blood Bank Exam (Ch. 2, 3, & 4)
Which of the following components in the complement cascade mediates the lysis of the target cells? a. C1qrs b. C4a, C3a, and C5a c. C5 to C9 d. C3a and C3b
C5 to C9
You have added IgG-sensitized red cells to the negative indirect antiglobulin test result in the antibody screen procedure. You observe no agglutination in the tube. What is the interpretation for this antibody screen? a. Positive b. Negative c. Cannot determine
Cannot determine
In which source are the regulations regarding the manufacturing of blood banking reagents published? A. Code of Federal Regulations B. AABB Standards for Blood Banks and Transfusion Services C. AABB Technical Manual D.AABB Accreditation Requirements Manual
Code of Federal Regulations
What of the following describes the expression of most blood group inheritance? A. Dominant B. Recessive C. Sex-linked D.Codominant
Codominant
Select the sources of antigen for immunohematology testing. a. Patient red cells and plasma b. Commercial and patient red cells c. Patient plasma and commercial red cells d. Commercial antisera and red cells
Commercial and patient red cells
What source of antigen is selected to determine the presence of a red cell antibody in a patient sample A. Commercial reagent red cells B. Commercial antisera C. Patient serum D.Patient's red cell
Commercial antisera
What source of antibody is selected to determine the specificity of a red cell antigen in a patient sample? A. Commercial reagent red cells B. Commercial antisera C. Patient serum D.Patient plasma
Commercial reagent red cells
To determine the presence of a red cell antibody in a patient's sample, what is the source of antigen? A. Commercial reagents red cells B. Commercial antisera C. Patient serum D.Patient red cells
Commercial reagents red cells
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.
Compliment activation was inhibited by calcium in the plasma
What characteristic is associated with monospecific AHG reagents? A. Increase the dielectric constant in vitro B. Contain either ant-IgG or anti-C3d antibody specificities C. Are not useful in identifying the molecule causing a positive DAT D.Contain human IgG or complement molecules
Contain either anti-IgG or anti-C3d antibody specificities
What is the name of synthetic single-stranded DNA that determines the sequence of DNA for amplification in the PCR reaction? A. Amplicons B. Nucleotides C. DNA primer D.Taq polymerases
DNA primer
What term is used when red cells with the genotype MM react stronger with anti-M than red cells with genotype MN? A. Trans effect B. Dosage effect C. Cis effect D.Suppressor effect
Dosage effect
Select the term that describes the unique part of the antigen that is recognized by a corresponding antibody. A. Immunogen B. Epitope C. Avidity D.Clone
Epitope
In transfusion medicine, what is the name of the process whereby antibodies attached to red cell antigens signal clearance in the liver and spleen? a. Classical complement pathway b. Intravascular hemolysis c. Alternative complement pathway d. Extravascular hemolysis
Extra vascular hemolysis
What regulatory agency provides licensure for blood banking reagents? A. AABB B. FDA C. American Red Cross D.College of American Pathologists
FDA
An antibody molecule can possess one kappa and one lambda light chain. a.True b.False
False
Parents, who both phenotype as group A, cannot have a group O child. a. True b. False
False
What is the potential effect in a tube agglutination result if a red cell suspension with a concentration less than 5% is used? a. False negatives b. False positives c. Hemolysis d. No effect
False negatives
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
Select the method that uses the principle of sieving to separate larger agglutinates from smaller agglutinates in Ag-Ab reactions. A. Gel technology B. Solid-phase adherence C. Microplate D.None of the above
Gel technology
In relationship testing, what is the criterion for a direct exclusion? A. Genetic marker is absent in child but present in the mother and alleged father B. Genetic marker is absent in the child, present in mother, and absent in the alleged father C. Genetic marker is present in the child, absent in the mother, and present in the alleged father D.Genetic marker is present in the child, but absent in both the mother and the alleged father
Genetic marker is present in the child, but absent in both the mother and the alleged father.
