ISBB - PAHABOL NOTES Flashcards by Patricia Baltazar

Who is not permanently deferred from blood donation
a. covid 19 positive
b. positive for prion disease
c. has been receiving transfusion since the 90’s

a. covid 19 positive

**Donors who had symptomatic disease should refrain from donating blood for at least 14 days after complete resolution of symptoms related to COVID-19

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Most severe hemolytic anemia
a. Warm-(WAIHA)
b. Cold- presence of IgM antibodies (or autoantibodies) can cause intravascular hemolysis.
c. Drug induced

a. Warm-(WAIHA)

Note:
* Warm AIHA- most common AIHA
* Drug induced HA-
* Hapten mechanism: penicillin and cephalosporin
* Membrane modification: cephalosporin
* Drug-Ab complex deposition: quinidine and phenacetin
* Auto-Ab: methyldopa

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Cytokine for bacterial infection with fever
a. TNF
b. IL-7
c. IL-12
d. IL-2

a. TNF

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**Immunoglobulin seen in secretions

IgD
IgM
IgG
IgA

IgA (Stevens)

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** MCH 1 and 2 is needed for

a. Autologous
b. allogenic

allogenic*

**Allogeneic tissue transplantation requires the donor and the recipient to be MHC 1 and 2 compatible.

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** What blood component should be transfused to avoid transmission of CMV?
A. Leukoreduced
B. Irradiated
C. Whole blood
D. Packed RBC

A. Leukoreduced

*also leukopoor

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** In the indirect fluorescent anti-nuclear antibody test, a speckled pattern may indicatethe presence of antibody
to:
A. Histones
B. Sm
C. RNA
D. DNA”

B. Sm

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ANAs

With Homogenous pattern:

ANAs

With Homogenous pattern: anti-dsDNA, anti-ssDNA, anti-histones, anti-DNP

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ANAs

With speckled pattern:

With speckled pattern: anti-Sm, anti-SSA/Ro, anti-SSb/La, anti-centromere (discrete)

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ANAs

With nucleolar pattern: Anti-centromere

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**Shelf life if CPDA-1 is the anticoagulant:

: 35 days

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**CPDA-1
A. 21 days
B. 28 days
C. 35 days
D. 42 days

C. 35 days

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**Seen in medullary thyroid carcinoma
A. ACTH
B. Neuron-specific enolase
C. ALP
D. Calcitonin

D. Calcitonin
Calcitonin is a tumor marker for medullary thyroid carcinoma

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**How to get PLT-rich plasma

Whole blood + light spin (2,000 g x 3 minutes) = packed RBC + platelet-rich plasma

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**Aspirin intake hours of deferral:

48 hours
*No restriction for whole blood donation.
*Other references: 3 days for platelet apheresis.

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**enhanced by enzyme:

KALIPR:

Kidd
ABO
Lewis
Ii
P1
Rh

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**Soluble antigen with soluble antibody

(precipitation)

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**What is the possible blood type of offsprings of Xg (+) father and Xg (-) mother
A. All sons Xg (-) all daughters (+)
B. All sons (+) daughters (-)
C. All are (+)
D. All are (-)

A. All sons Xg (-) all daughters (+)

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FTA-Abs, MHA-TP, TP-PA, EIA, CLIA, MFI

**Treponemal tests-

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**Anti-RNP antibody is for:

Mixed connective tissue disease

*mixed connective tissue disease (MCTD) and, to a lesser extent, systemic lupus erythematosus (SLE)

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**Storage temp of frozen RBC-

–60 to -80C—10 years. But latest experiments, up to 37 years

*Other references: -65C to -120C

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**Conditions for RhIg administration:

Mother is Rh negative, fetus is Rh positive.
Mother is anti-D negative.
RhIg is given to Rh(-) mothers at 28 weeks gestation and after delivery.
**Donor Deferrals (review mothernotes/GFC notes)

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**Which is routinely used for freezing?
A. 40% glycerol
B. 20% glycerol

A. 40% glycerol

Harmening: most widely used because equipment is fairly simple to use and the products require less delicate
handling.

