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Blood banking > Part 1 > Flashcards

Part 1 Flashcards

1
Q

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 genotyping and phenotyping

D. Polymerase chain reaction

A

B. Phenotyping

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2
Q

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

A

A. Dosage

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3
Q

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

A. Gender

B. Race

C. Gender and race

D. Medication

A

C. Gender and race

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4
Q

Which of the following statements is true?

A. An individual with the 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

A

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

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5
Q

Which genotype is heterozygous for C?

A. DCe\dce

B. DCE\DCE

C. Dce\dce

D. DCE\dCe

A

A. DCe\dce

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6
Q

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

A. HH only

B. HH and Hh

C. Hh and hh

D. hh only

A

D. hh only

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7
Q

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

A

A. 1N

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8
Q

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

A. Interphase

B. Prophase

C. Anaphase

D. Telophase

A

A. Interphase

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9
Q

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

A. Dominant

B. Recessive

C. Codominant

D. Corecessive

A

C. Codominant

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10
Q

What blood type is not possible for an offspring of an AO and BO mating?

A. AB

B. A or B

C. O

D. All are possible

A

D. All are possible

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11
Q

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

A

D. Indirect\secondary\second order

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12
Q

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

A

B. Linkage disequilibrium

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13
Q

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

A

B. The homozygous population of one allele

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14
Q

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

A

C. X-linked dominant

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15
Q

Why do IgM antibodies, such as those formed against the ABO antigens, have the ability to directly agglutinate red blood cells (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

A

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

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16
Q

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

A

A. LISS

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17
Q

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

A. Primary

B. Secondary

C. Tertiary

D. Anaphylactic

A

B. Secondary

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18
Q

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

A

B. Anti-IgG and anti-C3d

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19
Q

Which of the following distinguishes A1 from A2 blood groups?

A. A2 antigen will not react with anti-A, A1 will react strongly (4+)

B. An A2 person may form anti-A1; an A1 person will not form anti-A1

C. An A1 person may form anti-A2, an A2 person will not form anti-A1

D. A2 antigen will not react with anti-A from a nonimmunized donor; A1 will react with any anti-A

A

B. An A2 person may form anti-A1; an A1 person will not form anti-A1

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20
Q

A patient’s serum is incompatible with O cells. The patient RBCs give a negative reaction to anti-H lectin. What is the most likely cause of these results?

A. The patient may be a subgroup of A

B. The patient may have an immunodeficiency

C. The patient may be a Bombay

D. The patient may have developed alloantibodies

A

C. The patient may be a Bombay

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21
Q

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

A

D. Anti-A, B, and H

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22
Q

Acquired B antigens have been found in:

A. Bombay individuals

B. Group O persons

C. All blood groups

D. Group A persons

A

D. Group A persons

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23
Q

Blood is crossmatched on an A positive person with a negative antibody screen. The patient received a transfusion of A positive RBCs 3 years ago. The donors chosen for crossmatch were A positive. The crossmatch was run on the Ortho Provue and yielded 3+ incompatibility. How can these results be explained?

A. The patient has an antibody to a low-frequency antigen

B. The patient has an antibody to a high-frequency antigen

C. The patient is an A2 with anti-A1

D. The patient is an A1 with anti-A2

A

C. The patient is an A2 with anti-A1

24
Q

A patient’s red cells forward as group O, serum agglutinates B cells (4+) only. Your next step would be:

A. Extend reverse typing for 15 minutes

B. Perform an antibody screen including a room-temperature incubation

C. Incubate washed red cells with anti-A1 and anti-A,B for 30 minutes at room temperature

D. Test patient’s red cells with Dolichos biflorus

A

C. Incubate washed red cells with anti-A1 and anti-A,B for 30 minutes at room temperature

25
Q

Which typing results are most likely to occur when a patient has an acquired B antigen?

A. Anti-A 4+, anti-B-3+, A1 cells neg, B cells neg

B. Anti-A 3+, anti-B neg, A1 cells neg, B cells neg

C. Anti-A 4+, anti-B 1+, A1 cells neg, B cells 4+

D. Anti-A 4+, anti-B 4+, A1 cells 2+, B cells neg

A

C. Anti-A 4+, anti-B 1+, A1 cells neg, B cells 4+

26
Q

Which blood group has the least amount of H antigen?

