Question 1

A couple requests blood typing of a 2-year-old girl (man is B, Rh-; woman is B, Rh+). The child's blood type is found to be O+. Which of the following conclusions concerning the child's parentage is valid?

A)The child could be the natural offspring of this couple
B)The mother could be the natural mother, but the father could not be the natural father
C)The father could be the natural father, but the mother could not be the natural mother
D)Neither the father nor the mother could be the natural parents

A

Accepted Answer

The child having an O+ blood type is possible with parents who are both B (one Rh+ and the other Rh-), as the O and Rh+ genes can come from both parents, indicating the child could indeed be the natural offspring of this couple.

Question 2

Hyperacute rejection is most likely to occur in the setting of which of the following?&#10;A)Isograft&#10;B)Xenograft&#10;C)Autograft&#10;D)Allograft

Accepted Answer

Hyperacute rejection occurs within minutes after transplantation and is caused by pre-existing antibodies in the recipient's serum that react with the donor's antigens. Because xenografts involve the transplantation of tissues or organs from a different species, there is a higher likelihood of pre-existing antibodies and therefore hyperacute rejection. Isografts and autografts are less likely to be rejected because the donor tissues are genetically similar to the recipient's tissues. Allografts are more likely to be rejected than isografts and autografts, but less likely to result in hyperacute rejection because there is usually not a pre-existing antibody response to the donor's antigens.

Question 3

A previously healthy, blood type O+, 22-year-old woman is admitted to the hospital forf gastrointestinal bleeding. She has a hematocrit of 25%. She receives three units of blood. During administration of a fourth unit, she develops severe back pain, shortness of breath, fever, decreased blood pressure, and reddish brown urine. Which of the following is the most likely result of these findings?

A)ABO incompatibility
B)Bacterial contamination of the blood
C)Rh factor incompatibility
D)Elevated immunoglobulin E

A

Accepted Answer

The symptoms described are consistent with a hemolytic transfusion reaction, which occurs when donor blood is incompatible with the recipient's blood type. In this case, the patient is blood type O+, so she can only receive O+ or O- blood. The symptoms of back pain, shortness of breath, fever, decreased blood pressure, and reddish brown urine are all indicative of hemolysis, or the breakdown of red blood cells. This can occur when the recipient's immune system attacks the donor blood cells, leading to the release of hemoglobin into the bloodstream, which can cause kidney damage and other complications. ABO incompatibility is the most likely cause of the hemolytic transfusion reaction in this case.

Question 4

Erythroblastosis fetalis due to Rh incompatibility can, in the newborn, lead to all of the following conditions except:&#10;A)Severe anemia&#10;B)Jaundice due to increased circulating levels of bilirubin&#10;C)Mental retardation&#10;D)Atrophy of the spleen and the liver

Accepted Answer

Erythroblastosis fetalis can cause severe anemia, jaundice, and potentially mental retardation due to high bilirubin levels, but it does not cause atrophy of the spleen and liver; rather, these organs may become enlarged.

Question 5

Which agglutinogens are present in a person with A+ blood?&#10;A)A, B, D&#10;B)A, D&#10;C)D&#10;D)A&#10;E)None

Accepted Answer

A person with A+ blood type has A and D agglutinogens. The A refers to the A antigen on the red cells, and D indicates the presence of the Rh factor, which is positive in this case.

Question 6

Which of the following transfusions will result in an immediate transfusion reaction?&#10;A)O Rh- blood to an AB Rh+ patient&#10;B)B Rh+ blood to an A Rh+ patient&#10;C)AB Rh- blood to an AB Rh+ patient&#10;D)B Rh- blood to a B Rh- patient

Accepted Answer

The best choice that will result in an immediate transfusion reaction is B. This is because the recipient patient has type A blood, which means they have anti-B antibodies in their plasma. If they are given B blood, their antibodies will recognize the B antigens on the transfused cells as foreign and launch an immediate immune response, leading to a transfusion reaction. The other options may cause a transfusion reaction eventually due to differences in ABO or Rh blood types, but not necessarily immediately.

Question 7

Which of the following is true concerning erythroblastosis fetalis?&#10;A)There is a decrease in vitamin B&#8321;&#8322; in the fetus&#10;B)There are increased numbers of granulocytes in the mother&#10;C)The erythropoietin level of the fetus is decreased&#10;D)The free hemoglobin level in the fetus is elevated

Accepted Answer

Erythroblastosis fetalis is a condition that occurs when there is an incompatibility between the blood types of the mother and fetus, leading to the destruction of fetal red blood cells. This destruction results in an increase in free hemoglobin levels in the fetus as the red blood cells are broken down.

Question 8

A mother of blood type A+ who has always been perfectly healthy just delivered her second child. The father is of blood group O-. Knowing that the child is of blood group O- (O, Rh-), what would you expect to find in this child?

A)The child will have erythroblastosis fetalis due to rhesus incompatibility
B)The child will have erythroblastosis fetalis due to ABO blood group incompatibility
C)The child will have both A and B
D)The child would not be expected to develop hemolytic disease of the newborn

Accepted Answer

Since the mother is blood type A+ and the father is blood type O-, it is impossible for the child to inherit the A antigen from the mother. Therefore, there is no ABO blood group incompatibility that could lead to hemolytic disease of the newborn. Additionally, since the father is Rh negative, there is no Rh incompatibility either. Therefore, the child would not be expected to develop hemolytic disease of the newborn.

Question 9

Which couple cannot be the biological parents of a child with blood group AB?&#10;A)Mother AB, father AB&#10;B)Mother AB, father OO&#10;C)Mother OB, father AA&#10;D)Mother AA, father BB&#10;E)Mother OA, father OB

Accepted Answer

A child with blood group AB can only inherit the A and B alleles from their parents. Therefore, a parent with blood group O cannot pass on either A or B alleles to their child, making choice B the only one where biological parents cannot have a child with blood group AB.

Deck 36: Blood Types; Transfusion; Tissue and Organ Transplantation