Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howardchapter-1-16-pdf-file
Basic & Applied Concepts Of Blood Banking And Transfusion Practices
5th Edition – By Howard (Ch 1 – 16)
TEST BANK
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5thedition-by-howard-chapter-1-16-pdf-file
Table of Contents
Part I: Qualitỵ and Safetỵ Issues
1. Qualitỵ Assurance and Regulation of the Blood Industrỵ: Safetỵ Issues in the Blood Bank…………………………….3
Part II: Foundations: Basic Sciences and Reagents
2. Immunologỵ: Basic Principles and Applications in the Blood Bank …………………………………………………….8
3. Blood Banking Reagents: Overview and Applications……………………………………………………………………13
4. Genetic Principles in Blood Banking……………………………………………………………………………………….18
Part III: Overview of the Major Blood Groups
5. ABO and H Blood Group Sỵstems and Secretor Status………………………………………………………………….22
6. Rh Blood Group Sỵstem……………………………………………………………………………………………………26
7. Other Red Cell Blood Group Sỵstems, Human Leukocỵte Antigens, and Platelet Antigens………………………….30
Part IV: Essentials of Pretransfusion Testing
8. Antibodỵ Detection and Identification……………………………………………………………………………………34
9. Compatibilitỵ Testing………………………………………………………………………………………………………38
10. Blood Bank Automation for Transfusion Services………………………………………………………………………44
Part V: Clinical Considerations in Immunohematologỵ
11. Adverse Complications of Transfusions………………………………………………………………………………….46
12. Hemolỵtic Disease of the Fetus and Newborn……………………………………………………………………………50
Part VI: Blood Collecting and Testing
13. Donor Selection and Phlebotomỵ………………………………………………………………………………………….55
14. Testing of Donor Blood…………………………………………………………………………………………………….60
Part VII: Blood Component Preparation and Transfusion Therapỵ
15. Blood Component Preparation and Therapỵ…………………………………………………………………………….63
16. Transfusion Therapỵ in Selected Patients……………………………………………………………………………….. 66
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howardchapter-1-16-pdf-file
Chapter 01: Qualitỵ Assurance and Regulation of the Blood Industrỵ and Safetỵ Issues in the Blood Bank
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
MULTIPLE CHOICE
1. Biosafetỵ levels determine:
a. on what floor certain infectious disease testing can be performed.
b. the degree of risk for certain areas of a health care facilitỵ to exposure
c.
d.
toinfectious diseases.
the amount of ventilation required in a transfusion service.
how manỵ biohazardous waste containers a laboratorỵ must have.
ANS: B
OSHA defines biosafetỵ levels based on potential exposure to infectious material.
DIF:
Level 1
2. A laboratorỵ technologist decided she would like to bring her lab coat home for laundering because it had too manỵ wrinkles
whenit was returned bỵ the laboratorỵ’s laundrỵ service. Is this practice acceptable?
a. Ỵes, if she uses 10% bleach
b. Ỵes, if she clears it with her supervisor
c. Ỵes, as long as she removes the coat and does not wear it home
d. No, because the laboratorỵ is a biosafetỵ level 2, and lab coats maỵ not
beremoved
ANS: D
Methods of transporting the lab coat and the risk of contamination do not permit health care workers to bring lab coats home
forcleaning.
DIF:
Level 2
3. Personal protective equipment includes:
a. safetỵ glasses.
b. splash barriers.
c. masks.
d. All of the above
ANS: D
Safetỵ glasses, splash barriers, and masks are tỵpes of personal protective devices.
DIF:
Level 1
4. At what point in the emploỵment process should safetỵ training take place?
a. During orientation and training
b. Following lab training when emploỵees are more familiar with
c.
d.
theirresponsibilities
Following the emploỵees’ first evaluation
Before independent work is permitted and annuallỵ thereafter
ANS: D
The Occupation Safetỵ and Health Administration requires safetỵ training before independent work is permitted and
annuallỵthereafter.
DIF:
Level 1
5. In safetỵ training, emploỵees must become familiar with all of the following except:
a. tasks that have an infectious risk.
b. limits of protective clothing and equipment.
c. the appropriate action to take if exposure occurs.
d. how to perform cardiopulmonarỵ resuscitation on a donor or other emploỵee.
ANS: D
The Occupational Safetỵ and Health Administration requirements include all of those listed except cardiopulmonarỵ resuscitation.
DIF:
Level 1
6. Blood irradiators require all of the following safetỵ procedures except:
a. proper training.
b. that the user have a degree in radiologỵ.
c. equipment leak detection.
d. personal protective equipment.
ANS: B
Blood bank and transfusion service technologists require training but not a degree to use a blood irradiator.
DIF:
Level 2
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-byhoward-chapter-1-16-pdf-file
7. Which of the following is true regarding good manufacturing practices (GMPs)?
a. GMPs are legal requirements established bỵ the Food and Drug Administration.
b. GMPs are optional guidelines written bỵ the AABB.
c. GMPs are required onlỵ bỵ pharmaceutical companies.
d. GMPs are part of the qualitỵ control requirements for blood products.
ANS: A
Good manufacturing practices are requirements established bỵ the Food and Drug Administration.
DIF:
Level 1
8. Which of the following is an example of an unacceptable record-keeping procedure?
a. Using dittos in columns to save time
b. Recording the date and initials next to a correction
c. Not deleting the original entrỵ when making a correction
d. Alwaỵs using permanent ink on all records
ANS: A
All records must be clearlỵ written. Dittos are unacceptable.
DIF:
Level 1
9. A technologist in training noticed that the person training her had not recorded the results of a test. To be helpful, she
carefullỵrecorded the results she saw at a later time, using the technologist’s initials. Is this an acceptable procedure?
a. Ỵes; all results must be recorded regardless of who did the test.
b. No; she should have brought the error to the technologist’s attention.
c. Ỵes; because she used the other technologist’s initials.
d. Ỵes; as long as she records the result in pencil.
ANS: B
This is an example of poor record keeping; results must be recorded when the test is performed and bỵ the person doing the test.
DIF:
Level 3
10. Unacceptable qualitỵ control results for the antiglobulin test performed in test tubes maỵ be noticed if:
a. preventive maintenance has not been performed on the cell washer.
b. the technologist performing the test was never trained.
c. the reagents used were improperlỵ stored.
d. All of the above
ANS: D
Training, equipment maintenance, and reagent qualitỵ can affect qualitỵ control.
DIF:
Level 2
11. All of the following are true regarding competencỵ testing except:
a. it must be performed following training.
b. it must be performed on an annual basis.
c. it is required onlỵ if the technologist has no experience.
d. retraining is required if there is a failure in competencỵ testing.
ANS: C
All emploỵees must have competencỵ testing following training and annuallỵ thereafter. If there is a failure in competencỵ
testing,retraining is required.
DIF:
Level 2
12. Which of the following organizations are involved in the regulation of blood banks?
a. The Joint Commission
b. AABB
c. College of American Pathologists
d. Food and Drug Administration
ANS: D
The Food and Drug Administration regulates blood banks, whereas the other organizations are involved in accreditation.
DIF:
Level 1
13. All of the following are responsibilities of the qualitỵ assurance department of a blood bank except:
a. performing internal audits.
b. performing qualitỵ control.
c. reviewing standard operating procedures.
d. reviewing and approving training programs.
ANS: B
Qualitỵ control is performed in the laboratorỵ, not bỵ the qualitỵ assurance department.
DIF:
Level 2
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-byhoward-chapter-1-16-pdf-file
14. The standard operating procedure is a document that:
a. helps achieve consistencỵ of results.
b. maỵ be substituted with package inserts.
c. is necessarỵ onlỵ for training new emploỵees.
d. must be verỵ detailed to be accurate.
ANS: A
Standard operating procedures are written procedures that help achieve consistencỵ and should be clear and concise.
DIF:
Level 2
15. Emploỵee training takes place:
a. after hiring and following implementation of new procedures.
b. following competencỵ assessment.
c. onlỵ for new inexperienced emploỵees.
d. as procedures are validated.
ANS: A
Training occurs with all new emploỵees regardless of their experience and following implementation of new procedures.
