SUMMATIVE PART 2

100問 • 1年前

問題一覧

The key structural difference that distinguishes immunoglobulin subclasses is the: A. Number of domains B. Stereometry of the hypervariable region C. The sequence of the constant regions D. Covalent linkage of the light chains

C. The sequence of the constant regions

lmmunoglobulin classes are differentiated according to the molecular structure of: A. Light chains B. Heavy chains C. Fab fragment D. Fc fragment

B. Heavy chains

.A 54-year-old female previous smoker presents with a recent history of fever, swollen joints, and morning stiffness. § Laboratory results indicate elevated C-reactive protein, positive cyclic citrullinated peptide of 205 units (cut-off: 20 units), speckled ANA pattern (titer 1:320), and negative rheumatoid factor. What is the most likely diagnosis? A. Reactive arthritis B. Rheumatoid arthritis C. Systemic sclerosis D. Sjogren syndrome

B. Rheumatoid arthritis

Which of the following is used for the confirmation of infection with HIV-1? A. Western blot (immunoblot) assay B. ELISA C. Complement fixation D. p24 Antigen testing

A. Western blot (immunoblot) assay

Which technique is used for the confirmation of infection with HIV-1 and HIV-2? A. Western blot (immunoblot) assay B. ELISA C. FDA-approved NAT D. p24 Antigen testing

C. FDA-approved NAT

Clinical assays for tumor markers are most important for: A. Screening for the presence of cancer B. Monitoring the course of a known cancer C. Confirming the absence of disease D. Identifying patients at risk for cancer

B. Monitoring the course of a known cancer

. In general, in which of the following situations is the analysis of a tumor marker most useful? A. Testing for recurrence B. Prognosis C. Screening D. Diagnosis

A. Testing for recurrence

The chemical composition of an antibody is: A. Protein B. Lipid C. Carbohydrate D. Glycoprotein

D. Glycoprotein

What is the most common clinical incident that results in alloantibody production? A. Viral infection B. Solid tumor C. Red cell transfusion D. Autoimmune disease

C. Red cell transfusion

What antibodies are present in polyspecific AHG reagent? A. Anti-IgG B. Anti-IgM and anti-IgG C. Anti-IgG and anti-C3d D. Anti-C3d

C. Anti-IgG and anti-C3d

Which of the following medications is most likely to cause production of AUTOANTIBODIES? A. Penicillin B. Cephalosporin C. Methyldopa D. Tetracycline

C. Methyldopa

Red cells from a recently transfused patient were DAT positive when tested with anti-IgG. Screen cells and a panel performed on a patient’s serum showed very weak reactions with inconclusive results. What procedure could help to identify the antibody? A. Elution followed by a panel on the eluate B. Adsorption followed by a panel on the adsorbed serum C. Enzyme panel D. Antigen typing the patient’s red cells

A. Elution followed by a panel on the eluate

The procedure that removes intact antibodies from the red cell membranes is: A. Autoadsorption B. Enzyme pretreatment C. Neutralization D. Elution

D. Elution

Crossmatch results at the antiglobulin phase were negative. When 1 drop of check cells was added, NO AGGLUTINATION was seen. The most likely explanation is that the: A. Red cells were overwashed B. Residual patient serum inactivated the AHG reagent C. Centrifuge speed was set too high D. Laboratorian did not add enough check cells

B. Residual patient serum inactivated the AHG reagent

Autoantibodies demonstrating blood group specificity in warm autoimmune hemolytic anemia are associated more often with which blood group system? A. Rh B. I C. P D. Fy

A. Rh

Which antibody is frequently seen in patients with warm autoimmune hemolytic anemia? A. Anti-Jka B. Anti-e C. Anti-K D. Anti-Fyb

B. Anti-e

Many enhancement media used in the blood bank promote hemagglutination in the presence of lgG antibodies by reducing which of the following? A. Hydrophilic forces B. Low ionic potential C. van der Waals forces D. Zeta potential

