Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

1. What is the maximum volume of blood that can be collected from a 110-lb donor, including samples for processing?

a. 450 mL

b. 500 mL

c. 525 mL

d. 550 mL

c. 525 mL

2. How often can a blood donor donate whole blood?

a. Every 24 hours

b. Once a month

c. Every 8 weeks

d. Twice a year

c. Every 8 weeks

3. When RBCs are stored, there is a "shift to the left." This means:

a. Hemoglobin oxygen affinity increases, owing to an increase in 2,3-DPG.

b. Hemoglobin oxygen affinity increases, owing to a decrease in 2,3-DPG.

c. Hemoglobin oxygen affinity decreases, owing to a decrease in 2,3-DPG.

d. Hemoglobin oxygen affinity decreases, owing to an increase in 2,3-DPG.

b. Hemoglobin oxygen affinity increases, owing to a decrease in 2,3-DPG.

4. The majority of platelets transfused in the United States today are:

a. Whole blood-derived platelets prepared by the platelet-rich plasma method.

b. Whole blood-derived platelets prepared by the buffy coat method.

c. Apheresis platelets.

d. Prestorage pooled platelets.

c. Apheresis platelets.

5. Which of the following anticoagulant preservatives provides a storage time of 35 days at 1°C to 6°C for units of whole blood and prepared RBCs if an additive

solution is not added?

a. ACD-A

b. CP2D

c. CPD

d. CPDA-1

d. CPDA-1

6. What are the current storage time and storage temperature for platelet concentrates and apheresis platelet components?

a. 5 days at 1°C to 6°C

b. 5 days at 24°C to 27°C

c. 5 days at 20°C to 24°C

d. 7 days at 22°C to 24°C

c. 5 days at 20°C to 24°C

7. What is the minimum number of platelets required in a platelet concentrate prepared from whole blood by centrifugation (90% of sampled units)?

a. 5.5 _ 1011

b. 3 _ 1010

c. 3 _ 1011

d. 5.5 _ 1010

d. 5.5 _ 1010

8. RBCs can be frozen for:

a. 12 months.

b. 1 year.

c. 5 years.

d. 10 years.

d. 10 years.

9. What is the minimum number of platelets required in

an apheresis component (90% of the sampled units)?

a. 3 _ 1011

b. 4 _ 1011

c. 2 _ 1011

d. 3.5 _ 1011

a. 3 _ 1011

10. Whole blood and RBC units are stored at what temperature?

a. 1°C to 6°C

b. 20°C to 24°C

c. 37°C

d. 24°C to 27°C

a. 1°C to 6°C

11. Additive solutions are approved for storage of red blood cells for how many days?

a. 21

b. 42

c. 35

d. 7

b. 42

12. One criterion used by the FDA for approval of new

preservation solutions and storage containers is an

average 24-hour post-transfusion RBC survival of more

than:

a. 50%.

b. 60%.

c. 65%.

d. 75%.

d. 75%.

13. What is the lowest allowable pH for a platelet component at outdate?

a. 6

b. 5.9

c. 6.8

d. 6.2

d. 6.2

14. Frozen and thawed RBCs processed in an open system can be stored for how many days/hours?

a. 3 days

b. 6 hours

c. 24 hours

d. 15 days

c. 24 hours

15. What is the hemoglobin source for hemoglobin-based oxygen carriers in advanced clinical testing?

a. Only bovine hemoglobin

b. Only human hemoglobin

c. Both bovine and human hemoglobins

d. None of the above

c. Both bovine and human hemoglobins

16. Which of the following occurs during storage of red blood cells?

a. pH decreases

b. 2,3-DPG increases

c. ATP increases

d. plasma K+ decreases

a. pH decreases

17. Nucleic acid amplification testing is used to test donor blood for which of the following infectious diseases?

a. Hepatitis C virus

b. Human immunodeficiency virus

c. West Nile virus

d. All of the above

d. All of the above

18. Which of the following is NOT an FDA-approved test for quality control of platelets?

a. BacT/ALERT

b. eBDS

c. Gram stain

d. Pan Genera Detection (PGD) test

c. Gram stain

19. Prestorage pooled platelets can be stored for:

a. 4 hours.

b. 24 hours.

c. 5 days.

d. 7 days.

c. 5 days.

