Question 1

Which of the following forward-typing reagents may generate false-positive results in a patient with a warm-reacting autoantibody?

Accepted Answer

A)  Anti-A 
B)  Anti-B 
C)  Anti-A, B 
D)  Anti-D 
A)  Anti-A 
B)  Anti-B 
C)  Anti-A, B 
D)  Anti-D

Question 2

In cases of warm autoimmune hemolytic anemia, what subclass of IgG is most efficient in binding complement?

Accepted Answer

A)  IgG2 
B)  IgG1 
C)  IgG3 
D)  IgG4 
A)  IgG2 
B)  IgG1 
C)  IgG3 
D)  IgG4

Question 3

A patient with a positive DAT needs to be phenotyped for Jka. What reagent can be used on red blood cells to ensure accurate typing?

Accepted Answer

A)  DTT 
B)  Chloroquine diphosphate 
C)  Ficin 
D)  Digitonin 
A)  DTT 
B)  Chloroquine diphosphate 
C)  Ficin 
D)  Digitonin

Question 4

What is one indication a positive DAT might be due to alloantibody coating donor red blood cells?

Accepted Answer

A)  Positive eluate 
B)  Positive rosette test 
C)  Microscopic mixed-field appearance 
D)  Panagglutinin reaction in panel studies 
A)  Positive eluate 
B)  Positive rosette test 
C)  Microscopic mixed-field appearance 
D)  Panagglutinin reaction in panel studies

Question 5

All of the following are classifications of immune hemolytic anemia except:

Accepted Answer

A)  hyperimmune. 
B)  alloimmune. 
C)  autoimmune. 
D)  drug-induced. 
A)  hyperimmune. 
B)  alloimmune. 
C)  autoimmune. 
D)  drug-induced.

Question 6

What reagent cell type is used in the immune complex formation test to detect drug-antidrug interaction?

Accepted Answer

A)  Group A 
B)  Group B 
C)  Group AB 
D)  Group O 
A)  Group A 
B)  Group B 
C)  Group AB 
D)  Group O

Question 7

Which of the following signifies intravascular hemolysis in AIHA?

Accepted Answer

A)  Increased haptoglobin 
B)  Bilirubinemia 
C)  Hemoglobinuria 
D)  Spherocytosis 
A)  Increased haptoglobin 
B)  Bilirubinemia 
C)  Hemoglobinuria 
D)  Spherocytosis

Question 8

The antigen I is often:

Accepted Answer

A)  found on all cord cells. 
B)  absent on all cord cells. 
C)  a rare antigen. 
D)  only found in the white population. 
A)  found on all cord cells. 
B)  absent on all cord cells. 
C)  a rare antigen. 
D)  only found in the white population.

Question 9

Approximately what percentage of AIHA cases are due to paroxysmal cold hemoglobinuria (PCH)?

Accepted Answer

A)  70% 
B)  12% 
C)  1% to 2% 
D)  18% 
A)  70% 
B)  12% 
C)  1% to 2% 
D)  18%

Question 10

What is the most common drug associated with the drug-adsorption mechanism?

Accepted Answer

A)  Erythromycin 
B)  Penicillin 
C)  Methyldopa 
D)  Insulin 
A)  Erythromycin 
B)  Penicillin 
C)  Methyldopa 
D)  Insulin

Question 11

Cold panel results obtained are: A1 cells: 4+
A2 cells: 4+
O cells: 4+
O cord cells: 0
These results suggest which antibody?

Accepted Answer

A)  H 
B)  IH 
C)  I 
D)  i 
A)  H 
B)  IH 
C)  I 
D)  i

Question 12

What is the recommended treatment for drug-induced hemolytic anemia caused by the immune complex mechanism?

Accepted Answer

A)  Splenectomy 
B)  Immunosuppressive therapy 
C)  Cessation of drug administration 
D)  Transfusion 
A)  Splenectomy 
B)  Immunosuppressive therapy 
C)  Cessation of drug administration 
D)  Transfusion

Question 13

How is the serology workup for an autoantibody produced by a drug-induced hemolytic anemia different from other autoantibody workups?

Accepted Answer

A)  The antibody will only be reactive with red blood cells in the presence of the drug. 
B)  The antibody is not detected in the presence of the drug. 
C)  Eluate is detectable when drug-coated red blood cells are present. 
D)  Complement will be detected on red blood cells. 
A)  The antibody will only be reactive with red blood cells in the presence of the drug. 
B)  The antibody is not detected in the presence of the drug. 
C)  Eluate is detectable when drug-coated red blood cells are present. 
D)  Complement will be detected on red blood cells.

Question 14

In which case might you see an anti-i?

Accepted Answer

A)  Mononucleosis 
B)  Viral hepatitis 
C)  Paroxysmal nocturnal hemoglobinuria 
D)  None of the above 
A)  Mononucleosis 
B)  Viral hepatitis 
C)  Paroxysmal nocturnal hemoglobinuria 
D)  None of the above

Question 15

How can cold autoantibody interference with ABO grouping be avoided?

