MLT 120 Blood Bank Final Review
Match the transfusion reaction with the description that best fits. Circulatory overload (TACO) MATCHING
can be prevented by transfusion slowly
Match the transfusion reaction with the description that best fits. Transfusion-related acute lung injury MATCHING
caused by donor white cell antibodies
Which of the following transfusion reactions can be linked to the administration of whole blood to a patient with cardiac insufficiency? a) delayed hemolytic reaction b) transfusion-related acute lung injury (TRALI) c) circulatory overload (TACO) d) Febrile nonhemolytic reaction
circulatory overload (TACO)
Equal expression of two different inherited genes as in most blood group systems. MATCHING
codominant genes
The inheritance of the Rh antigens are: A) X-linked recessive. B) X-linked dominant. C) autosomal recessive. D) codominant.
codominant. -As with most blood group systems, inheritance patterns follow a codominant expression, meaning that both genes from the parents are expressed equally.
The inheritance of the Rh antigens are: a. X-linked recessive. b. X-linked dominant. c. autosomal recessive. d. codominant.
codominant. -As with most blood group systems, inheritance patterns follow a codominant expression, meaning that both genes from the parents are expressed equally.
Your blood bank mistakenly released a D-positive red blood cell unit that subsequently transfused to a patient who typed as D-negative. That patient had no history of a previous transfusion or pregnancy. Antibody detection testing was negative in pretransfusion testing. Predict the crossmatch result in this case. a) compatible at immediate-spin b) incompatible at immediate-spin only c) not necessary to perform d) incompatible at antihuman-globulin only
compatible at immediate-spin
Which of the following is not a factor that affects sensitization? a) temperature b) pH c) concentration of antigen and antibody d) ionic strength
concentration of antigen and antibody
Why is a recipient's antibody screening performed as a component of compatibility testing? a) detects red cell alloantibodies b) detects irregular antigens on the recipient's red cells c) detects human leukocyte antigen antibodies d) detects incompatibilities with the donor's red cells
detects red cell alloantibodies
The use of the electronic (computer) crossmatch is restricted to recipients who: a) are group O b) do not have a clinically significant antibody c) have had successful transfusions in the past d) have transfusion history that has been documented in the computer
do not have a clinically significant antibody
All the following statements are true regarding Lewis system antibodies except antibodies: a. may be observed at the immediate-spin, 37 C, and antihuman globulin phases. b. can be neutralized by Lewis substance. c. may cause hemolysis in vitro. d. do not react following enzyme treatment of cells.
do not react following enzyme treatment of cells.
All the following statements are true regarding Lewis system antibodies except antibodies: A) may be observed at the immediate-spin, 37° C, and antihuman globulin phases. B) can be neutralized by Lewis substance. C) may cause hemolysis in vitro. D) do not react following enzyme treatment of cells.
do not react following enzyme treatment of cells. -Anti-Leb may be enhanced with enzyme treatment.
What are the two components of the major crossmatch? a) recipient red cells and donor serum b) donor red cells and recipient serum c) reverse ABO cells and recipient serum d) screening cells and donor serum
donor red cells and recipient serum
Antibodies to Kidd, Kell, and Duffy blood group antigens share all the following characteristics except: A) can cause hemolytic disease of the newborn. B) usually detected only by the indirect antiglobulin test. C) enhanced with enzyme treatment. D) can cause transfusion reactions.
enhanced enzyme treatment -The Duffy system antibodies do not react with enzyme-treated cells.
Antibodies to Kidd, Kell, and Duffy blood group antigens share all the following characteristics except: a) can cause hemolytic disease of the newborn b) usually detected only by the indirect antiglobulin test c) enhanced with enzyme treatment d) can cause transfusion reactions
enhanced with enzyme treatment
Part of the antigen that the immunoglobulin binds to. MATCHING
epitope
What is the potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used? a) false negatives b) false positives c) hemolysis d) no effect
false negatives
A technologist added 4 drops of a 5% red cell suspension instead of the required 1 drop to a hemagglutination test. What is the potential consequence to the test results? a) false-positive b) false-negative c) hemolysis due to complement activation d) test results are not affected
false-negative
A patient's red cells are agglutinated by anti-A, but not by anti-B. What is this patient's ABO phenotype? a) group B b) group O c) group AB d) group A
group A
Which of the following situations is most likely to cause intravascular hemolysis when an incompatible transfusion is given? a) group B packed cells to a group O recipient b) group A packed red cells to a group AB recipient c) group AB plasma to a group A recipient d) group AB plasma to a group O recipient
group B packed cells to a group O recipient
Given the following ABO phenotyping data: FORWARD Anti-A: 2+ mf Anti-B: 0 REVERSE A1 cells: 0 B cells: 3+ What could be a plausible explanation for this discrepancy? a) T-activation of red cells b) group O blood products given to group A c) rouleaux formation d) positive direct antiglobulin test
group O blood products given to group A
What ABO and D types are selected for RBC units issued to a patient in emergency release?
group O, D-negative
A group A man marries a group AB woman. The father of the group A man was group O. What possible ABO phenotypes could be expected in the offspring? a) groups A, B, AB, and O b) groups A and B c) groups A, B, and AB d) groups A and AB
groups A, B and AB A O A AA AO B AB BO
The linked HLA genes on each chromosome are inherited as a: a. haplotype. b. phenotype. c. genotype. d. antithetical pair.
haplotype. -Closely linked genes on a chromosome such as the HLA genes are inherited as a group or haplotype.
When two genes are close together on the same chromosome and are inherited as a "group" or "bundle". MATCHING
haplotypes
What part of the immunoglobulin molecule distinguishes the isotype? a) light chain b) heavy chain c) kappa chain d) lambda chain
heavy chain
The major histocompatibility complex is located on chromosome 6 and is important in all the following immune functions except: a. recognition of nonself. b. graft rejection. c. hemolysis. d. coordination of cellular and humoral immunity.
hemolysis.
Which of the following conditions can result from long-term red blood cell transfusions? a) citrate toxicity b) hemosiderosis c) graft-versus-host disease d) transfusion-related acute lung injury
hemosiderosis
Documentation of a transfusion reaction investigation should include all of the following except: A) posttransfusion patient temperature. B) human leukocyte antigen (HLA) typing. C) re-identification of the patient and transfused component. D) collection of a blood sample.
human leukocyte antigen (HLA) typing. -Human leukocyte antigen typing is not necessary in investigating a transfusion reaction.
Variable region of an immunoglobulin. MATCHING
idiotype
A group O patient was crossmatched with group B red blood cells. What phase of the crossmatch will first detect this incompatibility? a) immediate-spin b) 37 oC low-ionic strength solution c) indirect antiglobulin d) none of them; unit is compatible
immediate-spin
Why is the agglutination reaction phase important in the interpretation of the antibody screen or antibody identification panel? a) indicates the class of the antibody b) determines whether there is a delayed transfusion reaction c) determines whether an autoantibody is present d) provides clues on antibody dosage
indicates the class of the antibody
All of the following can cause the D antigen expression to be weaker except: a) inheriting the G gene b) inheriting the C antigen in trans to the D antigen c) an RHD gene that is genetically weaker d) partial D expression
inheriting the G gene
What component is indicated for patients who receive directed donations from immediate family members to prevent graft-versus-host transfusion reactions? a) irradiated red blood cells b) packed red blood cells c) washed red blood cells d) cytomegalovirus-negative red blood cells
irradiated red blood cells
The type of immunoglobulins determined by the heavy chain. MATCHING
isotype
A patient's antibody history listed an anti-Cellano. This antigen is also known as: a) c in the Rh system b) k in the Kell system c) Cs in the Cost system d) SC in the Scianna system
k in the Kell system
A patient's antibody history listed an anti-Cellano. This antigen is also known as: A) c in the Rh system. B) k in the Kell system. C) Cs in the Cost system. D) SC in the Scianna system.
k in the Kell system. -Cellano is the original name of the k antigen (KEL2) in the Kell system, a high-frequency antigen that is antithetical to K (KEL1).
One of the two types of the light chains. MATCHING
kappa or lambda
Which blood product is recommended for transfusions to individuals with a history of febrile nonhemolytic transfusion reactions? a) leukocyte-reduced red blood cells b) packed red blood cells c) frozen red blood cells d) whole blood
leukocyte-reduced red blood cells
Which of the following facts is not a characteristic of Kell system antibodies? a) usually clinically significant IgG antibodies b) best detected in indirect antiglobulin test phases c) lose reactivity with proteolytic enzyme reagents d) do not bind complement proteins
lose reactivity with proteolytic enzyme reagents
What organ of the recipient's body is involved in a TRALI? a) heart b) lung c) liver d) brain
lung
To what does the abbreviation "MSBOS" refer? a) monthly surgical blood order schedule b) minimum surgical blood order staffing c) maximum blood order schedule d) minimum safe blood order schedule
maximum blood order schedule
When does crossing over occur? a) meiosis b) mitosis c) somatic cell division d) zygote formation
meiosis
Which condition is often associated with the presence of anti-I? a) infectious mononucleosis b) mycoplasma pneumoniae infection c) pregnancy d) colon cancer
mycoplasma pneumoniae infection
Predict the agglutination reaction of red cells from a Bombay phenotype when combined with anti-H lectin. a) strong 4+ b) mixed field c) weak 1+ d) negative
negative
When is the immediate-spin or abbreviated crossmatch an acceptable procedure for the recipient? a) no prior or existing clinically significant antibodies b) never been pregnant or transfused c) needs blood before a sample can be obtained d) using blood from a directed donation
no prior or existing clinically significant antibodies
When type O blood is not available for transfusion for a type O recipient, what is the next alternative? a) group A red blood cells b) group AB red blood cells c) washed group B red blood cells d) none
none
What is the systolic blood pressure minimum requirement for donating blood. a) 80 b) 90 c) 140 d) none of the above
none of the above
Match the storage temperature to the blood product provided. Frozen RBCs MATCHING
none of the above (options were: -18oC, 1-6oC, 20-24oC) right answer is -65oC
What is the most likely cause for this discrepancy? FORWARD Anti-A: 4+ Anti-B: 0 REVERSE A1 cells: 0 B cells: 4+
normal A blood type
If a D-positive person appears to have anti-D in their serum, what is the most likely explanation? a) D-deletion phenotype b) compound antigen c) partial D antigen d) transposition effect
partial D antigen
What type of red cells is used in an autoadsorption to remove antibody from the serum? a) donor red cells b) patient red cells c) antibody screening cells d) antibody identification panel cells
patient red cells
When testing for the A antigen in a patient, what would you use to perform the test? a) patient's plasma and commercial A red cells b) commercial A cells and anti-A c) patient's red cells and anti-A d) none of the above
patient's red cells and anti-A
What does a negative reaction in the MTS Gel Test look like in the gel card? a. layer of cells at the top of the column. b. cells distributed only in the bottom half of the column. c. pellet of cells at the bottom of the column. d. cells evenly distributed throughout the column.
pellet of cells at the bottom of the column.
