Blood bank ALL QUIZ REVIEWS
A 21-year-old college student wishes to participate in the "double red" program at the local blood center by donating red blood cells collected by apheresis. What is the minimum height and weight requirement that she must meet? Select one: a. Height: 5'1", 130 lbs b. Height: 5'3", 125 lbs c. Height: 5'5", 150 lbs d. No height requirement, 110 lbs
c
A blood bank technologist needed to confirm the presence of anti-P1 in a patient specimen. Fresh cells were not available for use, so an old panel that contained cells positive for P1 was used. No cells positive for the antigen reacted at any phase of the antiglobulin test, whereas cells from the screening cells showed specificity for the presence of anti-P1. What is a possible explanation for this? Select one: a. Technologist omitted LISS b. Technologist forgot to add AHG c. P1 antigen deteriorates rapidly upon storage d. Patient expresses the p phenotype
c
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? Select one: a. Patient's anti-E reacted with the IgG-sensitized red cells. b. IgG-sensitized red cells spontaneously agglutinated. c. Antihuman globulin washing procedure was adequate. d. Crossmatch was incompatible.
c
A person who inherits the In(Lu) gene will not express which antigens? Select one: a. S b. K c. Lua d. c
c
According to Landsteiner's rule (law), what ABO antibody will be detected in a group A individual's serum? Select one: a. Anti-A b. None c. Anti-B d. Anti-A,B
c
According to Landsteiner's rule (law), what ABO antibody will be detected in a group A individual's serum? Select one: a. None b. Anti-A,B c. Anti-B d. Anti-A
c
All of the following are characteristics of Duffy antibodies except: Select one: a. They are destroyed by enzymes b. They are IgG in nature c. They are not implicated in HDN d. They may or may not show dosage
c
An antibody screen is performed, and all three tubes are negative after adding AHG. Check cells are added, and the tubes are centrifuged. No agglutination occurs after the addition of check cells. What is the next course of action? Select one: a. Recentrifuge the tubes b. Add one drop of control cells c. Repeat the antibody screen d. Add one drop of AHG
c
Anti-Anton recognizes the same specificity as: Select one: a. Anti-Aua b. Anti-Lu3 c. Anti-Wj d. anti-Lub
c
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? Select one: a. D-positive if the sample is from a patient b. D-negative c. Unable to interpret without further testing d. D-positive
c
Antigen has a higher frequency in females a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
c
At what age does I antigen become detectable on infant cells? Select one: a. 18 years b. 1 years c. 18 months d. 4 years e. 1 month
c
At what temperature do IgM antibodies react? Select one: a. 56°C b. 37°C c. 22°C d. 42°C
c
Below are the results of the medical screening for a prospective female donor: Age: 16 Hematocrit: 35% Temperature: 37.2° C Hemoglobin: 12.0 g/dL History: HPV immunization, 1 week ago How many of the above results would exclude this donor from donating? Select one: a. None, she is acceptable. b. 1 c. 2 d. 3
c
Current theory regarding the genetics of the Rh system suggests that: Select one: a. each Rh system antigen is coded by its own gene locus. b. one gene locus with multiple alleles codes for the protein antigens. c. Rh system antigens are coded by two closely linked genes. d. the Rh system genes are a haplotype that codes for three sets of alleles.
c
Following delivery, what is the deferral time for donating a unit of whole blood? Select one: a. 2 weeks b. 4 weeks c. 6 weeks d. 8 weeks
c
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? Select one: a. Anti-E b. Anti-P1 c. Anti-K d. Anti-k
c
How can pathologic anti-I be differentiated from benign anti-I? Select one: a. Immunoglobulin class b. Complement-binding capacity c. Broad thermal range of reactivity d. All of the above
c
How long following transfusion must the recipient's sample be stored? Select one: a. 5 days b. 10 days c. 7 days d. 14 days
c
If a D-positive person appears to have anti-D in their serum, what is the most likely explanation? Select one: a. D-deletion phenotype b. Transposition effect c. Partial D antigen d. Compound antigen
c
If a group O mother gives birth to a group A baby, which of the following antibodies is usually responsible for crossing the placenta and causing hemolytic disease of the newborn (HDN)? Select one: a. Anti-AB b. Anti-H c. Anti-A d. Anti-B
c
If not stored in a monitored refrigerator, how long can RBC units remain outside the transfusion service to allow reissue? Select one: a. 60 minutes b. 45 minutes c. 30 minutes d. 15 minutes
c
Lewis antibodies are of what immunoglobulin class? Select one: a. IgA b. IgG c. IgM d. IgE
c
Lewis cell-bound antigens absorbed from plasma onto the red blood cell membranes are: Select one: a. Glycoproteins b. Ceramides c. Glycolipids d. Sphingolipids
c
Of the three following categories of altered D antigen, in which variation of D antigen expression are you more likely to encounter an allo-anti-D? Select one: a. C in Trans to RhD b. Weak D c. Partial/Mosaic D d. None of the above
c
Polyspecific AHG contains: Select one: a. anti-IgG b. anti-IgG and anti-IgM c. anti-IgG and anti- C3d d. anti-C3b-C3d
c
Reverse grouping showed negative reactions with A1 and B cells. Forward grouping showed positive reactions with A, B, and AB antisera. What blood type is consistent with these results? Select one: a. B b. A c. AB d. O
c
Secretor studies were performed on a person who expressed weak reactions in forward grouping. Only B and H substance were present in the saliva. What is this person's ABO group? Select one: a. AB b. A c. B d. O
