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BB PREFINAL EXAM

Total questions: 93

Worksheet time: 3615secs

Name
Class
Date
1.

Where are the Lewis antigens produced?

a)

Platelets

b)

RBCs

c)

White Blood Cells

d)

Tissue cells

e)

All of the above

2.

Biochemically, Lewis antigens are classified as what in

secretions?

a)

Glycoproteins

b)

Polyproteins

c)

Glycolipids

d)

Glycophorins

3.

Biochemically, Lewis antigens are classified as what in

plasma and RBCs?

a)

Glycoproteins

b)

Polyproteins

c)

Glycolipids

d)

Glycophorins

4.

Which of the following characteristics best describes

Lewis antibodies?

a)

IgM, naturally occurring, cause HDN

b)

IgM, naturally occurring, do not cause HDN

c)

IgG, in vitro hemolysis, cause hemolytic transfusion

reactions

d)

IgG, in vitro hemolysis, do not cause hemolytic transfusion

reactions

5.

The Le gene codes for a specific glycosyltransferase that

transfers an L-fucose to the N-acetylglucosamine on:

a)

Type 1 precursor chain

b)

Type 2 precursor chain

c)

Types 1 and 2 precursor chain

d)

Either type 1 or type 2 in any one individual but not in

both

6.

Secretions of a person with the genes B, Se, and Le contain

which of the following?

a)

B substance, H substance, Lea and Leb substances

b)

B substance, Lea substance

c)

H substance, Lea and Leb substances

d)

H substance, Lea and Leb substances

7.

Secretions of a person with the genes B, sese, and Le

contain which of the following?

a)

B substance, Lea substance

b)

H substance, Lea substance

c)

H substance, Lea and Leb substance

d)

Lea substance

8.

An individual with genes A, H, Se, and lele has which of

the following phenotypes?

a)

ABH, Le(a-b-)

b)

ABH, Le(a+b-)

c)

AH, Le(a-b-)

d)

AH, Le(a+b-)

9.

In what way do the Lewis antigens change during pregnancy?

a)

Lea antigen increases only

b)

Leb antigen increases only

c)

Lea and Leb both increase

d)

Lea and Leb both decrease

10.

Lec and Led antigens are found in individuals with the

phenotype of:

a)

Le(a-b-)

b)

Le(a+b-)

c)

Le(a-b+)

d)

Le(a+b+)

11.

The Lewis phenotype that is most commonly associated

with H. pylori infection is:

a)

Le(a+b-)

b)

Le(a-b-)

c)

Le(a-b+)

d)

Le(a-x+)

12.

Which of the following best describes MN antigens and

antibodies?

a)

Well developed at birth, susceptible to enzymes, generally saline-reactive

b)

Not well developed at birth, susceptible to enzymes, generally saline-reactive

c)

Well developed at birth, not susceptible to enzymes, generally saline-reactive

d)

Well developed at birth, susceptible to enzymes, generally antiglobulin-reactive

13.

Which autoantibody specificity is found in patients with

paroxysmal cold hemoglobinuria?

a)

I

b)

i

c)

P

d)

P1

14.

Which of the following is the most common antibody

seen in the blood banks after ABO and Rh antibodies?

a)

Anti-Fyb

b)

Anti-k

c)

Anti-Jsa

d)

Anti-K

15.

Which blood group system is associated with resistance

to P. vivax malaria?

a)

P

b)

Kell

c)

Duffy

d)

Kidd

16.

Which antibody does NOT fit with the others with

respect to optimum phase of reactivity?

a)

Anti-S

b)

Anti-P1

c)

Anti-Fya

d)

Anti-Jkb

17.

Which of the following Duffy phenotypes is prevalent in

blacks but virtually nonexistent in whites?

a)

Fy(a+b+)

b)

Fy(a-b+)

c)

Fy(a-b-)

d)

Fy(a+b-)

18.

Antibody detection cells will NOT routinely detect which antibody specificity?

a)

Anti-M

b)

Anti-Kpa

c)

Anti-Fya

d)

Anti-Lub

19.

Which of the following blood group systems is known

for showing dosage?

a)

I

b)

P

c)

Kidd

d)

Lutheran

20.

Which antibody is most commonly associated with delayed hemolytic transfusion reactions

a)

Anti-s

b)

Anti-k

c)

Anti-Lua

d)

Anti-Jka

21.

A patient with an M. pneumoniae infection will most likely develop a cold autoantibody with specificity to which antigen?

a)

I

b)

i

c)

P

d)

P1

22.

Which antigen is routinely destroyed by enzymes?

a)

P1

b)

Jsa

c)

Fya

d)

Jka

23.

