ISBB RECALLS of it is common to all T cells, but two chains—alpha and beta—

contain variable regions that can bind to only certain antigens.

1. Who developed the technology of hybridoma cells used in
the production of monoclonal antibodies?
A. Kohler and Milstein 5. Functions of T helper cells:
B. Susumu Tonegawa 1.Stimulate B cell growth and differentiation
C. Joseph Marvin 2.Lysis of virus infected cells
D. Rodney porter 3. Macrophage activation by secreted cytokines
4. Antibody production
RATIO: a.1 and 3
Susumo Tonegawa- Antibody diversity/specificity b.2 and 4
Rodney porter – structure of antibodies c.1,2,3
d.1,2,3,4
2. The first line of defense in protecting the body from
infection includes all of the following components except: RATIO:
A. Unbroken skin -T cells bearing the CD4 receptor are termed helper, or inducer
B. Normal microbial flora cells
C. Phagocytic leukocytes -Helper T cells- acts as the orchestrator/ stimulator of the
effector mechanisms of the immune response such as Antibody
D. Secretions such as mucus
synthesis, macrophage activation, Cytotoxic T cell killing, and
NK cell activation. THEY ARE KNOWN AS THE MASTER
RATIO: SWITCH OF THE PHAGOCYTIC SYSTEM AND IMMUNE SYSTEM
The First line of defense is also known as external defense -Number 2 is a function of Cytotoxic or Cytolytic T cells
system which is composed of structural barriers that prevent
most infectious agents from entering the body.
6. The mechanisms of nonspecific immunity include:
-A phagocytic cell belongs to the second line of defense or
1.The physical barrier of the skin
internal defense system
-Both first and second line of defense provides natural 2.The flushing away of particulate matter that enters
immunity from the air
3.inflammation
3. All statements are true for natural killer cells, except: A. 4.The development of antibodies
Synonymous with Large granular lymphocytes B. Make up A. 1 and 3
to 60 to 80 percent of the B. 2 and 4
circulating lymphoid pool C. 1,2 and 3
C. Found mainly in the spleen and peripheral blood D. 1,2,3 and 4
D. NK cells are capable of recognizing any foreign RATIO:
cell and destroying it without regard to MHC Production of antibodies is a function of a B cell/ Plasma cell. It
restriction, they present the first line of defense is one of the responses of adaptive immunity and not by the
against virally infected and tumor cells natural immunity

RATIO:
7. Which of the following MHC classes encodes complement
The third population of lymphocytes, otherwise known as
components?
Natural killer cells, represents 10-15% or ≤10%of the total
lymphocyte population. They are also under the natural A. Class I
immunity with a distinct CD markers of CD16, CD56, and CD94 B. Class II
C. Class III
4. A group of molecules expressed with TCR making up the D. Class IV
complete TCR complex on the T cell surface. RATIO:
A. CD2 Between the class I and class II regions on chromosome 6 is
B. CD3 the area of class III genes, which code for complement
C. CD10 proteins and cytokines such as tumor necrosis factor. Class III
proteins are secreted proteins that have an immune function,
D. CD19
but they are not expressed on cell surfaces.
RATIO:
8. Which of the following blood group system expresses
-1984 = year for Discovery of the T cell receptor gene (recall!) receptors for complement component?
-CD3/TCR is the T-cell receptor for antigen. The major portion
A. Indian
 B. Gerbich d.1,2,3, and 4
C. Chido/Rodgers
D. Cromer REMINDERS:
-APRs are normal serum constituents that increase rapidly by
at least 25 percent due to infection, injury, or trauma to the
RATIO: tissues
ISBT 017 CHIDO/RODGERS - They are indicator of inflammation
-Alleles for RG and CH have been located on two closely linked -They are produced mainly by the LIVER or in the Reticulo
genes known as C4A and C4B on Chromosome #6 -Composed endothelial system / Macrophage phagocytic system
of nine antigens, they are on the fourth component of
complement (C4), and are adsorbed onto RBCs from plasma
12. Which region determines whether an immunoglobulin
molecule can fix complement?
A. VH
9. The results in tissue matching/mixed lymphocyte reaction B. CH
(MLR) are expressed as:
C. VL
A. Counts per minute
D. CL
B. Percent relative response
C. Stimulation index
13. The area of the immunoglobulin molecule referred to as
D. All of the above the hinge region is located between which domains? A.
VH and VL
REMINDERS: B. CH1 and CH2
MLR – It is a CELLULAR METHOD For detection HLA-D related C. CH2 and CH3
antigens or MHC CLASS II antigens D. CH3 and VL

