Immunoserology and Bloodbank Part 2 Flashcards
Natural barriers of the immune system include all except which of the following?
a. pH of secretions
b. Coughing
c. Hair follicles
d. Intestinal bacteria
C
The fundamental difference between primary and secondary organs of the lymphatic system is:
a. Antibody production occurs only in the primary lymph organs
b. Complement production occurs only in the primary lymph organs
c. Maturation of lymphocytes occurs in secondary organs, and activation occurs in primary organs
d. Maturation of lymphocytes occurs in primary organs, and activation occurs in secondary organs
D
Severe combined immunodeficiency is characterized by which of the following?
a. Diagnosed in infancy
b. Shortened life span
c. No antibody production
d. All of the above
D
A 3-year-old boy is seen by his physican because of many recent bacterial infections. Flow cytometery indicates normal levels of T and B cells. The nitroblue tetrazolium test for oxidative reduction is negative. The most likely cause is:
a. Wegener’s syndrome
b. Chronic granulomatous disease
c. Bruton’s agammaglobulinemia
d. Diabetes mellitus
B
A 25-year-old man was seen by his physican for recurrent infections. Immunoelectrophoresis revealed hypogammaglobulinemia. This man most likely has which of the following?
a. Bruton’s agammaglobulinemia
b. Common variable immunodeficiency
c. X-linked agammaglobulinemia
d. DiGeorge’s syndrome
B
In which disease would you expect to see an IgM spike on electrophoresis?
a. Transient hypogammaglobulinemia of infancy
b. Wiskott-Aldrich syndrome
c. Leukocyte adhesion disease
d. Waldenstrom’s macroglobulinemia
D
A person has an infected bug bite with pain, swelling, and redness. What is the cause of these physical symptoms of inflammation?
a. Production of antibody
b. Secondary immune response
c. Increased blood flow and neutrophils to site
d. Activation of NK cells
C
The type of graft rejection that occurs within minutes of a tissue transplant is ____________.
a. Acute
b. Chronic
c. Hyperacute
d. Accelerated
C.
Accelerated- 2 to 5 hours
Acute- days to months or 7-21 days
Chronic- 1 year or more or later than 3 months
GVHD- 100 days or more but involves donors t cell attacking the recipients tissues
Toll-like receptors act in which way?
a. Enhance recognition of bacteria by phagocytic cells
b. Activate B cells to produce antibody
c. Activate helper T cells
d. Aid in processing antigen in the form of an MHC molecule
A.
TLR 2- for gram positive (binds to teichoic acid)
TLR 4- for gram negative (binds to LPS)
TLR 5- for bacterial flagellin
TLR 10- anti inflammatory
Neutrophils and monocytes have receptors for which part of the immunoglobulin molecule?
a. Fc
b. Fab
c. Hinge region
d. Variable region
A
One B-cell marker of early-stage B-cell development is _____, whereas ____ is a marker for later stages of B-cell development.
a. CD20; CD10
b. CD21; CD10
c. CD10; CD20
d. CD19; CD10
C
A double-positive T cell would express which markers?
a. CD4+CD8+CD3+
b. CD4CD8+CD3+
c. CD4CD8CD3
d. CD4+CD8-CD3+
A
Which cell is considered to be a bridge between the
innate and adaptive immune systems?
a. NK cell
b. Mast cell
c. Monocyte-macrophage
d. T cell
A
. _______ are involved in cell-mediated immunity, whereas _______ are involved in humoral immunity.
a. T cells; B cells
b. T cells; antibodies
c. B cells; T cells
d. AandB
D
Antigens that make very good immunogens include which of the following?
a. Carbohydrates
b. Proteins
c. Both a and b
d. Neither a or b
B
Carbohydrates are also immunogenic but lesser compared to protein and polysaccharides
The function of the complement system include(s) which of the following?
a. Clearance of cellular debris
b. Chemotaxis
c. Lysis of bacteria
d. All of the above
D
When C3 is cleaved by C3 convertase, what is the result?
a. C3a is released
b. C3b is used as an opsonin
c. C3b is combined with other complement proteins to form C5 convertase
d. All of the above
D
Characteristics of cytokines include which of the following?
a. They can have a pleomorphic effect
b. Cytokines are redundant
c. Cytokines enhance cellular differentiation of lymphocytes
d. All of the above
D
Immunoglobulin idiotypes are antibodies with variations in the domains of which of the following?