A patient has a rise in temperature and chills during a transfusion. The transfusion is stopped, and a posttransfusion blood sample is carefully drawn. What should the transfusion service immediately perform upon receipt of this postreaction sample? a) perform a clerical check, observe the color of serum and perform an antibody screen b) perform a clerical check, observe the color of serum and perform a direct antiglobulin test c) perform an antibody screen and a direct antiglobulin test d) perform an antibody screen and a crossmatch
perform a clerical check, observe the color of serum and perform a direct antiglobulin test
If an anti-I is suspected in a patient's sample that requires a transfusion, what is the most acceptable course of action? a) crossmatch cord blood b) perform the prewarm technique c) perform a cold autoadsorption d) call the rare donor registry
perform the prewarm technique
Testing for the weak D expression is performed by: A) using anti-Du antisera with an extended incubation. B) using monoclonal anti-D. C) performing the indirect antiglobulin test with anti-D. D) performing the direct antiglobulin test with anti-D.
performing the indirect antiglobulin test with anti-D. -The weak D test (previously called the Du test) involves the indirect antiglobulin test using anti-D reagent.
Testing for the weak D expression is performed by: a. using anti-Du antisera with an extended incubation. b. using monoclonal anti-D. c. performing the indirect antiglobulin test with anti-D. d. performing the direct antiglobulin test with anti-D.
performing the indirect antiglobulin test with anti-D. -The weak D test (previously called the Du test) involves the indirect antiglobulin test using anti-D reagent.
When an individual is group A, which of the following genetic terms applies? a) alleles b) haplotype c) genotype d) phenotype
phenotype
What is the cause of posttransfusion purpura? a) red cell antibodies b) white cell antibodies c) platelet antibodies d) bacterial contamination
platelet antibodies
Having two or more alleles at a given gene locus. MATCHING
polymorphic
A smooth layer of cells in the bottom of the well is interpreted as a/an ____________ reaction when the solid-phase red cell adherence method is completed for the antiglobulin test: a. positive b. negative c. mixed field d. indeterminate
positive
In relationship testing, a "direct exclusion" is established when a genetic marker is: a) present in the child but absent in both the mother and alleged father. b) present in the child, absent in the mother, and present in the alleged father. c) absent in the child, present in the mother, and the alleged father. d) absent in the child, present in the mother, and absent in the alleged father.
present in the child but absent in both the mother and alleged father
Match the transfusion reaction with the description that best fits. Graft-versus-host disease MATCHING
prevented by irradiation of components
Match the transfusion reaction with the description that best fits. Febrile, nonhemolytic MATCHING
prevented by leukocyte-reduced components
What biological molecules are considered the most immunogenic? a) carbohydrates b) lipids c) proteins d) enzymes
proteins
What is a characteristic of Rh system antibodies? a) weak reactions with panel cells b) strong reactions with panel cells when read at immediate-spin phase c) mixed-field reactions on panels d) reactions that are enhanced with enzymes
reactions that are enhanced with enzymes
When a gene product is expressed only when it is inherited by both parents. MATCHING
recessive
What is an advantage of the MTS gel technology over test tubes when performing panels? a. decreased reagent cost. b. shorter centrifugation time. c. reduced patient sample requirements. d. the incubation step is optional.
reduced patient sample requirements.
What is an advantage of the MTS gel technology over test tubes when performing panels? a. the incubation step is optional. b. shorter centrifugation time. c. reduced patient sample requirements. d. decreased reagent cost.
reduced patient sample requirements.
If an emergency exists and there is not enough time to perform a crossmatch for red cells, what is the correct procedure? a) release group O, D-negative whole blood b) release group O, D-negative RBC units c) release group AB fresh frozen plasma until the blood type is performed d) release ABO-compatible blood based on the patient's prior record in the computer
release group O, D-negative RBC units
What is the next step in the investigation of a positive direct antiglobulin test with polyspecific antihuman globulin reagent? a) repeat the direct antiglobulin test using monospecific anti-IgG and anti-C3 reagents b) repeat the direct anti-globulin test using warm saline c) perform an eluate d) add IgG-sensitized red cells to verify positive reaction
repeat the direct antiglobulin test using monospecific anti-IgG and anti-C3 reagents
Match the phenotype with the most probable genotype in the Weiner nomenclature. ce MATCHING
rr
Which of the following phenotypes will react with anti-f? a) rr b) R1R1 c) R2R2 d) R1R2
rr
Which one of the following transfusion reactions is associated with high fever, shock, hemoglobinuria, and DIC? a) anaphylactic b) sepsis c) circulatory overload d) allergic
sepsis
Extravascular destruction of blood cells occurs in the: a) blood vessels b) lymph nodes c) spleen d) thymus
spleen
Which of the following would disqualify a person from being eligible to donate blood? a) Hgb of 13.5 g/dL b) Hct of 39% c) temperature of 99 oF d) suspected alcohol intoxication
suspected alcohol intoxication
Select the best description of the elution technique. a) technique that disassociates IgG antibodies from red cells for further identification b) technique that disassociates IgM antibodies from red cells for further identification c) technique that adsorbs IgG antibodies from serum d) technique that separates IgG and IgM antibodies in serum
technique that disassociates IgG antibodies from red cells for further identification
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. What is the most likely cause of the discrepancy? a) contaminated reagent antisera b) rouleaux formation c) that the patient has autoantibodies d) that patient has low-titer isoagglutinins
that patient has low-titer isoagglutinins
If two traits occur higher in a population together than each occurs separately, they may be linked. What does this fact suggest? a) they are found far apart on the same chromosome. b) they are inherited on different chromosomes. c) crossover has occurred d) the genes are close together on the same chromosome.
the genes are close together on the same chromosome
A patient is diagnosed with cardiac insufficiency and needs a red blood cell transfusion. How should the transfusion be administered? a) the red blood cell unit should be transfused slowly over a 4-hour period b) the unit should be transfused as whole blood c) diuretics should be administered with the unit d) transfusion should be avoided
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. a) the sample must be labeled at the bedside b) the sample requires a new numeric identifier for the patient for each admittance c) the sample may be labeled at any time in an emergency d) the sample does not require a means to identify the phlebotomist
the sample must be labeled at the bedside
Red cells that phenotype as D-negative indicate that: a. they inherited two D genes. b. there is no genetic material inherited from the RHD gene from both parents. c. a suppressor gene was inherited that is turning off the D gene expression. d. reagents currently in use are not detecting the D antigen.
there is no genetic material inherited from the RHD gene from both parents. -The D-negative phenotype is caused by the absence of genetic material at the RHD gene locus. This lack of genetic material must be inherited from both parents to result in a negative expression.
Why is it sometimes necessary to distinguish A1 and A2 blood types? a) to resolve a discrepancy between the forward and reverse typing b) to prevent A1 recipients from receiving A2 blood c) to determine the secretor status of group A individuals d) to prevent hemolytic disease of the newborn
to resolve a discrepancy between the forward and reverse typing
Mitosis results in ______________________ chromosomes as the original. a. four cells with half as many b. two cells with the same number of c. four cells with the same number of d. two cells with half as many
two cells with the same number of -Mitosis is cell division of somatic cells, resulting in two cells with the same number of chromosomes as the original cell.
In an antibody identification panel, only one red cell 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? a) two more k-negative cells should be tested b) perform an adsorption using "k"-positive cells c) treat the panel cells with enzymes and perform the panel again d) two more K-negative cells should be tested
two more k-negative cells should be tested
Anti-D reagent and the D control were tested with patient's red cells. Both tests were 2+ agglutination reactions. What is the interpretation of the results? a) D-positive b) D-negative c) unable to interpret without further testing d) D-positive if the sample if from a patient
unable to interpret without further testing
A 44-year-old woman has a hemoglobin level of 6.1 g/dL. White blood cell and platelet counts are within normal levels. The patient is group O D-negative with a negative antibody screen. Crossmatches are compatible. However, 15 minutes after the start of the first transfusion, she experiences erythema and hives. What type of transfusion reaction is occurring? a) urticarial b) febrile nonhemolytic c) delayed hemolytic d) acute hemolytic
urticarial
Select the region of the antibody molecule responsible for imparting unique antibody specificity. a) variable region b) constant region c) hinge region d) Fc fragment
variable region
An autoadsorption may be performed to investigate underlying autoantibodies. When is this procedure acceptable? a) when the autoantibody is reactive at 4 oC b) when the patient has not been recently transfused c) only if complement is coating the red cells d) when the eluate is negative
when the patient has not been recently transfused
Match the storage temperature to the blood product provided. Cryopreceipitate MATCHING
-18 degrees C
Match the storage temperature to the blood product provided. FFP (fresh frozen plasma) MATCHING
-18 degrees C
Essay: Explain the primary and secondary immune response.