D. Zeta potential

Low ionic strength saline (LISS) acts as an enhancement medium and facilitates antibody uptake by: A. Activating complement B. Increasing flexibility in hinge region C. Removing water molecules D. Reducing zeta potential

D. Reducing zeta potential

Which antibody would not be detected by group O screening cells? A. Anti-N B. Anti-A1 C. Anti-Dia D. Anti-k

B. Anti-A1

Screening cells, major crossmatch, and patient autocontrol are positive in all phases. Identify the problem. A. Specific cold alloantibody B. Specific cold autoantibody C. Abnormal protein or nonspecific autoantibody D. Cold and warm alloantibody mixture

C. Abnormal protein or nonspecific autoantibody

What corrective action should be taken when rouleaux causes positive test results? A. Perform a saline replacement technique B. Perform an autoabsorption C. Run a panel D. Perform an elution

A. Perform a saline replacement techniqu

. Screening cells and major crossmatch are positive on IS only, and the autocontrol is negative. Identify the problem. A. Cold alloantibody B. Cold autoantibody C. Abnormal protein D. Antibody mixture

A. Cold alloantibody

Which of the following describes the expression of most blood group inheritance? A. Dominant B. Sex-linked C. Recessive D. Codominant

D. Codominant

Which genotype(s) will give rise to the Bombay phenotype? A. HH only B. HH and Hh C. Hh and hh D. hh only

D. hh only

What should be done if all forward and reverse ABO results as well as the autocontrol are positive? A. Wash the cells with warm saline, autoadsorb the serum at 4°C B. Retype the sample using a different lot number of reagents C. Use polyclonal typing reagents D. Report the sample as group AB

A. Wash the cells with warm saline, autoadsorb the serum at 4°C

A patient types as AB positive. Two units of blood have been ordered by the physician. Currently, the inventory shows no AB units, 10 A-positive units, 1 Anegative unit, 5 B-positive units, and 20 O-positive units. Which should be set up for the major crossmatch? A. A-positive units B. O-positive units C. B-positive units D. Call another blood supplier for type-specific blood

A. A-positive units

A physician orders 2 units of leukocyte-reduced red blood cells. The patient is a 55-year-old male with anemia. He types as an AB negative, and his antibody screen is negative. There is only 1 unit of AB negative in inventory. What is the next blood type that should be given? A. AB positive (patient is male) B. A negative C. B negative D. O negative

B. A negative

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: A. Anti-c B. Anti-d C. Anti-e D. Anti-E

A. Anti-c

What antibodies could an R1R1 make if exposed to R2R2 blood? A. Anti-e and anti-C B. Anti-E and anti-c C. Anti-E and anti-C D. Anti-e and anti-c

B. Anti-E and anti-c

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

D. 37°C incubation + IAT

RhIg (Rhogam) is indicated for: A. Mothers who have anti-D B. Infants who are Rh-negative C. Infants who have anti-D D. Mothers who are Rh-negative

D. Mothers who are Rh-negative

.RhIG should be administered within how many hours of delivery? A. 4 B. 48 C. 72 D. 96

C. 72

Which of the following antigens is poorly expressed on cord blood cells? A. K B. M C. Leb D. D

C. Leb

Which of the following is characteristic of anti-i? A. Often associated with hemolytic disease of the newborn B. Reacts best at 37ºC C. Reacts best at room temperature or 4ºC D. Is usually IgG

C. Reacts best at room temperature or 4ºC

PAROXYSMAL COLD HEMOGLOBINURIA (PCH) is associated with antibody specificity toward which of the following? A. Kell system antigens B. Duffy system antigens C. P antigen D. I antigen

C. P antigen

In the DONATH-LANDSTEINER TEST, patient’s serum are incubated at various temperatures with: A. Group O RBCs that express the P antigen B. Group O RBCs that express the P1 antigen C. Group AB RBCs that express the P antigen D. Group AB RBCs that express the P1 antigen

A. Group O RBCs that express the P antigen

Excluding ABO, __ is rated second only to D in immunogenicity. A. Kell B. Cellano C. Duffy D. Kidd