a. CH1 and CH2
b. VH and VL
c. VH and CL
d. CH1, CH2, and CH3
B
Idiotype- variation in variable region (VH AND VL)
Isotype- variation in heavy chain that is unique in every immunoglobulin classes (CH1, CH2, CH3, VH)
Allotype- minor variation in the constant region (CH2 AND CH3)
Mannose-binding lectin is similar to which component of the classical pathway?
a. C3
b. C2
c. C1q
d. C5a
C
A patient with a viral infection to the ABC virus is found to have a high antibody titer to the ABC virus’s RNA, or anti-ABCr. Which of the following is true?
a. MHC class I molecules presented antigen to CD4+Tcells
b. MHC class II molecules presented antigen to CD8+Tcells
c. MHC class I molecules presented antigen to CD8+ T cells
d. MHC class II molecules presented antigen to CD4+Tcells
C
What is the main difference between agglutination and precipitation reactions?
a. Agglutination occurs between a soluble antigen and antibody
b. Agglutination occurs when the antigen is particulate
c. Precipitation occurs when the antigen is particulate
d. Precipitation occurs when both antigen and anti- body are particulate
B
Postzone causes false-negative reactions in antibody titers as a result of which of the following?
a. Too much diluent added to test
b. Excess antibody in test
c. Excess antigen in test
d. Incorrect diluent added to test
C
Antibodies produced against two or more epitopes of specific antigen are considered ____________.
a. Monoclonal
b. Pleomorphic
c. Dimorphic
d. Polyclonal
D
In the radial immunodiffusion test, the gel contains which of the following?
a. The antigen to be tested
b. Antibody
c. Patient sample
d. None of the above; the gel is the medium to which the antibody and antigen are applied in equal proportion
B
Antibodies are fixed uniformly in the support gel while the antigen (present in patients serum) is placed in the well cut into the gel
Which statement is true regarding the radial immunodiffusion test?
a. The area of the precipitin ring is directly proportional to the concentration of antigen in the
sample
b. The area of the precipitin ring is directly proportional to the concentration of antibody in the sample c. The area of the precipitin ring is directly proportional to the concentration antibody and the antigen in the sample
d. The area of the precipitin ring indicates a partial identity to the antibody in the sample
A
The indirect antiglobulin test is for ______________, whereas the direct antiglobulin test is for__________.
a. Serum antigen; bound antigen
b. Serum antigen; bound antibody
c. Serum antibody; bound antigen
d. Serum antibody; bound antibody
D
In an indirect immunofluorescent antibody test for CMV antibodies, the conjugated antibody used for visualizing is:
a. Antihuman globulin conjugated to a fluorescent dye
b. Anti-CMV antibody conjugated to a fluorescent dye
c. CMV virus conjugated to a fluorescent dye
d. Antihuman globulin conjugated to an enzyme
A
What is the difference between nephlometry and turbidimetry?
a. There is no difference between the two assays, only in name
b. Nephlometry is a newer example of turbidimetry
c. Nephlometry measures light transmitted through a solution, and turbidimetry measures light scattered in a solution
d. Nephlometry measures light scattered in a solution, and turbidimetry measures light transmitted
through a solution
D
In an Ouchterlony immunodiffusion, the line of precipitation between the antibody and the antigen wells forms an X. This reaction would be described as which of the following?
a. Nonidentity
b. Partial identity
c. Identity
A
An initial titer of 4 followed by a subsequent titer of 16 for the same patient, drawn 2 weeks later, is indicative of which of the following?
a. Infection
b. Convalescence
c. Past exposure
d. No exposure
A. To diagnose an infection, titer should increase fourfold (4x4= 16)
A deficiency of T cells can result in which of the following?
a. Low levels of complement
b. Dysfunctional macrophages
c. Fewer B cells maturing to plasma cells
d. Contact dermatitis
C
A 2-week-old baby is seen for a possible infection with CMV. Which of the following statements is false?
a. A positive anti-CMV result from baby’s specimen is inconclusive
b. An initial titer of anti-CMVIgG would need to be established
c. A positive result for anti-CMV IgM would indicate infection
d. All are false statements
B
What is the basic difference between the RPR and VDRL tests?
