Clinical Hematology
Final Test Solutions
Course Introduction
Clinical Hematology is a comprehensive course designed to provide students with an in-depth understanding of the physiology and pathology of blood and its components. Emphasizing both theoretical knowledge and practical skills, the course covers the principles of hematopoiesis, the diagnosis and management of common and complex hematological disorders, and the interpretation of laboratory findings, including blood smears and bone marrow examinations. Students will explore topics such as anemia, leukemias, lymphomas, coagulopathies, and transfusion medicine, while gaining exposure to modern diagnostic techniques and current therapeutic strategies. The course prepares learners for clinical practice by integrating case studies and hands-on laboratory experience, fostering critical thinking and diagnostic proficiency in hematology.
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) Which is the principle isotype found in blood and extracellular fluid?
A)IgD
B)IgE
C)IgG
D)IgM
Answer: C
Q2) Which scientist proved that infections were caused by microorganisms?
A)Edward Jenner
B)Robert Koch
C)Louis Pasteur
D)Emil von Behring
Answer: B
Q3) Which class of antibodies is generally less efficient at activating complement but may cause extravascular hemolysis or destruction of the red blood cells outside the circulation?
A)IgD
B)IgE
C)IgG
D)IgM
Answer: C
Page 3
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Chapter 2: Immunogenetics: the Origin of Antigens
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Sample Questions
Q1) The site of the gene on the chromosome is the A)allele
B)codon
C)locus
D)null
Answer: C
Q2) The sex cells,either eggs or sperm,are ________ in humans,meaning that they contain one copy of each chromosome rather than two.
A)complementary
B)haploid
C)homologous
D)linear
Answer: B
Q3) Which of the following is the method used for predicting genotype frequencies of offspring?
A)Combination grouping
B)Dominant grouping
C)Dosage effect
D)Punnett square
Answer: D
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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) All of the following are characteristics of IgG except
A)Demonstrates agglutination in antiglobulin tests
B)Has a plasma half-life of about 23 days
C)Has a valence of 10
D)Is able to cross the placenta
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
Page 5
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Chapter 4: Abo and Hh Blood Group Systems
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Sample Questions
Q1) What is the immunodominant sugar of the A antigen?
A)D-galactose
B)D-glucose
C)N-acetyl-D-galactosamine
D)L-fucose
Q2) If an ABO discrepancy is due to an antibody and a low-incidence antigen is suspected,a viable course of action would be to test several different examples of A)A or B cells
B)A or O cells
C)B or O cells
D)AB cells
Q3) Cold-reactive alloantibodies can be identified by testing plasma against panels of cells with known
A)antibodies
B)genes
C)microorganisms
D)phenotypes
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6
Chapter 5: Rh, Rhag, and Lw Blood Group Systems
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Sample Questions
Q1) 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
Q2) Which antigen is routinely tested for in all blood donors and recipients in most countries?
A)C
B)D C)E D)O
Q3) The RHD gene codes for the ____ antigen. A)A B)B C)C D)D
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Chapter 6: Other Blood Group Systems
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Sample Questions
Q1) Which antibody commonly causes delayed hemolytic transfusion reactions?
A)Anti-A,B
B)Anti-Jk
C)Anti-K
D)Anti-Le
Q2) A gene,XK,carried on the X chromosome results in production of the high-incidence antigen
A)Jsb
B)KEL
C)Kpb
D)Kx
Q3) The full expression of Lewis antigens is not reached until around ___ years of age.
A)3
B)5
C)7
D)9
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Chapter 7: Pretransfusion and Compatibility Testing
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Sample Questions
Q1) Crossmatch is also known as
A)Compatibility testing
B)Donor cell antigen typing
C)Immediate spin phase testing
D)Patient cell antigen typing
Q2) 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
Q3) Allocating can be considered a separate process or it can be considered the ___ step in the crossmatch process.
A)Critical
B)First
C)Last
D)Second
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9
Chapter 8: Identification of Unexpected Antibodies
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Sample Questions
Q1) The chance of finding a ____ antibody screening cell is very small.
