Question 1

During a first-trimester prenatal examination,a pregnant group A,D-negative woman had an anti-D titer of 8.What is the most likely course of action?

Accepted Answer

A)  The anti-D is probably from prenatal Rh immune globulin; another dose should be given at birth. 
B)  Repeat the titer in 4 weeks to determine if significant rise in titer is detected. 
C)  The pregnancy is considered high risk, and the mother should be followed up immediately with amniocentesis or percutaneous umbilical cord testing. 
D)  None of the above is correct. 
A)  The anti-D is probably from prenatal Rh immune globulin; another dose should be given at birth. 
B)  Repeat the titer in 4 weeks to determine if significant rise in titer is detected. 
C)  The pregnancy is considered high risk, and the mother should be followed up immediately with amniocentesis or percutaneous umbilical cord testing. 
D)  None of the above is correct. B

Question 2

Anti-D in the serum of a third-trimester pregnant woman with a titer of 16 is indicative of:

Accepted Answer

A)  the presence of Rh immune globulin administered at 28 weeks. 
B)  active immunization. 
C)  passive immunization. 
D)  None of the above 
A)  the presence of Rh immune globulin administered at 28 weeks. 
B)  active immunization. 
C)  passive immunization. 
D)  None of the above B

Question 3

Select the most common antibody specificity associated with hemolytic disease of the fetus and newborn.

Accepted Answer

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

Question 4

All of the following are goals of an exchange transfusion except to:

Accepted Answer

A)  correct anemia. 
B)  remove high levels of unconjugated bilirubin. 
C)  remove high levels of maternal antibody. 
D)  restore the platelet count. 
A)  correct anemia. 
B)  remove high levels of unconjugated bilirubin. 
C)  remove high levels of maternal antibody. 
D)  restore the platelet count.

Question 5

A weakly reactive anti-D was detected in a sample from a D-negative mother one day following delivery of a D-negative baby.Based on these results,what is the next step?

Accepted Answer

A)  Titer the anti-D 
B)  Perform a rosette test 
C)  Review records for prenatal RhIG administration 
D)  Administer RhIG 
A)  Titer the anti-D 
B)  Perform a rosette test 
C)  Review records for prenatal RhIG administration 
D)  Administer RhIG

Question 6

Rh immune globulin contains:

Accepted Answer

A)  IgG anti-D. 
B)  immune serum globulin. 
C)  IgM anti-D. 
D)  gamma globulin. 
A)  IgG anti-D. 
B)  immune serum globulin. 
C)  IgM anti-D. 
D)  gamma globulin.

Question 7

Which of the following best describes the principle of the Kleihauer-Betke test?

Accepted Answer

A)  Fetal hemoglobin is resistant to acid elution and remains in the cell to stain pink, whereas adult cells appear as ghost cells. 
B)  Adult hemoglobin is resistant to acid elution and remains in the cell to stain pink, whereas fetal cells appear as ghost cells. 
C)  D-positive cells from the fetus form rosettes around the IgG-coated mother's cells. 
D)  Indicator cells form rosettes around the fetal D-positive cells. 
A)  Fetal hemoglobin is resistant to acid elution and remains in the cell to stain pink, whereas adult cells appear as ghost cells. 
B)  Adult hemoglobin is resistant to acid elution and remains in the cell to stain pink, whereas fetal cells appear as ghost cells. 
C)  D-positive cells from the fetus form rosettes around the IgG-coated mother's cells. 
D)  Indicator cells form rosettes around the fetal D-positive cells.

Question 8

Which of the following is true regarding the rosette test?

Accepted Answer

A)  The test is a staining procedure differentiating fetal and adult cells 
B)  The test is valid only if the mother is D-negative and the infant is D-positive. 
C)  Indicator cells bind to the D-positive maternal cells forming a rosette. 
D)  The test is a quantitative test to determine how many vials of Rh immune globulin to administer. 
A)  The test is a staining procedure differentiating fetal and adult cells 
B)  The test is valid only if the mother is D-negative and the infant is D-positive. 
C)  Indicator cells bind to the D-positive maternal cells forming a rosette. 
D)  The test is a quantitative test to determine how many vials of Rh immune globulin to administer.

Question 9

Amniotic fluid analysis showed a marked increase into zone III of the Liley graph.Lecithin-sphingomyelin ratios indicated that the fetal lungs were not mature.Select the most appropriate decision regarding medical intervention.

Accepted Answer

A)  No immediate need for intervention 
B)  An intrauterine transfusion 
C)  Delivery by cesarean section 
D)  None of the above 
A)  No immediate need for intervention 
B)  An intrauterine transfusion 
C)  Delivery by cesarean section 
D)  None of the above

Question 10

A 0.3% fetomaternal bleed was determined by a Kleihauer-Betke stain of postpartum blood.What is the estimated volume of the fetomaternal bleed expressed as whole blood?

