lea

Which of the following antibodies have not been known to cause hemolytic disease of the fetus and newborn? Anti-K Anti-C Anti-Lea Anti-S

Anti-Lea

Which of the following antibodies does not match the others in terms of optimal reactive temperature? Anti-Fya Anti-Jkb Anti-N Anti-U

Anti-N

Which set of antibodies could you possibly find in a patient with no history of transfusion or pregnancy? Anti-I, anti-s, anti-P1 Anti-Leb, anti-A1, anti-D Anti-M, anti-c, anti-B Anti-P1, anti-Lea, anti-I

Anti-P1, anti-Lea, anti-I

A recipient phenotypes as group O with the following Rh phenotype: D+C+c-E+e+. If this recipient is transfused with red blood cells from six random group O D-positive donors, what Rh alloantibody could this patient produce as a result of transfusion? Anti-E Anti-D Anti-C Anti-c

Anti-c

If D-negative red cells are given to an R1Rz individual what is the most likely antibody that could develop? Anti-D Anti-c Anti-E Anti-d

Anti-c

Antibodies are ruled out using cells that are homozygous for the corresponding antigen because: Multiple antibodies may be present All of the above Antibodies show dosage It results in a P value of .05 for proper identification of the antibody

Antibodies show dosage

Which of the following is responsible for the activation of the classic pathway of complement? Virus Bacteria Antibody bound to antigen Foreign proteins

Antibody bound to antigen

For autologus units transfused within the collection facility, which part of the compatibility procedure is not required? Transfusion history check Antibody screen ABO phenotyping D phenotyping

Antibody screen

If all the panel cells were reactive at the same strength at the antihuman globulin phase, no negative reactions were observed, and the autocontrol was negative, what should be suspected? Warm autoantibody Antibody to a low-frequency antigen Multiple antibody specificities Antibody to a high-frequency antigen

Antibody to a high-frequency antigen

Which of the following red cell antigens do proteolytic enzymes destroy? Antigens in the Kidd system Antigens Fya and Fyb in the Duffy system Rh system antigens Lewis system antigens

Antigens Fya and Fyb in the Duffy system

A donor unit with a positive DAT would cause reactions at what phase of the crossmatch? All phases None; it would be compatible Immediate spin Antiglobulin

Antiglobulin

Which of the following is not a cause for temporary deferment of a whole blood donor? Question options: Oral polio vaccine taken 1 week previously Hepatitis B immunoglobutin taken 4 weeks previously Rubella injection 1 week previously Aspirin ingestion 12 hours previously

Aspirin ingestion 12 hours previously

An individual presents with the following ABO grouping results: Anti-A: 0 Anti-B: 4+ Anti-A,B: 4+ A1 cells: 4+ B cells: 0 This individial is blood group: A B AB O

B

Select the cell involved in humoral immunity. B lymphocytes Monocytes Neutrophils T lymphocytes

B lymphocytes

At what point in the employment process should safety training take place? During orientation and traning Before independent work is permitted and annually thereafter Following the employee's first evaluation Following lab training when employees are more familiar with their responsibilities

Before independent work is permitted and annually thereafter

How it is genetically possible for a child to phenotype as D-negative? Both parents are homozygous D-positive. Mom is homozygous D-positive, and Dad is heterozygous D-positive. The sibling is D-positive. Both parents are heterozygous D-positive.

Both parents are heterozygous D-positive.

In the complement cascade, lysis of the target cell is mediated by which of the following components? C1qrs C5 to C9 C4a, C3a, and C5a C3a and C3b

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 Weiner notation R1R2 translates to Fisher-Race as: CDe/CDE CDe/cDe CDE/cDE CDe/cDE

CDe/cDE

Can be prevented by transfusion slowly

Circulatory overload

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. The plasma sample was collected incorrectly. The serum sample was contaminated. The serum sample was fresher.

Complement activation was inhibited by calcium in the plasma sample.

Which of the following contributes to permanent rejection of a donor? Question options: Confirmed positive test for hepatitis B surface antigen 10 years previously A tattoo 5 months previously Two units of blood transfused 4 months previously Contact with a patient with viral hepatitis

Confirmed positive test for hepatitis B surface antigen 10 years previously

The antigen missing in the Rh negative individual is: D c d C

D

To be considered a candidate for Rh immune globulin, the mother is _________ and the infant is __________. D-negative, D-positive D-negative, D-negative D-positive, D-positive D-positive, D-negative

D-negative, D-positive

How would a donor who tested negative with anti-D reagent in the immediate spin test but tested positive at anti-human globulin with anti-D reagent be labeled? D-positive D-negative

D-positive

Which of the following tests is not included in routine compatibility testing? ABO phenotyping D typing Antibody screen Direct antiglobulin test

DAT

The Kell blood group system antigens have sensitivity to: proteolytic enzymes DTT high protein media complement