A. A1B

B. A2

C. B

D. A1

A

A. A1B

27
Q

What type RBCs can be transfused to an A2 person with anti-A1?

A. A only

B. A or O

C. B

D. AB

A

B. A or O

28
Q

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 the serum at 4°C

B. Retype the sample using a different lot number of reagents

C. Use polyclonal typing reagents

D. Report the sample as group AB

A

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

29
Q

What should be done if all forward and reverse ABO results are negative?

A. Perform additional testing such as typing with anti-A1 lectin and anti-A,B

B. Incubate at 22°C or 4°C to enhance weak expression

C. Repeat the test with new reagents

D. Run an antibody identification panel

A

B. Incubate at 22°C or 4°C to enhance weak expression

30
Q

N-acetyl-D-galactosamine is the immunodominant carbohydrate that reacts with:

A. Arachis hypogaea

B. Salvia sclarea

C. Dolichos biflorus

D. Ulex europeaus

A

C. Dolichos biflorus

31
Q

A stem cell transplant patient was retyped when she was transferred from another hospital. What is the most likely cause of the following results?

Patient cells: Anti-A, neg Anti-B, 4+

Patient serum: A1 cells, neg B cells, neg

A. Viral infection

B. Alloantibodies

C. Immunodeficiency

D. Autoimmune hemolytic anemia

A

C. Immunodeficiency

32
Q

What reaction would be the same for an A1 and an A2 person?

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

A

D. Positive reaction with anti-A,B

33
Q

A female patient at 28 weeks’ gestation yields the following results:

Patient cells: Anti-A, 3+ Anti-B, 4+

Patient serum: A1 cells, neg B cells, 1+ O cells, 1+

Which of the following could be causing the ABO discrepancy?

A. Hypogammaglobulinemia

B. Alloantibody in patient serum

C. Acquired B

D. Weak subgroup

A

B. Alloantibody in patient serum

34
Q

Which condition would most likely be responsible for the following typing results?

Patient cells: Anti-A, neg Anti-B, neg

Patient serum: A1 cells, neg B cells, 4+

A. Immunodeficiency

B. Masking of antigens by the presence of massive amounts of antibody

C. Weak or excessive antigen(s)

D. Impossible to determine

A

C. Weak or excessive antigen(s)

35
Q

Which of the following results is most likely discrepant?

Anti-A, neg Anti-B, 4+

A1 cells, neg B cells, neg

A. Negative B cells

B. Positive reaction with anti-B

C. Negative A1 cells

D. No problem with this typing

A

C. Negative A1 cells

36
Q

A 61-year-old male with a history of multiple myeloma had a stem cell transplant 3 years ago. The donor was O positive and the recipient was B positive. He is admitted to a community hospital for fatigue and nausea. Typing results reveal the following:
Anti-A = 0
Anti-B =0
Anti-A,B = 0
Anti-D = 4+
A1 cells = 4+
B cells = 0
How would you report this type?

A. O positive
B. B positive
C. A positive
D. Undetermined

A

D. Undetermined

37
Q

A complete Rh typing for antigens C, c, D, E, and e revealed negative results for C, D, and E. How is the individual designated?

A. Rh positive

B. Rh negative

C. Positive for c and e

D. Impossible to determine

A

B. Rh negative

38
Q

How is an individual with genotype Dce\dce classified?

A. Rh positive

B. Rh negative

C. Rhnull

D. Total Rh

A

A. Rh positive

39
Q

If a patient has a positive direct antiglobulin test, should you perform a weak D test on the cells?

A. No, the cells are already coated with antibody

B. No, the cells are Rhnull

C. Yes, the immunoglobulin will not interfere with the test

D. Yes, Rh reagents are enhanced in protein media

A

A. No, the cells are already coated with antibody

40
Q

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

A. r ́r

B. R0R1

C. R2r ́

D. r ́ry

A

D. r ́ry

41
Q

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

A. DCE\DCE

B. Dce\dCe

C. D-\D-

D. -CE-ce

A

C. D-\D-

42
Q

Why is testing for Rh antigens and antibodies different from ABO testing?

