L1 ISBB

Question 1

He was said to have been given the world’s first blood transfusion by his Jewish physician Giacomo di San Genesio, who made him drink the blood of three 10-year-old boys:

A. Pope Innocent VII
B. Pope Pius I
C. Pope Gregory III
D. Pope Boniface IV

Answer 1

A. Pope Innocent VII

Question 2

He carried out vein-to-vein transfusion of blood by using multiple syringes and a special cannula for puncturing the vein through the skin:

A. Unger
B. Edward Lindemann
C. Audrey Smith
D. Loutit and Mollison

Answer 2

B. Edward Lindemann

Question 3

What blood type is/are NOT possible for an offspring of heterozygous A and homozygous B parents?
1. A
2. B
3. O
4. AB

A. 1 only
B. 1 and 3
C. 2 and 4
D. 1, 2 and 3

Answer 3

B. 1 and 3

Question 4

A person’s saliva incubated with the following antibodies and tested with appropriate A, O, and B indicator cells: the following test results are obtained:

Antibody specificity: Test results:
Anti-A reactive
Anti-B inhibited
Anti-H inhibited

The person’s phenotype is:

A. A
B. B
C. O
D. Bombay phenotype

Answer 4

B. B

Question 5

Which of the following describes A1 subgroup?

A. Reacts with anti-A
B. Reacts with anti-A1 and anti-A
C. MF reaction with anti-A and anti-AB
D. Reacts with Anti-AB but no reaction with anti-A

Answer 5

B. Reacts with anti-A1 and anti-A

Question 6

All of the following statements are true regarding the A2 blood group, EXCEPT:

A. Dolichos biflorus lectin generally does not agglutinate A2 RBCs
B. A2 RBCs have more A antigen than A1 RBCs
C. A2 RBCs are agglutinated with anti-A antisera
D. Most A2 individuals have the same form of anti-B as A1 individuals

Answer 6

B. A2 RBCs have more A antigen than A1 RBCs

Question 7

What reaction would be the same for A1 and A2 subgroups?

A. Positive reaction with anti-A1 lectin
B. Positive reaction with A1 cells
C. Equal reaction with Anti-H
D. Positive reaction with Anti-A, B

Answer 7

D. Positive reaction with Anti-A, B

Question 8

Which of the following errors would cause the most severe reactions?

A. Group A blood given to group O patient
B. Group O blood given to group A patient
C. Group B blood given to group AB patient
D. Group O blood given to group B patient

Answer 8

A. Group A blood given to group O patient

Question 9

With regard to inheritance of the Rh system, which of the following applies?

A. Sex-linked dominant
B. Sex-linked recessive
C. Autosomal recessive
D. Autosomal codominant

Answer 9

D. Autosomal codominant

Question 10

What type of antigen characteristic of RBCs is unique to an individual or a related family of individuals and, therefore, is not commonly found on all cells (usually less than 1% of the population)?

A. Private antigen
B. Public antigen
C. Syngeneic antigen
D. Xenoantigen

Answer 10

A. Private antigen

Question 11

A patient has a positive antibody screen and positive antibody panel. The patient specimen is retested with antibody panel cells that have been treated with the enzyme ficin. The antibody panel is now negative. Which of the following antibodies would give you these results?

A. Anti-Jka
B. Anti-Xga
C. Anti-K
D. Anti-Sc1

Answer 11

B. Anti-Xga

Question 12

How can interfering anti-P1 antibodies be removed from a mixture of antibodies?

A. Neutralization with saliva
B. Agglutination with human milk
C. Combination with urine
D. Neutralization with hydatid cyst fluid

Answer 12

D. Neutralization with hydatid cyst fluid

Question 13

If group O blood is crossmatched with group B recipient, what is the expected result?

A. Major crossmatch will be incompatible
B. Minor crossmatch will be incompatible
C. Both major and minor crossmatch will be incompatible
D. Both major and minor crossmatch will be compatible

Answer 13

B. Minor crossmatch will be incompatible

Question 14

A patient needs few units of whole blood for tomorrow’s surgery. The antibody screen of the patient reveals two antibodies. Anti-Jka and Anti-K. The negative frequency of Jka antigen in the population is 75% and the positive frequency of K antigen in the population is 25%. How many units of blood are needed to screen to find 5 units of compatible blood?

A. 8 units
B. 9 units
C. 26 units
D. 27 units

Answer 14

B. 9 units

Question 15

Under extreme emergency condition when there is no time to determine ABO group for transfusion, the technologist should:

A. Refuse to release any blood until the patient’s sample has been typed
B. Release O, Rh-negative whole blood
C. Release O, Rh-negative red blood cells
D. Release O, Rh-positive red blood cells

Answer 15

C. Release O, Rh-negative red blood cells

Question 16

Two thousand cells were counted and one hundred od these cells appeared to contain fetal hemoglobin. Calculate the number of vials of Rh immune globulin.

A. 7
B. 8
C. 9
D. 10

Answer 16

C. 9

Question 17

What type of serological testing does the blood bank technologist perform when determining the blood group of a patient?

A. Genotyping
B. Phenotyping
C. Both
D. Polymerase chain reaction

Answer 17

B. Phenotyping

Question 18

If anti-K reacts 3+ with a donor cell with a genotype KK and 2+ with a Kk cell, the antibody is demonstrating:

A. Dosage
B. Linkage disequilibrium
C. Homozygosity
D. Heterozygosity

Answer 18

A. Dosage

Question 19

Carla expresses the blood group antigens Fya, Fyb, and Xga. James shows expressions of none of these antigens. What factors may account for the absence of these antigens in James?

A. Gender
B. Race
C. Gender and race
D. Medication

Answer 19

C. Gender and race

Question 20

Which of the following statements is true?

A. An individual with BO genotype is homozygous for B antigen
B. An individual with the BB genotype is homozygous for B antigen
C. An individual with the OO genotype is heterozygous for O antigen
D. An individual with the AB phenotype is homozygous for A and B antigens

Answer 20

B. An individual with the BB genotype is homozygous for B antigen

Question 21

Which genotype is heterozygous for C?

A. DCe/dce
B. DCE/DCE
C. Dce/dce
D. DCE/dCe

Answer 21

A. DCe/dce

Question 22

Which genotype will give rise to the Bombay phenotype?

A. HH only
B. HH and Hh
C. Hh and hh
D. hh only

Answer 22

D. hh only

Question 23

Meiosis in cell division is limited to the ova and sperm producing four gametes containing what complement of DNA?

A. 1N
B. 2N
C. 3N
D. 4N

Answer 23

A. 1N

Question 24

A cell that is not actively dividing is said to be in:

A. Interphase
B. Prophase
C. Anaphase
D. Telophase

Answer 24

A. Interphase

Question 25

Which of the following describes the expression of most blood group antigens?

A. Dominant
B. Recessive
C. Codominant
D. Corecessive

Answer 25

A. Dominant

Question 26

The alleged father of a child in a disputed case of paternity is blood group AB. The mother is group O and the child is group O. What type of exclusion is this?

A. Direct/primary/first order
B. Probability
C. Random
D. Indirect/Secondary/second order

Answer 26

D. Indirect/Secondary/second order

Question 27

If the frequency of gene Y is 0.4 and the frequency of gene Z is 0.5, one would expect that they should occur together 0.2(20%) of the time. In actuality, they are found together 32% of the time. This is an example of:

A. Crossing over
B. Linkage disequilibrium
C. Polymorphism
D. Chimerism

Answer 27

B. Linkage disequilibrium

Question 28

In the Hardy-Weinberg formula, p2 represents:

A. The heterozygous population of one allele
B. The homozygous population of one allele
C. The recessive allele
D. The dominant allele

Answer 28

B. The homozygous population of one allele

Question 29

In this type of inheritance, the father carries the trait on his X chromosome. He has no sons with the trait because he passed his Y chromosome to his sons; however, all his daughters will express the trait.

A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive

Answer 29

C. X-linked dominant

Question 30

Why do IgM antibodies, such as those formed against the ABO antigens, have the ability to directly agglutinate RBCs and cause visible agglutination?

A. IgM antibodies are larger molecules and have the ability to bind more antigen.
B. IgM antibodies tend to clump together more readily to bind more antigen.
C. IgM antibodies are found in greater concentrations than IgG antibodies.
D. IgM antibodies are not limited by subclass specificity.

Answer 30

A. IgM antibodies are larger molecules and have the ability to bind more antigen.

Question 31

Which of the following enhancement mediums decreases the zeta potential, allowing antibody and antigen to come closer together?

A. LISS
B. Polyethylene glycol
C. Polybrene
D. ZZAP

Answer 31

A. LISS

Question 32

This type of antibody response is analogous to an anamnestic reaction.

A. Primary
B. Secondary
C. Tertiary
D. Anaphylactic

Answer 32

B. Secondary

Question 33

Which antibodies to a component of complement are contained in the rabbit polyspecific antihuman globulin reagent for detection of in vivo sensitization?

A. Anti-IgG and anti-C3a
B. Anti-IgG and anti-C3d
C. Anti-IgG and anti-IgM
D. All of these

Answer 33

B. Anti-IgG and anti-C3d

Question 34

The number of H antigen structures currently identified are:

A. Two
B. Four
C. Six
D. Eight

Answer 34

B. Four

Question 35

Greatest amount of H antigen:

A. A1
B. O
C. AB
D. B

Answer 35

B. O

Question 36

Bombay phenotype antibodies include:

A. Anti-A
B. Anti-B
C. Anti-H
D. All of the choices

Answer 36

D. All of the choices

Question 37

Methylenedioxymethamphetamine (MDMA) or commonly known as:

A. Cannabis
B. Shabu
C. Meth
D. Ecstasy

Answer 37

D. Ecstasy

Question 38

THERAPEUTIC DRUG MONITORING
Anticoagulant suitable for most drug analysis.

A. Heparin
B. Citrate
C. Oxalate
D. EDTA

Answer 38

A. Heparin

Serum or plasma is the specimen of choice for the determination of circulating concentrations of most drugs.
Heparinized plasma is suitable for most drug analysis.
The calcium-binding anticoagulants add a variety of anions and cations that may interfere with analysis or cause a drug to distribute differently between cells and plasma.
As a result, ethylenediaminetetracetic acid (EDTA), citrated and oxalated plasma are not usually acceptable specimens

Question 39

Agglutination reactions characterized by many small agglutinates in a background of free cells would be graded in tube testing as:

A. 1+
B. 2+
C. 3+
D. 4+

Answer 39

A. 1+

Question 40

An order for blood products for a recent recipient of a bone marrow graft was received in the transfusion service. Because these patients are especially susceptible to GVHD from a transfusion, which blood product would best prevent GVHD?

A. Leukocyte reduction of the unit
B. Washing the unit with normal saline
C. Irradiation of the blood product
D. Providing HLA-matched blood products

Answer 40

C. Irradiation of the blood product

Question 41

Monospecific AHG reagents:

A. Increase the dielectric constant in-vitro
B. Contain either anti-IgG or anti-C3d antibody specificities
C. Are not useful in identifying the molecule causing a positive DAT
D. Contain human IgG or complement molecules

Answer 41

B. Contain either anti-IgG or anti-C3d antibody specificities

Question 42

What antibodies are present in polyspecific AHG reagent?

A. Anti-IgG
B. Anti-IgG and anti-C3d
B. Anti-IgM and anti-IgG
D. Anti-C3d

Answer 42

B. Anti-IgG and anti-C3d

Question 43

An individual has the genotype of AO, hh. What antigens would be present on the red cells of this individual?

A. A only
B. A and O
C. A and H
D. None of the above

Answer 43

D. None of the above

Question 44

An antibody commonly associated with delayed transfusion reactions is:

A. Anti-Lu^a
B. Anti-Jk^b
C. Anti-S
D. Anti-M

Answer 44

B. Anti-Jk^b

Question 45

Which phenotype is associated with a resistance to Plasmodium vivax?

A. Fy(a−b−)
B. Le(a−b−)
C. Jk(a−b−)
D. Lu(a−b−)

Answer 45

A. Fy(a−b−)

Question 46

Glycophorin A and glycophorin B possess antigen sites for which blood group system?