DTT

Alloantibody to red cell antigens

Delayed hemolytic

What are the two components of the major crossmatch? Reverse ABO cells and recipient serum Recipient red cells and donor serum Donor red cells and recipient serum Screening cells and donor serum

Donor red cells and recipient serum

Ensures the safety and efficacy of biologics, drugs, and devices

FDA

What portion of the antibody molecule binds to receptors on macrophages and assists in the removal of antibody bound to red cells? Hinge region J chain Fab fragment Fc fragment

Fc fragment

Prevented by leukocyte-reduced components

Febrile, nonhemolytic

Which elution method is ideal in the investigation of ABO hemolytic disease of the fetus and newborn? Glycine-acid Chloroform Xylene Freeze-thaw

Freeze-thaw

Which of the following Duffy phenotypes is prevalent in blacks but virtually nonexistent in whites? Fy(a+b-) Fy(a+b+) Fy(a-b+) Fy(a-b-)

Fy(a-b-)

Which of the following is true regarding good manufacturing practices (GMPs)? GMPs are required only by pharmaceutical companies. GMPs are optional guidelines written by the AABB. GMPs are legal requirements established by the Food and Drug Administration. GMPs are part of the quality control requirements for blood products.

GMPs are legal requirements established by the Food and Drug Administration.

Select the method that uses a dextran-acrylamide matrix. Tube techniques Solid-phase red cell adherence Microplate Gel technology

Gel technology

Prevented by irradiation of components

Graft-versus-host disease

Which of the following blood products requires a crossmatch to be performed before issuing? Cryoprecipitated AHF Group AB fresh frozen plasma that is transfused to a group O Granulocyte concentrates that have more than 2 mL of red blood cells Human leukocyte antigen-matched platelets

Granulocyte concentrates that have more than 2 mL of red blood cells

Acquired B antigens have been found in: Bombay individuals Group O persons All blood groups Group A persons

Group A persons

Select the term that is associated with the B-cell response to antigens. Humoral immunity Nonspecific immunity Cellular immunity Innate immunity

Humoral

The binding of two complementary pairs of DNA

Hybridization

Of the following antigens, which one may be found in soluble form in secretions? M E I S

I

Of the following antigens, which one may be found in soluble form in secretions? N I M C

I

An anaphylactic transfusion reaction is caused by __________ antibodies. IgA IgG IgE All of the above

IgA

Most Rh system antibodies are of which immunoglobulin class? IgA IgG IgE IgM

IgG

What immunoglobulin class is capable of crossing the placenta? IgG IgA IgM IgE

IgG

Antibodies detected in the immediate spin crossmatch are usually of the following immunoglobulin classes? IgD IgA IgM IgG

IgM

Most "naturally occurring" ABO system antibodies fall into which class? IgG IgA IgM IgE

IgM

A group O patient was crossmatched with group B red blood cells. What phase of the crossmatch will first detect this incompatibility? Indirect antiglobulin Immediate spin None of them; unit is compatible 37° C low-ionic strength solution

Immediate spin

: In which of the following situations can be crossmatch test be omitted? In a patient who is receiving a directed donation In a bone marrow transplant recipient In a patient who is pregnant In a patient who has received a massive transfusion within a 24-hour period

In a patient who has received a massive transfusion within a 24-hour period

50-year-old woman on vacation in the United States who currently lives in England

Indefinite deferral

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. Call the Food and Drug Administration to report the incident. Fire the donor room supervisor, and discard the blod collected in the expired bags. Change the expiration date on the bags to avoid legal issues.

Initiate a root cause analysis and quarantine the blood collected in the expired bags.

What component is indicated for patients who receive directed donations from immediate family members to prevent graft-versus-host transfusion reactions? Packed red blood cells Cytomegalovirus-negative red blood cells Irradiated red blood cells Washed red blood cells

Irradiated red blood cells

An antibody identification panel was performed and interprested. A select cell panel was then performed to confirm and eliminate possible antibodies identified in the original panel. The suspected antibody was anti-Jkb. Antibodies that could not be ruled our were E and K. From the following list of cells, choose the one that would not be appropriate for helping to confirm anti-Jkb and rule our anti-E and anti-K. Jkb positive; E negative, K negative Jkb positive; E negative, K positive Jkb negative; E negative, K positive Jkb negative; E positive, K negative

Jkb positive; E negative, K positive

Which of the following blood group systems is known for showing dosage? P Lutheran I Kidd

Kidd

All of the following antigens are commonly found on screening cells except: Kpa. D. k. C.