c
Select the region of the antibody molecule responsible for imparting unique antibody specificity. Select one: a. Hinge region b. Constant region c. Variable region d. Fc fragment
c
The M and N antigens exhibit dosage. Therefore, if a person inherits the homozygous genotype MM, their red blood cells will react _______ with anti-M than/as those of a person with a heterozygous genotype of MN. Select one: a. Negative b. The same c. Stronger d. Weaker
c
The biochemical structure of the Rh antigens is a nonglycosylated protein, meaning: Select one: a. Lipids are not attached to protein structure b. Glucose is attached to protein c. Carbohydrates are not attached to protein structure d. Glycerol is attached to protein
c
The numeric Rh4 nomenclature refers to which antigen in the Rosenfield notation? Select one: a. E b. C c. c d. e
c
The recessive LuLu gene is different from the dominant In(Lu) gene because individuals with the recessive LuLu gene: Select one: a. Abnormal expression of P1 b. Express the Lu(a-b-) phenotype c. Normal expression of P1 d. Expression of trace amounts of i antigen
c
The true Lewis phenotype will normally be detected at what age? Select one: a. Not ever, as circumstances such as pregnancy may alter or mask an individual's true Lewis phenotype b. Birth c. 6 years d. 10 days
c
What fatal disease is associated with the McLeod phenotype? Select one: a. Grave's disease b. Fanconi's syndrome c. Chronic granulomatous disease d. Lymphoma
c
What immunodominant sugar is responsible for H specificity? Select one: a. N-acetyl-D-galactosamine b. D-galactose c. L-fucose d. D-glucose
c
What is Kell's antithetical partner? Select one: a. Penney b. Rautenberg c. Cellano d. Sutter
c
What is the minimum hemoglobin level for a potential female allogeneic donor? Select one: a. 11 g/dL b. 12 g/dL c. 12.5 g/dL d. 14 g/dL
c
What is the test procedure that combines patient's serum with commercial A1 and B reagent red cells? Select one: a. ABO forward grouping b. Antibody screen c. ABO reverse grouping d. Antibody panel
c
What percentage of the white population has type-O blood? Select one: a. 10% b. 32% c. 45% d. 4%
c
What protocol is put in place to validate Rh testing when high-protein reagents are used, especially when the patient types as an AB-positive? Select one: a. Add LISS to test system b. Use only saline reactive anti-D c. Run a control with Rh test d. Wash cells before testing
c
When there is an excess of antigen in a serologic test system, what course of action should be followed? Select one: a. Add complement b. Decrease the serum-to-cell ration c. Increase the serum-to-cell ratio d. Dilute the serum
c
When type O blood is not available for transfusion for a type O recipient, what is the next alternative? Select one: a. Washed group B red blood cells b. Group A red blood cells c. None d. Group AB red blood cells
c
Where will the ABO discrepancy occur in cis-AB individuals? Select one: a. Forward grouping with anti-AB b. Reverse grouping with A1 cells c. Reverse grouping with B cells d. Forward grouping with anti-A
c
Which ABO group's reaction will be the weakest with anti-H lectin? Select one: a. A1 b. B c. AB d. A2B
c
Which antigen(s) is/are antithetical partner(s) to s? Select one: a. f b. E c. MN d. U
c
Which group of antigens below best represents the definition of high-frequency antigens? Select one: a. Kpa, Jsa b. K, k c. Jsb, Kpb d. Jka, K
c
Which of the following is not a clinical application for a direct antiglobulin test? Select one: a. AIHA b. HDN c. Heterophile detection d. HTR
c
Which of the following is not true of monoclonal reagents? Select one: a. Monoclonal reagents are highly characterized and are uniformly reactive. b. Monoclonal reagents are produced by hybridoma technology. c. Monoclonal reagents are produced for single antigens with more than one epitope. d. Monoclonal reagents are highly specific.
c
Which one of the following histories represents an acceptable male donor? Hematocrit / Blood Pressure (mm Hg) / Temperature / Pulse (beats/min) / Age a. 39, 110/70, 99.9° F, 75, 40 b. 35, 136/86, 98.6° F, 80, 18 c. 39, 90/60, 98.9° F, 65, 65 d. 40, 190/90, 98.6° F, 78, 56
c
Why is determination of Rh status crucial for obstetric patients? Select one: a. All Rh-positive mothers are possible candidates for Rh immune globulin. b. An Rh-positive mother can form anti-D, which will destroy D-positive red blood cells of the fetus. c. All Rh-negative mothers are possible candidates for Rh immune globulin. d. An Rh-negative mother can form anti-D if she gives birth to an Rh-negative baby.
c
19-year-old woman who recently finished the three-part vaccination for hepatitis B surface antigen after starting a volunteer position at the hospital a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
d
28-year-old man who was incarcerated overnight for unspecified reason 2 months ago a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
d
53-year-old woman taking a beta-blocker for hypertension and over-the-counter low-dose aspirin for blood-clot prevention a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
d
65-year-old woman taking sleep medication at night a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
d
A 58-year-old woman revealed that she had experimented with intravenous drugs as a teenager. Is she an acceptable donor? Select one: a. She is an acceptable donor because testing will pick up evidence of hepatitis. b. She will need to be deferred for 12 months. c. She is an acceptable donor, if she has had the hepatitis B vaccine. d. She is deferred.
