Clinical Pathology
Exam Answer Key
Course Introduction
Clinical Pathology is a branch of medical science that focuses on the diagnosis of disease through the laboratory analysis of bodily fluids, such as blood, urine, and tissue homogenates. This course provides a comprehensive overview of the principles and procedures used in clinical laboratories to analyze samples for abnormalities, assess organ function, detect infections, and monitor disease progression. Students will gain practical skills in interpreting laboratory results, understanding the significance of various tests, and correlating findings with clinical presentations. Emphasis is placed on hematology, clinical chemistry, microbiology, immunology, and transfusion medicine, preparing students for roles in healthcare where laboratory data informs patient care decisions.
Recommended Textbook
Basic and Applied Concepts of Immunohematology 2nd Edition by Kathy D. Blaney
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393 Verified Questions
393 Flashcards
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Chapter 1: Immunology: Basic Principles and Applications in the Blood Bank
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Sample Questions
Q1) Human leukocyte antigen antibodies are often stimulated following a patient's repeated transfusions of platelets. This poor response to platelet transfusion is known as:
A) nonresponders.
B) refractoriness.
C) immune activation.
D) responders.
Answer: B
Q2) Which of the following will cause an antigen to elicit a greater immune response?
A) Small antigen size
B) Composed largely of carbohydrates
C) Size greater than 10,000 daltons
D) Similarity to the host
Answer: C
Q3) Incubation step is not necessary
A)Indirect antiglobulin test
B)Direct antiglobulin test
C)Both the direct and indirect antiglobulin test
Answer: B
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Chapter 2: Blood Banking Reagents: Overview and Applications
in Immunohematology
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Sample Questions
Q1) Product limitations and technical considerations for each reagent can be found in the:
A) standard operating procedure.
B) product insert.
C) Food and Drug Administration code of regulations.
D) AABB standards.
Answer: B
Q2) The gel technology method uses a concentration of red cells that is:
A) higher than tube techniques.
B) lower than tube techniques.
C) the same as the 3% to 5% requirement for tube testing.
D) variable according to the test performed.
Answer: B
Q3) Reagent antibodies prepared from human sources are:
A) unsafe.
B) too low of potency to be effective.
C) polyclonal in specificity.
D) preferred because of their lower cost.
Answer: C
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Chapter 3: Genetic Principles in Blood Banking
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Sample Questions
Q1) In a family study it was determined that all four siblings in the family had a different blood type: A, B, O, and AB. The parents were most likely ____________.
A) AA and BB
B) AO and BB
C) OO and AB
D) AO and BO
Answer: D
Q2) Mitosis results in __________ chromosomes as the original.
A) four cells with half as many
B) two cells with the same number of
C) four cells with the same number of
D) two cells with half as many
Answer: B
Q3) An advantage of the polymerase chain reaction for viral marker testing is:
A) it is quicker to perform than most other tests.
B) it is more cost effective than traditional test methods.
C) a small amount of DNA or RNA can be detected.
D) cross-contamination of samples is not a problem.
Answer: C
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Page 5
Chapter 4: Abo and H Blood Group Systems and Secretor
Status
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Sample Questions
Q1) What forward typing reagent can be used to confirm group O units before placing them in inventory?
A) Anti-A
B) Anti-B
C) Anti-A,B
D) Anti-H
Q2) A group A man marries a group AB woman. The father of the group A man was group O. What possible ABO phenotypes could be expected in the offspring?
A) Group A, B, AB, and O
B) Group A and B
C) Group A, B, and AB
D) Group A and AB
Q3) Most "naturally occurring" ABO system antibodies fall into which class?
A) IgA
B) IgM
C) IgE
D) IgG
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Page 6
Chapter 5: Rh Blood Group System
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Sample Questions
Q1) The weak D test detects:
A) the Du antigen.
B) the missing D mosaic.
C) a weak D antibody.
D) a weak D antigen.
Q2) Most Rh system antibodies are of which immunoglobulin class?
A) IgM
B) IgG
C) IgA
D) IgE
Q3) r'
A)Ce
B)CE
C)DCE
D)Dce
Q4) Which of the following phenotypes will react with anti-f?
A) rr
B) R<sub>1</sub>R<sub>1</sub>
C) R<sub>2</sub>R<sub>2</sub>
D) R<sub>1</sub>R<sub>2</sub>
Page 7
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Chapter 6: Other Blood Group Systems
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Sample Questions
Q1) Red cells that phenotype as S-s- are also:
A) M-negative.
