BB02 - ABO and Rh systems

  1. Patient's cells: anti-A = 4+, Anti-B = 0
    Patient's serum: A1 cells = 1+, B cells = 4+
    O Screening Cell I: IS = 1+, RT = 2+
    O Screening Cell II: IS = 1+, RT = 2+
    Autocontrol Cell: IS = 1+, RT = 2+
    What is the MOST LIKELY cause of this discrepancy?

    A) cold autoantibody
  2. Weak ABO antibodies can occur because of:

    B) All of the above
  3. If an unexpected cold antibody is discovered, how can it be circumvented so that ABO testing can

    A) All of the Above
  4. A 40 year old man had the following results on routine preadmission testing:
    Anti-A: 3+
    Anti-B: 0
    Anti-D: 3+
    Rh control: 0
    A1 cells: 1+
    B cells: 4+
    Without further testing possible explantation(s) include:

    A) All of the above are possible
  5. Group B Rh(D) negative blood donor has a positive DAT. Which of the following situations would occur?

    B) The weak D test and control would be positive
  6. Of the following mating pairs of phenotypes, which could produce a Group A Rh(D) negative child.

    A) All of the above
  7. Forward ABO Group Results: 1+weak mixed-field (mf) reactions with reagent anti-A and anti-A,B
    antisera. Negative reactions with reagent anti-B and anti-A1 lectin (Dolichos biflorus) are observed.
    Without further testing, the most likely conclusion is that the patient is group:

    A) A3
  8. A patient is group A2B, Rh(D) positive and has a 37C antiglobulin-reacting anti-A1 in his serum. He is
    bleeding profusely in the operating room and group A2B Packed Red Blood Cells are NOT available.
    Which of the following types of blood should be given as a first choice?

    A) B, Rh(D) positive
  9. (T/F) In an emergency, a Bombay individual can be safely transfused Group O RBCs.
  10. The immunodominant sugar responsible for blood group B specificity is:
    jQuery1101036414751096253295_1483763750411B gene codes for a glycotransferase enzyme that adds the sugar D-galactose to the H substance type 2
  11. Anti-Rh antibodies:

    A) Are a known cause of hemolytic transfusion reactions
  12. Match the following reagents with their intended use (use each answer only once):

    Ulex europaeus lectin
    Dolichos biflorus lectin
    Anti-Human Globulin
    37C Warm Saline

    A1 Antigen Detection
    H Antigen Detection
    Removal of IgM Cold Autoaggl
    Hemagglutination Inhibition Te
    Weak D Testing
    • Dolichos biflorus lectin: A1 Antigen Detection
    • Ulex europaeus lectin: H Antigen Detection
    • 37C Warm Saline: Removal of IgM Cold Autoaggl
    • Anti-A: Hemagglutination Inhibition Te
    • Anti-Human Globulin: Weak D Testing
  13. Among common Rh phenotypes, which one expresses the most D antigen on the red blood cells.

    C) R2R2
  14. Mother cde/cde
    Father CDe/cde
    These parents could have a child with the genotype:

    D) rr
  15. Match the Fisher Race genotypes on the left with the equivalent modified Wiener genotypes on the right.'


    • DCE/DCe: RzR1
    • dCe/dce: r'r
    • DCe/DcE: R1R2
    • DCe/dce: R1r
    • Dce/dce: Ror
  16. Partial D antigen expression is associated with:

    A) All of the above
  17. Rh Null red blood cells:

    B) Lack all Rh antigens
  18. A donor is tested with Rh antisera, with the following results:
    D+ C+ E= c= e+
    What is the most probable Rh genotype?

    C) R1R1
  19. Routine testing for weak Rh(D) antigen by AHG test is not required for

    C) Rh(D) negative blood recipients
  20. The ABO antibodies cause the most severe hemolytic reactions because:

    1. IgM antibody strongly binds complement
    2. IgM antibodies react at room temperature
    3. The reactions are intravascular
    4. Both a and c
    d. Both 1 and 3
  21. A patient has Rouleaux which interferes with the ABO back typing of the patient's blood. This can be
    eliminated by:

    C) Saline replacement technique
  22. Weak ABO antibodies in plasma can be better detected by:

    C) Extended cold incubation with reagent cells
  23. Compare and contrast the antibodies of the ABO and Rh systems. Include antibody class and optimumtemperature of in vitro reactivity. Which are naturally-occurring and which are immune antibodies?Compare the type and severity of the transfusion reaction when ABO or Rh incompatible cells aretransfused.
    • jQuery110109557850502420566_1483764999322 ABO-Ab
    • are considered naturally occuring bc they are made with out Ag exposure
    • IgM
    • activate complement
    • react at room temp and colder
    • lead to intravascular hemolysis
    • more severe
    • Rh-Ab
    • are mostly IgG
    • react at 37C
    • are produced in response to Ag exposure via pregnancy or txn
    • do NOT activate complement
    • EXtravascular hemolysis of IgG coated cells
    • cause hemolytic transfusion reactions
    • also causes HDN hemolytic dz of newborn as IgG is able to cross the placenta
  24. How does the acquired B phenomenon develop?
    jQuery1101017148240563246997_1483769732536 Acquired B-Ag is caused by cancer or bacteria infection that goes systemic, bacteria in the blood streamhave enzymes that are able to cleave acetyl groups from the A-Ag, this altered A-Ag is reactove with anti-B Ab. It is usually transient and subsides with treatment
  25. What ABH substance(s) would be found in a group B secretor?

    B) H and B
  26. Which of the following ABO groups contains the least amount of H substance?

    D) A1B
  27. Rh antibodies have been associated with which of the following clinical conditions?

    1. Hemolytic Disease of the Newborn
    2. Hemolytic Transfusion Reactions
    3. Cold Agglutinin Disease
    4. Both 1 and 2
    Both 1 and 2
  28. Which Rh antigen is present in 85% of the white population, has been a primary cause of HemolyticDisease of the Newborn and is always significant in transfusion?

    D) D
  29. Which Rh antibody may be produced by a person with the genotype R1r after prior transfusion?

    B) anti-E
  30. How are Rh antigens inherited?

    D) Codominant alleles, haplotype from each parent
  31. An example of a technical error which can cause an ABO typing discrepancy is:

    C) Cell suspension that is too heavy
  32. You are working on a patient you suspect is a Bombay phenotype. If true, which of the following
    reactions do you expect to see?

    A) Patient cells + Ulex europaeus = no agglutination
  33. Why is routine ABO typing not usually affected by the presence of warm autoantibodies?

    A) All of the above
  34. Donor red cells carrying a weak D antigen require the use of which test to demonstrate its presence?

    B) Indirect antiglobulin test
  35. (T/F) A partial D individual is characterized by lacking one or more epitopes of the D mosaic antigen and mayproduce antibody to the missing epitopes when exposed to RBCs with the complete antigen.
  36. (T/F) Donor blood for transfusion is considered Rh(D) positive if either the D or weak D test is positive. If boththe tests for D and weak D are negative, it is considered Rh(D) negative.
Card Set
BB02 - ABO and Rh systems
BB02 - ABO and Rh systems