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
