Blood Bank Practice Test 2-Lecture
A.
A patient's serum contains a mixture of antibodies. One of the antibodies is identified as anti D. Anti-Jka or anti-Fya and possibly another antibody are also present. What technique(s) may be helpful to identify the other antibody(ies)? A. Enzyme panel; select panel cells to run. B. Thiol reagents. C. Lowering the pH and increasing the incubation time. D. Using albumin as an enhancement medium in combination with selective adsorption.
A.
Anti-M is sometimes found with reactivity detected at the immediate spin phase that persists in strength to the AHG phase. What is the main testing problem with a strong anti-M? A. Anti-M may not allow detection of a clinically significant antibody. B. Compatible blood may not be found for the patient with a strong reacting anti-M. C. The anti-M cannot be removed from the serum. D. The anti-M may react with the patient's own cells.
B.
4 units of blood are ordered for a patient. Blood bank records are checked and indicate that 5 years ago this patient had an ant-Jkb. What is the next course of action? A. Antigen type units for the Jkb antigen and only crossmatch units for Jkb. B. Antigen type units for the Jkb antigen and only crossmatch units negative for Jkb. C. Randomly pull four units of blood that are ABO compatible and crossmatch. D. Perform an immediate spin crossmatch on 4 Jkb-negative units.
B.
A baby has been diagnosed with HDN, what conditions would be most threatening to the survival of the infant? A. Anemia and a positive DAT B. Hyperbilirubinemia and anemia C. Hyperbilirubinemia and jaundice D. Hyperbilirubinemia and kernicterus
D.
A group O mother has given birth to an infant who appears, upon initial testing to be group AB. What should be done next? A. Nothing, report the result. B. Retype both using a different lot number of anti-A and anti-B antisera. C. Question the phlebotomist about the identity of the the samples. D. Check all labels, repeat the tests, and obtain new samples if the results are the same.
A.
A neonate with a positive DAT indicates that there was an incompatibility between a mother and her fetus. The system that is most commonly associated with an incompatibility is: A. ABO B. Rh C. Kell D. Kidd
A.
A patient is admitted to the hospital. Medical records indicate that the patient has a history of anti-Jkb. When you performed the type and screen, it was negative, you should: A. Crossmatich using Jkb negative units. B. Crossmatch random units, since the antibody is not demonstrable. C. Request a new sample because you think they drew the sample from the incorrect patient. D. All of the above are incorrect.
A.
A patient is suspected of having paroxymal cold hemoglobinuria (PCH). Which pattern of reactivity is characteristic of Donath Landsteiner antibody, which causes this condition? A. The antibody attaches to RBCs at 4C and causes hemolysis at 37C. B. The antibody attaches to RBCs at 37C and causes agglutination at AHG phase. C. The antibody attaches to RBCs at 22C and causes hemolysis at 37C. D. The antibody attaches to RBCs and causes agglutination at AHG phase.
A.
A patient that is recuperating from a Mycoplasma pneumonia infection has a potential antibody reacting on immediate spin with all reagent red cells except the cord cell. A cold agglutinin is run and has a titer of 1:320. What antibody would be associated with this patient? A. Auto anti-I B. Auto anti-P C. Allo Anti-I D. Allo Anti-P
C.
A patient with WAIHA has a history of anti-Jka in her autoadsorbed serum, and an anti-e in her eluate. Her autoadsorbed serum today is not showing anti-Jka on prewarmed panel, but the eluate is still showing anti-e. What blood would be selected for crossmatching packed red cells today? A. e-negative B. Jka negative C. Jka negative and e-negative D. No screening is necessary
D.
A patient's preoperative antibody screening test is negative, but the autocontrol is positive. A DAT performed on his RBCs is 2+ with anti-IgG. His last transfusion was 12 months ago, and he has a negative drug history. Which of the following would be the most likely cause of his positive DAT? A. No antibody B. Alloantibody C. Alloantibody and autoantibody D. autoantibody
D.
To confirm that an antibody identification is correct: A. Make an eluate B. Do saliva testing C. Run an additional panel D. Type the patient's cells for the corresponding antigens.
B.
