Immunohematology Chapters 1-4 Test Review

Which agency administers the Clinical Laboratory Improvement Amendments?

Center for Medicare-medicaid services (CMS)

A laboratory technologist decided she would like to bring her lab coat home for laundering because it had too many wrinkles when returned by the laboratory's laundry service. Is this practice acceptable ?

No

At what point in the employment process should safety training take place?

During orientation

In safety training, employees must become familiar with

Tasks that have an infectious risk, limits of protective clothing, appropriate action to take if exposure occurs

Blood irradiators require the following safety procedures

Proper draining, PPE, equipment leak detection

What is true regarding good manufacturing practices (GMPs)?

GMPs are legal requirements established by the FDA

Examples of an unacceptable record-keeping procedure

using dittos in columns to save time

A technologist in training noticed that the person training her had not recorded the results of a test. To be helpful, she carefully recorded the results she saw at a later time, using the technologist's initials. Is this an acceptable procedure?

No

When is unacceptable quality control results for the antiglobulin test performed in test tubes may be noticed?

If no PM of cell washer, lack of training, improperly stored reagent (All of the above)

What is true regarding competency testing?

Preformed following training, on an annual basis, and retraining is required if failed

Organization involved in the regulation of blood bank

FDA and AABB

Responsibilities of the quality assurance department of a blood bank

Preforming internal audits, reviewing SOPs, reviewing and approving training programs

The standard operating procedure is a document that

helps achieve consistency of results

When does employee training takes place?

After hiring and implementation of new polcies

Plans that provide the framework for establishing quality assurance in an organization are

continuous quality improvement plans

What is a potential outcome if a facility foes not validate a refrigerator before use?

Violation of current good manufacturing practices and could be cited by the FDA

In a routine audit of a facilities blood collection area, the quality assurance department found that the blood bags used on the particular day had expired. What is the appropriate course of action?

Initiate a root cause analysis and quarantine the blood collected in expired bags

Several units were released to a hospital by mistake before all viral marker testing was completed. What is the appropriate course of action?

Report error to the FDA

Does OSHA require the routine use of gloves by phlebotomist working with healthy prescreenced donors or changing unsoiled gloves between donors

Yes

Are all accidents, even minor ones, must be reported to a supervisor?

Yes

Is quality control the same as quality assurance?

No

Cell involved in humoral immunity is

B lymphocytes

What process is described by opsonization?

Binding to cells or antigens

Term that described cells or tissue from a genetically different individual within the same species is

Allogenic

The substance that regulates the activity of other cells by binding to specific receptors is

cytokines

Who is responsible for the activation of the classic pathway of complement?

Antibody bind to antigen

Biological molecules considered the most immunogenic are

Proteins

Part of the immunoglobulin molecule that distinguishes the isotype

Heavy chain

The immunoglobulin class produced first in the primary immune response

IgM

In a serologic test, the term prozone is also known as

Antibody excess

The potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used it

False negatives

How should a reaction be graded after adding antigen and antibody to a test tube and one large agglutinate was observed?

4+

The portion of the antibody molecule that imparts the antibody's unique class function is

constant tegion of heavy chain

The portion of the antibody molecule that binds to receptors on macrophages and assists in the removal of antibody bound to red cells is

Fc fragment

The region of the antibody molecule responsible for imparting unique antibody specificity is

Variable region

Immunoglobulin class capable of crossing the placenta

IgG

Immunoglobulin class that reacts best at room temperature at immediate-spin is

IgM

Antigen that originates for the individual is termed

Autoantigen

What will cause an antigen to elicit a greater immune response?

Size >10,000 daltons

Extravascular destruction of blood cells occur in

spleen

What is the most likely explanation if an antibody identified in the transfusion service appeared to be reacting stronger following the second exposure to an antigen from a transfusion?

Affinity maturation of immunoglobulin molecules, anamnestic response, isotype switching

Which components in the complement cascade mediates the lysis of the targets cells?

C5-C9

What requires adjustment in order to enhance the reaction of an antibody in vitro?

increase incubation time

Hemolysis was observed at room temperature when testing a patient's serum with reagent red cells used for screening. When this test was repeated using the patient's plasma, no hemolysis was observed. What was the most likely explanation for the different reactions?

Complement activation was inhibited by calcium in the plasma sample

Immunoglobulin class impacted by the zeta potential in a hemagglutination test is

IgG

What would you use when testing for the A antigen in a patient?

Patient red cells and Anti-A

What is the potential consequence to the test results if a technologist adds 4 drops of a 5% red cell suspension instead of the required 1 drop to a hemagglutination test?

