Question 1

What is the most frequent antibody specificity in CHD?

Accepted Answer

A)  Anti-IH 
B)  Anti-i 
C)  Anti-I 
D)  Anti-P 
A)  Anti-IH 
B)  Anti-i 
C)  Anti-I 
D)  Anti-P C

Question 2

An EDTA sample is preferred over a clotted sample for performing DAT testing because:

Accepted Answer

A)  hemolysis is less likely to occur in a smaller EDTA tube. 
B)  complement coating is better detected in an EDTA tube. 
C)  the EDTA prevents complement binding in-vitro. 
D)  there is less likely to be fibrin in the EDTA tube. 
A)  hemolysis is less likely to occur in a smaller EDTA tube. 
B)  complement coating is better detected in an EDTA tube. 
C)  the EDTA prevents complement binding in-vitro. 
D)  there is less likely to be fibrin in the EDTA tube. C

Question 3

A 5-year-old boy suffering from the measles complained of back pain, chills, and stomach pain. A visit to the doctor revealed hemoglobinuria, bilirubinemia, and hemoglobinemia. The child's hemoglobin level had fallen to 6 g/dL. A Donath- Landsteiner test was performed and showed the following: control sample = no hemolysis; test sample = hemolysis. The results are consistent with what disorder?

Accepted Answer

A)  Warm autoimmune hemolytic anemia 
B)  Cold hemagglutinin disease 
C)  Paroxysmal cold hemoglobinuria 
D)  Secondary cold AIHA 
A)  Warm autoimmune hemolytic anemia 
B)  Cold hemagglutinin disease 
C)  Paroxysmal cold hemoglobinuria 
D)  Secondary cold AIHA C

Question 4

Which of the following describes a cold autologous absorption procedure?

Accepted Answer

A)  An aliquot of patient cells is incubated with an equal aliquot of patient serum at 37°C; autoantibody is removed and alloantibody remains in the serum. 
B)  An aliquot of patient cells is incubated with an equal aliquot of patient serum at 37°C; alloantibody is removed while autoantibody remains in the serum. 
C)  An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; alloantibody is removed while autoantibody remains in the serum. 
D)  An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; autoantibody is removed while alloantibody remains in the serum. 
A)  An aliquot of patient cells is incubated with an equal aliquot of patient serum at 37°C; autoantibody is removed and alloantibody remains in the serum. 
B)  An aliquot of patient cells is incubated with an equal aliquot of patient serum at 37°C; alloantibody is removed while autoantibody remains in the serum. 
C)  An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; alloantibody is removed while autoantibody remains in the serum. 
D)  An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4°C; autoantibody is removed while alloantibody remains in the serum.

Question 5

What treatment for warm autoimmune hemolytic anemia aids in the reduction of antibody and removes a potent site of red blood cell damage and destruction?

Accepted Answer

A)  Corticosteroids 
B)  Splenectomy 
C)  Immunosuppressive drugs 
D)  Transfusion 
A)  Corticosteroids 
B)  Splenectomy 
C)  Immunosuppressive drugs 
D)  Transfusion

Question 6

Approximately what percentage of warm autoimmune hemolytic anemia will produce a positive DAT with both IgG and C3d antibodies?

Accepted Answer

A)  20% 
B)  67% 
C)  10% 
D)  13% 
A)  20% 
B)  67% 
C)  10% 
D)  13%

Question 7

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 8

All of the following are clinical manifestations of cold hemagglutinin disease (CHD) except:

Accepted Answer

A)  agglutination of red blood cells in skin capillaries. 
B)  acrocyanosis of the hands and feet. 
C)  hepatosplenomegaly. 
D)  Raynaud's phenomena. 
A)  agglutination of red blood cells in skin capillaries. 
B)  acrocyanosis of the hands and feet. 
C)  hepatosplenomegaly. 
D)  Raynaud's phenomena.

Question 9

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 10

Which of the following regarding the immune complex mechanism in serologic testing is true?

Accepted Answer

A)  The antibody is directed against a red blood cell antigen. 
B)  The antibody screen will be positive in Coombs' phase 
C)  The DAT will be positive with monospecific C3 but negative with IgG. 
D)  The eluate will be positive. 
A)  The antibody is directed against a red blood cell antigen. 
B)  The antibody screen will be positive in Coombs' phase 
C)  The DAT will be positive with monospecific C3 but negative with IgG. 
D)  The eluate will be positive.

Question 11

If a false-positive reaction was suspected with anti-D in the forward grouping due to the presence of a cold autoantibody, which of the following would show reactivity?

Accepted Answer

A)  Du test 
B)  DAT 
C)  Rh control 
D)  All of the above 
A)  Du test 
B)  DAT 
C)  Rh control 
D)  All of the above

Question 12

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 13

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 14

In warm autoimmune hemolytic anemia, the autoantibody will frequently demonstrate___________ -like specificity.

Accepted Answer

A)  Fya 
B)  K 
C)  Rh 
D)  Jkb 
A)  Fya 
B)  K 
C)  Rh 
D)  Jkb

Question 15

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 16

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 17

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 18

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

Question 19

Which alloantibody is frequently present in the serum of i adults?

Accepted Answer

A)  Anti-IH 
B)  Anti-H 
C)  Anti-I 
D)  All of the above 
A)  Anti-IH 
B)  Anti-H 
C)  Anti-I 
D)  All of the above

Question 20

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

Exam 20: Autoimmune Hemolytic Anemias

What is the most frequent antibody specificity in CHD?

An EDTA sample is preferred over a clotted sample for performing DAT testing because:

Which of the following describes a cold autologous absorption procedure?

What treatment for warm autoimmune hemolytic anemia aids in the reduction of antibody and removes a potent site of red blood cell damage and destruction?

Approximately what percentage of warm autoimmune hemolytic anemia will produce a positive DAT with both IgG and C3d antibodies?

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

All of the following are clinical manifestations of cold hemagglutinin disease (CHD) except:

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

Which of the following regarding the immune complex mechanism in serologic testing is true?

If a false-positive reaction was suspected with anti-D in the forward grouping due to the presence of a cold autoantibody, which of the following would show reactivity?

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

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

In warm autoimmune hemolytic anemia, the autoantibody will frequently demonstrate___________ -like specificity.

Which of the following signifies intravascular hemolysis in AIHA?

Which theory supports production of autoantibodies?

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

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

Which alloantibody is frequently present in the serum of i adults?

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

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 the Other Blood Groups

Detection and Identification of Antibodies

Pre-Transfusion Testing

Overview of the Routine Blood Bank Laboratory

Other Technologies and Automation

Donor Screening and Component Preparation

Apheresis

Transfusion Therapy

Cellular Therapy

Transfusion-Transmitted Diseases

Hemolytic Disease of the Fetus and Newborn

The Hla System

Relationship Testing

Quality Management

Transfusion Safety and Federal Regulatory Requirements

Utilization Management

Laboratory Information Systems

Medicolegal and Ethical Aspects of Providing Blood Collection and Transfusion Services

Tissue Banking: A New Role for the Transfusion Service

Filters