-During the primary immune response, there is a long lag phase and IgM and IgG antibodies are produced at the same rate. (IgM is first antibody seen) -During the secondary immune response, the lag phase is shorter and the same amount of IgM antibodies are produced as the first immune response. More IgG antibodies are produced during secondary immune response compared to primary immune response. -With each subsequent exposure, the lag phase gets shorter, IgM antibodies are produced at the same rate, and more IgG antibodies are produced than the last exposure.
Short Answer: List the four major blood groups in order from most common to least common.
-O -A -B -AB
Match the storage time frame to the blood product provided. Cryopreceipitate MATCHING
1 year
Match the storage time frame to the blood product provided. FFP (fresh frozen plasma) at -18 degrees C MATCHING
1 year
Match the storage temperature to the blood product provided. Whole blood MATCHING
1-6 degrees C
Match the storage time frame to the blood product provided. Frozen RBC MATCHING
10 years
What is the minimum weight requirement to donate a full unit of blood? a) 90 b) 100 c) 110 d) 120
110
The frequency of the D-negative phenotype in the population is: A) 15%. B) 85%. C) 50%. D) 35%.
15% -Fifteen percent of the population is D-negative.
The frequency of the D-negative phenotype in the population is: a. 15%. b. 85%. c. 50%. d. 35%.
15%. -Fifteen percent of the population is D-negative.
How many units of red blood cells are required to raise the hematocrit of a 70-kg nonbleeding adult man from 24% to 30%? A) 1 B) 2 C) 3 D) 4
2 -Each red cell unit should raise the hematocrit by 3%.
What is the approximate probability of finding a compatible unit of blood for a D-positive patient with antibodies to C, E, and K, if the frequency of C is 70%, E is 30%, and K is 10%? a. 2 out of 10 units b. 4 out of 10 units c. 2 out of 100 units d. 4 out of 100 units
2 out of 10 units -Multiply the negative frequencies for each antigen: C x E x K or 0.30 x 0.70 x 0.90 =0.19, which is about 2 out of 10 units.
Medium sized agglutinates with a clear background would be graded as a ____________ in tube testing. A) 2+ B) 1+ C) 3+ D) 4+
2+
What percentage of the group A population are type as A2? A) 1% B) 10% C) 20% D) 35%
20%
What percentage of the group A population are type as A2? a. 1% b. 10% c. 20% d. 35%
20% -The A2 subgroup is coded by the A2 gene and is essentially a less branched version of the A antigen.
Match the storage temperature to the blood product provided. Platelets MATCHING
20-24 degrees C
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? A) 3 days B) 5 days C) 7 days D) 10 days
3 days -The sample can be used for 72 hours if additional crossmatches are required.
When performing tube testing, what is the appropriate cell suspension for forward typing? A) 3-5% B) .5-1% C) 5-7% D) 0.8%
3-5%
If not stored in a monitored refrigerator, how long can RBC units remain outside the transfusion service to allow reissue? a) 15 minutes b) 30 minutes c) 45 minutes d) 60 minutes
30 minutes
Match the storage time frame to the blood product provided. As-1 Packed RBC MATCHING
30-45 days
At what temperature do we see IgG reacting strongest? A) 56 degrees C B) 4 degrees C C) 37 degrees C D) 22 degrees C
37 degrees
After adding antigen and antibody to a test tube, one large agglutinate was observed. How should this reaction be graded? a) 2+ b) 3+ c) 4+ d) 0
4+
If gene A and B are the only alleles found at a given location and gene A makes up 57% of the gene pool, how much of the genetic material is gene B? A) 57% B) 53% C) 47% D) 43%
43%
In a random population, 16% of the population is homozygous for a particular trait. What percentage of the same population is heterozygous for that particular trait? a) 32% b) 64% c) 48% d) 84%
48% p + q = 1 p^2 + 2pq + q^2 = 100 p^2 and q^2 = homozygous 2pq = heterozygous convert percentages to decimals 16% = .16 p^2 = .16 square root of p^2 = .4 p = .4 1 - .4 = .6 q = .6 2(.4)(.6) = .48 .48 = 48% Using the Hardy Weinberg formula, (p + q)2 = 1.0 therefore the square root of 16 is 4 and 4 + 6 = 1. Since the expanded formula is p2 + 2pq + q2 = 1.0, then 2pq is the heterozygous population, which is 2 x 4 x 6 = 48.
How long must recipient sample be kept in blood bank following compatibility testing
7 days
How long following transfusion must the recipient's sample be stored? A) 5 days B) 7 days C) 10 days D) 14 days
7 days -The recipient's sample should be stored at 1° to 6° C for 7 days in case there is a transfusion reaction that requires investigation.
Approximately what is the percentage of individuals who demonstrate H in their saliva? A) 15% B) 50% C) 80% D) 98%
80%
Approximately what is the percentage of individuals who demonstrate H in their saliva? a) 15% b) 50% c) 80% d) 98%
80%
Match the storage time frame to the blood product provided. Irradiated RBC MATCHING
>30 days -28 days
Why is the determination of the D antigen important for women during pregnancy? a) A D-positive mother can form anti-D during pregnancy that may destroy the D-positive red cells of the fetus b) A D-negative mother should be given Rh immune globulin to prevent potential formation of anti-D during delivery of a D-positive infant c) A D-negative mother may form anti-D if the father of the child is also D-negative d) 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
Why is the determination of the D antigen important for women during pregnancy? A) A D-positive mother can form anti-D during pregnancy that may destroy the D-positive red cells of the fetus. B) A D-negative mother should be given Rh immune globulin to prevent potential formation of anti-D during delivery of a D-positive infant. C) A D-negative mother may form anti-D if the father of the child is also D-negative. D) 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. -D-negative females who are pregnant should be given Rh immune globulin at 28 weeks to prevent the formation of anti-D, which may cause hemolytic disease of the fetus and newborn on subsequent pregnancies. The exposure to the D antigen on delivery of a D-positive fetus triggers the formation of anti-D.
What ABO phenotype would agglutinate in the presence of anti-A,B produced by group O individuals? a) A only b) B only c) A and B d) O only
A and B
What ABO phenotype would agglutinate in the presence of anti-A,B produced by group O individuals? A) A only B) B only C) A and B D) O only
A and B -Group O individuals make anti-A,B, an antibody with a specificity to both the A and B antigens.
Anti-Jsb was identified in a patient scheduled for elective surgery at a later date. What is the best approach to finding compatible blood? a. Contact the rare donor registry since Js(b-) units are rare. b. Request that family members be tested to determine if they share the same phenotype. c. Screen donors from the black population because Js(b-) phenotype is common. d. A and B are correct.
A and B are correct.
Anti-Jsb was identified in a patient scheduled for elective surgery later. What is the best approach to finding compatible blood? A) Contact the rare donor registry since Js(b-) units are rare. B) Request that family members be tested to determine if they share the same phenotype. C) Screen donors from the black population because Js(b-) phenotype is common. D) A and B are correct.
A and B are correct. -Js(b-) individuals are less than 1% of the black population and even rarer in the white donor population. The rare donor registry is the most likely source of units; however, they would probably be stored as frozen red cells. Since the units are not required urgently, family members should be typed to locate potentially compatible blood.
What ABO antibodies are expected to be in an individual that forward types as an O. A) A only B) B only C) A and B only D) O only
A and B only
HLA matching between the donor and recipient is important for progenitor cell transplantation to avoid: a. graft versus host disease (GVHD). b. graft rejection. c. transfusion reactions. d. A and B.
A and B.
Match the antigen to the sugar needed to produce it. N- acetylgalactosamine MATCHING
A antigen
Essay: Explain the concept of dosage in relation to antigen concentration.
A homozygous person will have a higher antigen concentration compared to a heterozygous person because they have two genes creating the same antigen rather than one.
What is an advantage of Nucleic Acid Testing (NAT) for viral marker testing? a. Quicker to perform than most other tests b. More cost effective than traditional test methods c. A small amount of DNA or RNA can be detected d. No problem with cross-contamination of samples
A small amount of DNA or RNA can be detected -Polymerase chain reaction is used for viral marker testing in the blood bank because it can detect very small quantities of viral material in donor samples.
What is the meaning of the term autosomal? a. A trait that is not carried on the sex chromosomes b. A trait that is carried on the sex chromosome c. A trait that is expressed only in the parents d. A gene that does not express a characteristic
A trait that is not carried on the sex chromosomes -Autosomal genetic expression is demonstrated in somatic cells, that is, cells in the body that are not gametes.
A 29-year-old female was admitted to the emergency room with severe bleeding. The blood type was group 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) AB, D positive b) A, D negative c) A, D positive d) O, D negative
A, D negative
What substances are found in the saliva of a group A person who also inherited the secretor gene? A) A, H B) H C) A, Se D) A, B, H
A, H
What substances are found in the saliva of a group A person who also inherited the secretor gene? a. A, H b. H c. A, Se d. A, B, H
A, H -The secretor gene codes for the secretion of H in secretions, allowing the expression of H, as well as the ABO antigens.
A patient admitted to the trauma unit requires emergency release of fresh frozen plasma his blood donor card states he is a group AB, Rh positive. Which of the following blood groups of FFP should be issued
AB
A recipient with group A phenotype requires a transfusion of 2 units of frozen plasma. Which of the following types are appropriate to select for transfusion? A) AB and B B) B and A C) O and A D) AB and A
AB and A
A recipient with group A phenotype requires a transfusion of 2 units of frozen plasma. Which of the following types are appropriate to select for transfusion? a. AB and B b. B and A c. O and A d. AB and A
AB and A -Group AB plasma contains no ABO system antibodies, and group A plasma contains anti-B, which would be compatible with the recipient's red cells.