A. Duffy
B. Lewis
C. Kidd
D. MNS

Answer 46

D. MNS

Question 47

Cold autoantibodies are usually of which specificity?

A. I
B. M
C. P1
D. S

Answer 47

A. I

Question 48

Select the disease commonly associated with the McLeod phenotype:

A. Infectious mononucleosis
B. Hodgkin’s disease
C. Chronic granulomatous disease
D. PCH

Answer 48

C. Chronic granulomatous disease

Question 49

Chronic granulomatous disease is associated with a depression of the antigens in the ____ blood group system.

A. Duffy
B. P
C. Kidd
D. Kell

Answer 49

D. Kell

Question 50

In the gel test, a button of cells at the bottom of the well is a:

A. 4+ positive reaction
B. 1+ positive reaction
C. Negative reaction
D. Invalid reaction

Answer 50

C. Negative reaction

Question 51

What plasma protein functions to bind hemoglobin following intravascular hemolysis?

A. Albumin
B. Transferrin
C. Haptoglobin
D. C-reactive protein

Answer 51

C. Haptoglobin

Question 52

Which of the following adverse complications of transfusion is prevented by the irradiation of blood components?

A. TRALI
B. Febrile
C. Hyperkalemia
D. TA-GVHD

Answer 52

D. TA-GVHD

Question 53

What blood group system antibodies are commonly associated with delayed hemolytic transfusion reactions?

A. Rh
B. MNS
C. ABO
D. Kidd

Answer 53

D. Kidd

Question 54

Cells known to be actively phagocytic include:

A. Neutrophils, monocytes, basophils
B. Neutrophils, eosinophils, monocytes
C. Monocytes, lymphocytes, neutrophils
D. Lymphocytes, eosinophils, monocytes

Answer 54

B. Neutrophils, eosinophils, monocytes

Question 55

Which test is used to evaluate the cellular immune system in a patient?

A. Skin test for commonly encountered antigens
B. Determination of isohemagglutinin titer
C. Immunoelectrophoresis of serum
D. Lymphocyte proliferation to mitogen/antigen

Answer 55

A. Skin test for commonly encountered antigens

Question 56

T cells are incapable of:

A. Collaborating with B cells in antibody responses
B. Secretion of immunoglobulins
C. Secretion of cytokines
D. Producing positive skin tests

Answer 56

B. Secretion of immunoglobulins

Question 57

Some MHC class Ill genes code for?

A. Antigens
B. Antibodies
C. Lymphocytes
D. Complement

Answer 57

D. Complement

Question 58

MHC Class I includes which molecules?

A. Complement
B. HLA-A, B, C
C. Cytokines
D. HLA-DP, DQ, DR

Answer 58

B. HLA-A, B, C

Question 59

Treatment of lgG with papain results in how many fragments from each immunoglobulin molecule?

A. 2
B. 3
C. 4
D. 5

Answer 59

B. 3

Question 60

All of the following are immunologic functions of complement except:

A. Induction of an antiviral state
B. Opsonization
C. Chemotaxis
D. Anaphylatoxin formation

Answer 60

A. Induction of an antiviral state

Question 61

Which complement component is found in both the classic and alternative pathways?

A. C1
B. C4
C. Factor D
D. C3

Answer 61

D. C3

Question 62

Which immunoglobulin(s) help(s) initiate the classic complement pathway?

A. IgA and IgD
B. IgM only
C. IgG and IgM
D. IgG only

Answer 62

C. IgG and IgM

Question 63

Which immunoglobulin class(es) has (have) a J chain?

A. IgM
B. IgE and IgD
C. IgM and sIgA
D. IgG3 and IgA

Answer 63

C. IgM and sIgA

Question 64

Which of the following cell surface molecules is classified as an MHC class II antigen?

A. HLA-A
B. HLA-B
C. HLA-C
D. HLA-DR

Answer 64

D. HLA-DR

Question 65

Which MHC class of molecule is necessary for antigen recognition by CD4-positive T cells?

A. Class I
B. Class II
C. Class III
D. No MHC molecule is necessary for antigenrecognition

Answer 65

B. Class II

Question 66

Which of the following are products of HLA class III genes?

A. T-cell immune receptors
B. HLA-D antigens on immune cells
C. Complement proteins C2, C4, and Factor B
D. Immunoglobulin VL regions

Answer 66

C. Complement proteins C2, C4, and Factor B

Question 67

What molecule on the surface of most T cells recognizes antigen?

A. IgT
B. MHC protein
C. CD3
D. TcR

Answer 67

D. TcR

Question 68

What substance is detected by the rapid plasma reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests for syphilis?

A. Cardiolipin
B. Anticardiolipin antibody
C. Anti-T. pallidum antibody
D. Treponema pallidum

Answer 68

B. Anticardiolipin antibody

Question 69

What type of antigen is used in the RPR card test?

A. Live treponemal organisms
B. Killed suspension of treponemal organisms
C. Cardiolipin
D. Tanned sheep cells

Answer 69

C. Cardiolipin

Question 70

What is the main difficulty associated with the development of an HIV vaccine?

A. The virus has been difficult to culture; antigen extraction and concentration are extremely laborious
B. Human trials cannot be performed
C. Different strains of the virus are genetically diverse
D. Anti-idiotype antibodies cannot be developed

Answer 70

C. Different strains of the virus are genetically diverse

Question 71

Which method is used to test for HIV infection in infants who are born to HIV-positive mothers?

A. ELISA
B. Western blot test
C. Polymerase chain reaction
D. Viral culture

Answer 71

C. Polymerase chain reaction

Question 72

Which hepatitis B marker is the best indicator of early acute infection?

A. HBs Ag
B. HBe Ag
C. Anti-HBc
D. Anti-HBs

Answer 72

A. HBs Ag

Question 73

Which is the first antibody detected in serum after infection with hepatitis B virus (HBV)?

A. Anti-HBs
B. Anti-HBc IgM
C. Anti-HBe
D. All are detectable at the same time

Answer 73

B. Anti-HBc IgM

Question 74

Which hepatitis antibody confers immunity against reinfection with hepatitis B virus?

A. Anti-HBc IgM
B. Anti-HBc IgG
C. Anti-HBe
D. Anti-HBs

Answer 74

D. Anti-HBs

Question 75

A synonym for an antigenic determinant is:

A. Immunogen
B. Epitope
C. Binding site
D. Polysaccharide

Answer 75

B. Epitope

Question 76

Bonding of antigen to antibody exists exclusively as:

A. Hydrogen bonding
B. Van der Waals forces
C. Electrostatic forces
D. Noncovalent bonding

Answer 76

D. Noncovalent bonding

Question 77

The bonding of antigen to antibody is exclusively noncovalent.
The four types of noncovalent bonds involved in antigen-antibody reactions are:

A. Hydrophobic bonds
B. Hydrogen bonds
C. Van der Waals forces
D. Electrostatic forces

Answer 77

D. Electrostatic forces

Question 78

Chronic granulomatous disease represents a defect of:

A. Oxidative metabolism
B. Abnormal granulation of neutrophils
C. Diapedesis
D. Chemotaxis

Answer 78

A. Oxidative metabolism

Question 79

The three complement activation pathways converge at the point of cleavage of complement component _____.

A. C3
B. C5
C. C7
D. C8

Answer 79

A. C3

Question 80

Which complement component is present in the greatest quantity in plasma?

A. 2
B. 3
C. 4
D. 8

Answer 80

B. 3

Question 81

Complement can be inactivated in human serum by heating to _____° C.

A. 25
B. 37
C. 45
D. 56

Answer 81

D. 56

Question 82

INACTIVATION OF SERUM: Heating at 56C for 30 minutes
REINACTIVATION: Heating at 56C for 10 minutes
A specimen should be reinactivated when more than ____ hour(s) has (have) elapsed since inactivation.

A. 1
B. 2
C. 4
D. 8

Answer 82

C. 4

Question 83

Speed and time of rotation for serum VDRL test:

A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

Answer 83

C. 180 rpm for 4 minutes

Question 84

Speed and time of rotation for CSF VDRL test:

A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

Answer 84

D. 180 rpm for 8 minutes

Question 85

Speed and time of rotation for RPR:

A. 100 rpm for 4 minutes
B. 100 rpm for 8 minutes
C. 180 rpm for 4 minutes
D. 180 rpm for 8 minutes

Answer 85

B. 100 rpm for 8 minutes

Question 86

CSF VDRL test:

A. Tube 1
B. Tube 2
C. Tube 3
D. Any of these tubes

Answer 86

A. Tube 1

Question 87

What substance added to the antigen in the RPR test allows for more macroscopically visible flocculation?

A. Latex particles
B. Extracellular antigens
C. Heparin-magnesium chloride particles
D. Charcoal particles

Answer 87

D. Charcoal particles

Question 88

In the RPR test, what is the gauge of the needle for antigen delivery?

A. 16
B. 18
C. 20
D. 21

Answer 88

C. 20

Question 89

LASER is an acronym for:

A. Light amplification by stimulated emission of radiation
B. Light augmentation by stimulated emitted radiation
C. Light amplified by stimulated energy radiation
D. Large angle stimulation by emitted radiation

Answer 89

A. Light amplification by stimulated emission of radiation

Question 90

The only serologic marker during the anti-core window period of hepatitis B (the time between disappearance of detectable HBsAg and appearance of detectable anti-HBs) may be:

A. Anti-HBs
B. Anti-HBc
C. Anti-HBe
D. HBsAg

Answer 90

B. Anti-HBc

Question 91

Which surface marker is a reliable marker for the presence of high levels of hepatitis B virus (HBV) and a high degree of infectivity?

A. HBe Ag
B. HBs Ag
C. HBc Ag
D. Anti-HBs

Answer 91

A. HBe Ag

Question 92

The most frequent malignancy observed in AIDS patients is:

A. Pneumocystis jiroveci (P. carinii)
B. Kaposi’s sarcoma
C. Toxoplasmosis
D. Non-Hodgkin’s lymphoma

Answer 92

B. Kaposi’s sarcoma

Question 93

Type IV hypersensitivity reactions are responsible for all the following except:

A. Contact sensitivity
B. Elimination of tumor cells
C. Rejection of foreign tissue grafts
D. Serum sickness

Answer 93

D. Serum sickness

Question 94

Patients with Waldenström’s macroglobulinemia exhibit abnormally large amounts of:

A. IgM
B. IgG
C. IgE
D. IgA

Answer 94

A. IgM

Question 95

Anti-CCP (cyclic citrullinated proteins) is specifically associated with which autoimmune disease?

A. Rheumatoid arthritis
B. Myasthenia gravis
C. Autoimmune hepatitis
D. Goodpasture’s syndrome

Answer 95

A. Rheumatoid arthritis

Question 96

Class I includes HLA-________ antigens.

A. A,B and C
B. B, C and D
C. DR, DC(DQ), and A
D. DR, DC(DQ), and SB

Answer 96

A. A,B and C

Question 97

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease?

A. Cathepsin-D
B. CA-15-3
C. Retinoblastoma gene
D. Estrogen receptor (ER)

Answer 97

B. CA-15-3

Question 98

Which tumor marker is used to determine the usefulness of TRASTUZUMAB (HERCEPTIN) therapy for breast cancer?

A. PR
B. CEA
C. HER-2/neu
D. Myc

Answer 98

C. HER-2/neu

Question 99

Which genotype(s) will give rise to the Bombay phenotype

A. HH only
B. HH and Hh
C. Hh and hh
D. hh only

Answer 99

D. hh only

Question 100

Which of the following describes the expression of most blood group antigens?

A. Dominant
B. Recessive
C. Codominant
D. Corecessive

Answer 100

C. Codominant

Question 101

Which antibodies to a component of complement are contained in the rabbit polyspecific antihuman globulin reagent for detection of in vivo sensitization?

A. Anti-IgG and anti-C3a
B. Anti-IgG and anti-C3d
C. Anti-IgG and anti-IgM
D. All of these options

Answer 101

B. Anti-IgG and anti-C3d

Question 102

What antibodies are formed by a Bombay individual?