Kpa

Select the answer that most closely corresponds to the description. Found predominantly in whites. Ss Kpa Mg McLeod phenotype

Kpa

Reagent derived from plants used to distinguish group A1 from group A2 red cells

Lectins

Which blood product is recommended for transfusions to individuals with a history of febrile nonhemolytic transfusion reactions? Leukocyte-reduced red blood cells Frozen red blood cells Whole blood Packed red blood cells

Leukocyte-reduced red blood cells

Which of the blood group systems is associated with antibodies that are generally IgM? Kell Lewis Rh Duffy

Lewis

To what does the abbreviation "MSBOS" refer? Maximum blood order schedule Minimum surgical blood order staffing Monthly surgical blood order schedule Minimum safe blood order schedule

Maximum blood order schedule

What would be the agglutination reaction of red cells from a Bombay phenotype with anti-H lectin? Negative Mixed field Strong 4+ Weak 1+

Negative

Why is reverse grouping omitted in the neonatal period for ABO testing? The maternal antibody is identical to that of the newborn. Newborns do not produce their own antibody until about 4 months. The newborn's antibody is the same as the paternal antibody. None of the above is correct.

Newborns do not produce their own antibody until about 4 months.

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. Yes; as long as she records the result in pencil Yes; all results must be recorded regardless of who did the test. Yes; because she used the other technologist's initials.

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. B. A. AB.

O

Which ABO phenotype selection contains the most H antigen and the least H antigen, respectively, on the red cell's surface? B, A A1B, O A2, A1B O, A1B

O, A1B

Ensures safe and healthful working conditions

OSHA

Which of the following is a characteristic of Kidd system antibodies? Usually IgM antibodies Cooresponding antigens are destroyed by enzymes Usually strong and stable during storage Often implicated in delayed hemolytic transfusion reactions

Often implicated in delayed hemolytic transfusion reactions

Which of the following statements is not true about anti-U? Only occurs in S-s- individuals Only occurs in Fy(a-b-) individuals is only found in black individuals is clinically significant

Only occurs in Fy(a-b-) individuals

Assays using Gel technology are performed with which of the following instruments: NEO TANGO ECHO PROVUE

PROVUE

Before donation, the intended venipuncture site must be cleaned with: Question options: PVP-iodine complex 10% acetone Green soap Alcohol

PVP-iodine complex

Reagent to identify the specificity of a red cell antibody antisera

Panel cells

Ten days after the transfusion of units, a patient had a 2 g/dL drop in hemoglobin and was slightly jaundiced. No evidence of bleeding was found. What tests would be helpful in determining whether the patient is experiencing a delayed hemolytic transfusion reaction? Compare pretransfusion and posttransfusion ABO and D typing. Perform hepatitis B surface antigen test. Culture the donor unit. Perform an antibody screen on the current posttransfusion sample.

Perform an antibody screen on the current posttransfusion sample.

Technique used to replicate a specific targeted

Polymerase chain reaction

Which type of autologous donation procedure is the most common for most types of surgery? Question options: Postoperative salvage Preoperative donation Intraoperative blood salvage Preoperative hemodilution

Preoperative donation

The antibody produced during the secondary response to a foreign antigen is usually: Present at a higher titer than after a primary response IgM A product of T lymphocytes Produced a month or more after the second stimulus

Present at a higher titer than after a primary response

Marks the sequence to be amplified during PCR

Primer

Short sergment of DNA with a known sequence that can be labeled with a marker

Probe

Each of the following genotypes is possible for an individual whose red cells reach as indicated below except: ANTISERA REACTIONS anti-C + anti-D + anti-E + anti-c + anti-e + R0r'. R1r". R1R2. Rzr.

R0r'.

A patient phenotypes as D+C+E-c-e+. The most likely genotype is: R1R1. R1r". R1R. R1R0.

R1R1.

If an emergency exists and there is not enough time to perform a crossmatch for red cells, what is the correct procedure? Release group AB fresh frozen plasma until the blood type is performed. Release group O, D-negative whole blood. Release ABO-compatible blood based on the patient's prior record in the computer. Release group O, D-negative red blood cells.

Release group O, D-negative red blood cells.

During the first-trimester prenatal examination, it was determined that a pregnant woman was group A, D-negative with an anti-D titer of 8. What is the most likely course of action? The anti-D is probably from prenatal Rh immune globulin and should be given another dose at birth. Repeat the titer in 4 weeks to determine if significant if a rise in titer is detected. The pregnancy is considered high risk, and the mother should be followed up immediately with amniocentesis or percutaneous umbilical cord testing. None of the above are correct.

Repeat the titer in 4 weeks to determine if significant if a rise in titer is detected.

A tube was received in the blood bank for crossmatching. The label was torn and the only information that was visible was the patient's last name and the medical record number. Which of the following in an acceptable procedure? Call the phlebotomist back to relabel the tube. Reprint a label using the MRI as the identifier. Request a recollection of the specimen. Use the tube since the MRI is visible.

Request a recollection of the specimen.

