1. Isoimmunisation to platelet antigen (PI A1) and the placental transfer of maternal antibodies
would be xpected to cause newborn:
a. Erythroblastosis
b. Leukocytosis
c. Leukopenia
d. Thrombocytopenia
2. Following plasmaheresis, how long must a person wait before being eligible to donate a unit of
Whole Blood?
a. 8 weeks
b. 2 weeks
c. 48 hours
d. 24 hours
3. Each unit of whole blood will yield approximately how many units of cryoprecipitated AHF?
a. 40
b. 80
c. 130
d. 250
4. Addition of which of the following will enhance the shelf- life of whole blood?
a. Heparin
b. Adenine
c. Hydroxyethyl starch
d. Lactated Ringer’s solution
6. Severe intravascular hemolysis is most likely caused by antibodies of which blood group system?
a. ABO
b. Rh
c. Kell
d. Duffy
7. Under extreme emergency conditions when there is no time to determine ABO group for
transfusion, the technologist should:
a. Refuse to release any blood until the patient’s sample has been typed
b. Release O, Rh- negative whole bold
c. Release O, Rh- negative red blood cells
d. Release O, Rh- positive red blood cells
8. An obstetrical patient has had three 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
Blood Banking and Serology
19. Mixed- field reactions with anti- A and anti- A, B and negative reactions with anti- B and anti-
A1 lectin (Dolichos biflorus) are observed. Without further testing, the most likely conclusion is
that the patient is group:
a. A1
b. A2
c. A3
d. A4
21. A patient received two units of Red Blood Cells and had a delayed hemolytic transfusion
reaction. Pretransfusion records indicate a negative antibody screen. Repeat testing of the
pretransfusion specimen detected an antibody at the antiglobulin phase. What is the most likely
explanation for the original results?
a. Red cells were overwashed
b. Centrifugation time was prolonged
c. Patient’s serum was omitted from the original testing
d. Antiglobulin reagent was neutralized
24. Mixed- field agglutination at the anti- human globulin phase of a crossmatch may be attributed
to:
a. Recently transfused cells
b. Intrauterine exchange transfusion
c. An antibody such as anti- Sd
d. Fetomaternal hemorrhage
Blood Banking and Serology
25. In suspected cases of hemolytic disease of the 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. A differential to estimate the absolute number of lymphocytes present
d. Determination of the presence of spherocytes and elevated numbers of nucleated red blood
cells’
26. As a preventive measure against graft- versus- host disease, red blood cells prepared for infants
who have received intrauterine transfusions should be:
a. Saline- washed
b. Irradiated
c. Frozen and deglycerolized
d. Group and Rh compatible with the mother
27. Which of the following is the preferred specimen for the initial compatibility testing in exchange
transfusion therapy?
a. Maternal serum
b. Eluate prepared from infant’s red blood cells
c. Paternal serum
d. Infant’s post exchange serum
28. When the main objective of an exchange transfusion is to remove the infant’s 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 washed
c. Fresh Frozen Plasma
d. Heparinized Red Blood Cells
30. According to AABB standards, 75% of all Platelet, Pheresis units tested shall contain how many
platelets per µL?
a. 5.5 x 10 10
b. 6.5 x 10 10
c. 3.0 x 10 11
d. 5.0 x 10 11
31. Following the second spin in the preparation of Platelet, Pheresis units tested shall contain how
many platelets per µL?
a. Allowed to sit undisturbed for 1 hour
b. Agitated immediately
c. Pooled immediately
d. Transfused within 48 hours
Blood Banking and Serology
32. Which of the following is proper procedure for preparation of Platelets, from whole blood?
a. Light spin followed by a hard spin
b. Light spin followed by two hard spins
c. Two light spins
d. Hard spin followed by a light spin
34. Platelets prepared in a polyolefin type container, stored at 22o C- 24oC in 50 mL of plasma and
gently agitated can be used for up to:
a. 24 hours
b. 48 hours
c. 3 days
d. 5 days
35. The enzyme responsible for conferring H activity on the red cell membrane is alpha:
a. Galactosyl transferase
b. N- acetylgalactosaminyl transferase
c. L- fucosyl transferase
d. Glucosyl transferase
37. A 25- year- old Caucasian woman, gravida 3, para 2, required two units of Whole Blood. The
antibody screen was positive and the results of the antibody panel are shown above. Which of the
following antibodies may be the cause of the positive antibody screen?