A patient is suspected of having paroxysmal cold hemoglobinuria (PCH). Which pattern of reactivity is characteristic of the DonathLandsteiner antibody, which causes this condition?

a)

The antibody attaches to RBCs at 4°C and causes hemolysis at 37°C

b)

The antibody attaches to RBCs at 37°C and causes agglutination at the IAT phase

c)

The antibody attaches to RBCs at 22°C and causes hemolysis at 37°C

d)

The antibody attaches to RBCs and causes agglutination at the IAT phase

24.

An antibody shows strong reactions in all test phases. All screen and panel cells are positive. The serum is then tested with a cord cell and the reaction is negative. What antibody is suspected?

a)

Anti-I

b)

Anti-i

c)

Anti-H

d)

Anti-p

25.

How can interfering anti-P1 antibody be removed from a mixture of antibodies?

a)

Neutralization with saliva

b)

Agglutination with human milk

c)

Combination with urine

d)

Neutralization with hydatid cyst fluid

26.

Which characteristics are true of all three of the following antibodies: anti-Fya, anti-Jka, and anti-K?

a)

Detected at the IAT phase; may cause hemolytic disease of the newborn and hemolytic transfusion reactions

b)

Not detected with enzyme-treated cells

c)

Requires the IAT technique for detection; usually not associated with HDN

d)

Enhanced reactivity with enzyme-treated cells; may cause severe hemolytic transfusion reactions

27.

All of the following are reasons for a positive DAT on cord blood cells of a newborn except:

a)

High concentrations of Wharton’s jelly on cord cells

b)

Immune anti-A from an O mother on the cells of an A baby

c)

Immune anti-D from an Rh negative mother on the cells of an Rh-positive baby

d)

Immune anti-K from an K-negative mother on the cells of a K-negative baby

28.

A fetal screen yielded negative results on a mother who is O negative and infant who is O positive. What course of action should be taken?

a)

Perform a Kleihauer–Betke test

b)

Issue one full dose of RhIg

c)

Perform a DAT on the infant

d)

Perform an antibody screen on the mother

29.

All of the following are interventions for fetal distress caused by maternal antibodies attacking fetal cells except:

a)

Intrauterine transfusion

b)

Plasmapheresis on the mother

c)

Transfusion of antigen-positive cells to the mother

d)

Early induction of labor

30.

Should an O-negative mother receive RhIg if a positive DAT on the newborn is caused by immune anti-A?

a)

No, the mother is not a candidate for RhIg because of the positive DAT

b)

Yes, if the baby’s type is Rh negative

c)

Yes, if the baby’s type is Rh positive

d)

No, the baby’s problem is unrelated to Rh blood group antibodies

31.

Should an A-negative woman who has just had a miscarriage receive RhIg?

a)

Yes, but only if she does not have evidence of active Anti-D

b)

No, the type of the baby is unknown

c)

Yes, but only a minidose regardless of trimester

d)

No, RhIg is given for term pregnancies only

32.

A Kleihauer–Betke acid elution test identifies 40 fetal cells in 2,000 maternal red cells. How many full doses of RhIg are indicated?

a)

1

b)

2

c)

3

d)

4

33.

Kernicterus is caused by the effects of:

a)

Anemia

b)

Unconjugated bilirubin

c)

Antibody specificity

34.

What testing is done for exchange transfusion when the mother’s serum contains an alloantibody?

a)

Crossmatch and antibody screen

b)

ABO, Rh, antibody screen, and crossmatch

c)

ABO, Rh, antibody screen

d)

ABO and Rh only

35.

Which blood type may be transfused to an AB-positive baby who has HDN caused by anti-D?

a)

AB negative, CMV negative, Hgb S negative; irradiated or O negative, CMV negative, Hgb S negative

b)

AB positive, CMV negative; irradiated or O positive, CMV negative

c)

AB negative only

d)

O negative only

36.

What can be done if HDN is caused by maternal anti-K?

a)

Give Kell immune globulin

b)

Monitor the mother’s antibody level

c)

Prevent formation of K-positive cells in the

fetus

d)

Not a problem; anti-K is not known to cause HDN

37.

Which of the following patients would be a candidate for RhIg?

a)

B-positive mother; B-negative baby; first pregnancy; no anti-D in mother

b)

O-negative mother; A-positive baby; second pregnancy; no anti-D in mother

c)

A-negative mother; O-negative baby; fourth pregnancy; anti-D in mother

d)

AB-negative mother; B-positive baby; second pregnancy; anti-D in mother

38.

A patient developed a combination of Rh antibodies: anti-C, anti-E, and anti-D. Can compatible blood be found for this patient?

a)

It is almost impossible to find blood lacking the C, E, and D antigens

b)

rr blood could be used without causing a problem

c)

R0R0 may be used because it lacks all three

antigens

d)

Although rare, ryr blood may be obtained from close relatives of the patient

39.

Testing reveals a weak D that reacts 1+ after indirect antiglobulin testing (IAT). How is this result classified?

a)

Rh-positive

b)

Rh-negative, Du positive

c)

Rh-negative

d)

Rh-positive, Du positive

40.

