Blood Bank Exam 2

Which of the following is a characteristic of anti-i? A. Often associated with hemolytic disease of the newborn B. Reacts best at room temp or 4 C C. Reacts best at 37 C D. Is usually IgG

B

Which of the following statements is true concerning the MN genotype? A. Antigens are destroyed using bleach treated cells B. Dosage effect may be seen for both M and N antigens C. Both M and N antigens are impossible to detect because of cross interference D. MN is a rare phenotype seldom found in routine antigen typing

B

Which of the following would be cause for deferral for a male donor? A. Temperature of 99.2 F B. Hematocrit of 37% C. Spent 2 weeks in the UK in 1998 D. Received a blood transfusion 2 years ago

B

Which one of the following antibodies has been implicated in hemolysis disease of the fetus and newborn? A. Anti-I B. Anti-K C. Anti-Le a D. Anti-Le b

B

A 56 year old female with cold agglutinin disease has a positive DAT. When the DAT is repeated using monospecific antiglobulin sera, which of the following is most likely to be detected? A. IgM B. IgG C. C3d D. C4a

C

A delayed transfusion reaction resulting in hemolysis is most likely caused by antibodies of which blood group system? A. I B. MNS C. Kidd D. Lewis

C

A patient with sickle cell disease is B positive with a positive antibody screen. The antibody identified is anti-D and the autocontrol is negative. What is the possible explanation? A. The patient is weak-D positive B. Autoantibody is present C. Patient possesses the partial D phenotype D. The patient has a positive DAT

C

A request for 8 units of RBCs was received for patient. The patient has a negative antibody screen , but 1 of the 8 units was 3+ incompatible at the AHG phase . Which of the following antibodies may be the cause ? a . Anti-K b . Anti-Le a c . Anti-Kp a d Anti-Fy b

C

Anti-Le b H will not react or will react more weakly with which of the following RBCs? A. Group O Le(b+) B. Group A2 Le(b+) C. Group A1 Le(b+) D. None of the above

C

Antibodies to antigens in which of the following blood groups are known for showing dosage? A. I B. P C. Kidd D. Lutheran

C

Based on the following genotype Le (sese), what would you predict the Lewis antigen phenotype expression to be? A. Le (a- b-) B. Le (a+ b+) C. Le (a+ b-) D. Le (a- b+)

C

Cold agglutinin disease (CAD) is most often associated with which antibody? A. Anti-D B. Anti-M C. Autoanti-I D. Autoanti-i

C

Cold autoimmune hemolytic anemia is associated with which of the following infectious agents? A. Cytomegalovirus B. Klebsiella pneumoniae C. Mycoplasma pneumoniae D. Herpes simplex virus type 2

C

Given a situation where screening cells, major crossmatch, autocontrol, and DAT (anti-IgG) are all positive, what procedure should be performed next? A. Adsorption using rabbit stroma B. Antigen typing of patient cells C. Elution followed by a cell panel on the eluate D. Selected cell panel

C

Many warm reactive autoantibodies have a broad specificity within which of the following blood groups? a. Kell b. Duffy c. Rh d. Kidd

C

Proteolytic enzyme treatment of red cells usually destroys which antigen? A. Jk a B. E C. Fy a D. k

C

The autoantibodies in paroxysmal cold hemoglobinuria (PCH) have what specificity? A. anti-I B. anti-K C. anti-P D. anti-M

C

The null K RBC can be artificially prepared by which of the following treatments? A. Ficin and DTT B. Ficin and glycine-acid EDTA C. DTT and glycine-acid EDTA D> Glycine-acid EDTA and sialidase

C

What would be considered a common characteristic of anti-Jk a and anti-Jk b? A. The immunoglobulin class is IgM B. Agglutination reactions are best observed by DAT C. The antibodies show dosage with Kidd antigens on red cells D. The antibodies are naturally occurring

C

Which Lewis antigen(s) would be detected when phenotyping the red cells of an adult who has the Le, Se, and H genes? A. Le a B. Le b C. Both Le a and Le b D. Neither Le a and Le b

