Blood Bank : Blood Product & Blood Group Systems Quiz: Exam!

1. The test that is currently used to detect donors who are infected with the AIDS virus is:

Anti-HBc

Anti-HIV 1,2

HBsAg

ALT

The causative agent for AIDS is the human immunodeficiency virus types 1
and 2.

Explanation

The causative agent for AIDS is the human immunodeficiency virus types 1
and 2.

2. A commonly used screening method for anti-HIV-1 detection is:

Latex agglutination

Radioimmunoassay (RIA)

Thin-layer-chromatography (TLC)

Enzyme-labeled immunosorbent assay (ELISA)

The enzyme-labeled immunosorbent assay (ELISA) method is a very sensitive method employed to screen donors for markers of transfusion-transmitted viruses.

Explanation

The enzyme-labeled immunosorbent assay (ELISA) method is a very sensitive method employed to screen donors for markers of transfusion-transmitted viruses.

3. A father donating Platelets for his son is connected to a continuous flow machine, which uses the principle of centrifugation to separate Platelets from Whole Blood. As the Platelets are harvested, all other remaining elements are returned to the donor. This method offers Platelet collection is known as:

Apheresis

Autologous

Homologous

Fractionation

The apheresis process is to remove whole blood, the desired component removed, and the remaining portion of blood returned to the donor/patient.

Explanation

The apheresis process is to remove whole blood, the desired component removed, and the remaining portion of blood returned to the donor/patient.

4. The most common cause of posttransfusion hepatitis can be detected in donors by testing for:

Anti-HCV

HBsAg

Anti-HAV IgM

Anti-HBe

The most common posttransfusion hepatitis is hepatitis B. The estimated risk of transmission is 1:220,000 units transfused. The risk of hepatitis C transmission is 1:1,800,000 units. Hepatitis B surface
antigen (HBsAg) is a required donor test for
detection of acute or chronic HBV infection.

Explanation

The most common posttransfusion hepatitis is hepatitis B. The estimated risk of transmission is 1:220,000 units transfused. The risk of hepatitis C transmission is 1:1,800,000 units. Hepatitis B surface
antigen (HBsAg) is a required donor test for
detection of acute or chronic HBV infection.

5. Human blood groups were discovered around 1900 by:

Jules Bordet

Louis Pasteur

Karl Landsteiner

PL Mollison

The ABO blood group system was discovered by Karl Landsteiner.

Explanation

The ABO blood group system was discovered by Karl Landsteiner.

6. According to AABB standards, Fresh Frozen Plasma must be infused within what period of time following thawing?

24 hours

36 hours

48 hours

72 hours

Per AABB standards, thawed FFP should be stored at 1 ° -6°C for no more than
24 hours.

Explanation

Per AABB standards, thawed FFP should be stored at 1 ° -6°C for no more than
24 hours.

7. Which one of the following constitutes permanent rejection status of a donor?

A tattoo 5 months previously

Recent close contact with a patient with viral hepatitis

2 units of blood transfused 4 months previously

Confirmed positive test for HBsAg 10 years previously

A positive test for HbsAg at any time is an indefinite deferral.

Explanation

A positive test for HbsAg at any time is an indefinite deferral.

8. In a quality assurance program, Cryoprecipitated AHF must contain a minimum of how many international units of Factor VIII?

60

70

80

90

FDA requires that 4 representative units be tested each month for Factor VIII levels of 80 IU or higher. If the average value is less than 80 IU of Factor VIII, corrective action must be taken.

Explanation

FDA requires that 4 representative units be tested each month for Factor VIII levels of 80 IU or higher. If the average value is less than 80 IU of Factor VIII, corrective action must be taken.

9. The optimum storage temperature for platelets is:

- 20°C

- 12°C

4°C

22°C

The required temperature for storage of platelets is 20' -24°C.

Explanation

The required temperature for storage of platelets is 20' -24°C.

10. In the liquid state, plasma must be stored at:

1°- 6°C

22°c

37°C

56°c

The required temperature for storage of thawed plasma is 1°- 6°C.

Explanation

The required temperature for storage of thawed plasma is 1°- 6°C.

11. Cryoprecipitated AHF contains how many units of Factor VIII?

40

80

130

250

Cryoprecipitate contains at least 80 units of AHF.

Explanation

Cryoprecipitate contains at least 80 units of AHF.

12. According to AABB Standards, Platelets prepared from Whole Blood shall have at least:

5.5 x 1010 platelets per unit in at least 90% of the units tested

6.5 x 1110 platelets per unit in 90% of the units tested

7.5 x 1010 platelets per unit in 100% of the units tested

8.5 x 1010 platelets per unit in 95% of the units tested

Per AABB standards, at least 90% of the platelet units prepared from Whole Blood that are sampled must contain at least
5.5 x 10¹⁰ platelets.

Explanation

Per AABB standards, at least 90% of the platelet units prepared from Whole Blood that are sampled must contain at least
5.5 x 10¹⁰ platelets.

13. A unit of Red Blood Cells expiring in 35 days is split into 5 small aliquots using a sterile pediatric quad set and a sterile connecting device. Each aliquot must be labeled as expiring in:

6 hours

12 hours

5 days

35 days

Sterile docking devices allow entry into donor units without affecting the expiration date of the product.

Explanation

Sterile docking devices allow entry into donor units without affecting the expiration date of the product.

14. Which of the following blood components contains the most Factor VIII concentration relative to volume?

Single-Donor Plasma

Cryoprecipitated AHF

Fresh Frozen Plasma

Platelets

Cryoprecipitated AHF contains at least 80 IU of Factor VIII concentrated in about 10 mL of plasma.

Explanation

Cryoprecipitated AHF contains at least 80 IU of Factor VIII concentrated in about 10 mL of plasma.

15. Prior to blood donation, the intended venipuncture site must be cleaned with a scrubsolution containing:

Hypochlorite

Isopropyl alcohol

10% aceton

PVP iodine complex

The scrub must use iodine, eg, PVP iodine complex. Donors who are sensitive to iodine can have the area cleaned with a preparation of 2% chlorhexidine and 70% isopropyl alcohol.

Explanation

The scrub must use iodine, eg, PVP iodine complex. Donors who are sensitive to iodine can have the area cleaned with a preparation of 2% chlorhexidine and 70% isopropyl alcohol.

16. Which of the following is proper procedure for preparation of Platelets from Whole Blood?

Light spin followed by a hard spin

Light spin followed by 2 hard spins

2 light spins

Hard spin followed by a light spin

Whole blood-derived Platelets are prepared by a light spin to separate the Red Blood Cells from the platelet-rich plasma (PRP), followed by a heavy spin of the PRP to concentrate the platelets.

Explanation

Whole blood-derived Platelets are prepared by a light spin to separate the Red Blood Cells from the platelet-rich plasma (PRP), followed by a heavy spin of the PRP to concentrate the platelets.

17. The Western blot is a confirmatory test for the presence of:

CMV antibody

Anti-HIV-1

HBsAg

Serum protein abnormalities

Western blot uses purified HIV proteins to confirm reactilrity in samples whose screening test for anti-HIV is positive.

Explanation

Western blot uses purified HIV proteins to confirm reactilrity in samples whose screening test for anti-HIV is positive.

18. According to AABB standards, Platelets must be:

Gently agitated if stored at room temperature

Separated within 12 hours of Whole Blood collection

Suspended in sufficient plasma to maintain a pH of 5.0 or lower

Prepared only from Whole Blood units that have been stored at 4°C for 6 hours

Per AABB standards, store Platelets at 20°-24°C with continuous agitation. Platelets must be separated from Whole Blood units and maintained at a
temperature of at least 20°C. The pH must be at least 6.2 at the end of the storage time.

