HOWARD – IMMUNOHEMATOLOGY 4TH EDITION STUDY QUESTIONS

HOWARD – IMMUNOHEMATOLOGY 4TH EDITION STUDY QUESTIONS. What area does the Centers for Medicare and Medicaid Services (CMS) regulate? a. Donor testing only b. All laboratory testing c. All laboratory testing including research d. Recipient testing only  CMS regulates all laboratory testing (except research) performed on humans in the United States. The Clinical Laboratory Improvement Amendments of 1988 were enacted to ensure safe and accurate laboratory work. CMS issues a certification to laboratories or other test sites performing clinical tests on human samples. 4. Select the statement that BEST describes Good Manufacturing Practices (GMPs). a. Apply to the blood bank and not the transfusion service b. Include SOP and written record guidelines but not computerized record guidelines c. Do not apply to supplier qualifications d. Regulations that itemize what needs to be done without specifying how  Good Manufacturing Practices are performed in blood banks and transfusion services as part of QA and are legal requirements established by the FDA. These regulations itemize “what” needs to be done without necessarily specifying “how.” In other words, each organization must determine the best way to implement all these practices. HOWARD – IMMUNOHEMATOLOGY 4TH EDITION STUDY QUESTIONS 2 | P a g e 5. A new technologist reported to work in her regulation scrubs with her long hair neatly tied back. She was wearing her new large hoop earrings and gold bangles. Her shoes were new leather sneakers for comfort. Did she violate any safety rules for personal attire? a. No, she met all safety requirements. b. Yes, her hair was too long to work in the lab. c. Yes, her shoes were not made of nylon. d. Yes, she had excessive jewelry that could be a problem.  Hair should be secured away from the face and off the shoulders. Jewelry should be kept to a minimum, and rings that could perforate gloves should not be worn. Open-toed shoes are not permitted in areas where blood exposure exists. Cosmetics should not be applied in the laboratory. 6. What is the minimum personal protective equipment needed when splashes are likely to occur in the laboratory? a. Lab coat, gloves, safety glasses b. Lab coat, gloves, protective apron c. Lab coat and gloves d. None of the above  Safety glasses or goggles should be worn when splashes are likely to occur during a task. Face shields offer greater protection because they protect the mouth, nose, and eyes. Face shields are made of shatterproof plastic and wrap around the face. 7. Where should biohazardous needles and glass materials be disposed? a. Biohazardous waste red plastic bag b. Regular trash can c. Leakproof solid plastic container (“sharps”) d. Any of the above  Needles and glass need a special hard plastic container for disposal called a sharps container. 8. A technologist in training noticed that the person training her had some food and water stored in her reagent refrigerator. Is this an acceptable practice? a. Yes b. No Food or drink should not be allowed in the blood storage or testing areas. TRUE/FALSE 1. The Food and Drug Administration classifies blood as a drug. ANS: T  Yes, the FDA classifies blood as a drug and requires all blood banks and transfusion services to follow its legally required standards. HOWARD – IMMUNOHEMATOLOGY 4TH EDITION STUDY QUESTIONS 3 | P a g e 2. Proper glove techniques require that gloves are washed with soap after handling blood samples so they can be used again. ANS: F  A prudent part of the safety procedure of the blood bank includes the policy that all employees must wear gloves when tasks are likely to involve exposure to blood. Gloves used in a contaminated area should not be worn to a “clean” area or when using or touching telephones, doorknobs, or computer terminals. Gloves should be discarded after use and never washed. HOWARD – IMMUNOHEMATOLOGY 4TH EDITION STUDY QUESTIONS 4 | P a g e Chapter 02 Immunology: Basic Principles and Applications in the Blood Bank Review Questions 1. Select the cells that will undergo transformation to become plasma cells. a. Neutrophils b. T lymphocytes c. B lymphocytes d. Monocytes  B lymphocytes have the ability to transform into plasma cells and produce antibodies, which is considered a humoral response. 2. What process is described by the engulfment of antibody-coated red cells? a. Lysis of cells b. Binding to cells or antigens c. Agglutination d. Phagocytosis  Phagocytosis removes antibody-coated red cells from the circulation through the mononuclear phagocyte system (also known as reticuloendothelial system). 3. Select the sources of antigen for immunohematology testing. a. Patient red cells and plasma b. Commercial and patient red cells c. Patient plasma and commercial red cells d. Commercial antisera and red cells  For antigen testing, antigens are on patient and commercial red cells; antibodies are in patient plasma and commercial antisera. 4. In transfusion medicine, what is the name of the process whereby antibodies attached to red cell antigens signal clearance in the liver and spleen? a. Classical complement pathway b. Intravascular hemolysis c. Alternative complement pathway d. Extravascular hemolysis  Extravascular hemolysis: red cell destruction by phagocytes residing in the liver and spleen, usually facilitated by IgG opsonization. 5. What antibodies are best detected at 37° C and can cause immune-mediated destruction of transfused red cells possessing the corresponding antigen? a. IgM b. IgG c. Both IgM and IgG d. Neither IgM nor IgG  Most clinically important antibodies react at body temperature (37° C), are IgG, and can cause immune destruction of transfused red cells possessing the corresponding antigen. HOWARD – IMMUNOHEMATOLOGY 4TH EDITION STUDY QUESTIONS 5 | P a g e 6. What type of immune response occurs within 1 to 3 days of exposure and contains a significant production of memory B cells? a. Primary b. Secondary c. Tertiary d. None of the above  The second contact with the identical antigen initiates a secondary immune response, or anamnestic response, within 1 to 3 days of exposure. Because of the significant production of memory B cells from the initial exposure, the concentrations of circulating antibody are much higher and sustained for a much longer period. 7. What is the classification of red cell antibodies produced in response to transfusion and pregnancies? a. Naturally occurring antibodies b. HLA antibodies c. Alloantibodies d. Autoantibodies  The antibodies produced in response to transfusion and pregnancies are classified as alloantibodies. 8. What is the potential effect in a tube agglutination result if a red cell suspension with a concentration less than 5% is used? a. False negatives b. False positives c. Hemolysis d. No effect  Antibody excess is termed prozone and will lessen the reaction, causing a false-negative result. 9. After adding antigen and antibody to a test tube, small agglutinates with many unagglutinated cells were observed. How should this reaction be graded? a. 1+ b. 2+ c. 3+ d. 4+ Small agglutinates with many unagglutinated red cells are a 1+ reaction. TRUE/FALSE 1. An antibody molecule can possess one kappa and one lambda light chain. FALSE  There are two types of light chains: kappa chains and lambda chains. Antibodies possess either two kappa or two lambda chains but never one of each.