Immunohematology Quizzes first half

Which of the following best characterizes naturally occurring antibodies?

IgG

Produced in response to transfusion

IgM

Made in response to foreign protein

IgM

A gene codes for the production of a _____ ?

Carbohydrate

Protein

Lipid

Polysaccharide

Protein

Most genes coding for red cell antigens follow what type of inheritance pattern?

Dominant

Recessive

Co-dominant

X-linked

Co-dominant

Can an antibody alone cause red cell destruction?

No

Immune alloantibodies differ from non-red cell stimulated (naturally occurring) alloantibodies in that immune alloantibody:

Are generally IgG

Are unable to cross the placenta

Cause direct agglutination at room temperature

Rarely cause clinical immediate hemolysis

Are generally IgG

The secondary immune response is characterized by which of the following?

Strong IgM response followed by a strong IgG response

Weak IgM response followed by a strong IgG response

Weak IgM response and weak IgG response concurrently

Strong IgM response and weak IgG response

Weak IgM response followed by a strong IgG response

Which of the following is characteristic of IgM?

MW 150,000

Crosses the placenta

Pentamer

Weak activator of complement

Pentamer

A father carriers the Xg^a antigen and passes it to all of his daughters but none of his sons. What type of inheritance does this represent?

Autosomal dominant

Autosomal recessive

X-linked dominant

X-linked recessive

X-linked dominant

What class of immunoglobin is most effective at crossing the placenta?

IgG

IgM

IgE

IgA

IgG

What 2 components of complement most often detected in immunohematogic testing?

C3b

C3c

C3d

C4

C3b and C3d

Which of the following is NOT an antigenic determinant found on red cells?

Protein

Carbohydrate

Lipid

Glycoprotein

Lipid

Each red cell expresses multiple antigens aside from the ABO and RhD antigens. Antibodies can be formed against antigens presented to the immune system. These can be directed against antigens in the recipient or the donor cells. What is an alloantibody?

An antibody transmitted in the donor red cells to the recipient

An antibody to viral particles transmitted during an infection

An antibody formed against a person's own red cells

An antibody formed against another person's red cells

An antibody formed against another person's red cells

A gene, such as the O gene, that produces no detectable product is called:

an amorph

a trait

an allele

dominant

amorph

How do antibodies show dosage?

Antibodies will react more when there are more antigens causing stronger agglutination with homozygous antigens than heterozygous antigens

What are the 5 blood bank wants?

C --> accreditation/Certification

A --> understand Abo and rh typing

A --> understanding Antibody screening and which ones are significant

P --> understanding Procedure and good communication

E --> pension for Error identification and understanding

Which of the following effect Stage I hemagglutination?

Incubation

Number of antigen sites

Temperature

All of the above

All of the above

Which of the following defines avidity?

Degree of fit

Strength of antibody binding

Rate of antibody update

Equilibrium of antigen-antibody complex

Strength of antibody binding

What immunodominant sugar is responsible for H specificity?

D-galactose

L-fucose

N-acetyl-D-galactosamine

D-glucose

L-fucose

What is the product of the Se (FUT2) gene?

Alpha-2-L-fucosyltransferase

Alpha-3-N-acetylgalatosaminyltransferase

Alpha-3-D-galactosyltransferase

L-fucose

Alpha-2-L-fucosyltransferase

Which of the following influence Stage II of hemagglutination the most?

pH

centrifugation

water

lenth of incubation

centrifugation

What is the link between the Gal and GlcNAc of the carbohydrate type 2 chain?

Gal (alpha 1-3)GlcNAc

Gal(Beta 1-3)GlcNAc

Gal(alpha 1-4)GlcNAc

Gal(beta 1-4)GlcNAc

Gal(beta 1-4)GlcNAc

Persons who inherit hh alleles do not produce _______ transferase necessary for formation of the H structure

L-fucosyl

N-acetylgalatosaminyl

D-galactosyl

D-glucosyl

L-fucosyl

Which of the following is included in pretransfusion testing?