A. Anti-A and anti-B
B. Anti-H
C. Anti-A,B
D. Anti-A, B, and H

Answer 102

D. Anti-A, B, and H

Question 103

Acquired B antigens have been found in:

A. Bombay individuals
B. Group O persons
C. All blood groups
D. Group A persons

Answer 103

D. Group A persons

Question 104

Which blood group has the least amount of H antigen?

A. A1B
B. A2
C. B
D. A1

Answer 104

A. A1B

Question 105

Which donor unit is selected for a recipient with anti-c?

A. r ́r
B. R0R1
C. R2r ́
D. r ́ry

Answer 105

D. r ́ry

Question 106

Which genotype usually shows the strongest reaction with anti-D?

A. DCE/DCE
B. Dce/dCe
C. D–/D–
D. -CE/-ce

Answer 106

C. D–/D–

Question 107

What is one possible genotype for a patient who develops anti-C antibody?

A. R1r
B. R1R1
C. r ́r
D. rr

Answer 107

D. rr

Question 108

What antibodies could an R1R1 make if exposed to R2R2 blood?

A. Anti-e and anti-C
B. Anti-E and anti-c
C. Anti-E and anti-C
D. Anti-e and anti-c

Answer 108

B. Anti-E and anti-c

Question 109

What techniques are necessary for weak D testing?

A. Saline + 22°C incubation
B. Albumin or LISS + 37°C incubation
C. Saline + 37°C incubation
D. 37°C incubation + IAT

Answer 109

D. 37°C incubation + IAT

Question 110

How can interfering anti-P1 antibody be removed from a mixture of antibodies?

A. Neutralization with saliva
B. Agglutination with human milk
C. Combination with urine
D. Neutralization with hydatid cyst fluid

Answer 110

D. Neutralization with hydatid cyst fluid

Question 111

Which of the following antibodies characteristically gives a refractile mixed-field appearance?

A. Anti-K
B. Anti-Di
C. Anti-Sd
D. Anti-s

Answer 111

C. Anti-Sd

Question 112

The k (Cellano) antigen is a high-frequency antigen and is found on most red cells. How often would one expect to find the corresponding antibody?

A. Often
B. Rarely
C. It depends upon the population, because certainracial and ethnic groups show a higher frequencyof anti-k
D. Impossible to determine without consultingregional blood group antigen charts

Answer 112

B. Rarely

Question 113

What ABO types may donate to any other ABO type?

A. A negative, B negative, AB negative, O negative
B. O negative
C. AB negative
D. AB negative, A negative, B negative

Answer 113

B. O negative

Question 114

What may be found in the serum of a person who is exhibiting signs of TRALI (transfusion-related acute lung injury)?

A. Red blood cell alloantibody
B. IgA antibody
C. Antileukocyte antibody
D. Allergen

Answer 114

C. Antileukocyte antibody

Question 115

Which type of transfusion reaction occurs in about 1% of all transfusions, results in a temperature rise of 1°C or higher, is associated with blood component transfusion, and is not related to the patient’s medical condition?

A. Immediate hemolytic
B. Delayed hemolytic
C. Febrile nonhemolytic reaction
D. Transfusion-related acute lung injury

Answer 115

C. Febrile nonhemolytic reaction

Question 116

What would be the result of group A blood given to an O patient?

A. Nonimmune transfusion reaction
B. Immediate hemolytic transfusion reaction
C. Delayed hemolytic transfusion reaction
D. Febrile nonhemolytic transfusion reaction

Answer 116

B. Immediate hemolytic transfusion reaction

Question 117

LEUKOREDUCED RED CELLS is a product in which the absolute WBC count in the unit is reduced to ____, and contains at least ____ of the original RBC mass.

A. 1 x 10 10th, 85%
B. 3.0 x 10 11th, 85%
C. 5.5 x 10 10th, 85%
D. 5 x 10 6th, 85%

Answer 117

D. 5 x 10 6th, 85%

Question 118

Standards require that granulocyte components collected by apheresis contain a minimum of ____ granulocytes in about 75% of units tested.

A. 1.0 x 10 10th
B. 5.5 x 10 10th
C. 3.0 x 10 10th
D. 1.5 x 10 10th

Answer 118

A. 1.0 x 10 10th

Question 119

RANDOM-DONOR PLATELETS (RDP) must contain at least:

A. 3.0 x 10 10th platelets
B. 5.5 x 10 10th platelets
C. 3.0 x 10 11th platelets
D. 5.5 x 10 11th platelets

Answer 119

B. 5.5 x 10 10th platelets

Question 120

SINGLE-DONOR PLATELETS (SDP) must contain at least:

A. 3.0 x 10 10th platelets
B. 5.5 x 10 10th platelets
C. 3.0 x 10 11th platelets
D. 5.5 x 10 11th platelets

Answer 120

C. 3.0 x 10 11th platelets

Question 121

Which transfusion reaction presents with fever, maculopapular rash, watery diarrhea, abnormal liver function, and pancytopenia?

A. Transfusion-associated sepsis
B. Transfusion-related acute lung injury
C. Transfusion-associated graft-versus-host disease
D. Transfusion-associated allergic reaction

Answer 121

C. Transfusion-associated graft-versus-host disease

Question 122

Which animals were immunized that led to the discovery of the Rh blood group?

A. Rhesus macaque monkeys
B. Mice and rats
C. Frogs
D. Guinea pigs and rabbits

Answer 122

D. Guinea pigs and rabbits

Question 123

A 63-year-old man with a hemoglobin value of 130 g/L (13 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, permanently 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

Answer 123

C. PD, because of the human PGH

Question 124

A 38-year-old female weighing 153 lbs, 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

Answer 124

B. TD because of the packed cells 8 weeks ago

Question 125

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

Answer 125

A. PD, needle marks on both arms

Question 126

Individuals with a ________ are prone to developing severe, recurrent life-threatening infections with encapsulated bacteria such as Streptococcus pneumoniae and may also be subject to immune complex diseases; such complexes can lodge in the kidney and result in glomerulonephritis:

A. C1 deficiency
B. C2 deficiency
C. C3 deficiency
D. C5 deficiency

Answer 126

C. C3 deficiency

Question 127

A single ASO titer is considered to be moderately elevated if the titer is at least ____ Todd units in an adult.

A. 200 Todd units
B. 240 Todd units
C. 320 Todd units
D. 340 Todd units

Answer 127

B. 240 Todd units

Question 128

A single ASO titer is considered to be moderately elevated if the titer is at least ____ Todd units in a child.

A. 200 Todd units
B. 240 Todd units
C. 320 Todd units
D. 340 Todd units

Answer 128

C. 320 Todd units

Question 129

Most common and easiest method to detect varicella-zoster virus (VZV) antibodies:

A. Enzyme-linked immunosorbent assay (ELISA)
B. Fluorescent ab to membrane ag (FAMA)
C. Hemagglutination
D. Polymerase chain reaction (PCR)

Answer 129

A. Enzyme-linked immunosorbent assay (ELISA)

VARICELLA-ZOSTER VIRUS ANTIBODIES
1. ELISA - MOST COMMON, automated, provides objective results, and does not require viral culture
————–
2. FAMA (fluorescent antibody to membrane antigen) - REFERENCE METHOD, most sensitive and reliable; requires live, virus-infected cells and is not suitable for large-scale routine testing

Question 130

It is considered as the reference method for VZV antibody; most sensitive and most reliable:

A. Enzyme-linked immunosorbent assay (ELISA)
B. Fluorescent ab to membrane ag (FAMA)
C. Hemagglutination
D. Polymerase chain reaction (PCR)

Answer 130

B. Fluorescent ab to membrane ag (FAMA)

VARICELLA-ZOSTER VIRUS ANTIBODIES
1. ELISA - MOST COMMON, automated, provides objective results, and does not require viral culture
————–
2. FAMA (fluorescent antibody to membrane antigen) - REFERENCE METHOD, most sensitive and reliable; requires live, virus-infected cells and is not suitable for large-scale routine testing

Question 131

An immunocompromised patient was admitted to the hospital with a diagnosis of hemorrhagic cystitis. Which combination of virus and specimen would be most appropriate to diagnose a viral cause of this disorder?

A. BK virus—urine
B. Human papilloma virus—skin
C. Hepatitis B virus—serum
D. Epstein–Barr virus—serum

Answer 131

A. BK virus—urine

Question 132

Discovery of genetic principles underlying the generation of antibodies with different specificities:

A. Gerald Edelman
B. Cesar Milstein
C. Susumu Tonegawa
D. Louis Pasteur

Answer 132

C. Susumu Tonegawa

Question 133

Father of Immunology: (Stevens, Turgeon)

A. Edward Jenner
B. Louis Pasteur
C. Ellie Metchnikoff
D. Susumu Tonegawa

Answer 133

B. Louis Pasteur

Question 134

Which immunoglobulin class(es) has (have) a J chain?

A. IgM
B. IgE and IgD
C. IgM and sIgA
D. IgG3 and IgA

Answer 134

C. IgM and sIgA

Question 135

All of the following statements are true for IgE, except:

A. Most heat-stable of all immunoglobulins
B. Activate mast cells and basophils
C. Least abundant immunoglobulin in the serum
D. Serve a protective role by triggering an acute inflammatory reaction that recruits neutrophils and eosinophils to the area

Answer 135

A. Most heat-stable of all immunoglobulins

Question 136

Individuals with a _________ are prone to developing severe, recurrent life-threatening infections with encapsulated bacteria such as Streptococcus pneumoniae and may also be subject to immune complex diseases; such complexes can lodge in the kidney and result in glomerulonephritis:

A. C1 deficiency
B. C2 deficiency
C. C3 deficiency
D. C5 deficiency

Answer 136

C. C3 deficiency

Question 137

CONVERGENCE OF THE THREE PATHWAYS
It serves as the pivotal point for all three complement pathways:

A. C1
B. C2
C. C3
D. C5

Answer 137

C. C3

Question 138

Current recommendations include the combined detection of mannan and anti-mannan antibodies for the specific identification of _____ species in serum samples:

A. Bordetella
B. Candida
C. Cryptococcus
D. Mycobacterium

Answer 138

B. Candida

Question 139

Signal amplification differs from target amplification when designing protocols for identification of nucleic acids. Which of the following is an example of a signal amplification technique?

A. Branched-chain DNA detection
B. Ligase chain reaction
C. Polymerase chain reaction
D. Reverse-transcriptase PCR

Answer 139

A. Branched-chain DNA detection

Question 140

Which technique involves PROBE amplification rather than target amplification?

A. Southern blot
B. PCR
C. Transcription-mediated amplification
D. Ligase chain reaction

Answer 140

D. Ligase chain reaction

Question 141

Which technique is used to detect DNA containing a specific base sequence by applying a labeled probe to DNA bands immobilized onto nitrocellulose paper following electrophoresis?

A. Southern blot
B. Northern blot
C. Dot blot
D. Western blot

Answer 141

A. Southern blot

Question 142

MINIMUM precentrifugation time for specimens drawn in serum separator tubes is:

A. 10 minutes
B. 15 minutes
C. 20 minutes
D. 30 minutes

Answer 142

D. 30 minutes

Specimens drawn in serum separator tubes (SSTs) generally clot within 30 minutes.
Consequently, to prevent latent fibrin formation in the serum, the minimum precentrifugation time for an SST is 30 minutes.

Question 143

According to CLSI, the MAXIMUM time limit for separating serum or plasma from cells is:

A. 15 minutes from the time of collection
B. 30 minutes from the time of collection
C. 1 hour from the time of collection
D. 2 hours from the time of collection

Answer 143

D. 2 hours from the time of collection

All specimens should be transported to the laboratory promptly.
According to Clinical and Laboratory Standards Institute (CLSI) guidelines, unless conclusive evidence indicates that longer times do not affect the accuracy of test results, specimens should be separated from the cells as soon as possible, with a maximum time limit of 2 hours.

