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Blood Banking 2
Practice test for 2nd Blood Banking exam DelTech Owens
| Question | Answer |
|---|---|
| Antigens are molecules that bind to antibodies or __ __. | T-cell receptors |
| How would you describe allogeneic antigens? | they are nonself antigens |
| How would you describe autologous antigens? | they are self antigens |
| __ are partial antigens that require a carrier molecule to elicit an immune response. | Haptens |
| Antigens contain different __ __ that can elicit different types of antibodies. | antigenic determinants |
| Another word for antigenic determinants is ? | epitopes |
| Most reactions in transfusion medicine are ? | humoral |
| B cells that produce the majority of antibodies are called ? | plasma cells |
| B cells that respond rapidly to the next exposure to a pathogen and transform into plasma cells are called ? | memory B cells |
| After they recognize an antigen, B lymphocytes present the antigen to ? | T lymphocytes |
| After B cells have presented an antigen to a T cell, the T cells will trigger B cells to produce ? | plasma cells |
| What kind of cell can respond to the next exposure to a pathogen without activation from a T cell? | Memory B cells |
| What are the best immunogens? | Proteins |
| What are the 2nd best immunogens? | complex carbohydrates |
| Degree of __ is a factor contributing to the immunogenicity of a particle. | foreigness |
| What region determines that class of an antibody? | Constant region |
| What region binds the antigen? | variable |
| Which antibody works in the immediate spin phase? | IgM |
| Which antibody works in the AHG phase? | IgG |
| Which antigen has a lag phase of 5 to 10 days before it reacts to an immunogen? | IgM |
| What do you call the structure that forms when the antigen and antibody combine? | immune complex |
| The strength of the binding between the antibody and the antigen is influenced by what 3 things? | 1. size 2. shape 3. charge ... of the antigen |
| Immune complexes are held together by __ forces and contribute to the __ of the attachment. | noncovalent forces, avidity/strength of attachment |
| Which antibody has a lag phase of only 1 to 3 days? | IgG |
| The attraction between 2 molecules on the basis of opposite charge is called ? | ionic bonding |
| The attraction of 2 negatively charged groups for a H+ atom is called ? | hydrogen bonding |
| The attraction between the electron cloud of one atom and the protons within the nucleus of another atom is called ? | van der Waals forces |
| For blood banking, antigens are located on the membranes of __. | RBCs |
| Antibodies are molecules found in __ or __. | plasma or serum |
| Which are glycoproteins or glycolipids: antigens or antibodies? | antigens |
| IgG antibodies react at what temp? | 37C |
| IgM antibodies react at what temp? | room temp |
| Which antibodies are considered clinically significant: IgG or IgM? | IgG |
| When are IgM antibodies considered clinically significant? | when they activate complement (ABO antibodies can do this) |
| In vivo reactions happen where? | in the body |
| in vitro reactions happen where? | the test tube/lab |
| Exposure of foreign antigens during transfusion or pregnancy may cause sensitization resulting in production of __. | alloantibodies |
| An antibody that occurs naturally against foreign tissues from a person of the same species is called ? | alloantibody |
| What kind of test will detect alloantibodies? | antibody screen test |
| Detection of alloantibodies BEFORE a transfusion helps the patient how? | It prevents formation of antibodies to the transfusion in vivo. |
| Antibodies can activate what kind of proteins that could lead to the destruction of RBCs? | complement |
| The final phases of complement activate the __ __ __. | membrane attack complex |
| When activated, complement enhances what process? | immunologic |
| The classical complement pathway is activated by __. | antibodies |
| The alternative complement pathway is activated by __ __ __ __. | foreign cell surface constituents |
| What complement effect clears immune complexes, enhances phagocytosis, and promotes release of enzymes from neutrophils? | opsonization |
| What complement effect increases smooth muscle contraction and inflammation? | anaphylaxis |
| What complement effect recruits platelets and phagocytes to the lyse the invader? | chemotactic |
| No agglutination means there was no __. | reaction |
| What are the 2 steps of agglutination? | 1. sensitization 2. lattice formation |
| Sensitization is when ? | antibody binds to antigen before a visible reaction occurs |
| Lattice formation is when ? | antibody-coated cells cross-link to form visible agglutination |
| You need at least __ RBCs to bind together to get agglutination. | 2 |
| The distance between cells caused by charged ions is known as ? | zeta potential |
| When antigen and antibody concentrations are equal, this is called the zone of ? | equivalence |