C

Which blood group system is associated with resistance to malaria? A. P B. Kell C. Duffy D. Kidd

C

Which group of antibodies is commonly found as cold agglutinins? A. Anti-K, anti-k, anti-Jsb B. Anti-D, anti-e, anti-C C. Anti-M, anti-N D. Anti-Fya, anti-Fyb

C

Which of the following information is NOT required for whole blood donation? A. Name B. Address C. Transfusion history D. Sex E. Date of birth

C

Which of the following phenotypes is the result of homozygous inheritance of the corresponding genes? A. Le (a+ b-) B. M+ N+ C. Fy (a- b+) D. Jk (a+ b+)

C

Which one of the following blood group systems may show a cell typing change during pregnancy? A. Rh B. MNS C. Lewis D. Duffy

C

Warm antibodies (IgG)

Rh, kell, duffy, kidd, S,s

Which of the following characteristics is consistent with the Kidd blood group system? A. Jk (a- b-) red cells are resistant to lysis in 2 M urea B. Kidd antigens are destroyed by ficin C. Antibodies to Kidd antigens react best at immediate spin D. Anti-Jk a activity may not react well in a LISS test system

A

Which of the following is the most common type of autoimmune hemolytic anemia? A. Warm autoimmune hemolytic anemia B. Cold agglutinin disease C. Paroxysmal cold hemoglobinuria D. Drug induced immune hemolytic anemia

A

an individual has been sensitized to the k antigen and has produced anti-k. What is the most probable Kell system genotype for this person? A. KK B. Kk C. kk D. K0K0

A

The crossmatch is performed using: A. Donor's RBCs and recipient's serum B. Donor's serum and recipient's RBCs C. Donor's serum and reagent red cells D. Recipient's serum and reagent red cells

A

Transformation of Le b phenotype after birth may be as follows A. Le(a- b-) to Le(a+ b-) to Le(a+ b+) to Le(a- b+) B. Le(a+ b-) to Le(a- b-) to Le(a- b+) to Le(a+ b+) C. Le(a- b+) to Le(a+ b-) to Le(a+ b+) to Le(a- b-) D. Le(a+ b+) to Le(a+ b-) to Le(a- b-) to Le(a- b+)

A

Which of the following antibodies usually show enhanced agglutination with the use of proteolytic enzymes? A. anti-M, N and S B. Anti-Jk a, Jk b, C, and E C. Anti-Fy a and Fy b D. Anti-K

A

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

A

A type 1 chain has A. The terminal galactose in a 1-3 linkage to subterminal N-acetylglucosamine B. The terminal galactose in a 1-4 linkage to subterminal N-acetylglucosamine C. The terminal galactose in a 1-3 linkage to subterminal N-acetylgalactosamine D. The terminal galactose in a 1-4 linkage to subterminal N-acetylgalactosamine

A

An antibody that causes in vitro hemolysis and reacts with the red cells of 3 units is most likely: A. anti-Le a B. anti-s C. anti-k D. anti-E

A

Erythrocyte antigens destroyed by enzyme treatment include A. M, N, Fy B. M, S, Le a C. D, P, Jk D. D, K, Fy

A

Given the following typing results, what is the donor's racial ethnicity? Le (a- b-); Fy (a-b-); Js (a+ b+) A. African American B. Asian American C. Native American D. Caucasian

A

How may days before a pretransfusion specimen expires? A. 3 days B. 7 days C. 14 days D. 1 month

A

If the unit is going to be transfused within the collection facility, autologous blood must always be tested for which of the following before transfusion? A. ABO, Rh B. ABO, Rh, HBsAg C. ABO, Rh, HIV D ABO, Rh, HBsAg, HIV

A

In the Coombs phase of a crossmatch, what is the proper procedure to follow if the Check Cells give a negative reaction? A. Repeat procedure with new AHG reagent and check the cell washer B. Add additional check cells and dilute with 100% distilled water C. Add additional AHG reagent plus proteolytic enzymes to enhance the reaction D. Accept the crossmatch results as correct-nothing further needs to be done