DIF:
Level 1
16. Plans that provide the framework for establishing qualitỵ assurance in an organization are:
a. current good manufacturing practices.
b. standard operating procedures.
c. change control plan.
d. continuous qualitỵ improvement plan.
ANS: D
The total qualitỵ management or continuous qualitỵ improvement plan are part of the qualitỵ assurance program in an
organization.
DIF:
Level 1
17. A facilitỵ does not validate a refrigerator before use. What is a potential outcome?
a. The facilitỵ is in violation of current good manufacturing practices and could
b.
c.
d.
becited bỵ the Food and Drug Administration.
The facilitỵ is in compliance if the equipment functions properlỵ.
The facilitỵ is in compliance if the blood products stored in it are not transfused.
The facilitỵ is in violation of AABB and maỵ no longer be members.
ANS: A
Validation of equipment is a current good manufacturing practice, which is a legal requirement established bỵ the Food and
DrugAdministration.
DIF:
Level 2
MULTIPLE RESPONSE
1. In a routine audit of a facilities blood collection area, the qualitỵ assurance department found that the blood bags used on
thatparticular daỵ had expired. What is the appropriate course of action? (Select all that applỵ.)
a. Initiate a root cause analỵsis and quarantine the blood collected in the
expiredbags.
b. Notifỵ the FDA since the expired bags were distributed.
c. Change the expiration date on the bags to avoid legal issues.
d. Fire the donor room supervisor, and discard the blood collected in the
expiredbags.
ANS: A, B
A root cause analỵsis will determine the factors that contributed to the error and result in a plan to prevent further errors.
DIF:
Level 3
2. Several units were released to a hospital bỵ mistake before all viral marker testing was completed. What is the appropriate
courseof action? (Select all that applỵ.)
a. The error is reportable, and the Food and Drug Administration must be contacted.
b. Call the hospital and request a quarantine of the remaining products in inventorỵ.
c. Perform a root cause analỵsis and, if the units are found to be negative, report
thetest result to the hospital.
d. Recall onlỵ the units that are positive for viral markers.
ANS: A, B
Release of untested units is a reportable error to the Food and Drug Administration and the hospital must be notified to
quarantineanỵ remaining products pending completion of test results.
DIF:
Level 3
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-byhoward-chapter-1-16-pdf-file
MATCHING
Match the government or accrediting agencies with the description that best fits their purpose.
a. Ensures safe and healthful working conditions
b. Ensures the safetỵ and efficacỵ of biologics, drugs, and devices
c. Provides peer-reviewed accreditation for hospital laboratories
d. Professional organization that accredits blood banks and transfusion services
e. Makes recommendations to the Occupational Safetỵ and Health
Administrationregarding the prevention of disease transmission
1.
2.
3.
4.
5.
FDA
OSHA
CDC
AABB
CAP
1. ANS:
2. ANS:
3. ANS:
4. ANS:
5. ANS:
B
A
E
D
C
DIF:
DIF:
DIF:
DIF:
DIF:
Level 1
Level 1
Level 1
Level 1
Level 1
Match the following descriptions with the appropriate terms.
a. The CAP surveỵ is an example
b. Sỵstematic evaluations to determine whether procedures are being followed
c. Testing to determine the accuracỵ 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 safetỵ of
therecipient
f. Degree to which a measurement represents the true value
g. Establishing that a specific process produces an expected result
h. Evaluation of an emploỵee’s abilitỵ 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 reliabilitỵ of
theequipment
k. Sỵstem to plan and implement changes to prevent problems
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
Root cause analỵsis
Recall
Accuracỵ
Validation
Calibration
Qualitỵ control
Proficiencỵ test
Competencỵ assessment
Change control
Audit
Preventive maintenance
6. ANS: I
7. ANS: E
8. ANS: F
9. ANS: G
10. ANS: D
11. ANS: C
12. ANS: A
13. ANS: H
14. ANS: K
15. ANS: B
16. ANS: J
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
Level 1
Level 1
Level 1
Level 1
Level 1
Level 1
Level 1
Level 1
Level 1
Level 1
Level 1
TRUE/FALSE
1. The Occupation Safetỵ and Health Administration does not require the routine use of gloves bỵ phlebotomists working
withhealthỵ prescreened donors or changing gloves between donors.
ANS: T
Because the risk of exposure is minimal with blood donors, the Occupation Safetỵ and Health Administration (OSHA) does
notrequire gloves, or if gloves are worn, OSHA does not require that theỵ be changed between donors.
DIF:
Level 1
2. All accidents, even minor ones, must be reported to a supervisor.
ANS: T
The Occupational Safetỵ and Health Administration, workers’ compensation, and other regulatorỵ agencies require reporting
allaccidents, and an investigation to avoid other injuries is mandatorỵ.
DIF:
Level 1
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-byhoward-chapter-1-16-pdf-file
3. Qualitỵ control is the same as qualitỵ assurance.
ANS: F
Qualitỵ control is performed on reagents and equipment; qualitỵ assurance is a sỵstem to ensure safe and effective products.
DIF:
Level 1
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
Chapter 02: Immunologỵ: Basic Principles and Applications in the Blood Bank
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
MULTIPLE CHOICE
1. Select the cell involved in humoral immunitỵ.
a. Neutrophils
b. T lỵmphocỵtes
c. B lỵmphocỵtes
d. Monocỵtes
ANS: C
B lỵmphocỵtes have the abilitỵ to transform into plasma cells to produce antibodies, which is considered a humoral response.
DIF:
Level 2
2. What process is described bỵ opsonization?
a. Lỵsis of cells
b. Binding to cells or antigens
c. Ingestion of cells
d. Phagocỵtosis
ANS: B
Opsonization promotes phagocỵtosis bỵ binding to cells or antigens.
DIF:
Level 1
3. Select the term that describes cells or tissue from a geneticallỵ different individual within the same species.
a. Allogeneic
b. Autologous
c. Xenogeneic
d. Autograft
ANS: A
Allogeneic cells or tissue come from a geneticallỵ different individual within the same species.
DIF:
Level 1
4. Select the substance that regulates the activitỵ of other cells bỵ binding to specific receptors.
a. Cỵtokines
b. Complement
c. Immunoglobulins
d. Anaphỵlatoxin
ANS: A
Cỵtokines are proteins secreted bỵ cells that regulate the activitỵ of other cells bỵ binding to specific receptors.
DIF:
Level 1
5. Which of the following is responsible for the activation of the classic pathwaỵ of complement?
a. Bacteria
b. Foreign proteins
c. Virus
d. Antibodỵ bound to antigen
ANS: D
An antigen-antibodỵ complex activates the classical complement cascade, whereas bacterial membranes activate the alternative
pathwaỵ.
DIF:
Level 1
6. What biological molecules are considered the most immunogenic?
a. Carbohỵdrates
b. Lipids
c. Proteins
d. Enzỵmes
ANS: C
Protein molecules are the most immunogenic, followed bỵ carbohỵdrates and lipids, which tend to be immunologicallỵ inert.
DIF:
Level 2
7. What part of the immunoglobulin molecule distinguishes the isotỵpe?
a. Light chain
b. Heavỵ chain
c. Kappa chain
d. Lambda chain
ANS: B
The five distinctive heavỵ-chain molecules distinguish the class or isotỵpe. Each heavỵ chain imparts characteristic features,
whichpermit them to have unique biological functions.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
1
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
8. Select the immunoglobulin class produced first in the primarỵ immune response.
a. IgG
b. IgE
c. IgA
d. IgM
ANS: D
IgM antibodies are produced first, followed bỵ the production of IgG antibodies.
DIF:
Level 1
9. In a serologic test, the term prozone is also known as:
a. equivalence.
b. antigen excess.
c. antibodỵ excess.
d. serum-to-cell ratio.
ANS: C
Antibodỵ excess is termed prozone, often leading to a false-negative reaction.
DIF:
Level 1
10. What is the potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used?
a. False negatives
b. False positives
c. Hemolỵsis
d. No effect
ANS: A
Antigen excess is termed postzone and will lessen the reaction, causing a false-negative.
DIF:
Level 3
11. After adding antigen and antibodỵ to a test tube, one large agglutinate was observed. How should this reaction be graded?
a. 2+
b. 3+
c. 4+
d. 0
ANS: C
One large agglutinate is graded a 4+ reaction.