| What helps bring the cells closer together so you can see the reaction? | centrifugation |
| Agglutination reactions are graded on a semiquantitative scale ranging from what to what? | 0-4+ |
| What else, besides agglutination, indicates a positive reaction? | hemolysis |
| Hemolysis is usually caused by activation of ? | complement |
| After centrifugation, the RBC button is ? | smaller |
| After centrifugation, a pink or red __ is observed. | supernatant |
| Anticoags stop complement from activating in vitro by chelating __. | calcium |
| Where can HLAs be found? | on leukocytes and tissue cells (cells with a nucleus) |
| HLA antibodies can be produced as a result of what 2 things? | 1. transfusion 2. pregnancy |
| Antibodies have been associated with __ and transfusion reactions. | refractoriness |
| HLA testing can assess the __ __ for disease susceptibility. | risk factors |
| HLAs can be used for organ and HPC (hematopoietic progenitor cell) __. | transplants |
| Genes that code for HLA are part of the __. | MHC |
| Class I of MHC genes effect what? | 1. platelets 2. WBCs 3. nucleated cells |
| Class II of MHC genes effect what? | 1. macrophages 2. dendritic cells 3. B cells |
| Class III of MHC genes effect what? | 1. complement 2. cytokines |
| People inherit one __ from each parent. | haplotype |
| HPCs can be obtained from what 3 places? | 1. bone marrow 2. peripheral blood 3. cord blood |
| Platelet __ can trigger immune responses. | proteins |
| Antibodies to platelets can cause what 2 things? | 1. NAIT (neonatal alloimmune thrombocytopenia) 2. PTP (Posttransfusion purpura) |
| The most common platelet antibody is directed against ? | HPA-1a (or P1-a1) |
| NAIT (neonatal alloimmune thrombocytopenia) causes destruction of __ __ by __ __. | newborn platelets by maternal antibody |
| PTP (Posttransfusion purpura) causes destruction of platelets after a __. | transfusion |
| Routine testing methods for immunohematology include what 3 methods? | 1. tube testing 2. gel technology 3. solid-phase adherence technology |
| RBCs are tested with commercial __ to determine the identity of the antigen. | antisera |
| Serum or plasma is tested with commercial __ to identify antibodies. | RBCs |
| ABO/D blood typing detects A,B,D antigens on the patient's __. | RBCs |
| ABO serum testing detects ABO antibodies with specifity to __ __ __. | red cell antigens |
| The source of the antibody during an ABO/D typing is ? | commercial anti-A, anti-B, anti-D |
| The source of the antibody for ABO serum testing is ? | the patient's serum or plasma |
| ABO/D typing is also know by what 2 names? | Front/Forward typing |
| ABO serum testing is also known by what 2 names? | Back/Reverse typing |
| The antibody screening test detects (antibodies or antigens?) with specificity to blood cell (antibodies or antigens?) | 1. antibodies 2. red cell antigens |
| What is the source of the antibody used during an antibody screening test? | screening cells |
| What is the source of the antibody during an antibody screening test? | patient's serum or plasma |
| An antibody identification test identifies the specificity of red cell __. | antibodies |
| What is the source of the antigen used during an antibody identification test? | Panel cells |
| What is the source of the antibody during an antibody identification test? | Patient's serum or plasma |
| A crossmatch test determines the serological compatibility between donor and patient before __. | transfusion |
| What is the source of the antigens used during a crossmatch test? | Donor's RBCs |
| What is the source of the antibody used during a crossmatch test? | Patient's serum or plasma |
| One category of reagents used in blood banking includes RBCs with known __. | antigens |
| One category of reagents used in blood banking includes antisera with known __. | antibodies |
| One category of reagents used in blood banking includes what antiglobuline reagents? | 1. anti-IgG 2. complement (NOTE: it can either one or both) |
| One category of reagents used in blood banking includes potentiators to enhance __. | antibodies |
| Who licenses blood banking reagents? | Center for Biologics Evaluation and Research (FDA) |
| Componenents of a QC program include what 3 things? | 1. statement of criteria for reagent performance 2. documentation of reagent use 3. corrective actions for lack of performance |
| Polyclonal antibodies are made from several different clones of __ __ that secrete antibodies of different specificities. | B cells |
| Polyclonoal antibodies recognize multiple __. | epitopes |
| An example of polyclonal antibodies includes ? | antihuman globulin (AHG) |
| Monoclonal antibodies are made from single clones of B cells that secrete antibodies of the same __. | specificity |
| Monoclonal antibodies use __ technology. | hybridoma |
| Monoclonal antibodies recognize a single __. | epitope |
| Examples of monoclonal antibodies include what 3 antibodies? | 1. anti-A 2. anti-c 3. anti-IgG |
