Immunohematology Exam Solutions
Course Introduction
Immunohematology is the study of the immunologic and genetic aspects of blood, focusing on the principles and practices related to blood group antigens, antibodies, and their interactions. This course covers topics such as blood group systems, compatibility testing, blood component preparation and transfusion practices, as well as the diagnosis and management of hemolytic disease of the newborn, transfusion reactions, and autoimmune hemolytic anemias. Emphasis is placed on the laboratory techniques used to ensure safe and effective transfusion therapy, integrating theoretical knowledge with practical application in clinical settings.
Recommended Textbook
Basic and Applied Concepts of Blood Banking and Transfusion Practices 3rd Edition by Kathy D.
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16 Chapters
465 Verified Questions
465 Flashcards
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Chapter 1: Immunology: Basic Principles and Applications in the Blood Bank
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40 Verified Questions
40 Flashcards
Source URL: https://quizplus.com/quiz/38804
Sample Questions
Q1) The major histocompatibility complex is located on chromosome 6 and is important in all the following immune functions except:
A)recognition of nonself.
B)graft rejection.
C)hemolysis.
D)coordination of cellular and humoral immunity.
Answer: C
Q2) 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?
A)The plasma sample was collected incorrectly.
B)The serum sample was contaminated.
C)Complement activation was inhibited by calcium in the plasma sample.
D)The serum sample was fresher.
Answer: C
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Chapter 2: Blood Banking Reagents: Overview and Applications
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34 Verified Questions
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Sample Questions
Q1) Which of the following statements is true regarding IgG-sensitized red cells?
A)They must be used to confirm a negative antiglobulin tube test.
B)They must be used to confirm a positive antiglobulin test.
C)They must be used to confirm a direct antiglobulin test that was negative with anti-C3d.
D)They should be used only with the indirect antiglobulin test.
Answer: A
Q2) Which of the following is not an advantage of using a monoclonal antibody over a polyclonal antibody?
A)There are very few variations between lots.
B)There are no contaminating antibodies.
C)Direct agglutination is usually faster.
D)All variations of the antigen can be detected.
Answer: D
Q3) Monoclonal antibodies are prepared in:
A)vitro.
B)vivo.
C)laboratory animals.
D)humans.
Answer: A
Page 4
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Chapter 3: Genetic Principles in Blood Banking
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Sample Questions
Q1) 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
Q2) If two traits were found to occur higher in a population together than each occurs separately,they may be linked.This would suggest that:
A)they are found far apart on the same chromosome.
B)they are inherited on different chromosomes.
C)crossover has occurred.
D)the genes are close together on the same chromosome.
Answer: D
Q3) Equal expression of two different inherited genes as in most blood group systems
A)Haplotypes
B)Recessive
C)Amorphic genes
D)Codominant genes
E)Polymorphic
Answer: D
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Chapter 4: Abo and H Blood Group Systems and Secretor
Status
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Sample Questions
Q1) Which ABO phenotype selection contains the most H antigen and the least H antigen,respectively,on the red cell's surface?
A)O,A<sub>1</sub>B
B)A<sub>2</sub>,A<sub>1</sub>B
C)B,A
D)A<sub>1</sub>B,O
Q2) Bombay
A)D-galactose
B)L-fucose
C)N-acetylgalactosamine
D)None of the above
Q3) What ABO phenotype would agglutinate in the presence of anti-A,B produced by group O individuals?
A)A only
B)B only
C)A and B
D)O only
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Page 6
Chapter 5: Rh Blood Group System
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Sample Questions
Q1) If D-negative red cells are given to an R<sub>1</sub>R<sub>1 </sub>individual what is the most likely antibody that could develop?
A)Anti-E
B)Anti-d
C)Anti-D
D)Anti-c
Q2) r'
A)Ce
B)CE
C)DCE
D)Dce
Q3) Testing for the weak D expression is performed by:
A)using anti-Du antisera with an extended incubation.