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**All of the following is enhanced by enzymes except:
a. Rh
b. Duffy
c. ABO
d. Kidd

b. Duffy

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**Which one is enhanced by enzyme? a. Lutheran b. Rh c. Duffy d. Kell

b. Rh

**After blood donation, what is the proper action? a. Instruct the donor to stand slowly and ask how does she/he feel b. Immobilized the donor for less than 1 hour c. Let the donor sit for a couple of minutes

c. Let the donor sit for a couple of minutes **Once the needle has been removed from the donor’s arm, apply pressure over gauze, and ask the donor to raise his or her arm, continuing to exert pressure over the site. The donors are encouraged to remain lying down for a few minutes, and remain in the area where they can be observed for any reactions. **After a blood donation, it's crucial for the donor to sit and relax for a few minutes, allowing their body to adjust to the slight decrease in fluid volume, and to observe for any signs of lightheadedness or dizziness.

**Patient has B antigen what is the patient blood type? a. A b. B c. AB d. O

b. B

**All of the following are group 1 interferons except: a. Alpha b. Gamma c. Beta d. Delta

b. Gamma **Interferon delta (IFN-δ) (novel type 1 interferon) belongs to the type I interferon (IFN) family, which includes IFN-α, IFN-β, IFN-ε, IFN-ω, IFN-κ, IFN-τ, and IFN-ζ.

**2nd most important blood group: Rh ABO Mns Le

**Patient is experiencing vasovagal syncope, what to do?: lie down and raise the legs above the head

lie down and raise the legs above the head **Vasovagal syncope is a brief loss of consciousness due to sudden drop in BP or heart rate. Raise the patient’s legs above the level of the head and loosen tight clothing and secure airway.

**factor that affects blood component preparation: a. blood bag b. duration/time? c. Temperature d. ALL

d. ALL **Additive present in the blood bag dictates the shelf-life of the unit. Amount of time and temperature storage from blood collection is important in preparation.

Functions of interferon, except A. Occur naturally B. Interfere with viral replication C. Not virus specific D. Mobilize natural killer cells-yes, by type I interferons (IFN-α and IFN-β),

A. Occur naturally **All are correct- but the question is about function…a is the nature. **Interferons are not virus-specific; they are a broad-spectrum antiviral defense mechanism, meaning they can protect against a wide range of viruses, not just one specific type.

**If type O patient is given type B blood, what is the reaction? a. Agglutination in px red cell b. No agglutination-compatible c. Agglutination in donor serum-minor xm incompatible d. Agglutination in both px red cell and serum-autoagglutination-but mosat probable if agglutination happened in vivo

d. Agglutination in both px red cell and serum-autoagglutination-but mosat probable if agglutination happened in vivo **Ideal answer: agglutination in Px’s serum with donor RBCs-wrong recall *Major XM: Recipient Type O serum (with anti B) + Donor B cells = agglutination *Minor XM: Donor Type B serum (with anti-A) + recipient O cells = no agglutination

**Confirmatory for chlamydia:

NAAT (PCR)

**Confirmatory for treponema: a. darkfield microscope b. fluorescent microscope

darkfield microscope

**Primarily what type of antibody does red cell antibody have? IgG, Ige, IgA, IgM

IgG **The most common antibody found in red cell membranes, and in the blood in general, is IgG, which makes up about 70-75% of all antibodies

isoagglutinins are antibodies that can agglutinate cells (such as RBCs) of other individuals

Ig bound to RBC membrane-

**Which of the following is not usually present in the neonates? a. Jk (a-b-) b. Jk (a+b-) c. Jk (a-b+) d. Jk (a+b+)

a. Jk (a-b-)

*Blood donation duration: * The initial _____ of a blood transfusion are crucial for monitoring for adverse reactions, and the transfusion should be completed within____ of removal from storage.

