RhIg Microgram Question

You answered the question correctly.
How many micrograms (ug) of IgG anti-D are in a 1500 IU vial of RhIg?
The correct answer is highlighted below
100
150
200
250
300
Feedback5
300 ug of IgG anti-D are in a 1500 IU vial of RhIg. The conversion rate is one ug = 5
IU.
You answered the question incorrectly.
Given the Wiener and Fisher-Race nomenclatures shown below, which offspring is
NOT possible from a mother who is RoR1 and a father who is R1r?
Wiener Fisher-Race (haplotype)
R0 Dce
R1 DCe
R2 DcE
Rz DCE
r dce
r dCe
r dcE
ry dCE
The correct answers are highlighted below
DcE/DcE
DCe/DCe
DCe/DcE
DCe/dce
DCe/dCe
Feedback135
It is necessary to convert Wiener system shorthand nomenclature to Fisher-Race

nomenclature in order to make this determination.
The mothers Fisher-Race genotype for Wiener R0R1 would be Dce/DCe.

The fathers Fisher-Race genotype for Wiener R1r would be DCe/dce. The babys
Fisher-Race genotype for Wiener cannot be R2R2, (DcE/DcE) or R1R2 (DCe/DcE).
Neither parent has the rh (E) antigen. The last choice is also not a possible offspring
haplotype, as neither parent carried a dCe haplotype that could have been passed
down.
Which of the following would NOT be included in a hemolytic transfusion reaction

investigation?
ABO/Rh check of post-transfusion sample

Leukocyte antigen studies
Direct antiglobulin test (DAT) on post-transfusion sample
Clerical check
Feedback2
Leukocyte antigen studies would NOT be included in a hemolytic transfusion reaction

investigation.
The remaining procedures must be performed as part of the initial reaction

investigation. A post-transfusion specimen should be sent to the laboratory for work-
up. A clerical check should be performed to investigate possible errors in specimen
labeling, blood product issuance, or patient identification. The plasma must be
examined for hemolysis. A direct antiglobulin test (DAT) must be performed. The
patient's ABO, Rh, and antibody screen should be repeated and confirmed. The blood
product ABO/Rh can also be confirmed.
RhIg prophylaxis is typically given antenatally to Rh negative pregnant females

without knowing the Rh of the fetus.

True
False
Feedback1
RhIg is typically given antenatally to Rh negative pregnant females without knowing

the Rh of the fetus.
The fetus's Rh(D) type can be predicted based on the putative* father's probable Rh
genotype using tests with Rh typing sera, e.g., if the father is likely homozygous for
the RHD gene, the infant is probably D-positive. Molecular typing, which would
definitively determine the father's genotype, is not available in some locations.
* It is possible that the blood sample purporting to be that of the father is not the
actual father.
Of the following blood group antibodies, which has been most frequently associated
with severe cases of hemolytic disease of the fetus and newborn (HDFN)?
anti-A,B
anti-Lea
anti-K
Feedback3
Of those listed, anti-K is most frequently associated with severe forms of HDFN.
Anti-A,B is frequently implicated in HDFN, but the disease is generally mild, often
subclinical.
Anti-Lea is not implicated in HDFN for two reasons; the antibody is generally IgM
and the Lewis system antigens are poorly developed at birth.
What percentage of glycerol is generally used when freezing red cells of rare
phenotypes:
70 %
40 %
10 %
5%
Feedback2
Cryopreservation of red cells is expensive, and of limited value for routine use since
their shelf life after thawing is only 24 hours. It is invaluable for maintaining an
inventory of rare blood phenotypes.
Which of the following tests are suitable for quantifying the size of fetomaternal
hemorrhage (FMH)? Select all that apply.
Flow cytometry
Kleihauer-Betke test
Rosette test
Weak D (microscopic Du)test
Feedback12
Of these methods, only flow cytometry and the Kleihauer-Betke test can quantify the
size of a FMH.
The rosette test (but not the weak D test) is suitable to screen for FMH.
Which of the following blood group system antibodies is the direct antiglobulin test
(DAT) most UNRELIABLE in helping to diagnose hemolytic disease of the fetus
and newborn (HDFN)?
ABO
Duffy
Kell
Kidd
Rh
Feedback1
In ABO HDFN, the DAT may be weakly positive or negative, making it an unreliable
test.
The DAT is usually reliable for antibodies in the other listed blood group systems that
cause HDFN.
A patient who received an autologous transfusion one week ago can be reliably
antigen typed.
True
False
Feedback1
Autologous transfusion does not preclude valid antigen typing. Problems occur when
two red cell populations that are genetically different cause mixed-field agglutination.
Most blood group antibodies belong to which immunoglobulin classes?
IgA and IgD

IgA and IgM
IgE and IgD
IgG and IgM
Feedback4
Most blood group antibodies are of the IgG and IgM classes.
Which organism is MOST likely responsible for septic reactions associated with Red
Blood Cell transfusions?