False negatives

The test that uses IgG-sensitized red cells (check cells) is

Gel technology

Reagent that contains antibodies to multiple antigenic epitopes is

Polyclonal-based

Method that uses a dextran-acrylamide matric is

Gel technology

What provides evidence for reagent red cell deterioration?

Spontaneous agglutination, significant hemolysis, loss of agglutination strength over time

Reagent antibodies prepared from human sources are

polycloncal in specificity

Monoclonal antibodies are prepared in

Vitro

What is not an advantage of using a monoclonal antibody over a polyclonal antibody?

All vaiations can be detected

Where do we find product limitations and technical considerations for each reagent?

Product insert

Why does solid-phase red cell adherence used for antibody detection has an advantage over tube testing?

Endpoint is more clearly defined

What is true regarding IgG-sensitized red cells?

Must be used to confirm a negative antiglobulin tube test

What method displays a positive reaction as a compact red cell button?

Micro titre plate

How do you interpret the result where the anti-globulin test was performed using gel technology and a button of cells is observed at the bottom of the micro-tube following centrifugation?

Strong negative reaction

What is true regarding high-protein anti-D reagents?

Have been largely replaced with low protein-monoclonal reagents, contain approx. 20% bovine albumin, may increase possibility of false positive reaction requiring the use of a control

How would you interpret the results if both the anti-reagent and the Rh control were 2+ agglutination reactions?

Unable to determine without further testing

Red cells used to screen for antibodies in donor samples

pooled screening cells

Specificities that polyspecific anthuman globulin contain

Anti-IgG and Anti c3d

Temperature used for incubation in the indirect anti human globulin test

37 degrees Celsius

Incubation is omitted in the direct anti human globulin test because

Antigen-antibody complex has already formed in vivo

How does a negative test appear in the solid-phase red cell adherence test?

A button of cells on the bottom of the well

How would a reaction be graded following centrifugation of the gel card and red cells are evenly dispersed throughout one of the micro tubes?

2+

Immunoglobulin class that reacts best by antiglobulin testing is

IgG

Red cel antigens that proteolytic enzymes destroy

Duffy system ( Ag. fya, fyb

Purpose of adding anti body sensitized red cells following the antiglobulin test is

Check that wash procedure was sufficient to remove unbound antibodies

Polyethylene glycol reagent is added to the screen or panel to

Increase avidity of IgG Ab.

Rouleaux is a false positive reaction caused by elevated serum protein levels. Which test would not likely be affected by an elevated protein level?

Direct Antiglobulin Test (DAT)

A person whose red cells type as M+N+ with antisera would be

Heterozygous

The children of a group AB mother and a group B father could phenotype as

AB, A, B

What is the most likely genotypes of the parents in a family where all four sibling in the family had a different blood type: A,B,O and AB?

Ao, Bo

If anti-M was reacted with red cells that are M+N+, how would they compare with red cells that are M+N-?

Weaker

What type of inheritance pattern is demonstrated if a father carriers the Xga blood group trait and passes it on to all of his daughter but to none of his sons?

X-linked dominate

Which marker used to test for paternity provided the most useful statistical value?

HLA typing

Mitosis results in how many chromosomes?

2 cells with the same

Crossing occurs during

Meiosis (2genes on the same chromosome combine and produce 2 new chromosomes

Which generic term applies when an individual is group A?

Phenotype

Advantage of Nucleic Acid Testing (NAT) for viral marker testing

Small amount of DNA or RBA can be detected

Meaning of the term autosomal

Trait no carried on sex chromosomes

RNA different from DNA how?

RNA usually exhausts as a single strand, sugar ribose is substituted with deoxyribose (All of the above)

What is true when using the Hardy-Weinberg equation to calculate genetic frequencies?

Population stats must be larger, mutations cannot occur and mating must be random

If two traits occur higher in a population together than each occurs separately, they may be linked. What does this suggest?

Genes are close together on the same chromosome

The approximate probability of finding a compatible unit of blood for a D-positive patient with antibodies to C, E, and K, if the frequency of C is 70%, E 30% and K is 10% is

2 our of 10

In relationship testing, a "direct exclusion" is established when a genetic marker is

Present in child but absent in mother and alleged father

What percentage of the same population is heterozygous for a particular trait of a random population where 16% of the population is homozygous for a particular trait?

48%

How are most blood group systems inherited?

Autosomal codominate

The linked HLA genes on each chromosome are inherited as

Haplotype

What is the term for the short pieces of single-stranded DNA in the PCR reaction,that are complementary and mark the sequence to be amplified?

Primers

Which clinical application apply to molecular testing for blood group antigens?

Confirm D type of donors, identify fetus at risk for HDFN, predict phenotype of patient with AHA (acute immune hemolytic anemia)

Could parents, who both phenotype as group A, have a group O child?

Yes