IMMUNOSEROLOGY & BLOODBANKING PRACTICE EXAM

What should be done if all forward and reverse ABO results as well as the autocontrol are positive?

A. Wash the cells with warm saline, and auto adsorb the serum at 4°C

B. Retype the sample using a different lot number of reagents

C. Use polyclonal typing reagents

D. Report the sample as group AB

Correct Answer: A

All of the following are immunologic functions of complement except:

A. Induction of an antiviral state

B. Opsonization

C. Chemotaxis

D. Anaphylatoxin Formation

Correct Answer: A

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

A. Anti-K

B. Anti-Dia

C Anti-Sda

D. Anti-s

Correct Answer: C

Which Ig can cross the placenta?

A. IgG

B. IgM

C. IgA

D. IgE

Correct Answer: A

The k (Cellano) antigen is a high-frequency antigen and is found on most RBCs. 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. Depends on 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

Correct Answer: B

Which Ig cross-links mast cells to release histamine?

A. IgG

B. IgM

C. IgA

D. IgE

Correct Answer: D

What does a minor crossmatch consist of?

A. Recipient plasma and recipient RBCs

B. Recipient plasma and donor RBCs

C Recipient RBCs and Donor Plasma

D. Donor Plasma and Donor RBS

Correct Answer: C

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

Correct Answer: B

Which serum antibody response usually characterizes the primary (early) stage of syphilis?

A. Antibodies against syphilis are undetectable

B. Detected 1 to 3 weeks after appearance of the primary chancre

C. Detected in 50% of cases before the primary chancre disappears

D. Detected within 2 weeks after infection

Correct Answer: B

10. Which of the following is NOT a requirement for electronic crossmatching?

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

Correct Answer: D

Which tests are considered screening tests for HIV? A. ELISA, chemiluminescent, and rapid antibody tests B. IFA, Western Blot, Radioimmunoprecipitation assay

C. Culture, Antigen Capture Assay, DNA amplification D. Reverse Transcriptase and messenger RNA (mRNA) assay

Correct Answer: A

12. Which CD4:CD8 ratio is most likely in a patient with AIDS?

CD4 - CD8

A. 2:1

B. 3:1

C. 2:3

D. 1:3

Correct Answer: D

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

most likely problem.

A. Combination of Antibodies

B. Cold Alloantibody

C. Rouleaux

D. Test Error

Correct Answer: B

When may IS crossmatching be performed? Blood Bank

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

Correct Answer: B

SITUATION: A 53-year-old woman donates blood at her place of employment. She weighs 150lb and has a hemoglobin level of 13g/dL. She is currently on warfarin and vitamin B12. Is she an acceptable donor?

A. Yes

B. No, she is on warfarin

C. Yes, for RBCs only

D. No, her hemoglobin is too low

Correct Answer: C

Which of the following describes an idiotype?

A. Heavy chain that determines Ig Class

B. Variation in the constant region of both Heavy Chain and Light Chain

C. Variation in the variable region of both heavy chain and Light chain

D. None of these

Correct Answer: C

Who is the best candidate for a predeposit autologous donation?

A. A 45-year old man who is having elective surgery in 2 weeks; he has alloanti-k

B. A 23-year-old female patient with leukemia and a hemoglobin level of 10 g/dL

C. A 12-year-old boy who has hemophilia

D. A 53-year-old woman who has septicemia

Correct Answer: A

Which of the following statemerits is true for both the Prozone and Post Zone phenomenon?

A. Both cause False Positive Results; Perform an elution test to remove interference

B. Post Zone cause False Positive; Prozone cause False Negative; recollect sample to fix problem

C. Post zone cause False Negative; Prozone cause False Positive; incubate sample at 37°C as remedy

D. Both Cause False Negative Results; Perform a dilution to correct the phenomenon

Correct Answer: D

Principle of IFA in RMSF

A. Direct fluorescence microscopy

B. Cross reaction with Proteus antigen

C. Testing of whole bacteria

D. Light microscopy used

Correct Answer: B

Antibody-Antigen reactions are exclusively

A. Hydrogen Bonding

B. Van der Waals forces

C. Noncovalent

D. Electrostatic forces

Correct Answer: C

What should be done when a woman who is 24 weeks pregnant has a positive antibody screen?