Explanation

Per AABB standards, store Platelets at 20°-24°C with continuous agitation. Platelets must be separated from Whole Blood units and maintained at a
temperature of at least 20°C. The pH must be at least 6.2 at the end of the storage time.

19. Resistance to malaria is best associated with which of the following blood groups?

Rh

I/i

P

Duffy

The Duffy glycoprotein on red cells is a receptor for the malarial parasite Plasmodium vivax. Red cells with the phenotype Fy(a-b- ) are resistant to invasion by P vivax.

Explanation

The Duffy glycoprotein on red cells is a receptor for the malarial parasite Plasmodium vivax. Red cells with the phenotype Fy(a-b- ) are resistant to invasion by P vivax.

20. If the seal is entered on a unit of Red Blood Cells stored at 1 °C to 6°C, what is the maximum allowable storage period, in hours?

6

24

48

72

If the seal is broken during processing, components are considered to be prepared in an open system, rather than a closed system. The expiration time for Red Blood Cells in an open system is 24 hours.

Explanation

If the seal is broken during processing, components are considered to be prepared in an open system, rather than a closed system. The expiration time for Red Blood Cells in an open system is 24 hours.

21. An important determinant of platelet viability following storage is:

Plasma potassium concentration

Plasma pH

Prothrombin time

Activated partial thromboplastin time

The pH of platelets should be maintained at 6.2 or above throughout the storage period.

Explanation

The pH of platelets should be maintained at 6.2 or above throughout the storage period.

22. For apheresis donors who donate platelets more frequently than every 4 weeks, a platelet count must be performed prior to the procedure and be at least:

150 x 103/μL (150 x 109/L)

200 x 103/ μL (200 x 109/L)

250 x 103/μL (250 x 109/L)

300 x 103/ μL (300 x 109/L)

The minimum platelet count required for frequent repeat donors is 150 x 10³/μL (150 x 10⁹/L). A platelet count is not required prior to the first donation or if the interval between donations is at least 4 weeks.

Explanation

The minimum platelet count required for frequent repeat donors is 150 x 10³/μL (150 x 10⁹/L). A platelet count is not required prior to the first donation or if the interval between donations is at least 4 weeks.

23. Which one do you like?

Option 1

Option 2

Option 3

Option 4

not-available-via-ai

Explanation

not-available-via-ai

24. Even in the absence of prior transfusion or pregnancy, individuals with the Bombay phenotype (O^h) will always have naturally occurring:

Anti-Rh

Anti-K0

Anti-U

Anti-H

Bombay phenotypes ( O^h) lack H antigen on their red cells, and produce naturally occurring anti-H in their serum.

Explanation

Bombay phenotypes ( O^h) lack H antigen on their red cells, and produce naturally occurring anti-H in their serum.

25. To qualify as a donor for autologous transfusion a patient's hemoglobin should be at least:

8 g/dL (80 g/L)

11 g/dL (110 g/L)

13 g/dL (130 g/L)

15 g/dL (150 g/L)

Autologous donors have less stringent criteria than allogeneic donors. Donations must be collected at least 72 hours prior to surgery.

Explanation

Autologous donors have less stringent criteria than allogeneic donors. Donations must be collected at least 72 hours prior to surgery.

26. Which of the following prospective donors would be accepted for donation?

32-year-old woman who received a transfusion in a complicated delivery 5 months previously

19-year-old sailor who has been stateside for 9 months and stopped taking his anti-malarial medication 9 months previously

22-year-old college student who has a temperature of 99.2°F (37.3°C) and states that he feels well, but is nervous about donating

45-year-old woman who has just recovered from a bladder infection and is still taking antibiotics

The receipt of blood products is a 6-month deferral, the deferral for travel to areas endemic for malaria is 12 months regardless of antimalarial prophylaxis,
and a person taking antibiotics may have bacteremia. The requirement for
temperature is not over 37.5°C or 99.5°F.

Explanation

The receipt of blood products is a 6-month deferral, the deferral for travel to areas endemic for malaria is 12 months regardless of antimalarial prophylaxis,
and a person taking antibiotics may have bacteremia. The requirement for
temperature is not over 37.5°C or 99.5°F.

27. Platelets prepared in a polyolefin type container, stored at 22° -24°C in 50 mL of plasma, and gently agitated can be used for up to:

24 hours

48 hours

3 days

5 days

Whole Blood-derived platelets are stored at 20' -24 °C with continuous gentle agitation. Platelets prepared by the PRP method may be stored for up to 5 days.

Explanation

Whole Blood-derived platelets are stored at 20' -24 °C with continuous gentle agitation. Platelets prepared by the PRP method may be stored for up to 5 days.

28. The enzyme responsible for conferring H activity on the red cell membrane is alpha-:

Galactosyl transferase

N-acetylgalactosaminyl transferase

L-fucosyl transferase

N-acetylglucosaminyl transferase

Fucose is the immunodominant sugar for H.

Explanation

Fucose is the immunodominant sugar for H.

29. The Kell (Kl) antigen is:

Absent from the red cells of neonates

Strongly immunogenic

Destroyed by enzymes

Has a frequency of 50% in the random population

The Kell antigen is highly immunogenic. It is present on the red cells of up to 9% of adults and neonates, and is not affected by enzymes.

Explanation

The Kell antigen is highly immunogenic. It is present on the red cells of up to 9% of adults and neonates, and is not affected by enzymes.

30. Paroxysmal cold hemoglobinuria (PCH) is associated with antibody specificity toward which of the following?

Kell system antigens

Duffy system antigens

P antigen

I antigen

Autoanti-P, a cold-reactive IgG autoantibody described as a biphasic hemolysin, is associated with paroxysmal cold hemoglobinuria.

Explanation

Autoanti-P, a cold-reactive IgG autoantibody described as a biphasic hemolysin, is associated with paroxysmal cold hemoglobinuria.

31. Rejuvenation of a unit of Red Blood Cells is a method used to:

Remove antibody attached to RBCs

Restore 2,3-DPG and ATP to normal levels

Filter blood clots and other debris

Rejuvenation of RBCs uses additives to restore or enhance 2,3-DPG and ATP levels.

Explanation

Rejuvenation of RBCs uses additives to restore or enhance 2,3-DPG and ATP levels.

32. Unit of packed cells is split into 2 aliquots under closed sterile conditions at 8 AM. The expiration timeline for each aliquot is now:

4 PM on the same day

8 PM on the same day

8 AM the next morning

The original date of the unsplit unit

Sterile docking devices allow entry into donor units without affecting the expiration date of the product.

Explanation

Sterile docking devices allow entry into donor units without affecting the expiration date of the product.

33. Which of the following is the best source of HLA-compatible platelets?

Mother

Father

Siblings

Cousins

If an exact match of HLA-A and HLA-B antigens is necessary, siblings would be
the most likely match , since siblings may have received the same haplotypes from the parents.

Explanation

If an exact match of HLA-A and HLA-B antigens is necessary, siblings would be
the most likely match , since siblings may have received the same haplotypes from the parents.

34. Which one do you like?

Option 1

Option 2

Option 3

Option 4

35. A cause for permanent deferral of blood donation is:

Diabetes

Residence in an endemic malaria region

History of jaundice of uncertain cause

History of therapeutic rabies vaccine

Jaundice is a sign of liver impairment,
which might be due to HBV or HCV.
Infection with HBV and HCV is a cause for
indefinite deferral.

Explanation

Jaundice is a sign of liver impairment,
which might be due to HBV or HCV.
Infection with HBV and HCV is a cause for
indefinite deferral.

