Eiman Mgeed

MLS(ASCPi) Sep 2014

Labce Free Questions

uestion (50 points)

Below are results of a mini-panel chosen to confirm anti-D and exclude other
antibodies in an Rh negative woman at delivery who received antenatal RhIg and who
has a positive antibody screen consistent with passive anti-D.

Mini-Panel Results

Cel
Rh Rhesus Kell Duffy Kidd MNSs P Lewis Results
l
Gel
C D E c e K k Fya Fyb Jka Jkb M N S s P1 Lea Leb
IAT*
1 rr 0 0 0 + + + + + 0 + 0 0 + + 0 +S + 0 1+
2 rr 0 0 0 + + 0 + 0 + + 0 + + 0 + +S + 0 0
3 r'r + 0 0 + + 0 + + 0 0 + + 0 + 0 0 + 0 0
4 r'r + 0 0 + + + + + + + + + 0 + + + 0 + 1+
5 r"r 0 0 + + + 0 + 0 + 0 + + + 0 + + + 0 0
6 r"r 0 0 + + + 0 + + + + + + + + + + 0 + 0
7 Ror 0 + + + + 0 + + + + + + + + + + 0 + 2+
8 Auto 0

* IAT = indirect antiglobulin test

Anti-? is the most likely cause of the mini-panel test results with screen cells #1 and
#4.

Enter one letter to designate the most likely antibody, e.g., D or C, etc.

Enter your answer

Feedback

Anti-K is the most likely cause of the reactions with cells #1 and #4, which are the
only cells that are K+. Cell #7 reacts since it is D+.

However, other causes are possible. An antibody identification would be done to

identify the antibody or antibodies.

Question (69 points)

Which of the following is true of genotype screening in pharmacogenomics?

 Eiman Mgeed

MLS(ASCPi) Sep 2014

Labce Free Questions

Please select the single best answer

Genotype screening gives a better overall picture of drug metabolism than

measuring metabolism with probe drugs.
Genotyping does not take into account drug interactions which can affect
metabolism.
Genotyping typically involves measuring only one mutation site or
polymorphism.

Feedback2

Genotyping, while more robust and definitive, cannot factor in environmental or

health variables that could affect drug metabolism. Probe drug analysis does factor in
these variables, but it is more complex and tedious.

Genotyping typically involves measuring many polymorphisms. For example, a

laboratory that offers CYP2D6 profiling may measure twelve of the most common
and significant mutation sites on this enzyme.

Question (50 points)

Antibody identification interpretations would be considered correct 95% of the time

or have a P value of 0.05 if you have:

Please select the single best answer

2 positive reactions to rule in an antibody and 2 negative reactions to rule out an

antibody
1 positive reaction to rule in an antibody and 3 negative reactions to rule out an
antibody
3 positive reactions to rule in an antibody and 3 negative reactions to rule out an
antibody
3 positive reactions to rule in an antibody and 1 negative reaction to rule out an
antibody

Feedback3

Based on Fisher's exact method, the probability of having reliable results increases if
you are able to have more rule out and rule in cells. So 3 to rule in and 3 to rule out
would give the highest probability. By comparing the patterns of reactivity and non-
reactivity, we can more safely assume that an observed pattern is not the result of
chance alone.
 Eiman Mgeed

MLS(ASCPi) Sep 2014

Labce Free Questions

Question (48 points)

Antibodies to which of the following are the most frequent cause of febrile
transfusion reactions:

Please select the single best answer

Platelets
Red cells
Granulocytes
Plasma proteins

Feedback3

The most common type of febrile reaction occurs as the result of cytotoxic antibodies
or leukoagglutinins (leukocyte antibodies).

Question (52 points)

Rh immune globulin therapy in postpartum women provides:

Please select the single best answer

Long term protection

Antibody blocking
Passive protection
Active immunity

Feedback3

Protection against alloimmunization is only for the recent pregnancy. There is of

course no long term protection against the development of Rh antibodies if the patient
is exposed again in the future.

Question (59 points)

For which of these reasons would a molecular method be used to determine a

pregnant woman's Rh type?
 Eiman Mgeed

MLS(ASCPi) Sep 2014

Labce Free Questions

Please select the single best answer

To determine if she is homozygous or heterozygous for D

To determine if she is Rh negative
To differentiate between weak D or partial D

Feedback3

Differentiating between weak D and partial D is useful because women with partial D,
but not usually weak D, may make anti-D and should be considered Rh negative for
purposes of administering RhIg. Anti-D reagents cannot distinguish between the two
D variants.

Question (28 points)

Most antibodies present in cord blood are of ________ origin.

Please select the single best answer

fetal
maternal
paternal
maternal and paternal

Feedback2

Infants who are less than 6 months old usually do not produce alloantibodies, but
newborns may have passive antibodies of maternal origin.

Question (34 points)

Given the following results, what is the immune status of the patient?

HbsAg - neg
HbeAg - neg
Anti-Hbc - neg
 Eiman Mgeed

MLS(ASCPi) Sep 2014

Labce Free Questions

anti-HBs - pos
anti-HBe - neg

The correct answer is highlighted below

acute infection
chronic infection
immunization
susceptible

Feedback

Anti-HBs is expected to be positive post-vaccination. Since there are no other

antigens or corresponding antibodies present in the patient sample, it is likely that
patient has been immunized to hepatitis B and is no longer susceptible.

Question (56 points)

If an antinuclear antibody indirect immunofluorescence test shows a positive,

speckled pattern, which would be the MOST appropriate additional test to perform?

The correct answer is highlighted below

Anti-mitochondrial antibody
Immunoglobulin quantitation
Screen for Sm and RNP antibodies
Anti-DNA antibody using C. lucillae
Mitochondrial antigen identification

Feedback3

In systemic lupus erythematosis, a speckled ANA pattern is noted. To help confirm

this diagnosis, often anti-Sm and anti-RNP antibody tests are ordered; this detects
immune response against extractable nuclear antigens.

Question (40 points)

 Eiman Mgeed

MLS(ASCPi) Sep 2014

Labce Free Questions

Which of the following antibodies is most often implicated as a cause of delayed hemolytic
?transfusion reaction (DHTR)

The correct answer is highlighted below

Anti-S

Anti-M

Anti-FYa

Anti-Jka

Feedback2

Of the antibodies that are listed, anti-Jka is most often reported as the cause of DHTR. Jkb is
.also well documented as a cause of DHTR

.Antibodies that are also implicated in a DHTR include Kell, Rh, and Duffy system antibodies

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