Bloodbank Review

(Quiz 1) A gene, such as the O gene, that produces no detectable product is called:

A. an amorph

B. a trait

C. an allele

D. recessive

A. an amorph

(Quiz 1) When an individual is said to have blood group A, it refers to the individual's:

A. alleles on the chromosome

B. genotype

C. phenotype

D. haplotype

C. Phenotype

(Quiz 1) What is the definition of an immunoglobulin?

A. A protein molecule produced in response to an antigen

B. A protein molecule produced in response to an antibody

C. A substance that aids in the primary immune response

D. A substance that aids in the growth and proliferation of leukocytes

A. A protein molecule produced in response to an antigen

(Quiz 1) A father carries the Xg^a trait and passes it on to all of his daughters but none of his sons. What type of inheritance does this represent?

A. Autosomal dominant

B. X-linked dominant

C. X-linked recessive

D. Autosomal recessive

C. X-linked recessive

(Quiz 1) At what temperature do IgM antibodies react?

A. 22oC

B. 37oC

C. 56oC

D. 42oC

A. 22oC

(Quiz 1) In an immune response, __________ antibodies are formed before ________.

A. IgG, IgA

B. IgM, IgG

C. IgG, IgM

D. IgM, IgA

B. IgM, IgG

(Quiz 1) Which of the following are produced after exposure to genetically different nonself antigens of the same species?

A. Alloantibodies

B. Autoantibodies

C. Drug-induced antibodies

D. All of the above

A. Alloantibodies

(Quiz 1) Most antigens in the various blood group systems follow what kind of inheritance patterns?

A. Codominant

B. Homozygous

C. Dominant

D. Autosomal

A. Codominant

(Quiz 1) Which immunoglobulin exists in a pentameric configuration?

A. IgG

B. IgM

C. IgA

D. IgE

B. IgM

(Quiz 1) Which of the following antibodies is considered the most significant in blood banking because it reacts at body temperature?

A. IgG

B. IgM

C. IgA

D. IgE

A. IgG

(Quiz 1) Which immunoglobulin is found in greatest concentration in serum?

A. IgE

B. IgM

C. IgG

D. IgA

C. IgG

(Quiz 1) When antigen and antibody combine, they are held together by noncovalent forces. With the absence of a visible lattice, this stage is called ______.

A. adhesion

B. sensitization

C. agglutination

D. Inhibition

B. sensitization

(Quiz 1) At what temperature do IgG antibodies react optimally?

A. 22oC

B. 37oC

C. 56oC

D. 4oC

B. 37oC

(Quiz 1) In an immune response, what is the time called during which no antibody is detected in the test serum?

A. Secondary response time

B. Primary response time

C. Latency period

D. Amnestic response time

C. Latency period

(Quiz 1) Anti-A from a group B individual is primarily what class of immunoglobulin?]

A. IgM

B. IgG

C. IgA.

D. All of the above

A. IgM

(Quiz 1) What class of immunoglobulin is capable of crossing the placenta?

A. IgM

B. IgG

C. IgE

D. IgD

B. IgG

(Quiz 1) In the MN blood group system, a person who inherits an "M" allele and an "N" allele expresses both M and N antigens on the RBCs. Which of the following is true?

A. M is dominant to N

B. N is dominant to M

C. M an N are codominant alleles

D. M and N are located on the same chromosome

C. M an N are codominant alleles

(Quiz 1) What is meant by the term autosomal?

A. Trait is not carried on the sex chromosomes

B. Trait is carried on sex chromosomes

C. Trait is not expressed in the parents

D. Organism possesses different alleles for a given characteristic

A. Trait is not carried on the sex chromosomes

(Quiz 1) A woman with blood group A marries a man with blood group O. Their firstborn child has blood group O. The mother's most probable genotype is:

A. OO

B. AA

C. AB

D. AO

D. AO

(Quiz 2) Anti-A from a group B individual is primarily what class of immunoglobulin?

A. IgM

B. IgG

C. IgA

D. All of the above

A. IgM

(Quiz 2) Where are ABH substances detected in secretors?