A recipient with group B phenotype requires a transfusion of 2 units of frozen plasma. Which of the following types are appropriate to select for transfusions? a) AB and B b) B and A c) O and A d) AB and A
AB and B
What is the only blood type that now requires the use of D control? A) A Positive B) AB positive C) O negative D) B Positive
AB positive
Which of the following blood group systems are structurally related to antigens of the Psystem? a. MNS b. ABH c. Kell d. Duffy
ABH
Which of the following blood group systems are structurally related to antigens of the P system? A) MNS B) ABH C) Kell D) Duffy
ABH -The P system antigens are formed by the action of glycosyltransferases, similar to the ABO system genes and antigen products.
Which of the following blood group systems has been implicated in transfusion reactions on the first exposure to incompatible red blood cells? A) Rh B) Kell C) Kidd D) ABO
ABO -Antibodies to the ABO system antigens exist before exposure to blood products.
What is the test procedure that combines patient's serum with commercial A1 and B reagent red cells? A) ABO forward grouping B) ABO reverse grouping C) Antibody screen D) Antibody panel
ABO reverse grouping
What is the test procedure that combines patient's serum with commercial A1 and B reagent red cells? a) ABO forward grouping b) ABO reverse grouping c) antibody screen d) antibody panel
ABO reverse grouping
One group B, D-positive unit of RBCs is received in the transfusion service. What repeat testing is required on this donor unit?
ABO typing only
What test would you run if there is an error in patient or sample identification
ABO/D phenotyping
Short Answer: What are the ISBT numbers for the ABO and H blood group system?
ABO: 001 H: 018
In a family study, all four siblings in the family had a different blood type: A, B, O, and AB. What is the most likely genotypes of the parents? a) AA and BB b) AO and BB c) OO and AB d) AO and BO
AO and BO
What subgroup of A possesses the least amount of A antigen? A) A3 B) Ax C) A2 D) Ael
Ael
What subgroup of A possesses with the least amount of A antigen? a. A3 b. Ax c. A2 d. Ael
Ael -The Ael subgroup requires adsorption and elution procedures to detect the A antigen on the red cells.
LIS interfaces are an important component in automation because of its potential in: a. recognizing errors in sample ID. b. flagging discrepancies with previous test results. c. providing a mechanism for the electronic crossmatch. d. All of the above
All of the above
Which of the following items is required before implementing new automation technology into the transfusion service setting? a. Validation b. Training c. Written procedures d. All of the above
All of the above
An antibody identified in the transfusion service appeared to be reacting stronger followingthe second exposure to an antigen from a transfusion. The most likely explanation of thisobservation is: a. affinity maturation of the immunoglobulin molecule. b. anamnestic response. c. isotype switching. d. All of the above
All of the above -Genetic changes in the variable region, stimulation of memory B cells, and class switching contribute to the increased strength and specificity of an antibody following the second exposure to an antigen.
Which of the following nonimmune mechanisms can lead to a hemolytic reaction to red blood cells? A) Incompatible intravenous solutions mixed with the unit B) Improper storage of the unit C) Bacterial contamination of the unit D) All of the above
All of the above -Mechanisms for nonimmune hemolysis include incompatible intravenous solutions mixed with the unit, improper storage of the unit, or bacterial contamination of the unit. It should be considered if an antibody is not present in the prereaction or postreaction specimen.
Which of the following clinical applications applies to molecular testing for blood group antigens? a. Confirm the D type of blood donors b. Identify fetus at risk for HDFN c. Predict the phenotype of a patient with autoimmune hemolytic anemia d. All of the above
All of the above -Molecular testing for blood group antigens is becoming more common and useful. The technique can predict a red cell phenotype, identify an at risk fetus, confirm a D typing and identify antigen-negative blood donors.
Which of the following is associated with the Rhnull phenotype? A) Membrane abnormalities B) Immunized Rhnull individuals may produce anti-Rh29 C) Mutation of the RhAG regulator gene D) All of the above
All of the above -The Rhnull phenotype lacks all Rh system antigens and is associated with membrane abnormalities. An antibody to all other Rh antigens can be produced if a null person becomes immunized and Rhnull blood would be required for transfusion. One of the mechanisms for inheritance of this phenotype is a mutation in the regulator gene called RhAG.
What can be done to increase the sensitivity of the antibody screen in a compatibility test? A) Extend the incubation time. B) Increase the serum-to-cell ratio. C) Use an enhancement such as polyethylene glycol. D) All of the above are correct.
All of the above are correct -Extending the incubation time, increasing the serum to cell ratio, and using an enhancement such as polyethylene glycol will all increase sensitivity.
Why have Lewis system antibodies not been implicated in hemolytic disease of the fetus and newborn? A) The antigens are not fully developed at birth. B) Lewis system antibodies do not cross the placenta. C) The antibodies are not clinically significant. D) All of the above are correct.
All of the above are correct. -Lewis antibodies are often found during pregnancy but do not cross the placenta because they are IgM. The antigens are not well developed at birth.
How is RNA different from DNA? a) RNA usually exists as a single strand b) the sugar ribose is substituted for deoxyribose. c) the basic uracil exists only in RNA. d) All of the above are true
All of the above are true -RNA usually exists as a single strand -the sugar ribose is substituted for deoxyribose. -the basic uracil exists only in RNA.
What test are included in a compatibility testing a. Blood typing of recipient b. Antibody screening of recipient c. crossmatch d. All the above
All the above
Match the transfusion reaction with the description that best fits. Delayed hemolytic MATCHING
Alloantibodies to red cell antigens
Amplified target sequences of DNA produced by polymerase chain reaction: a. Primer b. Polymerase chain reaction c. Hybridization d. Probe e. Amplicon DNA sequence
Amplicon DNA sequence
What characterizes the Donath-Landsteiner antibody? A) An IgG auto anti-P. B) An IgM auto anti-I. C) Anti-IH that reacts at cold temperatures. D) An IgG anti-Pk.
An IgG auto anti-P -The Donath-Landsteiner antibody is a biphasic hemolysin that binds at colder temperatures in the body (extremities) and activates complement to cause hemolysis at warmer temperatures.
What forward typing reagent can be used to confirm group O units before placing them in inventory? A) Anti-A B) Anti-B C) Anti-A,B D) Anti-H
Anti-A,B
According to Landsteiner's rule (law), what ABO antibody will be detected in a group A individual's serum? A) Anti-A B) Anti-B C) Anti-A,B D) None
Anti-B
According to Landsteiner's rule (law), what ABO antibody will be detected in a group A individual's serum? a. Anti-A b. Anti-B c. Anti-A,B d. None
Anti-B -According to Landsteiner, a person is expected to demonstrate the ABO antibody to the antigen he or she lacks on the red cells.
Predict the probable antibody's identity if all red cells tested at room temperature are positive with a patient's serum except for cord cells. a) anti-Lu b) anti-Le^a c) anti-I d) anti-M
Anti-I
Predict the probable antibody's identity if all red cells tested at room temperature are positive with a patient's serum except for cord cells. A) Anti-Lu B) Anti-Lea C) Anti-I D) Anti-M
Anti-I -The I antigen is found on adult red cells, not on cord red cells. Anti-I reacts best at colder temperatures.
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 incompatible crossmatches with one 1 of 10 random donor units? a. Anti-K b. Anti-E c. Anti-P1 d. Anti-k
Anti-K
Select the statement that is FALSE regarding anti-P1. a. Anti-P1 will not react with enzyme-treated P1 positive red cells. b. P2 individuals can make anti-P1. c. Anti-P1 is clinically not significant. d. Anti-P1 reacts best at room temperature.
Anti-P1 will not react with enzyme-treated P1 positive red cells.
Select the statement that is FALSE regarding anti-P1. A) Anti-P1 will not react with enzyme-treated P1 positive red cells. B) P2 individuals can make anti-P1. C) Anti-P1 is clinically not significant. D) Anti-P1 reacts best at room temperature.
Anti-P1 will not react with enzyme-treated P1 positive red cells. -Anti-P1 is an IgM alloantibody that is made by P2 individuals and reacts best at colder temperatures
If D-negative red cells are transfused to an R1R1 individual, what is the most likely Rh antibody that could develop? A) Anti-E B) Anti-d C) Anti-D D) Anti-c
Anti-c -Anti-c could develop since the recipient is c-negative and the donor is most likely rr or ce/ce.
An anti-E was identified in a patient who recently received a transfusion. What other Rh system antibody should be investigated? A) Anti-G B) Anti-f C) Anti-D D) Anti-c
Anti-c -Anti-c is often found in patients who make anti-E. Anti-c is often weaker and shows dosage when the patient is developing the antibody from the first exposure to the antigen.
An anti-E was identified in a patient who recently received a transfusion. What other Rh system antibody should be investigated? a. Anti-G b. Anti-f c. Anti-D d. Anti-c
Anti-c -Anti-c is often found in patients who make anti-E. Anti-c is often weaker and shows dosage when the patient is developing the antibody from the first exposure to the antigen.
What is displayed on an antigram? A) Antigens that can be found in antiseras used for blood typing B) Antibodies that can be found on blood cells used for antibody identification C) Antigens that can be found on blood cells used for antibody identification D) Antibodies that can be found in antiseras used for blood typing
Antigens that can be found on blood cells used for antibody identification
A donor unit with a positive DAT would cause reactions at what phase of the crossmatch? a. Antiglobulin b. None; it would be compatible c. All phases d. Immediate-spin
Antiglobulin
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. What is the proper interpretation of this 2+-agglutination reaction? A) Antihuman globulin washing procedure was adequate. B) IgG-sensitized red cells spontaneously agglutinated. C) Crossmatch was incompatible. D) Patient's anti-E reacted with the IgG-sensitized red cells.
Antihuman globulin washing procedure was adequate. -IgG-sensitized red cells should be positive if adequate washing was performed and antihuman globulin reagent was added.
Match the transfusion reaction with the description that best fits. Acute hemolytic MATCHING
Assocaited with ABO incompatibilities
The mixed lymphocyte culture (MLC) is a procedure that has been used in HLA testing to determine: a. class I HLA antigen determination. b. class II HLA antigen determination. c. HLA antibody identification. d. compatibility testing for tissue typing. e. B and D.