*8-10 minutes or less than 15 minutes 15 mins 4 hours

**Which is a volume expander? a. Whole Blood B. Plasma C. granulocytes

plasma, and specifically products derived from it like albumin, can be used as a volume expander

**Most common congenital infection?

CMV

**What to transfuse in B(-) a. O- b. A+ c. B+ d. AB+

a. O- **A person with B-negative blood type can safely receive blood transfusions from B-negative or O-negative donors.

**What is performed/used for HDFN Diagnosis HDFN evaluation begins by first determining risk by identifying the presence of maternal RBC antibodies in an indirect antibody test (ie, Coombs test) or a positive direct antibody test (DAT) of the infant's serum. DAT testing typically involves using a polyspecific reagent consisting of IgG and complement C3 a. IAT with anti-IgG reagent b. IAT with anti-IgM reagent c. DAT with anti-IgG reagent d. DAT with anti-IgM reagent

c. DAT with anti-IgG reagent

Who shall be administered with postpartum RhIG a. Mother who is D(-); Antibody screen: immune anti-D positive; Fetus D(+) b. Mother who is D(+); Antibody screen: negative; Fetus D(-) c. Mother who is D(-); Antibody screen: negative; Fetus D(+)

c. Mother who is D(-); Antibody screen: negative; Fetus D(+) ****When the antigen is particulate (insoluble) (like bacteria or red blood cells), the binding of the antibody can cause the antigen to clump together, a process called agglutination.

** Ahapten is A. Half of an immunoglobulin molecule B. A earner molecule for an antigen that is not antigenic alone C. An immunoglobulin functional only in the presence of complement D. A determinant capable of stimulating an immune response only when bound to a carrier

D. A determinant capable of stimulating an immune response only when bound to a carrier

**Cryoprecipitate AHF contains all of the following, EXCEPT: A. Red Blood Cells B. Fibrinogen C. vWF D. Fibronectin

A. Red Blood Cells **Cryoprecipitate contains most of the factor VIII, fibrinogen, factor XIII, von Willebrand factor and fibronectin found in FFP. Cryoprecipitate has a shelf life of 12 months when stored at –25º C or below.

** The Venereal Disease Research Laboratory (VDRL) test for syphilis is classified as a(n) A. Agglutination reaction B. Flocculation reaction C. Hemagglutination reaction D. Precipitation reaction

B. Flocculation reaction

**False positive VDRL, what condition

SLE

** Which of the following is characteristic of B cells? A. Phagocytic B. Participate in antibody-dependent cellular cytotoxicity (ADCC) reactions C. Contain surface immunoglobulins D. Secrete the C5 component of complement

C. Contain surface immunoglobulins

** Which of the following is characteristic of contact hypersensitivity reactions? A. Caused by preformed IgE antibody B. Characterized by infiltration of neutrophils into the area of reaction C. The primary symptoms often occur in the respiratory tract. D. Usually due to a hapten

D. Usually due to a hapten

**Phenotype of D negative a. (+/+) b. (-) c. (+) d. (-/-)

b. (-) **The genotype is a set of genes in DNA responsible for unique traits or characteristics (2 symbols), while the phenotype is the physical appearance or characteristic of an organism-final observable trait.

** IgM antibodies react well in complement fixation (CF) tests. Because of this, CF tests for antibodies should A. Be positive early in the course of the disease B. Be useful in identifying antibodies responsible for a delayed hypersensitivity reaction C. Be useful in identifying antibodies responsible for anaphylactic reactions D. Detect transplacental antibodies

A. Be positive early in the course of the disease

** A lymphokine is A. A soluble mediator produced by granulocytes and affecting lymphocytes B. A soluble mediator produced by lymphocytes C. A soluble mediator produced by plasma cells D. An antibody that reacts with lymphocytes

B. A soluble mediator produced by lymphocytes

**Sda can be neutralized by? A. hydatid cyst fluid B. plasma C. human breast milk D. urine

D. urine **The Sd(a) antigen exhibits autosomal dominant inheritance. The antigen is not only expressed on the surface of red blood cells but is found in soluble form in human plasma, breast milk, saliva and meconium, and is present in very high quantities in the urine, where it is carried on Tamm-Horsfall glycoprotein. **Anti-Sd(a) is a naturally occurring antibody, meaning Sd(a) negative individuals produce it without having been exposed to Sd(a) positive blood through transfusion or pregnancy.