a. The RPR detects antigen, whereas the VDRL detects antibody
b. TheRPRtestisreadmacroscopically,whereasthe VDRL is read microscopically
c. The RPR test is a treponemal test, whereas the VDRL is nontreponemal
d. There is no difference because they are both specific
B
A patient has the following hepatitis B serology:
HBsAg: Negative
Anti-HBc: Positive
Anti-HBS: Positive
These results are consistent with which of the following?
a. Acute hepatitis B
b. Chronic hepatitis B
c. Recovery from hepatitis B
d. Acute hepatitis A
C
The HLA genes are inherited as:
a. Diplotypes: Two diplotypes from each parent
b. Haplotypes: One haplotype from each parent
c. HLAs are not inherited, instead are proteins absorbed onto cells
d. Only the HLA-A antigen is an inheritable trait
B
Agglutination and precipitation that is visible depends on antigen–antibody ratios ________.
a. With antigen in excess
b. With antibody in excess
c. That are equivalent
d. All of the above
C
Which of the following cell types is implicated in immediate hypersensitivity?
a. Neutrophil
b. Mast cell
c. Macrophage
d. Monocyte
B
Anti-dsDNA antibodies are associated with which of the following?
a. Syphilis
b. CMV infection
c. Systemic lupus erythematosus
d. Hemolytic anemia
C
Rheumatoid factor is typically an IgM autoantibody with specificity for which of the following?
a.SS-B
b. Double-stranded DNA
c. Ribonucleoprotein
d. Fc portion of IgG
D
All of the following are autoimmune diseases except:
A.Rheumatoid arthritis
B. Rh disease of the fetus and newborn
C. Grave’s disease
D. Myasthenia gravis
B
An autoantibody found in Hashimotos thyroiditis reacts with which of the following?
a. TSH receptor
b. Islet cells
c. CRP
d. Thyroglobulin
D
In Grave’s disease, one of the main autoantibodies
a. Anti-CCP
b. Antibody to islet cells of pancreas
c. Antibody to thyroid-stimulating hormone receptor
d. Anti-dsDNA
C
Skin testing for exposure to tuberculosis is an example of which type of hypersensitivity?
a. Type I
b. Type II
c. Type III
d. Type IV
D
Which of the following is a test for specific trepone- mal antibody?
a. VDRL
b. RPR
c. FTA-ABS
d. All of the above
C
Serum tested positive for HBsAg and anti-HBc IgM. The patient most likely has which of the following?
a. Acute hepatitis C
b. Chronic hepatitis B
c. Acute hepatitis B
d. Acute hepatitis A
C
The main difference between leukemias and lympho- mas is which of the following?
a. Leukemias are malignancies of cells in the bone marrow
b. Lymphomas are maligniancies of cells in the bone marrow
c. Lymphomas are classified as either acute or chronic
d. Leukemias are malignancies in lymphoid tissue
A
A 1-year-old boy is seen for having many recurrent infections with Streptococcus pneumoniae. Laboratory tests revealed a normal quantity of T cells, but no B cells and no immunglobulins were seen on electrophoresis. Which of the following would most likely be the cause?
a. Chronic granulotomatous disease
b. Bruton’s agammaglobulinemia
c. DiGeorge’s syndrome
d. Wiskott-Aldrich syndrome
B
A patient with hereditary angiodema has which of the following deficiencies?
a. C5-9
b. Phagocytic cell function
c. Mature B cells
d. C1 Inhibitor
D
A radiograph of a 1-year-old boy indicates the lack of a thymus. Complete blood count and flow cytometry confirm a below-normal lymphocyte count and a lack of T cells. Which of the following would most likely be the cause?
a. DiGeorge’s syndrome
b. Wiskott-Aldrich syndrome
c. Bare lymphocyte syndrome
d. Bruton’s agammaglobulinemia
A
Severe combined immunodeficiency is characterized by which of the following?
a. Diagnosed in infancy
b. Shortened life span
c. No antibody production
d. All of the above
D
A 3-year-old boy is seen by his physican because of many recent bacterial infections. Flow cytometery indicates normal levels of T and B cells. The nitroblue tetrazolium test for oxidative reduction is negative. The most likely cause is:
a. Wegener’s syndrome
b. Chronic granulomatous disease
c. Bruton’s agammaglobulinemia
d. Diabetes mellitus
B
A 25-year-old man was seen by his physican for recurrent infections. Immunoelectrophoresis revealed hypogammaglobulinemia. This man most likely has which of the following?