d
An advantage of polyclonal anti-IgG over monoclonal anti-IgG is: Select one: a. Polyclonal anti-IgG also has anticomplement activity b. Polyclonal anti-IgG recognizes only one IgG epitope c. AHG produced in rabbits is more specific than AHG produced in mice d. Polyclonal anti-IgG will recognize IgG variants
d
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 observation is: Select one: a. affinity maturation of the immunoglobulin molecule. b. isotype switching. c. anamnestic response. d. All of the above
d
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: Select one: a. R0r. b. R2r. c. R1R2. d. R1r.
d
Anti-Jka was identified in a previously transfused patient. Five cells that were homozygous for Jka yielded 2+ reactions in the AHG phase. The same cells were treated with ficin and yielded 3+ reactions in AHG. Therefore, Jka is _________ by enzyme treatment. Select one: a. Destroyed b. Unaffected c. Weakend d. Enhanced
d
Anti-Jka was identified in a previously transfused patient. Five cells that were homozygous for Jka yielded 2+ reactions in the AHG phase. The same cells were treated with ficin and yielded 3+ reactions in AHG. Therefore, Jka is _________ by enzyme treatment. Select one: a. Weakend b. Destroyed c. Unaffected d. Enhanced
d
Anti-Jsb was identified in a patient scheduled for elective surgery later. What is the best approach to finding compatible blood? Select one: a. Screen donors from the black population because Js(b-) phenotype is common. b. Contact the rare donor registry since Js(b-) units are rare. c. Request that family members be tested to determine if they share the same phenotype. d. A and B are correct.
d
Antigens Yta and Ytb are in this system a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
d
Following donation, how long does it take to replace the fluid lost from giving whole blood? Select one: a. 3 hours b. 12 hours c. 48 hours d. 72 hours
d
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?Select one: a. Positive direct antiglobulin test b. Rouleaux formation c. T-activation of red cells d. Group O blood products given to group A
d
If an emergency exists and there is not enough time to perform a crossmatch for red cells, what is the correct procedure? Select one: a. Release ABO-compatible blood based on the patient's prior record in the computer. b. Release group O, D-negative whole blood. c. Release group AB fresh frozen plasma until the blood type is performed. d. Release group O, D-negative RBC units.
d
In which population is the genetic Du most commonly found? Select one: a. White b. Native American c. Asian d. Black
d
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. Select one: a. IgG, recipient's b. IgM, donor's c. IgM, recipient's d. IgG, donor's
d
Match the following phenotypes with the most probable genotype in the Weiner nomenclature. DCce a) R2R2 b) rr c) R1R1 d) R1r
d
Pregnant women usually express which phenotype? Select one: a. Le(a+b-) b. Le(a-b+) c. Le(a+b+) d. Le(a-b-)
d
Select the substance that regulates the activity of other cells by binding to specific receptors. Select one: a. Complement b. Anaphylatoxin c. Immunoglobulins d. Cytokines
d
The biochemical structure of the Rh antigens is a nonglycosylated protein, meaning: Select one: a. Glycerol is attached to protein b. Lipids are not attached to protein structure c. Glucose is attached to protein d. Carbohydrates are not attached to protein structure
d
What Kidd antibody will react with all panel cells and phenotype as Jk(a-b-)? Select one: a. Anti-Jka b. Anti-Jkb c. Anti-K d. Anti-Jk3
d
What biological molecules are considered the most immunogenic? Select one: a. Lipids b. Carbohydrates c. Enzymes d. Proteins
d
What does the U in U antigen stand for? Select one: a. Unusual b. Unique c. Uniform d. Universal
d
What immunoglobulin class reacts best at room temperature at immediate-spin? Select one: a. IgG b. IgA c. IgE d. IgM
d
What immunoglobulin class reacts best at room temperature at immediate-spin? Select one: a. IgG b. IgE c. IgA d. IgM
d
What is a possible explanation for a weak reaction (1+) in a reverse ABO grouping test? Select one: a. Elderly patient b. Immunocompromised patient c. IgM deficiency d. All of the above e. Two of the above
d
What is the immunoglobulin class of antibodies detected in the immediate-spin crossmatch? Select one: a. IgA b. IgG c. IgD d. IgM
d
What is the optimal temperature for complement activation? Select one: a. 58°C b. 4°C c. 22°C d. 37°C
d
What protocol is put in place to validate Rh testing when high-protein reagents are used, especially when the patient types as an AB-positive? Select one: a. Add LISS to test system b. Use only saline reactive anti-D c. Wash cells before testing d. Run a control with Rh test
d
What red blood cell antigens do McLeod individuals express? Select one: a. KkKpbJsa b. KmKx c. None d. Trace kKpbJsbK11
d
What specificities does polyspecific antihuman globulin contain? Select one: a. Anti-IgG. b. Anti-C3b and anti-C3d. c. Anti-IgG and anti-IgM. d. Anti-IgG and anti-C3d.