A. ABO reactions are primarily due to IgM antibodies and usually occur at room temperature; Rh antibodies are IgG and agglutination usually requires a 37°C incubation and enhancement media

B. ABO antigens are attached to receptors on the outside of the red cell and do not require any special enhancement for testing; Rh antigens are loosely attached to the red cell membrane and require enhancement for detection

C. Both ABO and Rh antigens and antibodies have similar structures, but Rh antibodies are configured so that special techniques are needed to facilitate binding to Rh antigens

D. There is no difference in ABO and Rh testing; both may be conducted at room temperature with no special enhancement needed for reaction

A

A. ABO reactions are primarily due to IgM antibodies and usually occur at room temperature; Rh antibodies are IgG and agglutination usually requires a 37°C incubation and enhancement media

43
Q

Testing reveals a weak D that reacts 1+ after indirect antiglobulin testing (IAT). How is this result classified?

A. Rh-positive

B. Rh-negative, Du positive

C. Rh-negative

D. Rh-positive, Du positive

A

A. Rh-positive

44
Q

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

A. R1r

B. R1R1

C. r ́r

D. rr

A

D. rr

45
Q

A patient developed a combination of Rh antibodies: anti-C, anti-E, and anti-D. Can compatible blood be found for this patient?

A. It is almost impossible to find blood lacking the C, E, and D antigens

B. rr blood could be used without causing a problem

C. R0R0 may be used because it lacks all three antigens

D. Although rare, ryr blood may be obtained from close relatives of the patient

A

B. rr blood could be used without causing a problem

46
Q

A patient tests positive for weak D but also appears to have anti-D in his serum. What may be the problem?

A. Mixup of samples or testing error

B. Most weak D individuals make anti-D

C. The problem could be due to a disease state

D. A D mosaic may make antibodies to missing antigen parts

A

D. A D mosaic may make antibodies to missing antigen parts

47
Q

Which offspring is not possible from a mother who is R1R2 and a father who is R1r?

A. DcE\DcE

B. Dce\DCe

C. DcE\DCe

D. Dce\dce

A

A. DcE\DcE

48
Q

Why is testing a pregnant woman for weak D not required?

A. An Rh-negative fetus may yield false positive results in a fetal maternal bleed

B. An Rh-positive fetus may yield false positive results in a fetal maternal bleed

C. D antigen strength decreases during pregnancy

D. D antigen strength increases during pregnancy

A

B. An Rh-positive fetus may yield false positive results in a fetal maternal bleed

49
Q

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

A

B. Anti-E and anti-c

50
Q

What does the genotype —\— represent in the Rh system?

A. Rh negative

B. D mosaic

C. Rhnull

D. Total Rh

A

C. Rhnull

51
Q

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

A

D. 37°C incubation + IAT

52
Q

A patient types as AB and appears to be Rh positive on slide typing. What additional tests should be performed for tube typing?

A. Rh negative control

B. Direct antiglobulin test (DAT)

C. Low-protein Rh antisera

D. No additional testing is needed

A

A. Rh negative control

53
Q

According to the Wiener nomenclature and\or genetic theory of Rh inheritance:

A. There are three closely linked loci, each with a primary set of allelic genes

B. The alleles are named R1, R2, R0, r, r ́, r ̋, Rz, and ry

C. There are multiple alleles at a single complex locus that determine each Rh antigen

D. The antigens are named D, C, E, c, and e

A

C. There are multiple alleles at a single complex locus that determine each Rh antigen

54
Q

The Wiener nomenclature for the E antigen is:

A. hr ́

B. hrv ́

C. rh ̋

D. Rh0

A

C. rh ̋

55
Q

A physician orders 2 units of leukocyte-reduced red blood cells. The patient is a 55-year-old male with anemia. He types as an AB negative, and his antibody screen is negative. There is only 1 unit of AB negative in inventory. What is the next blood type that should be given?

A. AB positive (patient is male)

B. A negative

C. B negative

D. O negative

A

B. A negative

56
Q

Which technology may report an Rh-weak D positive as Rh negative?

A. Gel System

B. Solid Phase

C. Tube Testing

D. None of these options

A

A. Gel System

Blood banking (4 decks)

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