A. Kell

The K (KEL1) antigen is: A. Absent from the red cells of neonates B. Strongly immunogenic C. Destroyed by enzymes D. Has a frequency of 50% in the random population

B. Strongly immunogenic

The k (Cellano) antigen is a high-frequency antigen and is found on most red cells. How often would one expect to find the corresponding antibody? A. Often B. Rarely C. It depends upon the population D. Impossible to determine without consulting regional blood group antigen charts

B. Rarely

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. K0K0

A. KK

An antibody commonly associated with delayed transfusion reactions is: A. Anti-Lua B. Anti-S C. Anti-Jkb D. Anti-M

C. Anti-Jkb

What blood group system antibodies are commonly associated with delayed hemolytic transfusion reactions? A. Rh c B. MNS C. ABO D. Kidd

D. Kidd

What procedure would help to distinguish between an anti-Fya and anti-Jka in an antibody mixture? A. Lowering the pH of the patient’s serum B. Using a thiol reagent C. Testing at colder temperatures D. Ficin-treated panel cells

D. Ficin-treated panel cells

Which of the following antibodies characteristically gives a refractile mixed-field appearance? A. Anti-K B. Anti-Dia C. Anti-Sda D. Anti-s

C. Anti-Sda

A patient has symptoms indicating a possible hemolytic transfusion reaction. What should be done immediately? A. Stop the transfusion and discard the unit B. Contact the patient's doctor to ask if the transfusion should be stopped C. Stop the transfusion and call the patient's doctor to report the reaction D. Have patient blood samples sent to the lab to investigate the reaction

C. Stop the transfusion and call the patient's doctor to report the reaction

FATAL TRANSFUSION reactions are mostly caused by? A. Serologic errors B. Improper storage of blood C. Clerical errors D. Improper handling of the product

C. Clerical errors

Some blood group antibodies characteristically hemolyze appropriate red cells in the presence of: A. Complement B. Anticoagulants C. Preservatives D. Penicillin

A. Complement

PAIN AT INFUSION SITE and hypotension are observed with what type of reaction? A. Acute hemolytic transfusion reaction B. Allergic reaction C. Delayed hemolytic transfusion reaction D. Febrile nonhemolytic reaction

A. Acute hemolytic transfusion reaction

Hypotension, nausea, flushing, fever and chills are symptoms of which of the following transfusion reactions? A. Allergic B. Circulatory overload C. Hemolytic D. Anaphylactic

C. Hemolytic

Hemoglobinuria, hypotension and generalized bleeding are symptoms of which of the following transfusion reactions? A. Allergic B. Circulatory overload C. Hemolytic D. Anaphylactic

C. Hemolytic

The most serious hemolytic transfusion reactions are due to incompatibility in which of the following blood group systems? A. ABO B. Rh C. MN D. Duffy

A. ABO

What would be the result of group A blood given to an O patient? A. Nonimmune transfusion reaction B. Immediate hemolytic transfusion reaction C. Delayed hemolytic transfusion reaction D. Febrile nonhemolytic transfusion reaction

B. Immediate hemolytic transfusion reaction

A patient has a hemolytic reaction to blood transfused 8 days ago. What is the most likely cause? A. Immediate, nonimmunologic probably due to volume overload B. Delayed immunologic, probably due to an antibody such as anti-Jka C. Delayed nonimmunologic, probably due to iron overload D. Immediate, immunologic, probably due to clerical error, ABO incompatibility

B. Delayed immunologic, probably due to an antibody such as anti-Jka

In a DELAYED TRANSFUSION REACTION, the causative antibody is generally too weak to be detected in routine compatibility testing and antibody screening tests, but is typically detectable at what point after transfusion? A. 3 - 6 hours B. 3 - 7 days C. 60 - 90 days D. After 120 days

