Blood Bank Exam Iii

Front 1

What common characteristic do the P, I and Lutheran antigens have?

Back 1

None of their antigens are developed at birth and take from 18 months to years to develop.

Front 2

The P antibodies can all bind complement, which means they can all cause in-vivo _________

Back 2

hemolysis

Front 3

What structrue does the P phenotype have?

Back 3

Cer-Gluc-Gal-Gal-N-acetyl-gal

Front 4

What structrue does the p phenotype have?

Back 4

Cer-Gluc-Gal-N-acetyl-gal-Gal-NeuAC

Front 5

What structrue does the pk phenotype have?

Back 5

Cer-Gluc-Gal-Gal

Front 6

What structrue does the P1 phenotype have?

Back 6

Cer-Gluc-Gal-N-acetyl-gal-Gal-Gal

Front 7

The anti-P found as a naturally occurring antibody in the serum of all pk individuals is Ig
_____, while the anti-P found in PCH is Ig _____.

Back 7

M, G

Front 8

Fill in the following:

Phenotype Antigens

P1

P2

p

P1k

P2k

Back 8

P and P1
P
no p antigens
P1 and Pk
Pk

Front 9

Fill in the following:

Phenotype Possible Antibodies

P1

P2

p

P1k

P2k

Back 9

none
Anti-P1
Anti-P P1 Pk(Tja)
Anti-P
Anti-P and Anti-P1

Front 10

I antigen is strongest on ________ cells while i antigen is strongest on _________ cells.

Back 10

Adult, cord

Front 11

Which individual can build allo-anti-I?

Back 11

The rare i positive adult

Front 12

Which antibody system shows a loose mixed field agglutination pattern?

Back 12

Lutheran

Front 13

Anti-Lua is usually Ig _____ , while Anti-Lub is usually Ig _____.

Back 13

M, G

Front 14

Describe the three genetic pathways for the Lu(a-b-) phenotype.

Back 14

Dominant suppressor/inhibitor gene
Recessive silent allele
Recessive X-linked

Front 15

Which antibody is directed against an antigen found on the X chromosome?

Back 15

Xga

Front 16

Which antibody has been found in AIHA?

Back 16

Wra

Front 17

Which antigen has a higher incidence in North, South and Central American Indians?

Back 17

Dia

Front 18

Which antigen is poorly developed at birth and the corresponding antibody is found in individuals who are multi-transfused?

Back 18

Cartwright

Front 19

Define low avidity

Back 19

loose fragile agglutination

Front 20

List 5 HTLA antibodies.

Back 20

Chido, Rogers, York, Cost-Sterling, John Milton Hagen, Knops, McCoy

Front 21

Which 2 HTLA antibodies are neutralized by antigen positive plasma?

Back 21

Chido, Rogers

Front 22

Fill in the blanks:
HLA-B7 = _____
_______ = Bgb
HLA-A28 = ____

Back 22

Bga
HLA Bw17
Bgc

Front 23

Which of the following describe the HTLA antibodies?
Strong reactions at the AHG phase
Rarely react at the 37C phase
Reactions are similar with all red blood cells
Antibodies are IgG and noncomplement binding
Easily washed off
Often hard to reproduce the same reaction results

Back 23

Rarely reacts at 37C
IgG and Non Complement
Easily washed off
Often hard to reproduce results

Front 24

Do the HTLA antigens have a high or low frequency?

Back 24

High

Front 25

Based on AABB Standards, which of the following donor selection criteria is for the protection of the donor?
A. Whole blood donation interval
B. Temperature
C. History of infectious diseases
D. Recent ingestion of aspirin

Back 25

Whole blood donation interval

Front 26

Based on the AABB Standards, which of the following donor selection criteria is for the protection of the patient?
A. Blood pressure
B. Pregnancy
C. Recent vaccination
D. Pulse

Back 26

recent vaccination

Front 27

During a medical history evaluation, a prospective donor indicates that she returned from a trip to Southeast Asia 3 months ago. Malaria is endemic there, but she did not take any prophylactic medications. For what additional period of time must she be deferred?
A. 3 months longer
B. 6 months longer
C. 9 months longer
D. Defer indefinitely

Back 27

9 months longer

Front 28

Which of the following represents an acceptable donor?
Hct BP Temp Pulse Age
A 39 110/70 99.8 75 40
B 37 135/85 98.6 80 35
C 45 115/80 98.6 102 17
D 41 90/50 99.4 65 65

Back 28

D

Front 29

Which of the following medications will defer a donor for 30 days from last use?
A. Aspirin
B. Vitamins
C. Accutane
D. Tetracycline for acne

Back 29

Accutane

Front 30

A female donor who was hospitalized 6 months ago and received blood transfusions must be deferred for how long?
A. No additional deferral
B. 3 months
C. 6 months
D. 9 months

Back 30

6 months

Front 31

Below are the results of the history obtained from a prospective female blood donor. How many of the below results will exclude this donor from donating a unit of whole blood?
Age: 18
History: Tetanus toxoid immunization 1 week ago
Temp: 99.0
Hct: 38%
Pulse: 80 bts/min
Hgb: 12.5 g/dL

