Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening – Test Bank

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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

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

 

 

Chapter 19. Hemolytic Disease of the Fetus and Newborn

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   Which of the following best describes the principle of the Kleihauer-Betke test?

a. D-positive indicator cells form rosettes around maternal Rh-positive RBCs
b. D-positive indicator cells form rosettes around fetal Rh-positive red blood cells
c. Maternal hemoglobin is resistant to acid (alkali), appearing pink, whereas fetal cells appear as ghost cells
d. Fetal hemoglobin is resistant to acid (alkali) and appears pink, whereas maternal red blood cells appear as ghost cells

 

 

____     2.   What tests are indicated for cord blood specimens if the mother has made anti-K?

a. ABO, Rh, Antibody screen c. ABO, Rh, cold autoabsorption
b. ABO, Rh, DAT d. Kleihauer-Betke

 

 

____     3.   Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?

a. Hydrops fetalis c. Bilirubinemia
b. Kernicterus d. Bilirubinuria

 

 

____     4.   All of the following are goals of an exchange transfusion except:

a. to remove high levels of unconjugated bilirubin.
b. to correct anemia.
c. to remove high levels of conjugated bilirubin.
d. to remove high levels of maternal antibody.

 

 

____     5.   Why is suppression of erythropoiesis an advantage of exchange transfusions?

a. Reduces the production of compatible RBCs
b. Reduces the production of incompatible RBCs
c. Decreases the risk of iron overload
d. Clears nucleated RBCs from circulation

 

 

____     6.   Why is reverse grouping omitted in neonate ABO grouping?

a. Maternal ABO antibody is identical to newborn ABO antibody
b. Maternal antibodies mask the ABO antibodies of the neonate
c. Newborns do not produce isoagglutinins of their own
d. None of the above

 

 

____     7.   A cord blood specimen from a jaundiced infant should be tested for which of the following?

a. ABO c. DAT
b. Rh d. All of the above

 

 

____     8.   Why is the immediate spin eliminated in the prenatal antibody screen?

a. To reduce the detection of auto-antibodies
b. To reduce the detection of IgG antibodies
c. To reduce the detection of IgM antibodies
d. None of the above

 

 

____     9.   Which of the following reagents can be used to determine the immunoglobulin class of anti-M?

a. PEG c. 2-mercaptoethanol
b. Chloroquine d. Ficin

 

 

____   10.   All of the following are characteristic of ABO hemolytic disease of the fetus and newborn (HDFN) except:

a. the mother is group O. c. the antibody is IgM.
b. the mother has anti-A, B. d. the infant has mild HDFN.

 

 

____   11.   What is the physiological mechanism of Rh-immune globulin?

a. Attachment of fetal Rh-positive red blood cells in fetal circulation, inhibiting production of anti-D
b. Attachment of maternal Rh-negative red blood cells in maternal circulation, inhibiting production of anti-D
c. Attachment of fetal Rh-positive red blood cells in maternal circulation, inhibiting production of anti-D
d. Attachment of fetal Rh-negative red blood cells in maternal circulation, inhibiting production of anti-D

 

 

____   12.   Which of the following treatments uses ultraviolet light to treat hyperbilirubinemia after the infant is delivered?

a. Phototherapy c. Amniocentesis
b. Plasma exchange d. Electrophoresis

 

 

____   13.   A 300-µg dose of Rh-immune globulin contains sufficient anti-D to protect against how much whole blood?

a. 15 mL c. 50 mL
b. 30 mL d. 100 mL

 

 

____   14.   In HDFN, the IgG antibodies are directed against which antigen on the fetal red blood cells?

a. Maternal c. Bacterial
b. Paternal d. Viral

 

 

____   15.   An O-positive mother gave birth to an A- negative baby. After 24 hours the newborn’s bilirubin level rose to 18 mg/dL. A DAT performed on the cord blood specimen was positive with polyspecific AHG and anti-IgG reagents. It is probable that _______ from maternal circulation is coating the newborn’s red blood cells.

a. anti-A, B c. anti-A
b. anti-B d. anti-D

 

 

____   16.   Which red blood cell morphology is most characteristic in ABO HDFN and absent in Rh HDFN?

a. Target cells c. Microspherocytes
b. Teardrop cells d. Burr cells

 

 

____   17.   How is an intrauterine transfusion performed?

a. RBCs are injected into the placenta.
b. RBCs are injected into the fetal peritoneal cavity.
c. RBCs are injected into the maternal peritoneal cavity.
d. RBCs are injected into the mother and diffused through the placenta to the fetus.