Yersina entercolitica
Escherichia coli
Campylobacter species
Streptococcus pneumoniae
Feedback1
Yersina entercolitica is most likely responsible for septic reactions in transfusions of

Red Blood Cells. This organism is usually acquired by ingestion of contaminated food
and causes mild symptoms of abdominal pain and diarrhea. Growth of Y. entercolitica
is enhanced in iron-rich environments such as red cell components.
A severe hemophiliac, with a Factor VIII activity of less than 1%, is actively bleeding
due to a serious accident. The blood product of choice is:
Single-donor plasma
Factor VIII concentrate
Factor IX concentrate
Cryoprecipitate
Feedback2
Factor VIII concentrate can be administered to a hemophiliac patient during active

bleeds. The administered factor VIII will aid in the coagulation process to cease active
bleeding in the patient
Fresh frozen plasma should be used for which of the following:
Platelet replacement
Coagulation deficiencies
Volume replacement
Albumin replacement
Feedback2
FFP, or fresh frozen plasma, should be used to treat coagulation defiencies- though
the levels of factors V and VIII are usually decreased in FFP units. FFP is not used for
platelet replacement as there are virtually no platelets in FFP units. FFP should never
be used as a volume expander, unless traumatic bleeding is taking place. Finally, FFP
is not used to replace albumin in recipients.
For infants born to Rh negative females, a test for weak D is optional when initial D
typing shows the newborn to be Rh negative.
True
False
Feedback2
The statement is false. For such infants, blood safety standards require a weak D test
to be performed when initial D typing shows the newborn to be Rh negative.
Which of the following signs and symptoms may be associated with immediate
transfusion reaction, but is NOT usually associated with delayed hemolytic
transfusion reaction?
Fever and chills

Unexplained bleeding from surgical site
Unexplained drop in hemoglobin
Transient jaundice
Feedback2
Unexplained bleeding is associated with immediate hemolytic transfusion reactions,

but is not usually associated with delayed hemolytic transfusion reactions. The
bleeding results from disseminated intravascular coagulation (DIC) due to ABO
antibodies causing intraventricular hemorrhage (IVH).
Before testing all cord cells should be thoroughly washed in order to:
Remove Lea substances

Remove H substances
Remove Wharton's jelly
Hemolyze contaminating maternal cells
Feedback3
The proteins found in Wharton's jelly can interfere with blood typing.
For the test results shown above, which of the following antibodies is most likely to
be causing the newborn's positive DAT?
anti-c
anti-e
anti-K
anti-A
anti-B
Feedback3
The correct answer is anti-K.
Both the mother and infant are group A, eliminating ABO HDFN.
We are given the cell ID information for each of the screening cells. Screen
cell 1 is R1R1. Therefore these antigens are present: D,C, e.
Screen cell 2 is R2R2. Therefore these antigens are present: D,E,c
Screen cell 3 is rr. Therefore these antigens are present: c,e
The only cell that reacted was Screen cell 3. Both c and e are also present on
the nonreactive cells. The only choice that has not been eliminated is anti-K.
Also, the antibody screen reaction pattern (only cell 3 positive) is typical of anti-K.
Which of the following might cause a false positive indirect antiglobulin test:
Failure to adequately wash cells

Delay of addition of antiglobulin reagent.
Overcentrifugation
High concentration of IgG paraprotein in a patient's serum
Feedback3
Overcentrifugation may cause either a false negative result (if too much agitation is
required for resuspension), or a false positive, (if centrifuged clumps cannot be
completely dispersed). High concentration of IgG paraprotein, and failure to
adequately wash cells can leave unbound IgG which will neutralize antiglobulin
reagent. Delay of addition of antiglobulin reagent may allow previously bound IgG
antibody to dissociate from red cells.
Which of the following types of whole blood would be the least satisfactory to
transfuse to a type AB patient:
Group O
Group A
Group B
Group AB
Feedback1
Group O whole blood contains both anti-A and anti-B which could react with the
recipient's RBCs.
What is the major difference between paroxysmal cold hemoglobinuria (PCH) and
cold hemagglutinin disease (CHD)?
PCH is a cold autoimmune anemia while CHD is acquired

