Immunohematology-Immunohematology Problem Solving Flashcards
- Is there a discrepancy between the following blood
typing and secretor study results?
A. No problem, the sample is from a group A
secretor
B. Blood types as A and saliva types as B
C. Blood types as A, but the secretor study is
inconclusive
D. No problem, the sample is from a group A
nonsecretor
A. No problem, the sample is from a group A
secretor
- What is the best course of action given the
following test result? (Assume the patient has
not been transfused recently.)
A. Nothing, typing is normal
B. Type patient cells with anti-A1 lectin and type
serum with A2 cells
C. Retype patient cells; type with anti-H and
anti-A,B; use screen cells or A2 cells on patient
serum; run patient autocontrol
D. Wash patient cells four times with saline, then
repeat the forward type
C. Retype patient cells; type with anti-H and
anti-A,B; use screen cells or A2 cells on patient
serum; run patient autocontrol
3.The following results were obtained on a 41 year old female
Due to the discrepant reverse grouping, a panel
was performed on patient serum revealing the
presence of anti-M. How can the reverse grouping
be resolved?
A. Repeat the reverse grouping with a 10-minute
incubation at room temperature
B. Repeat the reverse grouping using A1 cells that
are negative for M antigen
C. Repeat the reverse grouping using A1 cells that
are positive for M antigen
D. No further work is necessary
B. Repeat the reverse grouping using A1 cells that
are negative for M antigen
- A 59-year-old male came through the emergency
department of a community hospital complaining
of dizziness and fatigue. History included no
transfusions and a positive rheumatoid factor
1 year ago. His CBC confirmed anemia. A
sample was sent to the blood bank for a type
and crossmatch. Upon receipt of the sample in
the blood bank, the MLS noticed the EDTA
sample appeared very viscous. Fearing the sample
would clog the ProVue, testing was performed
using the tube method. Initial results revealed the
following:
The patient’s red cells were washed eight times
with saline, and testing was repeated giving the
following results:
The antibody screen was negative at IS, 37°C,
and AHG phases; check cells were positive.
Crossmatch testing using two O-positive donor
units revealed a 1+ at immediate spin, and negative
results at 37°C and AHG phases. The check cells
were positive. In light of the crossmatch results,
what is the next course of action?
A. Use other donor cells for the crossmatch
B. Perform a saline replacement for the crossmatch
C. Run the crossmatch using the Gel system
D. Result the crossmatch as incompatible
B. Perform a saline replacement for the crossmatch
- The following results were obtained on a
51-year-old male with hepatitis C:
What should be done next?
A. Retype the patient’s sample to confirm group
AB positive
B. Repeat the Rh typing
C. Run a saline control in forward grouping
D. Report the patient as group AB, Rh positive
C. Run a saline control in forward grouping
- An Rh phenotyping shows the following results:
What is the most likely Rh genotype?
A. R1r´
B. R0r
C. R1R1
D. R1r
C. R1R1
- An obstetric patient, 34 weeks pregnant, shows
a positive antibody screen at the indirect
antiglobulin phase of testing. She is group B,
Rh negative. This is her first pregnancy. She has
no prior history of transfusion. What is the most
likely explanation for the positive antibody screen?
A. She has developed an antibody to fetal red cells
B. She probably does not have antibodies because
this is her first pregnancy, and she has not been
transfused; check for technical error
C. She received an antenatal dose of RhIg
D. Impossible to determine without further testing
C. She received an antenatal dose of RhIg
- A patient’s serum contains a mixture of antibodies.
One of the antibodies is identified as anti-D.
Anti-Jka or anti-Fya and possibly another antibody
are present. What technique(s) may be helpful to
identify the other antibody(s)?
A. Enzyme panel; select cell panel
B. Thio reagents
C. Lowering the pH and increasing the incubation
time
D. Using albumin as an enhancement media in
combination with selective adsorption
A. Enzyme panel; select cell panel
- An anti-M reacts strongly through all phases of
testing. Which of the following techniques would
not contribute to removing this reactivity so that
more clinically significant antibodies may be
revealed?
A. Acidifying the serum
B. Prewarmed technique
C. Adsorption with homozygous cells
D. Testing with enzyme-treated red cells
A. Acidifying the serum
- The reactivity of an unknown antibody could be
anti-Jka, but the antibody identification panel does
not fit this pattern conclusively. Which of the
following would not be effective in determining if
the specificity is anti-Jka?
A. Testing with enzyme-treated cells
B. Select panel of homozygous cells
C. Testing with AET-treated cells
D. Increased incubation time
C. Testing with AET-treated cells
- A cold-reacting antibody is found in the serum of a
recently transfused patient and is suspected to be
anti-I. The antibody identification panel shows
reactions with all cells at room temperature,
including the autocontrol. The reaction strength
varies from 2+ to 4+. What procedure would
help to distinguish this antibody from other
cold-reacting antibodies?
A. Autoadsorption technique
B. Neutralization using saliva
C. Autocontrol using ZZAP reagent-treated cells
D. Reaction with cord cells
D. Reaction with cord cells
- An antibody identification panel reveals the
presence of anti-Leb and a possible second
specificity. Saliva from which person would be best neutralize the Leb antibody ?
C.
- The Ortho Provue does not detect weak forms of
the D antigen. Why would running type and
screens on the Provue prevent a patient with a
weak D phenotype from forming anti-D?
A. Weak D persons cannot form anti-D
B. The Provue would result the sample as
Rh negative; the patient would receive
Rh-negative blood
C. The Provue would result the sample as
Rh positive; the patient would receive
Rh-positive blood
D. A and C
B. The Provue would result the sample as
Rh negative; the patient would receive
Rh-negative blood
- A cord blood workup was ordered on Baby Boy
Jones. The mother is O negative. Results on the
baby are as follows:
The test for weak D was positive at AHG. Is the
mother an RhIg candidate?
A. No, the baby is Rh positive
B. Yes, the baby’s Rh type cannot be determined
due to the positive DAT
C. No, the baby is Rh negative
D. Yes, the mother is Rh negative
B. Yes, the baby’s Rh type cannot be determined
due to the positive DAT
- Red cells from a recently transfused patient were
DAT positive when tested with anti-IgG. Screen
cells and a panel performed on a patient’s serum
showed very weak reactions with inconclusive
results. What procedure could help to identify the
antibody?
A. Elution followed by a panel on the eluate
B. Adsorption followed by a panel on the adsorbed
serum
C. Enzyme panel
D. Antigen typing the patient’s red cells
A. Elution followed by a panel on the eluate
- A 33-year-old maternity patient is drawn for a type
and screen at 36 weeks’ gestation. The following results are found on the Ortho Provue:
The reference lab identified anti-P1 in the patient
plasma using enzyme techniques. How could the
ABO discrepancy be solved?
A. Wash the patient’s red cells and repeat the
forward grouping
B. Test the patient’s plasma against A2 cells
C. Warm the patient plasma at 37°C for 10 minutes
and repeat the reverse grouping
D. Treat the A1 cells with dithiothreitol and repeat
the reverse grouping
C. Warm the patient plasma at 37°C for 10 minutes
and repeat the reverse grouping