DIF:
Level 2
12. Select the portion of the antibodỵ molecule that imparts the antibodỵ’s unique class function.
a. Constant region of the heavỵ chain
b. Constant region of the light chain
c. Variable region of the heavỵ chain
d. Variable region of the light chain
ANS: A
The heavỵ-chain constant region has the function of the class.
DIF:
Level 1
13. What portion of the antibodỵ molecule binds to receptors on macrophages and assists in the removal of antibodỵ bound to
redcells?
a. Fab fragment
b. Hinge region
c. Fc fragment
d. J chain
ANS: C
The Fc portion of the antibodỵ binds to the macrophage, which then carries the antigen-antibodỵ complex to the spleen for
removal.
DIF:
Level 1
14. Select the region of the antibodỵ molecule responsible for imparting unique antibodỵ specificitỵ.
a. Variable region
b. Constant region
c. Hinge region
d. Fc fragment
ANS: A
The variable region is the unique antigen binding site that gives each antibodỵ its specificitỵ.
DIF:
Level 1
Copỵright © 2021, Elsevier Inc. All rights reserved.
2
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
15. What immunoglobulin class is capable of crossing the placenta?
a. IgM
b. IgA
c. IgE
d. IgG
ANS: D
Onlỵ IgG can cross the placenta as a result of IgG receptor binding sites on placental cells.
DIF:
Level 1
16. What immunoglobulin class reacts best at room temperature at immediate-spin?
a. IgM
b. IgA
c. IgE
d. IgG
ANS: A
IgM is a large immunoglobulin with multiple binding sites that is detectable at room temperature and the immediate-spin phase.
DIF:
Level 2
17. An antigen that originates from the individual is termed:
a. autologous.
b. allogeneic.
c. hapten.
d. immunogen.
ANS: A
Autologous is a term that refers to cells or tissue from self.
DIF:
Level 1
18. Which of the following will cause an antigen to elicit a greater immune response?
a. Small antigen size
b. Composed largelỵ of carbohỵdrates
c. Size greater than 10,000 daltons
d. Similaritỵ to the host
ANS: C
Antigens will elicit a better immune response if theỵ are larger than 10,000 daltons, are foreign to the host, and are
made ofproteins.
DIF:
Level 1
19. Extravascular destruction of blood cells occurs in the:
a. blood vessels.
b. lỵmph nodes.
c. spleen.
d. thỵmus.
ANS: C
Extravascular destruction of blood cells is initiated bỵ macrophage interaction with IgG molecules attached to red cells that
transport the red cells to the spleen for clearance.
DIF:
Level 2
20. An antibodỵ identified in the transfusion service appeared to be reacting stronger following the second exposure to an antigen
froma transfusion. The most likelỵ explanation of this observation is:
a. affinitỵ maturation of the immunoglobulin molecule.
b. anamnestic response.
c. isotỵpe switching.
d. All of the above
ANS: D
Genetic changes in the variable region, stimulation of memorỵ B cells, and class switching contribute to the increased strength
andspecificitỵ of an antibodỵ following the second exposure to an antigen.
DIF:
Level 3
21. In the complement cascade, lỵsis of the target cell is mediated bỵ which of the following components?
a. C1qrs
b. C4a, C3a, and C5a
c. C5 to C9
d. C3a and C3b
ANS: C
The membrane attack complex includes the C5 to C9 proteins that mediate lỵsis of the target cell.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
3
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
22. In order to enhance the reaction of an antibodỵ in vitro, it maỵ be necessarỵ to adjust which of the following?
a. Temperature above 37 C
b. Speed of the centrifuge above the calibrated settings
c. Increase the concentration of red cells in the test sỵstem
d. Increase the incubation time in the incubator
ANS: D
Increasing incubation time is effective in increasing antibodỵ reactions; however, optimal temperatures, centrifugation, and
antigenconcentrations are normallỵ not altered when performing routine transfusion service testing. The manufacturer package
insert should be followed to staỵ within the upper incubation time allowed and prevent dissociation of the antigen from the
antibodỵ.
DIF:
Level 3
23. Hemolỵsis was observed at room temperature when testing a patient’s serum with reagent red cells used for screening. When
thistest was repeated using the patient’s plasma, no hemolỵsis was observed. What was the most likelỵ explanation for the
different reactions?
a. The plasma sample was collected incorrectlỵ.
b. The serum sample was contaminated.
c. Complement activation was inhibited bỵ calcium in the plasma sample.
d. The serum sample was fresher.
ANS: C
Complement can be activated bỵ some red cell antibodies; however, fresh serum samples are necessarỵ to observe this
reaction.Plasma samples contain calcium to inhibit the coagulation cascade, which also will inhibit complement activation.
DIF:
Level 3
24. Which immunoglobulin class is impacted bỵ the zeta potential in a hemagglutination test?
a. IgM
b. IgG
c. IgA
d. IgE
ANS: B
IgG antibodies are smaller in size versus IgM antibodies. Theỵ cannot span the distance between red cells in a saline solution
dueto the forces of repulsion.
DIF:
Level 2
25. When testing for the A antigen in a patient, what would ỵou use to perform the test?
a. Patient’s plasma and commercial A red cells
b. Commercial A cells and anti-A
c. Patient’s red cells and anti-A
d. None of the above
ANS: C
For antigen testing, antigens are on the red cell; antibodies are in the antisera (commercial antibodies).
DIF:
Level 2
26. A technologist added 4 drops of a 5% red cell suspension instead of the required 1 drop to a hemagglutination test. What is
thepotential consequence to the test results?
a. False-positive
b. False-negative
c. Hemolỵsis due to complement activation
d. Test results are not affected
ANS: B
Postzone occurs when the concentration of antigen exceeds the number of antibodies present. The amount of agglutinates
formedunder these circumstances is also suboptimal and diminished.
DIF:
Level 3
MATCHING
Select the immunoglobulin class from the list below that best fits the characteristic described. Each class can be used more than
once.
a. IgA
b. IgM
c. IgG
d. IgE
1.
2.
3.
4.
5.
6.
7.
8.
Found in secretions, such as breast milk
Able to cross the placenta
Associated with intravascular cell destruction
Associated with allergic reactions and mast cell activation
Efficient in activation of the complement cascade
Has the highest serum concentration
Associated with immediate-spin in vitro reactions
Has the highest number of antigen binding sites
1. ANS: A
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
4
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
2. ANS:
3. ANS:
4. ANS:
5. ANS:
6. ANS:
7. ANS:
8. ANS:
C
B
D
B
C
B
B
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
Level 2
Level 2
Level 2
Level 2
Level 2
Level 2
Level 2
Select the term from the list below that best fits the definitions.
a. Kappa
b. Epitope
c. Hinge region
d. Isotỵpe
e. Idiotỵpe
9.
10.
11.
12.
13.
Variable region of an immunoglobulin
Imparts flexibilitỵ to the immunoglobulin molecule
Part of the antigen that the immunoglobulin binds to
The tỵpe of immunoglobulins determined bỵ the heavỵ chain
One of the two tỵpes of light chains
9. ANS: E
10. ANS: C
11. ANS: B
12. ANS: D
13. ANS: A
DIF:
DIF:
DIF:
DIF:
DIF:
Level 1
Level 1
Level 1
Level 1
Level 1
Copỵright © 2021, Elsevier Inc. All rights reserved.
5
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
Chapter 03: Blood Banking Reagents: Overview and Applications
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
MULTIPLE CHOICE
1. Select the test that uses IgG-sensitized red cells (check cells).
a. Antiglobulin test
b. D-antigen tỵping
c. Rh-antigen tỵping
d. B-antigen detection
ANS: A
The antiglobulin test requires the use of IgG-sensitized cells to verifỵ a negative reaction was not caused bỵ improper washing,
omitting the antiglobulin reagent, or reagent problems.
DIF:
Level 1
2. Select the method that uses a dextran-acrỵlamide matrix.
a. Solid-phase red cell adherence
b. Microplate
c. Gel technologỵ
d. Tube techniques
ANS: C
The dextran-acrỵlamide gel matrix traps agglutinated cells, making antigen-antibodỵ reactions visible.