PCH is a warm autoimmune anemia while CHD is room temperature
PCH is caused by an IgG antibody while CHD is caused by an IgM antibody
PCH is an IgM antibody while CHD is an IgE
Feedback1
PCH is caused by an IgG antibody while CHD is caused by an IgM antibody.
Which of the following is the MOST likely discrepancy seen when a person
demonstrates an "acquired B-like" phenomenon?
Forward typing appears to be B, but reverse groups like O

Forward typing appears to be AB, but reverse groups like A
Forward typing appears to be O, but reverse groups like B
Forward typing appears to be B, but reverse groups like AB
Forward typing appears to be AB, but reverse groups like B
Feedback2
Acquired B is seen only in a subpopulation of group A1 individuals. The individuals

that demonstrate acquired B possess anti-B, but this anti-B does not react with the
acquired B antigen; consequently, the auto control is negative. These patients should
be transfused with group A or O blood.

Anti-H:
Does not react with group O cells

Reacts more strongly with A1 cells than with O cells
Never reacts with group A cells
Reacts more strongly with group A2 cells than with group A1 cells
Feedback4
A2 cells contain more H antigen than A1 cells.
Upon admission for thoracic surgery, a patient's physician ordered a type and screen.
The patient is O positive. After a positive antibody screen was obtained, an antibody
identification was performed. The results are shown on the right.
Which antibodies are most likely present and causing the reactions shown?
Note: You are ONLY identifying the antibodies most likely causing the reaction. You
may have additional antibodies which have not yet been ruled out.
Anti-D
Anti-Fya
Anti-S
Anti-C
Anti-K
Anti-Fyb
Anti-N
Feedback13
In this case, an enzyme panel was performed as well. Enzyme panels are usually
performed in order to destroy (Duffy, MN, Xga, P, and variable S,s)or stregnthen (Rh,
Kidd, Lewis, & Vel blood group system) antibodies. This is very helpful when more
than one antibody is present as the reactions can mask the underlying antibody. The
results clearly show the presence of an Anti-Fya antibody before the enzyme treated
cells were utilized. With the enzyme panel results, it is clear that Anti-C was the
underlying antibody. There may be other antibodies which cannot be formally ruled-
out, but they do not match the pattern shown here.
The prozone effect can be described by all of the following EXCEPT:
Results in a false negative reaction

The result of antibody excess
Dilution of antibody can help prevent its occurrence
Results in a false positive reaction
Feedback4
The only statement that is not true of prozone is the last answer choice.
The remaining answers all describe the prozone effect. Prozone is the result of
antibody excess; it appears as a false negative, which becomes positive as the patient's
serum is diluted.
How many international units (IU) of IgG anti-D are in 300 g vial of RhIg?
250
500
600
1000
1500
Feedback5
A 300 g vial of RhIg contains 1500 IU of IgG anti-D. The conversion is one g = 5
IU.
Essential components of compatibility testing include all of the following except :
Antibody screen on recipients serum

Major crossmatch or computer crossmatch
ABO and Rh typing of recipient
Direct Antiglobulin Test (DAT)
Feedback4
AABB Standards do not require a DAT, autologous control, or a minor crossmatch

for pretransfusion testing.
Which of the following statements about high-frequency antigens is correct?
High-frequency antigens are common and it's easy to identify their

corresponding antibodies
High-frequency antigens are common, but it's difficult to identify their
corresponding antibodies
High-frequency antigens are rare and it is difficult to identify their corresponding
antibodies
Feedback2
High-frequency antigens are present in >98% of all individuals. Occurance of an

antibody to these antigens is rare because most individuals have these antigens on
their red cells.
Looking for antigen negative, compatible blood would be difficult because only <2%
of the population would be negative for the antigens. Identifying the antibody to a
specific high-frequency antigen would be challenging due to the presence of other
high-frequency antigens on the panel. All high-frequency antigens tend to be present
on every panel cell.
Trying to rule out each individual antigen would be difficult since there would be no
negative panel cells.