36. The optimum storage temperature for cryoprecipitated AHF is:

-20°C

-12°C

4°C

22°C

Cryoprecipitated AHF is stored at-l8°C or lower

Explanation

Cryoprecipitated AHF is stored at-l8°C or lower

37. A blood component prepared by thawing Fresh Frozen Plasma at refrigerator temperature and removing the fluid portion is:

Plasma Protein Fraction

Cryoprecipitated AHF

Factor IX Complex

FP24

Cryoprecipitate is the fraction of plasma proteins that precipitate when FFP is slowly thawed at1°- 6°C.

Explanation

Cryoprecipitate is the fraction of plasma proteins that precipitate when FFP is slowly thawed at1°- 6°C.

38. According to AABB standards, which of the following donors may be accepted as a blood donor?

Traveled to an area endemic for malaria 9 months previously

Spontaneous abortion at 2 months of pregnancy, 3 months previously

Resides with a known hepatitis patient

Received a blood transfusion 22 weeks previously

A woman who had a spontaneous abortion at 2 months of pregnancy, 3 months previously would be acceptable. A donor is acceptable if she has not been pregnant in the previous 6 weeks.

Explanation

A woman who had a spontaneous abortion at 2 months of pregnancy, 3 months previously would be acceptable. A donor is acceptable if she has not been pregnant in the previous 6 weeks.

39. Which of the following is the correct storage temperature for the component ?

Cryoprecipitated AHF, 4°C

Fresh Frozen Plasma (FFP), -20°C

Red Blood Cells, Frozen, - 40°C

Platelets, 37°C

Fresh Frozen Plasma is stored at -l8°C or below for 12 months.

Explanation

Fresh Frozen Plasma is stored at -l8°C or below for 12 months.

40. The minimum hemoglobin concentration in a fingerstick from a male blood donor is:

12.0 g/dL (120 g/L)

12.5 g/dL (125 g/L)

13.5 g/dL (135 g/L)

15.0 g/dL (150 g/L)

All donors, regardless of sex, require
a minimum hemoglobin of 12.5 g/dL
(125 g/L). The value must not be performed
on an earlobe stick.

Explanation

All donors, regardless of sex, require
a minimum hemoglobin of 12.5 g/dL
(125 g/L). The value must not be performed
on an earlobe stick.

41. A unit of Red Blood Cells is issued at 9:00 AM. At 9:10 AM the unit is returned to the Blood Bank. The container has not been entered, but the unit has not been refrigerated during this time span. The best course of action for the technologist is to:

Culture the unit for bacterial contamination

Discard the unit if not used within 24 hours

Store the unit at room temperature

Record the return and place the unit back into inventory

Blood may be returned to the blood bank after issue provided that 1) the container has not been entered, 2) at least 1 sealed segment is attached to the container, 3) visual inspection of the unit is satisfactory and documented, and 4) the unit has been maintained at the appropriate storage or transport temperature. Studies have shown that refrigerated components
retain an acceptable temperature of for up to 30 minutes after removal from
the refrigerator.

Explanation

Blood may be returned to the blood bank after issue provided that 1) the container has not been entered, 2) at least 1 sealed segment is attached to the container, 3) visual inspection of the unit is satisfactory and documented, and 4) the unit has been maintained at the appropriate storage or transport temperature. Studies have shown that refrigerated components
retain an acceptable temperature of for up to 30 minutes after removal from
the refrigerator.

42. The most effective component to treat a patient with fibrinogen deficiency is:

Fresh Frozen Plasma

Platelets

Fresh Whole Blood

Cryoprecipitated AHF

Cryoprecipitate is indicated as a source of fibrinogen for hypofibrinogenemia. It contains a minimum of 150 mg of fi.brinogen concentrated in a small volume of plasma .

Explanation

Cryoprecipitate is indicated as a source of fibrinogen for hypofibrinogenemia. It contains a minimum of 150 mg of fi.brinogen concentrated in a small volume of plasma .

43. Cryoprecipitated AHF:

Is indicated for fibrinogen deficiencies

Should be stored at 4 °C prior to administration

Will not transmit hepatitis B virus

Is indicated for the treatment of hemophilia B

Cryoprecipitate is used primarily for fibrinogen replacement. It is stored at room temperature (20° -24 °C) after thawing and must be infused within 6 hours. If pooled with other cryo units, it must be infused within 4 hours.

Explanation

Cryoprecipitate is used primarily for fibrinogen replacement. It is stored at room temperature (20° -24 °C) after thawing and must be infused within 6 hours. If pooled with other cryo units, it must be infused within 4 hours.

44. A patient's red blood cells gave the following reactions: anti-D anti-C anti-E anti-c anti-e anti-f + + + + + 0 The most probable genotype of this patient is:

R1R2

R2r"

R2 r

RzRz

Nonreactivity with anti-f indicates the cells do not have an Rh polypeptide that
possesses both c and e, which is necessary to type as f+ . R₁R₂ is the most likely genotype.

Explanation

Nonreactivity with anti-f indicates the cells do not have an Rh polypeptide that
possesses both c and e, which is necessary to type as f+ . R₁R₂ is the most likely genotype.

45. Which of the following red cell antigens are found on glycophorin-A?

M,N

Lea, Leb

S, s

P, P1, pk

The M and N antigens are found on glycophorin A.

Explanation

The M and N antigens are found on glycophorin A.

46. According to AABB standards, what is the minimum pH required for Platelets at the end of the storage period?

6.0

6.2

6.8

7.0

Per AABB standards, at least 90% of platelet units sampled must have a pH of at least 6.2 at the end of the allowable storage.

Explanation

Per AABB standards, at least 90% of platelet units sampled must have a pH of at least 6.2 at the end of the allowable storage.

47. Irradiation of a unit of Red Blood Cells is done to prevent the replication of donor:

Granulocytes

Lymphocytes

Red cells

Platelets

Irradiation inhibits proliferation of T lymphocytes.

Explanation

Irradiation inhibits proliferation of T lymphocytes.

48. During the preparation of Platelet Concentrates from Whole Blood, the blood should be:

Cooled towards 6'C

Cooled towards 20°-24°C

Warmed to 37°C

Heated to 57°C

Platelets are prepared and stored at 20° -24°C for optimum function.

Explanation

Platelets are prepared and stored at 20° -24°C for optimum function.

49. When the red cells of an individual fail to react with anti-U, they usually fail to react with:

Anti-M

Anti-Leb

Anti-S

Anti-P1

The U antigen is a high incidence antigen found on the RBCs of all individuals except 1 % of African. Americans, who lack glycoprotein Band usually type S-s-U- .

Explanation

The U antigen is a high incidence antigen found on the RBCs of all individuals except 1 % of African. Americans, who lack glycoprotein Band usually type S-s-U- .

50. When platelets are stored on a rotator set on an open bench top, the ambient air temperature must be recorded:

Once a day

Twice a day

Every 4 hours

Every hour

If storage devices do not have automated temperature recording,
temperature must be manually monitored every 4 hours.

Explanation

If storage devices do not have automated temperature recording,
temperature must be manually monitored every 4 hours.

51. Which of the following blood components must be prepared within 8 hours after phlebotomy?

Red Blood Cells

Fresh Frozen Plasma

Red Blood Cells, Frozen

Cryoprecipitated AHF

Fresh Frozen Plasma (FFP) must be separated and frozen within 8 hours of Whole Blood collection.

Explanation

Fresh Frozen Plasma (FFP) must be separated and frozen within 8 hours of Whole Blood collection.

52. Cryoprecipitated AHF, if maintained in the frozen state at -18'C or below, has a shelf life of:

42 days

6 months

12 months

36 months

Cryoprecipitate has a shelf life of 12 months in the frozen state.

