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- 1. Open EndedIn a normal adult, the spleen acts as a site for: a. production of red blood cells b. synthesis of erythropoietin c. removal of aging red blood cells d. storage of red blood cells
- 2. Open EndedWhich of the following cells transport O2 and CO2? a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes
- 3. Open EndedPhagocytosis is a function of: a. erythrocytes b. granulocytes c. lymphocytes d. thrombocytes
- 4. Open EndedWhich of the following cells is the largest cell in the bone marrow? a. megakaryocyte b. histiocyte c. osteoblast d. mast cell
- 5. Open EndedIn patients who present with bleeding due to a low plt count, the most common type of bleeding is: a. hemarthrosis b. deep hematoma c. delayed bleeding d. mucosal bleeding
- 6. Open EndedTransfusion of which of the following is needed to help correct hypofibrinogenemia due to DIC? a. whole blood b. fresh frozen plasma c. cryoprecipitate AHF d. platelets
- 7. Open EndedA blood component used in the treatment of hemophilia A is: a. Factor VIII b. Fresh frozen plasma c. platelets d. whole blood
- 8. Open EndedA unit of fresh frozen plasma was inadvertently thawed and then immediately refrigerated at 4C on monday morning. on tuesday evening this unit may still be transfused as a replacement for: a. all coagulation factors b. factor V c. factor VIII d. factor IX
- 9. Open EndedA newborn demonstrates petechiae, ecchymosis, and mucosal bleeding. The preferred blood component for this infant would be: a. red blood cells b. fresh frozen plasma c. platelets d. cryoprecipitated AHF
- 10. Open EndedWhich of the would be the best source of platelets for transfusion in the case of alloimmune neonatal thrombocytopenia? a. father b. mother c. pooled platelet-rich plasma d. polycythemic donor
- 11. Open EndedFetal neonatal alloimmune thrombocytopenis (FNAIT) is caused by which of the following maternal antibodies? a. IgM alloantibodies against ABO antigens b. IgG alloantibodies against HLA antigens c. IgM alloantibodies against glycoprotein V (GPV) antigens d. IgG alloantibodies against HPA antigens
- 12. Open EndedBlood typing after a normal labor and delivery showed that the mother is group A, D-negative and demonstrates anti-D in her serum. Her jaundiced newborn is anemic and types as group O, D-negative with a 4+ DAT. Previous studies noted that the father was group O, D-positive. From the information given, which test result is questionable? a. Paternal D type b. Newborn D type c. Maternal ABO group d. Newborn DAT
- 13. Open EndedAn obstetrical patient has had 3 previous pregnancies. Her first baby was healthy, the second was jaundiced at birth and required an exchange transfusion, while the third was stillborn. Which of the following is the most likely cause? a. ABO incompatibility b. immune deficiency disease c. congenital spherocytic anemia d. Rh incompatibility
- 14. Open EndedA specimen of cord blood is submitted to the transfusion service for routine testing. The following results are obtained:Anti-A= 4; Anti-B= 0; Anti-D= 3+; Rh control=0; DAT=2+. It is known that the father is group B with the genotype of cde/cde. Of the following antibodies, which one is most likely cause of the positive DAT? a. anti-A b. anti-D c. anti-c d. anti-C
- 15. Open EndedABO-hemolytic disease of the newborn: a. usually requires an exchange transfusion b. most often occurs in first born children c. frequently results in stillbirth d. is usually seen only in the newborn of group O mothers
- 16. Open EndedWhich of the following antigens is most likely to be involved in hemolytic disease of the fetus and newborn? a. Lea b. P1 c. M d. Kell
- 17. Open EndedABO hemolytic disease of the fetus and newborn (HDFN) differs from Rh HDFN in that: a. Rh HDFN is clinically more severe than ABO HDFN b. the direct antiglobulin test is weaker in Rh HDFN that ABO c. Rh HDFN occurs in the first pregnancy d. the mother's antibody screen is positive in ABO HDN
- 18. Open EndedThe following results were obtained: Which of the following is the most probable explanation for these results? a. ABO hemolytic disease of the fetus and newborn b. Rh hemolytic disease of the fetus and newborn; infant has received intrauterine transfusion c. Rh hemolytic disease of the fetus and newborn, infant has a false negative Rh typing d. large fetomaternal hemorrhage
- 19. Open EndedA group A Rh positive infant of a group O, Rh positive mother has a weakly positive DAT and moderately elevated bilirubin 12 hours after birth. the most likely cause is: a. ABO incompatability b. Rh incompatability c. blood group incompatibility due to and antibody to a low frequency antigen d. neonatal jaundice not associated with blood group,
