Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening - Test Bank Instant Download - Complete Test Bank With Answers Sample Questions Are Posted Below Chapter 5. The Antiglobulin Test Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. …
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Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening – Test Bank
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Sample Questions Are Posted Below
Chapter 5. The Antiglobulin Test
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. If not labeled “gamma heavy chain-specific,” monospecific anti-IgG may contain antibodies to:
| a. | immunoglobulin light chains. | c. | mu heavy chains. |
| b. | alpha heavy chains. | d. | C3d. |
____ 2. In preparing anti-IgG, how is excess antibody removed for titer adjustment?
| a. | Elution | c. | Block titration |
| b. | Adsorption | d. | Dilution |
____ 3. An advantage of polyclonal anti-IgG over monoclonal anti-IgG is:
| a. | AHG produced in rabbits is more specific than AHG produced in mice. |
| b. | polyclonal anti-IgG will recognize IgG variants. |
| c. | polyclonal anti-IgG also has anticomplement activity. |
| d. | polyclonal anti-IgG recognizes only one IgG epitope. |
____ 4. How is a 40:1 ratio of serum to cells prepared for the AHG test?
| a. | 5 drops of serum + 1 drop of a 5% v/v RBC suspension |
| b. | 1 drop of serum + 1 drop of a 5% v/v RBC suspension |
| c. | 2 drops of serum + 1 drop of a 5% v/v RBC suspension |
| d. | 1 drop of serum + 5 drops of a 5% v/v RBC suspension |
____ 5. Why is incubation omitted in the direct AHG test?
| a. | Polyspecific AHG contains a higher dose of anti-IgG. |
| b. | Incubation will cause lysis of red blood cells. |
| c. | Incubation elutes complement components from red blood cells. |
| d. | In vivo antigen antibody complex is already formed. |
____ 6. Which of the following is consistent with hemolytic disease of the newborn (HDN)?
| a. | Recipient antibody coating donor red blood cells |
| b. | Maternal antibody coating fetal red blood cells |
| c. | Fetal antibody coating maternal red blood cells |
| d. | Autoantibody coating individual’s own red blood cells |
____ 7. What is the incubation time for the IAT when saline is used instead of LISS?
| a. | 10 minutes | c. | 30 minutes |
| b. | 15 minutes | d. | 1 hour |
____ 8. The antihuman globulin (AHG) test was discovered in 1945 by whom?
| a. | Landsteiner | c. | Coombs |
| b. | Mollison | d. | Sanger |
____ 9. A patient came in for a routine type and screen prior to surgery. The antibody screen was negative at 37°C and at the AHG phase. Check cells did not produce agglutination often. What is a possible explanation for this result?
| a. | Dirty glassware | c. | Inadequate washing |
| b. | Use of positive DAT cells | d. | Over-centrifugation |
____ 10. What effect does a low pH have on a saline AHG test?
| a. | Enhances antibody elution |
| b. | Enhances the antigen-antibody complex |
| c. | Increases hydrogen bonding |
| d. | Increases bacterial contamination |
____ 11. At what temperature is the incubation phase of the AHG test?
| a. | 22°C | c. | 4°C |
| b. | 37°C | d. | 56°C |
____ 12. What is a possible consequence of incubating tubes too long with LISS when performing the IAT?
| a. | Increased sensitivity |
| b. | Hemolysis |
| c. | Elution of antibody from red blood cells |
| d. | All of the above |
____ 13. Most clinically significant blood group antibodies are of which IgG subclasses?
| a. | IgG1 and IgG2 | c. | IgG2 and IgG3 |
| b. | IgG1 and IgG3 | d. | IgG2 and IgG4 |
____ 14. Polyspecific AHG contains:
| a. | anti-IgG. | c. | anti-IgG and anti- C3d. |
| b. | anti-C3b-C3d. | d. | anti-IgG and anti-IgM. |
____ 15. “Complete” agglutinins that agglutinate red blood cells in saline are of which immunoglobulin class?
| a. | IgG | c. | IgA |
| b. | IgM | d. | IgE |
____ 16. What do “check cells” contain?
| a. | A+ red blood cell coated with anti-D |
| b. | Rh(D)+ red blood cells coated with anti-D |
| c. | Rh(D)- red blood cells coated with anti-D |
| d. | B+ red blood cells coated with anti-D |
____ 17. All of the following are important in evaluating a positive DAT except:
| a. | patient diagnosis. | c. | transfusion history. |
| b. | drug therapy. | d. | donation history. |
____ 18. The indirect antiglobulin test detects which antigen-antibody reactions?
| a. | In vivo | c. | Both in vivo and in vitro |
| b. | In vitro | d. | None of the above |
____ 19. What is the action of PEG?
| a. | Reduces ionic strength to allow for faster antibody uptake |
| b. | Its macromolecules allow for closer contact of antibody-coated RBCs |
| c. | Increases the serum-to-cell ratio |
| d. | Removes water molecules, thereby concentrating antibody |
____ 20. Why was anticomplement introduced into AHG sera?
| a. | Certain clinically significant antibodies demonstrate complement activity. |
| b. | Complement components enhance Kell antibodies. |
| c. | It provides additional information for transfusion reaction workups. |
| d. | All of the above |
____ 21. How many IgG molecules must be present on the red blood cell for a positive IAT to occur?
| a. | 10 | c. | 50 |
| b. | 100 | d. | 500 |
____ 22. All of the following conditions may produce a positive DAT except:
| a. | hemolytic disease of the newborn. | c. | lymphoma. |
| b. | hemolytic transfusion reaction. | d. | drug-induced hemolytic anemia. |
____ 23. Which IgG antibodies are contained in polyspecific AHG?
| a. | High titer, high avidity |
| b. | High titer, low avidity |
| c. | Chemically modified |
| d. | Those that are pentameric in structure |
____ 24. All of the following complement proteins can be found on the red blood cell membrane except:
| a. | C3d | c. | C4a |
| b. | C4b | d. | C4d |
____ 25. A patient is discovered to have anti-Fya in their serum. The medical technologist needs to phenotype the patient’s cells for the corresponding antigen. What test is appropriate for phenotyping?