10. Molecular approaches that have been used for tissue RATIO:
matching include: -The segment of H chain located between the CH1 and CH2
1.Restriction fragment length polymorphism regions is known as the hinge region. It has a high content of
proline and hydrophobic residues; the high proline content
2.Tissue matching
allows for flexibility. This ability to bend lets the two antigen
3.PCR binding sites operate independently and engage in an angular
4.Mixed Lymphocyte reaction motion relative to each other and to the FC stem.

A. 1 and 3 - Gamma, delta, and alpha chains all have a hinge region, but
B. 2 and 4 mu and epsilon chains do not. However, the CH2 domains of
C. 1,2 and 3 these latter two chains are paired in such a way as to confer
flexibility to the Fab arms
D. 1,2 ,3 and 4
RATIO:
14. True about Immunoglobulin M:
Serological method Complement dependent
1.It accounts for 10% of the immunoglobulin
cell cytotoxicity
pool 2.It is largely confined to intravascular pool
Cellular method Mixed Lymphocyte reaction 3.It is produced early in an immune response
4.It is usually detectable in CSF
Molecular method PCR and RFLP
A. 1 and 3
B. 2 and 4
11. Clinically useful acute-phase reactants; C. 1,2, and 3
1.CRP D. 1,2,3 and 4
2.Fibrinogen
3.Alpha 1 Antitrypsin RATIO:
4.Orosomucoid -IgM is not normally found in CSF and is confined
intravascularly
a. 1 and 3 -Normal Antibodies found in Normal CSF – IgG and some IgA
b. 1,2,3
c.2 and 4 15. True about Immunoglobulin G:
 1.Major immunoglobulin in normal serum C. 1,2 and 3
2.It binds to a receptor on mast cells and basophils D. 1,2,3 and 4
3.It neutralizes toxins and binds microorganisms RATIO:
4.It is responsible for immunity to invading parasites Infection – natural active
Vaccination –Artificial active
Infusion of serum- Artificial passive
A. 1 and 3
Colostrum – Natural passive
B. 2 and 4
C. 1,2 and 3
20. In skin tests, a wheal and flare development are indicative
D. 1,2,3 and 4 of:
A. Immediate hypersensitivity
16. Which of the following statements is false about an B. Anergy
anamnestic response versus a primary response? A.
C. Delayed Hypersensitivity
Has a shorter lag phase
D. Arthus reaction
B. Antibodies decline more gradually
C. Has a longer plateau
RATIO:
D. IgM antibodies predominate Type 1 hypersensitivity is characterized by wheal and flare
reaction, and urticaria/hives
RATIO:
SECONDARY OR ANAMNESTIC 21. Type III hypersensitivity reactions:
The immune response to subsequent exposure to the same 1.Arthus reaction
antigenic stimulus 2. Serum sickness
1. Predominant ab produced: IgG 3. SLE
2. Shorter lag phase 4. Hay fever
3. Longer stationary/plateau phase A. 1 and 3
4. More gradual decline phase B. 2 and 4
C. 1,2 and 3
5. Increase antibody titer
D. 1,2,3 and 4
6. Faster and stronger response