A. Tears

B. Saliva

C. Milk

D. All of the above

D. All of the above

(Quiz 2) Which of the following is NOT characteristic of antibodies within the ABO system?

A. Antibodies are of IgM class

B. Antibodies are naturally occurring

C. ABO antibodies do not activate complement

D. ABO antibodies may cause immediate intravascular hemolysis

C. antibodies do not activate complement

(Quiz 2) What is a lectin?

A. A protein produced from immunized rabbits and cloned for specificity

B. A foreign protein that will elicit an immune response in most individuals

C. Seed extracts that agglutinate human cells with moderate specificity

D. A substance that will agglutinate sensitized cells in the presence of compliment

C. Seed extracts that will agglutinate human cells with moderate specificity

(Quiz 2) What ABO group contains the least amount of H substance?

A. A1

B. A2

C. A1B

D. A2B

D. A2B

(Quiz 2) What is the source of anti-A1 lectin?

A. Bandeiraea simplicifolia

B. Dolichos biflorus

C. Ulex europaeus

D. All of the above

B. Dolichos Biflorus

(Quiz 2) What is the biochemical structure of secreted A, B, and H substances?

A. Glycolipid

B. Glycoprotein

C. Sphingolipid

D. Ceramide

B. Glycoprotein

(Quiz 2) Which ABO group's reaction will be the weakest with anti-H lectin?

A. A1

B. B

C. A2B

D. AB

D. AB

(Quiz 2) All of the following is true regarding formation of ABH antigens EXCEPT:

A. H gene inheritance is independent of ABO gene inheritance

B. A, B, and H antigens are formed from the same precursor material

C. A type 1 structure refers to a beta 1-2 linkage

D. A type 2 structure refers to a beta 1-4 linkage

C. A type 1 structure refers to a beta 1-2 linkage

(Quiz 2) Two drops of serum are added to one drop of A1 cells, and two drops are added to one drop of B cells; the two tubes are centrifuged. The ubes show reactivity when read macroscopically. This is an example of:

A. Forward grouping

B. Reverse grouping

C. Antibody screen

D. Crossmatch

B. Reverse grouping

(Quiz 2) Why is reverse grouping not performed on cord blood specimens?

A. Antigens are not present at birth

B. Antibodies are generally not present at birth

C. Antibody titer is too high

D. Antigens are too weak

B. Antibodies are generally not present at birth

(Quiz 2) If a group O mother gives birth to a group A baby, which of the following antibodies is usually responsible for crossing the placenta and causing hemolytic disease of the newborn (HDN)?

A. Anti-AB

B. Anti-B

C. Anti-A

D, Anti-H

A. Anti-AB

(Quiz 2) What immunodominant sugar is responsible for H specificity?

A. D-galactose

B. L-fucose

C. N-acetyl-D-galactosamine

D. D-glucose

B. L-fucose

(Quiz 2) What percentage of the type A population is A2?

A. 1%

B. 10%

C. 20%

D. 80%

C. 20%

(Quiz 2) The ABO group antibodies are primarily:

A. alloantibodies

B. autoantibodies

C. naturally occurring

D. drug induced

C. naturally occuring

(Quiz 2) What percentage of the white population has type-O blood?

A. 45%

B. 10%

C. 4%

D. 32%

A. 45%

(Quiz 2) Reverse grouping showed negative reactions with A1 and B cells. Forward grouping showed positive reactions with A, B, and AB antisera. What blood type is consistent with these results?

A. A

B. B

C. AB

D. O

C. AB

(Quiz 2) What is the source of anti-B lectin?

A. Bandeiraea simplicifolia

B. Ulex europaeus

C. Dolichos biflorus

D. All of the above

A. Bandeiraea simplicifolia

(Quiz 2) Which blood group contains the highest concentration of H antigen?

A. A2

B. B

C. AB

D. O

D. O

(Quiz 2) The forward grouping of a patient showed no agglutination of patient cells and with anti-A, anti-B, or anti-A,B reagent antisera. The reverse grouping showed agglutination with A1 and B cells. What is this person's ABO group?