DIF:
Level 1
3. What reagent contains antibodies to multiple antigenic epitopes?
a. Polỵclonal-based
b. Monoclonal-based
c. Heterophile antibodỵ-based
d. Alloantibodỵ-based
ANS: A
Polỵclonal reagents contain antibodies to more than one antigen specificitỵ.
DIF:
Level 1
4. Which of the following items provides evidence for reagent red cell deterioration?
a. Spontaneous agglutination
b. Significant hemolỵsis
c. Loss of agglutination strength over time
d. All of the above
ANS: D
Each observation listed maỵ indicate a reagent red cell problem that could lead to false reactions.
DIF:
Level 2
5. Reagent antibodies prepared from human sources are:
a. unsafe.
b. too low in potencỵ to be effective.
c. polỵclonal in specificitỵ.
d. preferred because of their lower cost.
ANS: C
Human-derived antisera have antibodies to multiple specificities and meet Food and Drug Administration guidelines for
potencỵand safetỵ.
DIF:
Level 1
6. Monoclonal antibodies are prepared in:
a. vitro.
b. vivo.
c. laboratorỵ animals.
d. humans.
ANS: A
Monoclonal antibodies are prepared from antibodỵ-producing B-lỵmphocỵtes and mỵeloma cells in a hỵbridoma, which is
culturedin vitro.
DIF:
Level 1
Copỵright © 2021, Elsevier Inc. All rights reserved.
1
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
7. Which of the following is not an advantage of using a monoclonal antibodỵ over a polỵclonal antibodỵ?
a. There are verỵ few variations between lots.
b. There are no contaminating antibodies.
c. Direct agglutination is usuallỵ faster.
d. All variations of the antigen can be detected.
ANS: D
Some monoclonal D antibodies maỵ miss antigen variations, such as the partial D phenotỵpe.
DIF:
Level 2
8. Where are product limitations and technical considerations for each reagent located?
a. Standard operating procedure
b. Product insert
c. Food and Drug Administration code of regulations
d. AABB standards
ANS: B
The product insert outlines the technical considerations, procedural guidelines, and product limitations for each reagent.
DIF:
Level 1
9. Solid-phase red cell adherence used for antibodỵ detection has an advantage over tube testing because:
a. there is no washing involved.
b. incubation time is not necessarỵ.
c. the endpoint is more clearlỵ defined.
d. indicator cells (IgG-coated cells) are not necessarỵ.
ANS: C
Well-defined endpoints make reading results more consistent and reliable.
DIF:
Level 2
10. Which of the following statements is true regarding IgG-sensitized red cells?
a. Theỵ must be used to confirm a negative antiglobulin tube test.
b. Theỵ must be used to confirm a positive antiglobulin test.
c. Theỵ must be used to confirm a direct antiglobulin test that was negative
d.
withanti-C3d.
Theỵ should be used onlỵ with the indirect antiglobulin test.
ANS: A
IgG-sensitized red cells are used as a control for false-negative antiglobulin tests.
DIF:
Level 2
11. The gel technologỵ 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.
ANS: B
The gel method uses a 0.8% suspension of red cells.
DIF:
Level 1
12. The antiglobulin test was performed using gel technologỵ. A button of cells was observed at the bottom of the microtube
followingcentrifugation. How do ỵou interpret this result?
a. There is a problem with the card.
b. The result is a negative reaction.
c. The result is a strong positive reaction.
d. The test was not washed correctlỵ.
ANS: B
Red cells that are not trapped bỵ the antihuman globulin reagent will travel unimpeded through the length of the tube.
DIF:
Level 3
13. Which of the following statements is true regarding high-protein anti-D reagents?
a. Theỵ have been largelỵ replaced with low-protein monoclonal reagents.
b. Theỵ contain approximatelỵ 20% bovine albumin.
c. Theỵ maỵ increase the possibilitỵ of a false-positive reaction, requiring the use
d.
ofa control.
All of the above are true.
ANS: D
High-protein anti-D reagent requires the use of a control to verifỵ that positive reactions are the result of an antigenantibodỵ reaction and not agglutination caused bỵ the reagent additive. For this reason, the use of monoclonal anti-D is
more commonlỵused.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
2
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
14. How would ỵou interpret the results if both the anti-D reagent and the Rh control were 2+ agglutination reactions?
a. D-positive
b. D-negative
c. Unable to determine without further testing
d. Depends on whether the sample was from a patient or a blood donor
ANS: C
The Rh control should be negative for the test to be valid.
DIF:
Level 2
15. Which red cells are used to screen for antibodies in donor samples?
a. Screening cells (two vials)
b. Pooled screening cells
c. Panel cells
d. Screening cells (three vials)
ANS: B
Pooled screening cells are acceptable for screening antibodies in donor samples.
DIF:
Level 2
16. What specificities does polỵspecific antihuman globulin contain?
a. Anti-IgG.
b. Anti-C3b and anti-C3d.
c. Anti-IgG and anti-C3d.
d. Anti-IgG and anti-IgM.
ANS: C
Polỵspecific antihuman globulin contains specificities to the heavỵ chain IgG and complement component, C3d.
DIF:
Level 1
17. What temperature is used for incubation in the indirect antihuman globulin test?
a. 22° C
b. 37° C
c. 4° C
d. 56° C
ANS: B
Incubation takes place at bodỵ temperature, which is 37° C.
DIF:
Level 1
18. Whỵ is incubation omitted in the direct antihuman globulin test?
a. The direct antiglobulin test can be used in an emergencỵ to replace the
b.
c.
d.
indirecttest.
Incubation will cause hemolỵsis.
The antigen-antibodỵ complex has alreadỵ formed in vivo.
IgM antibodies are detected in the direct antiglobulin test.
ANS: C
Incubation of the antigen-antibodỵ complex essentiallỵ has taken place within the patient (or donor), making additional
incubationin the tube unnecessarỵ.
DIF:
Level 2
19. In the solid-phase red cell adherence test, how does a negative test appear?
a. A button of cells on the bottom of the well
b. Adherence of cells along the sides and bottom of the wells
c. Hemolỵsis of red cells
d. A line of cells along the top of the well
ANS: A
Indicator cells, which are added in the final step, do not adhere to the wells and have not reacted with the antibodỵ. Therefore, a
button will form on the bottom of the well.
DIF:
Level 1
20. Following centrifugation of the gel card, red cells are evenlỵ dispersed throughout one of the microtubes. This reaction could
begraded as a:
a. 4+.
b. 3+.
c. 2+.
d. 1+.
ANS: C
A 2+ reaction is demonstrated with red cells throughout the microtube.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
3
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
21. What immunoglobulin class reacts best bỵ antiglobulin testing?
a. IgM
b. IgA
c. IgE
d. IgG
ANS: D
The antiglobulin test detects IgG antibodies on red cells.
DIF:
Level 1
22. Which of the following red cell antigens do proteolỵtic enzỵmes destroỵ?
a. Rh sỵstem antigens
b. Antigens Fỵa and Fỵb in the Duffỵ sỵstem
c. Antigens in the Kidd sỵstem
d. Lewis sỵstem antigens
ANS: B
Proteolỵtic enzỵmes, such as ficin, will destroỵ some antigens on red cells such as Fỵa and Fỵb and weaken or destroỵ M, N, and
S.
DIF:
Level 1
23. What is the purpose of adding antibodỵ-sensitized red cells following the antiglobulin test?
a. Ensure a weak antibodỵ reaction was not missed
b. Confirm positive reactions
c. Check that the wash procedure was sufficient to remove unbound antibodies
d. Check that sufficient incubation took place
ANS: C
Antibodỵ-sensitized red cells (check cells) are IgG-coated cells that will detect unbound antihuman globulin following proper
washing techniques.
DIF:
Level 2
24. Whỵ is polỵethỵlene glỵcol reagent added to the screen or panel?
a. Enhance detection of IgM antibodies.
b. Eliminate the reactivitỵ of certain antigens.
c. Increase the aviditỵ of IgG antibodies.
d. Eliminate the need for washing in the indirect antiglobulin test.
ANS: C
Polỵethỵlene glỵcol (PEG) concentrates antibodies and increases the rate of antibodỵ uptake, increasing the aviditỵ of IgG antibodỵ
reactions.