22. The most common congenital immunodeficiency disorder:

17. In anamnestic response, all the following characteristics
A. Wiskott- Aldrich syndrome
are correct except:
B. DiGeorge anomaly
A. IgG is the predominant antibody type
C. Bruton’sagammaglobulinemia
B. The antibody titer is lower
D. Selective IgA deficiency
C. It has a shorter lag phase
D. It has a more gradual decline in antibody
response 23. Which of the following can interfere with the cryptococcal
antigen latex agglutination test?
A. Thyroglobulin
18. All of the following represent functions of the complement
system except: B. Monoclonal protein
A. Decrease clearance of antigen-antibody C. Rheumatoid factor
complexes D. CRP
B. Lysis of foreign cells
C. Increase vascular permeability RATIO:
D. Migration of neutrophils to the tissues -Cross-reactions may occasionally occur due to rheumatoid
factor (RF) or circulating antibodies that bind with nonreactive
polysaccharide in immune complexes. Treating the serum or
19. Refers to the Active acquired type of immunity: CSF specimens with a protease that destroys RF and cleaves
1.Infection antibodies in the immune complexes eliminates these reactions.
2.Infusion of serum Extraction of RF and circulating antibodies in serum can also be
accomplished by treatment with ethylenediaminetetraacetic acid
3.Vaccination (EDTA) and boiling for 5 minutes. False-positive results in spinal
4.Colostrum fluid can be eliminated simply by heating the specimen in a
A. 1 and 3 boiling water bath
24. The presence of anti-myocardial antibodies is diagnostic
B. 2 and 4
of:
 1. Dressler’s syndrome of HIV infection is:
2. Wegener’s granulomatosis A. Pnuemocystis carinii pneumonia
3. Rheumatic fever B. Kaposi’s sarcoma
4. Multiple sclerosis C. Burkitt like lymphoma
A. 1 and 3 D. None of the above
B. 2 and 4
C. 1,2, and 3 29. What is the disadvantage of gel technology?
D. 1,2,3 and 4 a. Inability to detect isomers
b. Requires a specialized instrument
RATIO: c. Variation in reading the reaction
-Anti neutrophilic cytoplasmic antibody = Found in Wegener’s d. standardization
Granulomatosis
NOTE
-Anti-Myelin Sheath antibody = Multiple sclerosis MAJOR ADVANTAGE:___________________

25. Cardiolipin antibodies are also called phospholipid 30. IL-2 is used in monitoring which of the following?
antibodies. Antibodies directed to cardiolipin are present in A. Pancreatic adenocarcinoma
patient with:
B. Colonic adenocarcinoma
A. Myasthenia gravis
C. Breast adenocarcinoma
B. SLE
D. Hairy cell leukemia
C. Pernicious anemia
D. Good pastures diease
31. Interpret Hepa B panel:
HBsAg: positive
RATIO:
Anti-HBc: positive
Autantibodies found in SLE
Anti-HBs: positive
1. Anti-nuclear antibodies such as anti-dsDNA(most specific)
2. Anti-cardiolipin / anti-phospholipids A. Susceptible to HBV
B. Acutely infected
26. HLA-B8 is associated with: C. Immune because of natural infection
1. Celiac disease D. Immune because of HBV vaccination
2. Myasthenia gravis RATIO:
3. Addison’s disease Anti-HBs
4. Sjogren’s syndrome -It is the Serologic marker of recovery and immunity
A. 1 AND3 -It is also produced after immunization with the
hepatitis B vaccine
B. 2 AND 4
-If you are immune due to natural/past infection, then
C. 1,2,3
other markers will be found
D. 1,2,3,4 -If you are immune because of
NOTE! REFER TO YOUR HANDOUTS FOR THE LIST OF Vaccination/Immunization, then no other markers are
HLA RELATED DISEASES present

27. The prozone phenomenon can result in a (an): 32. Which of the following stages of infectious mononucleosis
A. False positive reaction infection is/are characterized by heterophile antibody? A.
Recent or acute infection
B. Enhanced agglutination
B. Reactivation or latent infection
C. False negative reaction
C. Past or convalescent period
D. Diminished antigen response
D. Both A AND B

