Deck 15: Autoimmune and Drug-Induced Immune Hemolytic Anemias

Question 1

Which is true of the biphasic hemolysin usually associated with paroxysmal cold hemoglobinuria (PCH)?

A)Anti-P that binds to red blood cells at body temperature but activates complement at cool temperatures
B)Anti-P that binds to red blood cells at cool temperatures but activates complement at body temperature
C)Anti-P1 that binds to red blood cells at body temperature but activates complement at cool temperatures
D)Anti-P1 that binds to red blood cells at cool temperatures but activates complement at body temperature

Answer 1

Anti-P that binds to red blood cells at cool temperatures but activates complement at body temperature

Question 2

Red blood cell phenotyping by serologic methods can only be performed on specimens from patients who have

A)been transfused in the last 6 months
B)been transfused in the last year
C)not been transfused in the last month
D)not been transfused in the last 3 months

Answer 2

not been transfused in the last 3 months

Question 3

Which can identify the antigens that are not on a patient or donor's red blood cells?

A)Antigen typing test
B)Direct antiglobulin test
C)Donath-Landsteiner test
D)Indirect antiglobulin test

Answer 3

Antigen typing test

Question 4

Systemic lupus erythematosus (SLE)is associated with which of the following?

A)DAT-negative autoimmune hemolytic anemia
B)Drug-induced immune hemolytic anemia (DIIHA)
C)Mixed autoimmune hemolytic anemia (MAIHA)
D)Warm autoimmune hemolytic anemia (WAIHA)

Question 5

What is the most common underlying etiology of cold agglutinin syndrome (CAS)?

A)Autoimmune conditions
B)Bacterial or viral infections
C)Lymphoproliferative disorders
D)Systemic lupus erythematosus

Question 6

Which of the following is the least common autoimmune hemolytic anemia?

A)DAT-negative autoimmune hemolytic anemia
B)Drug-induced immune hemolytic anemia (DIIHA)
C)Mixed autoimmune hemolytic anemia (MAIHA)
D)Warm autoimmune hemolytic anemia (WAIHA)

Question 7

Which of the following describes alloadsorption?

A)Removal of antibody from plasma by incubation with donor or reagent red blood cells with specific phenotypes
B)Removal of autoantibody from plasma by incubation with the patient's own red blood cells
C)Removal of antibody bound to red blood cells by incubation with chloroquine
D)Removal of autoantibody bound to red blood cells by incubation with glycine

Question 8

Which of the following is defined as the process of removing antibodies bound to red blood cells?

A)Adsorption
B)Alloadsorption
C)Autoadsorption
D)Elution

Question 9

Corticosteroid therapy is most successful in treating which type of autoimmune hemolytic anemia?

A)Cold agglutinin syndorm (CAS)
B)Drug-induced immune hemolytic anemia (DIIHA)
C)Paroxysmal cold hemoglobinuria (PCH)
D)Warm autoimmune hemolytic anemia (WAIHA)

Question 10

Which term refers to the destruction of autologous red blood cells during a hemolytic transfusion reaction that is destroying allogeneic cells?

A)Hemagglutination
B)Hemostasis
C)Hemoglobinuria
D)Hyperhemolysis

Question 11

Warm autoimmune hemolytic anemia (WAIHA)occurs most frequently in which age group?

A)Infants
B)Toddlers
C)Teenagers
D)Older adults

Question 12

A positive direct antiglobulin test (DAT)using anti-complement reagent is generally interpreted as the presence of which class of antibody?

A)IgA
B)IgD
C)IgG
D)IgM

Question 13

Which is used as the primary means for determining whether immune-mediated destruction of red blood cells is contributing to a patient's anemia?

A)Antigen typing test
B)Direct antiglobulin test
C)Donath-Landsteiner test
D)Indirect antiglobulin test

Question 14

All of the following can be symptoms of anemia except

A)Brachycardia
B)Fatigue
C)Pallor
D)Tachycardia

Question 15

What is the most common laboratory result pattern seen in warm autoimmune hemolytic anemia (WAIHA)?

A)Positive autocontrol,negative DAT,negative antibody screen,panreactive eLuᵃte
B)Positive autocontrol,positive DAT,negative antibody screen,nonreactive eLuᵃte
C)Positive autocontrol,positive DAT,positive antibody screen,nonreactive eLuᵃte
D)Positive autocontrol,positive DAT,positive antibody screen,panreactive eLuᵃte

Question 16

Typical antihuman globulin reagents used in the direct antiglobulin test (DAT)may be directed against all of the following except

A)IgG only
B)IgM only
C)C3b and C3d
D)IgG,C3b,and C3d

Question 17

Which is the most common causative agent of drug-induced immune hemolytic anemia (DIIHA)today?

A)Anti-hypertensive medications
B)Anti-arrhythmia medications
C)Cephalosporin antibiotics
D)Penicillin antibiotics

Question 18

Which laboratory test result is associated with immune destruction of red blood cells?

A)Decreased serum lactate dehydrogenase
B)Decreased serum hemoglobin
C)Increased serum haptoglobulin
D)Increased serum bilirubin

Question 19

Which of the following is the most common autoimmune hemolytic anemia?

A)DAT-negative autoimmune hemolytic anemia
B)Drug-induced immune hemolytic anemia (DIIHA)
C)Mixed autoimmune hemolytic anemia (MAIHA)
D)Warm autoimmune hemolytic anemia (WAIHA)

Question 20

A positive direct antiglobulin test (DAT)results in a(an)

A)anemic patient is sufficient to diagnose an autoimmune hemolytic anemia
B)healthy blood donor is suggestive of anemia and should be investigated
C)hospitalized patient is sufficient to diagnose hyperhemolysis
D)recently transfused patient should be investigated as a possible transfusion reaction