Deck 1: Immunology: Basic Principles and Applications in the Blood Bank

Question 1

The major histocompatibility complex is located on chromosome 6 and is important in all the following immune functions except:

A)recognition of nonself.
B)graft rejection.
C)hemolysis.
D)coordination of cellular and humoral immunity.

Answer 1

C
The major histocompatibility complex codes for molecules on all nucleated tissues and cells to allow for immune recognition and response to foreign antigens.

Question 2

What immunoglobulin class is capable of crossing the placenta?

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

Answer 2

D
Only IgG can cross the placenta as a result of IgG receptor binding sites on placental cells.

Question 3

Opsonization is a term to describe what process?

A)Lysis of cells
B)Binding to cells or antigens
C)Ingestion of cells
D)Phagocytosis

Answer 3

B
Opsonization promotes phagocytosis by binding to cells or antigens.

Question 4

Select the cell involved in humoral immunity.

A)Neutrophils
B)T lymphocytes
C)B lymphocytes
D)Monocytes

Question 5

In a lymphocytotoxicity test,cells that take on the dye:

A)do not recognize a human leukocyte antigen.
B)recognize a red cell antibody.
C)are not affected by complement.
D)are recognized by a specific antibody.

Question 6

What portion of the antibody molecule binds to receptors on macrophages and assists in the removal of antibody bound to red cells?

A)Fab fragment
B)Hinge region
C)Fc fragment
D)J chain

Question 7

Extravascular destruction of blood cells occurs in the:

A)blood vessels.
B)lymph nodes.
C)spleen.
D)thymus.

Question 8

What is the potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used?

A)False negatives
B)False positives
C)Hemolysis
D)No effect

Question 9

An antigen that originates from the individual is termed:

A)autologous
B)allogeneic
C)hapten
D)immunogen

Question 10

What immunoglobulin class reacts best at room temperature at immediate spin?

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

Question 11

Select the portion of the antibody molecule that imparts the antibody's unique class function.

A)Constant region of the heavy chain
B)Constant region of the light chain
C)Variable region of the heavy chain
D)Variable region of the light chain

Question 12

Which of the following will cause an antigen to elicit a greater immune response?

A)Small antigen size
B)Composed largely of carbohydrates
C)Size greater than 10,000 daltons
D)Similarity to the host

Question 13

After adding antigen and antibody to a test tube,one large agglutinate was observed.How should this reaction be graded?

A)2+
B)3+
C)4+
D)0

Question 14

Which of the following is responsible for the activation of the classic pathway of complement?

A)Bacteria
B)Foreign proteins
C)Virus
D)Antibody bound to antigen

Question 15

In a serologic test,the term prozone is also known as:

A)equivalence.
B)antigen excess.
C)antibody excess.
D)serum-to-cell ratio.

Question 16

Select the region of the antibody molecule responsible for imparting unique antibody specificity.

A)Variable region
B)Constant region
C)Hinge region
D)Fc fragment

Question 17

Select the term that is associated with the B-cell response to antigens.

A)Humoral immunity
B)Cellular immunity
C)Innate immunity
D)Nonspecific immunity

Question 18

It was observed that an antibody identified in the transfusion service appeared to be reacting stronger following the second exposure to an antigen from a transfusion.The most likely explanation of this is:

A)affinity maturation of the immunoglobulin molecule.
B)anamnestic response.
C)isotype switching.
D)all of the above.

Question 19

A poor response to platelet transfusion that can be caused by antibodies to human leukocyte antigens is known as:

A)nonresponders.
B)refractoriness.
C)immune activation.
D)responders.

Question 20

Select the substance that regulates the activity of other cells by binding to specific receptors.

