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Blood banking > Part 2 > Flashcards

Part 2 Flashcards

1
Q

A patient has the Lewis phenotype Le(a−b−). An antibody panel reveals the presence of anti-Lea. Another patient with the phenotype Le(a−b+) has a positive antibody screen; however, a panel reveals no conclusive antibody. Should anti-Lea be considered as a possibility for the patient with the Le(a−b+) phenotype?

A. Anti-Lea should be considered as a possible antibody

B. Anti-Lea may be a possible antibody, but further studies are needed

C. Anti-Lea is not a likely antibody because even Leb individuals secrete some Lea

D. Anti-Lea may be found in saliva but not detectable in serum

A

C. Anti-Lea is not a likely antibody because even Leb individuals secrete some Lea

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2
Q

A technologist is having great difficulty resolving an antibody mixture. One of the antibodies is anti-Lea. This antibody is not clinically significant in this situation, but it needs to be removed to reveal the possible presence of an underlying antibody of clinical significance. What can be done?

A. Perform an enzyme panel

B. Neutralize the serum with saliva

C. Neutralize the serum with hydatid cyst fluid

D. Use DTT (dithiothreitol) to treat the panel cells

A

B. Neutralize the serum with saliva

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3
Q

What type of blood should be given to an individual who has an anti-Leb that reacts 1+ at the IAT phase?

A. Blood that is negative for the Leb antigen

B. Blood that is negative for both the Lea and Leb antigens

C. Blood that is positive for the Leb antigen

D. Lewis antibodies are not clinically significant, so any type of blood may be given

A

A. Blood that is negative for the Leb antigen

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4
Q

Which of the following statements is true concerning the MN genotype?

A. Antigens are destroyed using bleach-treated cells

B. Dosage effect may be seen for both M and N antigens

C. Both M and N antigens are impossible to detect because of cross-interference

D. MN is a rare phenotype seldom found in routine antigen typing

A

B. Dosage effect may be seen for both M and N antigens

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5
Q

Anti-M is sometimes found with reactivity detected at the immediate spin (IS) phase that persists in strength to the IAT phase. What is the main testing problem with a strong anti-M?

A. Anti-M may not allow detection of a clinically significant antibody

B. Compatible blood may not be found for the patient with a strongly reacting anti-M

C. The anti-M cannot be removed from the serum

D. The anti-M may react with the patient’s own cells, causing a positive autocontrol

A

A. Anti-M may not allow detection of a clinically significant antibody

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6
Q

A patient is suspected of having paroxysmal cold hemoglobinuria (PCH). Which pattern of reactivity is characteristic of the Donath-Landsteiner antibody, which causes this condition?

A. The antibody attaches to RBCs at 4°C and causes hemolysis at 37°C

B. The antibody attaches to RBCs at 37°C and causes agglutination at the IAT phase

C. The antibody attaches to RBCs at 22°C and causes hemolysis at 37°C

D. The antibody attaches to RBCs and causes agglutination at the IAT phase

A

A. The antibody attaches to RBCs at 4°C and causes hemolysis at 37°C

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7
Q

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

A

D. Neutralization with hydatid cyst fluid

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8
Q

Which antibody is frequently seen in patients with warm autoimmune hemolytic anemia?

A. Anti-Jka

B. Anti-e

C. Anti-K

D. Anti-Fyb

A

B. Anti-e

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9
Q

An antibody shows strong reactions in all test phases. All screen and panel cells are positive. The serum is then tested with a cord cell and the reaction is negative. What antibody is suspected?

A. Anti-I

B. Anti-i

C. Anti-H

D. Anti-p

A

A. Anti-I

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10
Q

Which group of antibodies is commonly found as cold agglutinins?

A. Anti-K, anti-k, anti-Jsb

B. Anti-D, anti-e, anti-C

C. Anti-M, anti-N

D. Anti-Fya, anti-Fyb

A

C. Anti-M, anti-N

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11
Q

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

A. Anti-K

B. Anti-Dia

C. Anti-Sda

D. Anti-s

A

C. Anti-Sda

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12
Q

What does the 3+3 rule ascertain?

A. An antibody is ruled in

B. An antibody is ruled out

C. 95% confidence that the correct antibody has been identified

D. 95% confidence that the correct antibody has not been identified

A

C. 95% confidence that the correct antibody has been identified

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13
Q

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, because it is a high frequency antibody

B. Rarely, because most individuals have the antigen and therefore would not develop the antibody

C. It depends upon the population, because certain racial and ethnic groups show a higher frequency of anti-k

D. Impossible to determine without consulting regional blood group antigen charts

A

B. Rarely, because most individuals have the antigen and therefore would not develop the antibody

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14
Q

Which procedure would help to distinguish between an anti-e and anti-Fya in an antibody mixture?