If an individual has blood type O, which of the following are possible genotypes?
AO and OO
BO and OO
OO only
AO, BO, and OO
Feedback3
Individuals who type as group O must have two O genes present since both the A and
B genes, if present, would have produced recognizable antigens.
The incidence of HDFN due to anti-D varies significantly according to race and
ethnicity.
True
False
Feedback1
The incidence of HDFN due to anti-D varies significantly according to race and
ethnicity because of the frequency of D in different populations. HDFN is rare in a
population that is almost exclusively Rh-positive.
Rh immune globulin is manufactured to be capable of neutralizing _____________

milliliters of Rh positive whole blood.
15
30
45
450
1000
Feedback2
Rh immune globulin, also known as RhoGAM, can neutralize approximately 30 mL

of Rh positive whole blood.
Which of the following is the proper temperature to use when crossmatching in the
presence of a cold antibody:
37 degrees Celsius
25 degrees Celsius
15 degrees Celsius
4 degrees Celsius
Feedback1
Most antibodies that are inactive at 37 degrees Celsius, and active only below 37
degrees Celsius (i.e. cold reactive antibodies), are of little clinical significance.
Which of the following donors could be accepted for blood donation?
22-year female who is currently pregnant

40-year-old female who lived in London from 1988 - 1992
44-year-old male who has been taking aspirin every four hours for the past two
days
24-year-old man who had a tooth extraction two months ago
Feedback4
A tooth extraction that occurred two months ago would not be a reason for rejection
as a blood donor. The remaining choices would all be reasons for rejection according
to the current Uniform Donor History Questionnaire that was created by the FDA
with input from the AABB donor history task force.
What are the possible ABO genotypes of offspring from parents whose genotypes are
OO and AB:
AB
OA
OB
OO
Feedback23
The only possible genotypes in this case would be OA and OB. This is solved by
utilizing a simple punnett square. This leaves a 50% chance of an inherited OA type
and a 50% chance of an inherited OB type.
Which of the following antigens is classified as a Major Histocompatibility Complex

Class II antigen (MHCII)?
HLA-A
HLA-B
HLA-C
HLA-DR
Feedback4
HLA-DR is a class II MHC.
HLA-A, HLA-B, and HLA-C are all class I MHC.

What is the maximum interval during which a recipient sample may be used for
crossmatching if the patient has been recently transfused, has been pregnant within
the past 3 months, or if relevant medical/transfusion history is unknown?
1 day
3 days
1 week
1 month
31 days
Feedback2
Generally, 3 days is used as the maximum interval for all recipient samples in most
blood banks.
Delayed hemolytic transfusion reactions are usually caused by antibodies directed

against what blood group system?
MNS
Kidd.
Kell.
Rh.
ABO
Feedback2
The most likely causes of delayed hemolytic reactions are Kidd system antibodies.
Both jka and jkb are often responsible for delayed hemolytic transfusion reactions.
Which of the following groups of antibodies generally reacts most strongly at 4o C:
Anti-A, Anti-P1 , Anti-Leb , Anti-M

Anti-B, Anti-K, Anti-Lua , Anti-Fya
Anti-H, Anti-S, Anti-Jkb , Anti-Leb
Anti-A, Anti-K, Anti-Lub , Anti-s
Feedback1
Anti-A, anti-P, anti-Leb, and anti-M all react best at 4o C as they are predominantly
IgM antibodies. Other antibody group choices above include IgG antibodies such as
anti-K, anti-s, anti-S, and anti-Fya, anti-Lub, etc. which react best at 37o C.
Which of the following actions should take place if a donor experiences numbness in
the mouth during an apheresis procedure?
Reduce the flow rate

Elevate the donor's head
Have the donor breathe into a paper bag
Stop the procedure and elevate the feet
Feedback1
Reducing the flow rate will help to alleviate the symptom of numbness in the mouth
during an apheresis procedure.
Which one of the following tests BEST correlates with the severity of hemolytic
disease of the newborn (HDN).
Rh antibody titer of babys blood