Question 144

Another formula to compute for FMH
= (Fetal cells divided by 2,000) x 5,000 mL
5,000 ML OR 5 LITERS MATERNAL BLOOD VOLUME
A Kleihauer–Betke acid elution test identifies 40 fetal cells in 2,000 maternal red cells. How many full doses of RhIg are indicated?

A. 1
B. 2
C. 3
D. 4

Answer 144

D. 4

Question 145

Most blood group system genes and their resulting genetic traits display what type of inheritance?

A. Sex-linked dominant
B. Sex-linked recessive
C. Autosomal recessive
D. Autosomal codominant

Answer 145

D. Autosomal codominant

Question 146

Which of the following red cell typings are most commonly found in the African American donor population?

A. Lu(a-b-)
B. Jk(a-b-)
C. Fy(a-b-)
D. K-k-

Answer 146

C. Fy(a-b-)

Question 147

Antibodies from which of the following blood group systems are notorious for causing delayed hemolytic transfusion reactions?

A. Rh
B. KEL
C. FY
D. JK

Answer 147

D. JK

Question 148

Which of the following genes is not in the MHC class I region?

A. HLA-A
B. HLA-8
C. HLA-C
D. HLA-DR

Answer 148

D. HLA-DR

Question 149

Paroxysmal cold hemoglobinuria (PCH) is associated with antibody specificity toward which of the following?

A. KEL system antigens
B. FY system antigens
C. P antigen
D. I antigen

Answer 149

C. P antigen

Question 150

Which of the following immunoglobulins is most efficient at activating complement via the classical pathway?

A. lgG2
B. lgG4
C. lgM
D. lgA

Answer 150

C. lgM

Question 151

Which of the following immunoglobulins is most efficient at causing direct hemagglutination?

A. lgG
B. lgM
C. lgA
D. lgE

Answer 151

B. lgM

Question 152

Appropriate antigen-antibody ratios are important to avoid an excess of unbound antibody, which is known as:

A. Dosage effect
B. pH effect
C. Postzone effect
D. Prozone effect

Answer 152

D. Prozone effect

Question 153

Low ionic strength saline (LISS) acts as an enhancement medium and facilitates antibody uptake by:

A. Activating complement
B. Increasing flexibility in hinge region
C. Removing water molecules
D. Reducing zeta potential

Answer 153

D. Reducing zeta potential

Low ionic strength saline (LISS) facilitates hemagglutination by decreasing ionic strength and reducing the zeta potential, allowing for antibodies to react with their respective red cell antigens. LISS may also increase antibody uptake and reduce incubation times.

Question 154

Which WBC is capable of further differentiation in tissues?

A. Neutrophil
B. Eosinophil
C. Basophil
D. Monocyte

Answer 154

D. Monocyte

Question 155

Antigenic groups identified by different sets of antibodies reacting in a similar manner to certain standard cell lines best describes:

A. Cytokines
B. Clusters of differentiation (CD)
C. Neutrophilic granules
D. Opsonins

Answer 155

B. Clusters of differentiation (CD)

Question 156

Which of the following best describes a hapten?

A. Cannot react with antibody
B. Antigenic only when coupled to a carrier
C. Has multiple determinant sites
D. A large chemically complex molecule

Answer 156

B. Antigenic only when coupled to a carrier

Question 157

Which best describes an epitope?

A. A peptide that must be at least 10,000 MW
B. An area of an immunogen recognized only by T cells
C. A segment of sequential amino acids only
D. A key portion of the immunogen

Answer 157

D. A key portion of the immunogen

Question 158

HLA molecules A, B, and C belong to which MHC class?

A. Class I
B. Class II
C. Class III
D. Class IV

Answer 158

A. Class I

Question 159

The structure formed by the fusion of engulfed material and enzymatic granules within the phagocytic cell is called a:

A. Phagosome
B. Lysosome
C. Vacuole
D. Phagolysosome

Answer 159

D. Phagolysosome

Question 160

A 40-year-old male who is a smoker develops symptoms of premature emphysema. The symptoms may be caused by a deficiency of which of the following acute-phase reactants

A. Haptoglobin
B. Alpha1-antitrypsin
C. Fibrinogen
D. Ceruloplasmin

Answer 160

B. Alpha1-antitrypsin

Question 161

Which is a distinguishing feature of a pre-B cell?

A. μ chains in the cytoplasm
B. Complete IgM on the surface
C. Presence of CD21 antigen
D. Presence of CD25 antigen

Answer 161

A. μ chains in the cytoplasm

Question 162

The subclasses of IgG differ mainly in:

A. The type of L chain
B. The arrangement of disulfide bonds
C. The ability to act as opsonins
D. Molecular weight

Answer 162

B. The arrangement of disulfide bonds

Question 163

All of the following are true of IgE except that it:

A. Fails to fix complement.
B. Is heat stable.
C. Attaches to tissue mast cells.
D. Is found in the serum of allergic persons.

Answer 163

B. Is heat stable.

Question 164

Why might a colony stimulating factor be given to a cancer patient?

A. Stimulate activity of NK cells
B. Increase production of certain types of leukocytes
C. Decrease the production of TNF
D. Increase production of mast cells

Answer 164

B. Increase production of certain types of leukocytes

Question 165

Mannose-binding protein in the lectin pathway is most similar to which classical pathway component?

A. C3
B. C1rs
C. C1q
D. C4

Answer 165

C. C1q

Question 166

Which of the following describes the role of properdin in the alternative pathway?

A. Stabilization of C3/C5 convertase
B. Conversion of B to Bb
C. Inhibition of C3 convertase formation
D. Binding and cleavage of Factor B

Answer 166

A. Stabilization of C3/C5 convertase

Question 167

A lack of C1-INH might result in which of the following conditions?

A. Paroxysmal nocturnal hemoglobinuria
B. Hemolytic uremic syndrome
C. Hereditary angioedema
D. Increased bacterial infections

Answer 167

C. Hereditary angioedema

Question 168

Which technique represents a single-diffusion reaction?

A. Radial immunodiffusion
B. Ouchterlony diffusion
C. Immunoelectrophoresis
D. Immunofixation electrophoresis

Answer 168

A. Radial immunodiffusion

Question 169

Reactions involving IgG may need to be enhanced for which reason?

A. It is only active at 25°C.
B. It may be too small to produce lattice formation.
C. It has only one antigen-binding site.
D. It is only able to produce visible precipitation reactions.

Answer 169

B. It may be too small to produce lattice formation.

Question 170

What is the immune phenomenon associated with the Arthus reaction?

A. Tissue destruction by cytotoxic T cells
B. Removal of antibody-coated RBCs
C. Deposition of immune complexes in blood vessels
D. Release of histamine from mast cells

Answer 170

C. Deposition of immune complexes in blood vessels

Question 171

Which of the following would be considered an organ-specific autoimmune disease?

A. SLE
B. RA
C. GPA
D. Hashimoto’s thyroiditis

Answer 171

D. Hashimoto’s thyroiditis

Question 172

Which of the following would be considered a significant finding in Graves disease?

A. Increased TSH levels
B. Antibody to TSHR
C. Decreased T3 and T4
D. Antithyroglobulin antibody

Answer 172

B. Antibody to TSHR

Question 173

Anti-CCP (cyclic citrullinated proteins) is specifically associated with which autoimmune disease?

A. RA
B. MG
C. Autoimmune hepatitis
D. Goodpasture’s syndrome

Answer 173

A. RA

Question 174

Forward-angle light scatter is an indicator of cell:

A. Granularity.
B. Density.
C. Size.
D. Number.

Answer 174

C. Size.

Question 175

Destruction of the myelin sheath of axons caused by the presence of antibody is characteristic of which disease?

A. MS
B. MG
C. Graves disease
D. Goodpasture’s syndrome

Answer 175

A. MS

Question 176

Antimitochondrial antibodies are strongly associated with which disease?

A. Autoimmune hepatitis
B. Celiac disease
C. Primary biliary cirrhosis
D. Goodpasture’s syndrome

Answer 176

C. Primary biliary cirrhosis

Question 177

What is the primary goal of TQM?

A. Precise test results
B. Increased laboratory productivity
C. Improved patient outcomes
D. Reproducible test results

Answer 177

C. Improved patient outcomes

Question 178

Antigen receptors on T lymphocytes bind HLA class II + peptide complexes with the help of which accessory molecule?

A. CD2
B. CD3
C. CD4
D. CD8

Answer 178

C. CD4

Question 179

Suppose a 30-year-old man was found to be a suitable donor for a kidney transplant to his younger sister. This transplant would be an example of a(an):

A. Autograft
B. Allograft
C. Isograft
D. Xenograft

Answer 179

B. Allograft

Question 180

A woman with breast cancer is treated with a monoclonal antibody to HER2. This is an example of:

A. Cancer vaccine
B. An immunotoxin
C. Passive immunotherapy
D. Active immunotherapy

Answer 180

C. Passive immunotherapy

Question 181

Each of the following markers is correctly paired with a disease in which it can be used for patient monitoring except:

A. CEA/choriocarcinoma
B. CA 15-3/breast adenocarcinoma
C. CA 125/ovarian adenocarcinoma
D. CA 19-9/pancreatic adenocarcinoma

Answer 181

A. CEA/choriocarcinoma

Question 182

Which of the following is a marker used in immunohistochemical staining to identify tumors of epithelial origin?

A. Cytokeratins
B. Vimentin
C. CD45
D. CD10

Answer 182

A. Cytokeratins

Question 183

Which of the following enzymes is used to detect the presence of H. pylori infections?

A. DNase
B. Hyaluronidase
C. Urease
D. Peptidase

Answer 183

C. Urease

Question 184

Antibodies to which of the following viral antigens are usually the first to be detected in HIV infection?

A. gp120
B. gp160
C. gp41
D. p24

Answer 184

D. p24

Question 185

The antigenic component of the hepatitis B vaccine differs from those of many of the conventional vaccines in that it consists of a:

A. Live, attenuated virus.
B. Inactivated virus.
C. Cryptic antigen.
D. Recombinant antigen.

Answer 185

D. Recombinant antigen.

Question 186

The hemorrhagic problems associated with scurvy are due to a deficiency of ______, which is a cofactor required for collagen synthesis.

A. Vitamin C
B. Prothrombin
C. Vitamin K
D. Protein C

Answer 186

A. Vitamin C

Question 187

Of the following therapeutic agents, those considered to be anti-platelet medications are:

A. Aspirin and Plavix
B. Coumadin and heparin
C. Heparin and protamine sulfate
D. Tissue plasminogen activator and streptokinase

Answer 187

A. Aspirin and Plavix

Question 188

Gaucher disease:

A. Monocyte-macrophage series
B. Neutrophilic series
C. Lymphocytic series
D. Erythrocytic series

Answer 188

A. Monocyte-macrophage series

Question 189

Niemann-Pick disease:

A. Monocyte-macrophage series
B. Neutrophilic series
C. Lymphocytic series
D. Erythrocytic series

Answer 189

A. Monocyte-macrophage series

Question 190

Chédiak-Higashi syndrome:

A. Monocyte-macrophage series
B. Neutrophilic series
C. Lymphocytic series
D. Erythrocytic series

Answer 190

B. Neutrophilic series

Question 191

Chronic granulomatous disease:

A. Monocyte-macrophage series
B. Neutrophilic series
C. Lymphocytic series
D. Erythrocytic series

Answer 191

B. Neutrophilic series

Question 192

Lazy leukocyte syndrome:

A. Monocyte-macrophage series
B. Neutrophilic series
C. Lymphocytic series
D. Erythrocytic series

Answer 192

B. Neutrophilic series

Question 193

A single ASO titer is considered to be moderately elevated if the titer is at least _____ Todd units in an adult.

A. 200 Todd units
B. 240 Todd units
C. 320 Todd units
D. 340 Todd units

Answer 193

B. 240 Todd units

Question 194

A single ASO titer is considered to be moderately elevated if the titer is at least _____ Todd units in a child.

A. 200 Todd units
B. 240 Todd units
C. 320 Todd units
D. 340 Todd units

Answer 194

C. 320 Todd units

Question 195

Interpret the following results for EBV infection: IgG and IgM antibodies to viral capsid antigen (VCA) are positive.