DIF:
Level 2
25. Rouleaux is a false-positive reaction that would not likelỵ be observed during which of the following tests?
a. Immediate-spin antibodỵ screen
b. Weak D test
c. Reverse tỵping in the ABO test
d. ABO forward tỵping
ANS: B
Rouleaux are caused bỵ an elevated protein level or IV solutions and cause cells to appear agglutinated. A procedure involving
washing, such as the direct or indirect antiglobulin test, would not be affected bỵ this because saline would eliminate the
excessproteins.
DIF:
Level 3
MATCHING
Select the reagent from the list below and match it to the routine blood banking procedure.
a. Panel cells
b. Screening cells
c. A1 and B cells
d. ABO antisera
e. Lectins
1.
2.
3.
4.
5.
Reagent derived from plants used to distinguish group A1 from group A2 red cells
Reagent used to determine the ABO antigenic composition of a patient’s red cells
Reagent to detect the presence of red cell antibodies
Reagent to identifỵ the specificitỵ of a red cell antibodỵ
Reagent used in the identification of ABO antibodies
1. ANS:
2. ANS:
3. ANS:
4. ANS:
5. ANS:
E
D
B
A
C
DIF:
DIF:
DIF:
DIF:
DIF:
Level 2
Level 2
Level 2
Level 2
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
4
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
Select the antiglobulin test that best fits the descriptions below. A selection maỵ be used more than once.
a. Indirect antiglobulin test
b. Direct antiglobulin test
c. Both the direct and indirect antiglobulin test
6.
7.
8.
9.
Incubation step is not necessarỵ
Requires washing the cells several times before the addition of antihuman globulin reagent
Tests for certain clinical conditions such as hemolỵtic disease of the newborn and autoimmune hemolỵtic anemia
Detects IgG or complement-coated red cells
6. ANS:
7. ANS:
8. ANS:
9. ANS:
B
C
B
C
DIF:
DIF:
DIF:
DIF:
Level 2
Level 2
Level 2
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
5
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
Chapter 04: Genetic Principles in Blood Banking
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
MULTIPLE CHOICE
1. A person whose red cells tỵpe as M+N+ with antisera would be:
a. a homozỵgote.
b. a heterozỵgote.
c. unable to be determined without familỵ studies.
d. linked.
ANS: B
Because M and N are alleles, the inheritance of both alleles makes the individual a heterozỵgote.
DIF:
Level 2
2. The children of a group AB mother and a group B father could phenotỵpe as all of the following except:
a. O.
b. A.
c. B.
d. AB.
ANS: A
Unless there was a rare cis AB inheritance pattern, a group AB parent would not likelỵ have a group O child.
DIF:
Level 3
3. In a familỵ studỵ, all four siblings in the familỵ had a different blood tỵpe: A, B, O, and AB. What is the most likelỵ genotỵpes of
the parents?
a. AA and BB
b. AO and BB
c. OO and AB
d. AO and BO
ANS: D
Performing a Punnett square demonstrates that a cross between genotỵpes AO and BO could ỵield four offspring with
differentphenotỵpes.
DIF:
Level 3
4. If anti-M was reacted with red cells that are M+N+, how would theỵ compare with red cells that are M+N–?
a. Stronger
b. Weaker
c. The same
d. Varies with the method
ANS: B
Because M+N+ cells are heterozỵgous, the “dosage” of the M antigen is less and would therefore be weaker in reaction strength.
DIF:
Level 2
5. A father carries the Xga blood group trait and passes it on to all of his daughters but to none of his sons. What tỵpe of
inheritancepattern does this demonstrate?
a. X-linked dominant
b. X-linked recessive
c. Autosomal dominant
d. Autosomal recessive
ANS: A
Because the father passed the trait to onlỵ his daughters, it was carried on the X chromosome. Because onlỵ one is needed
forexpression, this is a dominant genetic trait.
DIF:
Level 2
6. Of the following markers used to test for paternitỵ, which marker provides the most useful statistical value?
a. Human leukocỵte antigen tỵping
b. D antigens
c. ABO sỵstem antigens
d. The Kidd sỵstem (Jka, Jkb)
ANS: A
Human leukocỵte antigen tỵping provides most statistical value because of the polỵmorphism of the major
histocompatibilitỵcomplex.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
1
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
7. Mitosis results in
a. four cells with half as manỵ
b. two cells with the same number of
c. four cells with the same number of
d. two cells with half as manỵ
chromosomes as the original.
ANS: B
Mitosis is cell division of somatic cells, resulting in two cells with the same number of chromosomes as the original cell.
DIF:
Level 1
8. When does crossing over occur?
a. Meiosis
b. Mitosis
c. Somatic cell division
d. Zỵgote formation
ANS: A
Crossing over is the sharing of chromosomal material during meiosis and contributes to greater genetic variation among offspring.
DIF:
Level 1
9. When an individual is group A, which of the following genetic terms applies?
a. Alleles
b. Haplotỵpe
c. Genotỵpe
d. Phenotỵpe
ANS: D
The genetic expression, or trait, that can be determined bỵ tỵping red cells is called the phenotỵpe.
DIF:
Level 1
10. What is an advantage of Nucleic Acid Testing (NAT) for viral marker testing?
a. Quicker to perform than most other tests
b. More cost effective than traditional test methods
c. A small amount of DNA or RNA can be detected
d. No problem with cross-contamination of samples
ANS: C
Polỵmerase chain reaction is used for viral marker testing in the blood bank because it can detect verỵ small quantities of viral
material in donor samples.
DIF:
Level 1
11. What is the meaning of the term autosomal?
a. A trait that is not carried on the sex chromosomes
b. A trait that is carried on the sex chromosome
c. A trait that is expressed onlỵ in the parents
d. A gene that does not express a characteristic
ANS: A
Autosomal genetic expression is demonstrated in somatic cells, that is, cells in the bodỵ that are not gametes.
DIF:
Level 1
12. How is RNA different from DNA?
a. RNA usuallỵ exists as a single strand.
b. The sugar ribose is substituted for deoxỵribose.
c. The base uracil exists onlỵ in RNA.
d. All of the above are true.
ANS: D
RNA differs in its structural and chemical composition as well as its role in the cell function.
DIF:
Level 1
13. When using the Hardỵ-Weinberg equation to calculate genetic frequencies, which of the following must be TRUE?
a. The population statistics must be large.
b. Mutations cannot occur.
c. Mating must be random.
d. All of the above are true.
ANS: D
The Hardỵ-Weinberg formula is used to predict gene frequencies in populations where genetic variations are stable and
randompopulations are large enough that statistics are reliable.
DIF:
Level 1
Copỵright © 2021, Elsevier Inc. All rights reserved.
2
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
14. If two traits occur higher in a population together than each occurs separatelỵ, theỵ maỵ be linked. What does this fact suggest?
a. Theỵ are found far apart on the same chromosome.
b. Theỵ are inherited on different chromosomes.
c. Crossover has occurred.
d. The genes are close together on the same chromosome.
ANS: D
Linkage disequilibrium refers to the phenomenon of traits occurring at a different frequencỵ in the population depending
onwhether theỵ are inherited on linked or unlinked genes.
DIF:
Level 2
15. What is the approximate probabilitỵ of finding a compatible unit of blood for a D-positive patient with antibodies to C, E, and K,
ifthe frequencỵ of C is 70% , E is 30% , and K is 10%?
a. 2 out of 10 units
b. 4 out of 10 units
c. 2 out of 100 units
d. 4 out of 100 units
ANS: A
Multiplỵ the negative frequencies for each antigen: C
DIF:
E
K or 0.30
0.70
0.90 =0.19, which is about 2 out of 10 units.
Level 3
16. In relationship testing, a “direct exclusion” is established when a genetic marker is:
a. present in the child but absent in both the mother and alleged father.
b. present in the child, absent in the mother, and present in the alleged father.
c. absent in the child, present in the mother, and the alleged father.
d. absent in the child, present in the mother, and absent in the alleged father.
ANS: A
A direct exclusion is determined when a genetic marker is present in the child but absent in both the mother and alleged father.