B and D.
Match the antigen to the sugar needed to produce it. D- Galactose MATCHING
B antigen
Select the cell involved in humoral immunity. a. Neutrophils b. T lymphocytes c. B lymphocytes d. Monocytes
B lymphocytes -B lymphocytes have the ability to transform into plasma cells to produce antibodies, which isconsidered a humoral response.
What process is described by opsonization? a. Lysis of cells b. Binding to cells or antigens c. Ingestion of cells d. Phagocytosis
Binding to cells or antigens -Opsonization promotes phagocytosis by binding to cells or antigens.
Polyspecific AHG will contain? A) Both Anti-IgG and Anti-C3 B) Anti-IgG only C) Anti-C3 only D) It depends on the reagent manufacturer
Both Anti-IgG and Anti-C3
How is it genetically possible for a child to phenotype as D-negative? a) both parents are heterozygous D-positive b) both parents are homozygous D-positive c) Mom is homozygous D-positive, and Dad is heterozygous D-positive d) the sibling is D-positive
Both parents are heterozygous D-positive
In the complement cascade, lysis of the target cell is mediated by which of the followingcomponents? a. C1qrs b. C4a, C3a, and C5a c. C5 to C9 d. C3a and C3b
C5 to C9 -The membrane attack complex includes the C5 to C9 proteins that mediate lysis of the target cell.
Match the Fisher-Race notation with the correct Weiner notation for the following: r^y MATCHING
CE
Antigens Yta and Ytb are in this system: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
Cartwright
Match the Fisher-Race notation with the correct Weiner notation for the following: r' MATCHING
Ce
The TANGO, PROVUE, and NEO all use one of the following reagents or components in the indirect antiglobulin test. a. Centrifuge b. Indicator cells c. Washing mechanism d. Antihuman globulin
Centrifuge
Antibodies are sensitive to enzymes and have high-titer low-avidity characteristics: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
Chido/Rodgers
Most blood groups show what type of inheritance pattern? A) Independent segregation B) Dominant/Recessive C) Codominance D) Independent assortment
Codominance
Hemolysis was observed at room temperature when testing a patient's serum with reagent red cells used for screening. When this test was repeated using the patient's plasma, no hemolysis was observed. What was the most likely explanation for the different reactions? a) the plasma sample was collected incorrectly b) the serum sample was contaminated c) complement activation was inhibited by calcium in the plasma sample d) the serum sample was fresher
Complement activation was inhibited by calcium in the plasma sample
Select the portion of the antibody molecule that imparts the antibody's unique class function. a. Constant region of the heavy chain b. Constant region of the light chain c. Variable region of the heavy chain d. Variable region of the light chain
Constant region of the heavy chain -The heavy-chain constant region has the function of the class.
What test to Texar logical incompatibility between donor RBCs and recipient serum
Crossmatch
Select the substance that regulates the activity of other cells by binding to specific receptors. a. Cytokines b. Complement c. Immunoglobulins d. Anaphylatoxin
Cytokines -Cytokines are proteins secreted by cells that regulate the activity of other cells by binding to specific receptors.
How would you label a donor who tested negative with anti-D reagent upon immediate-spin and positive in antihuman globulin test? a) D-positive b) D-negative c) cannot label; more testing needed
D-positive
How would you label a donor who tested negative with anti-D reagent upon immediate-spin and positive in antihuman globulin test? A) D-positive B) D-negative C) Cannot label; more testing needed
D-positive -Donors are required to be tested for the weaker D expression by the antihuman globulin test with the unit labeled as D-positive.
The LW antigen expression is typically stronger on _____________ red cells. a. D-positive b. D-negative c. Rh null d. D-variant
D-positive -The original anti-D found by experiments with rhesus monkeys was actually anti-LW that reacts best with D-positive cells.
Short Answer: In Rosenfield, what are the numbers associated with the 5 major antigens in the Rh blood group system?
D: 004001 C: 004002 E: 004003 c: 004004 e: 004005
Which test is a snapshot of what is going on right now in the patients body (vivo)? A) DAT B) IAT C) BFG D) AHG
DAT
Match the Fisher-Race notation with the correct Weiner notation for the following: R^z MATCHING
DCE
Match the Fisher-Race notation with the correct Weiner notation for the following: R^0 MATCHING
Dce
Which of the following tests is not included in routine compatibility testing? a) ABO phenotyping b) Direct antiglobulin test c) D typing d) Antibody screen
Direct antiglobulin test
Which lectin can be used to distinguish A2 from A1 antigens? A) Iberis Amara B) Ulex Europaeus C) Vicia Graminea D) Dolichos Biflorus
Dolichos Biflorus
To distinguish between an A1 and A2 blood type, which reagent is used? A) Ulex europeaus lectin B) Anti-A,B C) Monoclonal anti-A D) Dolichos biflorus lectin
Dolichos biflorus lectin
To distinguish between an A1 and A2 blood type, which reagent is used? a) Ulex europeaus lectin b) anti-A,B c) monoclonal anti-A d) Dolichos biflorus lectin
Dolichos biflorus lectin
Which of the following is not a common source of antigen in Blood bank testing? A) Donor RBC units B) Donor plasma units C) Screen cells D) Reverse typing cells
Donor plasma units
Antibodies to which of the following blood group system show dosage (i.e., are stronger with homozygous expression of the antigen)? a. Lutheran b. P c. Duffy d. Kell
Duffy
System associated with resistance to malaria: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
Duffy
What blood group antigens have been identified as the attachment site for some plasmodium species? a) Kell b) Lutheran c) Duffy d) Kidd
Duffy
Antibodies to which of the following blood group system show dosage (i.e., are stronger with homozygous expression of the antigen)? A) Lutheran B) P C) Duffy D) Kell
Duffy -Stronger reactions are typically seen with red cells that have a "double dose" of the antigen in the Duffy system.
The term used to denote the actual site of antibody attachment to an antigen? A) Epitope B) Autologous C) Hapten D) Allogenic
Epitope
What portion of the antibody will bind to the antigenic determinant A) Fab B) Hinge C) Fc D) Constant region
Fab
A woman with the genotype AO would be considered homozygous. A) True B) False
False
If two genes are located on the same chromosome of a homologous pair they are said to be trans. A) True B) False
False
The determination of the ABO and D type by the NEO and ECHO uses the same solid-phase red cell adherence technique that is used for the antibody screen. a. True b. False
False
True or False Parents, who both phenotype as group A, cannot have a group O child.
False -If the parents are both heterozygous (AO), two O genes can be inherited by the offspring.
What portion of the antibody molecule binds to receptors on macrophages and assists in the removal of antibody bound to red cells? a) Fab fragment b) Hinge region c) Fc fragment d) J chain
Fc fragment
Which theory of Rh inheritance states that there are 3 genetic loci for the Rh antigens. a) Weiner b) Fisher-race c) Tippet d) Rosenfield
Fisher-race
Which of the following phenotypes is heterozygous? a) Fy(a-b+) b) Jk(a+b-) c) Fy(a+b+) d) Le(a+b-)
Fy(a+b+)
Which of the following phenotypes is heterozygous? A) Fy(a-b+) B) Jk(a+b-) C) Fy(a+b+) D) Le(a+b-)
Fy(a+b+) -If both alleles Fya and Fyb are present on the red cell, the genetic expression is heterozygous.
The segment of DNA that encodes for a particular protein is: A) Antithetical B) Gene C) Allele D) Chromosome
Gene
Essay: Define the following: genetic loci, alleles, antithetical
Genetic loci: sites on a gene of a chromosome Alleles: alternate forms of a gene at a given locus Antithetical: opposite antigens encoded at the same locus --polymorphic: genetic system that expresses 2 or more alleles at one locus--
Select the clinical sign that is not associated with a hemolytic transfusion reaction. A) Disseminated intravascular coagulation B) Renal failure C) Shock D) Graft-versus-host disease
Graft-versus-host disease -Kidney failure, shock, and disseminated intravascular coagulation are clinical signs of hemolytic transfusion reactions. These signs are due to the presence of excessive hemoglobin breakdown products. Graft-versus-host disease is a result of leukocytes given to an immunocompromised patient.
Which of the following blood products requires a crossmatch before issuing? A) Group AB fresh frozen plasma that is transfused to a group O B) Human leukocyte antigen-matched platelets C) Cryoprecipitated AHF D) Granulocyte concentrates that have more than 2 mL of red blood cells
Granulocyte concentrates that have more than 2 mL of red blood cells -Granulocytes may contain a significant amount of red blood cells because they are obtained from the "buffy coat" layer during apheresis. These units would require crossmatching before release.
What is the most likely cause for this discrepancy? FORWARD Anti-A: 4+ Anti-B: 1+ REVERSE A1 cells: 0 B cells: 4+
Group A with Acquired B
A patient who is AB D negative requires 1 unit of plasma. Which of the following units of plasma would be best for transfusion a. Group A, D neg b. Group B, D pos c. Group AB, D pos d. Group O, D neg
Group AB, D pos
A patient's red cells are agglutinated by anti-B, but not by anti-A. What is this patient's ABO phenotype? A) Group B B) Group O C) Group AB D) Group A
Group B
A patient's red cells are agglutinated by anti-B, but not by anti-A. What is this patient's ABO phenotype? a. Group B b. Group O c. Group AB d. Group A
Group B -Anti-B reacts with the B antigen, which is the blood type identified.
