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BLOODBANK LAB > Review Questions > Flashcards

Review Questions Flashcards

1
Q

The Rh system was first recognized in a case report of:

a. A hemolytic transfusion reaction.
b. Hemolytic disease of the fetus and newborn.
c. Circulatory overload.
d. Autoimmune hemolytic anemia.

A

a

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2
Q

What antigen is found in 85% of the white population
and is always significant for transfusion purposes?

a. d
b. c
c. D
d. E

A

c

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3
Q

How are weaker-than-expected reactions with anti-D
typing reagents categorized?

a. Rhmod
b. Weak D
c. DAT positive
d. Dw

A

b

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4
Q

Cells carrying a weak-D antigen require the use of what
test to demonstrate its presence?

a. Indirect antiglobulin test
b. Direct antiglobulin test
c. Microplate test
d. Warm autoadsorption test

A

a

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5
Q

How are Rh antigens inherited?

a. Autosomal recessive alleles
b. Sex-linked genes
c. Codominant alleles
d. X-linked

A

c

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6
Q

Biochemically speaking, what type of molecules are Rh
antigens?

a. Glycophorins
b. Simple sugars
c. Proteins
d. Lipids

A

c

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7
Q

Rh antibodies react best at what temperature (°C)?

a. 22
b. 18
c. 15
d. 37

A

d

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8
Q

Rh antibodies are primarily of which immunoglobulin
class?

a. IgA
b. IgM
c. IgG
d. IgD

A

c

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9
Q

Rh antibodies have been associated with which of the
following clinical conditions?

a. Erythroblastosis fetalis
b. Thrombocytopenia
c. Hemophilia A
d. Stomatocytosis

A

a

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10
Q

What do Rhnull cells lack?

a. Lewis antigens
b. Normal oxygen-carrying capacity
c. Rh antigens
d. MNSs antigens

A

c

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11
Q

What antigen system is closely associated phenotypically
with Rh?

a. McCoy
b. Lutheran
c. Duffy
d. LW

A

d

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12
Q

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

a. Rh-positive RBCs
b. Rh-negative RBCs
c. Rhnull RBCs
d. Rh:33 RBCs

A

c

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13
Q

Convert the following genotypes from Wiener nomenclature to Fisher-Race and Rosenfield nomenclatures,
and list the antigens present in each haplotype.

a. R1r
b. R2R0
c. RzR1
d. ryr

A

R1r
DCe/dce
Rh:1, 2, -3, 4, 5

R2R0
DcE/Dce
Rh:1, -2, 3, 4, 5

RzR1
DCE/DCe
Rh:1,2,3, -4,5

ryr
dCE/dce
RH: -1,2,3,4,5

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14
Q

Which Rh phenotype has the strongest expression of D?

a. R1r
b. R1R1
c. R2R2
d. D–

A

d

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15
Q

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

A

b

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16
Q

An individual has the following Rh phenotype: D+C+E+c+e+. Using Fisher-Race terminology, what is their most likely Rh genotype?

a. DCE/Dce
b. DCE/dce
c. DCe/dcE
d. DCe/DcE

A

d

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17
Q

Which of the following is the most common Rh phenotype in African Americans?

a. Dce/dce
b. DcE/dce
c. DCe/dce
d. Dce/dCe

A

a

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18
Q

The Rh system genes are:

a. RHD and RHCE.
b. RHD and LW.
c. RHD and RHAG.
d. RHCE and RHAG.

A

a

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19
Q

What Rh antigen is found in 85% of the Caucasian population and is always significant for transfusion purposes?

a. d
b. c
c. D
d. E

A

c

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20
Q

How are weaker-than-expected reactions with anti-D
typing reagents categorized?

a. Rhmod
b. Weak D
c. DAT positive
d. Dw

A

b

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21
Q

Which Rh phenotype has the strongest expression of D?

a. DCe/ce
b. DCe/DCe
c. DcE/DcE
d. D–

A

d

22
Q

An individual has the following serologic reactions:
D+C+E+c+e+f–. What is the most probable genotype?

a. R1R2
b. Rory
c. Rzr
d. R1r’’

A

a

23
Q

Which of the following is the most common haplotype
in the African American population?

a. DCe
b. DcE
c. Dce
d. ce

A

c

24
Q

If a patient who is R1R1 is transfused with RBCs that are
Ror, which antibody is he most likely to produce?

a. Anti-D
b. Anti-c
c. Anti-e
d. Anti-G

A

b

25
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

26
Q
  1. How is an individual with genotype Dce/dce classified?

A. Rh positive
B. Rh negative
C. Rhnull
D. Total Rh

A

A

27
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

28
Q

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

A. r´r
B. R0R1
C. R2r´
D. r´ry

A

D

29
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

30
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

31
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

32
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

33
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

34
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

35
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

36
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

37
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

38
Q

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

A. Rh negative
B. D mosaic
C. Rhnull
D. Total Rh

A

C

39
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.

40
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

41
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

42
Q

The Wiener nomenclature for the E antigen is:

A. hr´
B. hrv´
C. rh˝
D. Rh0

A

c

43
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

A

44
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

45
Q

Each unit of whole blood collected contains approximately 450 mL of blood and 63 mL of anticoagulant preservative solution or approximately 500 mL of blood and 70 mL of anticoagulant preservative solutio

A

True

46
Q

Mother-fetus Rh blood type incompatibility problems can occur if the mother is _____ and her fetus is _____

A

Rh negative; Rh positive

47
Q

A patient has the following Rh phenotype: D:+ C:+ c:+ E:+ e:+ What is her most likely Rh genotype?

R1R1
R1R2
R2r
R2r”

A

R1R2

48
Q

A Caucasian patient has the following Rh phenotype: D:+ C:+ c:+ E:- e:+ Which of the following is his most likely Rh genotype?

R1R0
R0r
R1r
R1R1

A

R1r

49
Q

If a patient had a positive direct antiglobulin test (DAT) with Anti-IgG, what would happen if you performed a Weak D test on the patient cells?

A false-positive result
A false-negative result
A valid test result
An indeterminate result

A

A false-positive result

50
Q

If a patient who is R1R1 is transfused with RBCs that are Ror, which antibody is he most likely to produce?

Anti-D
Anti-c
Anti-e
Anti-G

A

Anti-c

51
Q

What do Rh null cells lack? *

Lewis antigens
Normal oxygen-carrying capacity
Rh antigens
Hemoglobin

A

Rh antigens

52
Q

Which of the following should be done when suspecting a rouleaux formation during reverse typing?

Prewarm the sample and reagents
Rouleaux is nonsignificant, no action should be done
Perform cold adsorption test
Perform a saline replacement technique

A

Perform a saline replacement technique

BLOODBANK LAB (4 decks)

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