REINFORCEMENT EXAMINATION

SECOND UNIT EXAMINATION

1. All of the following statements are true regarding the Lewis blood group system, EXCEPT:
A. Lewis antigens are soluble antigens found in body fluids
B. Lewis phenotypes in the secretions result from the interaction of the Se and Le genes
C. All Lewis antigens are type I structures
D. Lewis phenotypes in the secretions depend on the interaction of ABO and Le genes
2. Which of the following is true for secretor system?
A. Approximately 20% of the population is secretors
B. Homozygous sese individuals secrete ABH antigens
C. Secretion of the Leb antigen substance depends on the interaction of the Le and Se genes
D. AOTA E. NOTA
3. At 4 wks after birth, a baby with Lele, HH, sese would type as which of the following Lewis phenotypes?
A. Le(a-b-) C. Le(a+b+ )
B. Le(a+b-) D. Le(a+b-)
4. Lec and Led antigens are found in individuals with which phenotype?
A. Le(a-b-) C. Le(a+b+)
B. Le(a+b-) D. Le(a+b-)
5. The Lewis phenotype that is most associated with increase susceptibility to H. Pylori infection is:
A. Le(a+b-) C. Le(a-b-)
B. Le(a-b+) D. NOTA
6. The specificity of the antibody described by Landsteiner and Weiner that was produces in rabbits injected with rhesus
monkey red cells was later found to be:
A. Anti-D C. Anti-LW
B. Anti-C D. Anri-Rh29
7. Which of the following phenotypes would have RBCs that would react with anti-f?
A. DCe/DcE C. Dce/dce
B. DcE/dCe D. AOTA
8. All Du individuals cannot produce an antibody against the D antigen, because this is only a weak expression of the D
antigen.
A. True B. False
9. Which of the following is/are true of amorph type Rhnull patients?
A. They are LW(a-B-) C. they demonstrate stomatocytes in p. blood semears
B. They have abnormal RBC survival D. AOTA
10. Highest expression of the D antigen is observed in which phenotype?
A. R2R2 C. D--
B. R1R1 D. D mosaic
11. RhIg is given when the Rh type of a pregnant mother and child are...
A. Mother is Rh(-) child Rh(-) C. mother Rh(+) child (-)
B. Mother is Rh(-) child Rh(+) D. mother Rh(+) child (+)
E. B and C only
12. Individuals without the Rho factor are classified as:
A. Rh (+) C. Rhnull
B. Rh (-) D. Du
13. RHD is the gene responsible for production of the D polypeptides, this gene is located in..
A. Chromosome 1 C. chromosome 6
B. Chromosome 11 D. chromosome 7
14. The gene responsible for the expression of the Rh antigens.
A. RHD C. RHAG
B. RHCE D. AOTA
15. Individuals with antibodies for HrO antigens would have the following antigen/s, except:
A. C C. E
B. D D. A and C only E. A, B, C only
16. Expression of Rh antigens would be possible for children with parents having what type of Rhnull syndrome?
A. Regulator type C. either
B. Amorphic type D. neither
17. Which of these antibodies has not been implicated in HDN?
A. Anti-k C. anti-P1
B. Anti-s D. NOTA
Write down the antigens expressed/ represented by the following haplotypes .

HAPLOTYPE FISHER-RACE ROSENFIELD WIENER

18. ry

19. r”

20. r

21. RO

22. Write down all the possible phenotypes that would have the indicated reactions with antisera. You can use the back of
your paper.
Example: D+, C+, E+, c+, e (-/0) = RzR2 or Rzr” or R2ry
Anti

D C E c e Wiener Fisher-Race Rosenfield

R1r’ DCe/dCe Rh:1,2,-3,-4,5
+ + 0 0 + R1R1 DCe/DCe Rh: 1,2,-3,-4,5
r’r’ dCe/dCe Rh: 1,2,-3,-4,5