ABO group

RhD type

Antibody Detection Test (Screen)

All of the above

All of the above

What immunodominant sugar is responsible for B specificity

D-galactose

L-fucose

N-acetyl-D-galactosamine

G-glucose

D-galactose

Which of the following methods utilize red blood cell stroma to visualize antibody present in an individual's serum/plasma?

PEG tube method

Solid Phase Red Cell Adherence

Protein A Coated wells

Column agglutination test

Solid Phase Red Cell Adherence

Reverse grouping showed negative reactions with A1 and B cells. Forward grouping showed positive reactions with Anti-A and Anti-B. What blood group is consistent with these results?

A

B

AB

O

AB

Which blood group contains the highest concentration of H antigen?

A2

B

AB

O

O

The ABO blood groups were discovered in 1900 by whom?

Charles Drew

Karl Landsteiner

Loutit and Mollison

Petz and Garratty

Karl Landsteiner

The product of the Se (FUT2) gene works on which carbohydrate chain?

Type 1

Type 2

Type 3

Type 4

Type 1

Approximately how many antigen sites exist on a group A1 individual's red cells?

1 million

400,000

100

10 million

1 million

The child of a group O mother and A1B father would most likely be which of the following genotypes?

A20

A1A1

A1O

BB

A1O

What is the product of the A1 gene?

N-acetyl-D-galactosamine

Alpha-3-N-acetylgalactosaminyltransferase

Alpha-3-D-galactosyltransferase

D-galactose

Alpha-3-N-acetylgalactosaminyltransferase

What is the action of PEG?

Reduces ionic strength to allow for faster antibody uptake

Its macromolecules allow for closer contact of antibody-coated RBCs

Increases the serum:cell ratio

Removes water molecules, thereby concentrating antibody

Removes water molecules, thereby concentrating antibody

Which of the following antibody detection methods use dextran acrylamide beads to detect the RBC antigen-antibody reaction?

LISS test tube method

PEG test tube method

Solid phase red cell adherence

Gel

Gel

The forward grouping of a patient showed no agglutination of patient cells with Anti-A or Anti-B reagent antisera. The reverse grouping showed agglutination with A1 and B cells. What is this person's ABO group?

A

B

AB

O

O

ABO typing showed the following results. Anti-A 4+, Anti-B 4+, A1 cells 2+, and B cells 4+. Which of the following is the most likely cause?

Normal A

A1 with anti-A1

A2 with anti-A1

Ax with anti-A1

A2 with anti-A1

Given that someone might be an A2 with and anti-A1, which of the following tests would give you the most useful information?

Anti-A1 lectin

Anti-A,B

Incubate tests at room temperature

Anti-H lectin

Anti-A1 lectin

What does the "R" represent in Rh-Hr terminology?

absence of D antigen

presence of D antigen

presence of C antigen

presence of e antigen

presence of D antigen

What does hr' refer to in the Weiner nomenclature?

C

E

c

e

c

Most Rh antibodies are of what immunoglobulin class?

IgM

IgG

IgA

IgE

IgG

In the Fisher-Race nomenclature, what does "d" refer to?

D antigen found inside RBCs

Amorph

Absence of D

all of the above

Absence of D

A group O person with strong autoantibody may demonstrate weak reactions in the forward grouping due to:

Red cells coated with antigen

Red cells coated with antibody

B(A) phenomenon

Acquired B

Red cells coated with antibody

The following results are obtained: Anti-A 4+mf, Anti-B 0, A1 cells 0, B cells 4+. Which of the following would explain this type?

Group A transfused with group O

A3 subgroup

Group A patient received stem cells from O donor

All of the above

All of the above

A person's Rh phenotype is R2R2. Which antigens are present on the patient's RBCs?

