Question 1

Cold hemagglutinin disease represents what percentage of autoimmune hemolytic anemia (AIHA) cases?

Accepted Answer

A)  18 
B)  70 
C)  12 
D)  25 
A)  18 
B)  70 
C)  12 
D)  25 A

Question 2

Cold autoanti-H is more prevalent in which blood group?

Accepted Answer

A)  A2 
B)  O 
C)  A1B 
D)  B 
A)  A2 
B)  O 
C)  A1B 
D)  B C

Question 3

Why do clotted specimens yield positive DAT results with anti-C3 in the presence of a benign cold autoagglutinin?

Accepted Answer

A)  Complement is inhibited due to calcium chelation. 
B)  Complement can be activated in vivo. 
C)  Complement can be activated in vitro. 
D)  Complement is activated in the absence of fibrinogen. 
A)  Complement is inhibited due to calcium chelation. 
B)  Complement can be activated in vivo. 
C)  Complement can be activated in vitro. 
D)  Complement is activated in the absence of fibrinogen. C

Question 4

A benign cold autoagglutinin may cause interference in antibody screening procedures when:

Accepted Answer

A)  anti-IgG AHG reagents are used in the test procedure. 
B)  polyspecific AHG reagents are used in the test procedure. 
C)  the immediate spin phase is omitted. 
D)  LISS is used as a potentiator at 37°C incubation. 
A)  anti-IgG AHG reagents are used in the test procedure. 
B)  polyspecific AHG reagents are used in the test procedure. 
C)  the immediate spin phase is omitted. 
D)  LISS is used as a potentiator at 37°C incubation.

Question 5

A patient with a warm reacting autoantibody needs 2 units of compatible, packed cells. Medical history reveals a blood transfusion 2 months ago. A homologous absorption is performed using the following red blood cell phenotype: R2R2, ss, Fy(a-b+), Jk(a+b-), kk. What alloantibody would remain in the serum after absorption?

Accepted Answer

A)  anti-Jka 
B)  anti-E 
C)  anti-S 
D)  anti-Fyb 
A)  anti-Jka 
B)  anti-E 
C)  anti-S 
D)  anti-Fyb

Question 6

A cold antibody titer greater than at 4°C is characteristic of pathological CHD.

Accepted Answer

A)  64 
B)  1,000 
C)  256 
D)  128 
A)  64 
B)  1,000 
C)  256 
D)  128

Question 7

How is RBC destruction characterized in drug-induced immune hemolytic anemia via immune complex mechanism?

Accepted Answer

A)  Extravascular hemolysis via macrophage ingestion of drug complex 
B)  Red blood cell death due to toxic granules released by neutrophils 
C)  Intravascular hemolysis precipitated by complement activation 
D)  None of the above 
A)  Extravascular hemolysis via macrophage ingestion of drug complex 
B)  Red blood cell death due to toxic granules released by neutrophils 
C)  Intravascular hemolysis precipitated by complement activation 
D)  None of the above

Question 8

Most cases of warm autoimmune hemolytic anemia will be DAT-positive with which of the following?

Accepted Answer

A)  Anti-IgG only 
B)  Anti-C3d only 
C)  Both anti-IgG and Anti-C3d 
D)  None of the above 
A)  Anti-IgG only 
B)  Anti-C3d only 
C)  Both anti-IgG and Anti-C3d 
D)  None of the above

Question 9

In a patient who has been recently transfused, a positive DAT may be due to:

Accepted Answer

A)  alloantibody coating patient cells. 
B)  alloantibody coating transfused donor cells. 
C)  antibodies to a drug coating donor cells. 
D)  none of the above. 
A)  alloantibody coating patient cells. 
B)  alloantibody coating transfused donor cells. 
C)  antibodies to a drug coating donor cells. 
D)  none of the above.

Question 10

Which drug-induced mechanism does not result in a hemolytic episode?