a. Anti- M and anti-K
b. Anti-c and anti- E
c. Anti- s and anti-c
d. Anti- Fyb and anti-c
38. A 25- year- old Caucasian woman, gravida 3, para 2, required two units of Whole Blood. The
antibody screen was positive and the results of the antibody panel are shown above. What is the
most probable genotype of this patient?
a. rr
b. r’r’
c. Ror
d. R1R1
Blood Banking and Serology
39. A 25- year- old Caucasian woman, gravida 3, para 2, required two units of Whole Blood. The
antibody screen was positive and the results of the antibody panel are shown above. Which
common antibody has NOT been ruled out by the panel?
a. Anti- S
b. Anti- Lea
c. Anti- Jka
d. Anti- K
40. A patient’s serum reacted weakly positive (1+w) with 16 of 16 group O panel c3ells at the AHG
test phase. The autocontrol was negative. Tests with ficin- treated panel cells demonstrated no
reactivity at the AHG phase. Which antibody is most likely responsible for these results?
a. Anti- Ch
b. Anti-k
c. Anti-e
d. Anti- Jsa
41. Use of EDTA plasma prevents activation of the classical complement pathway by:
a. Causing rapid decay of complement components
b. Chelating Mg++ ions, which prevents the assembly of C6
c. Chelating Ca++ ions, which prevents assembly of C1
d. Preventing chemotaxis
42. A 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 c. 25
b. 15 d. 35
43. The most effective component to treat a patient with fibrinogen deficiency is:
a. Fresh Frozen Plasma
b. Platelets
c. Fresh Whole Blood
d. Cryoprecipitated AHF
44. An assay of plasma from a bag of cryoprecipitate AHF yields a concentration of 9 international
units (IU) of factor VIII per mL of cryoprecipitate AHE. If the volume is 9mL, what is the Factor
VIII content of the bag in IU?
a. 9
b. 18
c. 27
d. 81
45. The approximate percentage of the original plasma content of Factor VIII recovered in
cryoprecipitate AHF is:
a. 10%- 20%
b. 20%- 40%
c. 40%- 80%
d. 80%- 100%
46. A newborn demonstrates petechiae, ecchymosis, and mucosal bleeding. The preferred blood
component for this infant would be:
a. Red blood cells c. Platelets
b. Fresh frozen plasma d. Cryoprecipitated AHF
Blood Banking and Serology
47. A 65-year-old woman experienced shaking, chills and a fever of 103oF approximately 40 minutes
following the transfusion of a second unit of Red Blood Cells. The most likely explanation for
the patient’s symptoms is:
a. Transfusion of bacterially contaminated blood
b. Congestive heart failure due to fluid overload
c. Anaphylactic transfusion reaction
d. Severe febrile transfusion reaction
48. An acid elution stain was made using a 1- hour post delivery 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 to that would be indicated under these circumstances.
a. 2
b. 3
c. 4
d. 5
49. The Liley method of predicting the severity of hemolytic disease of the newborn is based on the
amniotic fluid:
a. Bilirubin concentration by standard methods
b. Change in optical density measured at 450nm
c. Rh determination
d. Ratio of lecithin to sphingomyelin
50. A unit of Fresh Frozen Plasma was inadvertently thawed and then immediately refrigerated at 4o
C on Monday morning. On Tuesday evening this unit may still be transfused as a replacement
for:
