Blood Bank Final

A Group AB, Rh positive patient needs 4 units of blood, STAT. Your blood bank inventory is as follows: AB, Rh positive 2 units AB, Rh negative 0 units A, Rh positive 10 units A, Rh negative 6 units B, Rh positive 4 units B, Rh negative 0 units O, Rh positive 20 units O, Rh negative 4 units Which units should be selected for crossmatching? 4 units of Group B, Rh positive 2 units of Group AB, Rh positive; 2 units of Group A, Rh positive 4 units of Group O, Rh negative 4 units of Group O, Rh positive

2 units of Group AB, Rh positive; 2 units of Group A, Rh positive

If a person who is Rh negative is mistakingly transfused with a unit of Rh positive blood, what is the probable outcome? delayed hemolytic transfusion reaction 100% probability of sensitization to the D antigen 50-70% probability of sensitization to the D antigen immediate intravascular hemolytic transfusion reaction

50-70% probability of sensitization to the D antigen

Hemolyzed specimens are unacceptable for compatibility testing because: hemolysis can be indicative of a positive reaction and may indicate in-vitro complement activation by IgM. antibody neutralization may occur in hemolyzed samples A and B only agglutination reactions may be missed

A and B only

Which of the following genotypes would expain RBCs typed as group A Le(a+b-)? A/O Lele HH Sese A/O LeLe hh SeSe A/A Lele HH sese A/A LeLe hh sese

A/A Lele HH sese

A person forward groups as AB, with 4+ reactions noted for both the anti-A and the anti-B reagent antisera. On reverse grouping, which of the following sets of reactions would be expected? A1 cells negative A2 cells negative B cells negative A1 cells postive A2 cells postive B cells postive A1 cells postive A2 cells negative B cells postive A1 cells negative A2 cells postive B cells negative

A1 cells negative A2 cells negative B cells negative

If the person describe in questions #18 is in fact group A2, which set of reverse reactions would identify the presence of anti-A1 in the person's plasma/serum? A1 cellls negative A2 cells negative B cells positive A1 cells positive A2 cells positive B cells positive A1 cells positive A2 cells negative B cells positive A1 cells negative A2 cells positive B cells positive

A1 cells positive A2 cells negative B cells positive

If the person describe in questions #18 is in fact group A2, which set of reverse reactions would identify the presence of anti-A1 in the person's plasma/serum? A1 cells negative A2 cells positive B cells positive A1 cellls negative A2 cells negative B cells positive A1 cells positive A2 cells negative B cells positive A1 cells positive A2 cells positive B cells positive

A1 cells positive A2 cells negative B cells positive

Which of the following genotypes is not possible from the mating of a group O mother and a group A father? A1O A1A2 A2O OO

A1A2

An ABO type on a patient gives the following reactions: Patient Cells With Patient Serum/Plasma With Anti-A: Anti-B: A1 Cells: B cells: 4+ 4+. Neg Neg O AB A B

AB

Which of the following statements concerning modern transfusion practice is false? a donor who Rh types as weak D should be considered Rh positive the standard of practice for processing donated units of blood includes antibody screening on donor units blood to be transfused should be negative for any antigens that have a corresponding antibody detected in the recipient AB negative units are kept in reserve due to their usefulness as universal donors

AB negative units are kept in reserve due to their usefulness as universal donors

Consider the following results: Anti-A Anti-B A cells B cells Anti-D Rh control 4+ 4+. 0 0 3+ 0 AB negative O positive O negative AB positive

AB positive

Immediate spin saline (room temperature) is useful in the crossmatch to detect: presence of Kell antigen-antibody reactions low-titer Kidd antibodies ABO incompatibility incompatibility due to partient having anti-E

ABO incompatibility

The immediate spin crossmatch is used to detect ABO incompatibility IgG alloantibodies Rh incompatibility Warm autoantibodies

ABO incompatibility

Which antibody is most commonly associated with delayed hemolytic transfusion reactions? Anti-s Anti-Jka Anti-Lua Anti-k

Anti-Jka

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

Anti-K

Antibody detection cells will not routinely detect which antibody specificity? Anti-M Anti-Lub Anti-Fya Anti-Kpa

Anti-Kpa

Which one of the following antibodies is most likely to be detected at low temperatures? Anti-E Anti-M Anti-Jka Anti-K