Reagent to detect the presence of red cell antibodies and B cells

Screening cells

Hematopoietic progenitor cell engraftment evaluation following a transplant evaluates which specific markers in the recipient? Sequence specific primers Similarities and differences of short tandem repeats of DNA Hybridized probes HLA typing differences

Similarities and differences of short tandem repeats of DNA

Select the answer that most closely corresponds to the description. Linked with MN Kpa Ss Mg McLeod phenotype

Ss

The use of only male donors as a source of plasma for transfusion is a method to reduce the risk of: allergic reactions. febrile reactions. TRALI. circulatory overload.

TRALI.

18-year-old woman currently taking Accutane for acne

Temporarily deferred

22-year-old man who returned from Iraq 3 months ago and was vaccinated for tetanus and yellow fever before being deployed.

Temporarily deferred

25-year-old man treated for syphilis 3 months ago

Temporarily deferred

27-year-old woman returning from the Peace Corps in Nigeria who was vaccinated for typhoid 6 months ago

Temporarily deferred

48-year-old man taking Propecia for baldness

Temporarily deferred

Which of the following is a characteristic of the Xga blood group system? The Xga antigen has a higher frequency in women than in men. The Xga antigen has a higher frequency in men than in women. The Xga antigen is enhanced by enzymes. Xga is usually a saline-reacting antibody.

The Xga antigen has a higher frequency in women than in men.

Why is incubation omitted in the direct antihuman globulin test? Incubation will cause hemolysis. IgM antibodies are detected in the direct antiglobulin test. The direct antiglobulin test can be used in an emergency to replace the indirect test. The antigen-antibody complex has already formed in vivo.

The antigen-antibody complex has already formed in vivo.

During the donor screening process, the potential donor's blood drop sinks to the bottom of the copper sulfate solution within 15 seconds. What is the interpretation of this test? Question options: The specific gravity of the copper sulfate is incorrect. The donor is temporarily deferred. The hemoglobin is within limits; however, the hematocrit must be checked. The donor has an acceptable hemoglobin and hematocrit to donate.

The donor has an acceptable hemoglobin and hematocrit to donate.

In a suspected case of HDFN, what significant information can be obtained from the baby's blood smear? Increase in nucleated red cells Increase in monocytes The presence of spherocytes The estimated platelet count

The presence of spherocytes

A patient was identified as having cardiac insufficiency that needed a red blood cell transfusion. How should the transfusion be administered? The red blood cell unit should be transfused slowly over a 4-hour period. Transfusion should be avoided. The unit should be transfused as whole blood. Diuretics should be administered with the unit.

The red blood cell unit should be transfused slowly over a 4-hour period.

Select the correct statement regarding the collection of a blood sample for compatibility testing. The sample may be labeled at any time in an emergency. The sample requires a new numeric identifier for the patient for each admittance. The sample does not require a means to identify the phlebotomist. The sample must be labeled at the bedside.

The sample must be labeled at the bedside.

Which of the following is true regarding the rosette test? It is staining procedure that differentiates fetal and adult cells. The test is valid only if the mother is D-negative and the infant is D-positive. Indicator cells bind to the D-positive maternal cells forming a rosette. The test is a quantitative test to determine how many vials of Rh immune globulin to administer.

The test is valid only if the mother is D-negative and the infant is D-positive.

Which of the following statements is true regarding IgG-sensitized red cells? They should be used only with the indirect antiglobulin test. The must be used to confirm a positive antiglobulin test. They must be used to confirm a direct antiglobulin test was negative with anti-C3d. They must be used to confirm a negative antiglobulin tube test.

They must be used to confirm a negative antiglobulin tube test.

Why is it sometimes necessary to distinguish A1 and A2 blood types? To determine the secretor status of group A individuals To prevent hemolytic disease of the newborn To resolve a discrepancy between the forward and reverse typing To prevent A1 recipients from receiving A2 blood

To resolve a discrepancy between the forward and reverse typing

Caused by donor white cell antigens

Transfusion-related acute lung injury

In an antibody identification panel, only one red cell line was negative at the antihuman globulin phase. On ruling out and matching the pattern, an anti-k was identified. What further testing is necessary to confirm the antibody? Two more K-negative cells should be tested to satisfy the rule of three. Treat the panel cells with enzymes and perform the panel again. Perform an adsorption using "k"-positive cells. Two more k-negative cells should be tested so that the rule of three can be satisfied.

Two more k-negative cells should be tested so that the rule of three can be satisfied.