Which of the following situations is most likely to cause intravascular hemolysis when an incompatible transfusion is given? A) Group B packed cells to a group O recipient B) Group A packed red cells to a group AB recipient C) Group AB plasma to a group A recipient D) Group AB plasma to a group O recipient
Group B packed cells to a group O recipient
Given the following ABO phenotyping data: FORWARD Anti-A: 2+ mf Anti-B: 0 REVERSE: A1 cells: 0 B cells: 3+ What could be a plausible explanation for this discrepancy? A) T-activation of red cells B) Group O blood products given to group A C) Rouleaux formation D) Positive direct antiglobulin test
Group O blood products given to group Au
A group A man marries a group AB woman. The father of the group A man was group O. What possible ABO phenotypes could be expected in the offspring? A) Groups A, B, AB, and O B) Groups A and B C) Groups A, B, and AB D) Groups A and AB
Groups A, B, and AB
What substances are found in the saliva of a group O person who also inherited the secretor gene? a) A, H b) H c) O, Se d) A, B, H
H
Match the antigen to the sugar needed to produce it. l- Fucose MATCHING
H antigen
Short Answer: Explain the concept of high and low incidence antigens and give an example of each.
High incidence: majority of population has the antigen (ex. Js^b) Low incidence: majority of population does NOT have antigen (ex. Js^a)
Imparts flexibility to the immunoglobulin molecule. MATCHING
Hinge region
Of the following markers used to test for paternity, which marker provides the most useful statistical value? a. Human leukocyte antigen typing b. D antigens c. ABO system antigens d. The Kidd system (Jka, Jkb)
Human leukocyte antigen typing -Human leukocyte antigen typing provides most statistical value because of the polymorphism of the major histocompatibility complex.
The binding of two complementary pairs of DNA: a. Primer b. Polymerase chain reaction c. Hybridization d. Probe e. Amplicon DNA sequence
Hybridization
What is the typical specificity of cold autoantibodies? a) I b) M c) N d) Le^b
I
Found in secretions, such as breast milk: a. IgA b. IgM c. IgG d. IgE
IgA
What antibodies cause an anaphylactic transfusion reaction? a) IgA b) IgG c) IgE d) all of the above
IgA
Associated with allergic reactions and mast cell activation: a. IgA b. IgM c. IgG d. IgE
IgE
Able to cross the placenta: a. IgA b. IgM c. IgG d. IgE
IgG
Has the highest serum concentration: a. IgA b. IgM c. IgG d. IgE
IgG
What immunoglobulin class is capable of crossing the placenta? a) IgM b) IgA c) IgE d) IgG
IgG
What is the immunoglobulin class of the most Rh system antibodies? a) IgM b) IgG c) IgA d) IgE
IgG
Which immunoglobulin class is impacted by the zeta potential in a hemagglutination test? a. IgM b. IgG c. IgA d. IgE
IgG -IgG antibodies are smaller in size versus IgM antibodies. They cannot span the distance between red cells in a saline solution due to the forces of repulsion.
What is the immunoglobulin class of most Rh system antibodies? A) IgM B) IgG C) IgA D) IgE
IgG -Rh system antibodies are IgG, requiring the indirect antiglobulin test to detect.
What incompatibilities are detected in the antiglobulin phase of a crossmatch
IgG alloantibodies in recipient's serum
What incompatibilities are detected in the anti-globulin phase of a crossmatch
IgG alloantibodies in recipients serum
K-positive donor red cells were mistakenly transfused to a recipient with anti-K. The patient'sposttransfusion blood sample has a positive direct antiglobulin test with polyspecificantihuman globulin. The direct antiglobulin test is positive because anti-K is an __________antibody that has sensitized the __________ cells in vivo. a. IgG, donor's b. IgM, donor's c. IgG, recipient's d. IgM, recipient's
IgG, donor's
K-positive donor red cells were mistakenly transfused to a recipient with anti-K. The patient's posttransfusion blood sample has a positive direct antiglobulin test with polyspecific antihuman globulin. The direct antiglobulin test is positive because anti-K is an __________ antibody that has sensitized the __________ cells in vivo. A) IgG, donor's B) IgM, donor's C) IgG, recipient's D) IgM, recipient's
IgG, donor's -The anti-K in the recipient attached to the K antigen on the transfused donor red cells, which will cause them to be prematurely cleared by the spleen.
Associated with immediate-spin in vitro reactions: a. IgA b. IgM c. IgG d. IgE
IgM
Associated with intravascular cell destruction: a. IgA b. IgM c. IgG d. IgE
IgM
Efficient in activation of the complement cascade: a. IgA b. IgM c. IgG d. IgE
IgM
Has the highest number of antigen binding sites: a. IgA b. IgM c. IgG d. IgE
IgM
Select the immunoglobulin class produced first in the primary immune response. a) IgG b) IgE c) IgA d) IgM
IgM
What immunoglobulin class reacts best at room temperature at immediate-spin? a) IgM b) IgA c) IgE d) IgG
IgM
What is the immunoglobulin class of antibodies detected in the immediate-spin crossmatch? a) IgA b) IgM c) IgG d) IgD
IgM
Most "naturally occurring" ABO system antibodies fall into which immunoglobulin class? A) IgA B) IgM C) IgE D) IgG
IgM -ABO system antibodies are in the IgM class, which can agglutinate at immediate-spin and activate the complement cascade.
Most "naturally occurring" ABO system antibodies fall into which immunoglobulin class? a. IgA b. IgM c. IgE d. IgG
IgM -ABO system antibodies are in the IgM class, which can agglutinate at immediate-spin and activate the complement cascade.
During the primary immune response we typically see _____________ antibodies being produced, however during the secondary immune response we will typically see________________ antibodies A) IgG, IgM B) IgM, IgG C) IgG, IgG D) IgM, IgM
IgM, IgG
Short Answer: Explain how a person inherits the U antigen.
In order to inherit U antigen, an individual must inherit at least one version of S antigen (S and/or s) If the individual doesn't inherit any form of the S antigen then they don't express the U antigen.
In order to enhance the reaction of an antibody in vitro, it may be necessary to adjust which ofthe following? a. Temperature above 37 C b. Speed of the centrifuge above the calibrated settings c. Increase the concentration of red cells in the test system d. Increase the incubation time in the incubator
Increase the incubation time in the incubator -Increasing incubation time is effective in increasing antibody reactions; however, optimal temperatures, centrifugation, and antigen concentrations are normally not altered when performing routine transfusion service testing. The manufacturer package insert should be followed to stay within the upper incubation time allowed and prevent dissociation of the antigen from the antibody.
Select the appropriate strategy if the results of red cell and serum testing in the ABO typing procedure have negative agglutination reactions. A) Wash patient cells with warm saline. B) Use polyclonal typing reagents. C) Perform an autocontrol. D) Incubate tubes at room temperature or 4° C with an autocontrol.
Incubate tubes at room temperature or 4° C with an autocontrol.
Select the appropriate strategy if the results of red cell and serum testing in the ABO typing procedure have negative agglutination reactions. a. Wash patient cells with warm saline. b. Use polyclonal typing reagents. c. Perform an autocontrol. d. Incubate tubes at room temperature or 4° C with an autocontrol.
Incubate tubes at room temperature or 4° C with an autocontrol. -ABO antibodies are stronger at room temperature or lower. The autocontrol determines whether the enhanced antibody reaction was due to the ABO antibodies or to a cold reacting antibody. The autocontrol should be negative for the ABO typing to be valid.
Short Answer: Explain the concept of a biphasic hemolysin. How do we prove it is present in Vitro?
It binds to red blood cells only at cold temperatures and causes complement mediated hemolysis only after warming to body temperature. Put sample in the refrigerator and let it bind then warm up the sample and it will hemolyze.
Anti-D, anti-K, and anti-Jk^a are the antibodies that are tentatively identified on a panel after initially ruling out on negative cells. What selected cell from another panel should be chosen to confirm the presence of anti-K? a) K+, D+, Jk(a+) b) K+. D-, Jk(a+) c) K-, D+, Jk(a+) d) K+, D-, Jk(a-)
K+, D-, Jk(a-)
System associated with McLeod phenotype: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
Kell
System associated with chronic granulomatous disease: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
Kell
Which blood group antigens show susceptibility to sulfhydryl reagents? a) Kell b) Kidd c) Duffy d) Lewis
Kell
Antibodies from which blood group are often implicated in delayed hemolytic transfusion reactions? a) Kell b) Kidd c) Duffy d) MNS
Kidd
Antibodies to which blood group system is often implicated in delayed transfusion reactions? a) Kell b) ABO c) Duffy d) Kidd
Kidd
Which of the following blood group shows antigens that are enhanced by enzymes? a) Kell b) Duffy c) Kidd d) Lutheran
Kidd
The lack of which antigen causes the inheritance of the McLeod phenotype? a) K b) Kx c) k d) Kpa
Kx
What phenotype will be expressed when the Le, Se, and H genes are inherited? A) Le(a+b+) B) Le(a-b+) C) Le(a-b-) D) Le(a+b-)
Le (a-b+) -Inheriting H, Se, and Le genes will allow the Lewis transferase to convert H to Leb antigen and to be absorbed onto the red cells.
What phenotype will be expressed when the Le, Se, and H genes are inherited? a. Le(a+b+) b. Le(a-b+) c. Le(a-b-) d. Le(a+b-)
Le(a-b+)
What phenotype will be expressed when the le, Se, and H genes are inherited? a) Le(a+b+) b) Le(a-b+) c) Le(a-b-) d) Le(a+b-)
Le(a-b-)
Short Answer: If a fucose is added to the n acetyl glucosamine of a type 1 oligosaccharide chain, what antigen is produced? What about if we add the same sugar to the same position on an H antigen?
Le^a (Lewis a) Le^b (Lewis b)
Which of the following facts is not a characteristic of Kell system antibodies? A) Usually clinically significant IgG antibodies B) Best detected in indirect antiglobulin test phases C) Lose reactivity with proteolytic enzyme reagents D) Do not bind complement proteins
Lose reactivity with proteolytic enzyme reagents -Proteolytic enzymes do not affect the Kell system antigens.
Why are antibodies to Lu^b antigen not commonly detected? a) Lu^b antigen is of high incidence b) the antibodies do not cause transfusion reactions c) Lu^b antigen is not present on screening cells d) the antibodies react best at 4 oC
Lu^b antigen is of high incidence
Why are antibodies to Lub antigen not commonly detected? A) Lub antigen is of high incidence. B) The antibodies do not cause transfusion reactions. C) Lub antigen is not present on screening cells. D) The antibodies react best at 4° C.