a. Bruton’s agammaglobulinemia
b. Common variable immunodeficiency
c. X-linked agammaglobulinemia
d. DiGeorge’s syndrome
B
In which disease would you expect to see an IgM spike on electrophoresis?
a. Transient hypogammaglobulinemia of infancy
b. Wiskott-Aldrich syndrome
c. Leukocyte adhesion disease
d. Waldenstro ̈m’smacroglobulinemia
D
A person has an infected bug bite with pain, swelling, and redness. What is the cause of these physical symptoms of inflammation?
a. Production of antibody
b. Secondary immune response
c. Increased blood flow and neutrophils to site
d. Activation of NK cells
C
The type of graft rejection that occurs within minutes of a tissue transplant is ____________.
a. Acute
b. Chronic
c. Hyperacute
d. Accelerated
C
Which immunodominant sugar confers A antigen specificity?
a. D-Galactose
b. L-Fucose
c. N-Acetylgalactosamine
d. Both A and C
C
If a patient has an A2 ABO type, which of the following statements is true?
a. The patient’s red cells will react with anti-A1 lectin
b. The patient’s serum will react with A2 cells
c. The patient’s red cells will react with anti-A2 lectin
d. The patient’s serum will react with A1 cells if anti-A1 is present
D
Which genotype confers the Bombay blood type?
a. Hh
b. hh
c. Sese
d. Lele
B
Which genes encode for Rh antigens?
a. RHDCE
b. RHD
c. RHCE
d. Both b and c
D
Testing for the D antigen was conducted at the IAT phase. A control was included in the testing. Both the patient’s red cells and the control tube reacted at 4+. How would you interpret this test?
a. The test is invalid because the control tube was positive
b. The patient is D positive
c. The patient is D negative
d. The test should be repeated and the control tube omitted
A
Of the red cells listed, which has the most D antigen present?
a. Rh null
b. D positive
c. dce/dce
d. D
D
Which is true of the Duffy blood group system?
a. Antigens are resistant to enzyme treatment
b. Antibodies never show dosage
c. Fya and Fyb are codominant alleles
d. The majority of whites are Fy(ab)
C
Which antibody is typically considered to be an auto-
antibody if found in the serum of an adult? a. Anti-K
b. Anti-I
c. Anti-D
d. Anti-Fya
B
Which reagent destroys all of the Kell blood group
system antigens?
a. DTT
b. Chloroquine diphosphate
c. AHG
d. LISS
A
Which is true of antibodies to Kidd blood group sys- tem antigens?
a. They are enhanced by enzymes
b. Titers can quickly drop in patients
c. Both A and B
d. None of the above
C
Which of the following is true of the Lewis system?
a. Lewis antigens are found on type II precursor cells
b. Lewis antigens are well developed at birth
c. Antibodies to Lewis antigens always cause HTRs
d. Antibodies to Lewis antigens rarely cross the placenta
D
Which of the following is true of antibodies to MNS blood group system antigens?
a. Anti-U is directed at a high-incidence antigen
b. Anti-N is commonly found
c. Anti-M is always clinically significant
d. Anti-S is reactive with enzyme-treated cells
A
Which of the following antibodies is classified as “biphasic” and an autoantibody?
a. Anti-B
b. Anti-P
c. Anti-H
d. Anti-Lea
B
You have performed an antibody screen using the tube method. All three screening cells tested negative. The Coombs check cells in all three tubes are also nonreactive. What should you do?
a. Respin the tubes and reread them
b. Report the antibody screen as negative
c. Repeat the antibody screen
d. Perform an antibody identification panel
C
An antibody panel has six 2+ reactive cells at AHG phase. Panel testing using enzyme-treated cells showed no reactivity. Which is the most likely anti- body that is present?
a. Anti-Fya
b. Anti-e
c. Anti-k
d. Anti-Lua
A
A patient has a currently nonreactive antibody screen but has a history of anti-Jka in the patient file. Which type of crossmatch must be performed on this patient?
a. Immediate spin crossmatch
b. IAT crossmatch
c. Electronic crossmatch
d. Both a and c
B
A recently transfused patient has a 3+ reactive DAT with anti-IgG. Which procedure should be used to identify the specificity of the IgG antibody attached to the red cells?