A. Infection in the past
B. Infection with a mutual enhancer virus such as HIV
C. Current infection
D. Impossible to interpret; need more information

Answer 195

C. Current infection

Question 196

Antigen receptors on T lymphocytes bind HLA class II molecules with the help of which accessory molecule?

a. CD2
b. CD3
c. CD4
d. CD8

Answer 196

c. CD4

Question 197

What molecule on the surface of most T cells recognizes antigen?

a. IgT
b. MHC protein
c. CD3
d. TcR

Answer 197

d. TcR

Question 198

Antibody E (Anti-E) is for

a. bacteria
b. parasite
c. virus

Answer 198

b. parasite

Antibody E or IgE

Question 199

Which of the following cells expresses HLA class II antigens?

A. B cells
B. Erythrocytes
C. Platelets
D. T cells

Answer 199

A. B cells

Question 200

Select the term that describes the unique part of the antigen that is recognized by a corresponding antibody.

A. Immunogen
B. Epitope
C. Avidity
D. Clone

Answer 200

B. Epitope

Question 201

An epitope is also termed a(n):

A. Binding site
B. Allotype
C. Antigenic determinant
D. Immunogen

Answer 201

C. Antigenic determinant

Question 202

An order for blood products for a recent recipient of a bone marrow graft was received in the transfusion service. Because these patients are especially susceptible to GVHD from a transfusion, which blood product would best prevent GVHD

A. Leukocyte reduction of the unit
B. Washing the unit with normal saline
C. Irradiation of the blood product
D. Providing HLA-matched blood products

Answer 202

C. Irradiation of the blood product

Question 203

Which of the following describes the expression of most blood group inheritance?

A. Dominant
B. Sex-linked
C. Recessive
D. Codominant

Answer 203

D. Codominant

Question 204

What is the best source of an HLA-matched kidney?

A. Mother
B. Father
C. Cousin
D. Sibling

Answer 204

D. Sibling

Question 205

Which of the following is not a basic component of a QA program?

A. Calibration
B. Preventive maintenance
C. Viral marker testing
D. Record keeping

Answer 205

C. Viral marker testing

Question 206

Most commonly encountered autoimmune hemolytic anemia:

A. Drug-induced AIHA
B. Cold AIHA
C. Warm AIHA
D. Mixed-type AIHA

Answer 206

C. Warm AIHA

Question 207

Most common type of DNA change that can lead to leukemia. A part of one chromosome breaks off and becomes attached to a different chromosome

A. Addition
B. Deletion
C. Inversion
D. Translocation

Answer 207

D. Translocation

Question 208

Part of a chromosome is lost. This may result in the cell losing a gene that helped keep its growth in check, for example, a tumor suppressor gene.

A. Addition
B. Deletion
C. Inversion
D. Translocation

Answer 208

B. Deletion

Question 209

This occurs when part of a chromosome gets turned around, so it is now in reverse order. This can result in the loss of a gene (or genes) because the cell can no longer read its instructions in protein translation.

A. Addition
B. Deletion
C. Inversion
D. Translocation

Answer 209

C. Inversion

Question 210

An extra chromosome or part of a chromosome is gained. This can lead to too many copies of certain genes within the cell.

A. Addition
B. Deletion
C. Inversion
D. Translocation

Answer 210

A. Addition

Question 211

A stained blood film is held up to the light and observed to be bluer than normal. What microscopic abnormality might be expected on this film?

A. Rouleaux
B. Spherocytosis
C. Reactive lymphocytosis
D. Toxic granulation

Answer 211

A. Rouleaux

Question 212

What could be the possible interpretation?
HBsAg: negative
Anti-HBc: positive
Anti-HBs: positive

A. Recovering from acute HBV infection
B. Immune because of natural infection
C. Immune because of hepatitis B vaccination
D. Chronically infected

Answer 212

B. Immune because of natural infection

Question 213

What could be the possible interpretation?
HBsAg: negative
Anti-HBc: negative
Anti-HBs: positive

A. Recovering from acute HBV infection
B. Immune because of natural infection
C. Immune because of hepatitis B vaccination
D. Chronically infected

Answer 213

C. Immune because of hepatitis B vaccination

Question 214

STUDY THE CHOICES
Which description best fits the Donath-Landsteiner antibody?

A. lgM cold agglutinin
B. Biphasic lgM hemolysin
C. lgG biphasic hemolysin
D. lgG warm agglutinin

Answer 214

C. lgG biphasic hemolysin

Question 215

Which of the following cytokines is most responsible for eosinophil differentiation and release from the bone marrow?

A. IL-1
B. IL-2
C. IL-4
D. IL-5

Answer 215

D. IL-5

Question 216

Which of the following is characteristic of cellular changes as megakaryoblasts mature into megakaryocytes within the bone marrow?

A. Progressive decrease in overall cell size
B. Increasing basophilia of cytoplasm
C. Nuclear division without cytoplasmic maturation
D. Fusion of the nuclear lobes

Answer 216

C. Nuclear division without cytoplasmic maturation

Question 217

STUDY THE CHOICES
Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is:

A. Temperature-dependent
B. Complement-independent
C. Antibody-mediated
D. Caused by a red cell membrane defect

Answer 217

D. Caused by a red cell membrane defect

RBC membrane defect increases susceptibility to complement mediated lysis.

Question 218

Which of the following is most closely associated with iron deficiency anemia?

A. Iron overload in tissue
B. Macrocytes
C. Basophilic stippling
D. Chronic blood loss

Answer 218

D. Chronic blood loss

Question 219

Which of the following is the most characteristic finding in autoimmune hemolytic anemia:

A. Increased reticulocyte count
B. Leukopenia and thrombocytopenia
C. Peripheral spherocytosis
D. Positive direct antiglobulin test

Answer 219

D. Positive direct antiglobulin test

Question 220

Which of the following tumors are associated with erythrocytosis due to excessive erythropoietin production?

A. Renal cell carcinoma
B. Sarcoma
C. Basal cell carcinoma
D. Squamous cell carcinoma of the lung

Answer 220

A. Renal cell carcinoma

Question 221

Which abnormal RBC morphology is associated with pyruvate kinase deficiency?

A. Acanthocytes
B. Dacryocytes
C. Echinocytes
D. Drepanocytes

Answer 221

C. Echinocytes

Question 222

What is the specificity of cold autoagglutinin disease?

A. Anti-i
B. Anti-H
C. Anti-Pr
D. Anti-I

Answer 222

D. Anti-I

Question 223

In a patient with an increased red cell mass into the 99th percentile and serum erythropoietin level below reference range for normal, which of the following criteria confirms a diagnosis of polycythemia vera?

A. Bone marrow panmyelosis
B. Inv(16) mutation
C. JAK2 V617F mutation
D. BCR/ABL 1 translocation

Answer 223

C. JAK2 V617F mutation

Question 224

The Philadelphia chromosome is formed by a translocation between:

A. Chromosome 22 and chromosome 9
B. Chromosome 21 and chromosome 9
C. Chromosome 21 and chromosome 6
D. Chromosome 22 and chromosome 6

Answer 224

A. Chromosome 22 and chromosome 9

Question 225

Increased numbers of basophils are often seen in:

A. Acute infections
B. Chronic myelocytic leukemia
C. Chronic lymphocytic leukemia
D. Erythroblastosis fetalis (hemolytic disease of the newborn)

Answer 225

B. Chronic myelocytic leukemia

Basophils may be increased in CML as well as immature neutrophils and eosinophils.

Question 226

Which of the following is most closely associated with chronic myelogenous leukemia?

A. Ringed sideroblasts
B. Disseminated intravascular coagulation
C. Micromegakaryocytes
D. BCR/ABL fusion gene

Answer 226

D. BCR/ABL fusion gene

Question 227

QUANTITATIVE PLATELET DISORDER
The disease state that presents with a quantitative platelet disorder is:

A. von Willebrand disease
B. Hemophilia A
C. Glanzmann thrombasthenia
D. May-Hegglin anomaly

Answer 227

D. May-Hegglin anomaly

Incorrect Glanzmann’s = Qualitative or Functional Platelet Disorder

Question 228

Evidence of a hemolytic event is present in the peripheral blood smear when which of the following is seen?

A. Basophilic stippling
B. Increased polychromasia
C. Increased target cells
D. Stomatocytes

Answer 228

B. Increased polychromasia

due to bone marrow response to blood loss

Question 229

A common source of interference in measuring hemoglobin concentration is:

A. Hemolysis
B. Very high WBC count
C. Cold agglutinins
D. Clumped platelets

Answer 229

B. Very high WBC count

Question 230

Individuals who lack the Duffy antigen on the surface of their red blood cells are protected against which species of Plasmodium:

A. P. vivax
B. P. falciparum
C. P. malariae
D. P.ovale

Answer 230

A. P. vivax

Question 231

Most blood group system genes and their resulting genetic traits display what type of inheritance?

A. Sex-linked dominant
B. Sex-linked recessive
C. Autosomal recessive
D. Autosomal codominant

Answer 231

D. Autosomal codominant

Question 232

Which of the following genes is not in the MHC class I region

A. HLA-A
B. HLA-B
C. HLA-C
D. HLA-DR

Answer 232

D. HLA-DR

Question 233

Which of the following red cell antigens are found on glycophorin-A?

A. M,N
B. Le^a, Le^b
C. S, s
D. P, P1, Pk

Answer 233

A. M,N

Question 234

Which of the following is a characteristic of anti-i?

A. Associated with warm autoimmune hemolytic anemia
B. Found in the serum of patients with infectious mononucleosis
C. Detected at lower temperatures in the serum of normal individuals
D. Found only in the serum of group O individuals

Answer 234

B. Found in the serum of patients with infectious mononucleosis

Question 235

Which of the following antigens is most likely to be involved in hemolytic disease of the fetus and newborn?

A. Le^a
B. P1
C. M
D. K

Answer 235

D. K

Question 236

Mixed field agglutination encountered in ABO forward typing with no history of transfusion would most likely be due to:

A. Bombay phenotype (Oh)
B. T activation
C. A3 red cells
D. Positive indirect antiglobulin test

Answer 236

C. A3 red cells

Question 237

A patient’s serum sample is reactive with all cells except the autocontrol when tested by polyethylene glycol-antihuman globulin (PEG-AHG). The patient’s phenotype is confirmed as:
C-E+c+e+
K-k+, Kp(a-b+)
Js(a-b+)
Fy(a-b+)
Jk(a-b-)🌼
M+N+S+s+
Phenotypically similar cells are tested and found to be nonreactive. In what population of donors are we most likely to find a compatible donor for this patient?

A. African
B. Middle Eastern
C. South American
D. Polynesian

Answer 237

D. Polynesian

Fy (a-b-) Blacks
Jk (a-b-) Polynesians, Filipinos, Indonesians, Chinese, Japanese

Question 238

In an emergency situation, what type of blood should be given to a female patient of child-bearing age if the ABO group and Rh type are unknown?

A. Group 0, Whole Blood
B. Group 0, Rh-negative Red Blood Cells
C. Group 0, Rh-positive Red Blood Cells
D. Group 0, Washed Red Blood Cells

Answer 238

B. Group 0, Rh-negative Red Blood Cells

Question 239

A patient admitted to the trauma unit requires emergency release of Fresh Frozen Plasma (FFP). Which of the following blood groups of FFP should be issued?

A. A
B. B
C. AB
D. O

Answer 239

C. AB

Question 240

Severe intravascular hemolysis is most likely caused by antibodies of which blood group system?

A. ABO
B. Rh
C. KEL
D. FY

Answer 240

A. ABO

Question 241

Which of the following blood group systems is most commonly associated with delayed hemolytic transfusion reactions?

A. LE
B. JK
C. LU
D. I

Answer 241

B. JK

Question 242

ISBT BEGINNING WITH 030:

A. ABO
B. Scianna
C. John Milton Hagen
D. Rh-associated glycoprotein (RHAG)

Answer 242

D. Rh-associated glycoprotein (RHAG)

Question 243

What is the maximum volume of blood that can be collected from a 110-lb donor, including samples for processing?