Anti-M

Which autoantibody specificity is found in patients with paroxysmal cold hemoglobinuria? Anti-I Anti-i Anti-P Anti-P1

Anti-P

Rz

CDE

R1

CDe

ry

CdE

r'

Cde

The B antigen has which of the following carbohydrates added to H substance? L-fucose L-galactose N-acetylglucose D-galactose

D-galactose

The null K0 RBC can be artificially prepared by which of the following treatments? Glycine-acid EDTA and sialidase Ficin and DTT Ficin and glycine-acid EDTA DTT and glycine-acid EDTA

DTT and glycine-acid EDTA

A person forward groups as A with only a 2+ reaction noted for reagent anti-A and anti-A,B. What test result would indicate that this person is A2rather than A1? Ulex europaeus lectin negative Ulex europaeus lectin positive Dolichos biflorus lectin negative Dolichos biflorus lectin positive

Dolichos biflorus lectin negative

Enzymes destroy all of the following antibodies EXCEPT Xga N M E

E

A patient on chemotherapy who forward groups as an A but reverses as an O should be suspected of having a missing antibody due to the immunosuppressive effect of the chemotherapy. True False

False

A phenotype mating between a group A1 and a group A2B can result in an offspring who phenotypes as group O. True False

False

Iindividuals who test postive for the D antigen after the AHG reagent has been used are classified as Rh negative as blood donors. True False

False

Infant cord blood should never be used for forward grouping in the ABO system due to the presence of Wharton's jelly. True False

False

Rouleaux formation can cause false negative reactions for blood groupings True False

False

The elderly population, when exhibiting an ABO discrepancy in laboratory testing, most typically have the discrepancy due to the formation of extra antigens. True False

False

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

Fy(a-b-)

Which antigen is destroyed by enzymes? P1 Jka Jsa Fya

Fya

Anti-LebH will not react or will react more weakly with which of the following RBCs? Group O Le(b+) None of the above Group A1 Le(b+) Group A2 Le(b+)

Group A1 Le(b+)

What ABH substance(s) would be found in the saliva of a group B secretor? H and A H and B H, A, B H

H and B

Unless of the Bombay phenotype, ALL secretors (SeSe or Sese) secrete B substance A substance H substance O substance

H substance

What substances would be found in the saliva of a group B secretor who also has Lele genes? H, B, Leb H, B, Lea, Leb H, Lea H, B, Lea

H, B, Lea, Leb

The imported question text for this question was too long. Inconclusive High frequency alloantibody autoantibody Low frequency antibody

High frequency alloantibody

A patient with an M. pneumoniae infection will most likely develop a cold autoantibody with specificity to which antigen? P1 P I i

I

The "extended" or AHG crossmatch is important for detecting what incompatibility? cold autoantibodies ABO incompatibility IgM alloantibodies in the recipient's serum IgG alloantibodies in the recipient's serum

IgG alloantibodies in the recipient's serum

Naturally-occurring antibodies in the ABO system are: IgA IgM IgE IgG

IgM

The major immunoglobulin class(es) of anti-B in A group A individual is (are): IgG IgM and IgA IgM and IgG IgM

IgM

Which of the following characteristics best describes Lewis antibodies? IgG, in vitro hemolysis, do not cause hemolytic transfusion reactions IgG, in vitro hemolysis, cause hemolytic transfusion reactions IgM, naturally occurring, do not cause HDFN IgM, Naturally occurring, cause HDFN

IgM, naturally occurring, do not cause HDFN

The following phenotypes are written incorrectly except for: Jka+ Jk(a+) Jka+ Jka(+)

Jk(a+)

The occurrence of a delayed hemolytic transfusion reaction is most notably associated with antibodies of which of the following blood group systems? Kidd Rh ABO Kell

Kidd

Which of the following carbohydrates will convert precursor substance into H substance? L-glucose L-fructose D-galactose L-fucose

L-fucose

Transformation to Leb phenotype after birth may be as follows: Le(a-b+) to Le(a-b-) to Le(a-b+) to Le(a+b+) Le(a-b-) to Le(a+b-) to Le(a+b+) to Le(a-b+) Le(a+b+) to Le (a+b-) to Le(a-b-) to Le(a-b+) Le(a-b+) to Le(a+b-) to Le(a+b+) to Le (a-b-)