| a. | Absorption | c. | DAT |
| b. | Elution | d. | IAT |
____ 26. Why are check cells added to all negative reactions in the AHG test?
| a. | To ensure AHG was not neutralized by free globulin molecules |
| b. | To wash away any unbound antibody |
| c. | To increase the cell-to-serum ratio |
| d. | To bring the antibody closer to the antigen in the test system |
____ 27. What type of globulin does the antiglobulin test detect?
| a. | IgG alloantibodies | c. | C3b complement components |
| b. | IgG autoantibodies | d. | All of the above |
____ 28. In the production of polyspecific AHG, why are IgG and complement antibodies absorbed with A1, B, and O cells?
| a. | To eliminate the possibility of prozone |
| b. | To remove heterospecific antibody |
| c. | To eliminate false-negative results |
| d. | To standardize dilutions of antibody |
____ 29. How is polyclonal antiglobulin serum made?
| a. | Serum from one human is injected into another human, and an antibody is produced. |
| b. | Human serum is injected into rabbits, and an immune response triggers the production of an antibody. |
| c. | Murine serum is injected into rabbits, and an immune response triggers the production of an antibody. |
| d. | Murine serum is injected into mice, and an immune response triggers the production of an antibody. |
____ 30. All of the following statements regarding the AHG test are true except:
| a. | when washing cells, all saline should be removed completely. |
| b. | centrifugation should provide a firm pellet. |
| c. | incubation time with LISS should be a minimum of 30 minutes. |
| d. | Coombs’ control cells should be added to all negative tubes. |
____ 31. What class of antibody can be present in AHG?
| a. | IgG | c. | IgA |
| b. | IgM | d. | All of the above |
____ 32. An antibody screen is performed, and all three tubes are negative after adding AHG. Check cells are added, and the tubes are centrifuged. No agglutination occurs after the addition of check cells. What is the next course of action?
| a. | Recentrifuging the tubes | c. | Repeating the antibody screen |
| b. | Adding one drop of control cells | d. | Adding one drop of AHG |
____ 33. Conventional tube testing in AHG testing has one distinct advantage over gel testing. Identify the advantage.
| a. | Sensitivity | c. | Time savings |
| b. | Cost | d. | Automation |
____ 34. An advantage of monoclonal anti-C3 over polyclonal anti-C3 is:
| a. | with monoclonal anti-C3, the antibody potency can be controlled. |
| b. | contamination with anti-IgG is avoided with anti-C3. |
| c. | with monoclonal anti-C3, antibody to immunoglobulin light chains are eliminated. |
| d. | false-positives caused by cold agglutinins are avoided with anti-C3. |
____ 35. Why is the 37°C reading omitted when using PEG additive?
| a. | PEG may cause aggregation of RBCs at 37°C. |
| b. | Antibodies detected by PEG do not react at 37°C. |
| c. | Warm-reacting antibodies are not clinically significant. |
| d. | Unwanted reactions due to C3b will be detected at 37°C. |
____ 36. Anti-IgG is specific for what part of the IgG molecule?
| a. | FC fragment |
| b. | Constant region of Fab fragment |
| c. | Hypervariable region of Fab fragment |
| d. | Kappa light chain |
____ 37. What is the purpose of washing cells in the AHG test?
| a. | To dilute serum |
| b. | To remove all unbound protein |
| c. | To remove all bound protein |
| d. | To exclude a low-affinity antibody |
____ 38. Saline used for blood banking tests should have a pH of _________.
| a. | 5.0 to 5.5 | c. | 7.2 to 7.4 |
| b. | 6.8 to 7.2 | d. | 7.5 to 8.0 |
____ 39. How would a negative IAT be demonstrated in solid phase methodology?
| a. | The cells form a monolayer. |
| b. | There is a pellet at the bottom of the well. |
| c. | The well turns orange. |
| d. | Small agglutinins appear at the bottom of the well. |
____ 40. The inability to determine the _________ of anti-C3b and anti-C3d individually is one of the difficulties with polyclonal reagents.
| a. | potency | c. | presence |
| b. | titer | d. | volume |
____ 41. False-negative results in antihuman globulin testing can be caused by:
| a. | over-centrifugation. |
| b. | under-centrifugation. |
| c. | cell suspensions that are too weak or too heavy. |
| d. | all of the above. |
____ 42. Which of the following antibodies is least likely to bind complement?
| a. | Jka | c. | ABO |
| b. | Kell | d. | P |
____ 43. Which of the following is not a clinical application for a direct antiglobulin test?
| a. | HDN | c. | AIHA |
| b. | HTR | d. | Heterophile detection |
____ 44. You are performing an IAT, and you are suspicious of the results. It appears there may be a weak alloantibody present. You decide to repeat the test, and at the LISS stage you decide to add an extra two drops of serum to each tube being tested. What can you expect to happen?
| a. | There would be no effect. |
| b. | The additional serum increases reaction strengths, because more possible antibody is added to the reaction. |
| c. | Sensitivity of the test decreases, because you increased the ionic strength of the mixture. |
| d. | You lowered the zeta potential, thus enhancing your results. |
____ 45. What is the optimal temperature for complement activation?
| a. | 58°C | c. | 4°C |
| b. | 37°C | d. | 22°C |
Chapter 5. The Antiglobulin Test
Answer Section
MULTIPLE CHOICE
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