Lub antigen is of high incidence. -Lub antigen occurs at an incidence of greater than 99%.
System associated with glycophorin A and B: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
MNSs
Crossing over occurs during: A) It does not occur during cellular division B) Mitosis C) Normal cellular division D) Meiosis
Meiosis
In a delayed hemolytic transfusion reaction, what is a typical DAT result? A) Negative B) Positive due to C3 C) Mixed field positive D) Very strongly positive
Mixed field positive -Due to the small number of circulating donor cells that may be sensitized with the antibody, the DAT is often mixed field and weakly reacting.
What heavy chain is part of the IgM molecule? A) Mu B) Epsilon C) Delta D) Gamma
Mu
Which condition is often associated with the presence of anti-I? A) Infectious mononucleosis B) Mycoplasma pneumoniae infection C) Pregnancy D) Colon cancer
Mycoplasma pneumoniae infection -High-titer auto anti-I is often found in patients with Mycoplasma pneumoniae infections.
Predict the agglutination reaction of red cells from a Bombay phenotype when combined with anti-H lectin. A) Strong 4+ B) Mixed field C) Weak 1+ D) Negative
Negative
All panel and screen cells must be what blood type? A) A B) AB C) B D) O
O
The children of a group AB mother and a group B father could phenotype as all of the following except: a) O b) A c) B d) AB
O
Which ABO phenotype selection contains the most H antigen and the least H antigen, respectively, on the red cell's surface? A) O, A1B B) A2, A1B C) B, A D) A1B, O
O, A1B
Which ABO phenotype selection contains the most H antigen and the least H antigen, respectively, on the red cell's surface? a) O, A1B b) A2, A1B c) B, A d) A1B, O
O, A1B
Which of the following is a source of false positive results in antiglobulin testing? A) Improper incubation time B) Inadequate cell washing C) Over centrifugation D) Under centrifugation
Over centrifugation
Short Answer: What are the five phenotypes that can be seen in the P and Glob blood group system?
P1 P2 P1k P2k p
Which of the following instruments performs assays using gel technology? a. ECHO b. TANGO c. PROVUE d. NEO
PROVUE
If a D-positive person appears to have anti-D in their serum, what is the most likely explanation? A) D-deletion phenotype B) Compound antigen C) Partial D antigen D) Transposition effect
Partial D antigen -A person with a partial D antigen, who is exposed by pregnancy or transfusion to the complete D antigen, could potentially make an antibody that appears to be anti-D because it reacts with all D-positive cells on a panel, but not with D-negative cells. The antibody is actually directed to the part of the D epitope missing on the red cells.
Short Answer: What is the Bombay phenotype?
People who cannot produce the H antigen because they did not inherit the H antigen. Their genotype is hh.
An antibody screen on a patient with a prior history of transfusion was negative. The patient had an indication to perform an AHG crossmatch on file. The crossmatch was incompatible with 1 of 5 units selected at AHG phase. What is the next step in the investigation? A) Perform a prewarm procedure for crossmatching B) Perform a direct antiglobulin test on the incompatible unit C) Redraw the patient and begin a new crossmatch D) Crossmatch a new unit and discard the incompatible unit
Perform a direct antiglobulin test on the incompatible unit -The most likely reason for the incompatibility is that the blood unit has a positive direct antiglobulin test or the patient has developed an antibody to a low-frequency antibody. If the direct antiglobulin test is negative, testing the patient's serum against a selected cell panel of low-frequency antigen-positive cells should be performed.
Ten days after 2-unit RBC transfusion, a patient experienced a 2 g/dL drop in hemoglobin and appeared slightly jaundiced. No evidence of bleeding was observed. What test would be helpful in determining whether the patient is experiencing a related hemolytic transfusion reaction?
Perform an antibody screen and DAT on the current posttransfusion sample.
Essay: Explain the difference between phenotype and genotype.
Phenotype and genotype are both expressions of a gene. Phenotype is the physical/observable expression of the gene (ex. A blood type) Genotype is the specific genes in the genetic makeup (ex. AO)
Using an antisera to determine the antigens located on the surface of a cell is: A) Gel testing B) Agglutination C) Solid phase D) Phenotyping
Phenotyping
Technique used to replicate a specific DNA sequences: a. Primer b. Polymerase chain reaction c. Hybridization d. Probe e. Amplicon DNA sequence
Polymerase chain reaction
The term used to denote the strength of antigen and antibody reaction is? A) Continuity B) Specificity C) Potency D) Sensitivity
Potency
Select the item that compatibility procedures will not address. a) Prevent formation of all red cell antibodies b) prevent life-threatening transfusion reactions c) maximize in vivo survival rate of red cells d) Check ABO compatibility
Prevent formation of all red cell antibodies
Marks the sequence to be amplified during PCR: a. Primer b. Polymerase chain reaction c. Hybridization d. Probe e. Amplicon DNA sequence
Primer
In the PCR reaction, what is the term for the short pieces of single-stranded DNA that are complementary and mark the sequence to be amplified? a. Nucleotides b. Polymerases c. Primers d. Amplicons
Primers -Complementary strands of DNA that mark the target DNA for the initiation of replication during PCR are called primers.
Short segment of DNA with a known sequence that can be labeled with a marker: a. Primer b. Polymerase chain reaction c. Hybridization d. Probe e. Amplicon DNA sequence
Probe
The best immunogens are classified as? A) Protiens B) Lipids C) Simple Carbohydrates D) Complex Carbohydrates
Proteins
Each of the following genotypes is possible for an individual whose red cells react as indicated below except: a. R1R2. b. R1r". c. Rzr. d. R0r'.
R0r'
Each of the following genotypes is possible for an individual whose red cells react as indicated below except: ANTISERA REACTIONS: anti-C: + anti-D: + anti-E: + anti-c: + anti-e: + A) R1R2. B) R1r". C) Rzr. D) R0r'.
R0r'. -The R0r' genotype expresses the C, c, D, and e antigens, but it does not express the E antigen.
Match the phenotype with the most probable genotype in the Weiner nomenclature. DCe MATCHING
R1R1
A patient phenotypes as D+C+E-c-e+. Predict the most likely genotype. A) R1r B) R1R1 C) R1r' D) R1R0
R1R1 -R1R1 fits the phenotype and is also the more common of the choices given.
A patient phenotypes as D+C+E-c-e+. Predict the most likely genotype. a. R1r b. R1R1 c. R1r' d. R1R0
R1R1 -R1R1 fits the phenotype and is also the more common of the choices given.
Match the phenotype with the most probable genotype in the Weiner nomenclature. DCce MATCHING
R1r
An individual's red cells gave the following reactions with antisera: Anti-D: 4+ Anti-C: 3+ Anti-E: 0 Anti-c: 3+ Anti-e: 3+ Rh control: 0 The most probable genotype is: A) R1R2. B) R2r. C) R0r. D) R1r.
R1r. -The most probable genotype is based on the antigens present and the frequency of each allele in the population, thus since red cells that have this phenotype are most likely CDe/ce, the type is also expressed as R1r
An individual's red cells gave the following reactions with antisera: Anti-D 4+, Anti-C 3+, Anti-E 0, Anti-c 3+, Anti-e 3+, Rh control 0 The most probable genotype is: a. R1R2. b. R2r. c. R0r. d. R1r.
R1r. -The most probable genotype is based on the antigens present and the frequency of each allele in the population, thus since red cells that have this phenotype are most likely CDe/ce, the type is also expressed as R1r.
Match the phenotype with the most probable genotype in the Weiner nomenclature. DcE MATCHING
R2R2
In antiglobin crossmatch is performed with the donor RBC unit. The antiglobulin crossmatch results in a 2+ agglutination reaction what is the most likely explanation for test results?
Recipient possess an IgG alloantibody
Which of the following is necessary to prevent an anaphylactic reaction due to a known IgA antibody in a patient? A) All red blood cell units should be irradiated. B) Red blood cell units should be washed. C) All blood components should be leukocyte-reduced. D) Patient should be given antihistamine before transfusion.
Red blood cell units should be washed. -Blood products should be washed or from a donor who is IgA deficient.
Poor platelet response is also known as? A) Lattice formation B) Refractoriness C) Sensitization D) Secondary immune response
Refractoriness
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 is an acceptable procedure? A) Request a recollection of the specimen. B) Call the phlebotomist back to relabel the tube. C) Reprint a label using the MRI as the identifier. D) Use the tube since the MRI is visible.
Request a recollection of the specimen. -Tubes used for crossmatching must have the patient's name, unique number, date and time of collection and phlebotomist identifier at the minimum. Tubes that do not have proper labels should not be used and recollection is necessary.
Current theory regarding the genetics of the Rh system suggests that: a) each Rh system antigen is coded by its own gene locus. b) Rh system antigens are coded by two closely linked genes c) one gene locus with multiple alleles codes for the protein antigens d) the Rh system genes are a haplotype that codes for three sets of alleles
Rh system antigens are coded by two closely linked genes
What is the most likely cause for this discrepancy? FORWARD Anti-A: 4+ Anti-B: 4+ REVERSE A1 cells: 2+ B cells: 2+
Rouleaux
Antibody to this antigen demonstrates weak mixed field reaction: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
Sda antigen
The phase of agglutination where we initially bind the antigen to the antibody without any cross-linkage is referred to as: A) Lattice formation B) Sensitization C) Solid phase reactivity D) Antigenic determination
Sensitization
Which of the following will cause an antigen to elicit a greater immune response? a. Small antigen size b. Composed largely of carbohydrates c. Size greater than 10,000 daltons d. Similarity to the host
Size greater than 10,000 daltons -Antigens will elicit a better immune response if they are larger than 10,000 daltons, areforeign to the host, and are made of proteins.