A. Lower the pH of test serum

B. Run an enzyme panel

C. Use a thiol reagent

D. Run a LISS panel

A

B. Run an enzyme panel

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15
Q

Which characteristics are true of all three of the following antibodies: anti-Fya, anti-Jka, and anti-K?

A. Detected at the IAT phase; may cause hemolytic disease of the newborn and hemolytic transfusion Reactions

B. Not detected with enzyme-treated cells

C. Requires the IAT technique for detection; usually not associated with HDN

D. Enhanced reactivity with enzyme-treated cells; may cause severe hemolytic transfusion reactions

A

A. Detected at the IAT phase; may cause hemolytic disease of the newborn and hemolytic transfusion Reactions

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16
Q

A patient is admitted to the hospital. Medical records indicate that the patient has a history of anti-Jka. When you performed the type and screen, the type was O positive and screen was negative. You should:

A. Crossmatch using units negative for Jka antigen

B. Crossmatch random units, since the antibody is not demonstrating

C. Request a new sample

D. Repeat the screen with enzyme-treated screening cells

A

A. Crossmatch using units negative for Jka antigen

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17
Q

A technologist performs an antibody study and finds 1+ and weak positive reactions for several of the panel cells. The reactions do not fit a pattern. Several selected panels and a patient phenotype do not reveal any additional information. The serum is diluted and retested, but the same reactions persist. What type of antibody may be causing these results?

A. Antibody to a high-frequency antigen

B. Antibody to a low-frequency antigen

C. High titer low avidity (HTLA)

D. Anti-HLA

A

C. High titer low avidity (HTLA)

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18
Q

An antibody is detected in a pregnant woman and is suspected of being the cause of fetal distress. The antibody reacts at the IAT phase but does not react with DTT-treated cells. This antibody causes in vitro hemolysis. What is the most likely antibody specificity?

A. Anti-Lea

B. Anti-Lua

C. Anti-Lub

D. Anti-Xga

A

C. Anti-Lub

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19
Q

What sample is best for detecting complement-dependent antibodies?

A. Plasma stored at 4°C for no longer than 24 hours

B. Serum stored at 4°C for no longer than 48 hours

C. Either serum or plasma stored at 20°C-24°C no longer than 6 hours

D. Serum heated at 56°C for 30 minutes

A

B. Serum stored at 4°C for no longer than 48 hours

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20
Q

Which antibody would not be detected by group O screening cells?

A. Anti-N

B. Anti-A1

C. Anti-Dia

D. Anti-k

A

B. Anti-A1

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21
Q

Refer to Panel 1. Which antibody is most likely implicated?

A. Anti-Fyb

B. Anti-Jkb

C. Anti-e

D. Anti-c and anti-K
Link to Panels (https://docs.google.com/document/d/1PTPii_JLOi-ow0MWtPPDn4NMQB-AGkN_mKYVj_A2xmg/edit?usp=sharing)

A

B. Anti-Jkb

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22
Q

Refer to Panel 2. Which antibody specificity is most likely present?

A. Anti-S and anti-E

B. Anti-E and anti-K

C. Anti-Lea and anti-Fyb

D. Anti-C and anti-K
Link to Panels (https://docs.google.com/document/d/1PTPii_JLOi-ow0MWtPPDn4NMQB-AGkN_mKYVj_A2xmg/edit?usp=sharing)

A

D. Anti-C and anti-K

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23
Q

On Panel 2, which of the following antibodies could not be ruled out?

A. Anti-Jkb

B. Anti-C

C. Anti-M

D. Anti-Fyb
Link to Panels (https://docs.google.com/document/d/1PTPii_JLOi-ow0MWtPPDn4NMQB-AGkN_mKYVj_A2xmg/edit?usp=sharing)

A

B. Anti-C

24
Q

On Panel 2, which cells are homozygous for C?

A. 1, 2, 3

B. 1, 2, 9

C. 3, 4, 7

D. 7, 8, 10
Link to Panels (https://docs.google.com/document/d/1PTPii_JLOi-ow0MWtPPDn4NMQB-AGkN_mKYVj_A2xmg/edit?usp=sharing)

A

B. 1, 2, 9

25
Q

A 77-year-old female is admitted to a community hospital after a cardiac arrest. History includes an abdominal aortic aneurysm 2 years ago in which she received 6 units of packed cells. Her blood type is A positive and antibody screen is positive at AHG phase in screening cells II and III. A panel is performed using LISS. Referring to panel 3, which antibodies are likely implicated?