L/S ratio
amniotic fluid bilirubin
antibody titer of mothers blood
Feedback3
Amniotic fluid bilirubin is increased in association with the severity of hemolytic
diseases of the newborn. As red blood cells lyse during these conditions, bilirubin
builds up as a byproduct of the red cell destruction. The more red blood cells that are
being destroyed in the baby, the more increased the bilirubin level will become.
When monitoring maternal antibody strength using a doubling dilution, an increase in

titer from 16 to 32 is considered a significant rise in titer.
True
False
Feedback1
The statement is false. To be significant, a rise in titer needs to be a two tube increase
or more. A rise in titer from 16 to 32 in a doubling dilution is only a one tube
difference.
ABO blood groups were discovered by:
Mendelson
Morgan
Wiener
Landsteiner
Feedback4
Landsteiner first identified the presence of the separate red cell antigens A and B in
the early 1900's.
u answered the question correctly.
A febrile nonhemolytic transfusion reaction is characterized by which of the

following?
An increase in temperature of >1 degree C above 37 degrees during transfusion

appearance of rash
fever above 37 degrees which develops 24 hours later
An increase in temperature of >5 degrees C above 37 degrees following
transfusion.
Feedback1
Febrile nonhemolytic transfusion reactions (FNHTR) is defined as a >1oC rise in

temperature above 37oC, associated with transfusion. Fever usually appears during the
transfusion, but may develop 1-2 hours later.
Which of the following represents the approximate percentage of the population that
is Rh positive:
35 %
65 %
85 %
95 %
Feedback3
Approximately 85% of the population is Rh-positive.
Which of the following statements is NOT true about the Lewis blood group:
Antigen expression is influenced by secretor status

Antigens are adsorbed onto the red cells from the plasma
Antigens are a structural component of the red cell membrane
ABO group affects antigen expression
Feedback3
Lewis antigens are not produced by the red cell. They are adsorbed from the plasma.
FALSE-NEGATIVE results at the indirect antiglobulin phase of an antibody

screening test using a tube method (i.e., not a Gel-method) are usually caused by
which of the following?
Excessive washing of the red cells

Inadequate washing of the red cells
Warm autoantibody present in the patients serum
Failure to allow the blood to clot properly
Cold acting antibody
Feedback2
If an antigen-antibody reaction has occurred, but washing is inadequate, free

antibodies that have not attached to antigens on the red blood cells remain when the
anti-human globulin (AHG) is added. The AHG is bound by the free antibody rather
than attaching to the antibody on the red blood cells, causing a false-negative result.
This false-negative result is detected by using Check Cells as a control. If the free
antibody has already been bound by the AHG, there is no free AHG serum to react
with the Check Cells, and no agglutination will occur.
Use the drop-down boxes to match the blood types (phenotypes) that will be
expressed with the genotypes listed to the right of the boxes.
Your answers are on the left. The correct answers are on the right and highlighted.
O OO
A OA
AB AB
B BB
A AA
B OB
Feedback
Possible genotypes include:
Type O patients: OO
Type A patients: OA, AA
Type AB patients: AB
Type B patients: OB, BB
Which of the following steps should be taken in the IMMEDIATE investigation of a

potential hemolytic transfusion reaction? (choose all that apply)
ABO and DAT on the post-transfusion patient sample

Check for a clerical error
Serum bilirubin test
Gram stain the recipient's supernatant plasma
Visual examination of the post-reaction and pre-reaction (if available) plasma for
hemolysis
Feedback125
Serum bilirubin testing would not be done as part of the immediate investigation of a
possible hemolytic transfusion reaction. Peak levels of bilirubin occur 5 to 7 hours
after transfusion.
Gram stain would be useful if bacterial contamination of the donor blood were
suspected. This would not be a hemolytic transfusion reaction.
The majority of anti-Lea antibodies are of which immunoglobulin class?
IgM
IgG
IgA
Feedback1
The majority of Lea antibodies are IgM.

Which of the following best describes the primary function of antibodies:
Protect B-lymphocytes
Bind with antigen
Fix complement
Stimulate the immune response
Feedback2
The purpose of the antibody is to bind with its specific antigen.
What action should be taken if a large clot is noticed in a red blood cell unit while the
product is being prepared for release to the patient?
Issue the product as you normally would but with a filter.