- 20. Open EndedIn suspected cases of hemolytic disease of the fetus and newborn, what significant information can be obtained from the baby's blood smear? a. estimation of WBC, RBC, and platelet counts b. marked increase in immature neutrophils (shift to the left) c. differential to estimate the absolute number of lymphocytes present d. determination of the presence of spherocytes
- 21. Open EndedIn treating hyperbilirubinemia in hemolytic disease of the fetus and newborn, light phototherapy is used to: a. breakdown conjugated into conjugated bilirubin b. prevent further hemolysis of fetal red cells c. breakdown unconjugated bilirubin to a nontoxic isomer d. stimulate production of fetal liver enzymes to breakdown unconjugated bilirubin
- 22. Open EndedThe purpose of performing antibody titers on serum from an immunized, pregnant woman is to: a. determine the identity of the antibody b. identify candidates requiring additional fetal monitoring c. decide if the baby needs an intrauterine transfusion d. determine if early induction of labor is indicated
- 23. Open EndedWhich unit should be selected for exchange transfusion if the newborn is group A, Rh-positive and the mother is group A, Rh-positive with anti-c? a. A, CDe/CDe b. A, cDE/cDE c. O, cde/cde d. A, cde/cde
- 24. Open EndedA mother is group A, with anti-D in her serum. What would be the preferred blood product if an intrauterine is indicated? a. O, Rh-negative Red Blood Cells, Irradiated, CMV safe b. O, Rh-negative Red Blood Cells, Irradiated, CMV safe, HgbS-negative c. A, Rh-negative Red Blood Cells, Irradiated, CMV safe d. A. Rh-negative Red Blood Cells, Irradiated, HgbS-negative
- 25. Open EndedLaboratory studies of maternal and cord blood yield the following results: If exchange transfusion is necessary, the best choice of blood is: a. B, Rh-negative, E+ b. B, Rh-positive, E+ c. O, Rh-negative, E- d. O, Rh-positive, E-
- 26. Open EndedA blood specimen from a pregnant woman is found to be group B, Rh-negative and the serum contains anti-D with a titer of 512. what would be the most appropriate type of blood to have available for a passive exchange transfusion for her infant? a. O, Rh- b. O, Rh+ c. B, Rh- d. B, Rh+
- 27. Open EndedBlood selected for exchange transfusion must: a. lack red blood cell antigens corresponding to maternal antibodies b. be <3 days old c. be the same Rh type as the baby d. be ABO compatible with the father
- 28. Open EndedWhen the main objective of an exchange transfusion is to remove the infants antibody-sensitized red blood cells and to control hyperbilirubinemia, the blood product of choice is ABO compatible: a. Fresh Whole Blood b. Red Blood Cells (RBC) washed c. RBC suspended in Fresh Frozen Plasma d. heparinized Red Blood Cells
- 29. Open EndedTo prevent graft vs host disease RBC's prepared for infants who have received intrauterine transfusions should be: a. saline washed b. irradiated c. frozen and deglycerolized d. group-and Rh-compatabile with the mother
- 30. Open EndedWhich of the following is the preferred specimen for the initial compatibility testing in exchange transfusion therapy? a. maternal serum b. eluate prepared from infants RBCs c. paternal serum d. infant's postexchange serum
- 31. Open EndedThe following results are seen on a maternal postpartum sample: The most appropriate course of action is to: a. report the mother as Rh-negative b. report the mother as Rh-positive c. perform an elution on mother's RBCs d. investigate for a fetomaternal hemmorrahge
- 32. Open EndedIn cases where antepartum RhIG has been administered and anti-D is detected in the mother's serum at delivery, what laboratory studies may help determine if the anti-D is from the antepartum RhIG, or due to maternal alloimmunization? a. determine antibody titer of maternal anti-D b. repeat antibody identification studies with room temperature incubation c. perform inhibition studies on anti-D with maternal saliva d. repeat antibody identification studies use AET treated serum
- 33. Open EndedRefer to the following information: What is the best interpretation for the laboratory data given above? a. newborn needs weak D testing b. mother needs further weak D testing c. mother has a larger than normal FMH d. mother has a negative rosette test
- 34. Open EndedThe results of a kleihauer-Betke stain indicate a fetomaternal hemorrhage of 35 mL of whole blood. how many vials of Rh immune globulin would be required? a. 1 b. 2 c. 3 d. 4
- 35. Open EndedA fetomaternal hemorrhage of 35 mL of whole blood. how many vials of Rh immune globulin would be required? a. 0 b. 1 c. 2 d. 3
- 36. Open EndedCriteria determining Rh immune globulin eligibility include: a. mother is Rh-positive b. infant is Rh-negative c. mother has not been previously immunized to the D antigen d. infant has a positive direct antiglobulin test