 

 

____   18.   Immunization of the mother can be caused by as little as ____________ D-positive fetal cells.

a. 10 mL c. 50 mL
b. 1 mL d. 20 mL

 

 

____   19.   Active immunization induced by Rh(D) antigen can be prevented by the concurrent administration of:

a. gamma globulin. c. alpha-1 protease inhibitor.
b. Rh immunoglobulin. d. immune serum globulin.

 

 

____   20.   Due to a short supply of O-negative packed cells, an Rh-negative patient was transfused with 1 unit of Rh-positive red blood cells. Calculate the number of Rh-immune globulin vials needed to protect against 250 mL of Rh-positive packed cells.

a. 5 c. 10
b. 17 d. 23

 

 

____   21.   In order for the mother to be considered for Rh-immune globulin, her Rh type must be _________, and her newborn must be __________.

a. Du-positive/Rh-positive c. Du-negative/Du-negative
b. Rh-negative/Rh-positive d. Rh-positive/Rh-negative

 

 

____   22.   What is the most common clinical manifestation of ABO HDFN?

a. Severe anemia c. Hyperkalemia
b. Hyperbilirubinemia d. Hypotension

 

 

____   23.   Which of the following red blood cells is appropriate for neonatal transfusions?

a. Group A, CMV-negative c. Group O, CMV+
b. Group AB, CMV-negative d. Group O, CMV-negative

 

 

____   24.   The laboratory is presented with a case of HDFN due to ABO incompatibility. The mother is Group O and the infant is Group B. The most appropriate type of blood to use for an exchange transfusion for this infant is:

a. A c. O
b. B d. AB

 

 

____   25.   The most important serologic test for the diagnosis of HDFN is the ________ with anti-IgG reagents.

a. elution c. DAT
b. IAT d. fetal screen

 

 

____   26.   Which of the following antibodies have not been known to cause HDFN?

a. Anti-C c. Anti-D
b. Anti-S d. Anti-Lea

 

 

____   27.   What is the physiological path of indirect bilirubin produced as a result of red blood cell destruction in HDFN?

a. Indirect bilirubin is transported across the placenta and excreted via maternal kidneys.
b. Indirect bilirubin is conjugated in the fetal liver to direct bilirubin.
c. Indirect bilirubin crosses the placenta and is conjugated in the maternal liver to direct bilirubin.
d. None of the above

 

 

____   28.   All of the following are true regarding antibody titration of maternal IgG antibodies except:

a. the method must include the indirect antiglobulin test.
b. the difference of two or more dilutions between titrations is considered significant.
c. red blood cells should consist of the same genotype for each titration.
d. the first serum specimen should be run in parallel with all subsequent titrations.

 

 

____   29.   The D-positive fetal cells in Rh-HDN are __________.

a. homozygous c. amorphic
b. heterozygous d. homologous

 

 

____   30.   Why is the Rh-positive firstborn of an Rh-negative mother unaffected by Rh hemolytic disease of the fetus and newborn (Rh HDFN)?

a. The plasma volume of the mother is tripled during the first pregnancy which dilutes anti-D.
b. The titer of anti-D is too low to cause destruction of fetal antigens.
c. The mother has not been immunized to the D antigen before placental separation.
d. None of the above

 

 

____   31.   Besides the Rh antibodies, what other red blood cell antibody is common to cause severe HDFN?

a. Anti-M c. Anti-K
b. Anti-Lea d. Anti-Fyb

 

 

____   32.   The results of a Kleihauer-Betke stain indicate a fetomaternal bleed of 40 ml of whole blood. How many vials of Rh-immune globulin would be required?

a. 1 c. 3
b. 2 d. 4

 

 

____   33.   What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen?

a. The chance of maternal sensitization to Rh antigen is increased.
b. The chance of maternal sensitization to Rh antigen is decreased.
c. It has no effect.
d. None of the above

 

 

____   34.   Which of the following assays is used to calculate the amount of fetomaternal hemorrhage in a postpartum specimen?

a. Antibody specimen c. Rosette test
b. Kleihauer-Betke test d. Solid-phase adherence test

 

 

____   35.   In the event of a clinically significant antibody found in the mother’s serum, which of the following must be performed to determine its concentration?

a. Fetal screen c. Antibody titer
b. Antibody screen d. Elution

 

 

____   36.   What is the cause of HDFN?

a. Destruction of the mother’s RBCs by autoantibody
b. Destruction of the fetus’s RBCs by antibody produced by the mother
c. Destruction of the fetus’s RBCs by autoantibody
d. Destruction of the mother’s RBCs by antibody produced by the fetus