Issue the product, but note the presence of the clot in the computer records.
Filter the product prior to issue and record the process.
Do not issue the product.
Feedback4
This integrity of this specimen is compromised. The unit cannot be used.
In order to prevent a loss of viability in platelet concentrates during storage the pH

must be maintained above:
7.5
6.2
5.0
4.5
Feedback2
The proper pH for a unit of platelets must be above 6.2. According to the FDA,
accurate pH measurement is time dependent, and samples should be tested within 1
hour of sampling, or as suggested by the manufacturer of the pH measurement
system. It is recommended that a pH meter or gas analyzer be routinely used rather
than pH (nitrazine) paper. However, if the laboratory chooses to determine pH
measurements with nitrazine paper, the selected paper should read in increments of
one-tenth units, or it may provide inaccurate measurements. Maintaining proper pH
requires at least 35 ml, but preferably 50-70 ml of plasma per platelet unit.
If the antigen frequencies for K = 0.09 and Fya = 0.66, what percent of type-specific
units would be compatible for a patient with anti-K and anti-Fya?
10
43
31
92
100
Feedback3
The negative antigen frequencies are used in the formula below to determine the
percent of type-specific units that would be compatible for the patient. Negative
antigen frequencies are determined by subtracting the percent antigen frequency from
100%. The negative antigen frequency for K in this case is .91 (1.00 - .09) and the
negative antigen frequency for Fya is .34 (1.00 - .66).
% compatible units available = 100 x (Neg frequency #1 x Neg frequency #2...)
For this case, the calculation is:
% compatible units available = 100 x (0.91 x 0.34) = 30.94 or 31%
DR antigens are found in which of the following systems:
Kell system
HLA system
Duffy system
ABO system
Feedback
HLA-DR is a MHC class II(major histocompatibility complex) surface receptor on

the cellular surface which is encoded by the human leukocyte antigen complex, or
HLA.
Which one of the following red blood cell phenotypes will NOT react with Anti-Fy3?
Fy(a+b+)
Fy(a+b-)
Fy(a--b+)
Fy(a--b-)
Feedback
This immune antibody reacts with all red cells except those of the Fy(a-b-) phenotype.
Which of the following is the most common type of autoimmune hemolytic anemia?
Warm autoimmune hemolytic anemia.

Cold agglutinin disease.
Paroxysmal cold hemoglobinuria.
Drug-induced immune hemolytic anemia
Feedback
Warm autoimmune hemolytic anemia accounts for 60 - 70% of the cases of immune
hemolytic anemias.
Antibodies in the Rh system typically exhibit which one of the following

characteristics?
Reacts best at 37C and AHG

Reacts best at room temperature
Shows hemolysis better than agglutination
Feedback
Rh antibodies typically react the strongest at 37 degree temperatures and during the
AHG phase of typing.
Which of the following tests has been recommended by the FDA to replace the HIV-1
p24 antigen test in the screening of donated blood for infectious diseases?
HIV-1 NAT
Anti-HIV-1
Anti-HIV-2
HCV NAT
Feedback
The FDA recommends that HIV-1 nucleic acid testing (NAT) be done in place of
HIV-1 p24.
Anti-HIV-1 and anti-HIV-2 are still required screening tests. HCV NAT is
recommended as part of the battery of tests, but is not a replacement for HIV-1 p24
testing.
An urticarial reaction is characterized by:

Rapid rise in temperature
Difficulty breathing
Rash and hives
Blood in the urine
Feedback
Urticarial transfusion reactions occur in up to 1% of transfusions. They are manifested

by hives, rash, and itching. The transfusion may be resumed after successful
administration of antihistamines.
How many out of 1,000,000 Caucasians will have the following phenotype: Group 0,
K+, Jk(a+)
10,000
30,000
100,000
600,000
750,000
Feedback
Group O blood types comprise about 44% of the caucasian population. Out of
1,000,000 people, this leaves us with about 440,000 people. Approximately 9% of
caucasians have the K antigen, leaving us with 39,600 individuals who are group O,
K+. Approximately 77% of caucasians are positive for the Jka antigen. 77% of 39,600
individuals leaves us with 30,492 or approximately 30,000 individuals that are group
O, K+ and Jk(a+).
If possible, Rh immune globulin should be administered within what period of time

following the delivery of an Rh positive or weak-D positive infant, or other Rh
alloimmunizing event?