Explanation

Cryoprecipitate has a shelf life of 12 months in the frozen state.

53. All donor blood testing must include:

Complete Rh phenotyping

Anti-CMV testing

Direct antiglobulin test

Serological test for syphilis

Testing for syphilis was the first mandated donor screening test for infectious disease and is still part of donor screening.

Explanation

Testing for syphilis was the first mandated donor screening test for infectious disease and is still part of donor screening.

54. During storage, the concentration of 2,3-diphosphoglycerate (2,3-DPG) decreases in a unit of:

Platelets

Fresh Frozen Plasma

Red Blood Cells

Cryoprecipitated AHF

2,3-DPG declines during storage of Red Blood Cells, causing a "shift-to-the-left" in the oxygen dissociation curve and an impaired ability to deliver oxygen to the tissues.

Explanation

2,3-DPG declines during storage of Red Blood Cells, causing a "shift-to-the-left" in the oxygen dissociation curve and an impaired ability to deliver oxygen to the tissues.

55. Below are the results of the history obtained from a prospective female blood donor: age: 16 temperature: 99.0°F (37.2°C) Hct: 36% history: tetanus toxoid immunization 1 week previously How many of the above results excludes this donor from giving blood for a routine transfusion?

None

1

2

3

The Hct must be > 38%. A donor may be 16 unless state law differs. Temperature must not exceed 99.5°F/37.5°C, blood pressure must be less than 180 mm Hg systolic and less than 100 mm Hg diastolic, pulse 50-100 unless an athlete (which can be lower). Toxoids and vaccines from synthetic or killed sources have no deferral.

Explanation

The Hct must be > 38%. A donor may be 16 unless state law differs. Temperature must not exceed 99.5°F/37.5°C, blood pressure must be less than 180 mm Hg systolic and less than 100 mm Hg diastolic, pulse 50-100 unless an athlete (which can be lower). Toxoids and vaccines from synthetic or killed sources have no deferral.

56. The optimum storage temperature for Red Blood Cells, Frozen is:

-80°C

-20°C

- 12°C

4°C

Red Blood Cells, Frozen with 40% glycerol are stored at -65°C or lower.

Explanation

Red Blood Cells, Frozen with 40% glycerol are stored at -65°C or lower.

57. Refer to the following diagram:

Given the most probable genotypes of the parents, which of the following statements best describes the most probable Rh genotypes of the 4 children?

2 are R1r, 2 are R1R1

3 are R1 r, 1 is rr

1 is R0r, 1 is R1r, 2 are R1R1

1 is R0r', 1 is R1R1, 2 are R1 r

The mother has a 50% chance of passing on R_{1 and 50% chance of passing on r. The father will always pass on R_{1 . Statistically, 50% of the children will be R_{1r and 50% of the them will be R_{1 R_1.}}}}

Explanation

The mother has a 50% chance of passing on R_{1 and 50% chance of passing on r. The father will always pass on R_{1 . Statistically, 50% of the children will be R_{1r and 50% of the them will be R_{1 R_1.}}}}

58. What is/are the minimum pretransfusion testing requirement(s) for autologous donations collected and transfused by the same facility?

ABO and Rh typing only

ABO/Rh type, antibody screen

ABO/ Rh type, antibody screen, crossmatch

No pretransfusion testing is required for autologous donations

Only ABO and Rh is required with the patient's sample. Each autologous unit must be confirmed for ABO and Rh from an integrally attached segment.

Explanation

Only ABO and Rh is required with the patient's sample. Each autologous unit must be confirmed for ABO and Rh from an integrally attached segment.

59. Which apheresis platelets product should be irradiated?

Autologous unit collected prior to surgery

Random stock unit going to a patient with DIC

A directed donation given by a mother for her son

A directed donation given by an unrelated family friend

Blood products from blood relatives containing viable lymphocytes must be irradiated to inhibit the proliferation of T cells and subsequent GVHD.

Explanation

Blood products from blood relatives containing viable lymphocytes must be irradiated to inhibit the proliferation of T cells and subsequent GVHD.

60. A blood donor has the genotype: hh, AB. What is his red blood cell phenotype?

A

B

O

AB

The A and B structures can not be developed since there is no H precursor substance due to the lack of the H gene in the blood donor.

Explanation

The A and B structures can not be developed since there is no H precursor substance due to the lack of the H gene in the blood donor.

61. Plastic bag overwraps are recommended when thawing units of FFP in 37°C water baths because they prevent:

The FFP bag from cracking when it contacts the warm water

Water from slowly dialyzing across the bag membrane

The entry ports from becoming contaminated with water

The label from peeling off as the water circulates in the bath

FFP thawed in a water bath should be protected so that entry ports are not contaminated with water. One can may use a plastic overwrap or keep ports above the water level.

Explanation

FFP thawed in a water bath should be protected so that entry ports are not contaminated with water. One can may use a plastic overwrap or keep ports above the water level.

62. Upon inspection, a unit of platelets is noted to have visible clots, but otherwise appears normal. The technologist should:

Issue without concern

Filter to remove the clots

Centrifuge to express off the clots

Quarantine for Gram stain and culture

Clots in the unit may indicate contamination

Explanation

Clots in the unit may indicate contamination

63. Cells of the A3 subgroup will:

React with Dolichos bifl.orus

BE- with anti-A

Give a mixed-field reaction with anti-A,B

BE- with anti-H

Mixed-field reactivity with anti-A and anti-A,B is a typical finding for A3 subgroups.

Explanation

Mixed-field reactivity with anti-A and anti-A,B is a typical finding for A3 subgroups.

64. An assay of plasma from a bag of Cryoprecipitated AHF yields a concentration of 9 international units (IU) of Factor VIII per mL of Cryoprecipitated AHF. If the volume is 9 mL, what is the Factor Vlll content of the bag in IU?

9

18

27

81

To determine the total IU of Factor VIII per bag of cryoprecipitate, multiple the assayed value/ mL by the number of mL in the container.

Explanation

To determine the total IU of Factor VIII per bag of cryoprecipitate, multiple the assayed value/ mL by the number of mL in the container.

65. A unit of Whole Blood-derived (random donor) Platelets should contain at least:

1.0 x 1010 platelets

5.5 x 1010 platelets

5.5 x 1011 platelets

90% of the platelets from the original unit of Whole Blood

Whole blood-derived (random donor) Platelets should contain at least 5.5 x 10¹⁰ platelets platelets, be stored with continuous agitation at 20° -24°C, and have a pH of
6.2 or higher when tested at the end of the storage period.

Explanation

Whole blood-derived (random donor) Platelets should contain at least 5.5 x 10¹⁰ platelets platelets, be stored with continuous agitation at 20° -24°C, and have a pH of
6.2 or higher when tested at the end of the storage period.

66. Cold agglutinin syndrome is associated with an antibody specificity toward which of the following?

Fy:3

P

I

Rh:l

Anti-I is associated with cold agglutinin syndrome.

Explanation

Anti-I is associated with cold agglutinin syndrome.

67. In an emergency situation, Rh-negative red cells are transfused into an Rh-positive person of the genotype CDe/CDe. The first antibody most likely to develop is:

Anti-c

Anti-d

Anti-e

Anti-E

The most common genotype in Rh-negative individuals is rr. Anti-e would not be formed because the recipient's red cells contain the e antigen. The first antibody most likely to develop would be anti-c.

Explanation

The most common genotype in Rh-negative individuals is rr. Anti-e would not be formed because the recipient's red cells contain the e antigen. The first antibody most likely to develop would be anti-c.

68. Most blood group systems are inherited as:

Sex-linked dominant

Sex-linked recessive

Autosomal recessive

Autosomal codominant

Blood group genes are autosomal, they are not carried on the sex gene. Whenever the gene is inherited, the antigen is expressed on the red blood cells, which is
known as codominant.