A. 450 mL
B. 500 mL
C. 525 mL
D. 550 mL

Answer 243

C. 525 mL

Question 244

What are the possible ABO phenotypes of the offspring from the mating of a group A to a group B individual?

A. O, A, B
B. A, B
C. A, B, AB
D. O, A, B, AB

Answer 244

D. O, A, B, AB

Question 245

An ABO type on a patient gives the following reactions:
Anti-A 4+
Anti-B 4+
Anti-A1 Neg
A1 cells 2+
B cells Neg

The reactions above may be seen in a patient who is:

A. A1 with acquired B
B. A2B with anti-A1
C. AB with increased concentrations of protein in the serum
D. AB with an autoantibody

Answer 245

B. A2B with anti-A1

Question 246

Which of the following ABO blood groups contains the least amount of H substance?

A. A1B
B. A2
C. B
D. O

Answer 246

A. A1B

Question 247

How are Rh antigens inherited?

A. Autosomal recessive alleles
B. Sex-linked genes
C. Codominant alleles
D. X-linked

Answer 247

C. Codominant alleles

Question 248

Biochemically speaking, what type of molecules are Rh antigens?

A. Glycophorins
B. Simple sugars
C. Proteins
D. Lipids

Answer 248

C. Proteins

Question 249

Anti-LW will not react with which of the following?

A. Rh-positive RBCs
B. Rh-negative RBCs
C. Rh null RBCs
D. Rh:33 RBCs

Answer 249

C. Rh null RBCs

Question 250

Which of the following most commonly causes an individual to type RhD positive yet possess anti-D?

A. Genetic weak D
B. Partial D
C. C in trans to RHD
D. D epitopes on RhCE protein

Answer 250

B. Partial D

Question 251

The antibody to this high-prevalence antigen demonstrates mixed-field agglutination that appears shiny and refractile under the microscope:

A. Vel
B. JMH
C. Jr^a
D. Sd^a

Answer 251

D. Sd^a

Question 252

Which of the following is the most common antibodyseen in the blood bank after ABO and Rh antibodies?

A. Anti-Fy^a
B. Anti-k
C. Anti-Js^a
D. Anti-K

Answer 252

D. Anti-K

Question 253

Anti-Sd^a has been identified in patient ALF. What substance would neutralize this antibody and allow detection of other alloantibodies?

A. Saliva
B. Hydatid cyst fluid
C. Urine
D. Human breast milk

Answer 253

C. Urine

Question 254

Which of the following is a method for determining approximate volume of fetal-maternal bleed?

A. Kleihauer-Betke test
B. Eluate testing
C. Nucleic acid amplification testing
D. Antibody screening

Answer 254

A. Kleihauer-Betke test

Question 255

Which genotype(s) will give rise to the Bombay phenotype

A. HH only
B. HH and Hh
C. Hh and hh
D. hh only

Answer 255

D. hh only

Question 256

A cell that is not actively dividing is said to be in:

A. Interphase
B. Prophase
C. Anaphase
D. Telophase

Answer 256

A. Interphase

Question 257

Which of the following enhancement mediums decreases the zeta potential, allowing antibody and antigen to come closer together?

A. LISS
B. Polyethylene glycol
C. Polybrene
D. ZZAP

Answer 257

A. LISS

Question 258

What should be done if all forward and reverse ABO results as well as the autocontrol are positive?

A. Wash the cells with warm saline, autoadsorb theserum at 4°C
B. Retype the sample using a different lot numberof reagents
C. Use polyclonal typing reagents
D. Report the sample as group AB

Answer 258

A. Wash the cells with warm saline, autoadsorb theserum at 4°C

Question 259

Which donor unit is selected for a recipient with anti-c?

A. r ́r
B. R0R1
C. R2r ́
D. r ́ry

Answer 259

D. r ́ry

Question 260

Which genotype usually shows the strongest reaction with anti-D?

A. DCE/DCE
B. Dce/dCe
C. D–/D–
D. -CE/-ce

Answer 260

C. D–/D–

Question 261

What corrective action should be taken when rouleaux causes positive test results?

A. Perform a saline replacement technique
B. Perform an autoabsorption
C. Run a panel
D. Perform an elution

Answer 261

A. Perform a saline replacement technique

Question 262

A patient types as AB positive. Two units of blood have been ordered by the physician. Currently, the inventory shows:
No AB units
10 A-positive units
1 A-negative unit
5 B-positive units
20 O-positive units

Which should be set up for the major crossmatch?

A. A-positive units
B. O-positive units
C. B-positive units
D. Call another blood supplier for type-specific blood

Answer 262

A. A-positive units

Question 263

A Kleihauer–Betke acid elution test identifies 40 fetal cells in 2,000 maternal red cells. How many full doses of RhIg are indicated?

A. 1
B. 2
C. 3
D. 4

Answer 263

D. 4

Another formula to compute for FMH
= (Fetal cells divided by 2,000) x 5,000 mL
5,000 ML OR 5 LITERS MATERNAL BLOOD VOLUME

Question 264

A donor who has just donated 2 units of Apheresis Red Blood Cells will be deferred from further blood donation for a minimum of how many weeks?

A. 8
B. 12
C. 16
D. 24

Answer 264

C. 16

Question 265

The transport temperature for Red Blood Cells Leukocytes Reduced is:

A. 1-6°C
B. 1-10°C
C. 18-20°C
D. 20-24°C

Answer 265

B. 1-10°C

Question 266

A unit of Red Blood Cells expiring in 35 days is split into 5 small aliquots using a sterile pediatric quad set and a sterile connecting device. Each aliquot must be labeled as expiring in:

A. 6 hours
B. 12 hours
C. 5 days
D. 35 days

Answer 266

D. 35 days

Question 267

Upon inspection, a unit of Apheresis Platelets is noted to have visible clots, but otherwise appears normal. The technologist should:

A. Issue without concern
B. Filter to remove the clots
C. Centrifuge to express off the clots
D. Quarantine for Gram stain and culture

Answer 267

D. Quarantine for Gram stain and culture

Question 268

Red Blood Cells Leukocytes Reduced must be prepared by a method known to reduce the leukocyte count to:

A. <8.3 X 10^5
B. <5.0 x 10^6
C. <5.5 X 10^10
D. < 3.0 x 10^11

Answer 268

B. <5.0 x 10^6

Question 269

lastic bag overwraps are recommended when thawing units of FFP in 37°C water baths because they prevent:

A. The FFP bag from cracking when it contacts the warm water
B. Water from slowly dialyzing across the bag membrane
C. The entry ports from becoming contaminated with water
D. The label from peeling off as the water circulates in the bath

Answer 269

C. The entry ports from becoming contaminated with water

Question 270

Quality control of Apheresis Granulocytes must demonstrate which of the following granulocyte counts in 75% of units tested:

A. 1.0 X 10^10
B. 2.0 X 10^ 10
C. 3.0 X 10^10
D. 4.0 x 10^10

Answer 270

A. 1.0 X 10^10

Question 271

An important determinant of platelet viability during storage is:

A. Plasma potassium concentration
B. Plasma pH
C. Prothrombin time
D. Activated partial thromboplastin time

Answer 271

B. Plasma pH

Question 272

What percentage of red blood cells must be retained when preparing Red Blood Cells Leukocytes Reduced?

A. 50%
B. 70%
C. 85%
D. 100%

Answer 272

C. 85%

Question 273

In a quality assurance program, Cryoprecipitated AHF must contain a minimum of how many international units of Factor VIII:

A. 60
B. 70
C. 80
D. 90

Answer 273

C. 80

Question 274

Transfusion of which of the following is needed to help correct hypofibrinogenemia due to DIC?

A. Whole Blood
B. Fresh Frozen Plasma
C. Cryoprecipitated AHF
D. Platelets

Answer 274

C. Cryoprecipitated AHF

Question 275

Which of the following transfusion reactions is characterized by high fever, shock, hemoglobinuria, DIC and renal failure?

A. Bacterial contamination
B. Circulatory overload
C. Febrile
D. Anaphylactic

Answer 275

A. Bacterial contamination

Question 276

Hemoglobinuria, hypotension and generalized bleeding are symptoms of which of the following transfusion reactions?

A. Allergic
B. Circulatory overload
C. Hemolytic
D. Anaphylactic

Answer 276

C. Hemolytic

Question 277

Which of the following transfusion reactions occurs after infusion of only a few milliliters of blood and gives no history of fever?

A. Febrile
B. Circulatory overload
C. Anaphylactic
D. Hemolytic

Answer 277

C. Anaphylactic

Question 278

Hives and itching are symptoms of which of the following transfusion reactions?

A. Febrile
B. Allergic
C. Circulatory overload
D. Bacterial

Answer 278

B. Allergic

Question 279

Symptoms of dyspnea, hypoxemia, and pulmonary edema within 6 hours of transfusion is most likely which type of reaction?

A. Anaphylactic
B. Hemolytic
C. Febrile
D. TRALI

Answer 279

D. TRALI

Question 280

Congestive heart failure, severe headache and/or peripheral edema occurring soon after transfusion is indicative of which type of transfusion reaction?

A. Hemolytic
B. Febrile
C. Anaphylactic
D. TACO

Answer 280

D. TACO

Question 281

RBCs that have been leukoreduced must contain less than ______ and retain at least ______ of original RBCs.

A. 8 × 10^6 / 85%
B. 8 × 10^6 / 90%
C. 5 × 10^6 / 85%
D. 5 × 10^6 / 80%

Answer 281

C. 5 × 10^6 / 85%

Question 282

Which of the following can be given to an apheresis donor to increase the number of circulating granulocytes?

A. DDAVP
B. Hydroxyethyl starch (HES)
C. Immune globulin
D. G-CSF

Answer 282

D. G-CSF

Question 283

What component is most frequently involved with transfusion-associated sepsis?

A. Plasma
B. Packed red blood cells
C. Platelets
D. Whole blood

Answer 283

C. Platelets

Question 284

The HLA genes are located on which chromosome?

A. 2
B. 4
C. 6
D. 8

Answer 284

C. 6

Question 285

The majority of HLA antibodies belongs to what im- munoglobulin class?

A. IgD
B. IgE
C. IgG
D. IgM

Answer 285

C. IgG

Question 286

Of the following diseases, which one has the highest relative risk in association with an HLA antigen?

A. Ankylosing spondylitis
B. Juvenile diabetes
C. Narcolepsy
D. Rheumatoid arthritis

Answer 286

A. Ankylosing spondylitis

Question 287

Cold AIHA is sometimes associated with infection by:

A. Staphylococcus aureus
B. Mycoplasma pneumoniae
C. Escherichia coli
D. Group A Streptococcus

Answer 287

B. Mycoplasma pneumoniae

Question 288

The blood group involved in the autoantibody specificityin PCH is:

A. P
B. ABO
C. Rh
D. Lewis

Answer 288

A. P

Question 289

Which of the following blood groups reacts best with ananti-H or anti-IH?

A. O
B. B
C. A2
D. A1

Answer 289

A. O

Question 290

The first retrovirus to be associated with human disease was:

A. HCV
B. HIV
C. HTLV-I
D. WNV

Answer 290

C. HTLV-I

Question 291

Individuals exposed to EBV maintain an asymptomatic latent infection in:

A. B cells
B. T cells
C. All lymphocytes
D. Monocytes

Answer 291

A. B cells

Question 292

Which of the following practices has been useful in reducing the incidence of transfusion related acute lung injury (TRALI)?

A. Use of Fresh Frozen Plasma from male donors
B. Use of Fresh Frozen Plasma from female donors
C. Pathogen reduction treatment of Fresh Frozen Plasma
D. Leukocyte-reduced Fresh Frozen Plasma

Answer 292

A. Use of Fresh Frozen Plasma from male donors

Question 293

The red cells of a nonsecretor (se/se) will most likely type as:

A. Le (a-b-)
B. Le (a+b+)
C. Le (a+b-)
D. Le (a-b+)

Answer 293

C. Le (a+b-)

Question 294

Which of the following red cell typings are most commonly found in the African American donor population?