Accepted Answer

A)  Immune complex formation 
B)  Drug adsorption 
C)  Membrane modification 
D)  Methyldopa-induced autoantibody 
A)  Immune complex formation 
B)  Drug adsorption 
C)  Membrane modification 
D)  Methyldopa-induced autoantibody

Question 11

Persons diagnosed with pneumonia caused by Mycoplasma pneumoniae may produce a cold autoantibody with specificity.

Accepted Answer

A)  anti-H 
B)  anti-i 
C)  anti-I 
D)  anti-P 
A)  anti-H 
B)  anti-i 
C)  anti-I 
D)  anti-P

Question 12

Which of the following is a proposed theory for methyldopa-induced mechanism of immune hemolytic anemia?

Accepted Answer

A)  Normal red blood cell antigens are altered by the drug and are no longer recognized as "self," resulting in production of alloantibody to these red blood cell antigens. 
B)  The drug affects the synthesis of IgG, exerting a direct effect on T lymphocytes, which results in a loss of suppressor function and subsequent proliferation of autoantibodies by B lymphocytes. 
C)  The drug produces aberrations in the proliferation of normal lymphocytes, producing clones of normal immunologically competent cells, which produces antibody against foreign red blood cell antigens. 
D)  The drug modifies the red blood cells so that plasma proteins bind to the membrane. 
A)  Normal red blood cell antigens are altered by the drug and are no longer recognized as "self," resulting in production of alloantibody to these red blood cell antigens. 
B)  The drug affects the synthesis of IgG, exerting a direct effect on T lymphocytes, which results in a loss of suppressor function and subsequent proliferation of autoantibodies by B lymphocytes. 
C)  The drug produces aberrations in the proliferation of normal lymphocytes, producing clones of normal immunologically competent cells, which produces antibody against foreign red blood cell antigens. 
D)  The drug modifies the red blood cells so that plasma proteins bind to the membrane.

Question 13

What percentage of AIHA cases are caused by warm reacting autoantibodies?

Accepted Answer

A)  18% 
B)  70% 
C)  12% 
D)  25% 
A)  18% 
B)  70% 
C)  12% 
D)  25%

Question 14

Immune hemolytic anemia is defined as:

Accepted Answer

A)  an increased RBC destruction caused by radiation exposure. 
B)  a shortened RBC survival caused by defective DNA synthesis. 
C)  a shortened RBC survival mediated through humoral antibody production. 
D)  an increased RBC destruction caused by enzyme defects. 
A)  an increased RBC destruction caused by radiation exposure. 
B)  a shortened RBC survival caused by defective DNA synthesis. 
C)  a shortened RBC survival mediated through humoral antibody production. 
D)  an increased RBC destruction caused by enzyme defects.

Question 15

Which of the following characterizes an alloimmune response in immune hemolytic anemia?

Accepted Answer

A)  The patient produces an antibody reactive with her own red blood cells. 
B)  The patient produces an antibody to a prescribed antibiotic. 
C)  The patient produces anti-K to transfused red blood cells. 
D)  None of the above 
A)  The patient produces an antibody reactive with her own red blood cells. 
B)  The patient produces an antibody to a prescribed antibiotic. 
C)  The patient produces anti-K to transfused red blood cells. 
D)  None of the above

Question 16

What technique can be used to identify an alloantibody in the presence of a cold autoagglutinin?

Accepted Answer

A)  Prewarming 
B)  Enzyme treatment 
C)  Chloroquine treatment 
D)  Polyethylene glycol 
A)  Prewarming 
B)  Enzyme treatment 
C)  Chloroquine treatment 
D)  Polyethylene glycol

Question 17

Which of the following factors distinguishes a cold autoantibody produced in a patient with infectious mononucleosis from that produced in a patient with pneumonia?

