Advanced Clinical Laboratory Practices
Exam Solutions
Course Introduction
Advanced Clinical Laboratory Practices explores the principles and techniques crucial for modern clinical laboratory operations, emphasizing the integration of advanced diagnostic methodologies, quality assurance, and laboratory management. The course covers topics such as molecular diagnostics, automated instrumentation, advanced microscopy, and specialized testing in areas like hematology, microbiology, and immunology. Students will develop proficiency in interpreting complex test results, implementing laboratory safety protocols, and adhering to regulatory standards, all while enhancing their critical thinking and problem-solving skills essential for high-level clinical laboratory environments.
Recommended Textbook
Clinical Laboratory Blood Banking and Transfusion Medicine Practices 1st Edition by Gretchen Johns
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21 Chapters
420 Verified Questions
420 Flashcards
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Chapter 1: The Immune Process: the Origin and Interaction
Between Antigens and Antibodies
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Sample Questions
Q1) Approximately how many serum proteins are found in the complement system?
A)10
B)20
C)30
D)40
Answer: C
Q2) Most blood group antibodies react optimally at
A)Either cold or hot temperatures
B)Either cold or warm temperatures
C)Cold temperatures only
D)Hot temperatures only Answer: B
Q3) Which is the principle isotype found in blood and extracellular fluid?
A)IgD
B)IgE
C)IgG
D)IgM
Answer: C
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Chapter 2: Immunogenetics: the Origin of Antigens
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Sample Questions
Q1) Most common blood group alleles result from which type of DNA modification?
A)Chromosome crossover
B)Gene deletion
C)Multiple nucleotide transposition
D)Single nucleotide polymorphism
Answer: D
Q2) The site of the gene on the chromosome is the
A)allele
B)codon
C)locus
D)null
Answer: C
Q3) Which statement is true?
A)Blood group antigen molecules are produced as a result of alleles at a nonspecific gene locus.
B)Carbohydrate blood group antigens are produced directly by the allele.
C)Enzymes are proteins that catalyze a chemical reaction.
D)Red blood cell antigens cannot be a structural part of the red blood cell membrane.
Answer: C
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Page 4
Chapter 3: Blood Bank Applications of Antigenantibody
Reactions
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Sample Questions
Q1) The primary purpose of the immediate spin phase is to detect antibodies that react at room temperature,typically antibodies of the _____ class.
A)IgA
B)IgE
C)IgG
D)IgM
Answer: D
Q2) The antihuman globulin technique is used to detect which isotype of antibody?
A)IgD
B)IgE
C)IgG
D)IgM
Answer: C
Q3) For tube testing,the most commonly used plasma-to-cell ratio is
A)One drop of plasma and one drop of 5% suspension of red blood cells
B)One drop of plasma and two drops 5% suspension of red blood cells
C)Two drops of plasma and one drop of 5% suspension of red blood cells
D)Two drops of plasma and two drops of 5% suspension of red blood cells
Answer: C
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Chapter 4: Abo and Hh Blood Group Systems
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Sample Questions
Q1) Most ABO antibodies are
A)IgA
B)IgE
C)IgG
D)IgM
Q2) The gene for the ABO blood group system resides on chromosome
A)3
B)5
C)9
D)11
Q3) ABO discrepancies are categorized into ____ groups.
A)two
B)three
C)four
D)five
Q4) Alloantibodies that cause problems in ABO typing include
A)anti-Jk
B)anti-P1
C)A lectin
D)A lectin
Page 6
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Chapter 5: Rh, Rhag, and Lw Blood Group Systems
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Sample Questions
Q1) When testing for weak D using an indirect antigblobulin test (IAT),cells that are already coated with _____ can give a false-positive reaction in the antiglobulin phase.
A)IgA
B)IgD
C)IgE
D)IgG
Q2) Which of the following is not true about Cw antigen?
A)Antithetical to the high-incidence antigen MAR
B)Common in people of African ethnicity
C)May be present with C and c antigens
D)Originally thought to be an allele of the C/c locus
Q3) When both c and e antigens are present on the red blood cell membrane and the respective genes are in the cis position or on the same chromosome,which antigen is expressed?