A)Cytokines
B)Complement
C)Immunoglobulins
D)Anaphylatoxin

Question 21

Select the term from the list below that best fits the definitions.a.Kappa
b.Epitope
c.Hinge region
d.Isotype
e.Idiotype
The type of immunoglobulins determined by the heavy chain

Question 22

Select the term from the list below that best fits the definitions.a.Kappa
b.Epitope
c.Hinge region
d.Isotype
e.Idiotype
Part of the antigen that the immunoglobulin binds to

Question 23

Select the immunoglobulin class from the list below that best fits the characteristic described.Each class can be used more than once.a.IgA
b.IgM
c.IgG
d.IgE
Found in secretions,such as breast milk

Question 24

Select the immunoglobulin class from the list below that best fits the characteristic described.Each class can be used more than once.a.IgA
b.IgM
c.IgG
d.IgE
Efficient in activation of the complement cascade

Question 25

Select the term from the list below that best fits the definitions.a.Kappa
b.Epitope
c.Hinge region
d.Isotype
e.Idiotype
One of the two types of light chains

Question 26

Select the term from the list below that best fits the definitions.a.Kappa
b.Epitope
c.Hinge region
d.Isotype
e.Idiotype
Variable region of an immunoglobulin

Question 27

Which class of HLA antigens would be typed when matching patient and donors for platelet transfusion?

A)Class I only
B)Class II only
C)Class I and II
D)Classes I,II,and III

Question 28

HLA matching between the donor and recipient is important for progenitor cell transplantation to avoid:

A)graft versus host disease (GVHD).
B)graft rejection.
C)transfusion reactions.
D)A and B.

Question 29

Select the immunoglobulin class from the list below that best fits the characteristic described.Each class can be used more than once.a.IgA
b.IgM
c.IgG
d.IgE
Associated with allergic reactions and mast cell activation

Question 30

Select the immunoglobulin class from the list below that best fits the characteristic described.Each class can be used more than once.a.IgA
b.IgM
c.IgG
d.IgE
Associated with immediate-spin in vitro reactions

Question 31

Select the immunoglobulin class from the list below that best fits the characteristic described.Each class can be used more than once.a.IgA
b.IgM
c.IgG
d.IgE
Able to cross the placenta

Question 32

The mixed lymphocyte culture (MLC)is a procedure that has been used in HLA testing to determine:

A)Class I HLA antigen determination.
B)Class II HLA antigen determination.
C)HLA antibody identification.
D)compatibility testing for tissue typing.
E)B and D.

Question 33

In order to enhance the reaction of an antibody in vitro,it may be necessary to adjust which of the following?

A)Temperature above 37° C
B)Speed of the centrifuge above the calibrated settings
C)Increase the concentration of red cells in the test system
D)Increase the incubation time in the incubator

Question 34

Select the term from the list below that best fits the definitions.a.Kappa
b.Epitope
c.Hinge region
d.Isotype
e.Idiotype
Imparts flexibility to the immunoglobulin molecule

Question 35

In the complement cascade,lysis of the target cell is mediated by which of the following components?

A)C1qrs
B)C4a,C3a,and C5a
C)C5 to C9
D)C3a and C3b

Question 36

Select the immunoglobulin class from the list below that best fits the characteristic described.Each class can be used more than once.a.IgA
b.IgM
c.IgG
d.IgE
Associated with intravascular cell destruction

Question 37

A patient's record indicated that he had a history of an antibody to HPA-1a.What is the significance of this antibody if this patient requires a platelet transfusion?

A)The patient would require HPA-1a negative platelets,which are relatively rare.
B)Transfusion of HLA-matched platelet donors would yield a better response.
C)Washed platelets are necessary to avoid antibody interference.
D)No testing is necessary because the frequency of HPA-1a positive donors is very rare.

Question 38

Select the immunoglobulin class from the list below that best fits the characteristic described.Each class can be used more than once.a.IgA
b.IgM
c.IgG
d.IgE
Has the highest serum concentration

Question 39

Hemolysis was observed at room temperature when testing a patient's serum with reagent red cells used for screening.When this test was repeated using the patient's plasma,no hemolysis was observed.What was the most likely explanation for the different reactions?

A)The plasma sample was collected incorrectly.
B)The serum sample was contaminated.
C)Complement activation was inhibited by calcium in the plasma sample.
D)The serum sample was fresher.

Question 40

Select the immunoglobulin class from the list below that best fits the characteristic described.Each class can be used more than once.a.IgA
b.IgM
c.IgG
d.IgE
Has the highest number of antigen binding sites