B) N-negative.
C) Tj<sup>a</sup>-negative.
D) U-negative.
Q2) System associated with glycophorin A and B
A)Cartwright
B)MNSs
C)Kidd
D)Bg
E)Xg<sup>a</sup>
F)Sd<sup>a</sup> antigen
G)Chido
H)Knops
I)Duffy
J)Vel
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8
Chapter 7: Antibody Detection and Identification
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Sample Questions
Q1) High-titer, low-avidity antibodies typically:
A) react with antigens of high frequency in the population.
B) react with antigens of low frequency in the population.
C) are clinically significant.
D) react best at colder temperatures.
Q2) Which of the following situations can be found in a classic case of autoimmune hemolytic anemia?
A) Positive direct antiglobulin test
B) False-positive Fy<sup>a </sup>phenotyping
C) Crossmatch incompatibility at antihuman globulin
D) All of the above
Q3) An autoadsorption may be performed to investigate underlying autoantibodies. When is this procedure acceptable?
A) When the autoantibody is reactive at 4° C
B) When the patient has not been recently transfused
C) Only if complement is coating the red cells
D) When the eluate is negative
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Chapter 8: Compatibility Testing
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Sample Questions
Q1) To increase the sensitivity of the antibody screen in a compatibility test, what can be done?
A) Extend the incubation time.
B) Increase the serum to cell ratio.
C) Use an enhancement such as polyethylene glycol.
D) All of the above.
Q2) Select the correct statement regarding the collection of a blood sample for compatibility testing.
A) The sample must be labeled at the bedside.
B) The sample requires a new numeric identifier for the patient for each admittance.
C) The sample may be labeled at any time in an emergency.
D) The sample does not require a means to identify the phlebotomist.
Q3) Antibody screening of the recipient is performed as a component of compatibility testing to detect:
A) red cell alloantibodies.
B) irregular antigens on the recipient's red cells.
C) human leukocyte antigen antibodies.
D) incompatibilities with the donor's red cells.
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Chapter 9: Donor Selection and Phlebotomy
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Sample Questions
Q1) Allogeneic whole blood donors may donate every __________ days.
A) 24
B) 36
C) 56
D) 72
Q2) Which of the following is not a cause for temporary deferment of a whole blood donor?
A) Aspirin ingestion 12 hours previously
B) Hepatitis B immunoglobulin taken 4 weeks previously
C) Oral polio vaccine taken 1 week previously
D) Rubella injection 1 week previously
Q3) Blood collected from a therapeutic phlebotomy is:
A) acceptable for inventory under certain Food and Drug Administration guidelines.
B) unacceptable for inventory.
C) acceptable if the "volunteer donor" label is removed.
D) acceptable if the patient meets all regular donor criteria.
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Chapter 10: Testing of Donor Blood
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Sample Questions
Q1) The most common transmission of hepatitis B virus is by:
A) contaminated food and water.
B) transfusion.
C) sexual transmission.
D) intravenous drug use.
Q2) Cytomegalovirus-positive blood is dangerous for which of the following types of patients?
A) Premature infants
B) HIV-positive patients
C) Bone marrow recipients
D) Unborn infants of pregnant women who are seronegative
E) All of the above
Q3) Which of the following is the most common transfusion-transmitted disease?
A) AIDS
B) Syphilis
C) Cytomegalovirus
D) Hepatitis
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Chapter 11: Blood Component Preparation and Therapy
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Sample Questions
Q1) Following a platelet concentrate transfusion, a patient did not obtain the calculated corrected count increment that was expected. The possible reason(s) this did not occur is(are) the:
A) patient had a fever.
B) patient was actively bleeding.
C) patient has leukocyte antibodies.
D) all of the above are correct.
Q2) Leukocyte-poor red blood cells are indicated for patients with:
A) febrile transfusion reactions.
B) iron deficiency anemia.
C) hemophilia A.
D) cancer undergoing chemotherapy treatments.