Explanation

Blood group genes are autosomal, they are not carried on the sex gene. Whenever the gene is inherited, the antigen is expressed on the red blood cells, which is
known as codominant.

69. In chronic granulomatous disease (CGD), granulocyte function is impaired. An association exists between this clinical condition and a depression of which of the following antigens?

Rh

P

Kell

Duffy

Red blood cells of individuals with the McLeod phenotype lack Kx and Km and have significant depression of other Kell antigens. The McLeod phenotype has been found in patients with chronic granulomatous disease (CGD).

Explanation

Red blood cells of individuals with the McLeod phenotype lack Kx and Km and have significant depression of other Kell antigens. The McLeod phenotype has been found in patients with chronic granulomatous disease (CGD).

70. The antibody in the Lutheran system that is best detected at lower temperatures is:

Anti-Lua

Anti-Lub

Anti-Lu3

Anti-Luab

Most examples of anti-Lu^a agglutinate saline suspended cells. Most examples of anti-Lu^b are IgG and reacts at 37°C. Anti-Lu3 usually reacts at the AHG phase as does anti-Lu^ab.

Explanation

Most examples of anti-Lu^a agglutinate saline suspended cells. Most examples of anti-Lu^b are IgG and reacts at 37°C. Anti-Lu3 usually reacts at the AHG phase as does anti-Lu^ab.

71. Which of the following red cell typings are most commonly found in the African American donor population?

Lu(a-b-)

Jk(a-b-)

Fy(a-b-)

K-k-

The Fy(a-b-) phenotype occurs in 68% of the population of African descent, but is extremely rare in the other ethnic backgrounds. Lu(a-b-), Jk(a-b-) and K-k-are very rare in all ethnic backgrounds.

Explanation

The Fy(a-b-) phenotype occurs in 68% of the population of African descent, but is extremely rare in the other ethnic backgrounds. Lu(a-b-), Jk(a-b-) and K-k-are very rare in all ethnic backgrounds.

72. Anti-Sd^a is strongly suspected if:

The patient has been previously transfused

The agglutinates are mixed-field and refractile

The patient is group A or B

Only a small number of panel cells are reactive

Anti-Sda is an antibody to a high-prevalence antigen, which varies in strength
from person to person. Most examples of anti-Sda characteristically present as small, mixed-field, refractile agglutinates that may have a shiny appearance when observed microscopically after the antiglobulin test.

Explanation

Anti-Sda is an antibody to a high-prevalence antigen, which varies in strength
from person to person. Most examples of anti-Sda characteristically present as small, mixed-field, refractile agglutinates that may have a shiny appearance when observed microscopically after the antiglobulin test.

73. Proteolytic enzyme treatment of red cells usually destroys which antigen?

Jka

E

Fya

K

The Fy^a and Fy^b antigens are sensitive to denaturation by proteolytic enzymes. Serum containing anti- Fy^a reacts with untreated Fy(a+) cells, but not witht enzyme treated Fy(a+) cells.

Explanation

The Fy^a and Fy^b antigens are sensitive to denaturation by proteolytic enzymes. Serum containing anti- Fy^a reacts with untreated Fy(a+) cells, but not witht enzyme treated Fy(a+) cells.

74. Which of the following is a characteristic of anti-i?

Associated with warm autoimmune hemolytic anemia

Found in the serum of patients with infectious mononucleosis

Detected at lower temperatures in the serum of normal individuals

Found only in the serum of group O individuals

Patients with infectious monucleosis often demonstrate potent examples of anti-i that are transient in nature.

Explanation

Patients with infectious monucleosis often demonstrate potent examples of anti-i that are transient in nature.

75. The optimum storage temperature for Red Blood Cells is:

-80°C

20°C

-12°C

4°C

Red Blood Cells are stored at 1 ° -6°C.

Explanation

Red Blood Cells are stored at 1 ° -6°C.

76. A patient's red cells type as follows: Anti D Anti C Anti E 4+ 0 0 Which of the following genotype would be consistent with these results?

R0R0

R1r

R1 R2

R2 r

R₀R₀ is the only correct choice here. R₀ = D+C-E-c+e+.

Explanation

R₀R₀ is the only correct choice here. R₀ = D+C-E-c+e+.

77. Given the following typing results, what is this donor's racial ethnicity?

African American

Asian American

Native American

Caucasian

Fy(a-b-) individuals are very rare with all populations other than the individual of African descent. 68% of African Americans are Fy(a- b- ).

Explanation

Fy(a-b-) individuals are very rare with all populations other than the individual of African descent. 68% of African Americans are Fy(a- b- ).

78. A patient is typed with the following results: Patient's cells with Patient's serum with anti-A 0 A₁red cells 2+ anti-B 0 B red cells 4+ anti-A,B 2+ Ab screen 0 The most probable reason for these findings is that the patient is group:

O; confusion due to faulty group O antiserum

O; with an anti-A1

Ax; with an anti-A1

A1 ; with an anti-A

Ax cells are more strongly reactive with anti-A,B than with anti-A and the plasma frequently has anti-A₁ present.

Explanation

Ax cells are more strongly reactive with anti-A,B than with anti-A and the plasma frequently has anti-A₁ present.

79. The linked HLA genes on each chromosome constitute a(n):

Allele

Trait

Phenotype

Haplotype

The entire set of HLA antigens located on one chromosome is a haplotype.

Explanation

The entire set of HLA antigens located on one chromosome is a haplotype.

80. An individual has been sensitized to the k antigen and has produced anti-k. What is her most probable Kell system genotype?

KK

Kk

K0K0

This individual cannot have the k antigen on their cells. K₀K₀is rare and no Kell system antigens are detected on the red blood cells. Those individuals usually produce antibodies that are reactive with all normal cells. KK is the most probable genotype.

Explanation

This individual cannot have the k antigen on their cells. K₀K₀is rare and no Kell system antigens are detected on the red blood cells. Those individuals usually produce antibodies that are reactive with all normal cells. KK is the most probable genotype.

81. Cryoprecipitated AHF must be transfused within what period of time following thawing and pooling?

4 hours

8 hours

12 hours

24 hours

Cryoprecipitate must be transfused within 4 hours of pooling.

Explanation

Cryoprecipitate must be transfused within 4 hours of pooling.

82. family has been typed for HLA because 1 of the children needs a stem cell donor. Typing results are listed below: father: A1,3;88,35 mother: A2,23;812,18 child #1: A1,2;88,12 child #2: A1 ,23;88,18 child #3: A3,23;818,? What is the expected B antigen in child #3?

A1

A2

B12

B35

From the first 2 children it can be determined the mom has the haplotypes A2B12 and A23F18. The dad has the haplotypes A1B3 and A3B35. The expected B
antigen in child #3 is B35.

Explanation

From the first 2 children it can be determined the mom has the haplotypes A2B12 and A23F18. The dad has the haplotypes A1B3 and A3B35. The expected B
antigen in child #3 is B35.

83. Anti-N is identified in a patient's serum. If random crossmatches are performed on 10 donor units, how many would be expected to be compatible?

0

3

7

10

The N antigen is lacking in 30% of the Caucasian population.

Explanation

The N antigen is lacking in 30% of the Caucasian population.

84. Of the following blood components, which one should be used to prevent HLA alloimmunization of the recipient?

Red Blood Cells

Granulocytes

Irradiated Red Blood Cells

Leukocyte-Reduced Red Blood Cells

Leukoreduction of blood products reduces donor leukocytes to less than 5 x10 ⁶ decreases the risk of HLA alloimmunization.

