Question 1

How might a technologist detect a patient with drug-induced hemolytic anemia?

Accepted Answer

A)  Positive rosette test 
B)  Positive antibody screen 
C)  Positive DAT 
D)  ABO discrepancy 
A)  Positive rosette test 
B)  Positive antibody screen 
C)  Positive DAT 
D)  ABO discrepancy

Question 2

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 3

Which of the following describes the drug-adsorption (Hapten) mechanism?

Accepted Answer

A)  Drugs bind firmly to proteins of the RBC membrane 
B)  A soluble drug-antidrug complex absorbs nonspecifically to red blood cell membrane 
C)  Drugs alter the red blood cell membrane so that plasma proteins then bind to the membrane 
D)  The drug induces production of an autoantibody that recognizes red blood cell antigens 
A)  Drugs bind firmly to proteins of the RBC membrane 
B)  A soluble drug-antidrug complex absorbs nonspecifically to red blood cell membrane 
C)  Drugs alter the red blood cell membrane so that plasma proteins then bind to the membrane 
D)  The drug induces production of an autoantibody that recognizes red blood cell antigens

Question 4

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 5

Which of the following procedures can be used to resolve interference due to anti-I?

Accepted Answer

A)  Cold autoadsorption 
B)  Prewarm technique 
C)  Warm adsorption 
D)  Cold autoadsorption and prewarm technique 
A)  Cold autoadsorption 
B)  Prewarm technique 
C)  Warm adsorption 
D)  Cold autoadsorption and prewarm technique

Question 6

Which of the following is a characteristic of autoantibodies?

Accepted Answer

A)  The DAT is only reactive with anti-C3d 
B)  Antibody consists of IgM immunoglobulin 
C)  Antibody reacts with low-incidence antigens 
D)  Antibody reacts with high-incidence antigens 
A)  The DAT is only reactive with anti-C3d 
B)  Antibody consists of IgM immunoglobulin 
C)  Antibody reacts with low-incidence antigens 
D)  Antibody reacts with high-incidence antigens

Question 7

Which of the following can be found in warm autoimmune hemolytic anemia in the presence of hypoplastic marrow?

Accepted Answer

A)  Reticulocytopenia 
B)  Polychromasia 
C)  Reticulocytosis 
D)  Thrombocytopenia 
A)  Reticulocytopenia 
B)  Polychromasia 
C)  Reticulocytosis 
D)  Thrombocytopenia

Question 8

RBCs sensitized in which drug-induced hemolytic anemia mechanism act as "innocent bystanders"?

Accepted Answer

A)  Membrane modification 
B)  Immune complex 
C)  Drug absorption 
D)  Autoantibody formation 
A)  Membrane modification 
B)  Immune complex 
C)  Drug absorption 
D)  Autoantibody formation

Question 9

The onset of warm autoimmune hemolytic anemia (WAIHA) may be precipitated by:

Accepted Answer

A)  pregnancy. 
B)  bacterial infection. 
C)  trauma. 
D)  all of the above. 
A)  pregnancy. 
B)  bacterial infection. 
C)  trauma. 
D)  all of the above.

Question 10

In the case of an AB-positive individual, what test must be performed to ensure that a warm-reacting autoantibody is not causing false-positive reactions?

Accepted Answer

A)  Rh control 
B)  DAT 
C)  IAT 
D)  Rosette test 
A)  Rh control 
B)  DAT 
C)  IAT 
D)  Rosette test

Question 11

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 12

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 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

All of the following are characteristics of benign cold autoagglutinins except:

Accepted Answer

A)  Antibodies react best with ficin-treated cells 
B)  Autoantibodies are of the IgM class 
C)  Antibodies have a titer greater than 64 at 4°C 
D)  Autoantibodies can activate complement in vitro 
A)  Antibodies react best with ficin-treated cells 
B)  Autoantibodies are of the IgM class 
C)  Antibodies have a titer greater than 64 at 4°C 
D)  Autoantibodies can activate complement in vitro

Question 15

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 16

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 17

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

Question 18

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 19

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 20

In the digitonin-acid elution procedure, what is the purpose of adding phosphate buffer to the eluate solution?

Accepted Answer

A)  To disperse any debris left in the eluate 
B)  To protect against hemolysis 
C)  To restore neutrality to the eluate 
D)  To elute antibody from red blood cell membrane 
A)  To disperse any debris left in the eluate 
B)  To protect against hemolysis 
C)  To restore neutrality to the eluate 
D)  To elute antibody from red blood cell membrane

Exam 20: Autoimmune Hemolytic Anemias

How might a technologist detect a patient with drug-induced hemolytic anemia?

In which case might you see an anti-i?

Which of the following describes the drug-adsorption (Hapten) mechanism?

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:

Which of the following procedures can be used to resolve interference due to anti-I?

Which of the following is a characteristic of autoantibodies?

Which of the following can be found in warm autoimmune hemolytic anemia in the presence of hypoplastic marrow?

RBCs sensitized in which drug-induced hemolytic anemia mechanism act as "innocent bystanders"?

The onset of warm autoimmune hemolytic anemia (WAIHA) may be precipitated by:

In the case of an AB-positive individual, what test must be performed to ensure that a warm-reacting autoantibody is not causing false-positive reactions?

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

Which drug can cause production of autoantibody?

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

All of the following are characteristics of benign cold autoagglutinins except:

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

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

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

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

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

In the digitonin-acid elution procedure, what is the purpose of adding phosphate buffer to the eluate solution?

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

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