BOC BB High Yield #1

ABO hemolytic disease of the fetus and newborn (HDFN) differs from Rh HDFN in that

Rh HDFN is clinically more severe than ABO HDFN

Based on these reactions, what is the patient's ABO type?

Anti-A: 4+

Anti-B: 0

UE: 0

DB: 4+

A1

Which of the following blood group antibodies will no longer react with its respective antigens once those antigens are treated with proteolytic enzymes?

Duffy (Anti-Fya)

The direct antiglobulin test (DAT) in a patient with warm autoimmune hemolytic anemia (WAIHA) is most often positive for:

IgG and C3

In a prenatal workup, the results shown in the table are obtained:

FG

Anti-A: 4+

Anti-B: 2+

DAT: Neg

Antibody Detect Test: Neg

RG

Anti-D: 4+

Rh Control: 0

A1 Cell: 0

B Cells: 3+

This ABO discrepancy is thought to be due to an antibody directed against a component of the ABO typing sera. Which test would resolve this discrepancy?

Saline wash patient’s cells and repeat forward typing

In treating hyperbilirubinemia in hemolytic disease of the fetus and newborn (HDFN), light phototherapy is used to

breakdown unconjugated bilirubin to a nontoxic isomer

The blood typing results shown in this table are noted on a patient's sample:

Anti-A: 0

Anti-B: 4+

Anti-D: 4+

A1 Cells: 4+

B Cells: 0

Rh Results: C-E-c+e+

What is the patient's likely ethnicity?

Black

The results shown in this table are obtained on a patient's blood sample during routine ABO and Rh testing:

Anti-A: 0

Anti-B: 4+

Anti-D: 0+

Autocontrol: 0

A1 Cells: 4+

B Cells: 2+

perform antibody screening procedure at immediate spin and AHG using group O cells

The mating of an Xg(a+) man and an Xg(a–) woman will only produce:

Xg(a–) sons and Xg(a+) daughters

The drug cephalosporin can cause a positive direct antiglobulin test due to modification of the RBC membrane by the drug, which is independent of antibody production. This mechanism related to the drug cephalosporin is best described as:

nonimmunologic protein adsorption

Fresh Frozen Plasma:

should be transfused within 24 hours of thawing

ABO-hemolytic disease of the newborn:

is usually seen only in the newborn of group O mothers

Many enhancement media used in the blood bank promote hemagglutination in the presence of IgG antibodies by reducing which of the following?

zeta potential

Rh immune globulin administration would not be indicated in an Rh-negative woman who has a(n):

anti-D titer of 1:4096

Which of the following is a potential complication of massive transfusions?

hypothermia due to 1 - 6°C storage temperature of red cells

In which of the following clinical situations would DNA-based testing be useful?

evaluation of a patient with warm autoimmune hemolytic anemia and a positive direct antiglobulin test (DAT)

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

JK

Pathologic cold autoantibodies differ from benign cold autoantibodies in

Antibody titer

DNA arrays evaluate the encoding genes for common blood groups. These technologies detect small differences in the membrane proteins after amplification of what amino acid residues of genomic DNA?

SNP

A group O, Rh-negative pregnant female has anti-Vel in her serum. If needed, how might blood be provided for her infant?

Maternal donation

Which of the following infectious agents relies solely on donor questioning to avoid transmission from transfused blood products?

Plasmodium falciparum

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

M, N

A 32-year-old male types as group O, D-negative with a positive antibody detection test. Antibody identification studies demonstrate anti-D, anti-Jk^a, and anti-K. Patient records confirm that he received 12-units of group O, D-positive Red Blood Cells 2 months earlier following a motor vehicle accident. What testing should be performed to verify the patient's red cell phenotype?

microhematocrit cell separation and testing of autologous reticulocytes with monoclonal antisera

A patient's antibody identification panel demonstrates anti-M. The antibody is most reactive with homozygous M+ cells compared to heterozygous M+ cells. Which of the following cells would demonstrate the strongest reaction?