B)using monoclonal anti-D.
C)performing the indirect antiglobulin test with anti-D.
D)performing the direct antiglobulin test with anti-D.
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Chapter 6: Other Blood Group Systems
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Sample Questions
Q1) K1-positive donor red cells were mistakenly transfused to a recipient with anti-K.The patient's posttransfusion blood sample has a positive direct antiglobulin test with polyspecific antihuman globulin.The direct antiglobulin test is positive because anti-K is an __________ antibody that has sensitized the __________ cells in vivo.
A)IgG,donor's
B)IgM,donor's
C)IgG,recipient's
D)IgM,recipient's
Q2) Which of the following facts is not a characteristic of Kell system antibodies?
A)Usually clinically significant IgG antibodies
B)Best detected in indirect antiglobulin test phases
C)Lose reactivity with proteolytic enzyme reagents
D)Do not bind complement proteins
Q3) Antibodies to Kidd,Kell,and Duffy blood group antigens share all the following characteristics except:
A)can cause hemolytic disease of the newborn.
B)usually detected only by the indirect antiglobulin test.
C)enhanced with enzyme treatment.
D)can cause transfusion reactions.
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Page 8
Chapter 7: Antibody Detection and Identification
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Sample Questions
Q1) Proteolytic enzymes should not be used to screen for antibodies because:
A)the reagent is too expensive for routine use.
B)clinically insignificant antibodies are enhanced.
C)red cells must be treated with enzymes first,which makes this technique impractical.
D)some antigens are destroyed by enzymes,which would cause the antibodies to be missed.
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) DTT (dithiothreitol)would be useful in the identification of which of the following antibodies?
A)Anti-Js<sup>a</sup>
B)Anti-Kp<sup>b</sup>
C)Anti-Vel
D)Anti-K
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Chapter 8: Compatibility Testing
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Sample Questions
Q1) In which phase of reactivity would rouleaux typically be detected in the screen?
A)4<sup>\(\circ\)</sup> C
B)15<sup>\(\circ\)</sup> C
C)37<sup>\(\circ\)</sup> C
D)Antihuman globulin
Q2) A tube was received in the blood bank for crossmatching.The label was torn and the only information that was visible was the patient's last name and the medical record number.Which of the following is an acceptable procedure?
A)Request a recollection of the specimen.
B)Call the phlebotomist back to relabel the tube.
C)Reprint a label using the MRI as the identifier.
D)Use the tube since the MRI is visible.
Q3) The use of the electronic (computer)crossmatch is restricted to recipients who:
A)are group O.
B)do not have a clinically significant antibody.
C)have had successful transfusions in the past.
D)have transfusion history that has been documented in the computer.
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Chapter 9: Blood Bank Automation for Transfusion Services
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Sample Questions
Q1) The PROVUE,TANGO,and NEO have the ability to perform all of the following tests except:
A)ABO/D typing.
B)antibody ID panels.
C)direct antiglobulin test.
D)None of the above are correct.
Q2) A smooth layer of cells in the bottom of the well is interpreted as a/an _____ reaction when the solid phase testing is completed for the antiglobulin test:
A)positive
B)negative
C)indeterminate
D)mixed field
Q3) The TANGO,PROVUE,and NEO all use which of the following reagents or components used in the indirect antiglobulin test?
A)Washing mechanism
B)Centrifuge
C)Indicator cells
D)Antihuman globulin
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Chapter 10: Adverse Complications of Transfusions
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Sample Questions
Q1) Transfusion-related acute lung injury
A)Prevented by leukocyte-reduced components
B)Prevented by irradiation of components
C)Symptoms include hives and itching
D)Associated with ABO incompatibilities
E)Caused by donor white cell antibodies
F)Alloantibodies to red cell antigens
G)Can be prevented by transfusion slowly
Q2) Which of the following is necessary to prevent an anaphylactic reaction due to a known IgA antibody in a patient?
