Question 1

Immunization of the mother can be caused by as little as ___________D-positive fetal cells.

Accepted Answer

A)  10 mL 
B)  1 mL 
C)  50 mL 
D)  20 mL 
A)  10 mL 
B)  1 mL 
C)  50 mL 
D)  20 mL

Question 2

Which of the following assays is used to calculate the amount of fetomaternal hemorrhage in a postpartum specimen?

Accepted Answer

A)  Antibody specimen 
B)  Kleihauer-Betke test 
C)  Rosette test 
D)  Solid-phase adherence test 
A)  Antibody specimen 
B)  Kleihauer-Betke test 
C)  Rosette test 
D)  Solid-phase adherence test

Question 3

Blood transfusions to the fetus and premature infants should be___________ to prevent graft-versus-host disease.

Accepted Answer

A)  gamma irradiated 
B)  negative for hemoglobin S 
C)  less than 7 days old 
D)  beta irradiated 
A)  gamma irradiated 
B)  negative for hemoglobin S 
C)  less than 7 days old 
D)  beta irradiated

Question 4

Which prenatal serologic tests are recommended during the first trimester?

Accepted Answer

A)  ABO 
B)  Rh 
C)  Antibody screen 
D)  All of the above 
A)  ABO 
B)  Rh 
C)  Antibody screen 
D)  All of the above

Question 5

In order for the mother to be considered for Rh-immune globulin, her Rh type must be , and her newborn must be ___________.

Accepted Answer

A)  Du-positive/Rh-positive 
B)  Rh-negative/Rh-positive 
C)  Du-negative/Du-negative 
D)  Rh-positive/Rh-negative 
A)  Du-positive/Rh-positive 
B)  Rh-negative/Rh-positive 
C)  Du-negative/Du-negative 
D)  Rh-positive/Rh-negative

Question 6

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

Accepted Answer

A)  D-positive indicator cells form rosettes around maternal Rh-positive RBCs 
B)  D-positive indicator cells form rosettes around fetal Rh-positive red blood cells 
C)  Maternal hemoglobin is resistant to acid (alkali), appearing pink, whereas fetal cells appear as ghost cells 
D)  Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells 
A)  D-positive indicator cells form rosettes around maternal Rh-positive RBCs 
B)  D-positive indicator cells form rosettes around fetal Rh-positive red blood cells 
C)  Maternal hemoglobin is resistant to acid (alkali), appearing pink, whereas fetal cells appear as ghost cells 
D)  Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells

Question 7

What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen?

Accepted Answer

A)  The chance of maternal sensitization to Rh antigen is increased. 
B)  The chance of maternal sensitization to Rh antigen is decreased. 
C)  It has no effect. 
D)  None of the above 
A)  The chance of maternal sensitization to Rh antigen is increased. 
B)  The chance of maternal sensitization to Rh antigen is decreased. 
C)  It has no effect. 
D)  None of the above

Question 8

Which of the following red blood cells is appropriate for neonatal transfusions?

Accepted Answer

A)  Group A, CMV-negative 
B)  Group AB, CMV-negative 
C)  Group O, CMV+ 
D)  Group O, CMV-negative 
A)  Group A, CMV-negative 
B)  Group AB, CMV-negative 
C)  Group O, CMV+ 
D)  Group O, CMV-negative

Question 9

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

Accepted Answer

A)  to remove high levels of unconjugated bilirubin. 
B)  to correct anemia. 
C)  to remove high levels of conjugated bilirubin. 
D)  to remove high levels of maternal antibody. 
A)  to remove high levels of unconjugated bilirubin. 
B)  to correct anemia. 
C)  to remove high levels of conjugated bilirubin. 
D)  to remove high levels of maternal antibody.

Question 10

In which type of HDFN is the firstborn affected?

Accepted Answer

A)  ABO 
B)  Rh 
C)  Lewis 
D)  P 
A)  ABO 
B)  Rh 
C)  Lewis 
D)  P

Question 11

What is the most common clinical manifestation of ABO HDFN?

Accepted Answer

A)  Severe anemia 
B)  Hyperbilirubinemia 
C)  Hyperkalemia 
D)  Hypotension 
A)  Severe anemia 
B)  Hyperbilirubinemia 
C)  Hyperkalemia 
D)  Hypotension

Question 12

The results of a Kleihauer-Betke stain indicate a fetomaternal bleed of 40 ml of whole blood. How many vials of Rh-immune globulin would be required?

Accepted Answer

A)  1 
B)  2 
C)  3 
D)  4 
A)  1 
B)  2 
C)  3 
D)  4

Question 13

What tests are indicated for cord blood specimens if the mother has made anti-K?