What genetic information is provided by DNA assays for red cell antigens? A. Loci location B. Phenotype C. Polymorphism D.Genotype
Genotype
What is the chemical composition of an antibody? A. Protein B. Lipid C. Carbohydrate D.Glycoprotein
Glycoprotein
What part of the immunoglobulin molecule distinguishes the isotype? a. Light chain b. Heavy chain c. Kappa chain d. Lambda chain
Heavy chain
What term describes the inheritance of two of the same allele from each parent? A. Homozygous B. Allele C. Heterozygous D.Syntenic
Homozygous
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
Found in mucosal linings A. IgA B. IgG C. IgM D. IgE
IgA
Can initiate allergic reactions A. IgA B. IgG C. IgM D. IgE
IgE
Able to cross the placenta A. IgA B. IgG C. IgM D. IgE
IgG
Detected with the antiglobulin test A. IgA B. IgG C. IgM D. IgE
IgG
Highest plasma/serum concentration A. IgA B. IgG C. IgM D. IgE
IgG
What antibodies are best detected at 37° C and can cause immune-mediated destruction of transfused red cells possessing the corresponding antigen? a. IgM b. IgG c. Both IgM and IgG d. Neither IgM nor IgG
IgG
Which immunoglobulin class is impacted by the zeta potential in a hemagglutination test? a. IgM b. IgG c. IgA d. IgE
IgG
Activates the complement cascade most efficiently A. IgA B. IgG C. IgM D. IgE
IgM
Associated with the intravascular cell destruction A. IgA B. IgG C. IgM D. IgE
IgM
Contains 10 antigen-binding sites A. IgA B. IgG C. IgM D. IgE
IgM
Detected in the immediate-spin phase of the agglutination test A. IgA B. IgG C. IgM D. IgE
IgM
Produced early in a immune response A. IgA B. IgG C. IgM D. IgE
IgM
Reacts best at room temperature A. IgA B. IgG C. IgM D. IgE
IgM
Shape is a pentamer A. IgA B. IgG C. IgM D. IgE
IgM
Rouleaux is a false-positive reaction caused by elevated serum protein levels. Which of the following tests would not likely be affected by an elevated protein level? a. Immediate-spin antibody screen b. Direct antiglobulin test c. Reverse typing in the ABO test d. ABO forward typing
Immediate -spin antibody screen
Select a source of a potential false-positive result in antiglobulin testing. a. Improper centrifugation b. Failure to identify weak positive reactions c. Failure to incubate at 37° C d. Contamination of reagent with human serum
Improper centrifugation
Why is polyethylene glycol reagent added to the screen or panel? a. Enhance detection of IgM antibodies. b. Eliminate the reactivity of certain antigens. c. Increase the avidity of IgG antibodies. d. Eliminate the need for washing in the indirect antiglobulin test.
Increase the avidity of IgG antibodies
Which of the following requires adjustment in order to enhance the reaction of an antibody in vitro? 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
Which of the following situations can enhance hemagglutination reactions? A. Testing at a temperature higher than 37 C B. Increasing the incubation time C. Increasing the antigen concentration D.Making the pH greater than 7
Increasing the incubation time
What is the mode of inheritance when the genes are located close together on the same chromosome? A. Inherited as a haplotype B. Crossover C. Show independent assortment D.Suppress each other
Inherited as a haplotype
With which of the following red cell phenotypes would anti-Jka react most strongly? A. Jk (a-b+) B. Jk (a+b-) C. Jk (a+b-) D.Jk (a-b-)
Jk (a+b-)
What potentiator works by increasing the rate of antibody uptake? a. Bovine serum albumin b. Polyethylene glycol c. LISS d. Ficin
LISS
What reagents are derived from plant extracts? A. Panel cells B. Commercial anti-B C. Lectins D.Antiglobulin reagents
Lectins
What term is defined as the phenomenon of antigens occurring at a different frequency in the population, depending on whether they were inherited by linked or unlinked genes? a. X-linked dominant b. X-linked recessive c. Linkage disequilibrium d. Autosomal recessive
Linkage disequilibrium
What cells can produce antibodies? Natural killer cells B. T cells C. Macrophages Plasma cell
Lipid
Which of the following red cell phenotypes would react most strongly with anti-M? a. M+N+ b. M+N− c. M−N+ d. M−N−
M+N-
Primer? a. Short segment of DNA with a known sequence that can be labeled with a marker b. Technique used to replicate a specific DNA sequences c. The binding of two complementary pairs of DNA d. Marks the sequence to be amplified during PCR e. Amplified target sequences of DNA produced by polymerase chain reaction
Marked the sequence to be amplified during PCR
When does crossing over occur? a. Meiosis b. Mitosis c. Somatic cell division d. Zygote formation
Meiosis
Can you accurately interpret a patient's group AB, D-positive result in ABO and D typing tests using monoclonal antibody reagents without additional testing? a. Yes b. No
No