a. Adsorption
b. Neutralization
c. Titration
d. Elution
D
An O-negative mother gave birth to an O-positive baby. Her rosette test was positive. Which of the following is true?
a. The test is invalid because of the mother’s ABO type
b. A Kleihauer-Betke test should be performed to quantify the fetal maternal hemorrhage
c. The mother should be given a 300-mg dose of RhIG
d. A weak D test should be performed on the baby
B
In which of the following settings are platelet transfusions not indicated?
a. Thrombotic thrombocytopenic purpura
b. Immune thrombocytopenic purpura with severe intracranial hemorrhage
c. Massive transfusion
d. Vascular catheter placement, platelet count 24,000/mL
e. Brain biopsy, platelet count 62,000/mL
A
An obstetric patient presents to the hospital with marked vaginal bleeding and severe lower abdominal pain. During placement of an intravenous catheter, she was noted to have marked oozing. She is diagnosed with disseminated intravascular coagulation as a complication of her primary problem. She is given cryoprecipitate and fresh frozen plasma before going to the operating room. What element of cryoprecipitate is important in treating this patient?
a. Factor I
b. Factor II
c. Factor VIII:c
d. Factor VIII:vWF
e. Factor XIII
A
A patient’s ABO blood type is determined by which of the following?
a. Genetic inheritance and environmental factors
b. Genetic inheritance
c. Environmental factors
d. Immune function
e. Maternal blood type
B
A trauma patient with type AB is seen at a rural hospital. The hospital only has 3 units of type AB RBCs. What blood type of RBCs can the patient receive as an alternative?
a. Type O
b. Type B
c. Type A
d. None of the above
e. All of the above
E
A genetic state in which no detectable trait exists is called:
a. Recessive
b. Dominant
c. Incomplete dominance
d. Amorph
D
Most blood group antigens are expressed as a result of which of the following?
a. Autosomal recessive inheritance
b. X-linked dominant inheritance
c. Y-linked recessive inheritance
d. Autosomal codominant inheritance
D
What blood type is not possible for the offspring of AO and BO parents?
a. AB
b. A or B
c. O
d. All are possible
D
How many molecules of IgM are needed to fix complement?
a. 1
b. 2
c. 3
d. 4
A
For lysis of red blood cells to occur after antigen– antibody reaction, which compound is required?
a. Albumin
b. Glucose-6-phosphate dehydrogenase (G6PD)
c. Complement
d. Antihuman globulin (AHG)
C
An end-point of tube testing other than agglutination that must also be considered a positive reaction is called:
a. Clumping
b. Mixed field
c. Hemolysis
d. Microscopic
C
Mixed-field (mf) agglutination can be observed in the:
a. DAT on a person undergoing delayed hemolytic transfusion reaction
b. IAT result of a patient who has anti-Lea
c. DAT on a patient on high doses of penicillin
d. Typing result with anti-A of a patient who is A2 subgroup
A
In which situation(s) may the ABO serum grouping not be valid?
a. The patient has hypogammaglobulinemia
b. IgM antibodies are present
c. Cold autoantibodies are present
d. All of the above
D
If you knew the DAT is positive, what would you expect the Rh control to be when doing a weak D test through AHG?
a. Negative
b. Positive
c. Mixed field
d. Hemolysis at 37 C would be seen
B
How can IgG antibodies be removed from red cells?
a. Elution
b. Adsorption
c. Prewarming
d. Neutralization
A
Testing needs to be done with an antiserum that is rarely used. The appropriate steps to take in using
this antiserum include following the manufacturer’s procedure and:
a. Performing a cell panel to be sure that the antise- rum is performing correctly
b. Performing the testing on screen cells
c. Testing in duplicate to ensure the repeatability of the results
d. Testing a cell that is negative for the antigen and one that is heterozygous for the antigen
D
Which antibody can be neutralized with a specific reagent?
a. Anti-D
b. Anti-Jka
c. Anti-M
d. Anti-Lea
D
Group O red blood cells are used as a source of com- mercial screening cells because:
a. Anti-A is detected using group O cells
b. Anti-D reacts with most group O cells
c. Weak subgroups of A react with group O cells
d. ABO antibodies do not react with group O cells
D
The use of EDTA samples for the direct antiglobulin test prevents activation of the classical complement pathway by:
a. Causing rapid decay of complement proteins
b. Chelating Mg2+ ions, preventing assembly of C6
c. Chelating Ca2+ ions, preventing assembly of C1
d. Preventing chemotaxis
C
Check (Coombs control) cells are:
a. Added to every negative antiglobulin test
b. Added to negative direct antiglobulin tests only
c. Used to confirm a positive Coombs’ reaction
d. Coated with both IgM and C3d
A
What type(s) of red cells is(are) acceptable to trans- fuse to an AB-negative patient?
