Question 1

Secondary cold-reactive autoimmune hemolytic anemia is found most often in patients with:

Accepted Answer

A)  Hemolytic disease of the newborn caused by anti-A or anti-D 
B)  Acute myeloid leukemia and chronic myleogenous leukemia 
C)  Mycoplasma pneumoniae or infectious mononucleosis 
D)  Hereditary spherocytosis or hereditary elliptocytosis 
A)  Hemolytic disease of the newborn caused by anti-A or anti-D 
B)  Acute myeloid leukemia and chronic myleogenous leukemia 
C)  Mycoplasma pneumoniae or infectious mononucleosis 
D)  Hereditary spherocytosis or hereditary elliptocytosis C

Question 2

An Rh-negative woman is pregnant with her third child. She received little or no prenatal care during the first two pregnancies. Her anti-D titer is 1:512 at 30 weeks of gestation. What is the likely outcome for the baby?

Accepted Answer

A)  ABO hemolytic disease of the newborn 
B)  Rh hemolytic disease of the newborn 
C)  No or mild hemolysis but spherocytes on the blood film 
D)  Most likely not survive 
A)  ABO hemolytic disease of the newborn 
B)  Rh hemolytic disease of the newborn 
C)  No or mild hemolysis but spherocytes on the blood film 
D)  Most likely not survive B

Question 3

All of the following have been linked to excess erythrocyte destruction except:

Accepted Answer

A)  Drugs. 
B)  IgM autoimmune antibodies 
C)  Immunoglobulin E (Ig
E)  alloantibodies 
D)  IgG alloantibodies 
A)  Drugs. 
B)  IgM autoimmune antibodies 
C)  Immunoglobulin E (Ig
E)  alloantibodies 
D)  IgG alloantibodies C

Question 4

The Donath-Landsteiner antibody:

Accepted Answer

A)  Binds to the red cell membrane at 37 $\degree$C 
B)  Is found in serum and causes lysis of donor RBCs, which have first been incubated at 4 $\degree$ C and then warmed to 37 $\degree$C 
C)  Has specificity for Ii blood group antigens 
D)  Is associated with lymphoma 
A)  Binds to the red cell membrane at 37 $\degree$C 
B)  Is found in serum and causes lysis of donor RBCs, which have first been incubated at 4 $\degree$ C and then warmed to 37 $\degree$C 
C)  Has specificity for Ii blood group antigens 
D)  Is associated with lymphoma

Question 5

Which of the following is true regarding the mechanism of warm-reactive autoimmune hemolytic anemia?

Accepted Answer

A)  Immunoglobulin G (IgG) autoantibodies cause intravascular hemolysis. 
B)  IgG autoantibodies cause extravascular hemolysis. 
C)  Immunoglobulin M (IgM) alloantibodies cause complement activation. 
D)  IgM autoantibodies cause immune complex formation. 
A)  Immunoglobulin G (IgG) autoantibodies cause intravascular hemolysis. 
B)  IgG autoantibodies cause extravascular hemolysis. 
C)  Immunoglobulin M (IgM) alloantibodies cause complement activation. 
D)  IgM autoantibodies cause immune complex formation.

Question 6

A warm-reactive autoimmune hemolytic anemia found in combination with thrombocytopenia in a patient is called:

Accepted Answer

A)  Evans syndrome 
B)  Wiskott-Aldrich syndrome 
C)  Hereditary spherocytosis with thrombocytopenia 
D)  Paroxysmal cold hemoglobinuria 
A)  Evans syndrome 
B)  Wiskott-Aldrich syndrome 
C)  Hereditary spherocytosis with thrombocytopenia 
D)  Paroxysmal cold hemoglobinuria

Question 7

Red cell agglutination is found on a blood film. Select the best course of action.

Accepted Answer

A)  Report the morphology and all automated results. 
B)  Warm the blood, and rerun it though the automated cell counter. 
C)  Warm the blood, and make a new blood film. 
D)  Perform a cold agglutinin test. 
A)  Report the morphology and all automated results. 
B)  Warm the blood, and rerun it though the automated cell counter. 
C)  Warm the blood, and make a new blood film. 
D)  Perform a cold agglutinin test.

Question 8

Monospecific Coombs sera indicates that a patient's red cells have complement coating them. Which of the following red cell morphology would be more likely?

Accepted Answer

A)  Spherocytes 
B)  Schistocytes 
C)  Acanthocytes 
D)  Agglutination 
A)  Spherocytes 
B)  Schistocytes 
C)  Acanthocytes 
D)  Agglutination

Question 9

A type-A Rh-negative infant has spherocytes on his blood film and a weakly positive direct antiglobulin test. What antibody will most likely be found on the infant's red cells?