72 hours
One week
Two weeks
Prior to another pregnancy
Feedback
Rh immune globulin is administered within 72 hours of an Rh alloimmunizing event,

whenever possible.
A former patient had an anti-E four years ago, but her antibody panel is now negative.
Since she now needs blood for surgery, what should the blood bank do?
get autologous blood from relatives

crossmatch E-negative units
give group O negative whole blood
give random compatible units
Feedback
Once an antibody has been detected, and is part of the patient's historical record, units
that are considered for transfusion must be negative for that antigen.
In an extreme emergency , if the ABO and Rh type are unknown which of the
following should be given to the patient?
Group O, Rh positive blood

Group AB, Rh negative blood
Group O, Rh negative blood
Any blood type is OK
Feedback
"Universal donor", (a misnomer) is usually applied to group O, Rh negative blood.
Although it may be necessary to use group O, Rh negative blood in an extreme
emergency, it is preferable to use type specific blood for emergencies.
All of the following criteria for donor RBC to be used for an exchange transfusion
relate to both ABO HDFN and HDFN due to anti-D:
1. Less than or equal to 7 days old (or fresher)

2. Reconstituted with AB FFP
3. CMV negative
4. Negative for hemoglobin S
5. Irradiated
True
False
Feedback
The statement is true.
The listed criteria apply to donor RBC for exchange transfusions to treat any type of
HDFN, including those caused by antibodies outside the ABO and Rh blood group
systems.
Antibodies are ruled out using panel cells that are homozygous for the corresponding
antigen because:
multiple antibodies will not react with heterozygous cells

stronger reactions seen with homozygous cells
heterozygous cells are usually negative
heterozygous cells cannot be used at all for rule outs
Feedback
Cells in the homozygous state have a double dose of the antigen on the red cell so
reactions are stronger. When cells are in the heterozygous state, there are less antigen
sites to bind with so reactions are weaker.
Homozygous cells should be used for rule outs when possible so that weaker reacting
antibodies present in the heterozygous state aren't accidentally ruled out.
Which of the following is NOT a possible type for an offspring from the mating of an
O and an AB individual?
AB
AO
BO
Feedback
The AB inheritance is not possible. In this case, the parents' genotypes are OO and
AB, therefore one parent can only pass on the O gene. This is illustrated below with
the use of the Punnett square.
OOx AB O O
A AO AO
B BO BO
Which of the following is used as a source for irradiation of blood products:
Cs137
I131
C14
P51
Feedback
Irradiation is performed using cesium-137 or cobalt-60 in self-contained blood

irradiators or hospital radiation therapy machines.

Premedication with antihistamines may prevent an allergic reaction in patients with a
history of multiple urticarial transfusion reactions.
True
False
Feedback
Premedication with antihistamines 30 minutes prior to transfusion may be helpful in

preventing an allergic reaction in patients with a history of multiple urticarial
transfusion reactions.
Which of the following antibodies usually show enhanced agglutination with the use
of proteolytic enzymes?
anti-M,N, and S
anti-Jka, Jkb, C, and E
anti-Fya and Fyb
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Enzyme techniques are particularly useful in the identification of antibodies in the

Rh system (e.g., anti-C and E) and in the Kidd system (e.g., anti-Jka and Jkb).
Enzymes destroy some antigens, such as M, N, S, Fya, and Fyb. Therefore the
corresponding antibodies would not be detected.

RhIg Microgram Question

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RhIg Microgram Question

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Wiener Fisher-Race (haplotype)

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It is necessary to convert Wiener system shorthand nomenclature to Fisher-Race

The mothers Fisher-Race genotype for Wiener R0R1 would be Dce/DCe.

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Which of the following would NOT be included in a hemolytic transfusion reaction

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ABO/Rh check of post-transfusion sample

Leukocyte antigen studies would NOT be included in a hemolytic transfusion reaction

The remaining procedures must be performed as part of the initial reaction

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RhIg prophylaxis is typically given antenatally to Rh negative pregnant females

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RhIg is typically given antenatally to Rh negative pregnant females without knowing

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Most blood group antibodies belong to which immunoglobulin classes?

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IgA and IgD

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Yersina entercolitica is most likely responsible for septic reactions in transfusions of

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Factor VIII concentrate can be administered to a hemophiliac patient during active

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Fresh frozen plasma should be used for which of the following:

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Fever and chills

Unexplained bleeding is associated with immediate hemolytic transfusion reactions,

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Remove Lea substances

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The correct answer is anti-K.

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Failure to adequately wash cells

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PCH is a cold autoimmune anemia while CHD is acquired

PCH is caused by an IgG antibody while CHD is caused by an IgM antibody.

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Forward typing appears to be B, but reverse groups like O

Acquired B is seen only in a subpopulation of group A1 individuals. The individuals