RATIO:
Pro-zone = there is an antibody excess, can cause false 33. EBV- infected B lymphocytes express all of the following
negative reaction new antigens, EXCEPT:
Remedy: perform dilution A. Viral capsid antigen
28. The most frequent malignancy observed in the final phase B. Early Antigen
 C. Cytoplasmic antigen
D. Nuclear antigen
ANTI-VCA VCA is produced by infected B cells and
can be found in the cytoplasm.
(Viral capsid
Anti-VCA IgM is usually detectable early
antigen)
in the course of infection, but is low in
concentration and disappears within 2
to 4 months. Anti-VCA IgG can be
detected after onset of signs and
symptoms and can persist for life
Anti-EA EA is a complex of two components,
(Early antigen) early antigen–diffuse (EA-D), which is
found in the nucleus and cytoplasm of
the B cells, and early antigen–restricted
(EA-R), usually found as a mass only in
the cytoplasm.
Anti–EA-D and anti–EA-R IgG are not
consistent indicators of the disease
stage. Anti –EA-D strongly indicates
active infection.
Anti-EBNA EBNA is found in the nucleus of all EBV
(Epstein-B infected cells.
arr Antibodies to NA are absent or barely
Nuclear detectable during acute infectious
antigen) mononucleosis.
Anti-EBNA IgG does not appear until a
patient has entered the convalescent
period.
34. Antibodies to Viral Capsid antigen and Epstein Bar nuclear
antigen (EBNA) are present:
A. Susceptible to EBV
B. Primary infection with EBV
C. Reactivation of infection with EBV
D. Past infection with EBV
Refer to your handouts in IMS ☺
35. False positive HCG results:
1.Chorioepithelioma
2.Excessive ingestion of aspirin
3.Hyadatidiform mole
4.Dilute urine specimens
A. 1 and 3
B. 2 and 4
C. 1,2 and 3
D. 1,2,3 and 4
NOTE:
Diluted urine = can cause false negative result
Aspirin = can cause false positive result
36. What is the purpose auto-control in crossmatching? A.
to find possible alloantibodies in the patient B. to
confirm for the presence of alloantibodies in an
incompatible crossmatching
C. to find possible autoantibodies in the donor D. to
find possible autoantibodies in the patient
37. An employee who receives an accidental needlestick
should immediately:
A. Apply sodium hypochlorite to the area
B. Receive HIV prophylaxis
C. Notify a supervisor
D. Receive a Hepa-B booster shot
38. A Double negative or triple negative thymocytes are:
a. Immature thymocytes
b. Malignant thymocytes
c. Activated thymocytes
d. Circulating thymocytes
RATIO:
Double negative thymocytes = absence of both CD4 and CD8
Triple negative thymocytes= absence of CD4, CD8, and CD3
39. How much diluent needs to be added to 0.2ml of serum to
make a1:20 dilution?
A. 19.8ml
B. 4.0ml
C. 3.8ml
D. 10.0ml
RATIO:
COMPUTING FOR THE DILUENT
Equation no.1 place the given value in the formula
Dilution= solute/ Total volume
1/20 = 0.2 / (x), note that (X) represents the total volume
Equation no.2 Compute for the unknown (x)
(X) = (0.2) (20), then X = 4, so the total volume is 4ml
Equation no3. Compute for the diluent in the given formula:
Diluent = Total volume – solute
Diluent = 4 – 0.2
Diluent = 3.8ml
40. A cold agglutinin titer is performed. The results are
follows: WHAT IS THE PATIENT TITER
1:2 = 4+
1:4 = 4+
1:8 = 3+
 1:16 = 1+ D. Rheumatoid arthritis
1:32= 1+ Kindly please refer to your handouts in IMS
1:64 = 0
1:128 = 0
A. 8
B. 16 44. IgG subclass most efficient at complement fixation but is
not capable of binding the Fc portion of the molecule to
C. 32
staphylococcal protein A
D. 64
A. IgG1
RATIO:
Titer is a figure that represents the relative strength of an B. IgG3
antibody. It is the reciprocal of the highest dilution in which a C. IgG4
positive reaction occurs. D. IgG2
NOTE:
41. This cytokine stimulates the hepatic cells to secrete CRP: *Order of Fixation of the complement (Except IgG 4)
A. IL-1 Order = IgG 3>IgG 1 >IgG 2