M+N–S–s+

Anti-Fy^a is:

capable of causing hemolytic transfusion reactions

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

ABO

A donor is tested with Rh antisera with the results shown in this table:

Anti-D: +

Anti-C: +

Anti-E: 0

Anti-c: +

Anti-e: +

Rh Control: 0

R1r

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:

35 days

The direct antiglobulin test in a suspected case of warm autoimmune hemolytic anemia is positive. Which of the following monospecific reagents would be used in further direct antiglobulin testing?

anti-C3d

A massive transfusion event can result in what type of complication(s)?

citrate toxicity and hypocalcemia

Which phenotype could not result from the mating of a Jk(a+b+) female and a Jk(a–b+) male?

Jk(a–b–)

Review this set of instructions:

PATIENT SERUM + REAGENT GROUP “O” CELLS
INCUBATE → READ FOR AGGLUTINATION
WASH → ADD AHG → AGGLUTINATION OBSERVED

The next step would be to:

identify the cause of the agglutination

While performing an antibody screen, a test reaction is suspected to be rouleaux. A saline replacement test is performed and the reaction remains. What is the best interpretation?

original reaction was due to true agglutination

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

IgM

An antibody screen performed using solid phase technology revealed a diffuse layer of red blood cells across the entire well. These results indicate:

Pos reaction

A patient is group O, Rh-negative with anti-D and anti-K in her serum. What percentage of the general Caucasian donor population would be compatible with this patient?

6: (0.45 × 0.15 × 0.91)

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

removing water molecules

AHG control cells (check cells):

are coated only with IgG antibody

Which of the following antigens gives enhanced reactions with its corresponding antibody following treatment of the red cells with proteolytic enzymes?

E

Macrophages and monocytes have Fc receptors for which of the following immunoglobulins?

IgG

A patient receives 2 units of Red Blood Cells and has a delayed transfusion reaction. Pretransfusion antibody screening records indicate no agglutination except after the addition of IgG-sensitized cells. Repeat testing of the pretransfusion specimen detects an antibody at the antiglobulin phase. What is the most likely explanation for the original results?

patient's serum is omitted from the original testing

Which of the following Rh antigens has the highest frequency in Caucasians?

e

During a massive transfusion event, what other blood components are routinely administered in addition to Red Blood Cells or low-titer group O Whole Blood?

Fresh Frozen Plasma and Apheresis Platelets

To prevent donor lymphocytes from engraftment in the bone marrow of an immunosuppressed patient, all transfusion products must be:

Irradiated

Coughing, hypoxemia and difficult breathing are symptoms of which of the following transfusion reactions?

TACO

A group B, Rh-negative patient has a positive direct antiglobulin test (DAT). Which of the following situations would occur?

the weak D test and control would be positive

A patient who is group AB, Rh-negative needs 2 units of Fresh Frozen Plasma. Which of the following units of plasma would be most acceptable for transfusion?

group AB, Rh-positive

When the main objective of an exchange transfusion is to remove the infant's antibody-sensitized red blood cells and to control hyperbilirubinemia, the blood product of choice is ABO compatible:

RBC suspended in Fresh Frozen Plasma

An intraoperative strategy for patient blood management is:

acute normovolemic hemodilution

Which Apheresis Platelets product should be irradiated?

a directed donation given by a mother for her son

A patient is typed with the results shown in this table:

The most probable reason for these findings is that the patient is group:

A_x; with an anti‑A1

The purpose of testing with anti-A,B is to detect:

subgroups of A

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

Fy(a–b–)

Plasma Frozen Within 24 Hours (PF24) is given to patients who have:

coagulation factor deficiencies

According to AABB Standards, Apheresis Platelets shall demonstrate with 95% confidence that >75% of units contain ≥ how many platelets?

3.0 × 10¹¹

When platelets are stored on a rotator set on an open bench top, the ambient air temperature must be recorded:

every 4 hours

Which of the following statements is correct about hematopoietic progenitor cell (HPC) transplantation?

Sources for HPC collection include bone marrow, umbilical cord blood (UCB), and mobilized peripheral blood

A 40-year-old man with autoimmune hemolytic anemia due to anti-E has a hemoglobin level of 10.8 g/dL (108 g/L). This patient will most likely be treated with:

no transfusion

A common strategy to reduce alloimmunization in chronically transfused patients with Sickle Cell Disease (SCD) is to provide red cell units matched for which of the following antigens?