A. C and K

B. Jka and c

C. E and c

D. Fya and M
Link to Panels (https://docs.google.com/document/d/1PTPii_JLOi-ow0MWtPPDn4NMQB-AGkN_mKYVj_A2xmg/edit?usp=sharing)

A

C. E and c

26
Q

What observation is apparent with one of the antibodies present on Panel 3?

A. One antibody is only reacting with heterozygous cells

B. Both antibodies are only reacting with homozygous cells

C. One antibody is only reacting with homozygous cells

D. Both antibodies are exhibiting dosage
Link to Panels (https://docs.google.com/document/d/1PTPii_JLOi-ow0MWtPPDn4NMQB-AGkN_mKYVj_A2xmg/edit?usp=sharing)

A

C. One antibody is only reacting with homozygous cells

27
Q

SITUATION: An emergency trauma patient requires transfusion. Six units of blood are ordered stat. There is no time to draw a patient sample. O-negative blood is released. When will compatibility testing be performed?

A. Compatibility testing must be performed before blood is issued

B. Compatibility testing will be performed when a patient sample is available

C. Compatibility testing may be performed immediately using donor serum

D. Compatibility testing is not necessary when blood is released in emergency situations

A

B. Compatibility testing will be performed when a patient sample is available

28
Q

How would autoantibodies affect compatibility testing?

A. No effect

B. The DAT would be positive

C. ABO, Rh, antibody screen, and crossmatch may show abnormal results

D. Results would depend on the specificity of autoantibody

A

C. ABO, Rh, antibody screen, and crossmatch may show abnormal results

29
Q

An antibody screen is reactive at IAT phase of testing using a three-cell screen and the autocontrol is negative. What is a possible explanation for these results?

A. A cold alloantibody

B. High-frequency alloantibody or a mixture of alloantibodies

C. A warm autoantibody

D. A cold and warm alloantibody

A

B. High-frequency alloantibody or a mixture of alloantibodies

30
Q

What does a minor crossmatch consist of?

A. Recipient plasma and recipient red cells

B. Recipient plasma and donor red cells

C. Recipient red cells and donor plasma

D. Donor plasma and donor red cells

A

C. Recipient red cells and donor plasma

31
Q

Can crossmatching be performed on October 14th using a patient sample drawn on October 12th?

A. Yes, a new sample would not be needed

B. Yes, but only if the previous sample has no alloantibodies

C. No, a new sample is needed because the 2-day limit has expired

D. No, a new sample is needed for each testing

A

A. Yes, a new sample would not be needed

32
Q

A type and screen was performed on a 32-year-old woman, and the patient was typed as AB negative. There are no AB-negative units in the blood bank. What should be done?

A. Order AB-negative units from a blood supplier

B. Check inventory of A-, B-, and O-negative units

C. Ask the patient to make a preoperative autologous donation

D. Nothing—the blood will probably not be used

A

B. Check inventory of A-, B-, and O-negative units

33
Q

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

A

B. O negative

34
Q

What type(s) of red cells is (are) acceptable to transfuse to an O-negative patient?

A. A negative, B negative, AB negative, or O negative

B. O negative

C. AB negative

D. AB negative, A negative, B negative

A

B. O negative

35
Q

A technologist removed 4 units of blood from the blood bank refrigerator and placed them on the counter. A clerk was waiting to take the units for transfusion. As she checked the paperwork, she noticed that one of the units was leaking onto the counter. What should she do?

A. Issue the unit if the red cells appear normal

B. Reseal the unit

C. Discard the unit

D. Call the medical director and ask for an opinion

A

C. Discard the unit

36
Q

A donor was found to contain anti-K using pilot tubes from the collection procedure. How would this affect the compatibility test?

A. The AHG major crossmatch would be positive

B. The IS (immediate spin) major crossmatch would be positive

C. The recipient’s antibody screen would be positive for anti-K

D. Compatibility testing would not be affected

A

D. Compatibility testing would not be affected

37
Q

Which of the following is not a requirement for the electronic crossmatch?

A. The computer system contains logic to prevent assignment and release of ABO incompatible blood

B. There are concordant results of at least two determinations of the recipient’s ABO type on record, one of which is from the current sample

C. Critical elements of the system have been validated on site

D. There are concordant results of at least one determination of the recipient’s ABO type on file

A

D. There are concordant results of at least one determination of the recipient’s ABO type on file

38
Q

A patient showed positive results with screening cells and 4 donor units. The patient autocontrol was negative. What is the most likely antibody?