20. Which of the following is the most common cause of bacterial contamination of platelet products?

a. Entry of skin plugs into the collection bag

b. Environmental contamination during processing

c. Bacteremia in the donor

d. Incorrect storage temperature

a. Entry of skin plugs into the collection bag

1. Which of the following statements best describes mitosis?

a. Genetic material is quadruplicated, equally divided

between four daughter cells

b. Genetic material is duplicated, equally divided between two daughter cells

c. Genetic material is triplicated, equally divided between three daughter cells

d. Genetic material is halved, doubled, then equally divided between two daughter cells

b. Genetic material is duplicated, equally divided between two daughter cells

2. When a recessive trait is expressed, it means that:

a. One gene carrying the trait was present.

b. Two genes carrying the trait were present.

c. No gene carrying the trait was present.

d. The trait is present but difficult to observe.

b. Two genes carrying the trait were present.

3. In a pedigree, the "index case" is another name for:

a. Stillbirth.

b. Consanguineous mating.

c. Propositus.

d. Monozygotic twins..

c. Propositus.

4. Which of the following nitrogenous bases make up DNA?

a. Adenine, leucine, guanine, thymine

b. Alanine, cytosine, guanine, purine

c. Isoleucine, lysine, uracil, leucine

d. Adenine, cytosine, guanine, thymine

d. Adenine, cytosine, guanine, thymine

5. Proteins and peptides are composed of:

a. Golgi bodies grouped together.

b. Paired nitrogenous bases.

c. Nuclear basic particles.

d. Linear arrangements of amino acids.

d. Linear arrangements of amino acids.

6. Which phenotype(s) could not result from the mating

of a Jk(a+b+) female and a Jk(a-b+) male?

a. Jk(a+b-)

b. Jk(a+b+)

c. Jk(a-b+)

d. Jk(a-b-)

d. Jk(a-b-)

7. Exon refers to:

a. The part of a gene that contains nonsense mutations.

b. The coding region of a gene.

c. The noncoding region of a gene.

d. The enzymes used to cut DNA into fragments.

b. The coding region of a gene.

8. PCR technology can be used to:

a. Amplify small amounts of DNA.

b. Isolate intact nuclear RNA.

c. Digest genomic DNA into small fragments.

d. Repair broken pieces of DNA.

a. Amplify small amounts of DNA.

9. Transcription can be defined as:

a. Introduction of DNA into cultured cells.

b. Reading of mRNA by the ribosome.

c. Synthesis of RNA using DNA as a template.

d. Removal of external sequences to form a mature RNA

molecule.

c. Synthesis of RNA using DNA as a template.

10. When a male possesses a phenotypic trait that he passes to all his daughters and none of his sons, the

trait is said to be:

a. X-linked dominant.

b. X-linked recessive.

c. Autosomal dominant.

d. Autosomal recessive.

a. X-linked dominant.

11. When a female possesses a phenotypic trait that she passes to all of her sons and none of her daughters, the trait is said to be:

a. X-linked dominant.

b. X-linked recessive.

c. Autosomal dominant.

d. Autosomal recessive.

b. X-linked recessive.

12. DNA is replicated:

a. Semiconservatively from DNA.

b. In a random manner from RNA.

c. By copying protein sequences from RNA.

d. By first copying RNA from protein.

a. Semiconservatively from DNA.

13. RNA is processed:

a. After RNA is copied from DNA template.

b. After protein folding and unfolding on the ribosome.

c. Before DNA is copied from DNA template.

d. After RNA is copied from protein on ribosomes.

a. After RNA is copied from DNA template.

14. Translation of proteins from RNA takes place:

a. On the ribosomes in the cytoplasm of the cell.

b. On the nuclear membrane.

c. Usually while attached to nuclear pores.

d. Inside the nucleolus of the cell.

a. On the ribosomes in the cytoplasm of the cell.

15. Meiosis is necessary to:

a. Keep the N number of the cell consistent within populations.

b. Prepare RNA for transcription.

c. Generate new DNA sequences in daughter cells.

d. Stabilize proteins being translated on the ribosome.

c. Generate new DNA sequences in daughter cells.