A. Lu (a-b-)
B. Jk (a-b-)
C. Fy (a-b-)
D. K-k-

Answer 294

C. Fy (a-b-)

Question 295

The reason that group O individuals have the most amount of H antigen on their red cells compared to other ABO phenotypes is:

A. Group O individuals produce more precursor type I chain
B. Group A, B and AB individuals are heterozygous for the H gene
C. The O gene produces more transferase enzyme, which produces more H antigen
D. H antigen is left unchanged by the absence of A and/or B transferase enzymes

Answer 295

D. H antigen is left unchanged by the absence of A and/or B transferase enzymes

Question 296

Why does vaccination against hepatitis B virus (HBV) also prevent hepatitis D virus (HDV) infections?

A. An immunogen from HBV in thevaccine is also associated with HDV.
B. The HBV vaccine induces formationof heterophile antibodies that crossreact with HDV.
C. The HBV vaccine stimulates liver cells to produce antiviral molecules active against all hepatitis viruses.
D. HDV requires the host to be concurrently infected with HBV.

Answer 296

D. HDV requires the host to be concurrently infected with HBV.

Question 297

What antigens would be found in the saliva of an individual with the genotype Sese Lele AO HH?

A. A, H
B. Le^b, A, H
C. Le^a, Le^b, A, H
D. Le^a

Answer 297

C. Le^a, Le^b, A, H

Question 298

Which of the following is a characteristic of anti-i?

A. Often associated with hemolytic disease of the newborn
B. Reacts best at room temperature or 4°C
C. Reacts best at 37°C
D. Is usually lgG

Answer 298

B. Reacts best at room temperature or 4°C

Question 299

The K (KEL1) antigen is:

A. Absent from the red cells of neonates
B. Strongly immunogenic
C. Destroyed by enzymes
D. Has a frequency of 50% in the random population

Answer 299

B. Strongly immunogenic

Question 300

Which of the following is the preferred specimen for the initial compatibility testing in exchange transfusion therapy?

A. Maternal serum
B. Eluate prepared from infant’s red blood cells
C. Paternal serum
D. Infant’s post-exchange serum

Answer 300

A. Maternal serum

Question 301

A characteristic of the Xg^a antigen is that the Xg^a 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

Answer 301

A. Has a higher frequency in women than in men

Question 302

Anti-E will react with which of the following cells?

A. R0R0
B. R1R1
C. R2R2
D. rr

Answer 302

C. R2R2

Question 303

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

Answer 303

C. Anti-E

Question 304

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

Answer 304

A. Maintain the pH so the platelets will be alive before transfusion

Question 305

Nonspecific immunity includes all of the following except:

A. Inflammation
B. Phagocytosis by neutrophils
C. B cell activation to produce antibodies
D. Resident normal flora

Answer 305

C. B cell activation to produce antibodies

Question 306

Most laboratories use which type of fire extinguisher?

A. Type A
B. Type B
C. Type C
D. Combination ABC

Answer 306

D. Combination ABC

Question 307

What temperature is used to achieve DNA denaturation to a single strand?

A. 74 °C
B. 92 °C
C. 94 °C
D. 102 °C

Answer 307

C. 94 °C

Question 308

A widely used hemagglutination test for detecting antibody to Treponema pallidum is:

A. MHA-TP test
B. FTA-ABS test
C. VDRL test
D. Hemagglutination inhibition assay

Answer 308

A. MHA-TP test

VDRL Flocculation

Question 309

What substance added to the antigen in the RPR test allows for more macroscopically visible flocculation?

A. Latex particles
B. Extracellular antigens
C. Heparin-magnesium chloride particles
D. Charcoal particles

Answer 309

D. Charcoal particles

Question 310

What is the “M” component in monoclonal gammopathies?

a. IgM produced in excess
b. u Heavy chain produced in excess
c. Maligant proliferation of B cells
d. Monoclonal antibody or cell line

Answer 310

d. Monoclonal antibody or cell line

refers to any monoclonal protein or cell line produced in a monoclonal gammopathy such as multiple myeloma.

Question 311

The HLA genes are located on which chromosome?

A. 2
B. 4
C. 6
D. 8

Answer 311

C. 6

Question 312

The majority of HLA antibodies belong to what immunoglobulin class?

A. IgD
B. IgE
C. IgG
D. IgM

Answer 312

C. IgG

Question 313

What is the test of choice for HLA antigen testing?

A. Agglutination
B. Molecular
C. Cytotoxicity
D. ELISA

Answer 313

B. Molecular

Question 314

What is the classical test for HLA antigen typing?

A. Agglutination
B. Molecular
C. Cytotoxicity
D. ELISA

Answer 314

C. Cytotoxicity

Question 315

With cold-reactive autoantibodies, the protein coating the patient’s cells and detected in the DAT is:

A. C3
B. IgG
C. C4
D. IgM

Answer 315

A. C3

Question 316

Penicillin given in massive doses has been associated with RBC hemolysis. Which of the classic mechanisms is typically involved in the hemolytic process?

A. Immune complex.
B. Drug adsorption.
C. Membrane modification.
D. Autoantibody formation.

Answer 316

B. Drug adsorption.

Question 317

Which of the following can be given to an apheresis donor to increase the number of circulating granulocytes?

A. DDAVP
B. Hydroxyethyl starch (HES)
C. Immune globulin
D. G-CSF

Answer 317

D. G-CSF

Question 318

The most common anticoagulant used for apheresis procedures is:

A. Heparin
B. Sodium fluoride
C. Warfarin
D. Citrate

Answer 318

D. Citrate

Question 319

The minimum interval allowed between plateletpheresis component collection procedures is:

A. 1 day
B. 2 days
C. 7 days
D. 8 weeks

Answer 319

B. 2 days

Question 320

Pain at infusion site and hypotension are observed with what type of reaction?

A. Delayed hemolytic transfusion reaction
B. Acute hemolytic transfusion reaction
C. Allergic reaction
D. Febrile nonhemolytic reaction

Answer 320

B. Acute hemolytic transfusion reaction

Question 321

Irradiation of blood is performed to prevent:

A. Febrile nonhemolytic transfusion reaction
B. Delayed hemolytic transfusion reaction
C. Transfusion-associated graft-versus-host disease
D. Transfusion-associated circulatory overload

Answer 321

C. Transfusion-associated graft-versus-host disease

Question 322

Absolute IgA deficiency is a classic example of a severe allergic reaction. A result indicating an absolute IgA deficiency is:

A. <0.05 mg/dL
B. <0.50 mg/dL
C. <0.50 gm/dL
D. <5 mg/dL

Answer 322

A. <0.05 mg/dL

Question 323

Nonimmune hemolysis can be caused during transfusion by:

A. Use of small bore size needle
B. Use of an infusion pump
C. Improper use of a blood warmer
D. All of the above

Answer 323

D. All of the above

Question 324

The only presenting sign most often accompanying a delayed hemolytic transfusion reaction is:

A. Renal failure
B. Unexplained decrease in hemoglobin
C. Active bleeding
D. Hives

Answer 324

B. Unexplained decrease in hemoglobin

Question 325

Which transfusion reaction presents with fever, maculopapular rash, watery diarrhea, abnormal liver function, and pancytopenia?

A. Transfusion-associated sepsis
B. Transfusion-related acute lung injury
C. Transfusion-associated graft-versus-host disease
D. Transfusion-associated allergic reaction

Answer 325

C. Transfusion-associated graft-versus-host disease

Question 326

Which of the following lists the correct shelf life for the component?

A. Deglycerolized RBCs - 24 hours
B. RBCs (CPD) - 35 days
C. Platelet concentrate - 10 days
D. FFP - 5 years
E. RBCs (CPDA-1) - 21 days

Answer 326

A. Deglycerolized RBCs - 24 hours

Question 327

What blood group system antibodies are commonly associated with delayed hemolytic transfusion reactions?

A. Rh
B. MNS
C. ABO
D. Kidd

Answer 327

D. Kidd

Question 328

In FPIA, increased Ag:

a. Increased fluorescence
b. Decreased fluorescence
c. Increased fluorescence polarization
d. Decreased fluorescence polarization

Answer 328

d. Decreased fluorescence polarization

Question 329

Which test is recommended for testing cerebrospinal fluid for detection fo neurosyphilis?

a. RPR
b. VDRL
c. FTA-ABS
d. Enzyme immunoassay

Answer 329

b. VDRL

Question 330

For diagnosis of late latent or teritary syphilis, the most appropriate assay is:

a. RPR
b. VDRL
c. FTA-ABS
d. FTA-ABS IgM

Answer 330

c. FTA-ABS

Question 331

A widely used hemagglutination test for detecting antibody to Treponema pallidum is:

a. MHA - TP test
b. FTA-ABS test
c. VDRL test
d. Hemagglutination inhibition assay

Answer 331

a. MHA - TP test

Question 332

Which of the following is the most sensitive test to detect congenital syphilis?

a. VDRL
b. RPR
c. MHA-TP
d. PCR

Answer 332

d. PCR

Question 333

Tumor markers found in the circulation are most frequently measured by:

a. Immunoassays
b. Thin layer chromatography
c. High pressure liquid chromatography
d. Colorimetry

Answer 333

a. Immunoassays

Question 334

Which of the following tumor markers is used to monitor persons with breast cancer for recurrence of disease?

a. Cathepsin
b. CA - 15-3
c. Retinoblastoma gene
d. Estrogen receptor (ER)

Answer 334

b. CA - 15-3

Question 335

Which tumor marker is used to determine the usefulness of TRASTUZUMAB (HERCEPTIN) therapy for breast cancer?

a. PR
b. CEA
c. HER-2/neu
d. Myc

Answer 335

c. HER-2/neu

Question 336

A 55 year old male with early stage prostate cancer diagnosed by biopsy had his prostate gland removed (simple prostatectomy). His PSA prior to surgery was 10.0 ng/mL. If the surgery was successful in completely removing the tumor cells, what would the PSA result be 1 month after surgery?

a. Undetectable
b. 1-3 ng/mL
c. Less than 4 ng/mL
d. Less than 10 ng/mL

Answer 336

a. Undetectable

Question 337

A patient has a prostate-specific antigen level of 60 ng/mL the day before surgery to remove a localized prostate tumor. One week following surgery, the serum PSA was determined to be 8 ng/mL by the same method. What is the most likely cause of these results?

a. Incomplete removal of the malignancy
b. Cross reactivity of the anitbody with another tumor antigen
c. Testing too soon after surgery
d. Hook effect with the PSA assay

Answer 337

c. Testing too soon after surgery

Question 338

Antiglomerular basement membrane antibody is seen with:

A. Wegener granulomatosis
B. IgA nephropathy
C. Goodpasture syndrome
D. Diabetic nephropathy

Answer 338

C. Goodpasture syndrome

Question 339

Antineutrophilic cytoplasmic antibody is diagnostic for:

A. IgA nephropathy
B. Wegener granulomatosis
C. Henoch-Schönlein purpura
D. Goodpasture syndrome

Answer 339

B. Wegener granulomatosis

Question 340

Mucopolysaccharidoses, EXCEPT:

A. Hunter syndrome
B. Hurler syndrome
C. Lesch-Nyhan syndrome
D. Sanfilippo syndrome

Answer 340

C. Lesch-Nyhan syndrome

Question 341

A complete deficiency of hypoxanthine guanine phosphoribosyltransferase results in which disease?

A. Lesch-Nyhan syndrome
B. Modification of diet in renal disease
C. Maple syrup urine disease
D. Reye’s syndrome
E. Megaloblastic anemia

Answer 341

A. Lesch-Nyhan syndrome

Question 342

Which of the following is considered a primary lymphoid organ?

A. Peyer patch
B. Thymus
C. Lymph node
D. Spleen
E. Appendix

Answer 342

B. Thymus

Question 343

Which of the following is a characteristic of fluorescent in situ hybridization (FISH)?