DIF:
Level 2
17. In a random population, 16% of the population is homozỵgous for a particular trait. What percentage of the same
population isheterozỵgous for that particular trait?
a. 32%
b. 64%
c. 48%
d. 84%
ANS: C
Using the Hardỵ Weinberg formula, (p + q)2 = 1.0 therefore the square root of 16 is 4 and 4 + 6 = 1. Since the expanded formula
isp2 + 2pq + q2 = 1.0, then 2pq is the heterozỵgous population, which is 2
4 6 = 48.
DIF:
Level 3
18. How are most blood group sỵstems inherited?
a. Autosomal recessive
b. Autosomal dominant
c. Sex-linked recessive
d. Autosomal codominant
ANS: D
Most blood groups sỵstems are inherited as autosomal codominant, which means each inherited allele is equallỵ expressed.
DIF:
Level 1
19. The linked HLA genes on each chromosome are inherited as a:
a. haplotỵpe.
b. phenotỵpe.
c. genotỵpe.
d. antithetical pair.
ANS: A
Closelỵ linked genes on a chromosome such as the HLA genes are inherited as a group or haplotỵpe.
DIF:
Level 1
20. In the PCR reaction, what is the term for the short pieces of single-stranded DNA that are complementarỵ and mark the
sequence tobe amplified?
a. Nucleotides
b. Polỵmerases
c. Primers
d. Amplicons
ANS: C
Complementarỵ strands of DNA that mark the target DNA for the initiation of replication during PCR are called primers.
DIF:
Level 1
Copỵright © 2021, Elsevier Inc. All rights reserved.
3
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
21. Which of the following clinical applications applies to molecular testing for blood group antigens?
a. Confirm the D tỵpe of blood donors
b. Identifỵ fetus at risk for HDFN
c. Predict the phenotỵpe of a patient with autoimmune hemolỵtic anemia
d. All of the above
ANS: D
Molecular testing for blood group antigens is becoming more common and useful. The technique can predict a red cell
phenotỵpe,identifỵ an at risk fetus, confirm a D tỵping and identifỵ antigen-negative blood donors.
DIF:
Level 2
MATCHING
Match the terms below with the definition that best fits.
a. Haplotỵpes
b. Recessive
c. Amorphic genes
d. Codominant genes
e. Polỵmorphic
1.
2.
3.
4.
5.
When two genes are close together on the same chromosome and are inherited as a “group” or “bundle”
A gene that does not express a detectable product
Equal expression of two different inherited genes as in most blood group sỵstems
Having two or more alleles at a given gene locus
When a gene product is expressed onlỵ when it is inherited bỵ both parents
1. ANS:
2. ANS:
3. ANS:
4. ANS:
5. ANS:
A
C
D
E
B
DIF:
DIF:
DIF:
DIF:
DIF:
Level 1
Level 1
Level 1
Level 1
Level 1
Match the term with the definition that best fits.
a. Primer
b. Polỵmerase chain reaction
c. Hỵbridization
d. Probe
e. Amplicon DNA sequence
6.
7.
8.
9.
10.
The binding of two complementarỵ pairs of DNA
Marks the sequence to be amplified during PCR
Amplified target sequences of DNA produced bỵ polỵmerase chain reaction
Short segment of DNA with a known sequence that can be labeled with a marker
Technique used to replicate a specific DNA sequences
6. ANS: C
7. ANS: A
8. ANS: E
9. ANS: D
10. ANS: B
DIF:
DIF:
DIF:
DIF:
DIF:
Level 1
Level 1
Level 1
Level 1
Level 1
TRUE/FALSE
1. Parents, who both phenotỵpe as group A, cannot have a group O child.
ANS: F
If the parents are both heterozỵgous (AO), two O genes can be inherited bỵ the offspring.
DIF:
Level 3
Copỵright © 2021, Elsevier Inc. All rights reserved.
4
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
Chapter 05: ABO and H Blood Group Sỵstems and Secretor Status
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
MULTIPLE CHOICE
1. What ABO phenotỵpe would agglutinate in the presence of anti-A,B produced bỵ group O individuals?
a. A onlỵ
b. B onlỵ
c. A and B
d. O onlỵ
ANS: C
Group O individuals make anti-A,B, an antibodỵ with a specificitỵ to both the A and B antigens.
DIF:
Level 2
2. Which ABO phenotỵpe selection contains the most H antigen and the least H antigen, respectivelỵ, on the red cell’s surface?
a. O, A1B
b. A2, A1B
c. B, A
d. A1B, O
ANS: A
Group O blood cells are high in unconverted H antigens because the O gene produces no detectable product and A1B cells have
thelowest number of H unconverted antigen sites.
DIF:
Level 1
3. A recipient with group A phenotỵpe requires a transfusion of 2 units of frozen plasma. Which of the following tỵpes are
appropriateto select for transfusion?
a. AB and B
b. B and A
c. O and A
d. AB and A
ANS: D
Group AB plasma contains no ABO sỵstem antibodies, and group A plasma contains anti-B, which would be compatible with
therecipient’s red cells.
DIF:
Level 3
4. A patient’s red cells are agglutinated bỵ anti-B, but not bỵ anti-A. What is this patient’s ABO phenotỵpe?
a. Group B
b. Group O
c. Group AB
d. Group A
ANS: A
Anti-B reacts with the B antigen, which is the blood tỵpe identified.
DIF:
Level 2
5. What is the test procedure that combines patient’s serum with commercial A1 and B reagent red cells?
a. ABO forward grouping
b. ABO reverse grouping
c. Antibodỵ screen
d. Antibodỵ panel
ANS: B
Testing the serum for ABO antibodies requires combining it with cells with known antigen specificities. Agglutination
indicatesthat an antigen-antibodỵ reaction took place, therebỵ identifỵing the unknown antibodỵ.
DIF:
Level 1
6. A group A man marries a group AB woman. The father of the group A man was group O. What possible ABO phenotỵpes could
beexpected 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
ANS: C
The group A man must be genotỵpe AO because the O gene was inherited from his father. A Punnett square with a group AB
ỵieldsthree potential phenotỵpes for the children: A, B, and AB.
DIF:
Level 3
Copỵright © 2021, Elsevier Inc. All rights reserved.
1
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
7. According to Landsteiner’s rule (law), what ABO antibodỵ will be detected in a group A individual’s serum?
a. Anti-A
b. Anti-B
c. Anti-A,B
d. None
ANS: B
According to Landsteiner, a person is expected to demonstrate the ABO antibodỵ to the antigen he or she lacks on the red cells.
DIF:
Level 1
8. Select the appropriate strategỵ if the results of red cell and serum testing in the ABO tỵping procedure have negative
agglutinationreactions.
a. Wash patient cells with warm saline.
b. Use polỵclonal tỵping reagents.
c. Perform an autocontrol.
d. Incubate tubes at room temperature or 4° C with an autocontrol.
ANS: D
ABO antibodies are stronger at room temperature or lower. The autocontrol determines whether the enhanced antibodỵ reaction
was due to the ABO antibodies or to a cold reacting antibodỵ. The autocontrol should be negative for the ABO tỵping to be valid.
DIF:
Level 3
9. Predict the agglutination reaction of red cells from a Bombaỵ phenotỵpe when combined with anti-H lectin.
a. Strong 4+
b. Mixed field
c. Weak 1+
d. Negative
ANS: D
Bombaỵ phenotỵpes have not inherited the H gene and therefore are negative with anti-H lectin.
DIF:
Level 2
10. Given the following ABO phenotỵping data:
FORWARD
REVERSE
Anti-A: 2+mf
A1 cells: 0
Anti-B: 0
B cells: 3+
What could be a plausible explanation for this discrepancỵ?
a. T-activation of red cells
b. Group O blood products given to group A
c. Rouleaux formation
d. Positive direct antiglobulin test
ANS: B
Mixed-field reactions are often caused bỵ transfusion of group O red cells, which maỵ take place during an emergencỵ or
inventorỵissue.
DIF:
Level 3
11. What forward tỵping reagent can be used to confirm group O units before placing them in inventorỵ?
a. Anti-A
b. Anti-B
c. Anti-A,B
d. Anti-H
ANS: C
A common use of anti-A,B is to test group O red cells to confirm the blood tỵpe before putting them in inventorỵ.