Q3) Fresh frozen plasma (thawed)
A)20° to 24° C, 4 hours
B)1° to 6° C, 24 hours
C)20° to 24° C, 6 hours
D)< -18° C, 1 year from collection
E)1° to 6° C, < 5 days
F)< -65° C, 7 years
G)20° to 24° C, 48 hours
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Chapter 12: Adverse Complications of Transfusions
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Sample Questions
Q1) In what circumstance would a direct antiglobulin test be negative in the presence of a hemolytic process?
A) Bacterial contamination of the unit
B) Medications that were administered with the unit
C) Red blood cell unit transfused quickly through a leukopoor filter
D) All of the above
Q2) A hemolytic reaction to red blood cells can be caused by which of the following nonimmune mechanisms?
A) Incompatible intravenous solutions mixed with the unit
B) Improper storage of the unit
C) Bacterial contamination of the unit
D) All of the above
Q3) A patient was identified as having cardiac insufficiency that needed a red blood cell transfusion. How should the transfusion be administered?
A) The red blood cell unit should be transfused slowly over a 4-hour period.
B) The unit should be transfused as whole blood.
C) Diuretics should be administered with the unit.
D) Transfusion should be avoided.
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14
Chapter 13: Hemolytic Disease of the Fetus and Newborn
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Sample Questions
Q1) Select the true statement regarding ABO hemolytic disease of the fetus and newborn.
A) It is frequently seen in group A mothers with group O infants.
B) It cannot occur during prima gravida (first pregnancy).
C) Bilirubin levels often exceed 15 mg/dL in the affected infants.
D) The frequency of ABO hemolytic disease of the fetus and newborn is greater than Rh hemolytic disease of the fetus and newborn.
Q2) To identify the cause of suspected hemolytic disease of the fetus and newborn, which tests are performed?
A) ABO group
B) D testing
C) Direct antiglobulin test
D) All of the above
Q3) Which elution method is ideal in the investigation of ABO hemolytic disease of the fetus and newborn?
A) Glycine-acid
B) Freeze-thaw
C) Xylene
D) Chloroform
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Page 15
Chapter 14: Transfusion Therapy in Selected Patients
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Sample Questions
Q1) Intravascular volume expansion
A)Cryoprecipitated AHF
B)Fresh frozen plasma
C)Red blood cells
D)Platelets
E)Leukoreduced blood components
F)Washed red blood cells
G)Albumin/plasma protein fraction
H)Factor concentrates
I)Plasma, cryoprecipitate reduced
J)Irradiated blood products
Q2) Iron chelation should accompany red blood cell transfusion in which of the following?
A) Aplastic anemia
B) Autoimmune hemolytica anemia
C) Sickle cell anemia
D) Anemia caused by trauma
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Page 16
Chapter 15: Quality Assurance and Regulation of the Blood Industry
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Sample Questions
Q1) Quality control
A)The CAP survey is an example
B)Systematic evaluations to determine whether procedures are being followed
C)Testing to determine the accuracy and precision of reagents and equipment
D)Process of standardizing an instrument against a known value
E)Removal of products from the market that might compromise the safety of the recipient
F)Degree to which a measurement represents the true value
G)Establishing that a specific process produces an expected result
H)Evaluation of an employee's ability to perform a specific skill
I)Investigation and identification of the factors that contributed to an error
J)Maximizes the duration of equipment and increases the reliability of the equipment
K)System to plan and implement changes to prevent problems
Q2) Which of the following is true regarding good manufacturing practices (GMPs)?
A) GMPs are legal requirements established by the Food and Drug Administration.
B) GMPs are optional guidelines written by the AABB.
C) GMPs are required only by pharmaceutical companies.
D) GMPs are part of the quality control requirements for blood products.
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Chapter 16: Safety Issues in the Blood Bank
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Sample Questions
Q1) AABB
A)Ensures safe and healthful working conditions
B)Government agency that determines whether a health facility meets standards for reimbursement for Medicare
C)Assessment of medical wastes
D)Ensures the safety and efficacy of biologics, drugs, and devices
E)Voluntary accrediting agency for hospitals
F)Writes fire safety standards
G)Provides peer-reviewed accreditation for hospital laboratories
H)Professional organization that accredits blood banks and transfusion services
I)Makes recommendations to the Occupational Safety and Health Administration regarding the prevention of disease transmission
J)Governs all transportation except by mail
Q2) The Occupation Safety and Health Administration does not require the routine use of gloves by phlebotomists working with healthy prescreened donors or changing gloves between donors.
A) True
B) False
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