What blood group antigens do proteolytic enzymes destroy? A. Jka B. Fya C. D D. E
C.
What type of transfusion reaction is often diagnosed by a positive DAT and a GRADUAL drop in the patient's hemoglobin level? A. Anaphylactic B. Febrile C. Delayed hemolytic D. Acute hemolytic
C.
Which of the following would NOT be included when routine testing is performed early in pregnancy? A. ABO and Rh testing B. Antibody screening C. Amniocentesis D. Weak D testing on apparent Rh-negative patients.
There needs to be 3 cells (rows) that are E + and K-. There needs to be an additional 3 cells (rows) that are K+ and E-.
If there are no previously known antibodies in a patient, but their I.D. panel is showing 2 antibodies, how do they need to be confirmed in the panel using the rule of 3? Use antibodies E and K as an example.
E.
Immune hemolytic anemias may be classified in which of the following categories? A. Alloimmune B. Autoimmune C. Drug-induced D. A and B E. A, B, and C
C.
Often when trying to identify a mixture of antibodies, it is useful to neutralize one of the known antibodies. Which one of the following antibodies is neutralizable? A. Anti D B. Anti Jka C. Anti Lea D. Anti M
D.
Problems in routine testing caused by cold reactive autoantibodies can usually be resolved by all of the following EXCEPT: A. Prewarming B. Washing with warm saline C. Using anti-IgG antiglobulin serum D. Testing for clotted blood speciments.
A.
RBCs from a RECENTLY TRANSFUSED patient were DAT positive when tested with anti-IgG. Screen cells and a panel performed on the patient's serum showed very weak reactions with inconclusive results. What procedure could help to identify the antibody? A. Elution folowed by a panel on the eluate. B. Adsorption followed by a panel on the adsorbed serum. C. Enzyme panel D. Antigen typing the patient's RBCs.
1. Select more panel cells to limit antibody choices. 2. Enymes if you have an idea of which antibodies are present. 3. Antigen typing of patient cells to help rule out antibodies. (If they are positive, then the patient has the antigen and not that antibody.) 4. Alloadsorption, if you have an idea of which antibodies are present. This is used to remove specific alloantibodies from the patients serum that are masking another antibody. Use homologous phenotypes (except the antibody you wish to remove,) so as not to accidentally remove another antibody.
After running one set of panel cells, how can you resolve a patients type with suspected multiple alloantibodies?
C.
All of the following are interventions for fetal distress caused by maternal antibodies attacking fetal cells EXCEPT: A. Intrauterine transfusion. B. Plasmapheresis on the mother to remove circulating antibodies. C. Transfusion of antigen-positive cells to the mother. D. Early induction of labor.
D.
All of the following may be responsible for a positive DAT on cord cells of a newborn infant EXCEPT: A. High concentration of Wharton's jelly on cord cells. B. Immune anti-A from an O mother on the cells of an A baby. C. Immune anti-D from an Rh-negative mother on the cells of an Rh-positive baby. D. Immune anti-K from a K-negative mother on the cells of a K-negative baby.
D.
An O negative mother gives birth to a B positive infant. The mother has no history of antibodies or transfusion. This is her first child. The baby was mildly jaundiced and the DAT is weakly positive with polyspecific antisera. What is most likely causing the positive DAT? A. Anti-D from the mother is coating infant cells. B. An allo antibody like anti-K is coating infant cells. C. A non-specific protein is coating infant cells. D. Anti-B is coating infant cells.
C.
An obstetric patient, 34 weeks pregnant, shows a positive antibody screen at the AHG phase of testing. She is group B, Rh-negative. This is her first pregnancy. She has no prior history of transfusion. What is the most likely explanation for the possible antibody screen? A. She has developed an antibody to fetal red cells. B. She probably does not have have antibodies because this is her first pregnancy, and she not been transfused. Check for technical error. C. She recieved an antenatal dose of RhIg. D. Impossible to determine without further testing.
First you find one positive E, then make sure all the other cells are negative for E. In the cells negative for E, find a positive for each of the other antibodies.
How do you select cells for an I.D. panel when you have a previously known antibody? Use E as an example.
C.