A)All red blood cell units should be irradiated.
B)Red blood cell units should be washed.
C)All blood components should be leukocyte-reduced.
D)Patient should be given antihistamine before transfusion.
Q3) An anaphylactic transfusion reaction is caused by __________ antibodies.
A)IgA
B)IgG
C)IgE
D)All of the above
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Page 12
Chapter 11: Hemolytic Disease of the Fetus and Newborn
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Sample Questions
Q1) 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
Q2) A 300-\(\mu\)g dose of Rh immune globulin contains sufficient anti-D to protect against how much whole blood?
A)25 mL
B)30 mL
C)50 mL
D)100 mL
Q3) 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.
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Page 13
Chapter 12: Donor Selection and Phlebotomy
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Sample Questions
Q1) Before donation,the intended venipuncture site must be cleaned with:
A)PVP-iodine complex
B)Alcohol
C)10% acetone
D)Green soap
Q2) Which of the following contributes to permanent rejection status of a donor?
A)A tattoo 5 months previously
B)Contact with a patient with viral hepatitis
C)Two units of blood transfused 4 months previously
D)Confirmed positive test for hepatitis B surface antigen 10 years previously
Q3) 27-year-old woman returning from the Peace Corps in Nigeria who was vaccinated for typhoid 6 months ago
A)Acceptable donors
B)Temporarily deferred
C)Permanently deferred
D)Indefinite deferral
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14
Chapter 13: Testing of Donor Blood
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Sample Questions
Q1) 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
Q2) Nucleic acid tests are used to screen for:
A)hepatitis C virus,West Nile virus,and HIV-1.
B)Chagas disease,malaria,and syphilis.
C)hepatitis B virus,hepatitis C virus,and HIV.
D)human T-cell lymphotropic virus-I/human T-cell lymphotropic virus-II,HIV 1/HIV-2,and hepatitis C virus.
Q3) Which of the following products is tested for bacterial contamination following storage?
A)Cryoprecipitated AHF
B)Red blood cells,frozen
C)Platelets
D)Fresh frozen plasma
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Page 15
Chapter 14: Blood Component Preparation and Therapy
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Sample Questions
Q1) To prevent graft-versus-host disease,blood components prepared for a fetus that needs an intrauterine transfusion should be:
A)saline washed.
B)irradiated.
C)frozen and deglycerolized.
D)human leukocyte antigen-matched.
Q2) Whole blood collected from a donor should remain at what temperature before the separation and preparation of platelet concentrates?
A)20° to 24°<sup> </sup>C
B)1° to 6°<sup> </sup>C
C)1° to 10°<sup> </sup>C
D)Varies with the facility
Q3) Plastic overwraps are recommended for thawing FFP and CRYO to prevent:
A)contamination of the water bath.
B)rapid thawing,which affects labile factors.
C)entry ports from being contaminated with water.
D)the label from peeling off when thawing.
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Chapter 15: Transfusion Therapy in Selected Patients
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Sample Questions
Q1) Treatment of symptomatic anemia
A)Cryoprecipitated AHF
B)Fresh frozen plasma
C)Red blood cells
D)Platelets
E)Leuko-reduced blood components
F)Washed red blood cells
G)Albumin/plasma protein fraction
H)Factor concentrates
I)Plasma,cryoprecipitate reduced
J)Irradiated blood products
Q2) Which of the following contributes to the high blood use in a liver transplant surgery?
A)The liver is a very large organ.
B)It is difficult to find close human leukocyte antigen matches for liver transplants.
C)Platelets are stored in the liver.
D)The liver produces the vitamin K-dependent coagulation factors.
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Chapter 16: Quality Assurance and Regulation of the Blood
Industry and Safety Issues in the Blood Bank
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Sample Questions
Q1) Employee training takes place:
A)after hiring and following implementation of new procedures.
B)following competency assessment.
C)only for new inexperienced employees.
D)as procedures are validated.
Q2) Competency assessment
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
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