A)Ce
B)d
C)f
D)G
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Chapter 6: Other Blood Group Systems
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Sample Questions
Q1) Which antigens in the Lutheran system are not high-incidence antigens?
A)Au ,Au ,and Lu
B)Au ,Au ,and Lu
C)Lu ,Lu ,and AnWj
D)Lu ,Lu ,and Lu3
Q2) Within the Knops blood group system,all of the following are high-incidence antigens except
A)Kna
B)McCa
C)McCb
D)Yka
Q3) How many antigens are there in the Duffy blood group system?
A)3
B)6
C)8
D)9
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Chapter 7: Pretransfusion and Compatibility Testing
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Sample Questions
Q1) Which of the following should be performed if the current antibody screen is positive and/or the patient has a history of clinically significant antibodies?
A)Computer-assisted crossmatch (CAC)
B)Direct antiglobulin test (DAT)crossmatch
C)Immediate spin (IS)crossmatch
D)Indirect antiglobulin test (IAT)crossmatch
Q2) Another term for the electronic crossmatch is
A)computer-aided crossmatch
B)computer-assisted crossmatch
C)computer-enhanced crossmatch
D)computer-generated crossmatch
Q3) Issue of uncrossmatched red blood cells is defined as
A)ABO group has not been determined
B)Antibody identification has not been completed
C)Rh type has not been determined
D)Some or all required testing has not been completed
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Chapter 8: Identification of Unexpected Antibodies
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Sample Questions
Q1) Which antigen is destroyed by ficin?
A)D
B)C
C)Fy
D)Jk
Q2) What test is used to determine the phenotype of red blood cells?
A)Antigen typing
B)Direct antiglobulin test
C)Molecular typing
D)Reflex test
Q3) Enhancement reagents are also called
A)Antigrams
B)Elutions
C)Potentiators
D)Titrations
Q4) Which method is preferred for removing autoantibodies?
A)Autologous absorption
B)Allogenic absorption
C)Cutaneous absorption
D)Pathologic absorption
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Chapter 9: Donor Selection, Phlebotomy, and Required Testing
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Sample Questions
Q1) How many categories of deferrals are there?
A)Two
B)Three
C)Four
D)Five
Q2) Autologous donations are defined as donations
A)made by donors for their own use
B)made by donors for a specific recipient
C)made by pheresis donors for any recipient
D)made by pheresis donors for a specific recipient
Q3) What would be the deferral period for an individual who has been taking insulin from cows (bovine or beef insulin)?
A)6 months
B)3 years
C)Indefinite
D)Permanent
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11
Chapter 10: Blood Products: Preparation, Storage, and Shipment
of Blood Components
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Sample Questions
Q1) In which country is the platelet-rich plasma method mostly widely used?
A)Brazil
B)Canada
C)United Kingdom
D)United States
Q2) What temperature must be maintained for shipping platelets and granulocytes?
A)33.8-50° F (1-6° C)
B)33.8-50° F (1-10° C)
C)68-75.2° F (20-24° C)
D)75.2-89.6° F (24-32° C)
Q3) On average,whole blood has a minimum hematocrit of
A)38% (0.38)
B)50% (0.50)
C)65% (0.65)
D)80% (0.80)
Q4) Who coined the term "blood bank"?
A)Bernard Fantus
B)Francis Rous
C)JR Turner
D)Richard Weil
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Chapter 11: Component Therapy and Massive Transfusion
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Sample Questions
Q1) Which of the following is used as a presurgical prophylaxis to reduce or prevent bleeding in patients with mild hemophilia A?
A)Desmopressin
B)G-CSF
C)Vitamin K
D)Recombinant EPO
Q2) Whole blood transfusion achieves all of the following except
A)Improved cellular immune function
B)Improved tissue oxygenation
C)Replacement of fluid
D)Replacement of nonlabile coagulation factors
Q3) Which of the following modifications can help to prevent the formation of antibodies to HLA antigens?