1. Which of the following is not involved in the acquired or adaptive immune response?

a. Phagocytosis

b. Production of antibody or complement

c. Induction of immunologic memory

d. Accelerated immune response upon subsequent exposure to antigen

a. Phagocytosis

2. Which cells are involved in the production of antibodies?

a. Dendritic cells

b. T lymphocytes

c. B lymphocytes

d. Macrophages

c. B lymphocytes

3. Which of the following cells is involved in antigen recognition following phagocytosis?

a. B lymphocytes

b. T lymphocytes

c. Macrophages

d. Granulocytes

b. T lymphocytes

4. The role of the macrophage during an antibody response is to:

a. Make antibody

b. Lyse virus-infected target cells

c. Activate cytotoxic T cells

d. Process antigen and present it

d. Process antigen and present it

5. Which of the following immunoglobulins is produced

in the primary immune response?

a. IgA

b. IgE

c. IgG

d. IgM

d. IgM

6. Which of the following immunoglobulins is produced

in the secondary immune response?

a. IgA

b. IgE

c. IgG

d. IgM

c. IgG

7. Which of the following MHC classes are found on antigen presenting cells?

a. Class I

b. Class II

c. Class III

d. Class IV

b. Class II

8. Which of the following MHC classes encodes complement components?

a. Class I

b. Class II

c. Class III

d. Class IV

c. Class III

9. Which of the following immunoglobulins is most

efficient at binding complement?

a. IgA

b. IgE

c. IgG

d. IgM

d. IgM

10. Which portion of the immunoglobulin molecules

contains complement binding sites?

a. Heavy chain variable region

b. Light chain variable region

c. Heavy chain constant region

d. Light chain constant region

c. Heavy chain constant region

11. Which complement pathway is activated by the

formation of antigen-antibody complexes?

a. Classical

b. Alternative

c. Lectin

d. Retro

a. Classical

12. Which of the following is known as the "recognition

unit" in the classical complement pathway?

a. C1q

b. C3a

c. C4

d. C5

a. C1q

13. Which of the following is known as the "membrane

attack complex" in the classical complement pathway?

a. C1

b. C3

c. C4, C2, C3

d. C5b, C6, C7, C8, C9

d. C5b, C6, C7, C8, C9

14. Which of the following immunoglobulin classes is

capable of crossing the placenta and causing hemolytic disease of the newborn?

a. IgA

b. IgE

c. IgG

d. IgM

c. IgG

15. Which of the following refers to the effect of an

excess amount of antigen present in a test system?

a. Postzone

b. Prozone

c. Zone of equivalence

d. Endzone

a. Postzone

16. Which of the following refers to the presence of an

excess amount of antibody present in a test system?

a. Postzone

b. Prozone

c. Zone of equivalence

d. Endzone

a. Postzone

17. Which of the following refers to a state of

equilibrium in antigen-antibody reactions?

a. Postzone

b. Prozone

c. Zone of equivalence

d. Endzone

c. Zone of equivalence

18. Which one of the following properties of antibodies

is NOT dependent on the structure of the heavy chain

constant region?

a. Ability to cross the placenta

b. Isotype (class)

c. Ability to fix complement

d. Affinity for antigen

d. Affinity for antigen

19. Molecules that promote the update of bacteria for

phagocytosis are:

a. Opsonins

b. Cytokines

c. Haptens

d. Isotypes

a. Opsonins

20. Select the term that describes the unique confirmation of the antigen that allows recognition by a corresponding antibody:

a. Immunogen

b. Epitope

c. Avidity

d. Clone

b. Epitope

21. Which of the following terms refers to the net negative charge surrounding red blood cells?

a. Dielectric constant

b. Van der Waals forces

c. Hydrogen bonding

d. Zeta potential

d. Zeta potential

1. The central dogma of molecular biology states that:

a. DNA is the genetic material

b. RNA is the genetic material

c. DNA is translated to mRNA

d. Proteins are transcribed from mRNA

a. DNA is the genetic material

2. Recombinant-DNA technology is possible because:

a. Restriction endonucleases cut RNA

b. Restriction endonucleases cut proteins

c. The genetic code is universal

d. Bacteria are difficult to culture

c. The genetic code is universal

3. Agarose gel electrophoresis is a technique used for:

a. DNA synthesis

b. RNA synthesis

c. Separation of DNA molecules by size

d. Oligonucleotide synthesis

c. Separation of DNA molecules by size

4. Restriction fragment length polymorphism (RFLP) is

based on the use of the enzymes:

a. Reverse transcriptases

b. Bacterial endonucleases

c. DNA polymerases

d. RNA polymerases

b. Bacterial endonucleases

5. The polymerase chain reaction (PCR):

a. Is carried out in vivo

b. Is used for peptide synthesis

c. Requires RNA polymerase

d. Is used for the amplification of DNA

d. Is used for the amplification of DNA

6. Plasmids are:

a. Vectors used for molecular cloning

b. Antibiotics

c. Enzymes

d. Part of chromosomes

a. Vectors used for molecular cloning

7. Some model organisms:

a. Simplify the study of human disease

b. Are used to produce recombinant proteins

c. Are prokaryotes and some are eukaryotes

d. All of the above

d. All of the above

8. DNA sequencing:

a. Is more difficult than peptide sequencing

b. Requires the use of RNA polymerase

c. Can never be automated

d. Is an enzymatic in vitro reaction

c. Can never be automated

9. RFLP and SSP are techniques used for:

a. Protein isolation

b. RNA isolation

c. DNA typing

d. Protein typing

c. DNA typing

10. Recombinant DNA techniques:

a. Are not used in a clinical setting

b. Are useful research tools

c. Are not used in blood banking

d. Are useful only for research

b. Are useful research tools

11. Transcription mediated amplification:

a. Requires thermostable DNA polymerase

b. Is an isothermal procedure

c. Is an obsolete method currently replaced by SSOP

d. Utilizes probes labeled with fluorescent tags

b. Is an isothermal procedure

12. Preseroconversion window:

a. Is the time when donors can be infected but do not

yet test positive by serologic methods

b. May be narrowed by using molecular methods

c. Refers mainly to viral pathogens

d. All of the above

d. All of the above

13. Red blood cell molecular antigen typing is useful in

all listed situations except:

a. In screening RBC inventory for antigen-negative units

b. When reagent antibodies are weak or unavailable

c. In quantitative gene expression analysis

d. When resolving ABO discrepancies

c. In quantitative gene expression analysis

1. A principle of the antiglobulin test is:

a. IgG and C3d are required for RBC sensitization.

b. Human globulin is eluted from RBCs during saline

washings.

c. Injection of human globulin into an animal engenders

passive immunity.

d. AHG reacts with human globulin molecules bound to RBCs or free in serum.

d. AHG reacts with human globulin molecules bound to RBCs or free in serum.

2. Polyspecific AHG reagent contains:

a. Anti-IgG.

b. Anti-IgG and anti-IgM.

c. Anti-IgG and anti-C3d.

d. Anti-C3d.

c. Anti-IgG and anti-C3d.

3. Monoclonal anti-C3d is:

a. Derived from one clone of plasma cells.

b. Derived from multiple clones of plasma cells.

c. Derived from immunization of rabbits.

d. Reactive with C3b and C3d.

a. Derived from one clone of plasma cells.

4. Which of the following is a clinically significant antibody whose detection has been reported in some instances to be dependent on anticomplement activity in polyspecific AHG?

a. Anti-Jka

b. Anti-Lea

c. Anti-P1

d. Anti-H

a. Anti-Jka

5. After the addition of IgG-coated RBCs (check cells) to a negative AHG reaction during an antibody screen, a

negative result is observed. Which of the following is a correct interpretation?

a. The antibody screen is negative.

b. The antibody screen needs to be repeated.

c. The saline washings were adequate.

d. Reactive AHG reagent was added.

b. The antibody screen needs to be repeated.

6. RBCs must be washed in saline at least three times

before the addition of AHG reagent to:

a. Wash away any hemolyzed cells

b. Remove traces of free serum globulins

c. Neutralize any excess AHG reagent

d. Increase the antibody binding to antigen

b. Remove traces of free serum globulins

7. An in vitro phenomenon associated with a positive IAT is:

a. Maternal antibody coating fetal RBCs

b. Patient antibody coating patient RBCs

c. Recipient antibody coating transfused donor RBCs

d. Identification of alloantibody specificity using a panel of reagent RBCs

d. Identification of alloantibody specificity using a panel of reagent RBCs

8. False-positive DAT results are most often associated with:

a. Use of refrigerated, clotted blood samples in which complement components coat RBCs in vitro.

b. A recipient of a recent transfusion manifesting an immune response to recently transfused RBCs.

c. Presence of heterophile antibodies from administration of globulin.

d. A positive autocontrol caused by polyagglutination.

a. Use of refrigerated, clotted blood samples in which complement components coat RBCs in vitro.

9. Polyethylene glycol enhances antigen-antibody reactions by:

a. Decreasing zeta potential.

b. Concentrating antibody by removing water.

c. Increasing antibody affinity for antigen.

d. Increasing antibody specificity for antigen.

b. Concentrating antibody by removing water.

10. Solid-phase antibody screening is based on:

a. Adherence.

b. Agglutination.

c. Hemolysis.

d. Precipitation.

a. Adherence.