a. A negative, B negative, AB negative, O negative
b. O negative only
c. AB negative only
d. AB negative, A negative, B negative only
A
A nonbleeding adult of average height and weight with chronic anemia is transfused with 2 units of red blood cells. The pretransfusion Hgb is 7.0 g/dL. What is the expected posttransfusion Hgb?
a. 8 g/dL
b. 9 g/dL
c.10 g/dL
d. 11 g/dL
B
An IgA-deficient patient with clinically significant anti-IgA requires which of the following?
a. Leukocyte-reduced fresh frozen plasma
b. CMV-seronegative RBCs
c. Irradiated RBCs and platelets
d. Washed RBCs
D
Anti-H will react weakest with blood from a person with _____________.
a. Group O
b. Group A1
c. Group A2
d. Group A2B
B
Which of the following antibodies do not match the others in terms of optimal reactive temperature?
a. Anti-Fya
b. Anti-M
c. Anti-K
d. Anti-S
B
What antibody can an R1r patient make if transfused with R2R2 blood?
a. Anti-D
b. Anti-C
c. Anti-E
d. Anti-c
e. Anti-e
C
What is the probability of finding blood negative for the Jka and Fya antigens (23% of population is Jk [a ] and 34% of population is Fy[a ])?
a. 5.1%
b. 51%
c. 7.8%
d. 78%
C
If a person has the genetic makeup Hh, AO, LeLe, sese, what substance will be found in the secretions?
a. A substance
b. H Substance
c. Lea substance
d. Leb substance
C
Before A and B antigens can be expressed, the precursor substance must have the terminal sugar _______________.
a. d-Galactose
b. N-Acetylgalactosamine
c. Glucose
d. L-Fucose
D
If a D-positive person makes anti-D, this person is most likely:
a. Partial D
b. D negative
c. Weak D as position effect
d. Weak D because of transmissible genes
A
A serum containing anti-k is not frequently encountered because of which of the following?
a. People who lack the k antigen are rare
b. People who possess the k antigen are rare
c. The k antigen is not a good immunogen
d. Kell-null people are rare
A
A characteristic of the Xga antigen is that the Xga antigen:
a. Has a higher frequency in women than in men
b. Has a higher frequency in men than in women
c. Is enhanced by enzymes
d. Is usually a saline reacting antibody
A
Which of the following is a characteristic of the Kidd system antibodies?
a. The antibodies are usually IgM
b. The corresponding antigens are destroyed by enzymes
c. The antibodies are usually strong and stable during storage
d. The antibodies are often implicated in delayed hemolytic transfusion reactions
D
Anti-E will react with which of the following cells?
a. RoRo
b. R1R1
c. R2R2
d. rr
C
Which statement is not true concerning anti-Fya and anti-Fyb?
a. Are clinically significant
b. React well with enzyme-treated panel cells
c. Cause hemolytic transfusion reactions
d. Cause a generally mild hemolytic disease of the newborn
B
Which of the following antibodies can be neutralized with pooled human plasma?
a. Anti-Hy and anti-Ge:1
b. Anti-Cha and anti-Rga
c. Anti-Coa and anti-Cob
d. Anti-Doa and anti-Jsb
B
Donors who have received RBC transfusion within the last 12 months are deferred because:
a. Blood could transmit hepatitis or HIV
b. Donor red cell hemoglobin level may be too low
c. Donor health would prohibit the donation process
d. There will be two cell populations in this donor
A
Autologous presurgical donations are not allowed for which of the following patients?
a. Weigh less than 100 lb
b. Under the age of 14
c. With hemoglobin of 13 g/dL
d. With bacteremia
D
Which of the following viruses resides exclusively in leukocytes?
a. HCV
b. HBV
c. CMV
d. HIV
C
Which product is least likely to transmit hepatitis?