A)Freezing
B)Irradiation
C)Leukoreduction
D)Washing
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Chapter 12: Adverse Reactions to Transfusion
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Sample Questions
Q1) All of the following are signs and symptoms of an acute hemolytic transfusion reaction except
A)Fever
B)Muscle cramps
C)Chest pain
D)Dyspnea
Q2) What can be done to prevent transfusion-associated circulatory overload (TACO)in at-risk patients?
A)Irradiate blood products before transfusion
B)Split a red blood cell product in half and transfuse each half over 4 hours
C)Transfuse only leukoreduced blood products
D)Wait several hours after medication is given before starting a transfusion
Q3) Regarding febrile,nonhemolytic transfusion reactions (FNHTR),all of the following statements are true except
A)After an initial reaction,recurrence is uncommon.
B)Onset of symptoms occurs during or up to 4 hours after transfusion.
C)Prestorage filtration has been shown to be effective in reducing incidences.
D)Symptoms cause discomfort but are not life-threatening.
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14
Chapter 13: Transfusion-Transmitted Infections
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Sample Questions
Q1) Chronic infection is most common with which of the following types of viral hepatitis?
A)Hepatitis A
B)Hepatitis B
C)Hepatitis C
D)Hepatitis D
Q2) In the United States,all donated blood is tested for the following before transfusion except
A)Anti-HCV
B)CMV using NAT
C)HBsAg
D)WNV using NAT
Q3) Which of the following infects red blood cells?
A)Epstein-Barr virus
B)Cytomegalovirus
C)Parvovirus B19
D)West Nile virus
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Page 15
Chapter 14: Perinatal and Neonatal Transfusion Issues
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Sample Questions
Q1) Which donor red blood cells would be chosen to use in an intrauterine transfusion?
A)Group AB,Rh(D)negative that lack the offending antigen
B)Group AB,Rh(E)negative that lack the offending antigen
C)Group O,Rh(C)negative that lack the offending antigen
D)Group O,Rh(D)negative that lack the offending antigen
Q2) Complications of amniocentesis include
A)Infection
B)Pyruvate kinase deficiency
C)Rh sensitization
D)Thalassemia
Q3) All of the following are known to be IgM antibodies and have not been found to cause hemolytic disease of the fetus and newborn (HDFN)except
A)Anti-Le
B)Anti-Le
C)Anti-M
D)Anti-P1
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16
Chapter 15: Autoimmune and Drug-Induced Immune
Hemolytic
Anemias
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Sample Questions
Q1) Which of the following is the most common autoimmune hemolytic anemia?
A)DAT-negative autoimmune hemolytic anemia
B)Drug-induced immune hemolytic anemia (DIIHA)
C)Mixed autoimmune hemolytic anemia (MAIHA)
D)Warm autoimmune hemolytic anemia (WAIHA)
Q2) A positive direct antiglobulin test (DAT)results in a(an)
A)anemic patient is sufficient to diagnose an autoimmune hemolytic anemia
B)healthy blood donor is suggestive of anemia and should be investigated
C)hospitalized patient is sufficient to diagnose hyperhemolysis
D)recently transfused patient should be investigated as a possible transfusion reaction
Q3) What is the most common laboratory result pattern seen in warm autoimmune hemolytic anemia (WAIHA)?
A)Positive autocontrol,negative DAT,negative antibody screen,panreactive eLu te
B)Positive autocontrol,positive DAT,negative antibody screen,nonreactive eLu te
C)Positive autocontrol,positive DAT,positive antibody screen,nonreactive eLu te
D)Positive autocontrol,positive DAT,positive antibody screen,panreactive eLu te
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Page 17
Chapter 16: Platelet Refractory Patients
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Sample Questions
Q1) All of the following are factors that influence alloimmunization except
A)Antigen dose
B)Consumption rate
C)Immune status
D)Prior exposure
Q2) Which condition is not considered prothrombotic?