d
When red blood cells are placed in a solution of 2M urea, the red blood cells will lyse. However, it has been shown that which red blood cells are resistant to lysis? Select one: a. Jk(a-b+) b. Jk(a+b-) c. Jk(a+b+) d. Jk(a-b-)
d
Which condition is often associated with the presence of anti-I? Select one: a. Colon cancer b. Pregnancy c. Infectious mononucleosis d. Mycoplasma pneumoniae infection
d
Which of the following blood products requires a crossmatch before issuing? Select one: a. Cryoprecipitated AHF b. Human leukocyte antigen-matched platelets c. Group AB fresh frozen plasma that is transfused to a group O d. Granulocyte concentrates that have more than 2 mL of red blood cells
d
Which of the following is associated with the Rhnull phenotype? Select one: a. Immunized Rhnull individuals may produce anti-Rh29 b. Mutation of the RhAG regulator gene c. Membrane abnormalities d. All of the above
d
Which of the following phenotypes is heterozygous? Select one: a. Le(a+b-) b. Jk(a+b-) c. Fy(a-b+) d. Fy(a+b+)
d
Which of the following situations is most likely to cause intravascular hemolysis when an incompatible transfusion is given? Select one: a. Group AB plasma to a group A recipient b. Group AB plasma to a group O recipient c. Group A packed red cells to a group AB recipient d. Group B packed cells to a group O recipient
d
Which of the following statements contributes to permanent rejection status for a donor? Select one: a. A tattoo 5 months previously b. Contact with a patient with viral hepatitis c. Two units of blood transfused 4 months previously d. Confirmed positive test for hepatitis B surface antigen 10 years previously
d
Which of the following techniques/reagents may be useful in increasing the reactivity of anti-M? Select one: a. Papain pretreated cells b. Anticomplement AHG reagents c. Heterozygous MN Cells d. Acidified serum techniques
d
Which type of autologous donation procedure is most common for the majority of surgeries? Select one: a. Preoperative hemodilution b. Postoperative salvage c. Intraoperative blood salvage d. Preoperative donation
d
Why is a blood sample drawn in an EDTA tube not an appropriate sample for complement activation investigations? Select one: a. Antibodies are neutralized b. It dilutes plasma c. Antigens are destroyed d. Calcium is inactivated
d
Why was U antigen included in the MNSs blood group system? Select one: a. All U-positive red blood cells were also S+s+ b. U is enhanced by enzyme treatment c. All U-negative red blood cells were also M-N- d. All U-negative red blood cells were also S-s-
d
Your blood bank mistakenly released a D-positive red blood cell unit that subsequently transfused to a patient who typed as D-negative. The 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. Select one: a. Incompatible at antihuman globulin only b. Incompatible at immediate-spin only c. Not necessary to perform d. Compatible at immediate-spin
d
Cord blood was sent to the laboratory for blood type determination on twins A and B. Baby A demonstrated mixed-field reactions with anti-A and anti-AB and no reactivity with anti-B. Reverse grouping was not performed. Baby B showed a 1+ reaction with anti-A and anti-AB. What could be the reason for the variable reactions? Select one: a. Chimerism b. A dimorphic cell population c. Dispermy d. Two of the above e. All of the above
e
I and i antigens are found in plasma, serum, and what other possible source(s)? Select one: a. Saliva b. Breast milk c. Urine d. Two of the above e. All of the above
e
The Ii antigens are found on the membranes of which structures? Select one: a. Platelets b. Leukocytes c. Red blood cells d. Two of the above e. All of the above
e
Where are Lewis antigens found? Select one: a. Saliva b. Milk c. Plasma d. Two of the above e. All of the above
e
System associated with glycophorin A and B a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
f
System associated with resistance to malaria a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
g
System associated with McLeod phenotype a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
h
System associated with chronic granulomatous disease a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
h
Match the immunodominant sugar that corresponds to the ABO system group or antigen. Bombay
none
A1(subscript)
phenotype
Part of the antigen that the immunoglobulin binds to
Epitope
Variable region of an immunoglobulin
Idiotype
Found in secretions, such as breast milk
IgA
Associated with immediate-spin in vitro reactions
IgM
Associated with intravascular cell destruction
IgM
The type of immunoglobulins determined by the heavy chain
Isotype
One of the two types of light chains
Kappa
Match the immunodominant sugar that corresponds to the ABO system group or antigen. Group O
L-fucose
Match the immunodominant sugar that corresponds to the ABO system group or antigen. H antigen
L-fucose
A1(superscript)
allele
Match the following phenotypes with the most probable genotype in the Weiner nomenclature. cc a) R2R2 b) rr c) R1R1 d) R1r
b
A patient phenotypes as D+C+E-c-e+. Predict the most likely genotype. Select one: a. R1r b. R1r' c. R1R1 d. R1R0
c
Allogeneic whole blood donors may donate every __________ days. Select one: a. 24 b. 36 c. 56 d. 72
c
Anti-Lua reacts at what temperature? Select one: a. 37°C b. AHG c. Room temperature d. 4°C
c
Match the following phenotypes with the most probable genotype in the Weiner nomenclature. DCe a) R2R2 b) rr c) R1R1 d) R1r
c
The antigen ceCF is known as: Select one: a. V antigen b. Wrights antigen c. Crawford antigen d. D mosaic
c
The weak D test detects: Select one: a. the missing D mosaic. b. the Du antigen. c. a weak D antigen. d. a weak D antibody.
c
Anti-M will react strongest with which cells? Select one: a. M-N+ b. M+N+ c. M-N- d. M+N-
d
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? Select one: a. 10 days b. 5 days c. 7 days d. 3 days
d
Red cells that phenotype as D-negative indicate that: Select one: a. a suppressor gene was inherited that is turning off the D gene expression. b. they inherited two D genes. c. reagents currently in use are not detecting the D antigen. d. there is no genetic material inherited from the RHD gene from both parents.