a. All coagulation factors c. Factor VIII
b. Factor V d. Factor IX
Immunology
51. Which of the following statements about immunoglobulins is true?
a. Immunoglobulins are produced by T lymphocytes
b. The IgA class is determined by the gamma heavy chain
c. The IgA class exists as serum and secretory molecules
d. There are two subclasses of IgG
52. The classic antibody response pattern following infection with hepatitis A is:
a. Increase in IgM antibody; decrease in IgM antibody; increase in IgG antibody
b. Detectable presence of IgG antibody only
c. Detectable presence of IgM antibody only
d. Decrease in IgM antibody; increase in IgG antibody of the IgG3 subtype
53. Which of the following is the major residual split portion of C3?
a. C3a
b. C3b
c. C4
d. C1q
54. Which of the following releases histamine and other mediators from basophils?
a. C3a
b. Properdin factor B
c. C1q
d. C4
Blood Banking and Serology
55. The component associated only with the alternative pathway of complement activation is:
a. C4
b. C1q
c. Properdin factor B
d. C3a
56. Which of the following is cleaved as a result of activation of the classical complement pathway?
a. Properdin factor B
b. C1q
c. C4
d. C3b
57. The enzyme linked immunosorbent assay (ELISA) technique for the detection of HBsAg:
a. Requires radiolabeled C1q
b. Is quantitated by degree of fluorescence
c. Uses anti- HBs linked to horseradish peroxidase
d. Uses beads coated with HbsAg
62. The antigen marker most closely associated with transmissibility of HBV infection is:
a. HBs
b. Hbe
c. HBc
d. HBV
63. Hepatitis C (nonenteric form of non- A, non- B hepatitis) differs from hepatitis A and hepatitis B
because it:
a. Has highly stable incubation period
b. Is associated with a high incidence of icteric hepatitis
c. Is associated with a high incidence of the chronic carrier state
d. Is seldom implicated in cases of posttransfusion hepatitis
66. Initiation of the activation mechanism of the alternative complement pathway differs from that of
the classical pathway in that:
a. Antigen- antibody complexes containing IgM or IgG are required
b. Endotoxin alone cannot initiate activation
c. C1 component of complement is involved
d. Antigen- antibody complexes containing IgA or IgE may initiate activation
69. A 26- year old nurse developed fatigue, a low grade fever, polyarthritis and urticaria. Two
months earlier she had cared for a patient with hepatitis. Which of the following findings are
likely to be observed in this nurse?
a. negative hepatitis B surface antigen test
b. elevated AST and ALT levels
c. a positive rheumatoid factor
d. a positive Monospot TM test
70. The FTA- ABS test for the serologic diagnosis of syphilis is:
a. less sensitive and specific than the VDRL is properly performed
b. likely to remain positive after adequate antibiotic therapy
c. currently recommended for testing cerebrospinal fluid
d. preferred over darkfield microscopy for diagnosing primary syphilis
71. The hyperviscosity syndrome is most likely to be seen in monoclonal disease of which of the
following immunoglobulin classes?
a. IgA c. IgG
b. IgM d. IgD
72. Antibody class and antibody subclass are determined by major physiochemical differences and
antigenic variation found primarily in the:
a. constant region of heavy chain
b. constant region of light chain
c. variable regions of heavy and light chains
d. constant regions of heavy and light chains
73. Which of the following complement components is a strong chemotactic factor as well as a strong
anaphylatoxin?
a. C3a c. C5a
b. C3b d. C4a
Blood Banking and Serology
74. Which of the following complement components or pair of components is a viral neutralizer?
a. C1 c. C2b
b. C1, 4 d. C3a
77. A transfusion reaction to erythrocyte antigens will activate which of the following
immunopathologic mechanisms?
a. immediate hypersensitivity
b. arthus reaction
c. delayed hypersentivity
d. immune cytolysis
79. High titers of anti-microsomal antibodies are most often found in:
a. rheumatoid arthritis
b. systemic lupus erythematosus
c. chronic hepatitis
d. thyroid disease
80. SLE patients often have which of the following test results?
a. high titers of DNA antibody
b. decreased serum immunoglobulin levels
c. high- titers of anti- smooth muscle antibodies
d. high titers of antimichondrial body
81. Anti- RNA antibodies are often present in individuals having an antinuclear antibody
immunoflourescent pattern that is;
a. speckled
b. rim
c. diffuse
d. nucleolar
82. Antibodies to which of the following immunoglobulins are known to have produced anaphylactic
reactions following blood transfusion?