A. None
B. One
C. Two
D. Three

Back 31

None

Front 32

A person who has received a tattoo is deferred from donating blood for:
A. 6 months
B. 12 months
C. 3 years
D. Indefinitely

Back 32

12 months

Front 33

Below are the results of pre-donation screening for a female blood donor. Would this donor be acceptable?
Last donation: one year ago
Age: 30
Hct: 36%
Temp: 37.2C
Weight: 140 pounds
Pulse: 60 beats/min
BP: 160/90

A. Yes
B. No, the emperature is too high
C. No, the Hct is too low
D. No, the diastolic blood pressure is too high

Back 33

No, the Hct is too low

Front 34

Donors must be given an opportunity to indicated that their blood should not be used for transfusion. This must be done in a private, confidential manner and is called
A. Donor referral
B. Self exclusion
C. Donor interview
D. Donor look back

Back 34

Self exclusion

Front 35

What virus is responsible for greater than 90% of Hepatitis (hint: not HBV or HAV)?

Back 35

Hepatitis C.

Front 36

What was a surrogate tests for Hepatitis C? Why did the laboratory perform this test?

Back 36

The HBcAb. This test was used to indirectly identify donor blood that may be able to transmit hepatitis. This test is often abnormal in patient's with HCV and HBV infections, however, they are not specific for either infection. They were instituted before the test for HCV antibody was available. They were NOT discontinued when the specific test became available because it was uncertain how "good" the new test would be at preventing transfusion associated HCV infections. ALT is now not required except for plasma sent abroad.

Front 37

What type of reagent cell can be used for screening for antibodies in donor samples?
Why do you use different screening cells for patient's vs. donors?

Back 37

Pooled screening cells (cells from different donors combined into one vial) can be used for donor antibody screening tests. It is NOT important to detect low titer antibodies in donor serum because the antibody will be diluted when it is transfused.

This is NOT permitted when performing antibody screens for potential recipients because failure to detect a low titer antibody may result in a secondary immune response when RBCs carrying the corresponding antigen are transfused.

Front 38

What is the disposition of UNITS and do we defer the DONOR when:

Pos HIV antibody
EIA +, Western Blot -
EIA +, Western Blot +

Back 38

Discard, Permanent Deferral
Discard, Permanent Deferral; Notification

Front 39

What is the disposition of UNITS and do we defer the DONOR when:

Pos HBsAg
EIA +, Neutralization assay -
EIA+, Neutralization assay +

Back 39

Discard, Refer to Anti-HBc, if non-reactive no deferral
Discard, Permanent Deferral; Notification

Front 40

What is the disposition of UNITS and do we defer the DONOR when:
Pos antibody screen

Back 40

RBCs-Use, No deferral, Plasma-Discard

Front 41

What is the disposition of UNITS and do we defer the DONOR when:
Pos HBcAB (first time)

Back 41

Discard, Donor deferred only if subsequent units test positive

Front 42

What is the disposition of UNITS and do we defer the DONOR when:
ABO discrepancy

Back 42

Use if resolved, No deferral

Front 43

What is the disposition of UNITS and do we defer the DONOR when:
pos RPR
FTA neg
FTA pos

Back 43

Discard, 12 month deferral, Notification
Discard, Permanently deferred, Notification

Front 44

What infectious disease tests are currently required on all allogeneic donor units?

Back 44

Bacterial detection plts; STS; WNV
HBsAg; Anti HBc;
Anti HTLV I/II; Anti HIV-1/2; HIV-1 RNA
HCV RNA; Anti HCV;

Front 45

A donor unit which tests initially positive for an infectious marker
a. Is repeated in duplicate prior to reporting the results.
b. Can be labeled but then put in quarantine until testing is completed.
c. Should be discarded immediately.
d. Can be used for research.

Back 45

Is repeated in duplicate prior to reporting the results

Front 46

Circle all the serologic tests that are currently required on allogeneic donor units.
a. ABO forward and reverse type
b. RH type, including Weak D
c. Screen for unexpected red cell antibodies
d. DAT
e. ABO subtyping
f. Rh phenotyping

Back 46

ABO forward and reverse type
Rh type, including weak D
Screen for unexpected red cell antibodies

Front 47

Which statement is true regarding ABO/Rh typing of donor units?
a. Previous type records may be used to resolve a discrepancy and label unit.
b. ABO reverse grouping can only be done on serum, but not plasma from the donor.
c. Rh typing should be repeated only on units from donors previously typed as Rh negative.
d. Rh typing must include a test for weak D (Du) when the initial anti D typing is negative.

Back 47

Rh typing must include a test for weak D (Du) when the initial anti D typing is negative

Front 48

An asymptomatic donor who tests positive for HBsAg
a. Probably has a false positive test result
b. May be a chronic carrier of HBV.
c. May be in the incubation phase of acute hepatitis B.
d. Both b and c.

Back 48

May be a chronic carrier of HBV
May be in the incubation phase of acute hepatitis B

Front 49

Anti HBc in donor testing
a. Is a surrgate test for hepatitis.
b. Was instituted to reduce the risk of transfusion associated hepatitis.
c. May indicate the presence of HBV when positive.
d. All of the above.

Back 49

Is a surrogate test for hepatitis
Was instituted to reduce the risk of transfusion associated hepatitis.
May indicate the presence of HBV when positive.