a
23. Which of the following technique/s reagents would be the least useful in the detection of anti-Jk ?
A. Low-ionic strength solution C. Polyethelyne glycol
B. Prroteolytic enzyme D. Saline room temperature
24. The Lutheran null phenotype may be inherited by which of the following mechanisms?
A. Inheritance of the In(lU) gene
B. Inheritance of 2 recessive genes at the LU locus
C. Inheritance of a gene on the X chromososme
D. AOTA
25. Glycophorin B deficiency would affect the expression of what group of antigens?
a b a b
A. M, N, Di , Di C. M, N, Wr , Wr
B. Knops, JMH and Chido/ Rogers D. JMH, Dombrock and Cromer
26. Delayed hemolytic transfusion reaction is most associated with the presence of antibodies to..
a b
A. Jk and Jk C. Fy3
a b
B. Js and Js D. S
27. The presence of the In(Lu) gene suppresses the expression of...
a b a
A. Lutheran antigens only C. Le , Le , P, MER1, In , I, AnWj
a a a
B. Lu , Lub, P1, i, Inb, AnWj, MER2 D. Lub, Leb, Pk, Dr , Ts
28. Anti-Lu3 reacts with all of the following phenotypes, except:
A. Lu(a+b-) C. Lu(a-b-) [In(Lu)]
B. Lu(a-b+) D. AOTA
29. An antigen in the high incidence series that is enhanced by the addition of enzymes.
a
A. Vel C. At
a
B. Lan D. Sd
30. What antigen/s is/are not present in RBCs of an individual with Mcleod phenotype?
A. Kx C. both
B. Km D. neither
31. Which of the following groups of antigens are derived from the plasma rather than being an integral part of the RBC
membrane?
a a a c
A. K, Ch, Lu C. Fy , Le , Bg
b a a
B. Le , Rg, Ch D. Sd , Rg, Bg
32. Which antibody listed below has been associated increased incidence of spontaneous abortions?
b
A. Anti-kell C. anti-Le
a
B. Anti-PP1Pk D. anti-Fy
33. Amongst the indicated, who will have the greatest number of I antigen expressed in the RBCs?
A. Patient with Infectious mononucleosis C. patient with Mycoplasma pneumoniae infection
B. Bombay phenotype D. a newborn baby with a lot of hair
34. Ms Ns can also be expressed as:
A. M+N+S+s- C. M-N+S-s+
B. M+N-S+s- D. M+N+S-s+
a
35. Fy Fyx can also be expressed as:
 A. Fy (a+b+x+) C. Fy(a-b+)
B. Fy(a+b-) D. Fy(a-b-x+)
36. Antibodies that demonstrate weak reactivity whether using diluted or undiluted serum usually causing problems in
antibody screening.
a a
A. Anti-McC C. anti-Yk
B. Anti-Rg D. AOTA E. NOTA
37. Which antibodies are produced by “NRBC” stimulation?
a
A. Antibodies to Lewis, M, N, P and Lu antigens
b
B. Antibodies to Kell, Kidd, Duffy, S and Lu antigens
C. Antibodies to Lutheran, MNS, Lewis and P
D. Antibodies to Kell, Kidd, Duffy and Rh
38. The following antibodies react best at room temperature, Except:
A. Anti-M C. anti-Lub
B. Anti-P1 D. AOTA E. NOTA
39. A patient has the following genotype: AO, sese, Lele, Hh. Which of the following soluble antigens is/are present in the
saliva? ( you can have more than one answer; right MINUS wrong)
a b
A. A B. Le C. H D. Le E. NOTA
40. Antigens enhanced by the addition of enzymes.
A. Rh B. Kidd C. P D. A and C only E. A, B, and C
41. The Rh nomenclature that is best suited for use in electronic data processing.
A. Wiener C. Fisher-Race
B. Rosenfield D. AOTA E. NOTA
42. It is recommended that all individuals who types as weak D(+) be given D(-) blood.
A. True B. False
43. Amongst the various Rh system antigens, the most antigenic is
A. e C. c
B. d D. D E. E
44. Biochemically, Lewis antigens are present in secretions in what form?
A. Glycoproteins C. Glycophorins
B. Glycolipids D. Complement proteins
45. The presence of Antibodies to Chido/Rodgers antigens may be detected by performing which test?
A. Plasma inhibition C. Neutralization
B. DAT D. A & C only
E. A, B & C
46. All of the following apply to a double red cell unit apheresis collection, EXCEPT:
A. The hct must be at least 38 mL/dL.
B. The weight for a female is at least 130 lb
C. The height for a male is at least 5 feet 3 inches
D. The deferral period following collection is 16 weeks
47. Which of the following donors would be accepted for a Directed Donation?
A. A 37-year-old male currently taking etritinate (Tegison)
B. A 17-year-old female with a hemoglobin 12 g/dL
C. A 24-year-old male who just received the hepatits B vaccine prior to employment
D. A 49-year-old male from the UK who is visiting the US for the first time
48. Which of the following antibodies is enhanced by acidification of the patient’s serum?
A. Anti-Fya B. Anti-K C. Anti- E D. Anti-M
49. Choose the preferred criteria for donor units when issuing uncrossmatched blood for a patient for whom no
pretransfusion testing can be completed.
1. ABO and Rh specific C. ABO and Rh compatible
2. Group O, Rh-negative D. ABO specific, Rh negative
50. Which of the following is not true regarding plateletpheresis donation?
A. Pretransfusion platelet counts remain close to pretrasfusion level.
B. Aspirin ingestion is a cause for temporary deferral.
C. The plaetelet pheresis product is equivalent to six units of platelet concentrate.
D. Predonation platelet counts must be 150x109/L
51. What factors determine the maximum number of components that may be derived from one unit of whole
blood?
A. Time and anticoagulant C. temperature and collection size
B. Time and collection container composition D. container composition and anticoagulant
52. In solid phase technique, the indicator red cells are attached to the _____.
A. Microtiter well C. reagent anti-antibody
B. Reagent antibody D. patient antibody
53. Which of the following is not an outcome of the donor screening process?
A. Reduction of risk of adverse donor reactions C. either
B. Reduction in the risk of harm to the recipient D. neither
54. A disadvantage for both gel and solid-phase technology is:
A. Decrease sensitivity
B. Inability to test hemolyzed, lipemic, or icteric samples
C. Inability to detect C3d complement-coated cells
D. Large sample requirements
55. Which of the following lists four antibodies that all generally react best below 37oC?
A. Anti-A, anti-P1, anti-Lea, anti-M C. anti-H, anti-S, anti-Jka, anti-Leb
B. Anti-B, anti-K, anti-I, anti-Fya D. anti-B, anti-N, anti-E, anti-Jkb
56. Autologous transfusion minimizes the risk of the following, except:
A. Blood bank clerical errors C. IgA- mediated anaphylaxis
B. Hepatitis D. transfusion reaction due to atypical antibodies
57. A fundamental purpose of the crossmatch is to
A. Detect recipient antibodies that are directed against donor red cell antigens
B. Prevent immunization of the recipient
C. Prove that a recipient does or does not have an unexpected antibody in the serum
D. Verify that the donor and recipient are Rh-identical
58. If the antiglobulin phase of the crossmatch is omitted, which of the following antibodies would probably not
be detected?
A. Anti-K C. Anti-N
B. Anti- Lea D. Anti-P1
59. Given the panel of reagent red cells below tested against patient serum at IS, 37oC with LISS, and AHG,
which cells would show agglutination at some phase of testing if the serum contained antibodies to M and
Fya?