d
What is the purpose of a "diversion pouch" used when collecting blood from a donor? Select one: a. Collect samples for viral marker testing b. Prime the line to remove air c. Determine if blood flow is sufficient d. Avoid bacterial contamination of the blood product
d
Antibodies in this system often fall below detectable levels and are associated with delayed transfusion reactions a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
e
Antigen of high incidence; its antibody can cause hemolytic transfusion reactions a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
i
Match the immunodominant sugar that corresponds to the ABO system group or antigen. Group B
D-galactose
Imparts flexibility to the immunoglobulin molecule
Hinge region
Associated with allergic reactions and mast cell activation
IgE
Able to cross the placenta
IgG
Has the highest serum concentration
IgG
Efficient in activation of the complement cascade
IgM
Has the highest number of antigen binding sites
IgM
Match the immunodominant sugar that corresponds to the ABO system group or antigen. Group A
N-acetylgalactosamine
18-year-old woman currently taking Accutane for acne a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
a
22-year-old man who returned from Iraq 3 months ago and was vaccinated for tetanus and yellow fever before being deployed a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
a
25-year-old man treated for syphilis 3 months ago a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
a
27-year-old woman returning from the Peace Corps in Nigeria who was vaccinated for typhoid 6 months ago a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
a
48-year-old man taking Propecia for baldness a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
a
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? Select one: a. That patient has low-titer isoagglutinins b. Rouleaux formation c. That the patient has autoantibodies d. Contaminated reagent antisera
a
A donor unit with a positive DAT would cause reactions at what phase of the crossmatch? Select one: a. Antiglobulin b. None; it would be compatible c. Immediate-spin d. All phases
a
A group O patient was crossmatched with group B red blood cells. What phase of the crossmatch will first detect this incompatibility? Select one: a. Immediate-spin b. Indirect antiglobulin c. None of them; unit is compatible d. 37° C low-ionic strength solution
a
A group O person with warm autoimmune hemolytic anemia may demonstrate weak reactions in the forward grouping due to: Select one: a. Red blood cells being coated with antibody b. Red blood cells being coated with antigen c. Acquired B-like syndrome d. Exposure of T antigen
a
A patient was phenotyped for the presence of Lewis antigens (Lea and Leb). A 3+ reaction was observed when patient cells were incubated with anti-Lea. No reaction was observed with anti-Leb. Based on these results, the patient's phenotype is _____________ and the patient is a ____________ of ABH substances. Select one: a. Le(a+b-)/nonsecretor b. Le(a-b+)/secretor c. Le(a+b-)/secretor d. Le(a-b+)/nonsecretor
a
A patient's antibody history listed an anti-Cellano. This antigen is also known as: Select one: a. k in the Kell system. b. Cs in the Cost system. c. SC in the Scianna system. d. c in the Rh system.
a
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? Select one: a. Anti-c b. Anti-E c. Anti-C d. Anti-D
a
After adding antigen and antibody to a test tube, one large agglutinate was observed. How should this reaction be graded? Select one: a. 4+ b. 0 c. 3+ d. 2+
a
All the following statements are true regarding Lewis system antibodies except antibodies: Select one: a. do not react following enzyme treatment of cells. b. may cause hemolysis in vitro. c. may be observed at the immediate-spin, 37° C, and antihuman globulin phases. d. can be neutralized by Lewis substance.
a
An anti-E was identified in a patient who recently received a transfusion. What other Rh system antibody should be investigated? Select one: a. Anti-c b. Anti-f c. Anti-G d. Anti-D
a
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? Select one: a. Unable to interpret without further testing b. D-negative c. D-positive d. D-positive if the sample is from a patient
a
Anti-N is known to occur in ___________ patients undergoing dialysis with equipment sterilized by formaldehyde? Select one: a. Renal b. Thyroid c. Cancer d. Immunocompromised
a
Antibody to this antigen demonstrates weak mixed field reaction a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
a
At birth, infant cells are rich in ______, and ______ is nearly undetectable. Select one: a. i/I b. I/H c. I/i d. H/i
a
Before donation, the intended venipuncture site must be cleaned with: Select one: a. PVP-iodine complex. b. alcohol. c. 10% acetone. d. green soap.
a
Blood collected from a therapeutic phlebotomy is: Select one: a. acceptable for inventory under certain Food and Drug Administration guidelines. b. unacceptable for inventory. c. acceptable if the "volunteer donor" label is removed. d. acceptable if the patient meets all regular donor criteria.
a
Dithiothreitol (DTT), when used alone, can destroy antigens in which blood group system? Select one: a. Kell b. Kidd c. Duffy d. Lewis
a
Extravascular destruction of blood cells occurs in the: Select one: a. spleen. b. thymus. c. blood vessels. d. lymph nodes.
a
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? Select one: a. Complement activation was inhibited by calcium in the plasma sample. b. The serum sample was fresher. c. The serum sample was contaminated. d. The plasma sample was collected incorrectly.