A. Perform an antibody identification panel; titer, if necessary

B. No need to do anything until 30 weeks' gestation

C. Administer Rhlg

D. Adsorb the antibody onto antigen-positive cells

Correct Answer: A

Molecule on T cell surface that recognizes antigen:

A. MHC protein, a 2-chain molecule encoded by HLA region

B. TCR, consisting of 2 chains, alpha and beta

C. CD3, consisting of 6 different chains

D. IgT, a 4-chian molecule that recognizes the tau heavy chain

Correct Answer: B

23. What can be done if HDFN is caused by maternal Anti-K?

A. Give Kell immune globulin

B. Monitor the mother's Antibody level

C. Prevent the formation of K-positive cells in the fetus

D. Not a problem; anti-K is not known to cause HDFN

Correct Answer: B

Perform Red Cell Antibody Screening?

A. Blood Station

B. Blood Collection Unit

C. Blood Bank

D. Blood Center

Correct Answer: C

EBV causes latent infection in what cells?

A. B Cells

B. T Cells

C Monocytes

D. Erythrocytes

Correct Answer: A

Screening cells are positive, major crossmatch is positive in all 4 donor units, and autocontrol is negative. Which antibody is most likely to be present?

A. Anti-k

B. Anti-Kpa

C. Anti-H

D. Anti-S

Correct Answer: A

While ABO-compatible units are preferred, it is okay to use ABO-incompatible units with:

A. Cryoprecipitate

B. Platelets

C. FFP

D. Granulocytes

Correct Answer: B

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

D. The antibody must be adsorbed from the unit

Correct Answer: C

IgG subtype that could not cross the placenta?

A. IgG1

B. IgG2

C. IgG3

D. igG4

Correct Answer: B

What is the most common AIHA?

A. CAIHA

B. WAIHA

C. DIC

D. SLE

Correct Answer: B

Nontreponemal tests look for?

A. Treponemal Antibodies

B. Reagin

C. Cardiolipin

D. Charcoal

Correct Answer: B

Which monochromator specification is required in order to measure the true absorbance of a compound having a natural absorption bandwidth of 30nm?

A. 5-nm bandpass

B. 25-nm bandpass

C. 50-nm bandpass

D. 15-nm bandpass

Correct Answer: A

All the following are reasons for a positive DAT on cord blood cells of a newborn except:

A. Immune anti-A from an O mother on the cells of an A baby

B. High concentrations of Wharton's jelly on cord cells

C. Immune anti-K from a K-negative mother on the cells of a K-negative baby

D. Immune anti-D from an Rh-negative mother on the cells of an Rh-positive baby

Correct Answer: C

Type I hypersensitivity except:

A. Anaphylaxis

B. Urticaria

C. Serum Sickness

D. Allergic Rhinitis

Correct Answer: C

Blood group antigens related to HLA

A Bg

B. Di

C. ABO

D. Rh

Correct Answer: A

A patient has a prostate-specific antigen level of 60 ng/mL the day before surgery to remove a localized prostate tumor. One week following surgery, the serum PSA was determined to be 8 ng/mL by the same method. What is the most likely cause of these results?

A. Incomplete removal of the malignancy

B. Cross reactivity of the antibody with another tumor antigen

C. Testing too soon after surgery

D. Hook effects with the PSA assay

Correct Answer: C

Which is necessary for maintenance of adequate levels of 2,3-DPG

A. Citrate

B. Phosphate

C. Dextrose

D. Adenine

Correct Answer: B

Which blood group has the least amount of H antigen?

A. A1B

B. A2

C. B

D. A1

Correct Answer: A

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 of thiol reagent

D. Run a LISS panel

Correct Answer: B

Credited for the discovery of antibody diversity, wherein antibodies have different specificities:

A. Rosalyn Yalow

B Susumu Tonegawa

C. Robert Koch

D. Paul Ehrlich

Correct Answer: B

Antibody first described in the serum of Mrs. Jay, an individual with adenocarcinoma of the stomach

A. Anti-P1

B. Anti-PP1PK

C. Alloanti-P

D. Autoanti-P

Correct Answer: B

Which of the following is associated with MHC Class I?

A. HLA-A, B, C

B. HLA-DR, DP

C. TNF

D. C2

Correct Answer: A

Which of the following is associated with Myasthenia Gravis and Celiac Disease?

A HLA-B8

B. HLA-DQ

C. HLA-DR2

D. HLA-B27

Correct Answer: A

Which of the following is true regarding apheresis platelets?