A. A

B. B

C. AB

D. O

D. O

(Quiz 2) Forward grouping is defined as:

A. detecting antibody on an individual's red blood cells via reagent antisera.

B. detecting antigen(s) on an individual's red blood cells via reagent antisera

C. detecting ABO group antibody via reagent red blood cells

D. Detecting ABO group antigen via reagent red blood cells

B. detecting antigen(s) on an individual's red blood cells via reagent antisera

(Quiz 2) What does the hh genotype refer to?

A. Lewis

B. Sid

C. Bombay

D. Kell

C. Bombay

(Quiz 2) Approximately how many antigen sites can be found on A2 cells?

A. 1 million

B. 10,000

C. 260,000

D. 500,000

C. 260,000

(Quiz 2) A patient who was recently diagnosed with an obstructed bowel became septic from Proteus vulgaris. Prior to surgery, a routine type and screen was performed. Though this person typed as an A two years ago, his forward type is consistent with an AB individual, albeit weaker in strength with anti-B. What is the reason for this discrepancy?

A. Acquired "B"

B. Technical error

C. Incorrect patient history

D. Contaminated anti-A

A. Acquired "B"

(Quiz 2) How are ABH antigens formed?

A. Production of specific glycosyltransferases add sugars to precursor substances

B. Recombinant gene technology

C. ABO genes code for production of antigens

D. All of the above

A. Production of specific glycosyltransferases add sugars to precursor substances

(Quiz 2) What immunodominant sugar is responsible for B specificity?

A. D-galactose

B. L-fucose

C. N-acetyl-D-galactosamine

D. D-glucose

A. D-galactose

(Quiz 2) What is the source of anti-H lectin?

A. Bandeiraea simplicifolia

B. Ulex europaeus

C. Dolichos biflorus

D. All of the above

B. Ulex europaeus

(Quiz 2) An AB male mates with an AB female. What could be the genotype of the offspring?

A. AB

B. AA

C. BB

D. All of the above

D. all of the above

(Quiz 2) Persons who inherit the h allele do not produce ______ transferase necessary for formation of the H structure

A. L-fucosyl

B. N-acetylgalactosaminyl

C. D-galactosyl

D. D-glucosyl

A. L-fucosyl

(Quiz 2) Antibody titers specific to antigens from the ABO system are typically highest:

A. When the patient is a newborn

B. When the patient is around 10 years old

C. When the patient is around 30 years old

D. When the patient is around 60 years old

B. When the patient is around 10 years old

(Quiz 3) Which antigen represents Rh3 in Rosenfield terminology?

A. D

B. E

C. C

D. E

B. E

(Quiz 3) An individual of the dce/dce genotype given dCe/dce blood has an antibody response that appears to be anti-C and anti-D. The most likely explanation for this is:

A. The antibody is anti-G

B. The antibody is anti-partial D

C. The antibody is anti-Cw

D. There was an incorrect reading of the agglutination reactions.

A. The antibody is anti-G

(Quiz 3) What does Rh genotype refer to?

A. Antigens detected on a red blood cell by serologic methods

B. Antibodies detected in serum by serologic methods

C. Rh genes inherited from both parents

D. Rh genes inherited from the mother

C. Rh genes inherited from both parents

(Quiz 3) Where is the Rh antigen located relative to the red blood cell membrane?

A. Integrally

B. Peripherally

C. Centrally

D. None of the above

A. Integrally

(Quiz 3) Which of the following statements regarding anti-LW is true?

A. Anti-LW reacts poorly with cord cells

B. Anti-LW reacts stronger with Rh-positive cells than with Rh-negative cells

C. Rh-null individuals lack the LW gene

D. The gene coding for LW is located on the same chromosome as the Rh genes

B. Anti-LW reacts stronger with Rh-positive cells than with Rh-negative cells

(Quiz 3) Of the three following categories of altered D antigen, in which variation of D antigen expression are you more likely to encounter an allo-anti-D?