Le(a-b-) to Le(a+b-) to Le(a+b+) to Le(a-b+)

In what way do the Lewis antigens change during pregnancy? Lea antigen increases only Leb antigen increases only Lea and Leb both decrease Lea and Leb both increase

Lea and Leb both decrease

The immunodominate sugar responsible for blood group A specificity is: N-acetyl-d-galactosamine L-fucose D-galactose Uridine diphosphate-N-acetyl-D-galactose

N-acetyl-d-galactosamine

If a group A2 patient has been given 2 units of Group O packed red cells and anti-A is demonstrable in patient plasma, then which type of blood should be given? B A O AB

O

Screening cells are of this ABO blood group A AB B O

O

Which of the following denotes an amorphic gene? A2 O H A3

O

Naturally-occuring antibodies may exist for all of the following except: H substance B antigen A antigen O antigen

O antigen

Which blood type is referred to as the universal donor? O negative O positive AB Positive AB positive

O negative

What are the possible ABO phenotypes of the offspring from the mating of a group A to A group B individual? O,A,B,AB A,B,AB A,B O,A,B

O,A,B,AB

Consider the following results are available on a pre-op patient: IS 37 AHG I 0 0 0 II 0 0 1+ III 0 0 0 AC 0 0 0 What is the next step after adding check cells? Perform crossmatch through AHG phase. Perform DAT testing on patient cells. Perform immediate spin crossmatching. Perform antibody identification panels.

Perform antibody identification panels.

Which of the following genotypes is possible for the following phenotype: CDce? R0r R1R0 R1r' R1r'

R1R0

A patient who is homozygous E would not be at risk for producing anti-e if transfused with blood from which of the following donors? R2R2 R1R2 rr R1r

R2R2

highest degree of antigenicity? Kell Kidd Duffy Rh

Rh

A patient being prepared for a blood transfusion who tests as weak D should most safely be given blood that is: Rh positive Rh negative

Rh positive

Which one of the following is the most probable cause of an incompatible immediate spin crossmatch? anti-K reacting with K antigen Donor red blood cell sensitization Rouleaux ABO incompatibility

Rouleaux

The antibody to this high-prevalence antigen demonstrates mixed-field agglutination that appears shiny and refractile under the microscope JMH Vel Sda Jra

Sda

A type 1 chain has: The terminal galactose in a 1-4 linkage to subterminal N-Acetylglucosamine The terminal galactose in a 1-3 linkage to subterminal N-acetylgalactosamine The terminal glalctose in a 1-3 linkage to subterminal N-acetylglucosamine The terminal galactose in a 1-4 linkage to subterminal N-acetylgalactosamine

The terminal glalctose in a 1-3 linkage to subterminal N-acetylglucosamine

A Bombay phenotype will forward and reverse as a group O indivdual. True False

True

A phenotype mating between a group A1 and group A2B may result in an offspring who is group A2. True False

True

Approximately 15% of the population are negative for the D antigen. True False

True

Red blood cells of group B are agglutinated by anti-B antisera and anti-A,B antisera True False

True

The autocontrol contains 2 drops patient plasma and 1 drop 3% patient cells. True False

True

The phenomenon known as the "acquired B antigen" is more common than the "acquired A antigen". True False

True

The Le gene codes for a specific glycosyltransferase that transfers a fucose to the N-acetylglucosamine on: Either type 1 or type 2 in any one individual but not both Types 1 and 2 precursor chain. Type 1 precursor chain Type 2 precursor chain

Type 1 precursor chain

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

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

Immune anti-A (IgG) could be found in all of the following except: a group O newborn whose mother has immune anti-A (IgG) in her circulation a group B mother who has given birth to a group A infant a group A four-year old child with no history of previous blood transfusion a group O mother who has given birth to a group A infant

a group A four-year old child with no history of previous blood transfusion

Compatibility testing includes which of the following? 1. ABO grouping 2. Antibody screen 3. Rh grouping 4. Crossmatching 4 is correct only 1,2 and 3 are correct 2 and 3 only all of the above