a
How often can a person donate a unit of whole blood for a directed donation? Select one: a. 8 weeks b. 2 weeks c. 48 hours d. 24 hours
a
How would you label a donor who tested negative with anti-D reagent upon immediate-spin and positive in antihuman globulin test? Select one: a. D-positive b. D-negative c. Cannot label; more testing needed
a
If an individual with a partial D expression is transfused with a normal Rh-positive unit of blood, a likely result will be: Select one: a. The patient will form an antibody to the portion of Rh(D) protein that they are missing b. The patient will develop an anti-D antibody c. The patient will have an acute hemolytic transfusion reaction d. The patient will experience no consequence of receiving Rh-positive blood
a
If an individual with a partial D expression is transfused with a normal Rh-positive unit of blood, a likely result will be: Select one: a. The patient will form an antibody to the portion of Rh(D) protein that they are missing b. The patient will have an acute hemolytic transfusion reaction c. The patient will develop an anti-D antibody d. The patient will experience no consequence of receiving Rh-positive blood
a
Interpret the DAT: Poly: 2+ IgG: 2+ C3: 0 CC+ a) DAT positive due to IgG b) DAT positive due to complement c) DAT negative d) invalid
a
Match the following phenotypes with the most probable genotype in the Weiner nomenclature. DcE a) R2R2 b) rr c) R1R1 d) R1r
a
Mixed-field agglutination encountered in ABO forward grouping may be caused by: Select one: a. A3 b. Abnormal concentrations of serum proteins c. Cold reactive autoagglutinins d. para-Bombay
a
Persons who phenotype as Fy(a-b-) are resistant to infection by which organism? Select one: a. Plasmodium vivax b. Plasmodium falciparum c. Plasmodium ovale d. Plasmodium malariae
a
Red blood cells were treated with ficin to help rule in anti-M from a panel study. Cells not treated reacted at 2+ at immediate spin and 1+ at 37°C. There was no reactivity in the AHG phase. Ficin-treated cells would demonstrated a _______ reaction with patient serum containing anti-M. Select one: a. Negative b. 2+ c. 3+ d. 4+
a
Select the term that describes cells or tissue from a genetically different individual within the same species. Select one: a. Allogeneic b. Autologous c. Autograft d. Xenogeneic
a
The Del phenotype is most commonly found in individuals of which ethnicity? Select one: a. Asian b. African c. Whites d. Native Americans
a
The inheritance of the Rh antigens are: Select one: a. codominant. b. autosomal recessive. c. X-linked dominant. d. X-linked recessive.
a
The true Lewis phenotype will normally be detected at what age? Select one: a. 6 years b. Not ever, as circumstances such as pregnancy may alter or mask an individual's true Lewis phenotype c. 10 days d. Birth
a
Units that were positive for P² antigen had to be crossmatched with serum of a patient containing the corresponding antibody because of a short supply of blood. Which of the following crossmatch results would be considered acceptable for transfusion? Select one: a. IS=1+, 37=0, AHG=0 b. IS=0, 37=2+, AHG=3+ c. IS=0, 37=2+, AHG=1+ d. IS=2+, 37=1+, AHG=0
a
What are the two components of the major crossmatch? Select one: a. Donor red cells and recipient serum b. Recipient red cells and donor serum c. Reverse ABO cells and recipient serum d. Screening cells and donor serum
a
What characteristic differentiates Ss antigens from MN antigens? Select one: a. Enzyme degradation b. Biochemical structure rich in sialic acid c. S and s exhibit dosage d. Antigens well developed at birth
a
What characterizes the Donath-Landsteiner antibody? Select one: a. An IgG auto anti-P. b. An IgG anti-Pk. c. An IgM auto anti-I. d. Anti-IH that reacts at cold temperatures.
a
What does hr' refer to in the Weiner nomenclature? Select one: a. c b. C c. E d. r
a
What is responsible for recognition of the antibody-binding site to homologous antigen? Select one: a. Variable region of light/heavy chain b. Solubility of antigen c. Phenotype d. Complementarity
a
What is the purpose of washing cells in the AHG test? Select one: a. To remove all unbound protein b. To remove all bound protein c. To exclude a low-affinity antibody d. To dilute serum
a
What serologic factor distinguishes anti-Fy3 from anti-Fya or anti-Fyb? Select one: a. It is not destroyed by enzymes b. It does not bind complement c. It is an IgM antibody d. It shows dosage
a
What serologic factor distinguishes anti-Fy3 from anti-Fya or anti-Fyb? Select one: a. It is not destroyed by enzymes b. It is an IgM antibody c. It shows dosage d. It does not bind complement
a
When is the immediate-spin or abbreviated crossmatch an acceptable procedure for the recipient? Select one: a. No prior or existing clinically significant antibodies b. Using blood from a directed donation c. Needs blood before a sample can be obtained d. Never been pregnant or transfused
a
When there is an excess of antigen in a serologic test system, what course of action should be followed? Select one: a. Increase the serum-to-cell ratio b. Add complement c. Decrease the serum-to-cell ration d. Dilute the serum
a
Where are ABH substances detected in secretors? Select one: a. All of the above b. Two of the above c. MIlk d. Saliva e. Tears
a
Which IgG subclasses carry the most significance with regard to Rh antibodies? Select one: a. IgG1/IgG3 b. IgG3/IgG4 c. IgG1/IgG4 d. IgG2/IgG4
a
Which blood group system is not based on carbohydrates? Select one: a. Rh b. P c. Lewis d. ABO
a
Which gene combination is expressed in the greatest frequency in the black population? Select one: a. Dce b. dce c. DCE d. DCe
a
Which of the following Rh antigens is the most immunogenic? Select one: a. D b. C c. E d. e
a
Which of the following facts is not a characteristic of Kell system antibodies? Select one: a. Lose reactivity with proteolytic enzyme reagents b. Best detected in indirect antiglobulin test phases c. Usually clinically significant IgG antibodies d. Do not bind complement proteins
a
Which of the following is not a cause for temporary deferment of a whole blood donor? Select one: a. Aspirin ingestion 12 hours previously b. Hepatitis B immunoglobulin taken 4 weeks previously c. Oral polio vaccine taken 1 week previously d. Rubella injection 1 week previously
a
Which of the following is not a clinical application for a direct antiglobulin test? Select one: a. Heterophile detection b. AIHA c. HTR d. HDN
a
Which of the following statements regarding anti-LW is true? Select one: a. Anti-LW reacts stronger with Rh-positive cells than with Rh-negative cells. b. The gene coding for LW is located on the same chromosome as the Rh genes. c. Anti-LW reacts poorly with cord cells. d. Rh-null individuals lack the LW gene.