A. C in trans to RhD

B. Weak D

C. Partial D

D. None of the above

C. Partial D

(Quiz 3) A cord sample was sent to the blood bank for a type and DAT. Cells were washed six times with saline before testing. The forward grouping typed as an O. There was no agglutination with anti-D and washed cord cells. The DAT was a 3+ with polyspecific AHG. What is the Rh type of the baby?

A. Rh negative

B. Rh positive

C. Rh type cannot be determined

D. None of the above

C. Rh type cannot be determined

(Quiz 3) What are the dangers of transfusing donor Rh-negative RBCs to an Rh-positive patient?

A. There are no dangers

B. A hemolytic transfusion reaction will occur

C. A patient will be sensitized and will develop Anti-D

D. Most Rh-Negative blood is c- and e- positive, and because of their immunogenicity the patient may form an antibody to those antigens.

She accepted:

A. There are no dangers

And

D. Most Rh-Negative blood is c- and e- positive, and because of their immunogenicity the patient may form an antibody to those antigens.

(Quiz 3) How are the Rh antigens inherited?

A. X-linked recessive

B. Codominant alleles

C. X-linked dominant

D. None of the above

B. Codominant alleles

(Quiz 3) All of the following may cause a false-negative reaction in the Rh typing except:

A. omission of reagent

B. immunoglobulin coating cells

C. rouleaux

D. cell suspension that is too heavy

B. immunoglobulin coating cells

(Quiz 3) When a patient has Rh-null syndrome, what kind of packed RBCs need to be transfused?

A. ABO compatible Rh-positive blood

B. ABO compatible Rh-negative blood

C. ABO compatible Rh-null blood

D. O-negative PRBCs

C. ABO compatible Rh-null blood

(Quiz 3) Most Rh antibodies are of what immunoglobulin class?

A. IgM

B. IgG

C. IgA

D. IgE

B. IgG

(Quiz 3) What clinical manifestation may be associated with Rh-null syndrome?

A. Reticulocytosis

B. Stomatocytosis

C. Low hemoglobin

D. All of the above

D. All of the above

(Quiz 3) What does hr' refer to in the Weiner nomenclature?

A. dce

B. dCe

C. DcE

D. dcE

A. dce

(Quiz 3) All of the following may occur following an Rh-mediated hemolytic transfusion reaction except:

A. elevated fever

B. increased biliruben

C. intravascular hemolysis

D. positive DAT

C. intravascular hemolysis

(Quiz 3) All of the following are consistent with International Society of Blood Transfusion (ISBT) terminology except:

A. A six-digit number specifies each blood group antigen

B. 004 represents Rh group

C. D is written as "R1"

D. All genes are written in bold print

C. D is written as "R1"

(Quiz 3) Rh-immune globulin is effective in preventing which type of hemolytic disease of the newborn (HDN)

A. Anti-c

B. Anti-E

C. Anti-D

D. Anti-C

C. Anti-D

(Quiz 3) The biochemical structure of the Rh antigens is a nonglycosylated protein, meaning:

A. Lipids are not attached to protein structure

B. Carbohydrates are not attached to protein structure

C. Glucose is attached to protein

D. Glycerol is attached to protein

B. Carbohydrates are not attached to protein structure

(Quiz 3) The Rh testing on a blood donor was negative at immediate spin. The tube was incubated at 37oC for 15 mins. The tube was centrifuged and read macroscopically. The test was negative at 37oC. The tube was washed three times with saline, and two drops of AHG were added. After centrifugation, the tube yielded a 3+ reaction. How is this Rh type reported on the donor unit?

A. Rh-positive

B. Rh-negative

C. Du-positive

D. Rh-variable

A. Rh-positive

(Quiz 3) What does the "R" represent in Rh-Hr terminology?

A. Absence of D antigen

B. Presence of D antigen

C. Presence of C antigen

D. Presence of e antigen

B. Presence of D antigen

(Quiz 3) What is the basis of Rosenfield Rh terminology?