11. A positive DAT may be found in which of the following situations?

a. A weak D-positive patient

b. A patient with anti-K

c. HDN

d. An incompatible crossmatch

c. HDN

12. What do Coombs' control cells consist of?

a. Type A-positive cells coated with anti-D

b. Type A-negative cells coated with anti-D

c. Type O-positive cells coated with anti-D

d. Type O-negative cells coated with anti-D

c. Type O-positive cells coated with anti-D

13. Which of the following methods requires the use of check cells?

a. LISS

b. Gel

c. Solid-phase

d. Enzyme-linked

a. LISS

14. Which factor can affect AHG testing, yet is uncontrollable in the lab?

a. Temperature

b. Antibody affinity

c. Gravitational force in the centrifuge

d. Incubation time

b. Antibody affinity

15. If you had the authority to decide which primary AHG methodology to utilize at your lab, which method

would you choose based on the knowledge that the majority of the staff are generalists?

a. LISS

b. Polybrene

c. Solid phase or gel

d. Enzyme-linked

c. Solid phase or gel

16. A 27-year-old group O mother has just given birth to abeautiful, group A baby girl. Since the mother has IgGanti-A in her plasma, it is likely that the baby is experiencingsome in vivo red cell destruction. Which of thefollowing methods and tests would be most

effective atdetecting the anti-A on the baby's RBCs?

a. DAT using common tube technique

b. DAT using gel|

c. IAT using common tube technique

d. IAT using gel

b. DAT using gel|

1. An ABO type on a patient gives the following reactions: Patient Cells With Patient Serum With

Anti-A Anti-B A1 cells B cells

4+ 4+ Neg Neg

What is the patient's blood type?

a. O

b. A

c. B

d. AB

d. AB

2. The major immunoglobulin class(es) of anti-B in a group A individual is (are):

a. IgM

b. IgG

c. IgM and IgG

d. IgM and IgA

a. IgM

3. What are the possible ABO phenotypes of the offspring from the mating of a group A to a group B

individual?

a. O, A, B

b. A, B

c. A, B, AB

d. O, A, B, AB

d. O, A, B, AB

4. The immunodominant sugar responsible for blood group

A specificity is:

a. L-fucose

b. N-acetyl-D-galactosamine

c. D-galactose

d. Uridine diphosphate-N-acetyl-D-galactose

b. N-acetyl-D-galactosamine

5. What ABH substance(s) would be found in the saliva of a group B secretor?

a. H

b. H and A

c. H and B

d. H, A, and B

c. H and B

6. An ABO type on a patient gives the following reactions:

Patient Cells With Patient Serum With

Anti-A Anti-B Anti-A1 A1 cells B cells

4+ 4+ Neg 2+ Neg

The reactions above may be seen in a patient who is:

a. A1 with acquired B

b. A2B with anti-A1

c. AB with increased concentrations of protein in the

serum

d. AB with an autoantibody

b. A2B with anti-A1

7. Which of the following ABO blood groups contains the least amount of H substance?

a. A1B

b. A2

c. B

d. O

a. A1B

8. You are working on a specimen in the laboratory that you believe to be a Bombay phenotype. Which of the

following reactions would you expect to see?

a. Patient's cells + Ulex europaeus = no agglutination

b. Patient's cells + Ulex europaeus = agglutination

c. Patient's serum + group O donor RBCs = no

agglutination

d. Patient's serum + A1 and B cells = no agglutination

a. Patient's cells + Ulex europaeus = no agglutination

9. An example of a technical error that can result in an ABO discrepancy is:

a. Acquired B phenomenon.

b. Missing isoagglutinins.

c. Cell suspension that is too heavy.

d. Acriflavine antibodies.

c. Cell suspension that is too heavy.

10. An ABO type on a patient gives the following reactions:

Patient Cells With Patient Serum With

Anti-A Anti-B A1 cells B cells O cells Autocontrol 4+ Neg 2+ 4+ 2+ Neg

These results are most likely due to:

a. ABO alloantibody.

b. Non-ABO alloantibody.

c. Rouleaux.

d. Cold autoantibody.

b. Non-ABO alloantibody.

1. 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 hemolytic transfusion reaction.

2. 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

c. D

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

a. Rhmod

b. Weak D

c. DAT positive

d. Dw

b. Weak D

4. 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. Indirect antiglobulin test

5. How are Rh antigens inherited?

a. Autosomal recessive alleles

b. Sex-linked genes

c. Codominant alleles

d. X-linked

c. Codominant alleles