Practice Test Flashcards
Where is the paratope located?
the variable regions of the light and heavy chain, at the tip of the Y, form the paratope on the antibody.
What is the definition of an autoantibody ?
Reaction of ones own antibodies against one owns antigens
What is the definition of an alloantibody?
An antibody that is produced by one individual and reacts with an antigen found in other members of the same species
TRUE OR FALSE:
Monoclonal antibodies have homogeneous, restricted nature, are derived from a single clone and are used in diagnostic testing and are frequently used in commercial antiseras
True
Which class of antibodies: Mainly functions as an antigen receptor on B lymphs ?
IgD
Which class of antibodies: Can cross the placenta?
IgG
Which class of antibodies: Responds to allergic reactions?
IgE
Which class of antibodies: First to develop in the immune response?
IgM
Which class of antibodies: Reacts best at body temperatures?
IgG
Which class of antibodies: Forms in petamers or hexamers with molecular mass of 900,000 daltons?
IgM
Which class of antibodies provides protection against helminths(worms)?
IgE
What subclass of IgG .. Crosses placenta more readily
IgG1
Which IgG subclass …
Doesn’t cross placenta?
IgG2
Which IgG subclass …
Is the highest percentage present?
IgG1
Which IgG subclass …
Does not activate complement?
IgG4
Which IgG subclass …
Highest activator of complement?
IgG3
Which IgG subclass …
Has the highest affinity for the Fc receptor on phagocytic cells?
IgG1 & IgG3
What are the functions of complement?
Promote inflammatory response. Alter biological membrane to cause direct cel lysis or enhance susceptibility to phagocytosis
What are the two pathways of complement?
Classical and Alternate
What activates complement pathways?
Classical- single IgM or 2+ IgG
Alternate- Bacterial cell walls. Bacterial lipopolysaccarides. Fungal cell walls. Virus infected cells
Largest unit in the genetic code is _____________.
Chromosome
What is the definition of a gene?
A gene is a locatable sequence of DNA on a chromosome corresponding to an inheritable trait. The remaining DNA sequences on the chromosome have structural purposes or are involved in regulating the expression of genetic information
What is the definition of an allele?
Any one of two or more genes occupying a specific position (locus) on a chromosome
Genes actually present on an allele regardless of trait expressed is called an individuals __________.
Genotype
The expressed characteristic of an allele is called _______.
Phenotype
Serological differences due to the result of homozygous or heterozygous alleles are referred to as _________.
Dosage
TRUE OR FALSE:
Blood group antigens are expressed as dominant , recessive, or co-dominant?
True
Which ABO group gene is recessive?
O
What would be the possible ABO blood group of offspring with “A” mother and “O” father ?
AO or OO
What antigen is present on and individual with O gene ?
H
What antibody reacts optimally at 4 degrees Celsius and produced by virtually everyone lacking the antigen?
Anti-P1
The _______ blood group is notorious for severe delayed transfusion reactions
Kidd
What antigens virtually occur on everyone’s RBCs?
Public antigens & High incidence antigens
TRUE OR FALSE:
Autoantibodies are defined as antibodies produced by one individual and reacts with an antigen found in other members of the same species.
False
Which of the following are NOT IgM cold reacting antibodies? A) Lewis B) Anti-M & Anti-N C) Anti- P & Anti-I D) Duffy(Fy)
D) Duffy(Fy)
TRUE OR FALSE:
Most serum antibodies are polyclonal.
True
What antigen is second most in antigenicity to Anti D? A)Lewis B)MNSs C)Kell D)Kidd E)Duffy
C) Kell
What antibodies are generally IgG? A)Lewis B)P1 C)Ii D)Kell E)Kidd F)Duffy
D, E, F
The ____ antigen is expressed in individuals that posses LeSe
Leb
What is an antigen that only occurs in a very limited segment of the population is classified as?
Private antigens & Low Incidence antigens
Which of the following affects Stage I of agglutination (sensitization) of RBCs? (Circle all that apply) A) Temperature B) Incubation time C) Ab/ Ag proportions D) Enhancement media
A, B, C
TRUE OR FALSE:
Enhancement media is used to aid the second stage of agglutination by reducing the natural repulsive affect of RBCs.
True
TRUE OR FALSE:
A and B are always dominant over O
True
Bombay phenotype lacks what antigen?
