WEEK 1 - QA & Immunology

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

4+

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

A and B

Professional organization that accredits blood banks and transfusion services: AABB FDA CDC CAP OSHA

AABB

Degree to which a measurement represents the true value

Accuracy

It was observed that an antibody identified in the transfusion service appeared to be reacting stronger following the second exposure to an antigen from a transfusion. The most likely explanation of this is: Affinity maturation of the Ig molecule Anamnestic response Isotype switching All of the above

All of the above

Unacceptable quality control results for the antiglobulin test performed in test tubes may be noticed if: The technologist performing the test was never trained Preventative maintenance has not been performed on the cell washer The reagents used were improperly stored All of the above

All of the above

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

Antibody bound to antigen

In a lymphocytotoxicity test, cells that take on the dye: Recognize a red cell antibody Do not recognize a human leukocyte antigen Are not affected by complement Are recognized by a specific antibody

Are recognized by a specific antibody

Systematic evaluation to determine whether procedures are being followed

Audit

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

B lymphocytes

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

Before independent work is permitted and annually thereafter

Opsonization is a term to describe what process? Phagocytosis Lysis of cells Binding to cells or antigens Ingestion of cells

Binding to cells or antigens

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

C5 to C9

Provides peer-reviewed accreditation for hospital laboratories: AABB FDA CDC CAP OSHA

CAP

Makes recommendations to the Occupational Safety and Health Administration regarding the prevention of disease transmission: AABB FDA CDC CAP OSHA

CDC

System to plan and implement changes to prevent problems

Change control

Which class of HLA antigens would be typed when matching patients and donors for platelet transfusion? Class II only Classes I, II, and III Class I and II Class I only

Class I only

Evaluation of an employee's stability to perform a specific skill.

Competency assessment

Hemolysis was observed at room temperature when testing a patient's serum with reagent red cells used for screening. When this test repeated using the patient's plasma, no hemolysis was observed. What was the most likely explanation for the different reactions? The plasma sample was collected incorrectly. The serum sample was contaminated. Complement activation was inhibited by calcium in the plasma sample. 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. Constant region of the light chain Variable region of the light chain Constant region of the heavy chain Variable region of the heavy chain

Constant region of the heavy chain

Select the substance that regulates the activity of other cells by binding to specific receptors. Anaphylatoxin Cytokines Immunoglobulins Complement

Cytokines

Part of the antigen that the immunoglobulin binds to: Kappa Epitope Hinge region Isotype Idiotype

Epitope

Ensures the safety and efficacy of biologics, drugs, and devices: AABB FDA CDC CAP OSHA

FDA

Which of the following organizations are involved in the regulation of blood banks? AABB FDA The Joint Commission CAP

FDA

T/F: QC is the same as QA.

False

What is the potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used? No effect False negatives False positives Hemolysis

False negatives

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

Fc fragment

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

GMPs are legal requirements established by the Food and Drug Administration

The standard operating procedure is a document that: May be substituted with package inserts Must be very detailed to be accurate Helps achieve consistency of results Is necessary only for training new employees

Helps achieve consistency of results

The major histocompatibility complex is located on chromosome 6 and is important in all of the following immune functions except: Recognition on nonself Graft rejection Hemolysis Coordination of cellular and humoral immunity

Hemolysis

Imparts flexibility to the immunoglobulin molecule: Kappa Epitope Hinge region Isotype Idiotype

Hinge region

In safety training, employees must become familiar with all of the following except: The appropriate action to take if exposure occurs Limits of protective clothing and equipment Tasks that have an infectious risk How to perform cardiopulmonary resuscitation on a donor or other employee.

How to perform cardiopulmonary resuscitation on a donor or other employee.

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

Humoral immunity

The variable region of an immunoglobulin: Kappa Epitope Hinge region Isotype Idiotype

Idiotype

Ig that has the highest serum concentration?

IgG

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

IgG

Ig associated with intravascular cell destruction?

IgM

Ig that is efficient in activation of the complement cascade?