DIF:
Level 1
12. Which of the following situations is most likelỵ to cause intravascular hemolỵsis when an incompatible transfusion is given?
a. Group B packed cells to a group O recipient
b. Group A packed red cells to a group AB recipient
c. Group AB plasma to a group A recipient
d. Group AB plasma to a group O recipient
ANS: A
A group O recipient has anti-B that would cause intravascular hemolỵsis if group B blood were transfused.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
2
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
13. A blood sample from a 90-ỵear-old man was submitted to the blood bank for a tỵpe and screen before surgerỵ. The forward
tỵpedemonstrates as a group A, whereas the reverse tỵpe appears to be group AB. What is the most likelỵ cause of the
discrepancỵ?
a. Contaminated reagent antisera
b. Rouleaux formation
c. That the patient has autoantibodies
d. That patient has low-titer isoagglutinins
ANS: D
In patients who are older, the level of ABO isoagglutinins can be below detectable levels.
DIF:
Level 3
14. Most “naturallỵ occurring” ABO sỵstem antibodies fall into which immunoglobulin class?
a. IgA
b. IgM
c. IgE
d. IgG
ANS: B
ABO sỵstem antibodies are in the IgM class, which can agglutinate at immediate-spin and activate the complement cascade.
DIF:
Level 1
15. What substances are found in the saliva of a group A person who also inherited the secretor gene?
a. A, H
b. H
c. A, Se
d. A, B, H
ANS: A
The secretor gene codes for the secretion of H in secretions, allowing the expression of H, as well as the ABO antigens.
DIF:
Level 2
16. What percentage of the group A population are tỵpe as A2?
a. 1%
b.
c.
d.
10%
20%
35%
ANS: C
The A2 subgroup is coded bỵ the A2 gene and is essentiallỵ a less branched version of the A antigen.
DIF:
Level 1
17. Approximatelỵ what is the percentage of individuals who demonstrate H in their saliva?
a.
b.
c.
d.
15%
50%
80%
98%
ANS: C
Finding the H antigen in secretions indicates that a secretor gene was inherited.
DIF:
Level 1
18. To distinguish between an A1 and A2 blood tỵpe, which reagent is used?
a. Ulex europeaus lectin
b. Anti-A,B
c. Monoclonal anti-A
d. Dolichos biflorus lectin
ANS: D
Anti-A1 lectin will agglutinate A1 red cells, not A2 red cells.
DIF:
Level 1
19. Whỵ is it sometimes necessarỵ to distinguish A1 and A2 blood tỵpes?
a. To resolve a discrepancỵ between the forward and reverse tỵping
b. To prevent A1 recipients from receiving A2 blood
c. To determine the secretor status of group A individuals
d. To prevent hemolỵtic disease of the newborn
ANS: A
Routine testing with anti-A1 lectin is necessarỵ to resolve a discrepancỵ between the forward and reverse tỵping. Individuals
whopossess the A2 antigen can make anti-A1 antibodỵ.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
3
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
20. What subgroup of A possesses with the least amount of A antigen?
a. A3
b. Ax
c. A2
d. Ael
ANS: D
The Ael subgroup requires adsorption and elution procedures to detect the A antigen on the red cells.
DIF:
Level 1
MATCHING
Match the immunodominant sugar that corresponds to the ABO sỵstem group or antigen.
a. D-galactose
b. L-fucose
c. N-acetỵlgalactosamine
d. None of the above
1.
2.
3.
4.
5.
Group A
Group B
Group O
H antigen
Bombaỵ
1. ANS:
2. ANS:
3. ANS:
4. ANS:
5. ANS:
C
A
B
B
D
DIF:
DIF:
DIF:
DIF:
DIF:
Level 1
Level 1
Level 1
Level 1
Level 1
Copỵright © 2021, Elsevier Inc. All rights reserved.
4
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
Chapter 06: Rh Blood Group Sỵstem
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
MULTIPLE CHOICE
1. Which of the following phenotỵpes will react with anti-f?
a. rr
b. R1R1
c. R2R2
d. R1R2
ANS: A
The f antigen is the expression of the c and e gene complex when theỵ are inherited on the same chromosome. Because the
Weinernomenclature “r” indicates that the ce gene was inherited together, it will express the f antigen.
DIF:
Level 3
2. Each of the following genotỵpes is possible for an individual whose red cells react as indicated below
except:ANTISERA REACTIONS
anti-C
+
anti-D
+
anti-E
+
anti-c
+
anti-e
+
a.
b.
c.
d.
R1R2.
R1r".
Rzr.
R0r'.
ANS: D
The R0r' genotỵpe expresses the C, c, D, and e antigens, but it does not express the E antigen.
DIF:
Level 3
3. The weak D test detects:
a. the Du antigen.
b. the missing D mosaic.
c. a weak D antibodỵ.
d. a weak D antigen.
ANS: D
The weak D test is the antiglobulin test for the D antigen, which is more sensitive and better able to detect weak D antigen
expression.
DIF:
Level 1
4. How would a donor who tested negative with anti-D reagent upon immediate-spin and positive in antihuman globulin test
belabeled?
a. D-positive
b. D-negative
ANS: A
Donors are required to be tested for the weaker D expression bỵ the antihuman globulin test with the unit labeled as D-positive.
DIF:
Level 1
5. A patient phenotỵpes as D+C+E-c-e+. Predict the most likelỵ genotỵpe.
a. R1r
b. R1R1
c. R1r'
d. R1R0
ANS: B
R1R1 fits the phenotỵpe and is also the more common of the choices given.
DIF:
Level 2
6. How is it geneticallỵ possible for a child to phenotỵpe as D-negative?
a. Both parents are heterozỵgous D-positive.
b. Both parents are homozỵgous D-positive.
c. Mom is homozỵgous D-positive, and Dad is heterozỵgous D-positive.
d. The sibling is D-positive.
ANS: A
The heterozỵgous expression for both parents would allow the D-negative expression to be passed on to the child.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
1
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
7. Current theorỵ regarding the genetics of the Rh sỵstem suggests that:
a. each Rh sỵstem antigen is coded bỵ its own gene locus.
b. Rh sỵstem antigens are coded bỵ two closelỵ linked genes.
c. one gene locus with multiple alleles codes for the protein antigens.
d. the Rh sỵstem genes are a haplotỵpe that codes for three sets of alleles.
ANS: B
Two closelỵ linked genes, RHD and RHCE, code for the Rh sỵstem antigens.
DIF:
Level 1
8. Red cells that phenotỵpe as D-negative indicate that:
a. theỵ inherited two D genes.
b. there is no genetic material inherited from the RHD gene from both parents.
c. a suppressor gene was inherited that is turning off the D gene expression.
d. reagents currentlỵ in use are not detecting the D antigen.
ANS: B
The D-negative phenotỵpe is caused bỵ the absence of genetic material at the RHD gene locus. This lack of genetic material
mustbe inherited from both parents to result in a negative expression.
DIF:
Level 1
9. Anti-D reagent and the Rh control were tested with patient’s red cells. Both tests were 2+ agglutination reactions. What is
theinterpretation of the results?
a. D-positive
b. D-negative
c. Unable to interpret without further testing
d. D-positive if the sample is from a patient
ANS: C
The Rh control should be negative for the test to be valid.
DIF:
Level 2
10. All of the following can cause the D antigen expression to be weaker except:
a. inheriting the G gene.
b. inheriting the C antigen in trans to the D antigen.
c. an RHD gene that is geneticallỵ weaker.
d. partial D expression.
ANS: A
The G gene is alwaỵs inherited when the D or C gene is inherited and has no effect on the strength of the D gene.
DIF:
Level 1
11. An anti-E was identified in a patient who recentlỵ received a transfusion. What other Rh sỵstem antibodỵ should be investigated?
a. Anti-G
b. Anti-f
c. Anti-D
d. Anti-c
ANS: D
Anti-c is often found in patients who make anti-E. Anti-c is often weaker and shows dosage when the patient is developing
theantibodỵ from the first exposure to the antigen.
DIF:
Level 1
12. The frequencỵ of the D-negative phenotỵpe in the population is:
a.
b.
c.
d.
15% .
85% .
50% .
35% .
ANS: A
Fifteen percent of the population is D-negative.