What does the genotype —/— represent in the Rh system?

a)

Rh negative

b)

D mosaic

c)

Rh null

d)

Total Rh

41.

What techniques are necessary for weak D testing?

a)

Saline + 22°C incubation

b)

Albumin or LISS + 37°C incubation

c)

Saline + 37°C incubation

d)

37°C incubation + IAT

42.

A patient types as AB and appears to be Rh positive on slide typing. What additional tests should be performed for tube typing?

a)

Rh negative control

b)

Direct antiglobulin test (DAT)

c)

Low-protein Rh antisera

d)

No additional testing is needed

43.

The linked HLA genes on each chromosome consititute a:

a)

allele

b)

trait

c)

phenotype

d)

haplotype

44.

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

a)

KK

b)

Kk

c)

kk

d)

KoKo

45.

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

Le(a-b-); Js (a+b+)

a)

African American

b)

Asian American

c)

Native American

d)

Caucasian

46.

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

a)

anti-c

b)

anti-d

c)

anti-e

d)

anti-E

47.

Most blood group system are inherited as?

a)

Sex-linked dominant

b)

Sex-linked recessive

c)

Autosomal codominant

d)

Autosomal recessive

48.

The red cells of a nonsecretor (se/se) will most likely type as?

a)

Le (a-b-)

b)

Le (a+b+)

c)

Le (a+b-)

d)

Le (a-b+)

49.

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

a)

rr

b)

R1R1

c)

R2R2

d)

R2 r

50.

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?

a)

Indirect

b)

Direct

c)

Prior probability

d)

Hardy Weinberg

51.

Even in the absence of prior transfusion or pregnancy, individuals with Bombay phenotype (Oh) will always have naturally occuring:

a)

Anti-Rh

b)

anti-Lub

c)

anti-Lu3

d)

anti-Lua

52.

Which of the following antigens has the highest frequency in Caucasian?

a)

D

b)

E

c)

c

d)

e

53.

The phenomenon of an Rh positive person whose serum contains anti-D is best explained by:

a)

gene deletion

b)

missing antigen epitopes

c)

trans position effect

d)

gene inhibition

54.

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

a)

Anti-M

b)

Anti-Leb

c)

Anti-S

d)

Anti-P1

55.

Which of the following red cell antigens are found in glycophorin A?

a)

M, N

b)

Lea and Leb

c)

S,s

d)

P, P1, Pk

56.

Which of the following is a characteristics of anti-i?

a)

associated with warm autoimmune hemolytic anemia

b)

found in serum of patients with Infectious Mononucleosis

c)

detected at lower temperatures in serum of normal individuals

d)

found only in the serum of group O individuals

57.

The Kell (K1) antigen is:

a)

absent from the red cells of neonate

b)

strongly immunogenic

c)

destroyed by enzymes

d)

has a frequency of 50% in random population

58.

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

a)

Rh

b)

P

c)

Kell

d)

Duffy

59.

The antibodies of the Kidd blood group system:

a)

react best by the indirect antiglobulin test

b)

are predominantly IgM

c)

often cause allergic transfusion reactions

d)

do not generally react with antigen positive, enzyme treated RBCs

60.

Proteolytic enzyme treatment of red cells usually destroys which antigen?

a)

Jka

b)

E

c)

Fya

d)

k

61.

ABO hemolytic disease of the newborn

a)

usually requires an exchange transfusion

b)

most often in the first born children

c)

frequently results in stillbirth

d)

is usually seen only in the newborn of Group O mothers

62.

Which if the following antigens is most likely to be involved in hemolytic disease of the newborn?

a)

Lea

b)

P1

c)

M

d)

Kell

63.

Blood selected for exchange transfusion must:

a)

lack red blood cell antigens corresponding to maternal antibodies

b)

be <3 days old

c)

be the same as Rh type as the baby

d)

be ABO compatible with the father

64.

When the main objective of an exchange transfusion is to remove the infants antibody-sensitized red blood cells and to control hyperbilirubinemia, the blood product of choice is ABO compatible:

a)

Fresh whole Blood

b)

Red Blood Cells washed

c)

RBCs suspended in Fresh Frozen Plasma

d)

heparinized Red Blood Cells

65.

To prevent graft vs host disease, RBCs prepared for infants who received intrauterine transfusion should be?

a)

saline-washed

b)

irradiated

c)

Frozen and deglycerolized

d)

Group and Rh compatible with the mother

66.

Which of the following is the preferred specimen for the initial compatibility testing in exchange transfusion therapy?

a)

maternal serum

b)

eluate [prepared from infants red blood cells

c)

paternal serum

d)

infant's post exchange serum

67.