A)Graft versus host disease (GVHD)
B)Heparin-induced thrombocytopenia (HIT)
C)Hemolytic uremic syndrome (HUS)
D)Thrombotic thrombocytopenia purpura (TTP)
Q3) Transfusion of which blood component is most often associated with post-transfusion purpura (PTP)?
A)Plasma
B)Platelets
C)Red blood cells
D)White blood cells (granulocytes)
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18
Chapter 17: Transfusion Support of Selected Patient
Populations
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Sample Questions
Q1) Donor and patient red blood cells are typically matched for which antigens when a patient with sickle cell disease is going to be transfused?
A)C,c,E,e
B)C,E,K
C)E,K,S
D)M,N,S
Q2) Which of the following vitamins is stored in the liver?
A)B6
B)C
C)E
D)K
Q3) Which blood product is transfused to raise coagulation factor levels in patients with liver disease who are bleeding?
A)Cryoprecipitate
B)Factor VII
C)Fresh frozen plasma
D)Vitamin K
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Page 19
Chapter 18: Human Histocompatibility
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Sample Questions
Q1) All of the following are true about HLA class I molecules except A)Are expressed only on antigen presenting cells
B)Includes a 45 kDa glycoprotein heavy chain
C)Includes a 12 kDa -2 microglobulin light chain
D)Has a peptide-binding cleft that reacts with short peptides
Q2) The HLA class II genetic region is divided into which subregions?
A)DOA,DOB,DMA,DMB
B)DP,DO/DM,DQ,DR
C)HLA-A,HLA-B,HLA-C
D)MIC-A,MIC-B
Q3) The SSO (sequence-specific oligonucleotide)probe hybridization method
A)begins with amplification of the target DNA
B)determines the nucleotide sequence of the entire exon
C)employs primer pairs that are specific for unique sequences within an exon D)uses two rounds of polymerase chain reaction (PCR)
Q4) Which antigen would not be considered a Class I antigen?
A)HLA-A
B)HLA-B
C)HLA-C
D)HLA-D
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Chapter 19: Methods in Parentage Testing
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Sample Questions
Q1) All of the following statements are true regarding short tandem repeat (STR)except
A)Loci are repeated sequences from 2 to 25 base pairs
B)Loci typically occur in noncoding introns
C)Typing tests avoid some of the issues seen with other techniques for DNA testing
D)Typing tests are the principle technology used by parentage testing laboratories
Q2) How many loci are included in the core loci originally defined by the FBI for use in identification of individuals by genetic testing?
A)9
B)13
C)15
D)18
Q3) VNTR refers to
A)variable nucleotide test result in DNA testing
B)variable number of tandem repeats in a DNA sequence
C)venous nucleotide type repeat in DNA sequence
D)very neutral transition reactions in DNA synthesis
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Chapter 20: Transfusion Safety and Regulatory Issues
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Sample Questions
Q1) All of the following organizations offer certification for clinical laboratory scientists except
A)American Association of Bioanalysts
B)American Association of Blood Banks
C)Board of Certification of the American Society of Clinical Pathologists
D)College of American Pathologists
Q2) Which organization represents one of the most common voluntary accreditations that apply to medical laboratories?
A)American Association of Bioanalysts
B)American Medical Technologists
C)Board of Certification of the American Society of Clinical Pathologists
D)College of American Pathologists
Q3) In what year was the first test used to screen blood donors for HIV licensed?
A)1976
B)1981
C)1985
D)1990
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22
Chapter 21: Quality Assurance
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Sample Questions
Q1) Regulation grants the authority to stop production of blood products in a blood manufacturing organization when a problem is detected to which group of people?
A)Executive members
B)Leadership administrators
C)Production managers
D)Quality assurance unit
Q2) All of the following are true about quality control except
A)acceptable results or ranges must be predetermined
B)frequency and method for performance is determined by the manufacturer's requirements and/or regulatory or accreditation requirements
C)results must be documented within 7 days
D)routinely includes testing a specified number of each type of component when monitoring blood component production processes
Q3) Which of the following is an example of a quality assurance activity?
A)Trend analysis
B)Strategic planning
C)Vendor selection
D)Visual inspection
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