A, B and H
What blood type is possible from a B mother and B father ?
B and O
What antigen is present on the RBCs of an individual with the B gene?
B antigen
At a minimum how old must a baby be prior to performing reverse grouping in the ABO procedure?
4 months
TRUE OR FALSE
Rh antigens are codominant and will always be expressed if the gene is inherited?
True
TRUE OR FALSE:
Techniques to demonstrate weak D are required only for donor blood, for testing neonates born to Rh-negative mothers to determine Rh immunoglobulin candidacy
True
What is the correct phenotype for CDE/Cde?
A . CDEe
B. CcDdEe
C. cDdEe
D. CDE
A.
The IAT Principle is utilized in which of the following tests? (select all that apply)
a. Elution b. Crossmatch c. Antibody Screen d. Antibody Titration e. Antibody Identification f. Red Cell Antigen Screening (phenotyping)
B, C, E, F
Phenotyping involves using known __________ found in antisera to detect presence of unknown ___________ on cells.
Antibodies; Antigens
When selecting a positive control for phenotyping, (heterozygous or homozygous) cells possessing the antigen should be used?
Heterozygous
Agglutination in the test tube while performing a phenotype indicated the antigen is ________ on the RBC’s
Present
________ is used to detect unknown antibodies in patient’s serum.
IAT
________ is used to detect in vivo sensitization of red blood cells.
DAT
Why are group O screening cells used in antibody detection procedures?
a. Ensure activation of complement
b. Ensure reaction with majority of blood groups
c. Eliminate potential of reaction with anti-A and anti-B
d. Provide source of antigens for negative control
C.
TRUE OR FALSE:
AHG will react with any antibody present.
False
The IAT is also known as __________, ____________, and ______________.
Ab screen, phenotype & x-match
How long should antibody screens using Gel be incubated? a. 5min b. 10min c. 15 min d. 20 min
15 min
How long should antibody screens using Gel be centrifuged? a. 5min b. 10min c. 15 min d. 20 min
10min
In gel technology, the formation of a pellet at the bottom of the gel microtube indicates what result? a. invalid test b. agglutination c. no agglutination d. what's gel technology
No agglutination
Which of the following is not a source of error in the gel IAT test?
a. delay between addition of reagents and centrifugation
b. too many or too few cells used
c. using hemolyzed specimens
d. grading reactions 0 to 4+
D. grading reactions 0 to 4+
Which of the following is not a use of the DAT test?
a. Compatibility testing
b. Investigate transfusion reactions
c. Investigate drug-induced hemolysis
d. Diagnosing autoimmune hemolytic anemia and HDN
A. compatibility testing
TRUE OR FALSE:
Solid-phase microplate techniques uses immobilized antigen or antibody bound to the side of the reaction well.
True
In blood bank, what is routinely used as the source of antigen? a. Serum b. Plasma c. Latex particles d. Red Blood Cells e. Both A & B
D) RBCs
TRUE OR FALSE:
Only cells reacting at 37oC or at AHG can be used to eliminate potential antibodies.
False
TRUE OR FALSE:
An elution is used to remove free antibody from plasma or serum.
False
What type of elution is best suited for investigation of ABO HDN and elution of IgM antibodies?
Heat & Lui Freeze - Thaw Elutions
When would an elution be performed?
a. Positive DAT
b. Concentration/purification of antibodies
c. Removal of cold/warm auto antibodies from red blood cells
d. All of the above
D) All of the above
Reasons for performing antibody titer include:
Prenatal studies, ABID, separating multiple Abs in samples that contain more than one specificity
TRUE OR FALSE:
Titration is a semi-quantitative method to determine antibody concentration.
True
When performing a serial dilution, a known amount of _______ is added to each tube while the serum is repeatedly diluted reducing the amount of _____________present
Diluent; Patient Ab
TRUE OR FALSE:
“d” is termed an amorph because the gene does not result in the production of antigen on the RBC.
True
What Weiner nomenclature is represented by dcE? a. r b. r’ c. r” d. ry
C. r’’
ABO Subgroups occur due to:
ABO phenotypes that differ in the amount of ag carried on the cell
Fill in chart: Weiner Fisher & Race R0. Dce R1. \_\_\_\_ R2. DcE \_\_\_\_ DCE r. dce r’. dCe r’’. \_\_\_\_ \_\_\_ dCE
Rz. DCe
ry dcE
___________________ transfusion reaction is when there is red cell incompatibility and antibodies to donor’s leukocytes and plasma.