B. IL-6
*Order of passage to the placenta (Except IgG2)
C. IL-3
Order= IgG1>IgG3 >IgG4
D. IL-12
RATIO:
45. Refers to the RBC storage lesion:
*IL-1 = Endogenous pyrogen. It induces fever
*IL-3= Multi Hematopoietic Colony stimulating factor. It 1. Decrease 2,3 DPG
stimulates hematopoiesis 2.Decrease ATP
*IL-12 = NK stimulatory factor. It enhances the function of NK 3.Decrease Glucose
cells
4.Increaes lactic acid
5.Increase plasma potassium
42. It binds iron, an essential nutrient from some microbes:
6.Increase plasma haemoglobin
A. Defensins
A. 1,2 AND4
B. Lactoferrin
B. 1,2,3 AND 4
C. Lysozyme
C. 1,2,3,4 AND 6
D. Nitric oxide
D. 1,2,3,4,5 AND 6

NOTE:
NOTE
Lysozyme is an enzyme found in many secretions such as tears
and saliva, and it attacks the cell walls of microorganisms, Increase HK LA!
especially those that are gram-positive. (Mataas pangarap mo pag nakaabot ng Honkong and LA)
Alpha Produced by neutrophils, certain
defensins macrophage populations, and Paneth cells Increase= Hb, K, Lactic acid, and ammonia
of the small intestine. This class of
defensins is believed to disrupt the 46. What is the function of monoblastic sodium phosphate in
microbial membrane. anticoagulant solutions?
A. Chelates calcium; prevents clotting
Beta Produced by neutrophils as well as
B. Maintains pH storage; necessary for
defensins epithelial cells lining the various organs,
maintenance of adequate level of 2,3 DPG
including the bronchial tree and
genitourinary system. They are believed to C. Substrate for ATP production (cellular energy) D.
increase resistance of epithelial cells to Production of ATP (Extends shelf-life from 21 to 35
colonization days)
RATIO:
A pertains to Citrate
C pertains to Glucose or dextrose
43. Of the following diseases, which one has the highest D pertains to adenine
relative risk in association with an HLA antigen?
A. Ankylosing spondylitis 47. Frozen platelets can be stored for up to:
B. Juvenile diabetes A. 48 hours
C. Narcolepsy B. 5 days
 C. 1 year False-Positive Results
D. 2 years • Improper specimen (refrigerated, clotted) may cause
Component Shelf-life in vitro
complement attachment
At room temp with 5 days • Overcentrifugation and overreading
agitation
• Centrifugation after the incubation phase when PEG
or other
Stored at 1 to 6’C 2 days
positively charged polymers are used as an
Frozen platelet 2 years enhancement medium
• Bacterial contamination of cells or saline used in
Pooled (Open system) 4 hours
washing • Dirty glassware
Pooled (Closed system) 5 days • Presence of fibrin in the test tube may mimic
agglutination.
In an open system 4hours • Cells with a positive DAT will yield a positive
IAT. • Polyagglutinable cells
Washed platelets 4 hours
• Saline contaminated by heavy metals or colloidal silica
• Using a serum sample for a DAT (use EDTA, ACD, or
CPD anticoagulated
blood)
48. If a platelet bag is broken or opened, the platelets must • Samples collected in gel separator tubes may
be transfused within __ hours when stored at 20 -24 ‘C. have unauthentic
A. 4 hours
B. 6 hours
C. 24 hours
D. 5 days

49. In the DAT, the antiglobulin reagent is used to: A. Mediate

hemolysis of indicator RBC by providing complement
B. Precipitate anti RBC antibodies
C. Measure antibodies in a test serum by fixing
complement
D. Detect pre-existing antibodies on RBC

RATIO:
DAT (Direct antiglobulin test)
*Used to detect in vivo RBC sensitization / Detect pre-existing
antibodies on RBC
*Specimen used: ________________________