** For an antibody-coated antigen to be phagocytized, what part of the antibody molecule fits into a receptor on the phagocytic cell? A. Fc region B. Fab region C. Hinge region D. Variable region

A. Fc region

**The ability of a single cytokine to alter the expression of several genes is called A. Autocrine stimulation B. Endocrine C. Pleiotropy D. Redundancy

C. Pleiotropy **Pleiotropy describes the genetic effect of a single gene on multiple phenotypic traits. The underlying mechanism is genes that code for a product that is either used by various cells or has a cascade-like signaling function that affects various targets.

** Cell-mediated immunity is primarily mediated by A. B cells B. T helper cells C. Plasma cells D. Dendritic cells

B. T helper cells

**Which minor blood group system can cause HDN? A. Vel B. Gerbich C. Gregory D. Holley

A. Vel **Anti-Vel is characterized by its ability to activate complement and cause in vitro and in vivo hemolysis. The antibody is most often IgG but can be IgM, and it has caused severe, immediate HTRs. Anti-Vel has also caused one case of severe HDFN in which the mother had previously been transfused.

** Which of the following serologic tests is commonly performed by an immunofluorescence method? A. Anti-HBs-ELISA B. Antinuclear antibody (ANA) C. Antistreptolysin O (ASO)—red cells or latex agglutination D. C-reactive protein (CRP)- latex agglutination, turbidimetry, or nephelometry.

B. Antinuclear antibody (ANA)

**The HLA complex is located primarily on A. Chromosomes B. Chromosome 6 C. Chromosome 9 D. Chromosome 17

B. Chromosome 6

**Delayed Hemolytic Transfusion reaction EXCEPT: A. Hemolytic B. PTP C. TA-GVHD D. Hemosiderosis

A. Hemolytic

** In the classical pathway of complement activation, A. C3 is activated by binding C-reactive protein B. The sequence of activation is Cl, C2, C3,C4 C. Clq is activated by the presence of a single Fab region D. Activation by antibody requires one IgM or two IgG molecules

D. Activation by antibody requires one IgM or two IgG molecules

** Antibodies that bind to the same epitope are of the same A. Allotype B. Autotype C. Idiotype D. Isotype

C. Idiotype **Idiotype of an antibody refers to the antigen specificity of the molecule. isotype is the different classes and subclasses of antibodies (e.g., IgG, IgM, etc.). "Allotype" refers to different alleles of the same isotype. **Genetically different individuals will produce antibodies of the same isotype, but they would have a different allotype

** Which of the following is more likely to be diagnostic of an acute infection? A. A total acute antibody liter of 2 followed by a convalescent titer of 16 B. A total acute antibody titer of 80 followed by a convalescent titer of 40 C. A total antibody titer of 80 D. An IgG antibody titer of 80

A. A total acute antibody liter of 2 followed by a convalescent titer of 16

**Rh group are __

NONGLYCOSYLATED PROTEINS **The Rh blood group antigens (D, Cc and Ee series) are carried by a family of non glycosylated hydrophobic transmembrane proteins of 30-32 kDa which are missing from the red cells of rare Rhnull individuals that express several membrane defects.

** What is the predominant type of antibody found in the serum of neonates born after full-term gestation? A. Infant IgA B. Infant IgG C. Infant IgM D. Maternal IgG

D. Maternal IgG

**Improvement methodology referring to non-value added activities considered as waste. a. Scrum b. Agile c. Lean d. Waterfall

c. Lean

is an empirical process, where decisions are based on observation, experience and experimentation

Scrum

is a project management philosophy that utilizes a core set of values or principles

Agile

each process phase cascades downward sequentially through five stages (requirements, design, implementation, verification, and maintenance).