D+C+E+c-e+

D-C-E+c+e+

D+C-E+c+e-

D+C-E+c+e-

D+C-E+c+e-

Weak expression of D antigen can be caused by

mutation in RHD gene

hybrid RHD/RHCE

C in trans to RHD

all of the above

all of the above

Which of the following Rh antigens is the most immunogenic?

D

C

E

c

D

Which antigen represents Rh3 in Rosenfield terminology?

D

E

C

e

E

What type of molecules are Rh antigens present on?

Glycophorins

Carbohydrates

Lipids

Proteins

Proteins

What is the principle of the Rh-Hr (Weiner) terminology?

The Rh gene produces at least 3 factors within an agglutinogen

Each gene (D,C,c,E,e) produces one product or antigen

The Rh gene produces at least 3 factors within an agglutinin

Each gene is independent of the other

The Rh gene produces at least 3 factors within an agglutinogen

Which of the following ABO and Rh typing results would require an Rh control before interpretation

Anti-A 0 Anti-B 4+ Anti-D 4+

Anti-A 4+ Anti-B 4+ Anti-D 4+

Anti-A 4+ Anti-B 4+ Anti-D 0

Anti-A 4+ Anti-B 0 Anti-D 4+

Anti-A 4+ Anti-B 4+ Anti-D 4+

Which of the following is true of RhD-positive people?

They are either homozygous dominant (DD) or heterozygous (Dd)

They are all homozygous dominant (DD)

They are all homozygous recessive (dd)

They are all either homozygous recessive (dd) or heterozygous (DD)

They are either homozygous dominant (DD) or heterozygous (Dd)

What is a lectin?

Protein produced from immunized rabbits and cloned for specificity

Foreign protein that will elicit an immune response in most individuals

Protein, often seed extract, that binds to carbohydrate

Substance that will agglutinate sensitized cells in the presence of complement

Protein, often seed extract, that binds to carbohydrate

In which of the following cases is weak D testing required?

Pregnant people who type RhD negative

Blood donors who type RhD negative at immediate spin

Pregnant people who type as RhD positive

Male surgery patients who type as RhD negative

Blood donors who type RhD negative at immediate spin

What is the source of anti-A1 lectin?

Bandeiraea simlicifolia

Dolichos biflorus

Ulex europaeus

All of the above

Dolichos biflorus

What is the patient's most likely Rh genotype in Weiner terminology from the phenotype results: D+C+E-c+e+?

R0r'

R2r

R1r

r'r

R1r

The following Rh phenotype was obtained on a patient with sickle cell disease: D+C-E-c+e+. What is their most probable Rh genotype?

R0r

rr

R1r

r''r

R0r

Which of the following is true concerning the weak D types 1, 2, and 3?

It occurs when the D antigen has missing or abnormal parts (epitopes)

It is easily distinguished from partial D with serologic testing

It was historically identified when testing Anti-D in the IAT

They are at risk for making anti-D if D+ blood is given to them

It was historically identified when testing Anti-D in the IAT

A is also an OK answer

Antibodies to protein antigens are generally which immunoglobulin class?

IgG

IgM

IgA

IgD

IgG

What is reverse grouping not performed on cord blood specimens?

Antigens are not present at birth

Antibodies are generally not present at birth

Antibody titer is too high

Two of the above

Antibodies are generally not present at birth

Which ABO group will show the weakest activity with anti-H lectin?

A1

B

A2B

A1B

A1B

Which of the following antigens is present in the greatest amount on cord cells as compared to adult RBCs?

IH

H

I

i

i

The following results were obtained when testing a patient's serum after IS: I 2+, II 2+, Auto, 1+, and cord cells 0. What is teh most likely specificity of the antibody detected?

Anti-M

Autoanti-i

Autoanti-I

Autoanti-IH

Autoanti-I

Which phenotype can form both anti-Le^a and anti-Le^b?