A. The minimum platelet count must be 3.0 x 10^11; pH must be > 6.0

B. The minimum platelet count must be 3.0 x 10^11; pH must be > 6.2

C. The minimum platelet count must be 3.0 x 10^10; pH must be < 6.2

D. The minimum platelet count must be 3.0 x 10^10; pH must be > 6.0

Correct Answer: B

Which of the following is increased in RBC storage lesion?

A. pH

B. 2,3- DPG

C. Potassium

D. %Viable Cell

Correct Answer: C

Detection of Rheumatoid Factor (RF) indicates:

A. Hypergammaglobulinemia

B. Hypogammaglobulinemia

C. Agammaglobulinemia

D. Hypoproteinemia

Correct Answer: A

The CD4+ T lymphocyte count in Stage III HIV infection is:

A. 200-499/uL

B. <200/uL

C. >500/uL

D. >1300 uL

Correct Answer: B

Which of the following donor records can be retained indefinitely:

A. Medical Director approval for donation interval

B. Notification of abnormal results

C. Informed consent for donation

D. Donor ABO/Rh records

Correct Answer: B

In the ISBT nomenclature, the last three digits represent which of the following?

A. Immunogenicity

B. Blood Group System

C. Antigen Specificity

D. Collection

Correct Answer: C

Interpret the following laboratory results:

HBsAg = Reactive

HBeAg = Reactive

Anti-HBc = Nonreactive

Anti-HBe = Nonreactive

Anti-HBs = Nonreactive

A. Early acute infection

B. Early acute infection and very infectious

C. Recovery state of disease

D. Chronic Infection and very infectious

Correct Answer: B

Rotation speed and time in the CSF VDRK test:

A. 100 RPM for 8 minutes

B. 180 RPM for 8 minutes

C. 100 RPM for 4 minutes

D. 180 RPM for 4 minutes

Correct Answer: B

The final clerical check before blood transfusion is done by the:

A. Attending physician

B. Medical Technologist who conducted the crossmatch

C. Nurse

D. Head Nurse

Correct Answer: C

What could be the possible cause of the following reactions?

Forward Typing

Anti-A = 4+ Anti-B = 2+

Reverse Typing

A1 Cells = 0 B Cells = 4+

A. Weak antibodies

B. Cold Agglutinins

C. Acquired B phenomenon

D. Rouleaux formation

Correct Answer: C

When using RF latex test, a titer of 20-40 is considered as:

A. Positive

B. Negative

C. Weakly positive

D. Strongly positive

Correct Answer: C

Ferrata cells in exudates are indicative of:

A. Chronic Inflammation

B. Viral Infection

C. Norrnal Condition

D. Acute inflammation

Correct Answer: D

CA 27.29 is a tumor marker used for detecting

A. Lung Cancer

B. Stomach Cancer

C. Pancreatic Cancer

D. Breast Cancer

Correct Answer: D

What is one possible genotype for a patient who develops anti-C antibody?

A. R1r

B. rr

C. R1R1

D. r'r

Correct Answer: B

Nature of ABO antibodies:

A. IgM

B. IgG and IgM

C. IgA

D. IgG, IgM and IgA

Correct Answer: D

The minimum required total protein level for plasmapheresis donors is:

A. 5.0 g/L

B. 6.0 g/L

C. 5.0 g/dL

D. 6.0 g/dL

Correct Answer: D

Which of the following is a description of a type I hypersensitivity reaction?

A. Ragweed antigen cross links with IgE on the surface of mast cells, causing release of preformed mediators and resulting in symptoms of an allergic reaction

B. Anti-Fya from a pregnant woman crosses the placenta and attaches to the Fya antigen-positive red cells of the fetus, destroying the red cells

C. Immune complex deposition occurs on the glomerular basement membrane of the kidney, leading to renal failure

D. Exposure to poison ivy causes sensitized T cells to release lymphokines that cause a localized inflammatory reaction

Correct Answer: A

Reynaud's syndrome and Stevens-Johnson syndrome is associated to what bacterial infection?

A. Mycoplasma pneumoniae

B. Treponema Pallidum

C. Helicobacter pylori

D. Rickettsia spp.

Correct Answer: A

What are perfluorocarbons (PFC)?