Accepted Answer

A)  Washing cells with normal saline cooled to 4°C 
B)  Washing cells with normal saline warmed to 37°C 
C)  Treating red blood cells with ficin prior to testing 
D)  Washing cells with normal saline (room temperature) 
A)  Washing cells with normal saline cooled to 4°C 
B)  Washing cells with normal saline warmed to 37°C 
C)  Treating red blood cells with ficin prior to testing 
D)  Washing cells with normal saline (room temperature)

Question 16

Which drug can cause production of autoantibody?

Accepted Answer

A)  Ibuprofen 
B)  Isoniazid 
C)  Methyldopa 
D)  Tetracycline 
A)  Ibuprofen 
B)  Isoniazid 
C)  Methyldopa 
D)  Tetracycline

Question 17

A DAT was performed on a patient suspected of having autoimmune hemolytic anemia. The following results were obtained: PS AHG 3+, Anti-IgG 2+, Anti-C3d-negative. These results mean:

Accepted Answer

A)  the test is invalid. 
B)  the patient's cells are coated with IgG. 
C)  the patient's cells are coated with C3d. 
D)  the patient's cells are coated with both IgG and C3d. 
A)  the test is invalid. 
B)  the patient's cells are coated with IgG. 
C)  the patient's cells are coated with C3d. 
D)  the patient's cells are coated with both IgG and C3d.

Question 18

Autoanti-I was identified in a patient transfused 1 month ago. Which technique is advocated to detect alloantibodies in this patient?

Accepted Answer

A)  Cold autoabsorption 
B)  Prewarming 
C)  Warm autoabsorption 
D)  Enzyme treatment 
A)  Cold autoabsorption 
B)  Prewarming 
C)  Warm autoabsorption 
D)  Enzyme treatment

Question 19

Which theory supports production of autoantibodies?

Accepted Answer

A)  Loss of T-cell suppressor activity upon self-antigens leads to production of autoantibody. 
B)  Helper T cells assist immunocompetent B cells in making antibody against foreign antigens. 
C)  T suppressor cells prevent overproduction of antibody by B cells. 
D)  Loss of T helper cell activity upon self-antigens leads to production of autoantibodies. 
A)  Loss of T-cell suppressor activity upon self-antigens leads to production of autoantibody. 
B)  Helper T cells assist immunocompetent B cells in making antibody against foreign antigens. 
C)  T suppressor cells prevent overproduction of antibody by B cells. 
D)  Loss of T helper cell activity upon self-antigens leads to production of autoantibodies.

Question 20

What is the mechanism by which thiol reagents, such as dithiothreitol (DTT), disperse agglutination caused by cold-reactive autoantibody?

Accepted Answer

A)  Dissociation of IgG molecules from the red blood cell with no damage to the membrane 
B)  Cleavage of the intersubunit disulfide bonds of dimeric IgG molecules 
C)  Cleavage of the intersubunit disulfide bonds of pentameric IgM molecules 
D)  Dissociation of IgM molecules from the red blood cell with no damage to the membrane 
A)  Dissociation of IgG molecules from the red blood cell with no damage to the membrane 
B)  Cleavage of the intersubunit disulfide bonds of dimeric IgG molecules 
C)  Cleavage of the intersubunit disulfide bonds of pentameric IgM molecules 
D)  Dissociation of IgM molecules from the red blood cell with no damage to the membrane

Exam 21: Autoimmune Hemolytic Anemias

Which of the following forward-typing reagents may generate false-positive results in a patient with a warm-reacting autoantibody?

In cases of warm autoimmune hemolytic anemia, what subclass of IgG is most efficient in binding complement?

A patient with a positive DAT needs to be phenotyped for Jka. What reagent can be used on red blood cells to ensure accurate typing?

What is one indication a positive DAT might be due to alloantibody coating donor red blood cells?

All of the following are classifications of immune hemolytic anemia except:

What reagent cell type is used in the immune complex formation test to detect drug-antidrug interaction?

Which of the following signifies intravascular hemolysis in AIHA?

The antigen I is often:

Approximately what percentage of AIHA cases are due to paroxysmal cold hemoglobinuria (PCH)?

What is the most common drug associated with the drug-adsorption mechanism?

Cold panel results obtained are: A1 cells: 4+ A2 cells: 4+ O cells: 4+ O cord cells: 0 These results suggest which antibody?

What is the recommended treatment for drug-induced hemolytic anemia caused by the immune complex mechanism?

How is the serology workup for an autoantibody produced by a drug-induced hemolytic anemia different from other autoantibody workups?

In which case might you see an anti-i?

How can cold autoantibody interference with ABO grouping be avoided?

Which drug can cause production of autoantibody?

A DAT was performed on a patient suspected of having autoimmune hemolytic anemia. The following results were obtained: PS AHG 3+, Anti-IgG 2+, Anti-C3d-negative. These results mean:

Autoanti-I was identified in a patient transfused 1 month ago. Which technique is advocated to detect alloantibodies in this patient?

Which theory supports production of autoantibodies?

What is the mechanism by which thiol reagents, such as dithiothreitol (DTT), disperse agglutination caused by cold-reactive autoantibody?

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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A patient with a positive DAT needs to be phenotyped for Jk^a. What reagent can be used on red blood cells to ensure accurate typing?