A. Each gene produces one product or antigen

B. The positive (+) or negative (-) sign demonstrated the presence of absence of antigen on a red blood cell

C. The Rh gene produces at least three factors within an agglutinogen

D. The Rh gene produces at least five factors within an agglutinogen

B. The positive (+) or negative (-) sign demonstrated the presence of absence of antigen on a red blood cell

(Quiz 3) What protocol is put in place to validate Rh testing when high-protein reagents are used, especially when the patient types as an AB-positive?

A. Wash cells before testing

B. Run a control with Rh test

C. Add LISS to test system

D. Use only saline reactive Anti-D

B. Run a control with Rh test

(Quiz 3) On which chromosome are the genes that code for Rh proteins, namely RHD and RHCE located.

A. Chromosome 1

B. Chromosome 19

C. Chromosome 20

D. Chromosome 9

A. Chromosome 1

(Quiz 3) What is the principle of the Rh-Hr (Weiner) terminology?

A. The Rh gene produces at least three factors within an agglutinogen

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

C. The Rh gene produces at least three factors within an agglutinin

D. Each gene is independent of the others

C. The Rh gene produces at least three factors within an agglutinin

(Quiz 3) Which of the following reagents or methods is best for categorizing partial D types?

A. Saline based anti-D

B. High protein anti-D

C. A combination of serological typing and molecular analysis

D. Monoclonal anti-D reagents

C. A combination of serological typing and molecular analysis

(Quiz 3) All of the following are true regarding Rh antibodies except:

A. Rh antibodies can bind complement on the red blood cell membrane

B. An individual with a low titer Rh antibody may experience a secondary immune response on antigen exposure

C. Rh antibodies may cause a delayed hemolytic transfusion reaction

D. Red blood cell destruction is usually extravascular

A. Rh antibodies can bind complement on the red blood cell membrane

(Quiz 3) If an individual with a partial D expression is transfused with a normal Rh-positive unit of blood, a likely result will be:

A. The patient will develop an anti-D antibody

B. The patient will form an antibody to the portion of Rh(D) protein that they are missing

C. The patient will have an acute hemolytic transfusion reaction

D. The patient will experience no consequence of receiving Rh-positive blood

B. The patient will form an antibody to the portion of Rh(D) protein that they are missing

(Quiz 3) Convert Fisher-Race DcE/DcE to Weiner nomenclature:

A. R1R1

B. r'r'

C. r"r"

D. R2R2

D. R2R2

(Quiz 4) In order for an individual to express Le^b antigen on their red blood cells, they must have inherited which gene?

A. Le

B. Se

C. H

D. All of the above

D. All of the above

(Quiz 4) Lutheran antibodies are rarely associated with causing hemolytic disease of the newborn (HDN) for which of the following reasons?

A. Lutheran antigens are poorly developed at birth

B. Maternal Lutheran antibodies are absorbed onto glycoproteins on the placenta, decreasing the likelihood of HDN

C. Lutheran antibodies are generally IgM class and normally do not cross the placenta

D. All of the above

D. all of the above

(Quiz 4) What is the definition of a blood group system?

A. A group of antibodies produced by alleles at a single gene locus

B. A group of antigens produced by alleles at a single gene locus

C. A group of antibodies produced by alleles at multiple genetic loci

D. A group of antigens produced by alleles at multiple genetic loci

B. A group of antigens produced by alleles at a single gene locus

(Quiz 4) What sample requirement is essential for identification of a Kidd antibody?

A. Fresh Whole blood

B. Fresh serum or plasma

C. Fasting sample

D. Sample on ice

B. Fresh serum or plasma

(Quiz 4) Persons who phenotype as Fy(a-b-) are resistant to infection by which organism?

A. Plasmodium Falciparum

B. Plasmodium vivax

C. Plasmodium ovale

D. Plasmodium malariae

B. Plasmodium vivax

(Quiz 4) The M and N antigens are found in which glycoprotein?