waterfall methodlogy,

** Which class of immunoglobulin possesses 10 antigenic binding sites? A. IgA B. IgD C. IgG D. IgM

D. IgM

** Severe combined immunodeficiency (SCID) is an A. Immunodeficiency with decreased B cells and neutrophils B. Immunodeficiency with lymphocytopenia and eosinophilia C. Immunodeficiency with decreased or dysfunctional T and B cells D. Immunodeficiency with decreased lymphocytes and decreased complement concentration

C. Immunodeficiency with decreased or dysfunctional T and B cells

**ABO discrepancies between forward or reverse blood typing with weak reacting or missing antibodies. a. Patient with antibody to the weak Antigen b. Patient is very young or very old c. Patient with subgroup of Group d. d. Patient with acquired B phenomenon

b. Patient is very young or very old

** When performing the enzyme-multiplied immunoassay technique (EMIT), how is the ligand in the patient's serum detected? A. Agglutinates by binding to antibodycoated latex beads B. Binds to enzyme-labeled antibody C. Competes with enzyme-labeled antigen for binding to a specific antibody D. Forms antibody-antigen complex and precipitates

C. Competes with enzyme-labeled antigen for binding to a specific antibody

**Possible mother-fetus incompatibility if father is Rh +, mother is Rh - . They have their first child without undergoing treatment. a. 0% b. less than 50% c. 50% d. 100%

d. 100% **Rh incompatibility usually isn't a problem if it's the mother's first pregnancy. That's because the baby's blood does not normally enter the mother's circulatory system during the pregnancy. **if the exposure to the Rh D antigen occurs during the mother’s first pregnancy, the adverse consequences of Rh incompatibility do not typically affect that initial pregnancy because the fetus often is delivered before the development of the anti-D antibodies.

**Lectin Dolichus biflorus expresses ___ antigen. a. A1 b. P c. K d. I

a. A1

**The following are correct for storage and transport of blood components EXCEPT: a. Blood must not be hemolyzed b. Blood must be stored at -20C c. Blood must in a hygienic environment d. Blood must be protected from breakdown products of glycerol

b. Blood must be stored at -20C

** An example of immune injury due to the deposition of antigen-antibody complexes is A. Acute glomerulonephritis B. Bee-sting allergy C. Contact dermatitis D. Penicillin allergy

A. Acute glomerulonephritis

** In bone marrow transplantation, immunocompetent cells in the donor marrow may recognize antigens in the recipient and respond to those antigens. This phenomenon is an example of A. Acute rejection B. Chronic rejection C. Graft versus host disease D. Hyperacute rejection

C. Graft versus host disease

** A soluble antigen and soluble antibody reacting to form an insoluble product describes A. Agglutination reactions B. Heterophile reactions C. Labeled reactions D. Precipitation reactions

D. Precipitation reactions

**An IF test with antibodies to detect CD3 will detect which cell? a. Circulating T cells b. T helper lymphocytes only c. T. Suppressor lymphocytes only d. NK cells

a. Circulating T cells

**How is the patient who is RH negative in a RBC written. a. (+/-) b. (-/-) c. (+) d. (-)

d. (-)

** Which one of the following describes a direct immunofluorescence assay? A. Conjugated reagent antigen reacts with antibodies to form antigen-antibody complexes B. Antigens react with unlabeled antibody forming antigen-antibody complexes that attach to labeled antibodies C. A dye is attached to a molecule and it reacts with an immune complex to produce a color D. Conjugated reagent antibody reacts with antigen to form antigen-antibody complexes

D. Conjugated reagent antibody reacts with antigen to form antigen-antibody complexes

** A patient report states the presence of serum antibodies to OspC. What disease does the patient most likely have? A. Syphilis B. Strep throat C. Lyme disease D. Rubella

C. Lyme disease

**Red cell immune antibody: a. IgG b. IgA c. IgD d. IgE

a. IgG **The most common immune antibodies encountered in testing include those that react with the Rh, Kell, Duffy, Kidd, and Ss blood group systems.