B. 3 - 7 days

An unexplained fall in hemoglobin and mild jaundice in a patient transfused with Red Blood Cells 1 week previously would most likely indicate: A. Paroxysmal nocturnal hemoglobinuria B. Posttransfusion hepatitis infection C. Presence of HLA antibodies D. Delayed hemolytic transfusion reaction

D. Delayed hemolytic transfusion reaction

Fever and chills are symptoms of which of the following transfusion reactions? A. Citrate toxicity B. Circulatory overload C. Allergic D. Febrile

D. Febrile

Symptoms of dyspnea, hypoxemia, and pulmonary edema within 6 hours of transfusion is most likely which type of reaction? A. Anaphylactic B. Hemolytic C. Febrile D. TRALI

D. TRALI

What may be found in the serum of a person who is exhibiting signs of TRALI (transfusion-related acute lung injury)? A. Red blood cell alloantibody B. IgA antibody C. Anti-leukocyte antibody D. Allergen

C. Anti-leukocyte antibody

Hives and itching are symptoms of which of the following transfusion reactions? A. Febrile B. Allergic C. Circulatory overload D. Bacterial

B. Allergic

Which of the following transfusion reactions occurs after infusion of only a few milliliters of blood and gives no history of fever? A. Febrile B. Circulatory overload C. Anaphylactic D. Hemolytic

C. Anaphylactic

Anaphylactic reactions to transfusion are usually caused by: A. Anti-IgA in an IgA-deficient recipient B. Anti-IgG in an IgA-deficient C. IgA deficiency D. IgG deficiency

A. Anti-IgA in an IgA-deficient recipient

Which of the following transfusion reactions is characterized by high fever, shock, hemoglobinuria, DIC and renal failure? A. Bacterial contamination B. Circulatory overload C. Febrile D. Anaphylactic

A. Bacterial contamination

Coughing, hypoxemia and difficult breathing are symptoms of which of the following transfusion reactions? A. Febrile B. Allergic C. TACO D. Hemolytic

C. TACO

Congestive heart failure, severe headache and/or peripheral edema occurring soon after transfusion is indicative of which type of transfusion reaction? A. Hemolytic B. Febrile C. Anaphylactic D. TACO

D. TACO

Which of the following patient groups is at risk of developing graft-versus-host disease? A. Full-term infants B. Patients with history of febrile transfusion reactions C. Patients with a positive direct antiglobulin test D. Recipients of blood donated by immediate family members

D. Recipients of blood donated by immediate family members

The most frequent transfusion-associated disease complication of blood transfusions is: A. Cytomegalovirus (CMV) B. Syphilis C. Hepatitis D. HIV-1/2

C. Hepatitis

When evaluating a possible delayed hemolytic reaction, what is the best sample to use for bilirubin determination? A. 6 hours posttransfusion B. 12 hours posttransfusion C. 24 hours posttransfusion D. 48 hours posttransfusion

A. 6 hours posttransfusion

What is the primary reason that infectious agents can be transmitted following blood transfusion? A. Pathogen reduction technology failure B. Donor in the window period of early infection C. Leukocyte-reduction failure D. Donor history questionnaire not completed

B. Donor in the window period of early infection

. What may be done to RBCs before transfusion to a patient with cold agglutinin disease in order to reduce the possibility of a transfusion reaction? A. Irradiate to prevent graft-versus-host-disease (GVHD) B. Wash with 0.9% percent saline C. Warm to 37°C with a blood warmer D. Transport so that temperature is maintained at 20 to 24°C

C. Warm to 37°C with a blood warmer

Which of the following is an acceptable time in which a unit of whole blood is collected? A. 33 minutes B. 25 minutes C. 20 minutes D. 13 minutes

D. 13 minutes

How much anticoagulant would have to be removed from the collection bag given a donor who weighs 90 lb? A. 12 mL B. 15 mL C. 20 mL D. 23 mL

A. 12 mL

The minimum hemoglobin concentration in a finger stick from a female blood donor is: A. 12.0 g/dL (120 g/L) B. 12.5 g/dL (125 g/L) C. 13.0 g/dL (135 g/L) D. 15.0 g/dL (150 g/L)