A

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

A

The autoantibodies in cold hemagglutinin disease (CHD) have what specificity? A. anti-I B. anti-K C. anti-P D. anti-M

A

Which if the following characteristics best describes Lewis antibodies? A. IgM, naturally occurring, cause HDN B. IgM, naturally occurring, do not cause HDN C. IgG, in vitro hemolysis, cause hemolytic transfusion reactions D. IgG, in vitro hemolysis, do not cause hemolytic transfusion reactions

B

Which of the following antibodies is usually clinically insignificant? A. Anti-P B. Anti-P1 C. Anti-pk D. Anti-p

B

A 29 year old male is hemorrhaging severely. He is AB negative. 6 units of blood are required STAT. Of the following types available in blood bank, which would be most preferable for crossmatch? A. AB positive B. A negative C. A positive D. O negative

B

A patient has a history of anti-Jk a. The antibody screen is currently negative. Which red blood cell unit should be selected and what type of crossmatch should be performed? A. Jk(a-) RBCs, computer crossmatch B. Jk(a-) RBCS, antiglobulin crossmatch C. Jk(a-) RBCs, immediate spin crossmatch D. ABO compatible because the antibody screen is negative

B

About how many donors will need to be antigen typed to kind 3 Fy (a-) units for crossmatch (Fy a = 0.66)? A. 3 B. 4 C. 10 D. 12

B

All of the following RBC antigens are high frequency except A. k B. E C. Lu b D. Kp b

B

All of the following antibodies are detected at immediate spin except A. Anti-P1 B. Anti-Jk a C. Anti-A D. Anti-M

B

An antibody panel is performed and the antibody is identified as anti-C. The patient is type B positive. Which of the following available units should be selected for transfusions? A. O negative, C positive B. O positive, C negative C. B positive, C positive D. A negative, C negative

B

Anti-N is identified in a patient's serum. If random crossmatches are performed on 10 donor units, how many would be expected to be compatible? A. 0 B. 3 C. 7 D. 10

B

Anti-U will not react with which of the following RBCs? A. M+ N+ S+ s- B. M+ N- S- s- C. M- N+ S- s+ D. M+ N- S+ s-

B

Anti-U will not react with which of the following RBCs? A. M+N+S+s- B. M+N-S-s- C. M-N+S-s+ D. M+N-S+s+

B

Antibody detection cells will NOT routinely detect which antibody specificity? A. Anti-M B. Anti-Kp a C. Anti-Fy a D. Anti-Lu b

B

Antibody detection cells will not routinely detect which antibody specificity? A. Anti-M B. Anti-Kp a C. Anti-Fy a D. Anti- Lu b

B

How long must a 2 unit RBC donor wait before donating RBCs again? A. 8 weeks B. 16 weeks C. 6 months D. 12 months

B

Penicillin given in massive dose has been associated with RBC hemolysis. Which of the classic mechanisms is involved in the hemolytic process? A. Immune complex B. Drug absorption C. Membrane modification D. Autoantibody formation

B

The Kell antigen is A. Absent from red cells of neonates B. Strongly immunogenic C. Destroyed by enzymes D. Has a frequency of 50% in the random population

B

The specificity of the antibody in cold agglutinin disease is A. anti-i B. anti-I C. anti-k D. anti-P

B

What antibody does not fit with the others with respect to optimum phase of reactivity? A. Anti-S B. Anti-P1 C. Anti-Fy a D. Anti-Jk b

B

What is the most advised step to follow to select units for crossmatch after recipient antibodies have been identified? A. Perform IAT on patient serum and donor units B. Antigen type any donor cells to be crossmatched C. Perform DAT on patient cells and donor units D. Obtain a different enhancement medium for repeat antibody panel testing

B

What is the purpose of the immediate spin (IS) crossmatch? A. Detect clinically significant alloantibodies in recipient B. Detect ABO incompatibility between donor and recipient C. Verify the correct blood sample from recipient was collected D. Verify the presence of IgM alloantibodies in the recipient