How would you interpret the results if both the anti-D reagent and the Rh control were 2+ agglutination reactions? Depends on whether the sample was from a patient or a blood donor D-negative Unable to determine without further testing D-positive

Unable to determine without further testing

Anti-Sda has been identified in patient ALF. What substance would neutralize this antibody and allow detection of other alloantibodies? Human breast milk Saliva Urine Hydatid cyst fluid

Urine

Symptoms include hives and itching

Urticarial

Which of the following transfusion reactions has the highest incidence? Urticarial Hemolytic reactions due to ABO incompatibility Transfusion-related acute lung injury Graft-versus-host disease

Urticarial

Which of the following best describes MN antigens and antibodies? Well developed at birth, susceptible to enzymes, generally antiglobulin-reactive Not well developed at birth, susceptible to enzymes, generally saline-reactive Well developed at birth, not susceptible to enzymes, generally saline-reactive Well developed at birth, susceptible to enzymes, generally saline-reactive

Well developed at birth, susceptible to enzymes, generally saline-reactive

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? Autosomal dominant X-linked dominant X-linked recessive Autosomal recessive

X-linked dominant

A donor documented using a needle to administer a medication for relief of migraine headaches. Her physician prescribed the medication. Question options: indefinite deferral temporary deferral accept donor

accept donor

A new mother who gave birth 45 days ago. Question options: accept donor temporary deferral indefinite deferral

accept donor

A platelet pheresis donor who consumed aspirin one week ago for a toothache. Question options: accept donor temporary deferral indefinite deferral

accept donor

28-year-old man who was incarcerated overnight for unspecified reason 2 months ago

acceptable

A college student is donating at a blood drive on campus. The student is scheduled to study abroad in Argentina in one month. He received the following immunizations eight weeks previously: Yellow fever Hepatitis A (for prevention) Hepatitis B (for prevention) Typhoid (oral) The donor's donation status is: Question options: unacceptable for donation due to hepatitis A and B acceptable for donation unacceptable for donation due to hepatitis A, yellow fever, and typhoid unacceptable for donation due to yellow fever and typhoid

acceptable for donation

Blood collected from a therapeutic phlebotomy is: Question options: unacceptable for inventory. acceptable if the patient meets all regular donor criteria. acceptable for inventory under certain Food and Drug Administration guidelines. acceptable if the "volunteer donor" label is removed.

acceptable for inventory under certain Food and Drug Administration guidelines.

Anti-D in the serum of a third-trimester pregnant woman with a titer of 16 in indicative of: passive immunization. active immunization. the presence of Rh immune globulin administered at 28 weeks. none of the above.

active immunization.

Ch 1: Personal protective equipment includes: all of the above. safety glasses. splash barriers. masks.

all of the above

An LIS interface is an important component in automation because of its potential in: recognizing errors in sample ID. flagging discrepancies with previous test results. providing a mechanism for the electronic crossmatch. all of the above.

all of the above.

If all red cells tested at room temperature are positive with a patient's serum except for cord cells, the probable antibody identity is: anti-Lu. anti-I. anti-M. anti-Lea.

anti-I.

Polyspecific antihuman globulin contains: anti-C3b and anti-C3d. anti-IgG. anti-IgG and anti-C3d. anti-IgG and anti-IgM.

anti-IgG and anti-C3d.

Of the following antibodies, which one would not be affected by enzyme treatment of the red cells? anti-I anti-K anti-M anti-C

anti-K

In the process of identifying an antibody, the technologist observed 2+ reactions with 3 of the 10 cells in a panel at the immediate spin phase. These reactions disappeared following incubation at 37° C and the antihuman globulin phase of testing. The antibody most likely to be responsible is: anti-I. anti-D. anti-E. anti-Lea.

anti-Lea.

Antibodies to low-incidence antigens include all of the following except: anti-Cw. anti-Lua. anti-Vel. anti-V.

anti-Vel.

Antibodies to low-incidence antigens include all of the following except: anti-Vel. anti-Lua. anti-Cw. anti-V.

anti-Vel.

In a serologic test, the term prozone is also known as: antibody excess. equivalence. antigen excess. serum-to-cell ratio.

antibody excess

A patient was admitted to the hospital with acute bleeding. Anti-E was detected in the patient's serum. Four E-negative units of blood were crossmatched for the patient. The units were compatible at immediate spin and following the antiglobulin test. After the antiglobulin test was performed, IgG-sensitized red cells gave a 2+ agglutination reaction. The proper interpretation of this 2+ agglutination reaction is the: antihuman globulin washing procedure was adequate. patient's anti-E reacted with the IgG-sensitized red cells. IgG-sensitized red cells spontaneously agglutinated. crossmatch was incompatible.

antihuman globulin washing procedure was adequate.

Autologous donors may not donate if they: Question options: are taking aspirin. are on antibiotics for an infection. are over 65 years old. have a positive test for syphilis.

are on antibiotics for an infection.

An antigen that originates from the individual is termed: autologous allogeneic immunogen hapten

autologous

The purpose of a "diversion pouch" that is used when collecting blood from a donor is to: Question options: prime the line to remove air. collect samples for viral marker testing. determine if blood flow is sufficient. avoid bacterial contamination of the blood product.

avoid bacterial contamination of the blood product.