Cell # D C E c e K k Fya Fyb M N

1 + + 0 0 + + + + 0 + +
2 + + 0 0 + 0 + 0 + + 0
3 + 0 + + 0 0 + + 0 0 +
4 + 0 0 + + 0 + 0 + 0 +
5 0 + 0 + + 0 + 0 + + +

A. Cells 1,2,3, & 5 C. Cells 1,2,&5

B. Cells 1 &3 D. Cell 4 only
60. Which of the following differences between donors and recipients will the major crossmatch performed at
IS, 37oC LISS, and AHG phases of testing usually detect? In each situation, no unexpected antibodies are
present except those indicated.
A. Group O recipient mistyped as A; donor is A
B. Rh-negative recipient mistyped as Rh-positive; donor is Rh-positive
C. Recipient with AHG-reacting anti-Jka; donor is Jk(a-b-)
D. Rh-positive recipient; donor is Rh-positive
61. The abbreviated crossmatch may be done if...
A. The recipient has been transfused within the last 72 hours without reaction
B. The recipient currently has a negative Ab screen and no previous history of an unexpected Ab
C. The blood selected for the recipient is ABO-group and Rh-type specific
D. The recipient is a newborn who has not yet developed unexpected antibodies
62. From the abbreviated cell panel depicted below, determine the most probable antibody/ies in the patient’s
serum.

Cell Known Antigens Test result

#
C D E c e K k M N 37oC AHG CC
1 + + + + 0 0 + 0 + 2+ 3+ NP
2 0 + 0 + + 0 + + 0 0 0 2+
3 0 + + + 0 0 + + 0 2+ 4+ NP
 4 + + 0 0 + + + + + 0 0 2+
5 0 0 0 + + 0 + + 0 0 0 2+

A. Anti- k C. anti-E
B. Anti-e D. anti-C & anti-e
63. An incompatibility in the immediate spin phase on pretransfusion testing suggests a/an
A. Rh antibody C. anti-Fya
B. ABO mismatch D. positive donor antibody screen

64. Anti- E has been identified in a patient serum. If the E antigen has a frequency of 30% in the population,
how many units of 10 tested would you expect to crossmatch compatible with this patient? What is the
fewest number of donor units you could test to find two units that are E negative? (2 points)