a. Cryoprecipitate
b. Plasma protein fraction
c. RBC
d. Platelets
B
In preparing platelets from a unit of whole blood, the correct order of centrifugation is:
a. Hard spin followed by a hard spin
b. Light spin followed by a light spin
c. Light spin followed by a hard spin
d. Hard spin followed by a light spin
C
Which antibody could cause hemolytic disease of the fetus and newborn?
a. Anti-I
b. Anti-K
c. Anti-Lea
d. Anti-N
B
A group A, D-negative obstetric patient with anti-D (titer 256) is carrying a fetus who needs an intrauterine transfusion. The blood needed should be:
a. Group A, D-negative RBC
b. Group A, D-negative whole blood
c. Group O, D-negative RBC
d. Group O, D-negative whole blood
C
Which of the following mothers should receive RhIG?
a. A-negative mother; O-negative baby; no prenatal care, anti-D in mother
b. AB-negative mother; B-positive baby; anti-D in mother
c. O-negative mother; A-positive baby; no anti-D in mother
d. A-positive mother; A-positive baby; no anti-D in mother
C
How many doses of RhIG are indicated for a Kleihauer-Betke reading of 0.6%?
a. 1
b. 2
c. 3
d. 4
B
What should be done first if a mother types as O and the baby types as AB?
a. Report the results with no further testing
b. Try to get a sample from the father
c. Recheck all labels, get new samples, if necessary, and retest
d. Retype using all new reagents
C
A newborn has a positive DAT. What is the best pro- cedure to determine the antibody causing a positive DAT in this newborn?
a. An antibody titer on the mother’s serum
b. An antibody panel on the mother’s serum
c. Anantibodypanelperformedontheeluateofthe mother’s cells
d. Anantibodypanelperformedontheeluateofthe baby’s cells
B
Which of the following is(are) an example(s) of a record-keeping error?
a. Use of correction fluid or tape
b. Using pencil
c. Documentation after the fact
d. All of the above
D
Which of the antigens below is considered low incidence?
a. Fya
b. S
c. C
d. Kpa
D
Which of the antigens below is considered high incidence?
a. Fyb
b. Vel
c. E
d. S
B
In performing tube testing, you see many medium- sized agglutinates in a clear background. How would you grade this reaction?
a. 2+
b. 1+
c. 4+
d. 3+
A
Of the following, which genotypes would result in the B phenotype?
a. BB
b. AB
c. BO
d. aandb
e. aandc
E
A “directed donor” unit of blood is defined as a unit of blood from a person who gives blood for:
a. Relief of polycythemia or other blood disorder
b. His or her specific use only
c. First-degree blood relative
d. Another person he or she has specified
D
Before the patient can receive a directed donation unit, the patient requires which of the following tests to be completed?
a. Type and screen only
b. Type and screen and compatibility testing
c. Retype of patient and donor unit
d. No additional testing is required
B
An 18-year-old female with a hematocrit of 38%, temperature of 37 C, and blood pressure of 175/ 90 mm Hg presents for whole blood donation. Based on this information, would you accept, permanently defer (PD), or temporarily defer (TD) the donor?
a. Accept
b. TD, blood pressure is too high for a person of her age
c. TD, temperature is too high
d. PD, for all values listed
A
A 63 year old man with hemoglobin value of 30 g/dL and pulse of 80 beats/min, who received human pituitary growth hormone (PGH) when he was 10 years old, presents for whole blood donation. Based on this information, would you accept, perma- nently defer (PD,) or temporarily defer (TD) the donor?
a. Accept the donor
b. TD, because of the human PGH
c. PD, because of the human PGH
d. PD, because of the high hemoglobin value
C
A 38-year-old female weighing 153 lb, who received the rubella vaccine 2 months previously, presents to donate whole blood. She also received 2 units of packed cells after the delivery of her eighth child 8 weeks ago. Based on this information, would you accept, permanently defer (PD), or temporarily defer (TD) the donor?
a. Accept the donor
b. TD because of the packed cells 8 weeks ago
c. PD because of receiving blood products
d. TD because of the rubella vaccine
B
A 22-year-old female with a cousin with AIDS who had taken aspirin the day before and with needle marks on both arms presents to donate whole blood. Based on this information, would you accept, permanently defer (PD), or temporarily defer (TD) the donor?
