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