A. Glycophorin A

B. Glycophorin B

C. Glycophorin C

D. Band 3

A. Glycophorin A

(Quiz 4) All of the following are characteristics of Kidd antibodies except:

A. IgG immunoglobulins

B. Ability to bind complement

C. Naturally occurring

D. Exhibit dosage

C. Naturally occurring

(Quiz 4) Persons who express the phenotype P2 are at risk for developing anti-P1 when handling what animal species?

A. Dogs

B. Cats

C. Pigeons

D. Mice

C. Pigeons

(Quiz 4) Anti-I is found in association with what microorganism?

A. Mycoplasma pneumoniae

B. Treponema pallidum

C. Escherichia coli

D. Proteus vulgaris

A. Mycoplasma pneumoniae

(Quiz 4) All of the following are characteristics of Duffy antibodies except:

A. They are IgG in nature

B. They may or may not show dosage

C. They are destroyed by enzymes

D. They are not implicated in HDN

D. They are not implicated in HDN

(Quiz 4) Anti-i is found in association with what disease?

A. Pneumonia

B. Infectious mononucleosis

C. Syphilis

D. Gonorrhea

B. Infectious mononucleosis

(Quiz 4) At birth, infant cells are rich in _______, and ______ is nearly undetectable.

A. I/i

B. I/H

C. i/I

D. H/i

C. i/I

(Quiz 4) Which population has the greatest frequency of the Fy (a-b-) phenotype?

A. White

B. Black

C. Asian

D. Native American

B. Black

(Quiz 4) Enzymes destroy the antigens of which of the following blood groups?

A. N

B. Fy^a

C. M

D. All of the above

D. All of the above

(Quiz 4) Which of the following is known to reduce K antigen expression in the antihuman globulin test?

A. LISS

B. DTT

C. Albumin

D. Polyethylene glycol

B. DTT

(Quiz 4) At what phase of the antihuman globulin test will anti-Kell be detected?

A. IS

B. 37oC

C. AHG

D. All of the above

D. all of the above

(Quiz 4) Why are lewis antibodies not generally implicated in hemolytic disease of the newborn?

A. Lewis antigens are well developed at birth

B. Lewis antibodies are IgM and cannot cross the placenta

C. Lewis antigens can readily dissociate from the red blood cell upon transfusion of Lewis-positive cells

D. Lewis antibodies do not bind complement

B. Lewis antibodies are IgM and cannot cross the placenta

(Quiz 4) When red blood cells are placed in a solution of 2M urea, the red blood cells will lyse. However, it has been shown that ___________ red bood cells are resistant to lysis?

A. Jk(a+b-)

B. Jk(a+b+)

C. Jk(a-b-)

D. Jk(a-b+)

C. Jk(a-b-)

(Quiz 4) A person who inherits alleles Fy^a and Fy^b will carry which antigens on their red blood cells?

A. only Fy^a antigen

B. only Fy^b antigen

C. both Fy^a and Fy^b antigen

D. neither Fy^a or Fy^b antigen

C. both Fy^a and Fy^b antigen

(Quiz 4) Persons who are negative for Duffy antigens are less likely to contract which of the following?

A. Chicken pox

B. Influenza

C. Malaria

D. Polio

C. Malaria

(Quiz 4) What type of hemolytic transfusion reaction (HTR) occurs more frequently in patients with Jk antibodies?

A. Febrile

B. Delayed

C. Immediate

D. Bacterial

B. Delayed

(Quiz 4) Anti-Jk^a was identified in a previously transfused patient. Five cells that were homozygous for Jk^a yielded 2+ reactions in the AHG phase. The same cells were treated with ficin and yielded 3+ reactions in the AHG. Therefore, Jk^a is ________ by enzyme treatment.

A. destroyed

B. enhanced

C. unaffected

D. none of the above

B. enhanced

(Quiz 4) What fatal disease is associated with the McLeod phenotype?

A. Grave's disease

B. Chronic granulomatous disease

C. Lymphoma

D. Fanconi's syndrome

B. Chronic granulomatous disease