Question 1

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 2

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 3

Which of the following is a characteristic red blood cell morphology seen on a peripheral blood smear from a patient with warm autoimmune hemolytic anemia?

Accepted Answer

A)  Stomatocytes 
B)  Teardrop cells 
C)  Spherocytes 
D)  Target cells 
A)  Stomatocytes 
B)  Teardrop cells 
C)  Spherocytes 
D)  Target cells

Question 4

How can persons with CHD avoid hemolytic episodes?

Accepted Answer

A)  Have a splenectomy 
B)  Move to a warm climate 
C)  Corticosteroid therapy 
D)  None of the above 
A)  Have a splenectomy 
B)  Move to a warm climate 
C)  Corticosteroid therapy 
D)  None of the above

Question 5

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 6

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 7

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 8

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

Question 9

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 10

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

Question 11

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 12

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 13

What is the primary goal for treatment in patients with warm autoimmune hemolytic anemia?

Accepted Answer

A)  Reduce neoplastic tumors 
B)  Treat coexisting anemia 
C)  Treat the underlying disease 
D)  None of the above 
A)  Reduce neoplastic tumors 
B)  Treat coexisting anemia 
C)  Treat the underlying disease 
D)  None of the above

Question 14

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 15

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 16

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 17

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 18

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 19

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

Question 20

A 28-year-old female with cold hemagglutinin disease has a positive DAT. When the DAT is repeated using monospecific reagent, which of the following is most likely to be detected?

Accepted Answer

A)  IgM 
B)  IgG 
C)  C3d 
D)  C4d 
A)  IgM 
B)  IgG 
C)  C3d 
D)  C4d

Exam 20: Autoimmune Hemolytic Anemias

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

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

Which of the following is a characteristic red blood cell morphology seen on a peripheral blood smear from a patient with warm autoimmune hemolytic anemia?

How can persons with CHD avoid hemolytic episodes?

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?

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

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

Immune hemolytic anemia is defined as:

Which cells contain the most i antigen?

What is the primary goal for treatment in patients with warm autoimmune hemolytic anemia?

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

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

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

How can cold autoantibody interference with ABO grouping be avoided?

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

A 28-year-old female with cold hemagglutinin disease has a positive DAT. When the DAT is repeated using monospecific reagent, which of the following is most likely to be detected?

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