B. 12.5 g/dL (125 g/L)

Which of the following donors could be accepted for whole-blood donation? A. A construction worker who was incarcerated for opiate abuse B. A triathlete with a pulse of 45 C. A man who is currently taking finasteride (Propecia) D. A woman in her 14th week of pregnancy

B. A triathlete with a pulse of 45

How often can a blood donor donate whole blood? A. Every 24 hours B. Once a month C. Every 8 weeks D. Twice a year

C. Every 8 weeks

A donor who has just donated 2 units of Apheresis Red Blood Cells will be deferred from further blood donation for a minimum of how many weeks? A. 8 B. 12 C. 16 D. 24

C. 16

All of the following apply to a double red cell unit apheresis collection except: A. The hematocrit must be at least 38% B. The weight for a female is at least 150 lbs C. The height for a male is at least 5 ft 1 in. D. The deferral period following collection is 16 weeks

A. The hematocrit must be at least 38%

To qualify as a donor for autologous transfusion a patient’s hemoglobin should be at least: A. 8 g/dL B. 11 g/dL C. 13 g/dL D. 15 g/dL

B. 11 g/dL

Which one of the following constitutes permanent deferral status of a donor? A. A tattoo 5 months previously B. Recent close contact with a patient with viral hepatitis C. 2 units of blood transfused 4 months previously D. Confirmed positive test for HBsAg 10 years previously

D. Confirmed positive test for HBsAg 10 years previously

Donors who have received HBIG must wait ___ months to donate blood to be sure they were not infected since hepatitis B can be transmitted through transfusion to a patient. A. 2 weeks B. 1 month C. 3 months D. 12 months

D. 12 months

Which of the following vaccinations carries no deferral period? A. Rubella B. Varicella zoster C. Recombinant HPV D. Smallpox

C. Recombinant HPV

A donor bag is half filled during donation when the blood flow stops. Select the correct course of action. A. Closely observe the bag for at least 3 minutes; if blood flow does not resume, withdraw the needle B. Remove the needle immediately and discontinue the donation C. Check and reposition the needle if necessary; if blood flow does not resume, withdraw the needle D. Withdraw the needle and perform a second venipuncture in the other arm

C. Check and reposition the needle if necessary; if blood flow does not resume, withdraw the needle

A woman begins to breathe rapidly while donating blood. Choose the correct course of action. A. Continue the donation; rapid breathing is not a reason to discontinue a donation B. Withdraw the needle, raise her feet, and administer ammonia C. Discontinue the donation and provide a paper bag D. Tell her to sit upright and apply a cold compress to her forehead

C. Discontinue the donation and provide a paper bag

A unit tests positive for syphilis using the rapid plasma reagin test (RPR). The microhemagglutinin assayTreponema pallidum (MHA-TP) on the same unit is negative. What is the disposition of the unit? A. The unit may be used to prepare components B. The donor must be contacted and questioned further; if the RPR result is most likely a false positive, then the unit may be used C. The unit must be discarded D. Cellular components may be prepared but must be irradiated before issue

A. The unit may be used to prepare components

John Smith donated a unit of whole blood in May. Red blood cells made from the whole blood were transfused to a recipient of a community hospital in June with no apparent complications. The blood supplier notified the medical director of the hospital that the donor reported HIGH-RISK BEHAVIOR with another male in April, although viral tests remain negative and the donor is healthy. What course of action should be taken? A. No action should be taken B. The recipient’s physician should be notified C. The recipient’s physician and the recipient should be notified D. The recipient should be notified

B. The recipient’s physician should be notified

Rejuvenation of a unit of Red Blood Cells is a method used to: A. Remove antibody attached to RBCs B. Restore 2,3-DPG and ATP to normal levels C. Inactivate viruses and bacteria D. Filter blood clots and other debris