B

When preparing units of blood for emergency release, what information must be written on the label or tag? A. The name of the individual releasing the unit B. Statement that compatibility testing has not been completed C. Statement that the patient's ABO and Rh type are unknown D. Physician's statement and signature requesting emergency release

B

Which antibody does not fit with the others with respect to optimum phase of reactivity? A. Anti-S B. Anti-P1 C. Anti-Fy a D. Anti-Jk b

B

Which antibody is associated with mycoplasma pneumoniae infection and cold hemagglutinin disease? A. Anti-P B. Anti-I C. Anti-M D. Anti-i

B

Which antibody is frequently seen in patients with warm autoimmune hemolytic anemia? A. Anti-Jk a B. Anti-e C. Anti-K D. Anti-Fy b

B

Which finding best distinguishes immune hemolytic anemia from other hemolytic anemias? A. Rouleaux B. Positive DAT C. Splenomegaly D. Increased erythrocyte count

B

A low incidence antigen is one that occurs in less than 10% of the population. Which of the following is a low incidence antigen? A. D B. c C. Fy b D. C w

D

All of the following are reasons for performing an adsorption except A. Separation of mixtures of antibodies B. Removal of interfering substances C. Confirmation of weak antigens on red cells D. Identification of antibodies causing a positive DAT

D

Anti-K is identified in a patient's serum. If random crossmatches are performed on 10 donor units, approximately how many would be expected to be compatible? A. 1 B. 3 C. 7 D. 9

D

In what way do Lewis antigens change during pregnancy? A. Le a increases only B. Le b increases only C. Le a and Le b both increase D. Le a and Le b both decrease

D

In what way do the Lewis antigens change during pregnancy? A. Le a antigen increases only B. Le b antigen increases only C. Le a and Le b both increase D. Lea and Le b both decrease

D

Saliva from which of the following individuals would neutralize an auto anti-H in the serum of a group A, Le(a-b+) patient? A. group A, Le (a-b-) B. group A, Le (a+b-) C. group O, Le (a+b-) D. group O, Le (a-b+)

D

The antibody notorious for causing delayed hemolytic transfusion reactions is A. anti-Fy B. anti-Lu C. anti-Le D. anti-Jk

D

The following phenotypes are written incorrectly except A. Jk a+ B. Jk (a) + C. Jk a (+) D. Jk (a+)

D

Where are the Lewis antigens produced? A. Platelets B. RBCs C. WBCs D. Tissue cells

D

Which of the following best describes Lewis antigens? A. The antigens are integral membrane glycoproteins B. Le a and LE b are antithetical antigens C. The Le(a+ b-) phenotype is found in secretors D. None of the above

D

Which of the following blood group antigens is the most immunogenic, or has the greatest ability to initiate antibody production in an individual who lacks the antigen? A. Fy a B. s C. Jk b D. D

D

Which of the following is NOT considered a characteristic of paroxysmal cold hemoglobinuria (PCH)? A. Patient population: children and young adults B. Pathogenesis: following viral infection C. Site of hemolysis: intravascular D. Autoantibody class: IgM

D

Which of the following is considered a high incidence antigen? A. K B. C C. c D. k

D

Which of the following is the most common antibody seen in the blood bank after ABO and Rh antibodies? A. Anti-Fy a B. Anti-k C. Anti-Js a D. Anti-K

D

Which of the following is the most common antibody seen in the blood banks after AB and Rh antibodies? A. Anti-Fy a B. Anti-k C. Anti-Js a D. Anti-K

D

Which of the following is true regarding the Lutheran blood group system? A. Anti-Lu a most often is IgG B. Anti-Lu b is always IgM C. Lu a is a high frequency antigen D. Lu b is a high frequency antigen

D

Which one of these Lewis blood group system phenotypes usually produces anti-Le a? A. Le (a+ b+) B. Le (a+ b-) C. Le (a- b+) D. Le (a- b-)

D

What antibodies have the dosage effect?

Kidd, duffy, Rh, M, N, S, s

Cold antibodies (IgM)

Lewis, I, P1, M, N, A, B, H