Le(a+b-)

Le(a-b+)

Le(a-b-)

Le(a+b+)

None of the above

Le(a-b-)

What substance is found in the secretions of an individual with the Le(a+b-) phenotype?

Le^a

Le^a and Le^b

Neither Le^a or Le^b\

Type II H only

Type I H only

Le^a

Anti-U will be non-reactive with which of the following selected cells?

M+N+S-s-

M+N-S+s-

M-N+S-s+

M+N+S-s+

M+N+S-s-

Antibodies to antigens in which of the following blood groups are known for showing dosage?

Ii

P1Pk

MNS

Le

MNS

What antibody is most likely to cause a delayed hemolytic transfusion reaction?

Anti-D

Anti-Jk^a

Anti-Le^b

Anti-I

Anti-Jk^a

Which of the following blood group antigens are inherited on the X chromosome?

K

Jk^1

Lu^a

Xg^a

Xg^a

Which of the following is NOT considered a protein antigen?

P1

K

Jk^a

Fy^a

S

P1

Which of the following antibodies is most likely to be an immune (red cell stimulated) antibody?

Anti-s

Anti-P1

Anti-M

Anti-A1

Anti-I

Anti-s

Which of the following haplotypes is G+? (select all that apply)

Ce

ce

cE

CE

Dc

Ce, CE, and Dc

An individual who has the SE (FUT2) and LE (FUT3) genes will phenotype as:

Le(a+b-)

Le(a-b+)

Le(a+b+)

Lea(a-b-)

Le(a-b+)

Which of the blood group systems is the P antigen found?

P1Pk blood group system

Globoside blood group system

P blood group system

P1 blood group system

Globoside blood group system

What two antigens must be present on the same haplotype as an individual who types f+?

Ce

ce

cE

CE

ce

The Rh testing on a blood donor was negative at IS. The tube was incubated at 37C for 15 min. The tube was centrifuged and read macroscopically. The test was negative at 37C. The tube was washed four times with saline and two drops of AHG were added. After centrifugation, the tube yielded a 2+ rection. How would the donor unit be labeled?

Rh positive

Rh negative

Weak D positive

Rh variable

Rh positive

Which of the following antigens is considered a low prevalence antigen in the Kell blood group system?

Kx

K

Kp^b

Js^b

K

Which blood group system has antigens that act as a receptor for the malaria parasite Plasmodium vivax?

Duffy

MN

Kidd

Kell

Xg^a

Duffy

Which of the following antigens is low prevalence?

Jk^b

Lu^a

Kp^b

Lu^b

Lu^a

Which of the following antibodies is most likely to be a naturally occurring (non red cell stimulated) antibody?

Anti-K

Anti-Le^a

Anti-e

Anti-Jk^a

Anti-Fy^a

Anti-Le^a

Which of the following antibodies is not associated with hemolytic transfusion reactions?

Anti-Fy^a

Anti-Le^b

Anti-K

Anti-E

Anti-Le^b

Which of the following phenotypes is found most often in African American individuals?

D+C+E+c+e+

Le(a-b-)

Fy(a+b-)

K+k+

Le(a-b-)

A 68 year old male with anti-K and anti-Fy^a required two units of LRBCs for surgery tomorrow. How many units would you need to type to find 2 K-, Fy(a-) units if K- is 92% prevalent and Fy(a-) is 33% prevalent?

1

3

7

10

7

Which of the following antibodies is most likely to cause hemolysis in vitro?

Anti-Fy^a

Anti-Le^b

Anti-K

Anti-Jk^b

Anti-Jk^b

Which of the following statements is correct concerning the Js^a antigen?

Js^a is a high prevalence antigen found in more than 90% of all populations

Js^a is present in ~20% of individuals with African ancestry

Js^a is antithetical to the K antigen and is present in nearly all K-negative individuals

Js^a is more common in white populations that in Black populations

Js^a is present in ~20% of individuals with African ancestry