all of the above

The fundamental purpose of an antibody screen is to screen for alloantibodies other than ABO immunoglobulins antigens present on the patient's red cells antigens present on the reagent screening cells autoantibodies other than ABO immunoglobulins

alloantibodies other than ABO immunoglobulins

Individuals of blood group O have: A antigens on their RBC's B antigens on their RBC's only anti-A in their plasma only anti-B in their plasma anti-A, B in their plasma

anti-A, B in their plasma

To detect weak D (formerly know as Du), all of the following apply except: anti-Du antisera three saline washes after incubation antihuman globulin serum sensitization phase

anti-Du antisera

Intravascular red cell destruction is most likely to be caused by: IgG non-agglutinating non-complement-binding antibodies antibodies of the ABO blood group system Rh antibodies anti-IgA antibodies

antibodies of the ABO blood group system

Pretransfusion compatibility testing must include: DAT minor crossmatch Du testing on the patient antibody screen on the recipient

antibody screen on the recipient

Antibodies are ruled out using cells that are homozygous for the corresponding antigen because patterns of reactivity are non-conclusive multiple antibodies may be present autoantibodies may be masking alloantibodies. antigens show dosage effect

antigens show dosage effect

3% Coombs Check cells: neutralize the polyspecific anti-human globulin reagent are coated with IgG must be used to confirm all positive AHG reactions are used in the antibody screen procedure only

are coated with IgG

An O positive patient crossmatched with an O negative unit would show: major crossmatch compatible and minor crossmatch incompatible both major and minor crossmatches incompatible major crossmatch incompatible and minor corssmatch compatible both major and minor crossmatches compatible

both major and minor crossmatches compatible

R2

cDE

R0

cDe

Rh antibody formation: is naturally occcuring results in the formation of complete antibodies is not seen as a cause of hemolytic disease of the newborn can be the result of transfusion

can be the result of transfusion

r

cde

Anti-Jka is identified. A tech types 12 units for Jka antigen. 3 units are Jka negative and 9 units are Jka positive. The technologist should: randomly select another unit for crossmatching contact the rare donor file for compatible blood crossmatch the Jka negative units crossmatch the Jka positive units

crossmatch the Jka negative units

What is the fundamental purpose of the crossmatch? prevent immunization of the recipient detect donor antibodies directed against recipient cells prevent delayed transfusion reactions detect recipient antibodies directed against donor cells

detect recipient antibodies directed against donor cells

Other than agglutination, a positive reaction is defined by precipitation neutralization clotting hemolysis

hemolysis

The minor crossmatch is performed using: immediate crossmatch saline test only antiglobulin test only patient's cells and donor serum patient's serum and donor cells

immediate crossmatch saline test only

The primary test that is used in the antibody screen is the elution/absorption procedures weak D antigen testing direct antiglobulin technique indirect antiglobulin technique

indirect antiglobulin technique

When crossmatching five units for an A positive patient, using 3 units of A positive, one unit of A negative, and one unit of O negative, the technologist would find how many incompatible majors? one five two three none

none

Which of the following best describes Lewis antigens? The antigens are integral membrane glycolipids Lea and Leb are antithetical antigens The Le(a+b-) phenotype is found in secretors none of the above

none of the above

Which of the following is not a possible explanation for a negative check cell reaction in the indirect antiglobulin test? neutralization of AHG inadequate washing of the red blood cells overcentrifugation of the tube once check cells are added failure to add AHG

overcentrifugation of the tube once check cells are added

If the antibody screen is positive, then what should be done next? perform an antibody titer on the sample perform an antibody identification using patient serum set up an autocontrol and repeat the test for accuracy perform a direct antiglobulin test immediately

perform an antibody identification using patient serum

Reagent anti-A and anti-B are routinely used to determine an individual's: genotype phenotype

phenotype

Which of the following is added to the test systems to enhance the detection of Rh antigens on the red cell surface? protein saline complement

protein

The following statements are true concerning the A2 blood group antigen except: a smaller number of antigen sites exists for the subgroup A2 than for the A1 group the reaction with reagent anti-A may be weaker for cells that have the A2 antigen than for cells that have the A1 anitgen reagent antisera anti-A,B will not react with the A2 anitgen anti-A1 lectin will not read with the A2 anitgen

reagent antisera anti-A,B will not react with the A2 anitgen