Acute immunologic
__________________ transfusion reaction occurs with iron overload.
Delayed non immunologic
The Blood Transfusion Investigation form is: a. AF Form 1224 b. SF 518 c. AFMAN 41-111 d. None of the above
A. AF Form 1224
Required samples for a transfusion reaction workup include:
All pre transfusion samples, blood bag w infusion set, IV solutions , post reaction EDTA & Clot tubes, Urine Sample
TRUE OR FALSE:
Centrifuging the post-reaction EDTA sample is to check for hemolysis.
True
TRUE OR FALSE:
Perform a IAT on post-reaction sample to check for in vivo sensitization of RBC’s.
True
Frozen blood components, such as fresh frozen plasma (FFP), and cryoprecipitate AHF (cryo) should be transported and received frozen at a temperature. What is the frozen temp?
- 18 degrees Celsius
The Shipping Inventory of Blood Products is: a. AF Form 1224 b. SF 518 c. DD Form 573 d. SF 573
C. DD Form 573
Which of the following information is not provided on a DD Form 573? a. Unit number b. ABO/Rh c. Type of product d. Donor name e. Expiration date
D. Donor Blood
When a PRBC unit is received from another blood bank, what confirmation tests need to be performed?
a. ABO group confirmation
b. Confirmation of all Rh D negative PRBC units.
c. Confirmation of weak D is required
d. A& B
D. A &B
Frozen blood must be maintained and stored at: a. ≤ -18º C b. 1-6º C c. ≤ -65º C d. 1-6º C
C.
Blood and blood components must be maintained and stored at: a. ≤ -18 degrees Celsius b. 5 degrees Celsius c. 1-10 degrees Celsius d. 1-6 degrees Celsius
D. 1-6 degrees Celsius
TRUE OR FALSE:
Storage areas should be organized with designated areas to separate crossmatched, quarantined, unprocessed, autologous and autologous biohazard blood.
True
Blood bank temperature charts and QC data are maintained for how long? a. 1 yr b. 2 yr c. 5 yr d. 10 yr
5 year
HDN was originally called________________________ because of NRBC’s found in affected newborns circulation.
Erythroblastosis fetalis
HDN most often occurs with factors of Rh______, _______, _________ and ABO blood groups
anti-D, anti-C anti-E
The inability of the infant to conjugate __________ results in jaundice.
Bilirubin
TRUE OR FALSE:
HDN as a result of anti-D usually increases in severity, particularly between the first and second pregnancy.
True
TRUE OR FALSE:
IgM antibodies that cause ABO hemolytic disease of the newborn almost always occur in the mother’s circulation without an immunizing event such as pregnancy or transfusion.
False; IgG
TRUE OR FALSE:
In prenatal testing only ABO is performed on the mother and father.
False
What is the sample of choice for newborn testing?
Cord blood
What tests are performed for newborn testing?
ABO/Rh front type & DAT
What is the only preventative for HDN is the administration of _______.
RhIG
A \_\_\_\_\_\_\_\_\_ mg dose of RhIG is sufficient to counteract \_\_\_\_\_\_\_\_\_ mls of fetal blood. a. 500 / 50 b. 3000 / 30 c. 50 / 50 d. 300 / 30
D. 300; 30
RhIG therapy should be given within ___hrs of delivery.
72
Other than standard times throughout pregnancy, what other instances would RhIG be administered?
After miscarriage, accident, that could result in immunization of the mother
Which test is utilized as a screening method for the detection of 10mls or more of fetomaternal hemorrhaging? a. Rosette test b. Kleihauer-Betke c. Acid Elution Stain d. None of the above
A. Rosette test
Which test is a quantitative measurement to determine the amount of fetomaternal hemorrhage?
KB or Acid Elution stain
______________ is the best way to evaluate the degree of intrauterine hemolysis, fetal condition and severity of HDN.
Amniocentesis
What are the two indications for performing amniocentesis?
Antiglobulin titer at or above 16-32 for anti-D
Hx of previous pregnancy in which there was HDN due to anti-D or other antibodies, regardless of Ab titer
Why is exchange transfusion used and performed?
Treatment of severe HDN after baby is born
To remove ab coated fetal cells
“ maternal Ab
“ bilirubin & resolve anemia