a. PD, needle marks on both arms
b. TD, needle marks on both arms
c. PD, cousin with AIDS
d. TD, because of the aspirin
A
Each unit of blood must be tested for all of the fol- lowing except:
a. Anti-HIV 1/2
b. HBsAg
c. Anti-HCV
d. Antigen to HCV
D
The principle of the HBsAg test is to detect which of the following?
a. Antigen in patient’s plasma
b. Antigen on the patient’s RBCs
c. Antibody in patient’s serum
d. Antigen and antibody in patient’s serum
A
Cryoprecipitate is prepared by first thawing:
a. Fresh frozen plasma at 1 to 6 C, and then doing a cold centrifugation to pack the cryoprecipitate
to the bottom so the plasma may be removed
b. Fresh frozen plasma at room temperature, then placing in the freezer for 2 hours, then centrifuging and removing the cryoprecipitate
c. Cryoprecipitate at 1 to 6 C, then pooling the thawed cryoprecipitate in batches of 10 units, then quickly refreezing
d. Cryoprecipitate at room temperature, then centri- fugation in the cold to concentrate the cryoprecipitate to the bottom before adding more plasma to reconstitute
A
Platelets must be kept in constant motion for which of the following reasons?
a. Maintain the pH so the platelets will be alive before transfusion
b. Keep the platelets in suspension and prevent clumping of the platelets
c. Mimic what is going on in the blood vessels
d. Preserve the coagulation factors and platelet viability
A
After thawing and pooling cryoprecipitate for transfusion to a patient, the product should be stored at: a. Room temperature
b. 1 to 6 C
c. 37 C
d. 0 C
A
Fresh frozen plasma must be thawed at which temperature?
a. 1 to 6 C
b. Room temperature
c. 37 C
d. 40 C or higher
C
Frozen red blood cells are prepared for transfusion by thawing at:
a. Room temperature and then washing with saline
b. 37 C in a water bath and then washing with different concentrations of saline
c. 37 C control incubator and then mixing well before transfusion
d. 1 to 6 C for 2 days and then washing with different concentrations of dextrose
B
Which is the most likely reason frozen deglycerolized
red blood cells would be used?
a. A patient with antibodies to a high-frequency antigen
b. Pregnant women requiring intrauterine transfusions
c. Emergency transfusion situations
d. Group AB Rh-negative patients
A
One indication for transfusion of thawed/pooled cryoprecipitate would be replacement of which of the following?
a. Factor X in hemophiliacs
b. Factor VIII in massively transfused patients
c. Fibrinogen
d. Volume
C
A contraindication for transfusing red blood cells to a patient is if the patient:
a. Is massively bleeding
b. Has well-compensated anemia
c. Has bone marrow failure
d. Has decreased red blood cell survival
B
Concerning the component and the required quality
control results, which of the following is a true statement?
a. FFP must have 80 international units of fibrinogen in 7 units tested
b. Cryoprecipitate must have 80 international units of factor VIII
c. Leukocyte-reduced red blood cells must have fewer than 3.3 1011 WBCs in each unit 98.
d. Platelets must have no red blood cells
B
Fresh frozen plasma must be stored at:
a. Colder than 18 C for no longer than 1 year from donation
b. Colder than 38 C for no longer than 1 year from donation 99.
c. Exactly 18 C for no longer than 1 year from donation
d. 18Cto38Cforupto10yearsfrom donation
A
The storage temperature for packed red blood cells is _______________. 100.
a. 1 to 10 C
b. 1 to 4 C
c. 1 to 6 C
d. 20 to 25 F
C
Platelets made from a single whole blood donation should contain which of the following?
a. 3x10^11 platelets in 90% of samples
b. 3.3x10^9 platelets in 75% of samples
c. 5.5x10^10 platelets in 90% of samples
d. 10x10^10 platelets in 75% of samples
C
Frozen red blood cells must be stored at __________________.
a. 180 C or less
b. 18 C or less
c. 32 C or less
d. 65 C or less
D
The temperature for incubation of the indirect anti- globulin test (IAT) should be ____________.
a. 24 C
b. 6 C
c. 37 C
d. 3710 C
C
The temperature of a blood refrigerator without a continuous recording device should be recorded:
a. Daily
b. Every 4 hours
c. Once every 24 hours
d. Every 30 minutes
B
When should quality control be performed on rou- tine blood typing reagents?
a. At the beginning of each shift
b. Once daily
c. Weekly
d. Only when opening a new vial
B