Accepted Answer

A)  IgG anti-A antibody 
B)  IgM anti-A antibody 
C)  D antibody 
D)  Kell antibody 
A)  IgG anti-A antibody 
B)  IgM anti-A antibody 
C)  D antibody 
D)  Kell antibody

Question 10

Which of the following is most often the result of human error?

Accepted Answer

A)  Erythroblastosis from anti-D 
B)  ABO erythroblastosis 
C)  Delayed hemolytic transfusion reaction 
D)  Immediate hemolytic transfusion reaction 
A)  Erythroblastosis from anti-D 
B)  ABO erythroblastosis 
C)  Delayed hemolytic transfusion reaction 
D)  Immediate hemolytic transfusion reaction

Question 11

Which of the following causes of alloimmune hemolytic anemia accounts for the largest number of deaths?

Accepted Answer

A)  ABO blood type errors from patient misidentification 
B)  Drug reactions to antibiotic agents 
C)  ABO hemolytic disease of the newborn 
D)  ABO blood type technical testing errors 
A)  ABO blood type errors from patient misidentification 
B)  Drug reactions to antibiotic agents 
C)  ABO hemolytic disease of the newborn 
D)  ABO blood type technical testing errors

Question 12

A patient's blood film shows a moderate number of spherocytes and polychromasia. Select the best test to distinguish warm autoimmune hemolytic anemia from hereditary spherocytosis.

Accepted Answer

A)  Direct antiglobulin test 
B)  Bilirubin test 
C)  Haptoglobin test 
D)  Reticulocyte count 
A)  Direct antiglobulin test 
B)  Bilirubin test 
C)  Haptoglobin test 
D)  Reticulocyte count

Exam 25: Extrinsic Defects Leading to Increased Erythrocytedestructionimmune Causes

Secondary cold-reactive autoimmune hemolytic anemia is found most often in patients with:

An Rh-negative woman is pregnant with her third child. She received little or no prenatal care during the first two pregnancies. Her anti-D titer is 1:512 at 30 weeks of gestation. What is the likely outcome for the baby?

All of the following have been linked to excess erythrocyte destruction except:

The Donath-Landsteiner antibody:

Which of the following is true regarding the mechanism of warm-reactive autoimmune hemolytic anemia?

A warm-reactive autoimmune hemolytic anemia found in combination with thrombocytopenia in a patient is called:

Red cell agglutination is found on a blood film. Select the best course of action.

Monospecific Coombs sera indicates that a patient's red cells have complement coating them. Which of the following red cell morphology would be more likely?

A type-A Rh-negative infant has spherocytes on his blood film and a weakly positive direct antiglobulin test. What antibody will most likely be found on the infant's red cells?

Which of the following is most often the result of human error?

Which of the following causes of alloimmune hemolytic anemia accounts for the largest number of deaths?

A patient's blood film shows a moderate number of spherocytes and polychromasia. Select the best test to distinguish warm autoimmune hemolytic anemia from hereditary spherocytosis.

An Overview of Clinical Laboratory Hematology

Safety in the Hematology Laboratory

Specimen Collection

Care and Use of the Microscope

Quality Assurance in Hematology and Hemostasis Testing

Cellular Structure and Function

Hematopoiesis

Erythrocyte Production and Destruction

Energy Metabolism and Membrane Physiology of the Erythrocyte

Hemoglobin Metabolism

Iron Metabolism

Leukocyte Development, Kinetics, and Functions

Platelet Production, Structure, and Function

Routine and Point-Of-Care Testing in Hematology: Manual and Semiautomated Methods

Examination of the Peripheral Blood Film and Correlation With the Complete Blood Count

Bone Marrow Examination

Body Fluids in the Hematology Laboratory

Anemias: Red Blood Cell Morphology and Approach to Diagnosis

Disorders of Iron and Heme Metabolism

Anemias Caused by Defects of Dna Metabolism

Bone Marrow Failure

Introduction to Increased Destruction of Erythrocytes

Intrinsic Defects Leading to Increased Erythrocyte Destruction

Extrinsic Defects Leading to Increased Erythrocytedestructionnonimmune Causes

Hemoglobinopathies Structural Defects in Hemoglobin

Thalassemias

Nonmalignant Leukocyte Disorders

Introduction to Leukocyte Neoplasms

Cytochemistry

Cytogenetics

Molecular Diagnostics in the Clinical Laboratory

Flow Cytometric Analysis in Hematologic Disorders

Myeloproliferative Neoplasms

Myelodysplastic Syndromes

Acute Leukemias

Mature Lymphoid Neoplasms

Pediatric and Geriatric Hematology

Automated Cell-Counting Instrumentation

Normal Hemostasis and Coagulation

Hemorrhagic Coagulation Disorders

Thrombosis Risk Testing

Thrombocytopenia and Thrombocytosis

Qualitative Disorders of Platelets and Vasculature

Laboratory Evaluation of Hemostasis

Monitoring Antithrombotic Therapies

Coagulation Instrumentation

Filters