Match the transfusion reaction with the description that best fits. Urticarial MATCHING
Symptoms include hives and itching
The use of only male donors as a source of plasma for transfusion is a method to reduce the risk of: a) allergic reactions b) circulatory overload c) TRALI d) febrile reactions
TRALI
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. What is the most likely cause of the discrepancy? A) Contaminated reagent antisera B) Rouleaux formation C) That the patient has autoantibodies D) That patient has low-titer isoagglutinins
That patient has low-titer isoagglutinins
Random access is an important feature in selecting an automated instrument for testing in the transfusion service. What is random access? a. The ability to accommodate STAT testing b. The recognition of various types of barcodes c. Ability of multiple users to sign into the system d. The need for minimal maintenance procedures
The ability to accommodate STAT testing
Why is it dangerous to transfuse a group O person with the unit a group A blood
The patients anti-A would destroy the donors cells with severe consequences to the patient
Phenotype is defined as: A) The physical expression of inherited traits B) The actual genetic makeup of an individual
The physical expression of inherited traits
Essay: Parents who both phenotype as group A, cannot have a group O child. Is this statement correct? Prove it with a punnett square and explain your answer.
The statement is NOT correct. If both parents are heterozygous for A (AO) then there is a 25% chance of their offspring being an O blood type. A O A AA AO O AO OO
What is the purpose in the antibody screen? A) To ensure compatibility with a donor unit B) To detect antibodies to RBC antigens C) To detect ABO antibodies D) To ID RBC surface antigens
To detect antibodies to RBC antigens
Why is it sometimes necessary to distinguish A1 and A2 blood types? A) To resolve a discrepancy between the forward and reverse typing B) To prevent A1 recipients from receiving A2 blood C) To determine the secretor status of group A individuals D) To prevent hemolytic disease of the newborn
To resolve a discrepancy between the forward and reverse typing
The group O blood type is an example of an amorphic gene, meaning there is no detectable product. A) True B) False
True
True or False It is possible for a test to be precise but not accurate.
True
True or False: All subgroups of A with the exception of A1 can produce an antibody to the A1 antigen.
True
True or False: Hemolysis is always viewed as a positive reaction in blood bank due to complement activation.
True
Match the type of oligosaccharide chain to the best fit. Beta 1-3 linkage MATCHING
Type 1 oligosaccharide chain
Match the type of oligosaccharide chain to the best fit. Body fluids and secretions MATCHING
Type 1 oligosaccharide chain
Match the type of oligosaccharide chain to the best fit. Beta 1-4 linkage MATCHING
Type 2 oligosaccharide chain
Match the type of oligosaccharide chain to the best fit. Blood cells MATCHING
Type 2 oligosaccharide chain
Red cells that phenotype as S-s- are also: a) M-negative b) N-negative c) Tj^a-negative d) U-negative
U-negative
Red cells that phenotype as S-s- are also: A) M-negative. B) N-negative. C) Tja-negative. D) U-negative.
U-negative -When S and s are absent from the membrane, the high-frequency antigen U is also absent.
Anti-D reagent and the D control were tested with patient's red cells. Both tests were 2+ agglutination reactions. What is the interpretation of the results? A) D-positive B) D-negative C) Unable to interpret without further testing D) D-positive if the sample is from a patient
Unable to interpret without further testing -The Rh control should be negative for the test to be valid.
Which of the following transfusion reactions has the highest incidence? A) Hemolytic reactions due to ABO incompatibility B) Urticarial C) Graft-versus-host disease D) Transfusion-related acute lung injury
Urticarial -Because allergic reactions cannot be prevented or predicted, they are the most common reaction.
Antigen of high incidence; its antibody can cause hemolytic transfusion reactions: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
Vel
If anti-M was reacted with red cells that are M+N+, how would they compare with red cells that are M+N-? a. Stronger b. Weaker c. The same d. Varies with the method
Weaker -Because M+N+ cells are heterozygous, the "dosage" of the M antigen is less and would therefore be weaker in reaction strength. M+N+ is weaker compared to M+N-
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? a. X-linked dominant b. X-linked recessive c. Autosomal dominant d. Autosomal recessive
X-linked dominant -Because the father passed the trait to only his daughters, it was carried on the X chromosome.Because only one is needed for expression, this is a dominant genetic trait.
Antigen has a higher frequency in females: a. Cartwright b. MNSs c. Kidd d. Vel e. Xga f. Sda antigen g. Chido/Rodgers h. Kell i. Duffy
Xga
If a mother is type O and a Father is A, can they have a type O child? A) Yes, all of the children will be type O B) Yes, but only if the father is homozygous AA C) Yes, but only if the father is heterozygous AO D) No all of the children will be type A
Yes, but only if the father is heterozygous AO
A person whose red cells type as M+N+ with antisera would be: a) a homozygote b) a heterozygote c) unable to be determined without family studies d) linked
a heterozygote
The weak D test detects: a) the Du antigen b) the missing D mosaic c) a weak D antibody d) a weak D antigen
a weak D antigen
The weak D test detects: A) the Du antigen. B) the missing D mosaic. C) a weak D antibody. D) a weak D antigen.
a weak D antigen. -The weak D test is the antiglobulin test for the D antigen, which is more sensitive and better able to detect weak D antigen expression.
The PROVUE, TANGO, and NEO have the ability to perform all of the following tests except: a. ABO/D typing. b. antibody ID panels. c. direct antiglobulin test. d. acid elution.
acid elution
Under what circumstance would a direct antiglobulin test be negative in the presence of a hemolytic process? a) bacterial contamination of the unit b) medications administered with the unit c) red blood cell unit transfused quickly through a leukocyte reduction filter d) all of the above
all of the above -bacterial contamination of the unit -medications administered with the unit -red blood cell unit transfused quickly through a leukocyte reduction filter
Which of the following is associated with the Rh null phenotype? a) membrane abnormalities b) immunized Rh null individuals may produce anti-Rh29 c) mutation of the RhAG regulator gene d) all of the above
all of the above -membrane abnormalities -immunized Rh null individuals may produce anti-Rh29 -mutation of the RhAG regulator gene
Which of the following situations can be found in a classic state of autoimmune hemolytic anemia? a) positive direct antiglobulin test b) false-positive Fy^a phenotyping c) crossmatch incompatibility at antihuman globulin d) all of the above
all of the above -positive direct antiglobulin test -false-positive Fy^a phenotyping -crossmatch incompatibility at antihuman globulin
Why have Lewis system antibodies not been implicated in hemolytic disease of the fetus and newborn? a) the antigens are not fully developed at birth b) lewis system antibodies do not cross the placenta c) the antibodies are not clinically significant d) all of the above are correct
all of the above are correct -the antigens are not fully developed at birth -lewis system antibodies do not cross the placenta -the antibodies are not clinically significant
When using the Hardy-Weinberg equation to calculate genetic frequencies, which of the following must be TRUE? a) the population statistics must be large b) mutations cannot occur c) matings must be random d) all of the above are true
all of the above are true -the population statistics must be large -mutations cannot occur -matings must be random
Select the term that describes cells or tissue from a genetically different individual within the same species. a) allogenic b) autologous c) xenogenic d) autograft
allogenic
A gene that does not express a detectable product. MATCHING
amorphic genes
What characterizes the Donath-Landsteiner antibody? a) an IgG auto anti-P b) an IgM auto anti-I c) anti-IH that reacts at cold temperatures d) an IgG anti-P^k
an IgG auto anti-P
According to Landsteiner's rule (law), what ABO antibody will be detected in a group B individual's serum? a) anti-A b) anti-B c) anti-A,B d) none
anti-A
What forward typing reagent can be used to confirm group O units before placing them in inventory? a) anti-A b) anti-B c) anti-A,B d) anti-H
anti-A,B
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 oC and the antihuman globulin phase of testing. What is the most likely responsible antibody? a) anti-E b) anti-I c) anti-Le^a d) anti-D
anti-Le^a
An antibody was detected at immediate-spin and 37 oC that appeared to have anti-Le^b specificity. To confirm the antibody identity and determine if there were other antibodies in the serum, a Lewis neutralization technique was performed. Patient serum + Lewis substance = 0 Patient serum + saline control = 1+ Neutralization serum + Fy(a+b+) red cell = 0 What conclusion can be made from these results? a) antibody was not neutralized, therefore anti-Le^b has not been identified b) antibody other than anti-Le^b is most likely in the serum c) antibody was diluted, therefore no conclusion can be made d) anti-Le^b is confirmed
anti-Le^b is confirmed
Select the example of a cold alloantibody. a) anti-M b) anti-k c) anti-I d) anti-Lu^b
anti-M
A recipient is 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? a) anti-E b) anti-C c) anti-c d) anti-D
anti-c
If D-negative red cells are transfused to an R1R1 individual, what is the most likely Rh antibody that could develop? a) anti-E b) anti-d c) anti-D d) anti-c
anti-c
Which of the following is responsible for the activation of the classic pathway of complement? a) bacteria b) foreign proteins c) virus d) antibody bound to antigen
antibody bound to antigen
In a serologic test, the term prozone is also known as: a) equivalence b) antigen excess c) antibody excess d) serum-to-cell ratio
antibody excess
If all antibody identification panel cells were reactive at the same strength at the antihuman globulin phase, no negative reactions were observed, and the autocontrol was negative, what antibody should be suspected? a) antibody to a low-frequency antigen b) multiple antibody specificities c) antibody to a high-frequency antigen d) warm autoantibody
antibody to a high-frequency antigen
An antigen that originates from the individual is termed: a) autologous b) allogenic c) hapten d) immunogen
autologous
How are most blood group systems inherited? a) autosomal recessive b) autosomal dominant c) sex-linked recessive d) autosomal codominant
autosomal codominant
The numeric Rh4 nomenclature refers to which antigen in the Rosenfield notation? a) C b) c c) e d) E
b) c Rh1: D Rh2: C Rh3: E Rh4: c Rh5: e