a. IgA c. IgE
b. IgD d. IgG
Blood Banking and Serology
83. The latex agglutination titer commonly considered as the lower limit of positivity for diagnosis of
rheumatoid arthritis is;
a. 1:2 c. 1: 160
b. 1:40 d. 1: 6
84. A 16-year- old boy with infectious mononucleosis has a cold agglutinin titer of 1: 2000. An
important consideration of this antibody’s clinical relevance is the:
a. thermal range c. specificity
o
b. titer at 4 C d. light chain type
85. Which of the following is an important cellular mediator of immune complex tissue injury?
a. monocyte c. basophil
b. neutrophil d. eosinophil
86. A serologic test for syphilis that depends upon the detection of cardiolipin- lecithin- cholesterol
antigen is:
a. FTA- ABS
b. RPR
c. MHA- TP
d. TPI
87. In the FTA- ABS test, the presence of beaded pattern of fluorescence along the treponeme
indicates:
a. positive identification of treponema pallidum
b. presumptive diagnosis of active syphilis
c. presence of nontreponemal antibody (NTA)
d. false- positive reaction
88. The most important use of nontreponemal antibody (NTA) test alone is in;
a. establishing the diagnosis of acute active syphilis
b. establishing the diagnosis of chronic syphilis
c. evaluating the success of therapy
d. determining the prevalence of disease in the general population
89. The serologic test for syphilis recommended for detecting antibody in cerebrospinal fluid is;
a. nontreponemal antibody
b. CSF- VDRL
c. FTA- ABS
d. MHA- TP
90. The initial immune response following fetal infection with rubella is the production of which
class(es) of antibodies?
a. IgG
b. IgA
c. IgM
d. both IgG and IgA
Blood Banking and Serology
91. Within one week after exposure to rash illness, a maternal serum rubella titer that is equal to or
greater than 1:8 indicates:
a. probable immunity to rubella
b. evidence of acute rubella infection
c. susceptibility to rubella infection
d. absence of acute rubella
93. The area of the immunoglobulin molecule referred to as the hinge region is located between
which domains?
a. VH and VL c. CH2 and CH3
b. CH1 and CH2 d. CH3 and VL
94. Which class of immunoglobulin is thought to function as an antigenic receptor site on the surface
of immune B lymphocytes?
a. IgD c. IgA
b. IgM d. IgD
95. Which of the following terms describes a graft between genetically unidentical individuals
belonging to the same species?
a. autograft c. allograft
b. isograft d. xenograft
96. Which of the following is the “recognition unit” in the classical complement pathway?
a. C1q c. C4
b. C3a d. C5
97. A series of eight tubes are set- up with 0.79 mL of diluent in each. A serial dilution is performed
by adding 10uL of serum to the first tube, and then transferring 10 uL through each remaining
tube. What is the serum dilution of tube 7?
a. 1:2.431 x 1011
b. 1:2 621 x 10 11
c. 1:1.920 x 10 13
d. 1:2.097 x 10 13
99. The presence of HbsAg, anti- HBc and often HbeAg is characteristic of:
a. early acute phase HBV hepatitis
b. early convalescent phase HBV hepatitis
c. recovery phase of acute HBV hepatitis
d. carrier state of acute HBV hepatitis
Blood Banking and Serology
100. The disappearance of HbsAg and HbeAg, the persistence of anti- HBc, the appearance of anti-
HBs and often of anti- HBe indicate:
a. early acute HBV hepatitis
b. early convalescent phase HBV hepatitis
c. recovery phase of acute HBV hepatitis
d. carrier state of acute HBV hepatiti
Blood Banking and Serology