Deck 2: Blood Banking Reagents: Overview and Applications in Immunohematology

Question 1

Polyspecific antihuman globulin contains:

A) anti-IgG.
B) anti-C3b and anti-C3d.
C) anti-IgG, and anti-C3d.
D) anti-IgG, and anti-IgM.

Answer 1

C
Polyspecific antihuman globulin contains specificities to the heavy chain IgG and complement component, C3d.

Question 2

Why is incubation omitted in the direct antihuman globulin test?

A) The direct antiglobulin test can be used in an emergency to replace the indirect test.
B) Incubation will cause hemolysis.
C) The antigen-antibody complex has already formed in vivo.
D) IgM antibodies are detected in the direct antiglobulin test.

Answer 2

C
Incubation of the antigen-antibody complex essentially has taken place within the patient (or donor), making additional incubation in the tube unnecessary.

Question 3

Which of the following statements is true regarding high-protein anti-D reagents?

A) They have been largely replaced with low protein monoclonal reagents.
B) They contain approximately 20% bovine albumin.
C) They may increase the possibility of a false-positive reaction, requiring the use of a control.
D) All of the above are true.

Answer 3

D
High-protein anti-D reagent requires the use of a control to verify that positive reactions are the result of an antigen-antibody reaction and not agglutination caused by the reagent additive. For this reason, the use of monoclonal anti-D is more commonly used.

Question 4

Select the method that uses a dextran-acrylamide matrix.

A) Solid-phase red cell adherence
B) Microplate
C) Gel technology
D) Tube techniques

Question 5

The evidence for reagent red cell deterioration may include which of the following?

A) Spontaneous agglutination
B) Significant hemolysis
C) Loss of agglutination strength over time
D) All of the above

Question 6

Which red cells are used to screen for antibodies in donor samples?

A) Screening cells (two vials)
B) Pooled screening cells
C) Panel cells
D) Screening cells (three vials)

Question 7

The antiglobulin test was performed using gel technology. A button of cells was observed at the bottom of the microtube following centrifugation. This result indicates a:

A) problem with the card.
B) negative reaction.
C) strong positive reaction.
D) failure to wash correctly.

Question 8

What reagent contains antibodies to multiple antigenic epitopes?

A) Polyclonal-based
B) Monoclonal-based
C) Heterophile antibody-based
D) Alloantibody-based

Question 9

Product limitations and technical considerations for each reagent can be found in the:

A) standard operating procedure.
B) product insert.
C) Food and Drug Administration code of regulations.
D) AABB standards.

Question 10

Reagent antibodies prepared from human sources are:

A) unsafe.
B) too low of potency to be effective.
C) polyclonal in specificity.
D) preferred because of their lower cost.

Question 11

An advantage of using a monoclonal antibody over a polyclonal antibody includes all of the following except:

A) very few variations between lots.
B) no contaminating antibodies.
C) direct agglutination is usually faster.
D) all variations of the antigen can be detected.

Question 12

Select the test that uses IgG-sensitized red cells (check cells).

A) Antiglobulin test
B) D-antigen typing
C) Rh-antigen typing
D) B-antigen detection

Question 13

Following centrifugation of the gel card, red cells are observed to be evenly dispersed throughout one of the microtubes. This reaction could be graded as a:

A) 4+.
B) 3+.
C) 2+.
D) 1+.

Question 14

How would you interpret the results if both the anti-D reagent and the Rh control were 2+ agglutination reactions?

A) D-positive
B) D-negative
C) Unable to determine without further testing
D) Depends on whether the sample was from a patient or a blood donor

Question 15

In the solid-phase red cell adherence test, a negative test would appear as:

A) a button of cells on the bottom of the well.
B) adherence of cells along the sides and bottom of the wells.
C) hemolysis of red cells.
D) a line of cells along the top of the well.

Question 16

The indirect antihuman globulin test is incubated at what temperature?

A) 22° C
B) 37° C
C) 4° C
D) 56° C

Question 17

Which of the following statements is true regarding IgG-sensitized red cells?

A) They must be used to confirm a negative antiglobulin tube test.
B) They must be used to confirm a positive antiglobulin test.
C) They must be used to confirm a direct antiglobulin test that was negative with anti-C3d.
D) They should be used only with the indirect antiglobulin test.

Question 18

Solid-phase red cell adherence used for antibody detection has an advantage over tube testing because:

A) there is no washing involved.
B) incubation time is not necessary.
C) the endpoint is more clearly defined.
D) indicator cells (IgG-coated cells) are not necessary.

Question 19

The gel technology method uses a concentration of red cells that is:

A) higher than tube techniques.
B) lower than tube techniques.
C) the same as the 3% to 5% requirement for tube testing.
D) variable according to the test performed.

Question 20

Monoclonal antibodies are prepared in:

A) vitro.
B) vivo.
C) laboratory animals.
D) humans.

Question 21

Select the reagent from the list below and match it to the routine blood banking procedure.
a.Panel cells
b.Screening cells
c.A₁ and B cells
d.ABO antisera
e.Rh antisera
f.Lectins
Reagent to detect the presence of red cell antibodies

Question 22

Select the reagent from the list below and match it to the routine blood banking procedure.
a.Panel cells
b.Screening cells
c.A₁ and B cells
d.ABO antisera
e.Rh antisera
f.Lectins
Reagent to identify the specificity of a red cell antibody

Question 23

Select the reagent from the list below and match it to the routine blood banking procedure.
a.Panel cells
b.Screening cells
c.A₁ and B cells
d.ABO antisera
e.Rh antisera
f.Lectins
Reagent derived from plants used to distinguish group A₁ from group A₂ red cells

Question 24

Select the reagent from the list below and match it to the routine blood banking procedure.
a.Panel cells
b.Screening cells
c.A₁ and B cells
d.ABO antisera
e.Rh antisera
f.Lectins
Reagent used in the identification of ABO antibodies

Question 25

Select the reagent from the list below and match it to the routine blood banking procedure.
a.Panel cells
b.Screening cells
c.A₁ and B cells
d.ABO antisera
e.Rh antisera
f.Lectins
Reagent used to determine the ABO antigenic composition of a patient's red cells