Accepted Answer

A)  10 mL 
B)  15 mL 
C)  20 mL 
D)  25 mL 
A)  10 mL 
B)  15 mL 
C)  20 mL 
D)  25 mL

Question 11

What type of hemolytic disease of the fetus and newborn affects the first-born?

Accepted Answer

A)  ABO 
B)  D 
C)  E 
D)  M 
A)  ABO 
B)  D 
C)  E 
D)  M

Question 12

Select the situation where the administration of Rh immune globulin would be contraindicated.

Accepted Answer

A)    
B)   
C)    
D)    
A)    
B)   
C)    
D)

Question 13

In testing amniotic fluid,the Liley method of predicting the severity of hemolytic disease of the fetus and newborn is based on:

Accepted Answer

A)  colorimetric protein analysis. 
B)  optical density of bilirubin at 450 nm. 
C)  ratio of lecithin to sphingomyelin. 
D)  titration of antibody. 
A)  colorimetric protein analysis. 
B)  optical density of bilirubin at 450 nm. 
C)  ratio of lecithin to sphingomyelin. 
D)  titration of antibody.

Question 14

A 300-µg dose of Rh immune globulin contains sufficient anti-D to protect against how much whole blood?

Accepted Answer

A)  25 mL 
B)  30 mL 
C)  50 mL 
D)  100 mL 
A)  25 mL 
B)  30 mL 
C)  50 mL 
D)  100 mL

Question 15

In a suspected case of ABO HDFN,what significant information is obtained from the baby's blood smear?

Accepted Answer

A)  The estimated platelet count 
B)  Increase in nucleated red cells 
C)  The presences of spherocytes 
D)  Increase in monocytes 
A)  The estimated platelet count 
B)  Increase in nucleated red cells 
C)  The presences of spherocytes 
D)  Increase in monocytes

Question 16

The Kleihauer Betke test was performed using a 1-hour post-delivery maternal blood sample.
Results: 10 fetal cells/1000 cells counted
It is the policy to add 1 vial of Rh immune globulin to the calculated dose when the estimated volume of the hemorrhage exceeds 20 mL of whole blood.Calculate the number of vials of Rh immune globulin that would be indicated under these circumstances.

Accepted Answer

A)  2 
B)  3 
C)  4 
D)  5 
A)  2 
B)  3 
C)  4 
D)  5

Question 17

Why is reverse grouping omitted in the neonatal period for ABO testing?

Accepted Answer

A)  The maternal antibody is identical to that of the newborn. 
B)  Newborns do not produce their own antibody until about 4 months. 
C)  The newborn's antibody is the same as the paternal antibody. 
D)  None of the above is correct. 
A)  The maternal antibody is identical to that of the newborn. 
B)  Newborns do not produce their own antibody until about 4 months. 
C)  The newborn's antibody is the same as the paternal antibody. 
D)  None of the above is correct.

Question 18

Select the true statement regarding ABO hemolytic disease of the fetus and newborn (HDFN).

Accepted Answer

A)  It is frequently seen in group A mothers with group O infants. 
B)  It cannot occur during prima gravida (first pregnancy). 
C)  Bilirubin levels often exceed 15 mg/dL in the affected infants. 
D)  The frequency of ABO hemolytic disease of the fetus and newborn is greater than Rh hemolytic disease of the fetus and newborn. 
A)  It is frequently seen in group A mothers with group O infants. 
B)  It cannot occur during prima gravida (first pregnancy). 
C)  Bilirubin levels often exceed 15 mg/dL in the affected infants. 
D)  The frequency of ABO hemolytic disease of the fetus and newborn is greater than Rh hemolytic disease of the fetus and newborn.

Question 19

The rosette test will detect a fetomaternal hemorrhage as small as:

Accepted Answer

A)  5 mL 
B)  10 mL 
C)  15 mL 
D)  20 mL 
A)  5 mL 
B)  10 mL 
C)  15 mL 
D)  20 mL

Question 20

To prevent graft-versus-host disease,red blood cells prepared for intrauterine transfusions should be:

Accepted Answer

A)  frozen and deglycerolized. 
B)  saline washed. 
C)  ABO and D-compatible with the mother. 
D)  irradiated. 
A)  frozen and deglycerolized. 
B)  saline washed. 
C)  ABO and D-compatible with the mother. 
D)  irradiated.

During a first-trimester prenatal examination,a pregnant group A,D-negative woman had an anti-D titer of 8.What is the most likely course of action?

Anti-D in the serum of a third-trimester pregnant woman with a titer of 16 is indicative of:

Select the most common antibody specificity associated with hemolytic disease of the fetus and newborn.