IgM

What immunoglobulin class reacts best at room temperature at immediate spin? IgM IgE IgG IgA

IgM

In order to enhance the reaction of an antibody in vitro, it may be necessary to adjust which of the following? Temperature above 37 degrees C Increase the incubation time in the incubator Speed the centrifuge above the calibrated settings Increase the concentration of red cells in the test system

Increase the incubation time in the incubator

In a routine audit of a facilities blood collection area, the quality assurance department found that the blood bags being used on that particular day had expired. What is the appropriate course of action? Call the Food and Drug Administration to report the incident. Initiate a root cause analysis and quarantine the blood collected in the expired bags. Fire the donor room supervisor, and discard the blood collected in the expired bags. Change the expiration date on the bags to avoid legal issues

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

The type of immunoglobulins determined by the heavy chain: Kappa Epitope Hinge region Isotype Idiotype

Isotype

One of the two types of light chains: Kappa Epitope Hinge region Isotype Idiotype

Kappa

A laboratory technologist decided she would like to bring her lab coat home for laundering because it had too many wrinkles when it was returned by the laboratory's laundry service. Is this acceptable? Yes, if she uses 10% bleach Yes, as long as she removes the coat and does not wear it home No, b/c the laboratory is a biosafety level 2, and the lab coats may not be removed Yes, if she clears it with her supervisor

No, b/c the laboratory is a biosafety level 2, and the lab coats may not be removed

A technologist was being trained in a different area of the blood bank and noticed that the person training her had not recorded the results of a test. To be helpful, she carefully recorded the results she saw at a later time, using the technologist's initials. Is this acceptable procedure? Yes; all results must be recorded regardless of who did the test. Yes; as long as she records the result in pencil No; she should have brought the error to the technologist's attention. Yes; because she used the other technologist's initials.

No; she should have brought the error to the technologist's attention

Ensures safe and healthful working conditions: AABB FDA CDC CAP OSHA

OSHA

Maximizes the duration of equipment and increases the reliability of the equipment

Preventative maintenance

The CAP survey is an example

Proficiency test

Testing to determine the accuracy and precision of reagents and equipment.

Quality control

Removal of products from the market that might compromise the safety of the recipient

Recall

Investigation and identification of the factors that contributed to an error

Root cause analysis

Which of the following will cause an antigen to elicit a greater immune response? Small antigen size Composed largely of carbohydrates Similarity to the host Size greater than 10,000 daltons

Size greater than 10,000 daltons

Blood irradiators require all of the following safety procedures except: Proper training Personal protective equipment That the user have a degree in radiology Equipment leak detection

That the user have a degree in radiology

Several units were released to a hospital by mistake before all viral marker testing was completed. What is the appropriate course of action? Perform a root cause analysis and, if the units are found to be negative, report the test result to the hospital. The error is reportable, and the FDA must be contacted Ask the hospital to avoid transfusion and quickly complete the testing. Recall only the units that are positive for viral markers

The error is reportable, and the FDA must be contacted

A facility does not validate a refrigerator before use. What is a potential outcome? The facility is in violation of current good manufacturing practices and could be cited by the FDA. The facility is in violation of AABB and may no longer be members The facility is in compliance if the equipment functions properly. The facility is in compliance if the blood products stored in it are not transfused.

The facility is in violation of current good manufacturing practices and could be cited by the FDA.

A patient's record indicated that he had a history of an antibody to HPA-1a. What is the significance of this antibody if this patient requires a platelet transfusion? Transfusion of HLA-matched platelet donors would yield a better response The patient would require HPA-1a negative platelets, which are relatively rare. No testing is necessary because the frequency of HPA-1a positive donors is very rare Washed platelets are necessary to avoid antibody interference.

The patient would require HPA-1a negative platelets, which are relatively rare.

T/F: All accidents, even minor ones, must be reported to a supervisor

True

T/F: The OSHA does not require the routine use of gloves by phlebotomists working with healthy prescreened donors or changing gloves between donors.

True

Which of the following is an example of an unacceptable record-keeping procedure? Using dittos in columns to save time Always using permanent ink on all records Not deleting the original entry when making a correction Recording the date and initials next to a correction.

Using dittos in columns to save time

Establishing that a specific process produces an expected result

Validation

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

all of the above

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

antibody excess

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

autologous

An antigen that originates from the individual is termed: a. autologous b. allogeneic c. hapten d. immunogen

autologous

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

continuous quality improvement plan

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

it is required only if the technologist has no experience.

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

performing quality control

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

refractoriness

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

spleen

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

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