C, E, K

Which of the following is considered a low-prevalence antigen?

Wr^a

When preparing units of blood for emergency release, what information must be written on the label or tie-tag?

statement that compatibility testing has not been completed

Which of the following is proper procedure for preparation of Platelets from Whole Blood?

light spin followed by a hard spin

When the red cells of an individual fail to react with anti-U, they usually fail to react with:

Anti-S

Based on the results in this table, what is the next step in determination of the patient's ABO/Rh type?

repeat ABO red cell typing and include a control

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

Use of Fresh Frozen Plasma from male donors

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

IgG1 and IgG3

IgG antibody and/or C3b sensitized red blood cells can be phagocytized by cells in the reticuloendothelial system (RES). This phenomenon is clinically recognized as:

Extravascular hemolysis

Intraoperative strategies for blood management include:

reinfusing shed blood recovered during surgery that has been washed with normal saline

The results in this table are obtained on a blood donor sample at immediate spin:

Before labeling blood components from this donation, what additional testing must be completed?

perform weak D testing on donor RBCs

A mother has the red cell phenotype D+C+E–c–e+ with anti-c (titer of 32 at AHG) in her serum. The father has the phenotype D+C+E–c+e+. The baby is Rh-negative and not affected with hemolytic disease of the newborn. What is the baby's most probable Rh genotype?

r’r’

A 25-year-old pregnant female demonstrated anti-K in her serum. At delivery, the baby's cord blood sample demonstrate a 3+ direct antiglobulin test (DAT) with IgG antibody. What serologic testing should be done to verify that the positive DAT is related to the maternal anti-K?

perform and test acid elution from cord blood

A 25-year-old Caucasian woman, gravida 3, para 2, required 2 units of Red Blood Cells. The antibody screen is positive, and the results of the antibody panel are shown in this table:

R₁R₁

The patient's results are listed in this table. What is the most likely specificity based on the reaction pattern?

Autoantibody

What do the O_h (Classical Bombay), group O, and Lu(a–b–) phenotypes have in common?

result from inheritance of identical autosomal recessive genes

A transfusion request must show 2 recipient identifiers, the specific type and amount of blood component with any special processing requirements, and what additional information?

name of ordering physician or authorized health professional

An acceptable storage temperature for Red Blood Cells, Frozen is:

–80°C

Which of the following is the immunodominant sugar responsible for the A antigen?

N-acetylgalactosamine

Preliminary blood bank testing for neonates <4 months of age must include:

ABO forward typing and Rh testing for D antigen

Which of the following must be performed on a patient before, during, and after receiving a blood transfusion?

blood pressure, pulse, respiration rate and temperature

Which viral diseases have a lower incidence of transfusion-associated infections due to nucleic acid testing (NAT)?

HIV-1, HCV, WNV

Cryoprecipitated AHF:

is indicated for fibrinogen deficiencies

Which of the following red blood cells would lack the Lu3 antigen?

Lu(a–b–)

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

found in the serum of patients with infectious mononucleosis

Intravascular destruction of red blood cells results when:

IgM antibodies activate complement to completion

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

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

In solid phase red cell adherence assays (SPRCA) to detect platelet specific antibodies, the wells of the microtiter plates are coated with immobilized:

platelets

A mother is Rh-negative and the father Rh-positive. Their baby is Rh-negative. It may be concluded that:

the father is heterozygous for D

Which of the following methods may be useful in determining an accurate phenotype in a transfused patient?

density separation

Which of the following genes on chromosome 1 encodes for the 4 common antigen combinations ce, cE, Ce and CE?

RHCE

Proteolytic enzyme treatment of red cells usually destroys which antigen?

Fya

An individual has been sensitized to the k antigen and has produced anti-k. What is the most probable KEL system genotype for this individual?

KK

Two hours after receiving a blood transfusion, the recipient experienced fever, chills, back pain and hypotension. Patient blood samples are collected along with a urine sample and sent to the laboratory. Which of the following results could indicate that an acute hemolytic transfusion reaction is taking place?

hemolysis in posttransfusion sample only