A. Blood Product

B. Blood Component

C. Blood Substate

D. Blood Substitute

Correct Answer: D

The Gel Tube technology, a negative reaction refers to:

A. Solid band of agglutinated red cells on top of the medium

B. Predominant amount of agglutinated red cells on top, with few cells staggered below the thicker band

C. Red Cell agglutinates on top, with pellet of cells settled at the bottom of the tube

D. Red cells forming a well-delineated pellet at the bottom of the tube

Correct Answer: D

A type of immunologic reactions where the antigen-antibody reaction is non-visible:

A. Primary

B. Secondary

C. Tertiary

D. Latent

Correct Answer: A

Proteins of sample are first separated by electrophoresis on a support (agarose) according to their charge and after that the medium is overlaid with monospecific antisera reactive with specific protein - antigen. If the antigen is present a characteristic immunoprecipitin band will be formed.

A. Immunofixation electrophoresis

B. Rocket Electrophoresis

C. Immunoelectrophoresis

D. Counter Immunoelectrophoresis

Correct Answer: A

The most severe form of HDN is associated with: A. Anti-A

B. Anti-B

C. Anti-D

D. Anti-JK

Correct Answer: C

Can an autologous donor donate blood on Monday if he is having surgery on Friday?

A. Yes, they can donate up to 72 hours before surgery

B. No, they cannot donate within 7 days of surgery

C. Yes, they can donate but only a half a unit

D. No, they cannot donate within 5 days of surgery

Correct Answer: A

Identify the heterophile antibody detected using the following resuit:

Agglutination with Sheep RBC

Serum Absorbed with Beef Cells / High Titer

Serum Absorbed with Guinea Pig Cell / Low Titer

A. IM

B. Serum Sickness

C. Forsman

D. Anti-EBNA

Correct Answer: C

Inactivation of serum is done by heating at _____ for _____

A. 56 degrees Celsius, 30 minutes

B. 65 degrees Celsius, 20 minutes

C. 56 degrees Celsius, 10 minutes

D. 65 degrees Celsius, 10 minutes

Correct Answer: A

An intern has accidentally thawed a fresh frozen plasma bag, how many hours will it be viable and at what temperature should the thawed FFP be stored for it to be viable?

A. 1 hour, 1-6°C

B. 24 hours, 1-6°C

C. 6 hours, 20-24°C

D. 24 hours, 20-24°C

Correct Answer: B

CD present among Natural Killer Cells:

A. CD 16

B. CD 16, CD 56

C. CD 16, CD 56, CD 2

D. CD 16, CD 56, CD 2, CD 3

Correct Answer: C

Considered a central cytokine in acute viral disease, including those caused by influenza virus, dengue virus, and Ebola virus. It causes inflammation, makes the blood vessel more permeable and decrease platelets. The main trigger for production of this cytokine is LPS.

A. Tumor Necrosis Factor

B. Interferon Alpha

C. Interferon Gamma

D. Chemokine

Correct Answer: A

Which among the following is not possible to be produced by the Rh Blood group?

A. Anti-d

C. Anti-f

B. Anti-C

D. anti-CE

Correct Answer: A

Anti-P1 is associated with:

A. Fasciolosis

B. Clonorchis, Fasciolosis

C. Fasciolosis, Clonorchis, PCH

D. Fasciolosis, Clonorchis, PCH, PNH

Correct Answer: B

75. The receptor of the sheep RBC on the T cells:

A. CD 2

B. CD 4

C. CD 3

D. CD 8

Correct Answer: A

The enzyme responsible in killing extracellular organisms by the phagocyte:

A. Granzymes

B. NADPH Oxidase

C. Perforins

D. Catalase

Correct Answer: B

Interpret the following secretor result: Anti-A + Saliva + A cells: agglu (+)

Anti-B+ Saliva + B Cells: Agglu (+)

Anti-H+ Saliva + O Cells: Agglu (+)

A. Secretor group AB

B. Secretor group O

C. Secretor group B

D. Non Secretor

Correct Answer: D

B cell contains:

A. B antigen

B. Anti-A

C. Both A and B

D. more L-fucose

Correct Answer: A

79 One of the following lectins is used to differentiate A1 from an A2 subgroup in the ABH system

A. Vicea graminea

B. Griffonia simplicifolia

C. Dolichos biflorus

D. Ulex europeus

Correct Answer: C

An individual's red cells give the following reactions with Rh anti-sera

Antisera Reaction

Anti-D 4+

Anti-C 3+

Anti-E 0

Anti-c 3+

Anti-e 4+

A. DCe/dce

B. dCe/dce

C. DCE/Dce

D. DCE/DCe

Correct Answer: A

An individual has been sensitized to the Cellano antigen and has produced anti-Cellano. What is the most probable

genotype of the individual?