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
Where is the antigen located in a hemagglutination test? A. On the red cell membrane B. Secreted by the red cell C. In the red cell nucleus D.In the plasma or serum
On the red cell membrane
Where is a gene inherited in a cis positon to another gene located? A. On an opposite chromosome B. On a different chromosome number C. On the same chromosome D.Antithetical
On the same chromosome
Select the phrase that defines the term antiherical. A. Similar gene B. Opposite allele C. Opposite antigen D.Heterozygous gene
Opposite antigen
What describes molecules that bind to an antigen to increase phagocytosis? A. Opsonins B. Cytokines C. Haptens D.Isotypes
Opsonins
What is the name of the technique that uses a small amount of DNA and amplifies it for identification? A. RFLP B. DNA probe C. PCR D. Gene mapping
PRC
After the addition of anti-D reagent to a patient's red cell suspension, agglutination was observed. The result with anti-A reagent was negative. What is interpretation of this patient's D typing? A. Patient is D-negative B. Patient is D-positive C. Cannot interpret the test D.Invalid results
Patient is D-positive
After addition of anti-A reagent to a patient's red cell suspension, agglutination was observed. The result with anti-B reagent was negative. What is the interpretation of this patient's ABO typing? A. Patient is group B B. Patient is group A C. Cannot interpret this test D.False-positive results
Patient is group A
What process is described by the engulfment of antibody-coated red cells? a. Lysis of cells b. Binding to cells or antigens c. Agglutination d. Phagocytosis
Phagocytosis
The patient's red cell _____________ is determined by hemagglutination of red cell antigens using specific antisera. a. phenotype b. genotype c. haplotype d. idiotype
Phenotype
What genetic information is provided by hemagglutination testing for red cell antigens? A. Genotype B. Phenotype C. Zygosity D.Polymorphism
Phenotype
What call can produce antibodies? a. nature killer cells b. T cells c. macrophages d. Plasma Cell
Plasma Cell
Which red cells are used to screen for antibodies in donor samples? a. Screening cells (two vials) b. Pooled screening cells c. Panel cells d. Screening cells (three vials)
Pooled screening cells
After performing a tube test, the supernatant of the test was pinkish ad the red cell button was small. How do you interpret the results of this test? A. False-positive B. False-positive C. Positive D.Negative
Positive
The FDA has established minimum standards relating to product quality for use in blood banks and transfusion services before assignment of license to a commercial reagent. What term relates to the strength of the product? a. Potency b. Specificity
Potency
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.
Where can you locate information regarding reagent limitations? A. SOPs B. Blood bank computer system C. Product inserts D.Product catalogs
Product inserts
What biological molecules are considered the most immunogenic? a. Carbohydrates b. Lipids c. Proteins d. Enzymes
Proteins
What term describes technical procedures to determine whether the analytic testing phase is working properly? a. Quality assurance b. Specificity testing c. Quality control d. Reference standards
Quality control
What type of genetic inheritance trait is expressed by the group O phenotype? a. Codominant b. X-linked c. Dominant d. Recessive
Recessive
In molecular techniques for HLA typing, which high-resolution method analyzes the nucleotide sequence to define the allele? A. SSP B. SSO C. STR D.SBT
SBT
Select the reagent to use for detection of unexpected red cell antibodies in a patient's serum sample. A. A1 and B cells B. Panel cells C. IgG-sensitized cells D.Screening cells
Screening cells
What type of immune response occurs within 1 to 3 days of exposure and contains a significant production of memory B cells? a. Primary b. Secondary c. Tertiary d. None of the above
Secondary
Probe a. Short segment of DNA with a known sequence that can be labeled with a marker b. Technique used to replicate a specific DNA sequences c. The binding of two complementary pairs of DNA d. Marks the sequence to be amplified during PCR e. Amplified target sequences of DNA produced by polymerase chain reaction
Short segment of DNA with a known sequence that can be labeled with a marker
Molecular tests on samples from hematopoietic progenitor cell transplant recipients are used to determine if engraftment is successful. What is the name of this method? A. Sequence-specific primer (SSPs) B. Sequence-based typing (SBT) C. Short tandem repeats (STRs) D.Sequence-specific oligonucleotide probes (SSOPs)
Short tandem repeats (STRs)
Extravascular destruction of blood cells occurs in the: a. blood vessels. b. lymph nodes. c. spleen. d. thymus.