How is cold hemagglutinin disease (CHD) different from paroxysmal cold hemoglobinuria (PCH)? A. PCH is a common form of cold autoimmune anemia while CHD is rare. B. PCH is a warm autoimmune hemolytic anemia. C. The offending antibody in PCH is an IgG antibody unlike the IgM antibody which causes CHD. D. The offending antibody in PCH is an IgM antibody while an IgG antibody is common in CHD.
D.
Given that a patient's antibody screening test is negative, which of the following may cause a false positive result in a compatibility test? A. Incorrect ABO typing of the donor or patient. B. An alloantibody against a low frequency antigen on the donor cells. C. Prior coating of IgG antibody on the donor cells. D. All of the above.
First find a cell with one positive K with a negative E. Then find a cell with a positive E a negative K. Then for all of the other cells, make sure that both E and K are negative. In those cells, find positive antibodies for all of the others.
How do you find I.D. panel cells if there are two previously known antibodies? Use E and K as an example.
A. Since they have had a transfusion, they probably have more than one blood type in their system like they are A and were transfused with O.
In which of the following instances may mixed field agglutination be observed? A. DAT positive as a result of patient undergoing delayed hemolytic tranfusion reaction. B. Antibody screen positive as a result of a patient who has anti-Lea. C. DAT result of patient on high doses of methyldopa. D. Typing result with anti-A of patient who is A2 subgroup.
That autoantibodies could be covering up alloantibodies.
Screening Cells 1: (IS=) (AHG 3+) Screening Cells 2: (IS=) (AHG 3+) Screening Cells 3: (IS=) (AHG 3+) Auto Control: (IS=) (AHG 3+) What is the main concern with the antibody panel?
Autoantibodies and possibly alloantibodies.
Screening Cells 1: (IS=) (AHG 3+) Screening Cells 2: (IS=) (AHG 3+) Screening Cells 3: (IS=) (AHG 3+) Auto Control: (IS=) (AHG 3+) What type of antibodies may be present?
DAT and adsorption
Screening Cells 1: (IS=) (AHG 3+) Screening Cells 2: (IS=) (AHG 3+) Screening Cells 3: (IS=) (AHG 3+) Auto Control: (IS=) (AHG 3+) What would the next step(s) in identifying the antibody(ies) present?
No, you must remove the autoantibodies first, then test for any alloantibodies.
Screening Cells 1: (IS=) (AHG 3+) Screening Cells 2: (IS=) (AHG 3+) Screening Cells 3: (IS=) (AHG 3+) Auto Control: (IS=) (AHG 3+) Would the addition of enzymes help in the identification? Why or why not?
C.
What is the most important consideration in patients suffering from life-threatening anemia and whose serum contains warm autoantibodies. A. Determine the specificity of the autoantibody. B. Determine the immunoglobulin class of the autoantibody. C. Exclude the presence of alloantibodies. D. Avoid transfusion.
C.
What is the process of removing an antibody from the RBC membrane called? A. Absorption B. Adsorption C. Elution D. Neutralization
A.
What should be done when a woman who is 24 weeks pregnant has a positive antibody screen? A. Perform an antibody I.D. panel; titer if necessary. B. No need to do anything until 30 weeks of pregnancy. C. Administer Rh immune globulin. D. Adsorb the antibody onto antigen positive cells.
D.
What should you do to increase the probability that an antibody identification is correct? A. Make an eluate. B. Do saliva testing. C. Run an additional panel. D. Type the patient's cells for the corresponding antigens.
When there is multiple screening cells and or panel cells that have different strengths and or different phases.
When do you suspect multiple antibodies?
B.
Which 2 blood group systems are similar in that the RBC antigens are highly antigenic and may lead to the formation of clinically significant antibodies; the lack of normal antigens leads to damaged RBCs and resultant anemic conditions? There is also usually no problem finding antigen-negative blood for patients with antibodies to the most common antigens of the systems. A. Duffy and Kidd B. Rh and Kell C. P and I D. MNSs and Lewis
A.
Which of the following antibodies would most likely be implicated in an immediate hemolytic transfusion reaction? A. Anti-A B. Anti-Le^a C. Anti-M D. Anti-D