 

 

____   37.   What immunoglobulin is capable of crossing the placenta?

a. IgG c. IgA
b. IgM d. All of the above

 

 

____   38.   What life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepatomegaly and splenomegaly?

a. Thalassemia
b. Sickle cell anemia
c. Hereditary persistence of fetal hemoglobin
d. Hydrops fetalis

 

 

____   39.   What physiological phenomenon associates erythroblastosis fetalis with HDFN?

a. Release of nucleated red blood cells (RBC) into circulation of mother inflicted with HDFN
b. Release of mature RBCs into circulation of neonate inflicted with HDFN
c. Release of nucleated RBCs into circulation of neonate inflicted with HDFN
d. None of the above

 

 

____   40.   In which type of HDFN is the firstborn affected?

a. ABO c. Lewis
b. Rh d. P

 

 

____   41.   Cannulation of the umbilical vein under ultrasound guidance is known as:

a. cordocentesis. c. apheresis.
b. amniocentesis. d. pericardiocentesis.

 

 

____   42.   Why are premature newborns more likely to require exchange transfusions than full-term infants?

a. Premature newborns are deficient in carrier protein (albumin) for bilirubin transport.
b. Premature newborns have excess indirect bilirubin due to placental transfer of maternal bilirubin.
c. Premature newborn livers are too underdeveloped to conjugate bilirubin.
d. None of the above

 

 

____   43.   Blood transfusions to the fetus and premature infants should be ________ to prevent graft-versus-host disease.

a. gamma irradiated c. less than 7 days old
b. negative for hemoglobin S d. beta irradiated

 

 

____   44.   Which IgG subclass carries more potency in red blood cell hemolysis?

a. IgG2 c. IgG4
b. IgG3 d. None of the above

 

 

____   45.   Which of the following mother/infant blood types would be considered at risk for ABO hemolytic disease of the fetus and newborn?

a. Mother is group O; baby is group B.
b. Mother is group O; baby is group O.
c. Mother is group AB; baby is group B.
d. Mother is group A; baby is group O.

 

 

____   46.   When is the antenatal dose of Rh-immune globulin given?

a. 20 weeks c. 28 weeks
b. 13 weeks d. 36 weeks

 

 

____   47.   Rh-immune globulin should be given within how many hours after delivery?

a. 24 c. 36
b. 48 d. 72

 

 

____   48.   Which prenatal serologic tests are recommended during the first trimester?

a. ABO c. Antibody screen
b. Rh d. All of the above

 

 

____   49.   Anti-D in the serum of a third trimester pregnant woman with a titer of 16 is indicative of:

a. Rh-immune globulin. c. passive immunization.
b. active immunization. d. none of the above.

 

 

____   50.   How are units for exchange transfusion prepared?

a. Group O red blood cells and group O plasma
b. Group O red blood cells and group A plasma
c. Group O red blood cells and group AB plasma
d. Group O red blood cells and group B plasma

 

 

____   51.   Why does the rate of RBC destruction after birth decrease in an infant diagnosed with HDFN?

a. Maternal antibody is no longer entering infant circulation via the placenta.
b. Reticuloendothelial system of the neonate reaches an equilibrium with the rate of RBC destruction.
c. The bone marrow of the neonate compensates for sequestered RBCs.
d. None of the above

 

 

____   52.   What is done to prevent HDFN caused by maternal anti-Jka antibody formation?

a. Give Jka immune globulin.
b. Monitor the mother’s antibody level.
c. Prevent formation of Jka-positive cells in the fetus.
d. No action is necessary; anti-Jka will not cause HDFN.

 

 

True/False

Indicate whether the statement is true or false.

 

____     1.   Rh-immune globulin is of no benefit after a person has been actively immunized and formed anti-D.

 

____     2.   The antibody titer of maternal antibody is directly proportional to severity of HDFN.

 

____     3.   All Rh-negative recipients who are transfused with as little as 1 mL of Rh-positive cells will develop anti-D.

 

 

Chapter 19. Hemolytic Disease of the Fetus and

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  D                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 3

 

  1. ANS:  C                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  A                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  B                    PTS:   1                    KEY:  Taxonomy Level: 3

 

TRUE/FALSE

 

  1. ANS:  T                    PTS:   1                    KEY:  Taxonomy Level: 1

 

  1. ANS:  F                    PTS:   1                    KEY:  Taxonomy Level: 2

 

  1. ANS:  F                    PTS:   1                    KEY:  Taxonomy Level: 1

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