A)dCe/dCe
B)C/e/E/e
C)cis-AB
D)DCe/dce
Q2) The results of a titration showed 2+ positive reactions at 1:2,1:4,1:8,and 1:16 dilutions;1+ positive reactions at 1:32 and 1:64 dilutions;and a negative reaction at 1:128 dilution.What would be the titer result reported?
A)16
B)32
C)64
D)128
Q3) What is the most common sulfhydryl reagent used in transfusion medicine?
A)Bromelin
B)Chymotrypsin
C)Dithiothreitol
D)Papain
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10
Chapter 9: Donor Selection, Phlebotomy, and Required Testing
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Sample Questions
Q1) Which of the following organizations licenses blood centers in the United States?
A)AABB (American Association of Blood Banks)
B)ARC (American Red Cross)
C)CDC (Centers for Disease Control and Prevention)
D)FDA (Food and Drug Administration)
Q2) During the informed consent process,a donor must be made aware of which of the following?
A)Hemoglobin or hematocrit result
B)Foreseeable risks of donation
C)Potential benefits to the recipient
D)Transmissible disease testing methods
Q3) Which type of deferral means the prospective donor is unable to give blood to someone else for an unspecified period of time due to current regulatory requirements?
A)Flexible
B)Indefinite
C)Permanent
D)Temporary
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Page 11
Chapter 10: Blood Products: Preparation, Storage, and Shipment of
Blood Components
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Sample Questions
Q1) What is the approved shelf-life in days of red blood cell components that use one of the three additive solutions currently licensed in the United States?
A)7
B)21
C)35
D)42
Q2) Generally speaking,63 mL of anticoagulant is used to collect a target volume of ___ mL of whole blood.
A)300
B)350
C)450
D)500
Q3) In which country is the platelet-rich plasma method mostly widely used?
A)Brazil
B)Canada
C)United Kingdom
D)United States
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Page 12
Chapter 11: Component Therapy and Massive Transfusion
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Sample Questions
Q1) What gauge of needle is typically used for blood transfusions?
A)18
B)21
C)23
D)25
Q2) Which of the following can be used to stimulate platelet production in patients suffering from bone marrow suppression that has caused thrombocytopenia?
A)G-CSF
B)GM-CSF
C)Recombinant EPO
D)Recombinant TPO
Q3) Which of the following is the first treatment step in responding to massive blood loss?
A)Establish an intravenous access
B)Infuse colloid solutions
C)Improve oxygen delivery
D)Restore circulating systemic volume
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Chapter 12: Adverse Reactions to Transfusion
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Sample Questions
Q1) Hypotensive transfusion reactions are identified as a drop in blood pressure of
A)>10 mm Hg
B)>20 mm Hg
C)>30 mm Hg
D)>40 mm Hg
Q2) Which of the following defines hyperhemoloysis?
A)The patient's red blood cells are destroyed in addition to transfused donor cells.
B)The patient's white blood cells are destroyed in addition to transfused donor cells.
C)The presence of hemoglobin in the patient's urine.
D)The presence of free hemoglobin in the patient's plasma.
Q3) Hypothermia occurs when the body temperature drops below
A)92° F (33° C)
B)95° F (35° C)
C)98° F (37° C)
D)101° F (38° C)
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Chapter 13: Transfusion-Transmitted Infections
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Sample Questions
Q1) The hepatitis C virus belongs to which family?
A)Flaviviridae
B)Hepeviridae
C)Picornaviridae
D)Retroviridae
Q2) When was acquired immunodeficiency syndrome (AIDS)first reported as an infectious disease?
A)1940
B)1976
C)1981
D)1999
Q3) In the United States,what is the approximate risk for transfusion transmission of hepatitis B?
A)1:220,000
B)1:2 million
C)1:3 million
D)Unknown
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Chapter 14: Perinatal and Neonatal Transfusion Issues
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Sample Questions
Q1) Prior to giving Rh-immune globulin (RhIG),when should a second antibody screen be tested on an Rh(D)-negative woman whose initial antibody screen was negative?
A)8 weeks gestation
B)12 weeks gestation
C)24 weeks gestation
D)28 weeks gestation
Q2) A minimum of at least one ______ dose of Rh-immune globulin (RhIG)must be administered to all Rh(D)-negative women who deliver an Rh(D)-positive infant,provided the woman has not already made anti-D.