A. KK

B. Kk

C. kk

D. None of the choices

Correct Answer: A

Activated C4b2a is also called:

A. Properdin

B. Lymphokine

C. Anaphylatoxin

D. C3 convertase

Correct Answer: D

High titer of anti-smooth muscle antibodies is strongly suggestive of:

A. Wegener's Granulomatosis

B. Liver Carcinoma

C. Autoimmune hepatitis

D. Sjogren Syndrome

Correct Answer: C

The serological test used to diagnose lymphogranuloma venereum:

A. Mantoux test

B. Bachmann

C. Frei Test

D. Montenegro Test

Correct Answer: C

Which of the following blood group systems is most associated with DHTR?

A. Lewis

B. Kidd

C. MNS

D. I

Correct Answer: B

A qualitative test that distinguishes Rh positive fetal cells from Rh negative maternal cells

A. Kleihauer Betke Test

B. Rosette Test

C. Acid Elution Test

D. Cordocentesis

Correct Answer: B

All of the following are examples of Direct Agglutination, EXCEPT:

A. Blood Typing

B. Kauffman and white scheme

C. Determination of secretor status

D. Cold Agglutinin Test

Correct Answer: C

The deficiency of this complement will cause HANE

A. CHINH

B. DAF

C. HRF

D. Factor I

Correct Answer: A

A lymphoid organ responsible in detecting antigen present in the blood:

A. Lymph Node

B. Spleen

C. Appendix

D. MALT

Correct Answer: B

A Blood label color of Chartreuse is indicative that the blood is:

A. to be held for further processing

B. for autologous use only

C. Irradiated

D from therapeutic phlebotomy

Correct Answer: D

Which of the following screening tests for infectious diseases in a blood bank is least likely to be transferred?

A. Hepatitis C

B. Anti-HTLV I/II

C. Trypanosoma cruzi antibody

D. Syphilis

Correct Answer: D

A kleihauer Betke Acid Elution stain is reported 1.3% Rh negative mother post-partum after delivery of Rh Positive Infant. Calculate the total number of fetal maternal hemorrhage.

A. 130 mL

B. 65 mL

C. 32.5 mL

D. 97.5 mL

Correct Answer: B

Based on the answer of No. 92, how many vials of standard 300ug (WB) dose of Rhig should be administered 72 hours to the mother with this count of blood?

A. 2 Vials

B. 4 Vials

C. 3 Vials

D. 5 Vials

Correct Answer: C

Expiration of a pooled Cryo-precipitated antihemophilic factor:

A. 1 year

B. 3 years

C. 6 hours

D. 4 hours

Correct Answer: D

Which of the following domains functions as a site for Cytotrophic reactions to happen such as B cell attachment:

A. CH3

B. CH2

C. CH1/CL

D. VH/VL

Correct Answer: A

Which of the antibodies has a sediment coefficient of 8S?

A. IgG

B. IgM

C. IgE

D. Two of these

Correct Answer: C

A qualitative test useful in the detection of bacterial antigen in CSF and other body fluids when a rapid laboratory response is needed - the antigen will migrate to the anode

A. Counter Immunoelectrophoresis

B. Rocket Electrophoresis

C. Immunoelectrophoresis

D. Immunofixation Electrophoresis

Correct Answer: A

A blood product containing all stable proteins found in FFP and has normal levels of factor V; however, it has slightly reduced levels of factor VIII and Protein C:

A. Cryo-precipitate

B. PF24RT24

C. PF24

D. Deglycerolized/Frozen Red Cells

Correct Answer: C

99 The third step in deglycerolization uses the following:

A. 1.6% Saline

B. 0.9% Saline with 0.2% Dextrose

C. 12% Saline

D. AS-3 solution

Correct Answer: B

00. A passive immunodiffusion test known as the endpoint diffusion wherein the square of the diameter is proportional to the

concentration.

A. Ouidin Test

B. Fahey and McKelvey Method

C. Mancini Method

D. Ouchteriony Technique

Correct Answer: C