Spleen
Polymerase chain reaction a. Short segment of DNA with a known sequence that can be labeled with a marker b. Technique used to replicate a specific DNA sequences c. The binding of two complementary pairs of DNA d. Marks the sequence to be amplified during PCR e. Amplified target sequences of DNA produced by polymerase chain reaction
Technique used to replicate a specific DNA sequence
You have added IgG-sensitized red cells to a negative indirect antiglobulin test. You observe agglutination in the tube. What situation was not controlled for in testing by adding these control cells? A. The addition of patient serum B. The addition of AHG reagent C. Adequate washing of cell suspension D.Adequate potency of AHG reagent
The addition of patient serum
Hybridization? a. Short segment of DNA with a known sequence that can be labeled with a marker b. Technique used to replicate a specific DNA sequences c. The binding of two complementary pairs of DNA d. Marks the sequence to be amplified during PCR e. Amplified target sequences of DNA produced by polymerase chain reaction
The binding of two complementary pairs of DNA
Solid-phase red cell adherence used for antibody detection has an advantage over tube testing because: a. there is no washing involved. b. incubation time is not necessary. c. the endpoint is more clearly defined d. indicator cells (IgG-coated cells) are not necessary.
The endpoint is more clearly defined
Which of the following items is a useful genetic marker for relationship testing? A. All races have the same gene frequencies B. The genetic system is polymorphic C. There are no amorphic genes D.Recombination is common
The genetic system is polymorphic
The antiglobulin test was performed using gel technology. A button of cells was observed at the bottom of the microtube following centrifugation. How do you interpret this result? a. There is a problem with the card. b. The result is a negative reaction. c. The result is a strong positive reaction. d. The test was not washed correctly.
The result is a negative reaction
In PCR testing, the initial step involves adding the DNA in question to a mixture of Taq polymerase, excess nucleotides, MgCl2, and primers. Where does the amplification process take place? A. Flow cytometer B. Capillary array sequence C. Thermal cycler D.Electrophoresis chambe
Thermal cycler
Which of the following statements is true regarding high-protein anti-D reagents? a. They have been largely replaced with low-protein monoclonal reagents. b. They contain high concentrations of bovine albumin. c. They may increase the possibility of a false-positive reaction, requiring the use of a control. d. All of the above are true.
They have been largely replaced with low- protein monoclonal reagents.
Which of the following statements is true regarding IgG-sensitized red cells? a. They must be used to confirm a negative antiglobulin tube test. b. They must be used to confirm a positive antiglobulin test. c. They must be used to confirm a direct antiglobulin test that was negative with anti-C3d. d. They should be used only with the indirect antiglobulin test.
They must be used to confirm a negative anti globulin test
What is the purpose of including a reagent control when interpreting group AB, D-positive red cell after testing with a low-protein anti-D reagent? A. To detect false-positive agglutination reactions B. To detect false-negative agglutination reactions C. To identify a mix-up with a patient's sample D.To confirm ABO typing results
To detect false-positive agglutination reactions
Commercial antibody screening and panel cells always use group O. What is the reason for this choice? a. To avoid spontaneous agglutination b. To avoid significant hemolysis over time c. To prevent loss of agglutination strength over time d. To prevent reactions with anti-A and anti-B
To prevent reactions with anti-A and anti-B
Parents who both phenotype as group O cannot have a group AB child. a.True b.False
True
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
What lectin possesses the specificity for the H antigen? a. Iberis amara b. Dolichos biflorus c. Ulex europaeus d. Vicia graminea
Ulex eiropaeus
How would you interpret the results if both the anti-D reagent and the Rh control were 2+ agglutination reactions? a. D-positive b. D-negative c. Unable to determine without further testing d. Depends on whether the sample was from a patient or a blood donor
Unable to determine without further testing
What term describes the number of antigen-binding sites per molecule of antibody? A. Valency B. Bivalent C. Isotype D.Idiotype
Valency
When Ce is inherited in trans to D gene, what happens to the D antigen expression on the red cell? a. Stronger b. Weaker c. The same d. Varies with the method
Weaker
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
After adding antigen and antibody to a test tube, small agglutinates with many unagglutinated cells were observed. How should this reaction be graded? a. 1+ b. 2+ c. 3+ d. 4+
1+
How would you grade an agglutination reaction if you observe many small agglutinnates in a background of free cell in tube testing? A. 1+ B. 2+ C. 3+ D.4+
1+
Following centrifugation of the gel card, red cells are evenly dispersed throughout one of the microtubes. This reaction could be graded as a: a. 4+. b. 3+. c. 2+. d. 1+.