It is necessary to mix the unit frequently during the donation process to: Question options: avoid blood clots by mixing the anticoagulant with the blood. suspend the platelets throughout the unit. determine whether the volume is acceptable. allow the donation process to go more quickly.

avoid blood clots by mixing the anticoagulant with the blood.

The numeric Rh4 nomenclature refers to which antigen in the Rosenfield notation? E c C e

c

An antibody has been identified as anti-c. By employing elimination, anti-E cannot be ruled out. What antigen typing will be beneficial to confirming the identity of the antibody and helping to rule out anti-E? only E only c c and E no antigen typing will be useful

c and E

A technologist who is resolving a complex antibody combination discovers that all of the Kell blood group antigens appear to be absent. The hematology technologist reports that the peripheral smear has marked acathocytosis and polychromasia. The patient has repeated infections and has been referred to the local hematology practice for evaluation. The patient appears to be demonstrating what condition? sickle cell anemia acute myelogenous leukemia Burkitt's lymphoma chronic granulomatous disease

chronic granulomatous disease

Your blood bank mistakenly released a D-positive red blood cell unit that subsequently transfused to a patient who was typed as D-negative. The patient had no history of a previous transfusion or pregnancy. Antibody detection testing was negative in pretransfusion testing. The crossmatch in this case was: incompatible at immeditate spin only. compatible at immediate spin. not necessary to perform. incompatible at antihuman globulin only.

compatible at immediate spin.

Plans that provide the framework for establishing quality assurance in an organization are: standard operating procedures. current good manufacturing practices. change control plan. continuous quality improvement plan.

continuous quality improvement plan.

A unit of blood is collected. Upon inspection, the unit has dark purple areas. The unit should be: Question options: returned to storage until quarantine period is over transfused to a recipient discarded converted to washed red cells

discarded

The use of the electronic (computer) crossmatch is restricted to recipients who: have transfusion history that has been documented in the computer. are group O. have had successful transfusions in the past. do not have a clinically significant antibody.

do not have a clinically significant antibody.

Part of the antigen that the immunoglobulin binds to

epitope

Of the following, the antigen that is not high incidence or universal is: U f k e

f

Monoclonal an anti-D serum is being used in the blood bank of the local hospital. This blood bank also performs weak D testing on all donors and recipients. Choose the correct statement regarding the frequency that this lab will have to perform the weak D test compared to a lab that uses antisera that are not monoclonal. This lab will perform: fewer weak D tests unable to determine more weak D tests the same number of weak D tests

fewer weak D tests

An individual who is genetically AO/Sese will have which soluble antigens in their saliva: group A, B, and H none group H only group A and H group A only

group A and H

An individual presents with the following typing results: Anti-A: 4+ Anti-B: 0 Anti-A,B: 4+ A1 Cells: 1+ B cells: 4+ This individual is: group AB group A2 with anti-A1 group A1 with anti-A unable to determine

group A2 with anti-A1

The linked HLA genes on each chromosome are inherited as a: haplotype. genotype. antithetical pair. phenotype.

haplotype.

The immediate spin or abbreviated crossmatch is an acceptable procedure if the recipient: has no prior or existing clinically significant antibodies. has never been pregnant or transfused. needs blood before a sample can be obtained. is using blood from a directed donation.

has no prior or existing clinically significant antibodies.

Imparts flexibility to the immunoglobulin molecule

hinge region

Documentation of a transfusion reaction investigation should include all of the following except: reidentification of the patient and transfused component. human leukocyte antigen (HLA) typing. posttransfusion patient temperature. collection of a blood sample.

human leukocyte antigen (HLA) typing.

Variable region of an immunoglobulin

idiotype

Polyethylene glycol is a reagent that can be added to the screen or panel in order to: eliminate the need for washing in the indirect antiglobulin test. enhance detection of IgM antibodies. increase the avidity of IgG antibodies. eliminate the reactivity of certain antigen.

increase the avidity of IgG antibodies.

All of the following can cause the D antigen expression to be weaker except: inheriting the G gene. partial D expression. inheriting the C antigen in trans to the D antigen. an RHD gene that is genetically weaker.

inheriting the G gene.

To prevent graft-versus-host disease, red blood cells prepared for intrauterine transfusions should be: ABO and D-compatible with the mother. saline washed. frozen and deglycerolized. irradiated.

irradiated.

The type of immunoglobulins determined by the heavy chain

isotype

All of the following are true regarding competency testing except: it must be performed on an annual basis. it is required only if the technologist has no experience. it must be performed following training. retraining is required if there is a failure in competency testing.

it is required only if the technologist has no experience.