Rh immune globulin administration would not be indicated in an Rh-negative woman who has a:

a)

first trimester abortion

b)

husband who is RH positive

c)

anti-D titer of 1:4,096

d)

Positive DAT

68.

Anti-I will react strongly with

a)

Cord Cells

b)

Adult Cells

c)

Adult i cells

d)

PNH III

e)

HEMPAS

69.

Which MNS antibody is enhanced by glucose or serum acidification?

a)

Anti-M

b)

Anti-N

c)

Anti-S

d)

Anti-U

70.

Which MNS antigen is resistant to treatment with proteolytic enzymes?

a)

M

b)

N

c)

S

d)

s

e)

U

71.

Antibody(-ies) found in the serum of an individual with phenotype P2k

a)

Anti-PP1Pk

b)

Anti-P1 and anti-P

c)

Anti-P only

d)

none

72.

The HDFN caused by this antibody affects not only circulating red cells but also red cell precursors in the bone marrow?

a)

Anti-Jka

b)

Anti-Fyb

c)

Anti-C

d)

Anti-K

73.

Which phenotype may have Anti-Ku in their serum?

a)

Ko

b)

McLeod

c)

Jk(a-b-)

d)

Fy(a-b-)

74.

Which of the following is MISMATCHED?

a)

Ley : H.pylori

b)

Fy6: P. knowlesii

c)

GPA : P.falciparum

d)

None of the above

75.

Predict the antigens present on the red cells of an individual with Le/le, Sese, hh, A/B genotypes

a)

Lea, Leb, A, B, H

b)

Lea, A, B, H

c)

Lea, Leb, H

d)

Lea, Leb

76.

Le(a-b-) is frequently found in

a)

Newborns and pregnant women

b)

Filipino, Finns and Polynesians

c)

Japanese and European gypsies

d)

Mongolians

77.

Which statement is TRUE of Le(a+b-)?

a)

Have the genotype Lele/SeSe

b)

Have Lea and Leb in the body fluids

c)

Red cells contain Lea antigen only

d)

Only secretors have this phenotype

78.

Anti-P1

a)

Hydatid cyst

b)

Stomach ulcers

c)

Spontaneous abortion

d)

Mycoplasma pneumonia infection

e)

Chronic granulomatous disease

79.

H, Ley, Lex

a)

Hydatid cyst

b)

Stomach ulcers

c)

Spontaneous abortion

d)

Mycoplasma pneumonia infection

e)

Chronic granulomatous disease

80.

Autoanti-I

a)

Hydatid cyst

b)

Stomach ulcers

c)

Spontaneous abortion

d)

Mycoplasma pneumonia infection

e)

Chronic granulomatous disease

81.

McLeod phenotype

a)

Hydatid cyst

b)

Stomach ulcers

c)

Spontaneous abortion

d)

Mycoplasma pneumonia infection

e)

Chronic granulomatous disease

82.

Anti-Nf

a)

Hemodialysis

b)

Paroxysmal Cold hemoglobinuria

c)

Spontaneous abortion

d)

Mycoplasma pneumonia infection

e)

Cold agglutinin disease

83.

Autoanti-P

a)

Hemodialysis

b)

Paroxysmal Cold hemoglobinuria

c)

Spontaneous abortion

d)

Mycoplasma pneumonia infection

e)

Cold agglutinin disease

84.

Rh null

a)

Stomatocytosis

b)

Paroxysmal Cold hemoglobinuria

c)

Spontaneous abortion

d)

Mycoplasma pneumonia infection

e)

Cold agglutinin disease

85.

What is the protein carrier for these antigens: Jka and JKb

a)

Urea transporter

b)

Xk protein

c)

Glycophorin B

d)

Glycophorin A

86.

What is the protein carrier for this antigen: Kx

a)

Urea transporter

b)

Xk protein

c)

Glycophorin B

d)

Glycophorin A

87.

The Liley method of predicting the severity of the HDN is based on the amniotic fluid:

a)

bilirubin concentration by standard methos

b)

change in optical density measured at 450 nm

c)

Rh determination

d)

ratio of lecithin to spingomyelin

88.

The rosette test will detect a FMH as small as:

a)

10 mL

b)

15 mL

c)

20 mL

d)

30 mL

89.

ISBT No. of Rh blood group system?

a)

001

b)

002

c)

003

d)

004

90.

ISBT No. of Lewis blood group system?

a)

007

b)

005

c)

003

d)

004

91.

How are weaker-than-expected reactions with anti-D typing reagents categorized?

a)

Rhmod

b)

Partial D

c)

DAT positive

d)

Dw

92.

What antigen system is closely associated phenotypically with Rh?

a)

McCoy

b)

Lutheran

c)

Duffy

d)

LW

93.

Anti-LW will not react with which of the following?

a)

Rh-positive RBCs

b)

Rh-negative RBCs

c)

Rhnull RBCs

d)

Rh:33 RBCs

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