- 37. Open EndedWhile performing routine postpartum testing for an Rh immune globulin (RhIG) candidate, a weakly positive antibody screening test was found. anti-D was identified. this antibody is most likely the result of: a. massive fetomaternal hemorrhage occurring at the time of this delivery b. antenatal administration of Rh immune globulin at 28 weeks' gestation c. contamination of the blood sample with Wharton Jelly d. mother having a positive direct antiglobulin jelly
- 38. Open EndedRh immune globulin administration would not be indicated in an Rh-negative woman who has a(n): a. first trimester abortion b. husband who is Rh-positive c. anti-D titer of 1:4,096 d. positive direct antiglobulin test
- 39. Open EndedA Kleihauer-Betke stain of a postpartum blood film revealed 0.3% fetal cells. what is the estimated volume (mL) of the fetomaternal hemorrhage expressed as whole blood? a. 5 b. 15 c. 25 d. 35
- 40. Open EndedBased upon Kleihauer-Betke test results, which of the following formulas is used to determine the volume of fetomatemal hemorrhage in mL of Whole Blood? a. % of fetal cells present x 30 b. % of fetal cells present x 50 c. % of maternal cells present x 30 d. % of maternal cells present x 50
- 41. Open EndedAn acid elution stain was made using a 1-hour postdelivery maternal blood sample. Two thousand cells were counted and thirty of these cells appeared to contain fetal hemoglobin. It is the policy of the medical center to add one vial of Rh immune globulin to the calculated dose when the estimated volume of the hemorrhage exceeds 20 mL of whole blood. Calculate the number of vials of Rh immune globulin that would be indicated under these circumstances: a. 2 b. 3 c. 4 d. 5
- 42. Open EndedThe rosette test will detect a fetomaternal hemorrhage (FMH) as small as: a. 10 mL b. 15 mL c. 20 mL d. 30 mL
- 43. Open EndedA 40-year-old man with autoimmune hemolytic anemia due to anti-E has a hemoglobin level of 10.8 g/dL (108 g/L). This patient will most likely be treated with: a. whole blood b. red blood cells c. fresh frozen plasma d. no transfusion
- 44. Open EndedPathologic cold autoantibodies differ from benign cold autoantibodies in: a. antibody specificity b. immunoglobulin class c. antibody titer d. ability to bind complement
- 45. Open EndedThe DAT in a patient with WAIHA most often positive for: a. IgG only b. C3 only c. IgM only d. IgG and C3
- 46. Open EndedWhat is the most important consideration for a patient requiring red cell transfusion due to severe anemia when their serum contains a warm autoantibody? a. determine specificity of autoantibody b. determine the immunoglobulin class of the autoantibody c. determine the presence of underlying alloantibody(ies) d. avoid transfusion therapy
- 47. Open EndedA drug-induced immune hemolytic anemia caused by a drug-independent antibody would have which of the following results? a. positive DAT with IgG; positive antibody screen b. positive DAT with IgG; negative eluate c. positive DAT with C3d; negative antibody screen d. negative DAT; positive antibody screen
- 48. Open EndedThe autoantibody most often implicated in Paroxysmal Cold Hemoglobinuria (PCH) is: a. cold-reactive, IgG, anti-P b. cold-reactive, IgM, anti-P c. cold-reactive, IgG, anti-I d. cold-reactive, IgM, anti-I
- 49. Open EndedIndications for an autologous hematopoietic progenitor cell transplant include patient who have a. Hodgkin lymphoma with high-dose chemotherapy b. congenital hemoglobinopathies c. congenital immunodeficiency disorders d. inborn errors of metabolism
- 50. Open EndedWhich of the following statements is correct about HPC transplantation a. successful allogeneic transplantation requires that at least 5 out of 10 HLA loci match b. sources for HPC collection include bone marrow, umbilical cord blood (UCB) and mobilized peripheral blood c. bone marrow collection of HPC is preferred to apheresis collection because of fewer side effects d. HPC products are infused into the patient over a period of at least 6 hours
- 51. Open EndedA patient in the immediate post bone marrow transplant period has a hematocrit of 21%. The red cell product of choice for this patient would be: a. packed b. saline washed c. microaggregate filtered d. irradiated
- 52. Open EndedWhich of the following systems plays an important role in Transfusion Related Acute Lung Injury (TRALI), transfusion associated graft versus host disease (TA-GVHD), platelet refratoriness, and Febrile Nonhemolytic Transfusion Reactions (FNHTR) as well as in a. Rh b. HLA c. Lewis d. Diego
- 53. Open EndedWhich of the following statements is true about Class II HLA antigens? a. they are found on the surface of most nucleated cells b. Bg antigens are part of HLA class II c. HLA-DR, HLA-DQ and HLA-DP are all Class II d. they are only located on neurons and platelets
- 54. Open EndedThe most widely accepted QC test to measure probable Hematopoietic Progenitor Cell (HPC) engraftment is: a. clonogenic assay b. cell viability c. CD34+ cell enumeration d. manual differential
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