50. False positive results in AHG Testing:

1.Bacterial contamination of cells or saline used in
washing
2.improper specimen (clotted or refrigerated)
3. Using serum sample for a DAT
4. Inadequate washing of cells
A. 1 and 3
B. 2 and 4
C. 1,2 and 3
D. 1,2,3 and 4
RATIO:
 complement attachment. 4. MNSs
• Complement attachment when specimens are A. 1 and 3
collected from infusion B. 2 and 4
lines infusing dextrose solutions C. 1,2 and 3
• Preservative-dependent antibody directed D. 1,2,3 and 4
against reagents
RATIO:
False-Negative Results Enhanced by enzyme KLIRPA
• Inadequate or improper washing of cells Kidd, Lewis, I, Rh, P1, ABO
• Failure to wash additional times when increased
serum volumes are Destroyed by enzyme Duffy, MN, Xg, Ch/Rg
used
• Contamination of AHG by extraneous protein (i.e.,
glove, wrong dropper)
53. All statements are true regarding low ionic strength
• High concentration of IgG paraproteins in test
solution, EXCEPT
serum • Early dissociation of bound IgG from RBCs
A. Low salt medium that generally contains 0.2%
due to interruption in testing
NaCL
• Early dissociation of bound IgG from RBCs due
B. They decrease the ionic strength of the medium,
to improper testing
which reduces the zeta potential and therefore
temperature (i.e., saline or AHG too cold or hot) • allow antibodies to react efficiently with RBC
AHG reagent nonreactive because of deterioration membrane antigens
or neutralization C. They result in an increased rate of antibody
(improper reagent storage) uptake during sensitization
• Excessive heat or repeated freezing and thawing of D. They require increased reaction incubation
test serum time
• Serum nonreactive because of deterioration
of complement 54. All are associated with group 1 ABO discrepancies, Except;
• AHG reagent, test serum, or enhancement medium A. Newborns and elderly patients
not added
B. Patients with congenital immunodeficiency
• Undercentrifuged or overcentrifuged disease
• Cell suspension either too weak or too heavy C. Patients using immunosuppressive drugs
• Serum:cell ratios are not ideal D. Subgroup of A or B
• Rare antibodies are present that are only detectable
with polyspecific
RATIO:
AHG and when active complement is present. Group 1 = Weakly reacting or missing antibodies
• Low pH of saline *Most common discrepancy
• Inadequate incubation conditions in the IAT *discrepancies on reverse typing
• Poor reading technique
Letter D is an example of Group 2 ABO discrepancy