One of the two types of light chains

kappa

What is the greatest danger to the newborn affected by HDFN postpartum? a) low L/S ratio b) conjugated bilirubin c) anemia d) kernicterus

kernicterus

What is the mechanism for HDFN occurrence? a) maternal antigens react with fetal antibodies b) fetal antigens react with maternal antigens c) maternal antibodies react with fetal antigens d) fetal antibodies react with maternal antibodies

maternal antibodies react with fetal antigens

Some forms of weak D antigen may be: identical to the D antigen missing part of the D antigen an Rh negative antigen not at all related to the D antigen

missing part of the D antigen

All of the following are common characteristics of ABO hemolytic disease of the fetus and newborn except: Mild clinical symptoms. mother is group A. weak positive direct antiglobulin test. the antibody on the infant's cells is anti-A,B.

mother is group A.

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: failure to wash correctly. problem with the card. negative reaction. strong positive reaction.

negative reaction.

When type O blood is not available for transfusion for a type O recipient, what is the next alternative? Group A red blood cells Group AB red blood cells Washed group B red blood cells None

none

A patient is observed to have a rise in temperature and chills during transfusion. The transfusion is stopped, and a posttransfusion blood sample is carefully drawn. On receipt of this postreaction sample, the transfusion service should immediately: observe the color of serum and perform an antibody screen. observe the color of serum and perform a direct antiglobulin test. perform an antibody screen and a crossmatch. perform an antibody screen and a direct antiglobulin test.

observe the color of serum and perform a direct antiglobulin test.

Group A red cells may be transfused to which of the following blood groups: 1. group O 2. group B 3. group AB 1, 2, and 3 are correct only 1 is correct only 2 is correct only 3 is correct none of the above

only 3 is correct

In testing amniotic fluid, the Liley method of predicting the severity of hemolytic disease of the fetus and newborn is based on: titration of antibody. colorimetric protein analysis. ratio of lecithin to sphingomyelin. optical density of bilirubin at 450 nm.

optical density of bilirubin at 450 nm.

All of the following may be used to perform an antibody screen for an infant less than 4 months old during a cross match test workup except: paternal serum. maternal serum. infant serum. infant eluate.

paternal serum.

A negative reaction in the MTS Gel test would appear as a: cells distributed only in the bottom half of the column. cells evenly distributed throughout the column. layer of cells at the top of the column. pellet of cells at the bottom of the column.

pellet of cells at the bottom of the column.

An antibody screen on a patient with a prior history of transfusion was negative. The crossmatch was incompatible with 1 unit selected at AHG phase. The next step in the investigation would be to: redraw the patient and begin a new crossmatch. perform a direct antiglobulin test on the incompatible unit. crossmatch a new unit and discard the incompatible unit. perform a prewarm procedure for crossmatching

perform a direct antiglobulin test on the incompatible unit.

If an anti-I is suspected in a patient's sample that requires a transfusion, the most acceptable course of action is to: perform a cold autoadsorption. call the rare donor registry. crossmatch cord blood. perform the prewarm technique.

perform the prewarm technique.

If an anti-I is suspected in a patient's sample that requires a transfusion, the most acceptable course of action is to: perform the prewarm technique. perform a cold autoadsorption. call the rare donor registry. crossmatch cord blood.

perform the prewarm technique.

:All of the following are responsibilities of the quality assurance department of a blood bank except: performing quality control. reviewing standard operating procedures. performing internal audits. reviewing and approving training programs.

performing quality control.

When an individual is said to be group A, it refers to the individual's: alleles. genotype. haplotype. phenotype.

phenotype.

Postransfusion purpura is caused by: white cell antibodies. platelet antibodies. red cell antibodies. bacterial contamination.

platelet antibodies.

A smooth layer of cells in the bottom of the well is interpreted as a/an __________ reaction when the solid phase testing is completed for the antiglobulin test: negative positive indeterminate mixed field

positive

Compatibility procedures will address all of the following except to: prevent life-threatening transfusion reactions. maximize in vivo survival rate of red cells. prevent formation of all red cell antibodies. check ABO compatibility.

prevent formation of all red cell antibodies.

Product limitations and technical considerations for each reagent can be found in the: Food and Drug Administration code of regulations. AABB standards. product insert. standard operating procedure.

product insert.

Choose the genotype that is homozygous for E antigen: rRz R1R2 rr r"ry

r"ry

The following test results are obtained: Anti-D: 0 Anti-C: + Anti-c: + Anti-E: 0 Anti-e: + The most probably genotype is: R1r rr R0r r'r

r'r

Which of the following statements is not true of anti-Fya and anti-Fyb? cause a generally mild hemolytic disease of the newborn react well with enzyme-treated panel cells cause hemolytic transfusion reactions are clinically significant

react well with enzyme-treated panel cells

Rh system antibodies characteristically give: mixed-field reactions on panels. weak reactions with panel cells. reactions that are enhanced with enzymes. strong reactions with panel cells when read at immediate spin phase.

reactions that are enhanced with enzymes.