a
Which substance can be used to neutralize antibodies to P1? Select one: a. Hydatid cyst fluid b. Papain c. Milk d. Dolichos biflorus
a
Why are check cells added to all negative reactions in the AHG test? Select one: a. To ensure AHG was not neutralized by free globulin molecules b. To increase the cell-to-serum ratio c. To bring the antibody closer to the antigen in the test system d. To wash away any unbound antibody
a
Why do En(a-) individuals have a reduced chance of infection with Plasmodium falciparum? Select one: a. There is a reduction in N-acetylneuraminic acid b. There is a reduction in N-acetylgalactosamine c. GPB is in an altered state d. There is an increase in N-acetylneuraminic acid
a
Why is it important to use polyspecific AHG rather than monospecific? Select one: a. Polyspecific AHG is better at detecting IgG antibodies b. Polyspecific AHG is less sensitive to IgG antibodies c. Polyspecific AHG costs less than monospecific AHG d. Polyspecific AHG is easier to use than monospecific AHG
a
Why is it necessary to mix the unit frequently during the donation process? Select one: a. Avoid blood clots by mixing the anticoagulant with the blood b. Suspend the platelets throughout the unit c. Determine whether the volume is acceptable d. Allow the donation process to go more quickly
a
You have a patient with Anti-P1. Theoretically, how many units would be compatible if you set up 10 units of blood? Select one: a. 2 b. 9 c. 4 d. 6
a
A1
antigen
50-year-old woman on vacation in the United States who currently lives in England a) temporary deferral b) indefinite deferral c) permanent deferral d) acceptable donor
b
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? Select one: a. AB, D positive b. A, D negative c. A, D positive d. O, D negative
b
A blood bank technologist needed to confirm the presence of anti-P1 in a patient specimen. Fresh cells were not available for use, so an old panel that contained cells positive for P1 was used. No cells positive for the antigen reacted at any phase of the antiglobulin test, whereas cells from the screening cells showed specificity for the presence of anti-P1. What is a possible explanation for this? Select one: a. Technologist omitted LISS b. P1 antigen deteriorates rapidly upon storage c. Patient expresses the p phenotype d. Technologist forgot to add AHG
b
A male donor has a reactive nucleic acid test for hepatitis C. What kind of deferral is assigned to this donor? Select one: a. Indefinite b. Permanent c. Temporary d. None of the above
b
A patient presented in the emergency room needing to be transfused ASAP. According to the computer, the patient had a Kell antibody 5 years ago. The antibody screen is negative now. Of the following, the best procedure to obtain suitable blood for transfusion is: Select one: a. To assume the electronic crossmatch is acceptable b. To antigen type the units for Kell and completely crossmatch the negative ones c. To use immediate spin crossmatch compatible blood d. To take the time to crossmatch the units of blood through the AHG phase
b
A person who inherits alleles Fya and Fyb will carry which antigens on their red blood cells? Select one: a. Only Fyb antigen b. Both Fya and Fyb antigens c. Neither Fya or Fyb antigen d. Only Fya antigen
b
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? Select one: a. B and A b. AB and A c. O and A d. AB and B
b
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? Select one: a. Reprint a label using the MRI as the identifier. b. Request a recollection of the specimen. c. Use the tube since the MRI is visible. d. Call the phlebotomist back to relabel the tube.
b
A woman came in for a cesarean section. The antibody screen was positive with a 3+ reaction in the AHG phase using screening cell I. Screening cells II and III were negative in all phases. An 8-cell panel was performed that paralleled the antibody screen, where three cells reacted 3+ at AHG and five cells were negative at all phases of reactivity. The antibody identified was anti-Kell. What procedure might be helpful in predicting the infant's susceptibility to HDN? Select one: a. Determination of the mother's phenotype b. Determination of the father's phenotype c. A fetal screen (rosette test) on the mother d. Plasmapheresis of the mother's plasma
b
A woman undergoing a hysterectomy requires two units of blood. The antibody screen was negative. One unit was incompatible in the AHG phase (2+), the other unit was compatible. Give a reason why this antibody was not detected in the antibody screen. Select one: a. Existence of a high-frequency antigen b. Existence of a low-frequency antigen c. Antibody has low avidity to cell receptor d. False positive screening test
b
An antigen that originates from the individual is termed: Select one: a. hapten. b. autologous. c. immunogen. d. allogeneic.
b
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 probably genotype is: Select one: a. R1R2. b. R1r. c. R2r. d. R0r.
b
Anti-Lua reacts at what temperature? Select one: a. 4°C b. Room temperature c. 37°C d. AHG
b
Anti-N will react stronger with which phenotype? Select one: a. M+N- b. M-N+ c. M-N- d. M+N+
b
Antibodies are sensitive to enzymes and have high-titer low-avidity characteristics a) Sda antigen b) Chido/Rodgers c) Xga d) Cartwright e) Kidd f) MNSs g) Duffy h) Kell i) Vel
b
At what phase of the antihuman globulin (AHG) test will anti-Kell be detected? Select one: a. 4°C b. AHG c. 37°C d. IS
b
Autologous donors may not donate if they: Select one: a. have a positive test for syphilis. b. are on antibiotics for an infection. c. are taking aspirin. d. are over 65 years old.