Explanation

Leukoreduction of blood products reduces donor leukocytes to less than 5 x10 ⁶ decreases the risk of HLA alloimmunization.

85. Refer to the following data: anti-C anti-D anti-E anti-c anti-e + + + + + Given the reactions above, which is the most probable genotype?

R1R1

R1 r'

R0r"

R1 R2

All common Rh antigens are present on the red blood cells.R₁(DCe) and R₂ (DcE) are frequent genotypes.

Explanation

All common Rh antigens are present on the red blood cells.R₁(DCe) and R₂ (DcE) are frequent genotypes.

86. Which of the following is a characteristic of anti-i?

Often associated with hemolytic disease of the newborn

Reacts best at room temperature or 4°C

Reacts best at 37°C

Is usually IgG

Anti-i is an IgM antibody that reacts with cord cells and i adult cells. It is not associated with h emolytic disease of the newborn since IgM antibodies do not cross the placenta.

Explanation

Anti-i is an IgM antibody that reacts with cord cells and i adult cells. It is not associated with h emolytic disease of the newborn since IgM antibodies do not cross the placenta.

87. In a relationship testing case, the child has a genetic marker that is absent in the mother and cannot be demonstrated in the alleged father. What type of paternity exclusion is this known as?

Indirect

Direct

Prior probability

Hardy-Weinberg

Direct exclusion of paternity is established when a genetic marker is present in the child but is absent from the mother
and the alleged father.

Explanation

Direct exclusion of paternity is established when a genetic marker is present in the child but is absent from the mother
and the alleged father.

88. HLA antibodies are:

Naturally occurring

Induced by multiple transfusions

Directed against granulocyte antigens only

Frequently cause hemolytic transfusion reactions

HLA antibodies are formed in response to pregnancy, transfusion or transplantation and are therefore not naturally occurring. They are associated with febrile
nonhemolytic transfusion reactions and TRALI. They are directed against antigens found on granulocytes and other cells such as platelets.

Explanation

HLA antibodies are formed in response to pregnancy, transfusion or transplantation and are therefore not naturally occurring. They are associated with febrile
nonhemolytic transfusion reactions and TRALI. They are directed against antigens found on granulocytes and other cells such as platelets.

89. What is the approximate probability of finding compatible blood among random Rh-positive units for a patient who has anti-c and anti-K? (Consider that 20% of Rh-positive donors lack c and 90% lack K)

1%

10%

18%

45%

Multiplication of the individual compatibility frequencies results in the percentage of compatible donors that would lack both antigens. 0.20 x 0.90 = 0.18, or 18%.

Explanation

Multiplication of the individual compatibility frequencies results in the percentage of compatible donors that would lack both antigens. 0.20 x 0.90 = 0.18, or 18%.

90. According to AABB Standards, at least 90% of all Apheresis Platelets units tested shall contain a minimum of how many platelets?

5.5 X 1010

6.5 X 1010

3.0. X 1011

5.0 X 1011

Per AABB standards, at least 90% of platelet pheresis units sampled must contain at least 3.0 x 10¹¹ platelets.

Explanation

Per AABB standards, at least 90% of platelet pheresis units sampled must contain at least 3.0 x 10¹¹ platelets.

91. Which of the following phenotypes will react with anti-f?

Rr

R1R1

R2R2

R1R2

Anti-f will react with cells that carry c and e on the same Rh polypeptide. No other listed genotypes produce an Rh polypeptide that carries both c and e.

Explanation

Anti-f will react with cells that carry c and e on the same Rh polypeptide. No other listed genotypes produce an Rh polypeptide that carries both c and e.

92. Isoimmunization to platelet antigen HPA-la and the placental transfer of maternal antibodies would be expected to cause newborn:

Erythroblastosis

Leukocytosis

Leukopenia

Thrombocytopenia

HPA-la is a platelet specific antigen, which is the most common cause of neonatal alloimmune thrombocytopenia. Treatment consists of IVIG.

Explanation

HPA-la is a platelet specific antigen, which is the most common cause of neonatal alloimmune thrombocytopenia. Treatment consists of IVIG.

93. A donor is tested with Rh antisera with the following results: anti-D anti-C anti-E anti-c anti-e Rh control + + 0 + + 0 What is his most probable Rh genotype?

R1R1

R1r

R0r

R2r

The most likely haplotype is DCe/ dce.

Explanation

The most likely haplotype is DCe/ dce.

94. Four units of blood are needed for elective surgery. The patient's serum contains anti-C, anti-e, anti-Fy^a and anti-Jk^b. Which of the following would be the best source of donor blood?

Test all units in current stock

Test 100 group O, Rh-negative donors

Test 100 group-compatible donors

Rare donor file

The frequency of compatible donors for this patient can be calculated by multiplying the percentage of the population that is e-C- x Fy(a-) x Jk(b-). The blood supplier's immunohematology reference laboratory may have units in stock or can request blood from other IRLs through the American Rare
Donor w.

Explanation

The frequency of compatible donors for this patient can be calculated by multiplying the percentage of the population that is e-C- x Fy(a-) x Jk(b-). The blood supplier's immunohematology reference laboratory may have units in stock or can request blood from other IRLs through the American Rare
Donor w.

95. In a random population, 16% of the people are Rh-negative (rr). What percentage of the Rh-positive population is heterozygous for ?

36%

48%

57%

66%

The Hardy-Weinberg equation states p + q = 1.0.When the equation is expanded, it is P² + 2pq +P²= 1.0.

Explanation

The Hardy-Weinberg equation states p + q = 1.0.When the equation is expanded, it is P² + 2pq +P²= 1.0.

96. In relationship testing, a "direct exclusion" is established when a genetic marker is:

Absent in the child, but present in the mother and alleged father

Absent in the child, present in the mother and absent in the alleged father

Present in the child, absent in the mother and present in the alleged father

Present in the child, but absent in the mother and alleged father

When a marker is in a child that the mother and alleged father do not have, the alleged father can not be the biological
father of the child. This is a direct exclusion.

Explanation

When a marker is in a child that the mother and alleged father do not have, the alleged father can not be the biological
father of the child. This is a direct exclusion.

97. Leukocyte-Reduced Red Blood Cells are ordered for a newly diagnosed bone marrow candidate. What is the best way to prepare this product?

Crossmatch only CMV-seronegative units

Irradiate the unit with 1,500 rads

Wash the unit with saline prior to infusion

Transfuse through a Log3 leukocyte-removing filter

Newly diagnosed bone marrow candidates are at great risk for severe sequelae of CMV infections. Infection can best be reduced by using leukocyte-
reduction filters. CMV-seronegative units
are rarely used since leukocyte reducing via filtration is so effective. Washing does not remove as many leukocytes as filtering.

Explanation

Newly diagnosed bone marrow candidates are at great risk for severe sequelae of CMV infections. Infection can best be reduced by using leukocyte-
reduction filters. CMV-seronegative units
are rarely used since leukocyte reducing via filtration is so effective. Washing does not remove as many leukocytes as filtering.

98. Which of the following antibodies is neutralizable by pooled human plasma?

Anti-Kna

Anti-Ch

Anti-Yka

Anti-Csa

Anti-Ch and anti-Rg react at IAT with trace amounts of C4 (a component of
complement) present on normal RBCs. The Ch and Rg substance is found soluble in plasma. Neutralization studies with pooled plasma can help confirm the antibody reactivity in a patient's sample. If test procedures are used to coat cells with C4, a patient with anti-Ch or anti-Rg may agglutinate the cells directly.

Explanation

Anti-Ch and anti-Rg react at IAT with trace amounts of C4 (a component of
complement) present on normal RBCs. The Ch and Rg substance is found soluble in plasma. Neutralization studies with pooled plasma can help confirm the antibody reactivity in a patient's sample. If test procedures are used to coat cells with C4, a patient with anti-Ch or anti-Rg may agglutinate the cells directly.