A. Semiconductor nanocrystals
B. Method of tagging antibodies with super paramagnetic particles
C. Technology based on two different 200-nm latex particles
D. Molecular cytogenetic technique

Answer 343

D. Molecular cytogenetic technique

Question 344

The technique that uses fluorescent DNA probes to detect chromosomal abnormalities within cells in cytogenetic studies is referred to as:

A. Fluorescence in situ hybridization (FISH)
B. Karyotype in situ hybridization (KISH)
C. Fluorescence in situ PCR
D. Microarray

Answer 344

A. Fluorescence in situ hybridization (FISH)

Question 345

Which technique is used to detect DNA containing a specific base sequence by applying a labeled probe to DNA bands immobilized onto nitrocellulose paper following electrophoresis?

A. Southern blot
B. Northern blot
C. Dot blot
D. Western blot

Answer 345

A. Southern blot

Question 346

The polymerase chain reaction (PCR) involves three processes. Select the order in which these occur.

A. Extension→Annealing→Denaturation
B. Annealing→Denaturation→Extension
C. Denaturation→Annealing→Extension
D. Denaturation→Extension→Annealing

Answer 346

C. Denaturation→Annealing→Extension

Question 347

In the PCR cycle, how is denaturation accomplished?

A. Heat
B. Alkali treatment
C. Addition of sulfonylurea
D. Formamide

Answer 347

A. Heat

Question 348

What is the unique characteristic of the DNA polymerase, Taq DNA polymerase, used in PCR?

A. It can be enzyme labeled
B. It is more efficient than eukaryotic polymerases
C. It is heat stable
D. It works with DNA of any species

Answer 348

C. It is heat stable

Question 349

Which method is most useful for confirmation that a culture isolate is Group B streptococcus?

A. Southern blotting
B. Polymerase chain reaction
C. Direct hybridization
D. Probe capture assay

Answer 349

C. Direct hybridization

Question 350

Which region determines whether an immunoglobulin molecule can fix complement?

A. VH
B. CH
C. VL
D. CL

Answer 350

B. CH

Question 351

Macrophages produce which of the following proteins during antigen processing?

A. IL-1 and IL-6
B. γ-Interferon
C. IL-4, IL-5, and IL-10
D. Complement components C1 and C3

Answer 351

A. IL-1 and IL-6

Question 352

Which method is used to test for HIV infection in infants who are born to HIV-positive mothers?

A. ELISA
B. Western blot test
C. Polymerase chain reaction
D. Viral culture

Answer 352

C. Polymerase chain reaction

Question 353

A newborn is to be tested for a vertically transmitted HIV infection. Which of the following tests is most useful?

A. HIV PCR
B. CD4 count
C. Rapid HIV antibody test
D. HIV IgM antibody test

Answer 353

A. HIV PCR

Question 354

Can Rh positive blood be transfused to an Rh negative person?

A. Never, under no circumstances
B. Only if Rh positive blood has been previously administered
C. May be transfused to males or females past childbearing age
D. Depend on the responder status of the individual

Answer 354

C. May be transfused to males or females past childbearing age

Rh positive blood may be transfused to Rh negative males or to females past childbearing age. These Rh negative individuals, however, must not have anti-D.

Question 355

The rosette test will detect a fetomaternal hemorrhage (FMH) as small as:

A. 10 mL
B. 15 mL
C. 20 mL
D. 30 mL

Answer 355

A. 10 mL

The rosette test is a sensitive method that can measure a FMH ≥ 10 mL.

Question 356

A fetal screen yielded negative results on a mother who is O negative and infant who is O positive. What course of action should be taken?

A. Perform a Kleihauer-Betke test
B. Issue one full dose of Rhig
C. Perform a DAT on the infant
D. Perform an antibody screen on the mother

Answer 356

B. Issue one full dose of Rhig

The fetal screen or rosette test is negative, indicating the fetal maternal blood is negligible in a possible RhiG candidate, standard practice is to issue one dose of RhiG

Question 357

Anti-LW will not react with which of the following?

A. Rh-positive RBCs
B. Rh-negative RBCs
C. Rh null RBCs
D. Rh:33 RBCs

Answer 357

C. Rh null RBCs

Question 358

LW, G, f, V and vs antigens are associated with:

A. Rh blood group system
B. Lewis system

Answer 358

A. Rh blood group system

LW
-Originally identified as the Rh blood group system
G
-Present on most D+ and all C+ cells
f
-cis-product antigen; c and e are inherited as a haplotype
V
-Found in 30% of blacks and <1% of whites
VS
-es, occurs in 32% in blacks

Question 359

Inheritance of sese and the Lewis gene produces which of the following phenotype:

A. Le (a+ b-)
B. Le (a+b+)
C. Le (a-b+)
D. Le (a-b-)

Answer 359

A. Le (a+ b-)

Question 360

Inheritance of Sese and the Lewis gene produces which of the following phenotype:

A. Le (a+ b-)
B. Le (a+b+)
C. Le (a-b+)
D. Le (a-b-)

Answer 360

C. Le (a-b+)

Question 361

A whole-blood donor currently on clopidogrel (Plavix) is precluded (prevented) from donating which product?

A. Platelets
B. Red blood cells
C. FFP
D. Cryoprecipitate

Answer 361

A. Platelets

Question 362

A donor bag is half filled during donation when the blood flow stops. Select the correct course of action.

A. Closely observe the bag for at least 3 minutes; ifblood flow does not resume, withdraw the needle
B. Remove the needle immediately and discontinuethe donation
C. Check and reposition the needle if necessary; ifblood flow does not resume, withdraw the needle
D. Withdraw the needle and perform a secondvenipuncture in the other arm

Answer 362

C. Check and reposition the needle if necessary; ifblood flow does not resume, withdraw the needle

Question 363

All of the following apply to a double red cell unit apheresis collection except:

A. The hematocrit must be at least 38%
B. The weight for a female is at least 150 lb
C. The height for a male is at least 5 ft 1 in.
D. The deferral period following collection is16 weeks

Answer 363

A. The hematocrit must be at least 38%

Question 364

Who is the best candidate for a predeposit autologous donation?

A. A 45-year-old man who is having elective surgery in 2 weeks; he has alloanti-k
B. A 23-year-old female leukemia patient with a hemoglobin of 10 g/dL
C. A 12-year-old boy who has hemophilia
D. A 53-year-old woman who has septicemia

Answer 364

A. A 45-year-old man who is having elective surgery in 2 weeks; he has alloanti-k

Question 365

Which of the following donors could be accepted for whole-blood donation?

A. A construction worker who was incarcerated for opiate abuse
B. A triathlete with a pulse of 45
C. A man who is currently taking finasteride (Propecia)
D. A woman in her 14th week of pregnancy

Answer 365

B. A triathlete with a pulse of 45

Question 366

A woman begins to breathe rapidly while donating blood. Choose the correct course of action.

A. Continue the donation; rapid breathing is not areason to discontinue a donation
B. Withdraw the needle, raise her feet, andadminister ammonia
C. Discontinue the donation and provide a paper bag
D. Tell her to sit upright and apply a cold compressto her forehead

Answer 366

C. Discontinue the donation and provide a paper bag

Question 367

PLS CHECK MEANING OF PRECLUDE BEFORE ANSWERING
Which of the following precludes acceptance of a plateletpheresis donor?

A. Platelet count of 75 × 10^9/L in a donor who is a frequent platelet donor
B. Plasma loss of 800 mL from plasmapheresis1 week ago
C. Plateletpheresis performed 4 days ago
D. Aspirin ingested 7 days ago

Answer 367

A. Platelet count of 75 × 10^9/L in a donor who is a frequent platelet donor

Question 368

PCR involving the sequential use of two primer sets:

A. Multiplex PCR
B. Nested PCR
C. Arbitrary primed PCR
D. RT-PCR

Answer 368

B. Nested PCR

Question 369

The method considered to be the “gold standard” of molecular methods is:

A. DNA sequencing
B. Southern blot
C. Northern blot
D. Dot blot

Answer 369

A. DNA sequencing

Question 370

A unit tests positive for syphilis using the rapid plasma reagin test (RPR). The microhemagglutinin assay-Treponema pallidum (MHA-TP) on the same unit is negative.
What is the disposition of the unit?

A. The unit may be used to prepare components
B. The donor must be contacted and questioned further; if the RPR result is most likely a falsepositive, then the unit may be used
C. The unit must be discarded
D. Cellular components may be prepared but must be irradiated before issue

Answer 370

A. The unit may be used to prepare components

Question 371

John Smith donated a unit of whole blood in May. Red blood cells made from the whole blood were transfused to a recipient of a community hospital in June with no apparent complications.
The blood supplier notified the medical director of the hospital that the donor reported high-risk behavior with another male in April, although viral tests remain negative and the donor is healthy.
What course of action should be taken?

A. No action should be taken
B. The recipient’s physician should be notified
C. The recipient’s physician and the recipientshould be notified
D. The recipient should be notified

Answer 371

B. The recipient’s physician should be notified

Question 372

An EIA screening test for HTLV I/II was performed on a whole-blood donor. The results of the EIA were repeatedly reactive but the confirmatory test was negative. On the next donation, the screening test was negative by two different EIA tests. The donor should be:

A. Accepted
B. Deferred
C. Told that only plasma can be made from his donation
D. Told to come back in 6 months

Answer 372

A. Accepted

Question 373

Currently, nucleic acid amplification testing (NAT) testing is performed to detect which viruses?

A. HIV and HTLV-I
B. HTLV I/II
C. HIV, HCV, and WNV
D. HIV, HBV, and WNV

Answer 373

C. HIV, HCV, and WNV

Question 374

Which immunization has the longest deferral period?

A. HBIG
B. Rubella vaccine
C. Influenza vaccine
D. Yellow fever vaccine

Answer 374

A. HBIG

Question 375

Immunoassay method for thyroxine similar to ELISA in that there is a double-antibody system that forms a “sandwich” with the hormone:

A. Chemiluminescence
B. Fluorescent polarization immunoassay (FPIA)
C. Fluorescent substrate-labeled inhibition immunoassay
D. Microparticle enzyme immunoassay (MEIA)

Answer 375

D. Microparticle enzyme immunoassay (MEIA)

Question 376

Immunoassay method for thyroxine: addition of luminol or acridium esters substrate forms an oxidized product that emits light for short time.

A. Chemiluminescence
B. Fluorescent polarization immunoassay (FPIA)
C. Fluorescent substrate-labeled inhibition immunoassay
D. Microparticle enzyme immunoassay (MEIA)

Answer 376

A. Chemiluminescence

Question 377

Immunoassay method for thyroxine: antibody-bound labeled thyroxine rotates slowly, emitting lower energy light.

A. Chemiluminescence
B. Fluorescent polarization immunoassay (FPIA)
C. Fluorescent substrate-labeled inhibition immunoassay
D. Microparticle enzyme immunoassay (MEIA)

Answer 377

B. Fluorescent polarization immunoassay (FPIA)

Question 378

Immunoassay method for thyroxine: fluorogenic substrate–labeled thyroxine competing with patient T4 for antibody in a homogeneous assay; only unbound, leftover labeled T4 reacts with enzyme to form fluorescent product.

A. Chemiluminescence
B. Fluorescent polarization immunoassay (FPIA)
C. Fluorescent substrate-labeled inhibition immunoassay
D. Microparticle enzyme immunoassay (MEIA)

Answer 378

C. Fluorescent substrate-labeled inhibition immunoassay

Question 379

All of the following are reasons for performing an adsorption, except:

A. Separation of mixtures of antibodies
B. Removal of interfering substances
C. Confirmation of weak antigens on red cells
D. Identification of antibodies causing a positive DAT

Answer 379

D. Identification of antibodies causing a positive DAT

Question 380

How often can a blood donor donate whole blood?

A. Every 24 hours
B. Once a month
C. Every 8 weeks
D. Twice a year

Answer 380

C. Every 8 weeks

Question 381

Following PLASMAPHERESIS, how long must a person wait before being eligible to donate a unit of whole blood?

A. 8 weeks
B. 2 weeks
C. 48 hours
D. 24 hours

Answer 381

C. 48 hours