All of the following are goals of an exchange transfusion except to:

A weakly reactive anti-D was detected in a sample from a D-negative mother one day following delivery of a D-negative baby.Based on these results,what is the next step?

Rh immune globulin contains:

Which of the following best describes the principle of the Kleihauer-Betke test?

Which of the following is true regarding the rosette test?

Amniotic fluid analysis showed a marked increase into zone III of the Liley graph.Lecithin-sphingomyelin ratios indicated that the fetal lungs were not mature.Select the most appropriate decision regarding medical intervention.

A 0.3% fetomaternal bleed was determined by a Kleihauer-Betke stain of postpartum blood.What is the estimated volume of the fetomaternal bleed expressed as whole blood?

What type of hemolytic disease of the fetus and newborn affects the first-born?

Select the situation where the administration of Rh immune globulin would be contraindicated.

In testing amniotic fluid,the Liley method of predicting the severity of hemolytic disease of the fetus and newborn is based on:

A 300-µg dose of Rh immune globulin contains sufficient anti-D to protect against how much whole blood?

In a suspected case of ABO HDFN,what significant information is obtained from the baby's blood smear?

Why is reverse grouping omitted in the neonatal period for ABO testing?

Select the true statement regarding ABO hemolytic disease of the fetus and newborn (HDFN).

The rosette test will detect a fetomaternal hemorrhage as small as:

To prevent graft-versus-host disease,red blood cells prepared for intrauterine transfusions should be:

Quality Assurance and Regulation of the Blood Industry and Safety Issues in the Blood Bank

Immunology: Basic Principles and Applications in the Blood Bank

Blood Banking Reagents: Overview and Applications

Genetic Principles in Blood Banking

ABO and H Blood Group Systems and Secretor Status

Rh Blood Group System

Other Red Cell Blood Group Systems, Human Leukocyte Antigens, and Platelet Antigens

Antibody Detection and Identification

Compatibility Testing

Blood Bank Automation for Transfusion Services

Adverse Complications of Transfusions

Donor Selection and Phlebotomy

Testing of Donor Blood

Blood Component Preparation and Therapy

Transfusion Therapy in Selected Patients

Filters

Exam 12: Hemolytic Disease of the Fetus and Newborn

During a first-trimester prenatal examination,a pregnant group A,D-negative woman had an anti-D titer of 8.What is the most likely course of action?

Anti-D in the serum of a third-trimester pregnant woman with a titer of 16 is indicative of:

Select the most common antibody specificity associated with hemolytic disease of the fetus and newborn.

All of the following are goals of an exchange transfusion except to:

A weakly reactive anti-D was detected in a sample from a D-negative mother one day following delivery of a D-negative baby.Based on these results,what is the next step?

Rh immune globulin contains:

Which of the following best describes the principle of the Kleihauer-Betke test?

Which of the following is true regarding the rosette test?

Amniotic fluid analysis showed a marked increase into zone III of the Liley graph.Lecithin-sphingomyelin ratios indicated that the fetal lungs were not mature.Select the most appropriate decision regarding medical intervention.

A 0.3% fetomaternal bleed was determined by a Kleihauer-Betke stain of postpartum blood.What is the estimated volume of the fetomaternal bleed expressed as whole blood?

What type of hemolytic disease of the fetus and newborn affects the first-born?

Select the situation where the administration of Rh immune globulin would be contraindicated.

In testing amniotic fluid,the Liley method of predicting the severity of hemolytic disease of the fetus and newborn is based on:

A 300-µg dose of Rh immune globulin contains sufficient anti-D to protect against how much whole blood?

In a suspected case of ABO HDFN,what significant information is obtained from the baby's blood smear?

Why is reverse grouping omitted in the neonatal period for ABO testing?

Select the true statement regarding ABO hemolytic disease of the fetus and newborn (HDFN).

The rosette test will detect a fetomaternal hemorrhage as small as:

To prevent graft-versus-host disease,red blood cells prepared for intrauterine transfusions should be:

Quality Assurance and Regulation of the Blood Industry and Safety Issues in the Blood Bank

Immunology: Basic Principles and Applications in the Blood Bank

Blood Banking Reagents: Overview and Applications

Genetic Principles in Blood Banking

ABO and H Blood Group Systems and Secretor Status

Rh Blood Group System

Other Red Cell Blood Group Systems, Human Leukocyte Antigens, and Platelet Antigens

Antibody Detection and Identification

Compatibility Testing

Blood Bank Automation for Transfusion Services

Adverse Complications of Transfusions

Donor Selection and Phlebotomy

Testing of Donor Blood

Blood Component Preparation and Therapy

Transfusion Therapy in Selected Patients

Filters