B. Restore 2,3-DPG and ATP to normal levels

A technologist removed 4 units of blood from the blood bank refrigerator and placed them on the counter. A clerk was waiting to take the units for transfusion. As she checked the paperwork, she noticed that one of the units was leaking onto the counter. What should she do? A. Issue the unit if the red cells appear normal B. Reseal the unit C. Discard the unit D. Call the medical director and ask for an opinion

C. Discard the unit

What should be done if a noticeable clot is found in an RBC unit? A. Issue the unit; the blood will be filtered B. Issue the unit; note the presence of a clot on the release form C. Filter the unit in the blood bank before issue D. Do not issue the unit

D. Do not issue the unit

Upon inspection, a unit of Apheresis Platelets is noted to have visible clots, but otherwise appears normal. The technologist should: A. Issue without concern B. Filter to remove the clots C. Centrifuge to express off the clots D. Quarantine for Gram stain and culture

D. Quarantine for Gram stain and culture

Plastic bag overwraps are recommended when thawing units of FFP in 37°C water baths because they prevent: A. The FFP bag from cracking when it contacts the warm water B. Water from slowly dialyzing across the bag membrane C. The entry ports from becoming contaminated with water D. The label from peeling off as the water circulates in the bath

C. The entry ports from becoming contaminated with water

Which of the following anticoagulant preservative provides a storage time of 35 days at 1°C to 6°C for units of whole blood and prepared RBCs if an additive solution is not added? A. ACD B. CP2D C. CPD D. CPDA-1

D. CPDA-1

Appropriate preservative for modified whole blood: A. ACD B. CPD C. CPDA-1 D. All of these

D. All of these

All of the following are requirements for the tag on the crossmatched donor unit, EXCEPT: A. ABO and Rh type B. Name of the donor C. Unit expiration date D. Interpretation of the crossmatch

B. Name of the donor

What is the expected therapeutic effect in the recipient’s hematocrit after the transfusion of 1 unit of RBCs? A. Increase of 0.5% B. Increase of 1% C. Increase of 2% D. Increase of 3%

D. Increase of 3%

How many units of red blood cells are required to raise the hematocrit of a 70 kg nonbleeding man from 24% to 30%? A. 1 B. 2 C. 3 D. 4

B. 2

A 42-year-old male of average body mass has a history of chronic anemia requiring transfusion support. Two units of red blood cells are transfused. If the pretransfusion hemoglobin was 7.0 g/dL, the expected posttransfusion hemoglobin concentration should be: A. 8.0 g/dL B. 9.0 g/dL C. 10.0 g/dL D. 11.0 g/dL

B. 9.0 g/dL

Washed Red Blood Cells are indicated in which of the following situations? A. An IgA-deficient patient with a history of transfusion-associated anaphylaxis B. A pregnant woman with a history of hemolytic disease of the newborn C. A patient with a positive DAT and red cell autoantibody D. A newborn with a hematocrit of <30%

A. An IgA-deficient patient with a history of transfusion-associated anaphylaxis

According to AABB Standards, LEUKOREDUCED RED CELLS is a product in which the absolute WBC count in the unit is reduced to ____, and contains at least ______ of the original RBC mass. A. 1 x 10^10, 85% B. 3.0 x 10^11, 85% C. 5.5 x 10^10, 85% D. 5 x 10^6, 85%

D. 5 x 10^6, 85%

A unit of packed cells is split into 2 aliquots under CLOSED STERILE CONDITIONS at 8 AM. The expiration time for each aliquot is now: A. 4 PM on the same day B. 8 AM the next morning C. 8 PM on the same day D. The original date of the unsplit unit

D. The original date of the unsplit unit

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: A. 6 hours B. 12 hours C. 5 days D. 35 days

D. 35 days

100

A unit of packed RBCs is split using the OPEN SYSTEM. One of the half units is used. What may be done with the second half unit? A. Must be issued within 24 hours B. Must be issued within 48 hours C. Must be irradiated D. Must retain the original expiration date

A. Must be issued within 24 hours

other names parasitology

Yves Laure Pimentel · 70問 · 2年前

other names parasitology