b
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?Select one: a. T-activation of red cells b. Group O blood products given to group A c. Positive direct antiglobulin test d. Rouleaux formation
b
If a prospective donor has participated in a plasmapheresis program, how long must he or she wait to donate whole blood? Select one: a. 56 days b. 48 hours c. 24 hours d. 4 weeks
b
Interpret the DAT: Poly: 1+ IgG: 0 CC+ C3: 1+ a) DAT positive due to IgG b) DAT positive due to complement c) DAT negative d) invalid
b
Interpret the DAT: Poly: 1+ IgG: 0 CC+ C3: 1+ a) DAT positive due to IgG b) DAT positive due to complement c) DAT negative d) invalid
b
Select the appropriate strategy if the results of red cell and serum testing in the ABO typing procedure have negative agglutination reactions. Select one: a. Wash patient cells with warm saline. b. Incubate tubes at room temperature or 4° C with an autocontrol. c. Perform an autocontrol. d. Use polyclonal typing reagents.
b
Select the cell involved in humoral immunity. Select one: a. Neutrophils b. B lymphocytes c. T lymphocytes d. Monocytes
b
Select the correct statement regarding the collection of a blood sample for compatibility testing. Select one: a. The sample may be labeled at any time in an emergency. b. The sample must be labeled at the bedside. c. The sample does not require a means to identify the phlebotomist. d. The sample requires a new numeric identifier for the patient for each admittance.
b
Testing for the weak D expression is performed by: Select one: a. using monoclonal anti-D. b. performing the indirect antiglobulin test with anti-D. c. using anti-Du antisera with an extended incubation. d. performing the direct antiglobulin test with anti-D.
b
The M and N antigens are found in which glycoprotein? Select one: a. Glycophorin B b. Glycophorin A c. Band 3 d. Glycophorin C
b
The Miltenberger subsystem is related to what major blood group system? Select one: a. P b. MNSs c. Rh d. Kell
b
The biochemical structure of the Rh antigens is a nonglycosylated protein, meaning: Select one: a. Lipids are not attached to protein structure b. Carbohydrates are not attached to protein structure c. Glycerol is attached to protein d. Glucose is attached to protein
b
The use of the electronic (computer) crossmatch is restricted to recipients who: Select one: a. have had successful transfusions in the past. b. do not have a clinically significant antibody. c. have transfusion history that has been documented in the computer. d. are group O.
b
What Kidd antibody will react with all panel cells and phenotype as Jk(a-b-)? Select one: a. Anti-Jkb b. Anti-Jk3 c. Anti-Jka d. Anti-K
b
What does hr' refer to in the Weiner nomenclature? Select one: a. C b. c c. r d. E
b
What does the U in U antigen stand for? Select one: a. Uniform b. Universal c. Unusual d. Unique
b
What does the hh genotype refer to? Select one: a. Lewis b. Bombay c. Kell d. Lutheran e. Sid
b
What forward typing reagent can be used to confirm group O units before placing them in inventory? Select one: a. Anti-B b. Anti-A,B c. Anti-A d. Anti-H
b
What immunoglobulin class is capable of crossing the placenta? Select one: a. IgM b. IgG c. IgA d. IgE
b
What is the immunoglobulin class of most Rh system antibodies? Select one: a. IgA b. IgG c. IgE d. IgM
b
What is the immunoglobulin class of most Rh system antibodies? Select one: a. IgM b. IgG c. IgA d. IgE
b
What is the potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used? Select one: a. Hemolysis b. False negatives c. No effect d. False positives
b
What part of the immunoglobulin molecule distinguishes the isotype? Select one: a. Light chain b. Heavy chain c. Lambda chain d. Kappa chain
b
What percentage of the group A population are type as A2? Select one: a. 1% b. 20% c. 35% d. 10%
b
What percentage of the type A population is A2? Select one: a. 10% b. 20% c. 1% d. 80%
b
What phenotype will be expressed when the Le, Se, and H genes are inherited? Select one: a. Le(a+b+) b. Le(a-b+) c. Le(a-b-) d. Le(a+b-)
b
What red blood cell antigens do McLeod individuals express? Select one: a. KmKx b. Trace kKpbJsbK11 c. None d. KkKpbJsa
b
What temperature is used for incubation in the indirect antihuman globulin test? Select one: a. 22° C b. 37° C c. 4° C d. 56° C
b
Which antigen represents Rh3 in Rosenfield terminology? Select one: a. C b. E c. e d. D
b
Which of the following genotypes is consistent with f antigen expression? Select one: a. DCe/DcE b. Dce/DCE c. DCe/dCE d. DcE/DCe
b
Which of the following genotypes is consistent with f antigen expression? Select one: a. DcE/DCe b. Dce/DCE c. DCe/DcE d. DCe/dCE
b
Which of the following tests is not included in routine compatibility testing? Select one: a. D typing b. Direct antiglobulin test c. Antibody screen d. ABO phenotyping
b
Which population has the greatest frequency of the Fy(a-b-) phenotype? Select one: a. Asian b. Black c. Native American d. White
b
Why are antibodies to Lub antigen not commonly detected? Select one: a. The antibodies do not cause transfusion reactions. b. Lub antigen is of high incidence. c. The antibodies react best at 4° C. d. Lub antigen is not present on screening cells.
b
Why are the M and N antigens important and useful for paternity testing? Select one: a. Antigens are well developed on father's red blood cells b. Antigens are well developed at birth. c. Antigens are poorly developed on mother's cells d. Antigens are fully developed at 2 years of age
b
You have a patient with Anti-P1. Theoretically, how many units would be compatible if you set up 10 units of blood? Select one: a. 4 b. 2 c. 9 d. 6
b