A. Anti-H

B. Anti-S

C. Anti-Kpa

D. Anti-k

A

D. Anti-k

39
Q

Screening cells and major crossmatch are positive on IS only, and the autocontrol is negative. Identify the problem.

A. Cold alloantibody

B. Cold autoantibody

C. Abnormal protein

D. Antibody mixture

A

A. Cold alloantibody

40
Q

Six units are crossmatched. Five units are compatible, one unit is incompatible, and the recipient’s antibody screen is negative. Identify the problem:

A. Patient may have an alloantibody to a high-frequency antigen

B. Patient may have an abnormal protein

C. Donor unit may have a positive DAT

D. Donor may have a high-frequency antigen

A

C. Donor unit may have a positive DAT

41
Q

An incompatible donor unit is found to have a positive DAT. What should be done with the donor unit?

A. Discard the unit

B. Antigen type the unit for high-frequency antigens

C. Wash the donor cells and use the washed cells for testing

D. Perform a panel on the incompatible unit

A

A. Discard the unit

42
Q

Screening cells, major crossmatch, and patient autocontrol are positive in all phases. Identify the problem.

A. Specific cold alloantibody

B. Specific cold autoantibody

C. Abnormal protein or nonspecific autoantibody

D. Cold and warm alloantibody mixture

A

C. Abnormal protein or nonspecific autoantibody

43
Q

A panel study has revealed the presence of patient alloantibodies. What is the first step in a major crossmatch?

A. Perform a DAT on patient cells and donor units

B. Antigen type patient cells and any donor cells to be crossmatched

C. Adsorb any antibodies from the patient serum

D. Obtain a different enhancement medium for testing

A

B. Antigen type patient cells and any donor cells to be crossmatched

44
Q

What is the disposition of a donor red blood cell unit that contains an antibody?

A. The unit must be discarded

B. Only the plasma may be used to make components

C. The antibody must be adsorbed from the unit

D. The unit may be labeled indicating it contains antibody and released into inventory

A

D. The unit may be labeled indicating it contains antibody and released into inventory

45
Q

Given a situation where screening cells, major crossmatch, autocontrol, and DAT (anti-IgG) are all positive, what procedure should be performed next?

A. Adsorption using rabbit stroma

B. Antigen typing of patient cells

C. Elution followed by a cell panel on the eluate

D. Selected cell panel

A

C. Elution followed by a cell panel on the eluate

46
Q

A major crossmatch and screening cells are 2+ at IS, 1+ at 37°C, and negative at the IAT phase. Identify the most likely problem.

A. Combination of antibodies

B. Cold alloantibody

C. Rouleaux

D. Test error

A

B. Cold alloantibody

47
Q

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

A

A. Perform a saline replacement technique

48
Q

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

A

D. Identification of antibodies causing a positive DAT

49
Q

How long must a recipient sample be kept in the blood bank following compatibility testing?

A. 3 days

B. 5 days

C. 7 days

D. 10 days

A

C. 7 days

50
Q

What is the crossmatching protocol for platelets and\or plasma?

A. Perform a reverse grouping on donor plasma

B. No testing is required

C. Perform a reverse grouping on recipient plasma

D. Platelets must be HLA compatible

A

B. No testing is required

51
Q

What are the compatibility requirements for an autologous unit?

A. ABO and Rh typing

B. Type and screen

C. Major crossmatch

D. All of these options

A

A. ABO and Rh typing

52
Q

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, and 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

A

A. A-positive units

53
Q

Which of the following comprises an abbreviated crossmatch?

A. ABO, Rh, and antibody screen

B. ABO, Rh, antibody screen, IS crossmatch

C. Type and screen

D. ABO, Rh, IS crossmatch

A

B. ABO, Rh, antibody screen, IS crossmatch

54
Q

When may an IS crossmatch be performed?

A. When a patient is being massively transfused

B. When there is no history of antibodies and the current antibody screen is negative

C. When blood is being emergency released

D. When a patient has not been transfused in the past 3 months

A

B. When there is no history of antibodies and the current antibody screen is negative

55
Q

A patient had a transfusion reaction to packed red blood cells. The medical laboratory scientist began the laboratory investigation of the transfusion reaction by assembling pre- and post-transfusion specimens and all paperwork and computer printouts. What should he do next?

A. Perform a DAT on the post-transfusion sample

B. Check for a clerical error(s)

C. Repeat ABO and Rh typing of patient and donor unit

D. Perform an antibody screen on the post-transfusion sample

A

B. Check for a clerical error(s)

Blood banking (4 decks)

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