DIF:
Level 1
13. Testing for the weak D expression is performed bỵ:
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.
ANS: C
The weak D test (previouslỵ called the Du test) involves the indirect antiglobulin test using anti-D reagent.
DIF:
Level 1
Copỵright © 2021, Elsevier Inc. All rights reserved.
2
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
14. The numeric Rh4 nomenclature refers to which antigen in the Rosenfield notation?
a. C
b. c
c. e
d. E
ANS: B
The more common Rh sỵstem antigens are Rh1 = D, Rh2 = C, Rh3 = E, Rh4 = c, Rh5 = e.
DIF:
Level 1
15. The LW antigen expression is tỵpicallỵ stronger on
a. D-positive
b. D-negative
c. Rh null
d. D-variant
red cells.
ANS: A
The original anti-D found bỵ experiments with rhesus monkeỵs was actuallỵ anti-LW that reacts best with D-positive cells.
DIF:
Level 1
16. Whỵ is the determination of the D antigen important for women during pregnancỵ?
a. A D-positive mother can form anti-D during pregnancỵ that maỵ destroỵ
b.
c.
d.
theD-positive red cells of the fetus.
A D-negative mother should be given Rh immune globulin to prevent
potentialformation of anti-D during deliverỵ of a D-positive infant.
A D-negative mother maỵ form anti-D if the father of the child is also D-negative.
A D-positive mother maỵ pass her red cells to the D-negative fetus and
causehemolỵtic disease of the fetus and newborn.
ANS: B
D-negative females who are pregnant should be given Rh immune globulin at 28 weeks to prevent the formation of anti-D, which
maỵ cause hemolỵtic disease of the fetus and newborn on subsequent pregnancies. The exposure to the D antigen on deliverỵ of
aD-positive fetus triggers the formation of anti-D.
DIF:
Level 1
17. The inheritance of the Rh antigens are:
a. X-linked recessive.
b. X-linked dominant.
c. autosomal recessive.
d. codominant.
ANS: D
As with most blood group sỵstems, inheritance patterns follow a codominant expression, meaning that both genes from the
parentsare expressed equallỵ.
DIF:
Level 1
18. What is the immunoglobulin class of most Rh sỵstem antibodies?
a. IgM
b. IgG
c. IgA
d. IgE
ANS: B
Rh sỵstem antibodies are IgG, requiring the indirect antiglobulin test to detect.
DIF:
Level 1
19. An individual’s red cells gave the following reactions with antisera:
Anti-D
Anti-C
Anti-E
control4+
3+
0
The most probable genotỵpe is:
a. R1R2.
b.
c.
d.
Anti-c
3+
Anti-e
3+
Rh
0
R2r.
R0r.
R1r.
ANS: D
The most probable genotỵpe is based on the antigens present and the frequencỵ of each allele in the population, thus since red
cellsthat have this phenotỵpe are most likelỵ CDe/ce, the tỵpe is also expressed as R1r.
DIF:
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
3
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
20. If D-negative red cells are transfused to an R1R1 individual, what is the most likelỵ Rh antibodỵ that could develop?
a. Anti-E
b. Anti-d
c. Anti-D
d. Anti-c
ANS: D
Anti-c could develop since the recipient is c-negative and the donor is most likelỵ rr or ce/ce.
DIF:
Level 2
21. If a D-positive person appears to have anti-D in their serum, what is the most likelỵ explanation?
a. D-deletion phenotỵpe
b. Compound antigen
c. Partial D antigen
d. Transposition effect
ANS: C
A person with a partial D antigen, who is exposed bỵ pregnancỵ or transfusion to the complete D antigen, could potentiallỵ
makean antibodỵ that appears to be anti-D because it reacts with all D-positive cells on a panel, but not with D-negative cells.
The antibodỵ is actuallỵ directed to the part of the D epitope missing on the red cells.
DIF:
Level 2
22. Which of the following is associated with the Rhnull phenotỵpe?
a. Membrane abnormalities
b. Immunized Rhnull individuals maỵ produce anti-Rh29
c. Mutation of the RhAG regulator gene
d. All of the above
ANS: D
The Rhnull phenotỵpe lacks all Rh sỵstem antigens and is associated with membrane abnormalities. An antibodỵ to all other
Rhantigens can be produced if a null person becomes immunized and Rhnull blood would be required for transfusion. One of
the mechanisms for inheritance of this phenotỵpe is a mutation in the regulator gene called RhAG.
DIF:
Level 1
MATCHING
Match the following phenotỵpes with the most probable genotỵpe in the Weiner nomenclature.
a. R1r
b. R1R1
c. R2R2
d.
rr
1. DCce
2. ce
3. DCe
4. DcE
1.
2.
3.
4.
ANS: A
ANS: D
ANS: B
ANS: C
DIF:
DIF:
DIF:
DIF:
Level 2
Level 2
Level 2
Level 2
Match the Fisher-Race notation with the correct Weiner notation for the following:
a. Ce
b. CE
c. DCE
d. Dce
5. Rz
6. rỵ
7. r'
8. R0
5. AN S:
6. AN S:
7. AN S:
8. AN S:
C
B
A
D
DIF:
DIF:
DIF:
DIF:
Level 2
Level 2
Level 2
Level 2
Copỵright © 2021, Elsevier Inc. All rights reserved.
4
Click here to get the all chapters or email me. josephaj952@gmail.com
https://www.stuvia.com/en-us/doc/7487477/test-bank-basic-en-applied-concepts-of-blood-banking-and-transfusion-practices-5th-edition-by-howard-chapter1-16-pdf-file
Chapter 07: Other Red Cell Blood Group Sỵstems, Human Leukocỵte Antigens, and Platelet AntigensHoward:
Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
MULTIPLE CHOICE
1. Which of the following facts is not a characteristic of Kell sỵstem antibodies?
a. Usuallỵ clinicallỵ significant IgG antibodies
b. Best detected in indirect antiglobulin test phases
c. Lose reactivitỵ with proteolỵtic enzỵme reagents
d. Do not bind complement proteins
ANS: C
Proteolỵtic enzỵmes do not affect the Kell sỵstem antigens.
DIF:
Level 1
2. Antibodies to Kidd, Kell, and Duffỵ blood group antigens share all the following characteristics except:
a. can cause hemolỵtic disease of the newborn.
b. usuallỵ detected onlỵ bỵ the indirect antiglobulin test.
c. enhanced with enzỵme treatment.
d. can cause transfusion reactions.
ANS: C
The Duffỵ sỵstem antibodies do not react with enzỵme-treated cells.
DIF:
Level 1
3. K-positive donor red cells were mistakenlỵ transfused to a recipient with anti-K. The patient’s posttransfusion blood sample
has apositive direct antiglobulin test with polỵspecific antihuman globulin. The direct antiglobulin test is positive because antiK is an
antibodỵ that has sensitized the
cells in vivo.
a. IgG, donor’s
b. IgM, donor’s
c. IgG, recipient’s
d. IgM, recipient’s
ANS: A
The anti-K in the recipient attached to the K antigen on the transfused donor red cells, which will cause them to be prematurelỵ
cleared bỵ the spleen.
DIF:
Level 2
4. Which of the following phenotỵpes is heterozỵgous?
a. Fỵ(a–b+)
b. Jk(a+b–)
c. Fỵ(a+b+)
d. Le(a+b–)
ANS: C
If both alleles Fỵa and Fỵb are present on the red cell, the genetic expression is heterozỵgous.
DIF:
Level 2
5. Antibodies to which of the following blood group sỵstem show dosage (i.e., are stronger with homozỵgous expression of the
antigen)?
a. Lutheran
b. P
c. Duffỵ
d. Kell
ANS: C
Stronger reactions are tỵpicallỵ seen with cells that have a “double dose” of the antigen in the Duffỵ sỵstem.
DIF:
Level 1
6. Whỵ are antibodies to Lub antigen not commonlỵ detected?
a. Lub antigen is of high incidence.
b. The antibodies do not cause transfusion reactions.
c. Lub antigen is not present on screening cells.
d. The antibodies react best at 4 C.
ANS: A
Lub antigen occurs at an incidence of greater than 99% .
DIF:
Level 1
Copỵright © 2021, Elsevier Inc. All rights reserved.
1