Accepted Answer

A)  A titer greater than 64 
B)  An IgM class of antibody 
C)  A wide thermal range 
D)  Anti-i specificity 
A)  A titer greater than 64 
B)  An IgM class of antibody 
C)  A wide thermal range 
D)  Anti-i specificity

Question 18

In which of the following is the DAT reactive with anti-C3d only?

Accepted Answer

A)  Drug adsorption mechanism 
B)  Warm autoimmune hemolytic anemia 
C)  Cold hemagglutinin disease 
D)  Membrane modification 
A)  Drug adsorption mechanism 
B)  Warm autoimmune hemolytic anemia 
C)  Cold hemagglutinin disease 
D)  Membrane modification

Question 19

Which cells contain the most i antigen?

Accepted Answer

A)  Lymphocytes 
B)  Cord blood 
C)  Adult red blood cells 
D)  Platelets 
A)  Lymphocytes 
B)  Cord blood 
C)  Adult red blood cells 
D)  Platelets

Question 20

Chemically modified anti-D reacted negatively in a patient with a warm-reacting autoantibody. A Du test was performed using monospecific IgG, which was positive in Coombs' phase. A fetal screen (rosette test) was also performed on this patient and showed no rosettes when viewed microscopically. Based on these results, what is the correct Rh type of this patient?

Accepted Answer

A)  Rh-positive 
B)  Rh-negative 
C)  Rh-unknown 
D)  Du-positive 
A)  Rh-positive 
B)  Rh-negative 
C)  Rh-unknown 
D)  Du-positive

Exam 21: Autoimmune Hemolytic Anemias

Cold hemagglutinin disease represents what percentage of autoimmune hemolytic anemia (AIHA) cases?

Cold autoanti-H is more prevalent in which blood group?

Why do clotted specimens yield positive DAT results with anti-C3 in the presence of a benign cold autoagglutinin?

A benign cold autoagglutinin may cause interference in antibody screening procedures when:

A cold antibody titer greater than at 4°C is characteristic of pathological CHD.

How is RBC destruction characterized in drug-induced immune hemolytic anemia via immune complex mechanism?

Most cases of warm autoimmune hemolytic anemia will be DAT-positive with which of the following?

In a patient who has been recently transfused, a positive DAT may be due to:

Which drug-induced mechanism does not result in a hemolytic episode?

Persons diagnosed with pneumonia caused by Mycoplasma pneumoniae may produce a cold autoantibody with specificity.

Which of the following is a proposed theory for methyldopa-induced mechanism of immune hemolytic anemia?

What percentage of AIHA cases are caused by warm reacting autoantibodies?

Immune hemolytic anemia is defined as:

Which of the following characterizes an alloimmune response in immune hemolytic anemia?

What technique can be used to identify an alloantibody in the presence of a cold autoagglutinin?

Which of the following factors distinguishes a cold autoantibody produced in a patient with infectious mononucleosis from that produced in a patient with pneumonia?

In which of the following is the DAT reactive with anti-C3d only?

Which cells contain the most i antigen?

Red Blood Cells and Platelet Preservation: Historical Perspectives and Current Trends

Basic Genetics

Fundamentals of Immunology

Concepts in Molecular Biology

The Antiglobulin Test

The Abo Blood Group System

The Rh Blood Group System

Blood Group Terminology and Common Blood Groups

Uncommon Blood Groups

Detection and Identification of Antibodies

Pre-Transfusion Testing

Blood Bank Technologies and Automation

Donor Selection

Transfusion-Transmitted Diseases

Component Preparation

Transfusion Therapy

Adverse Effects of Blood Transfusion

Apheresis

Cellular Therapy in the Transplant Setting

Hemolytic Disease of the Fetus and Newborn

Tissue Banking As Part of the Transfusion Service

The Hla System

Relationship Testing

Quality Management

Patient Blood Management

Transfusion Safety and Federal Regulatory Requirements

Laboratory Information Systems in the Blood Bank

Medicolegal and Ethical Aspects of Providing Blood Collection and Transfusion Services

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