| Anti-A is directed toward which antigen? | A |
| Anti-A's reaction to group B antigens will be (+ or -?) | negative |
| Anti-B's reaction to blood type O will be (+ or -?) | negative |
| Reagents used to test for ABO typing will be used during which spin phase? | immediate (or IS for immediate spin) |
| When performing ABO typing using the immediate-spin phase, confirmation testing should check for expected __. | antibodies |
| What is the most important antigen in the rH blood group system? | D (due to increased immunogenicity) |
| The AABB's Standards for Blood Banks and Transfusion Servicees requires all blood samples to be typed for which antigen? | D |
| When typing for the D antigen, commercial anti-D is combined with what? | the patient AND donor RBCs |
| How do you ensure that a false-positive has not occurred when performing a D antigen typing test? | Use a negative reagent |
| High-protein or low-protein reagents have polyclonal antibodiese? | high-protein |
| High-protein or low-protein reagents have about 6% bovine albumin? | high-protein |
| High-protein or low-protein reagents have monoclonal antibodies OR monoclonal and polyclonal blends? | low-protein |
| Low-protein reagents that only have monoclonal antibodies use which kind of antibody? | IgM |
| High-protein or low-protein reagents have promote false-positive agglutination? | high-protein |
| High-protein or low-protein reagents have replaced the other in blood banking? | low-protein replaced high-protein |
| Low-protein reagent controls should show agglutination or no agglutination? | no agglutination |
| What can cause a false-positive agglutination when using low-protein reagent controls? | 1. strong cold autoantibodies 2. protein abnormalities |
| A separate control is used (instead of the low-protein reagent control) if RBCs agglutinae with __ __ antisera. | all ABO antisera |
| Name 3 procedures that use commercial RBCs that contain known antigens to confirm the prsence of antibodies in patient serum or plasma. | 1. ABO serum testing 2. Screening tests 3. Antibody identification |
| In ABO serum testing (also called reverse grouping), what cells are combined with the patient's serum or plasma to determine the reverse grouping? | A1 and B cells |
| When reverse grouping (or ABO serum testing), patients possess the antibody directed against the antigen of the ABO system that is __ in their RBCs. | lacking |
| When reverse grouping, a patient who has a positive reaction with reagent B cells has the anti-__ antibody. | B |
| When reverse grouping, a patient who has type O blood will register positive or negative for both anti-A and anti-B antibodies? | positive |
| A1 and B cells are resuspended to a concentration of what percent? | 2-5% |
| A1 and B cells used in reverse grouping must be from a single donor or a pool of donors? | either one |
| When reverse grouping, the A1 and B cells used in the ABO serum test must positive or negative for Rh antigens? | negative |
| A1 and B cells should not be used when reverse grouping is the red cells __, __ in the vial, or show hemolysis. | red cells darken or agglutinate in the vial |
| What kind of cells are used in antibody screen (detection) tests for unexpected antibodies? | screening cells |
| Can pooled donor cells be used as screening cells? | yes |
| When are only single-donor vials used in a screening test? | when the patient is about to receive a transfusion |
| Do single-donor cells or pooled-donor cells give a stronger screening test reaction? | single |
| Each lot of screening cells comes with an __ that shows the antigen profile. | antigram |
| Screening cells MUST express antigens associated with the most clinically significant __. | antibodies |
| Screening cells are regulated by the __. | FDA |
| Panel cells are similar to screening cells, but panel cells come in vials of __ or more while screening cells come in sets of __ or __ vials. | 10 or more, 2 or 3 |
| What is the name of the procedure where panel cells are used to identify antibodies? | antibody panel |
| Every lot of panel cells should have an antigram that shows the __ profile of each vial. | antigenic |
| During an antiglobulin test, commercial antibodies with a specificity toward human __ are used to agglutinate antibody-coated RBCs. | globulins |
| The reagent used in an antiglobulin test have antibodies toward what 2 things? | 1. IgG 2. complement (anti-C3d and anti-C3b) |
| Which test detects IgG or complement bound to RBCs in vivo? | DAT (Direct antiglobulin test) |
| When performing a DAT, anti-human globulin reagent is added after the RBCs have been __. | washed |
| If a patient has a transfusion reaction, the DAT test will be pos or neg? | positive |
| Hemolytic disease of the fetus and newborn will cause the DAT to be pos or negative? | positive |
| 26 |
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IsaacJ
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