Rh system antibodies characteristically give: reactions that are enhanced with enzymes. mixed-field reactions on panels. weak reactions with panel cells. strong reactions with panel cells when read at immediate spin phase.

reactions that are enhanced with enzymes.

Antibody screening of the recipient is performed as a component of compatibility testing to detect: irregular antigens on the recipient's red cells. incompatibilities with the donor's red cells. human leukocyte antigen antibodies. red cell alloantibodies

red cell alloantibodies

An advantage of the MTS Gel technology over test tubes when performing panels is: the incubation step is optional. reduced patient sample requirements. decreased reagent cost. shorter centrifugation time.

reduced patient sample requirements.

A poor response to platelet transfusion that can be caused by antibodies to human leukocyte antigens is known as: immune activation. nonresponders. refractoriness. responders.

refractoriness.

All of the following are goals of an exchange transfusion except to: remove high levels of unconjugated bilirubin. correct anemia. restore the platelet count. remove high levels of maternal antibody.

restore the platelet count.

Red cells that are used for reverse grouping are: enzyme treated suspended in gel lectins saline suspended

saline suspended

Which of the following transfusion reactions is associated with high fever, shock, hemoglobinuria, and DIC? Circulatory overload Anaphylactic Allergic Sepsis

sepsis

Proteolytic enzymes should not be used to screen for antibodies because: some antigens are destroyed by enzymes, which would cause the antibodies to be missed. clinically insignificant antibodies are enhanced. the reagent is too expensive for routine use. red cells must be treated with enzymes first, which makes this technique impractical.

some antigens are destroyed by enzymes, which would cause the antibodies to be missed.

Extravascular destruction of blood cells occurs in the: blood vessels. spleen. thymus. lymph nodes.

spleen

A 35-year-old male who was released from prison one month ago. Question options: temporary deferral accept donor indefinite deferral

temporary deferral

An antibody identification was performed in which the antibody reacted at the AHG phase with 2 of 10 cells. What is the next step that the technologist should take? request an additional sample from the patient and forward to a reference lab for confirmation of the antibody pretreat the red cells in the panel with papain and retest the plasma to provide additional positive cells for confirmation no additional steps are necessary test the plasma with more cells positive for the suspected antigen to provide a statistically sound confirmation

test the plasma with more cells positive for the suspected antigen to provide a statistically sound confirmation

A blood sample from a 90-year-old man was submitted to the blood bank for a type and screen before surgery. The forward type demonstrates as a group A, whereas the reverse type appears to be group AB. The most likely cause of the discrepancy is: rouleaux formation. that patient has low-titer isoagglutinins. contaminated reagent antisera. that the patient has autoantibodies.

that patient has low-titer isoagglutinins.

Random access is an important feature in selecting an automated instrument for testing in the transfusion service. Random access refers to: the recognition of various types of barcodes. the need for minimal maintenance procedures. the ability to accomodate STAT testing. ability of multiple users to sign into the system.

the ability to accomodate STAT testing.

Anti-Sda should be suspected if: the antibody reacts with most panel cells and are mixed field and refractile microscopically. weak reactions at the AHG phase titer out to high dilutions. weak reactions at the antiglobulin phase occur with several panel cells. reactions are stronger with enzymes at the immediate spin phase.

the antibody reacts with most panel cells and are mixed field and refractile microscopically.

Biosafety levels determine: how many biohazardous waste containers a laboratory must have. the amount of ventilation required in a transfusion service. the degree of risk for certain areas of a health care facility to exposure to infectious diseases. on what floor certain infectious disease testing can be performed.

the degree of risk for certain areas of a health care facility to exposure to infectious diseases.

Red cells that phenotype as D-negative indicate that: there is no genetic material inherited from the RHD gene from both parents. a suppressor gene was inherited that is turning off the D gene expression. they inherited two D genes. reagents currently in use are not detecting the D antigen.

there is no genetic material inherited from the RHD gene from both parents.

Fisher-Race describes the inheritance of the Rh antigens as resulting from: a single complete unit one locus with three subloci three separate closely linked loci linkage to the ABO genes

three separate closely linked loci

Mixed-field reactions were observed in the ID-MTS Gel Test for ABO and D phenotype when the test was automated. What is the most likely cause of this observaton? a) the use of contaminated reagents b) transfusion of group O cells to an A or B patient c) centrifugation error d) improper pipetting technique

transfusion of group O cells to an A or B patient

Ch 1: All accidents, even minor ones, must be reported to a supervisor.

true

Mitosis results in __________ chromosomes as the original. four cells with the same number of four cells with half as many two cells with half as many two cells with the same number of

two cells with the same number of

Monoclonal antibodies are prepared in: humans. vivo. laboratory animals. vitro.

vitro