Accepted Answer

A)  ABO, Rh, Antibody screen 
B)  ABO, Rh, DAT 
C)  ABO, Rh, cold autoabsorption 
D)  Kleihauer-Betke 
A)  ABO, Rh, Antibody screen 
B)  ABO, Rh, DAT 
C)  ABO, Rh, cold autoabsorption 
D)  Kleihauer-Betke

Question 14

Rh-immune globulin should be given within how many hours after delivery?

Accepted Answer

A)  24 
B)  48 
C)  36 
D)  72 
A)  24 
B)  48 
C)  36 
D)  72

Question 15

The D-positive fetal cells in Rh-HDN are___________ .

Accepted Answer

A)  homozygous 
B)  heterozygous 
C)  amorphic 
D)  homologous 
A)  homozygous 
B)  heterozygous 
C)  amorphic 
D)  homologous

Question 16

Why is the Rh-positive firstborn of an Rh-negative mother unaffected by Rh hemolytic disease of the fetus and newborn (Rh HDFN)?

Accepted Answer

A)  The plasma volume of the mother is tripled during the first pregnancy which dilutes anti-D. 
B)  The titer of anti-D is too low to cause destruction of fetal antigens. 
C)  The mother has not been immunized to the D antigen before placental separation. 
D)  None of the above 
A)  The plasma volume of the mother is tripled during the first pregnancy which dilutes anti-D. 
B)  The titer of anti-D is too low to cause destruction of fetal antigens. 
C)  The mother has not been immunized to the D antigen before placental separation. 
D)  None of the above

Question 17

What is the physiological path of indirect bilirubin produced as a result of red blood cell destruction in HDFN?

Accepted Answer

A)  Indirect bilirubin is transported across the placenta and excreted via maternal kidneys. 
B)  Indirect bilirubin is conjugated in the fetal liver to direct bilirubin. 
C)  Indirect bilirubin crosses the placenta and is conjugated in the maternal liver to direct bilirubin. 
D)  None of the above 
A)  Indirect bilirubin is transported across the placenta and excreted via maternal kidneys. 
B)  Indirect bilirubin is conjugated in the fetal liver to direct bilirubin. 
C)  Indirect bilirubin crosses the placenta and is conjugated in the maternal liver to direct bilirubin. 
D)  None of the above

Question 18

Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?

Accepted Answer

A)  Hydrops fetalis 
B)  Kernicterus 
C)  Bilirubinemia 
D)  Bilirubinuria 
A)  Hydrops fetalis 
B)  Kernicterus 
C)  Bilirubinemia 
D)  Bilirubinuria

Question 19

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

Accepted Answer

A)  15 mL 
B)  30 mL 
C)  50 mL 
D)  100 mL 
A)  15 mL 
B)  30 mL 
C)  50 mL 
D)  100 mL

Question 20

Why are premature newborns more likely to require exchange transfusions than full-term infants?

Accepted Answer

A)  Premature newborns are deficient in carrier protein (albumin) for bilirubin transport. 
B)  Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin. 
C)  Premature newborn livers are too underdeveloped to conjugate bilirubin. 
D)  None of the above 
A)  Premature newborns are deficient in carrier protein (albumin) for bilirubin transport. 
B)  Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin. 
C)  Premature newborn livers are too underdeveloped to conjugate bilirubin. 
D)  None of the above

Exam 19: Hemolytic Disease of the Fetus and Newborn

Immunization of the mother can be caused by as little as ___________D-positive fetal cells.

Which of the following assays is used to calculate the amount of fetomaternal hemorrhage in a postpartum specimen?

Blood transfusions to the fetus and premature infants should be___________ to prevent graft-versus-host disease.

Which prenatal serologic tests are recommended during the first trimester?

In order for the mother to be considered for Rh-immune globulin, her Rh type must be , and her newborn must be ___________.

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

What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen?

Which of the following red blood cells is appropriate for neonatal transfusions?

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

In which type of HDFN is the firstborn affected?

What is the most common clinical manifestation of ABO HDFN?

The results of a Kleihauer-Betke stain indicate a fetomaternal bleed of 40 ml of whole blood. How many vials of Rh-immune globulin would be required?

What tests are indicated for cord blood specimens if the mother has made anti-K?

Rh-immune globulin should be given within how many hours after delivery?

The D-positive fetal cells in Rh-HDN are___________ .

Why is the Rh-positive firstborn of an Rh-negative mother unaffected by Rh hemolytic disease of the fetus and newborn (Rh HDFN)?

What is the physiological path of indirect bilirubin produced as a result of red blood cell destruction in HDFN?

Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?

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

Why are premature newborns more likely to require exchange transfusions than full-term infants?

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

Autoimmune Hemolytic Anemias

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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