2+
In a random population, 25% of the population is homozygous for a particular trait. What percentage of the same population is heterozygous for that particular trait? a. 12% b. 37.5% c. 6.25% d. 56.25%
37.5%
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+
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%
Patient RJ types as group O with anti-D and anti-K alloantibodies and requires one unit of RBCs. What percentage of the white population would be compatible with her serum (group O = 0.45; D- = o.15: K- = 0.91)? A. 3% B. 6% C. 20% D.50%
6%
What is the approximate probability of finding a compatible unit of blood for a D-negative patient with antibodies to E and K, if the frequency of D is 85%, E is 30%, and K is 10%? a. 3 units out of 100 b. 6 units out of 100 c. 9 units out of 100 d. 12 units out of 100
9 units out of 100
When an individual phenotypes as group A, which of the following genotypes may apply? a. AA b. AO c. AA or AO d. None of the above
AA or AO
Why are group O red cells used as a source for commercial screening cells? A. Anti-A is detected using group O cells B. Anti-D reacts with most group O cells C. Weak subgroups of A reacts with group O cells D.ABO antibodies do not react with group O cells
ABO antibodies do not react with group O cells
How does complement activation demonstrate within the body? A. Cell lysis B. Enhanced cell clearance C. Neutrophil activation D. Generation of vasoactive amines E.All of the above
All of the above
How is RNA different from DNA? a. RNA usually exists as a single strand. b. The sugar ribose is substituted for deoxyribose. c. The base uracil exists only in RNA. d. All of the above are true.
All of the above are true
Which of the following is not an advantage of using a monoclonal antibody over a polyclonal antibody? a. There are very few variations between lots. b. There are no contaminating antibodies. c. Direct agglutination is usually faster. d. All variations of the antigen can be detected
All variations of the antigen can be detected
What term describes alternate forms of a gene at given genetic loci? A. Alleles' B. Amplicons C. Nucleotides D.Amorphs
Alleles'
Select the term that defines short sequences of amplified DNA flanked on either end by the primer. a. PCR b. Sequence-specific primers c. Single-nucleotide polymorphisms d. Amplicon
Amplicon
Amplicon DNA sequence? a. Short segment of DNA with a known sequence that can be labeled with a marker b. Technique used to replicate a specific DNA sequences c. The binding of two complementary pairs of DNA d. Marks the sequence to be amplified during PCR e. Amplified target sequences of DNA produced by polymerase chain reaction
Amplified target sequences of DNA produced by polymerase chain reaction.
What is the term for a gene that does not express a detectable product? A. An amorph B. A cis gene C. A trans gene D.A regulator gene
An amorph
What antibodies are present in polyspecific AHG reagent? A. Anti-IgG B. Anti-IgM and anti-IgG C. Anti-IgG and anti-C3d D. Anti-C3d
Anti-IgG and anti-C3d
Part of the daily quality control in the blood bank laboratory is the testing of reagent antisera with corresponding antigen- positive and antigen-negative red cells. What does this procedure ensure? A. Antibody class B. Antibody titer C. Antibody specificity D.Antibody sensitivity
Antibody specificity
Select the test method that may use a rabbit polyclonal anti-IgG. a. D phenotype b. Reverse ABO grouping c. Forward ABO grouping d. Antiglobulin test
Antiglobulin test
What document provides the antigen phenotypes for each donor used in the manufacture of commercially supplied screening and panel cells? a. Product insert b. Antigram c. Red cell profiles d. Donor phenotypes
Antigram
What is the classification of red cell antibodies produced in response to transfusion and pregnancies? a. Naturally occurring antibodies b. HLA antibodies c. Alloantibodies d. Autoantibodies
Autoantibodies
Select the cells that will undergo transformation to become plasma cells. a. Neutrophils b. T lymphocytes c. B lymphocytes d. Monocytes
B lymphocytes
Which term defines a group of antigens on the red cell membrane that share related serologic properties and genetic patterns of inheritance? A. Meiosis B. Regulator system C. Blood group system D.Molecular classification
Blood group system