A)100 µg
B)200 µg
C)300 µg
D)400 µg
Q3) Amniocentesis can be performed as early as
A)10 weeks gestation
B)15 weeks gestation
C)20 weeks gestation
D)25 weeks gestation
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16
Chapter 15: Autoimmune and Drug-Induced Immune
Hemolytic
Anemias
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Sample Questions
Q1) Red blood cell phenotyping by serologic methods can only be performed on specimens from patients who have
A)been transfused in the last 6 months
B)been transfused in the last year
C)not been transfused in the last month
D)not been transfused in the last 3 months
Q2) Which of the following is the least 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)
Q3) Which is used as the primary means for determining whether immune-mediated destruction of red blood cells is contributing to a patient's anemia?
A)Antigen typing test
B)Direct antiglobulin test
C)Donath-Landsteiner test
D)Indirect antiglobulin test
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Page 17
Chapter 16: Platelet Refractory Patients
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Sample Questions
Q1) 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)
Q2) Which of the following mechanisms results in immune-mediated platelet refractoriness?
A)Alloimmunization
B)Consumption
C)Sequestration
D)Thrombosis
Q3) What is the first step to take when platelet refractoriness is suspected in a patient?
A)Confirm the response to the transfusion
B)Obtain a complete and accurate history
C)Screen the patient for HLA and/or HPA antibodies
D)Transfuse ABO-identical platelets
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18
Chapter 17: Transfusion Support of Selected Patient
Populations
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Sample Questions
Q1) Red blood cell and platelet transfusions are used as supportive therapy in patients who have undergone a hematopoietic progenitor cell (HPC)transplant until when?
A)Chemotherapy is complete
B)CMV reactivation occurs
C)Engraftment occurs
D)Factor levels reach 70%
Q2) Which is the most common inherited disease in people of African ethnicity?
A)Hemophilia A
B)Hemophilia B
C)Sickle cell disease
D)von WilLe rand's disease
Q3) Which of the following is an oral iron chelator?
A)Deferasirox
B)Deferoxamine
C)Dexamethasone
D)Dimercaprol
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Chapter 18: Human Histocompatibility
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Sample Questions
Q1) Which of the following methods is typically used to crossmatch a recipient's serum with donor lymphocytes?
A)Flow cytometry
B)Sequence-specific primer typing
C)Signal transduction
D)Solid phase assay
Q2) 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)
Q3) Which type of transplant is frequently used to treat genetic and acquired dysfunction of the bone marrow?
A)Bone
B)B lymphocyte cell
C)Hematopoeitic progenitor cell
D)Liver
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Chapter 19: Methods in Parentage Testing
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Sample Questions
Q1) Regarding the PEx,which statement is false?
A)Begins with calculating the proportion of the population who would not be excluded.
B)Indicates the proportion of the population who could have been included in parentage.
C)Is a way to evaLu te results of parentage testing.
D)Is the probability the alleged parent would be excluded if they were falsely accused.
Q2) Which advancement first allowed probability of parentage to be calculated?
A)Accredited standardization
B)Arlie consensus
C)DNA polymorphism
D)HLA typing
Q3) Which standards are commonly followed by laboratories seeking accreditation for parentage testing?
A)AABB Standards for Blood Banks and Transfusion Services
B)AABB Standards for Relationship Testing Laboratories
C)ABA Standards for Blood Banks and Transfusion Services
D)ABA Standards for Parentage Testing Laboratories
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21
Chapter 20: Transfusion Safety and Regulatory Issues
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Sample Questions
Q1) When was the first license for a blood bank issued?
A)1902
B)1934
C)1946
D)1962
Q2) 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
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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Chapter 21: Quality Assurance
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Sample Questions
Q1) Which of the following is an example of a quality assurance activity?
A)Trend analysis
B)Strategic planning
C)Vendor selection
D)Visual inspection
Q2) The AABB Standards for Blood Banks and Transfusion Services are divided into how many quality system essentials?
A)10
B)13
C)21
D)23
Q3) All of the following are goals of a quality program except
A)Adversarial relationship with regulatory agencies
B)Cost containment
C)Knowledgeable and well-trained employees
D)Safe work environment
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