99. The antibodies of the Kidd blood group system:

React best by the indirect antiglobulin test

Are predominantly IgM

Often cause allergic transfusion reactions

Do not generally react with antigen-positive, enzyme-treated RBCs

Antibodies in the Kidd blood group system are IgG and react best at the antiglobulin phase. These antibodies are associated with delayed hemolytic
transfusion reactions and reactivity can be enhanced by testing with enzyme pretreated cells.

Explanation

Antibodies in the Kidd blood group system are IgG and react best at the antiglobulin phase. These antibodies are associated with delayed hemolytic
transfusion reactions and reactivity can be enhanced by testing with enzyme pretreated cells.

100. In a case of cold autoimmune hemolytic anemia, the patient's serum would most likely react 4+ at immediate spin with:

Group A cells, B cells and O cells, but not his own cells

Cord cells but not his own or other adult cells

All cells of a group O cell panel and his own cells

Only penicillin-treated panel cells, not his own cells

Anti-I is commonly found in all individuals, but when it causes hemolysis, the titer may be high and react at all temperatures. Cold agglutinin syndrome is mainly found in lymphoproliferative diseases.

Explanation

Anti-I is commonly found in all individuals, but when it causes hemolysis, the titer may be high and react at all temperatures. Cold agglutinin syndrome is mainly found in lymphoproliferative diseases.

101. An individual's red blood cells give the following reactions with Rh antisera: anti-D anti-C anti-E anti-c anti-e Rh control 4+ 3+ 0 3+ 3+ 0 The individual's most probable genotype is:

DCe/DcE

DcE/dce

Dce/dce

DCe/ dce

The patient lacks E. Since C and care alleles, C is inherited from one parent and c from the other. Since the person is homozygous fore, one of the genes needs to code force (RHce) and the other Ce (RHCe).
The RHD gene is more likely inherited with Ce than ce, so the person's most probable genotype is DCe/dce. This genotype is found in 31 % of the white and 15% of the black populations.

Explanation

The patient lacks E. Since C and care alleles, C is inherited from one parent and c from the other. Since the person is homozygous fore, one of the genes needs to code force (RHce) and the other Ce (RHCe).
The RHD gene is more likely inherited with Ce than ce, so the person's most probable genotype is DCe/dce. This genotype is found in 31 % of the white and 15% of the black populations.

102. Saliva from which of the following individuals would neutralize an auto anti-H in the serum of a group A, Le(a-b+) patient?

Group A, Le(a- b-)

Group A, Le(a+b-)

Group O, Le(a+b-)

Group O, Le(a-b+)

Group O have the most H substance in their saliva.The person must also be a secrete r of ABH substances. Due to gene interaction between the secretor gene and Lewis gene, people who are Le(a-b+) assures H in their saliva.

Explanation

Group O have the most H substance in their saliva.The person must also be a secrete r of ABH substances. Due to gene interaction between the secretor gene and Lewis gene, people who are Le(a-b+) assures H in their saliva.

103. Anti-Fy^a is:

Usually a cold-reactive agglutinin

More reactive when tested with enzyme-treated red blood cells

Capable of causing hemolytic transfusion reactions

Often an autoagglutinin. Fya

Anti-Fy^a is an IgG antibody that reacts best at the AHG phase, does not react with enzyme-treated red cells, is capable of causing hemolytic disease of the newborn, uand is not known to be an autoagglutinin.

Explanation

Anti-Fy^a is an IgG antibody that reacts best at the AHG phase, does not react with enzyme-treated red cells, is capable of causing hemolytic disease of the newborn, uand is not known to be an autoagglutinin.

104. Platelets prepared by apheresis should contain at least:

1 x 1010 platelets

3 x 1010 platelets

3 x 1011 platelets

5 x 1011 platelets

Apheresis (single donor) Platelets should contain at least 3.0 x 10¹¹ platelets, be stored with continuous agitation at 20° -24°C, and have a pH of 6.2 or higher
when tested at the end of the storage period.

Explanation

Apheresis (single donor) Platelets should contain at least 3.0 x 10¹¹ platelets, be stored with continuous agitation at 20° -24°C, and have a pH of 6.2 or higher
when tested at the end of the storage period.

105. A 25-year-old Caucasian woman, gravida 3, para 2, required 2 units of Red Blood Cells. The antibody screen was positive and the results of the antibody panel are shown below:

What is the most probable genotype of this patient?

Rr

R'r'

R0r

R1R1

After performing rule outs, the most likely antibody is anti-c. To form anti-c, the patient would need to inherit a gene from both parents that does not produce the c antigen. The most common gene that codes for no c antigen is denoted as R₁.

Explanation

After performing rule outs, the most likely antibody is anti-c. To form anti-c, the patient would need to inherit a gene from both parents that does not produce the c antigen. The most common gene that codes for no c antigen is denoted as R₁.

106. Genes of the major histocompatibility complex (MHC):

Code for HLA-A, HLA-B, and HLA-C antigens only

Are linked to genes in the ABO system

Are the primary genetic sex-determinants

Contribute to the coordination of cellular and humoral immunity

MHC consists of both class I and class II HLA antigens. Discrimination of self from nonself is the primary function of the HLA system and involves many immune responses.

Explanation

MHC consists of both class I and class II HLA antigens. Discrimination of self from nonself is the primary function of the HLA system and involves many immune responses.

107. Once thawed, Fresh Frozen Plasma must be transfused within:

4 hours

8 hours

12 hours

24 hours

Once thawed, FFP is stored at 1 ° -6°C for up to 24 hours.

Explanation

Once thawed, FFP is stored at 1 ° -6°C for up to 24 hours.

108. The phenomenon of an Rh-positive person whose serum contains anti-Dis best explained by:

Gene deletion

Missing antigen epitopes

Trans position effect

Gene inhibition

Individuals who are partial D are missing epitopes of the D antigen and can develop antibodies toward the epitopes they lack. Since all normal D antigens have all epitopes, the specificity of the person's antibody is anti-D.

Explanation

Individuals who are partial D are missing epitopes of the D antigen and can develop antibodies toward the epitopes they lack. Since all normal D antigens have all epitopes, the specificity of the person's antibody is anti-D.

109. How many Caucasians in a population of 100,000 will have the following combination of phenotypes? System Phenotype ABO 0 Gm Fb PGM1 2-1 EsD 2-1

1

14

144

1,438

When the percentages of each phenotype are multiplied together, the incidence of the phenotype occurs in 1.438% of the population, so in a population
of 100,000, there would be 1,438 with the phenotype.

Explanation

When the percentages of each phenotype are multiplied together, the incidence of the phenotype occurs in 1.438% of the population, so in a population
of 100,000, there would be 1,438 with the phenotype.

110. The observed phenotypes in a particular population are: Phenotype Number of persons Jk(a+b-) 122 Jk(a+b+) 194 Jk(a-b+) 84 What is the gene frequency of Jka in this population?

0.31

0.45

0.55

0.60.

Use the Hardy-Weinberg equation:
P² + 2pq + q² = 1.0 In this example, P² is the homozygous population, Jk(a+b- ). The square root of P² = p, which is the gene frequency of Jk^a in this population. Out of 400 people, 122, or 30% are homozygous. The square root of 0.30 = is 0.55.

Explanation

Use the Hardy-Weinberg equation:
P² + 2pq + q² = 1.0 In this example, P² is the homozygous population, Jk(a+b- ). The square root of P² = p, which is the gene frequency of Jk^a in this population. Out of 400 people, 122, or 30% are homozygous. The square root of 0.30 = is 0.55.