** Diagnosis of group A streptococci (Streptococcus pyogenes) infection is indicated by the presence of A. Anti-protein A B. Anti-DNaseB C. Anti-beta-toxin D. C-reactive protein

B. Anti-DNaseB

**CD8+ cell is also known as: a. helper b. Cytotoxic c. Killer d. Null

b. Cytotoxic

** Which cell is the principal source of interleukin 2? A. Bcell B. Tcell C. Monocyte D. Plasma cell

B. Tcell

**Which type of hypersensitivity reaction involves immune complexes? a. Type 1 b. Type 2 c. Type 3 d. Type 4

c. Type 3

** A major advantage of passive immunization compared to active immunization is that A. Antibody is available more quickly B. Antibody persists for the life of the recipient C. IgM is the predominant antibody class provided D. Oral administration can be used

A. Antibody is available more quickly

**superantigens:

Polyclonal T cell activation

**The red cell phenotype of an individual in routine forward and reverse grouping with the genotypes hh, AB a. O b. AB c. A d. B

a. O Observable trait. No H, so direct or forward typed as “O”.

** After activation of the complement system, leukocytes and macrophages are attracted to the site of complement activation by A. Cl B. C5a C. C8 D. IgM

B. C5a

**FFP is used to treat the following, EXCEPT: a. DIC b. Liver disease c. Vitamin K Def d. Idiopathic Thrombocytopenic Purpura

d. Idiopathic Thrombocytopenic Purpura

** The antibody most frequently present in systemic lupus erythematosus is directed against A. Surface antigens of bone marrow stem cells B. Surface antigens of renal cells C. Nuclear antigen D. Myelin

C. Nuclear antigen

** In a competitive radioimnumosorbent test (RIST), what does a high signal suggest? A. The patient sample has a low concentration of IgE. B. The patient sample has a low concentration of IgM. C. The patient sample has a high concentration of IgE. D. The patient sample has a high concentration of total antibody.

A. The patient sample has a low concentration of IgE.

**What is secreted by the subendothelial tissue (when damaged) that contributes to the manifestation of cardinal signs? a. serotonin b. Acetylcholine c. dopamine d. Prostaglandin

**Which of the ff is correct Southern blot: DNA southern blot: RNA Northern blot: DNA Northern blot: RNA

Southern blot: DNA Northern blot: RNA

**What would cause a deferral? a. antibiotic b. meds for hypertension c. Levonorgestrel pills, pill for contraception. d. Hepa B vaccination

d. Hepa B vaccination

**Where do antigen independent lymphocytes mature: mostly NK cells:

bone marrow and secondary lymphoid tissues

**Enchances ag-ab reaction by removing sialic acid except A. trypsin B. Ficin C. Papain D. PEG

D. PEG

**MOST reliable test for Hepa E A. PCR b. Western blot c. Nothern blot

A. PCR

gold standard for the detection of HEV infection.

HEV RNA (PCR) detection in blood or stool

**All are antibody potentiators except ✓ Fiscin ✓ Trypsin ✓ liss ✓ Peg

✓ Peg

**reactive at IS phase pero 0 in other phases a. IgG alloantibody b. IgM alloantibody c. warm antibody d. cold antibody

b. IgM alloantibody

**Which cells do not express MHC proteins: A. Macrophage B. Epithelial Cells C. Dendritic Cells D. Erythrocytes

D. Erythrocytes

**4 units of blood negative for antibody screening but one is tested is 4 plus in ahg phase a. anti d b. anti k c. anti lub d. anti p1

b. anti k

**mother’s antibody agglutinates the neonates a. hydrops fetalis b. erythblastosis fetalis

b. erythblastosis fetalis

**Major Functions of CRP A. Causes Vasodilation B. Help form Clot C. Act as Opsonin D. Binds Hemoglobin

C. Act as Opsonin

**Standard PCR Mix Includes the following except: A. dNTPs B. Primer C. EcoR1 D. Taq Polymerase

C. EcoR1

**Most appropriate Lab Procedure used in Serodiagnosis for Rheumatoid Arthritis. A. HLA - Inhibition B. IF C. Latex Agglutination D. ELISA

**light chain of Antibodies A. mμ and Gamma B. Kappa and Lambda C. Delta and Epsilon D. Gamma and Epsilon