111. A woman types as Rh-positive. She has an anti-c titer of 32 at AHG. Her baby has a negative DAT and is not affected by hemolytic disease of the newborn. What is the father's most likely Rh phenotype?

Rr

R"r

R1r

R2r

The baby appears to lack c since no HDFN was evident. The mom is most likely
R₁ R₁ , so had to pass R₁ onto the baby. The father must have passed on an Rh gene that also did not produce c. Given the choices, the father has to be R₁ r.

Explanation

The baby appears to lack c since no HDFN was evident. The mom is most likely
R₁ R₁ , so had to pass R₁ onto the baby. The father must have passed on an Rh gene that also did not produce c. Given the choices, the father has to be R₁ r.

112. Relationship testing produces the following red cell phenotyping results: ABO Rh alleged father: B D+C-c+E+e- mother: O D+C+E- c- e+ child: O D+C+E-c+e+ What conclusions may be made?

There is no exclusion of paternity.

Paternity may be excluded on the basis of ABO typing.

Paternity may be excluded on the basis of Rh typing.

Paternity may be excluded on the basis of both ABO and Rh typing.

The child's genotype does not include E.The alleged father is homozygous for E. If he was the father the child would also have E.The father can be excluded from paternity.

Explanation

The child's genotype does not include E.The alleged father is homozygous for E. If he was the father the child would also have E.The father can be excluded from paternity.

113. The red cells of a nonsecretor (se/se) will most likely type as:

Le(a-b-)

Le(a+b+)

Le(a+b-)

Le(a-b+)

The Lewis antigens are developed by gene interaction. Both the Lewis and Secretor gene are required for red cells to type as Le(a-b+). If a person has a Lewis gene, but not Secretor gene, then the cells type as Le(a+b-). The Le(a-b-) phenotype is derived when the Lewis gene is absent and the Secretor gene may or may not be present. The Le(a+b-) phenotype occurs in 22% or the population, and Le(a-b-) occurs in 6%, so the most likely phenotype of a nonsecretor (se/se) is Le(a+b-).

Explanation

The Lewis antigens are developed by gene interaction. Both the Lewis and Secretor gene are required for red cells to type as Le(a-b+). If a person has a Lewis gene, but not Secretor gene, then the cells type as Le(a+b-). The Le(a-b-) phenotype is derived when the Lewis gene is absent and the Secretor gene may or may not be present. The Le(a+b-) phenotype occurs in 22% or the population, and Le(a-b-) occurs in 6%, so the most likely phenotype of a nonsecretor (se/se) is Le(a+b-).

114. A patient is group O, Rh-negative with anti-D and anti-K in her serum. What percentage of the general Caucasian donor population would be compatible with this patient?

0.5

2.0

3.0

6.0

Determination of compatibility can be determined by multiplying the percentage of compatibility of each antigen. 46% of the population is group O, 15% are D- , and 91 % are K- . 0.46 x 0.15 x 0.91 = O.

Explanation

Determination of compatibility can be determined by multiplying the percentage of compatibility of each antigen. 46% of the population is group O, 15% are D- , and 91 % are K- . 0.46 x 0.15 x 0.91 = O.

115. Anti-D and anti-C are identified in the serum of a transfused pregnant woman, gravida 2, para 1. Nine months previously she received Rh immune globulin (RhIG) after delivery. Tests of the patient, her husband, and the child revealed the following: anti-D anti-C anti-E anti-c anit-e Patient 0 0 0 + + Father + 0 0 + + Child + 0 0 + + The most likely explanation for the presence of anti-C is that this antibody is:

Actually anti-Cw

From the RhIG dose

Actually anti-G

Naturally occurring

The G antigen is normally present on red cells possessing either C or D. Anti-G
reacts with panel cells that are D+ or C+ and the antibodies appear to be anti-C and anti-D. The G antigen is expressed on the child's D+ red blood cells.

Explanation

The G antigen is normally present on red cells possessing either C or D. Anti-G
reacts with panel cells that are D+ or C+ and the antibodies appear to be anti-C and anti-D. The G antigen is expressed on the child's D+ red blood cells.

116. The mating of an Xg(a+) man and an Xg(a- ) woman will only produce:

Xg(a- ) sons and Xg(a- ) daughters

Xg(a+) sons and Xg(a+) daughters

Xg(a-) sons and Xg(a+) daughters

Xg(a+) sons andXg(a- ) daughters

Sons inherit their X chromosome from their mother and Y chromosome from their father. Since the mother is Xg(a⁻), sons will be Xg(a⁻).

Daughters inherit one X chromosome from each parent. The father has Xg(a⁺) and the mother Xg(a⁻), so daughters will be Xg(a⁺)Xg(a⁻), but phenotypically considered Xg(a⁻) since a⁻ is recessive. However, as per the question’s allele notation, daughters carry one a⁺ and one a⁻.

Explanation

Sons inherit their X chromosome from their mother and Y chromosome from their father. Since the mother is Xg(a⁻), sons will be Xg(a⁻).

Daughters inherit one X chromosome from each parent. The father has Xg(a⁺) and the mother Xg(a⁻), so daughters will be Xg(a⁺)Xg(a⁻), but phenotypically considered Xg(a⁻) since a⁻ is recessive. However, as per the question’s allele notation, daughters carry one a⁺ and one a⁻.

117. Inhibition testing can be used to confirm antibody specificity for which of the following antibodies?

Anti-Lua

Anti-M

Anti-Lea

Anti-Fy

Lewis antigens are found soluble in saliva. If saliva containing Lewis substance
is added to a sample with anti-Le^a , then neutralization occurs. Le(a+) indicator
cells added to the test system would be nonreactive. A proper control system is
required whenever neutralization studies are performed.

Explanation

Lewis antigens are found soluble in saliva. If saliva containing Lewis substance
is added to a sample with anti-Le^a , then neutralization occurs. Le(a+) indicator
cells added to the test system would be nonreactive. A proper control system is
required whenever neutralization studies are performed.

118. What percent of group O donors would be compatible with a serum sample that contained anti-X and anti-Y if X antigen is present on red cells of 5 of 20 donors, and Y antigen is present on red cells of 1 of 10 donors?

2.5

6.8

25.0

68.0

75% of donors would be compatible with anti-X and 90% with anti-Y. The frequency of compatibility for both antigens is determined by multiplying
the 2 compatibility percentages: 0.75 X 0.90 = 0.675.

Explanation

75% of donors would be compatible with anti-X and 90% with anti-Y. The frequency of compatibility for both antigens is determined by multiplying
the 2 compatibility percentages: 0.75 X 0.90 = 0.675.

119. A mother has the red cell phenotype D+C+E-c-e+ with anti-c (titer of 32 at AHG) in her serum. The father has the phenotype D+C+E-c+e+. The baby is Rh-negative and not affected with hemolytic disease of the newborn. What is he baby's most probable Rh genotype?

R'r'

R'r

R1R1

R1 r

The baby is Rh-negative and lacks c, since there is no evidence of HDFN. Inheritance of no D and no c is denoted as r'. The baby must have inherited this gene from both parents, and is homozygous r'r'.

Explanation

The baby is Rh-negative and lacks c, since there is no evidence of HDFN. Inheritance of no D and no c is denoted as r'. The baby must have inherited this gene from both parents, and is homozygous r'r'.

120. Which of the following Rh antigens has the highest frequency in Caucasians?

D

E

C

E

The overall incidence of thee antigen is 98%. The overall incidence of c is 80%, Dis 85% and E is 30%.

Explanation

The overall incidence of thee antigen is 98%. The overall incidence of c is 80%, Dis 85% and E is 30%.