55. Agglutination reactions in the gel test are graded from1+

51. Low ionic strength solutions (LISS) or low salt media
to 4+ including mixed filed, just like the reactions in the
generally contain ____ sodium chloride.
test tube hemagglutination technique. Formation of solid
A. 0.2% NaCl band of agglutinated RBCs at the top of the gel column
B. 0.5% NaCl corresponds to a grade of:
C. 0.85% NaCl A. Negative
D. 0.9 % NaCl B. 2+
C. 3+
52. The use of enzymes provides enhanced antibody D. 4+
reactivity to: RATIO:
1.Rh, kidd
4+ Solid band of agglutinated red cells at the top
2. Fy antigens of the gel column. Usually no red cells are
3. P1, Lewis and I visible in the bottom of the microtube
3+ Predominant amount of agglutinated red
cells towards the top of the gel column with 57. An antigen present on most D- positive and all C-positive
a few agglutinates staggered below the RBCs:
thicker band. A. G
B. f
C. Rhi
D. Cw
The majority of agglutinates are observed in
the tophalf of the gel
RATIO:
2+ Red cell agglutinates dispersed throughout RH unusual phenotypes
the gel column with few agglutinates at the • The f antigen is expressed on the RBC when both c and
bottom of the microtubes. e are present on the same haplotype. It has been
Agglutinates should be distributed through called a compound antigen
the upper and lower halves of the gel. • G is an antigen present on most D-positive and all C
positive RBCs.
1+ Red cell agglutinates predominantly observed 58. What should be done if all forward and reverse ABO
in the lower half of the gel column with red
results as well as the auto-control are positive?
cells also in the bottom. These reactions may
be weak, with a few agglutinates remaining A. Wash the cells within warm saline,
in the gel area above the red cell pellet in autoabsorb the serum at 4’C
the bottom of the microtube B. Retype the sample using a different lot number
of reagents
Mixed Layer of red cell agglutinates at the top of
C. Use polyclonal typing reagents
Field the gel column accompanied by a pellet of
unagglutinated cells in the bottom of the D. Report the sample as group AB
microtube
RATIO:
Negative Red cells forming a well-delineated pellet in
Possible Cause RESOLUTION
the bottom of the microtube. The gel above
the red cell pellet is clear and free of
(1) Rouleaux (1) Wash RBCs; use saline
agglutinates dilution or saline
(2) Cold
autoantibody (3) replacement technique
Cold autoantibody (2) Perform cold panel
with underlying cold and autoabsorb or
56. What should be done if all forward and reverse ABO rabbit
results are negative? or RT reacting
erythrocyte stroma (RESt)
alloantibody
A. Perform additional testing such as typing with absorb or reverse type at
anti-A1 and Anti-AB 37°C (3) Perform cold panel
B. Incubate at 22’C or 4’C to enhance weak autoabsorb or RESt, and
expression run panel on absorbed
C. Repeat the test with new reagents serum; select reverse cells
D. Run an antibody identification panel lacking antigen for
identified alloantibody;
repeat reverse group on
RATIO: absorbed serum to
Possible Cause RESOLUTION determine true ABO group
or at 37°C
-Group O newborn or Check age and
elderly patient diagnosis of patient
-Patient may have and
agammaglobulinemia/H 59. Which of the following distinguishes A1 from A2? A.
immunoglobulin levels; if A2 antigen will not react with Anti-A,. A1 will strongly
ypo possible incubate at RT
gammaglobulinemia react (4+)
for 30 min or at 4°C for
-patient may be taking 15 min; include group O B. An A2 person may form Anti-A1; an A1
immunosuppressive and person will not form Anti –A1
drugs autologous cells at 4°C C. An A1 person may form anti-A2, and A2 person
will not form Anti-A1
D. A2 antigen wil not react with anti-A from a
 nonimmunized donor. ; A1 will react with any
anti-A 63. Blood banking Laboratory Information system (LIS)
password should be ____
RATIO: a. Encrypted in small letters
▪ A1 – found on 80% of the A population b. Strictly kept confidential
▪ A2-found on 20% of the A population
c. At least 8 characters
▪ 1-8% of A2 produces anti –A1, 22 -35% of A2B produces
d. Should be posted in the BB bulletin board
Anti-A1
▪ The very potent gene A1 creates between 810,000 and
1,170,000 antigen sites on the adult A1 RBC, whereas 64. Which antibody is enhanced by acidifying the patient
inheriting an A2 gene results in production of only serum?
240,000 to 290,000 antigen sites on the adult A2 RBC A. Anti-D
▪ A1 individual will react to ANTI-A1 lectin, while A2 B. Anti-Fya
individuals will not react to ANTI-A1 lectin
C. Anti-M
Type Antigen(s) Present on RBC
D. Anti-Jka
A1 A and A1
RATIO:
A2 A only Anti-M =pH-dependent, reacting best at pH 6.5. It can also be
enhanced by addition of glucose
65. Monoclonal antibody which reacts with most human red
cells except Fy(a-b-) and is responsible for susceptibility of
60. Anti-U will not react with which of the following RBCs? cells to penetration with Plasmodium vivax.
A. M+N+S+s A. FY1
B. M+N-S-s B. FY3
C. M-N+S-S+ C. FY5
D. M+N-S+s+ D. FY6

RATIO: NOTE:
U- stands for universal
• Rare but can be formed in S-s- individuals, found on Fy6 This antigen is important for invasion
black people for P.vivax and P.knowlesi
• Can also cause HDN
• Enhanced by Enzyme treatment
66. RBCs are resistant to lysis by 2M urea:
61. An antibody of this specificity is frequently found in A. Jk (a+b-)
dialysis patients:
B. Jk (a-b+)
A. M
C. Jk (a+b+)
B. N D. Jk (a-b-)
C. S
D. s NOTE:
Jk(a-b-) or the null phenotype-→ lack Jka , Jkb, and common
RATIO: Jk3 antigen, although very rare, this phenotype is most
Anti-Nf - seen in renal patient, who are dialyzed on equipment abundant among Polynesian, and is identified in Filipinos,
sterilized with formaldehyde Indonesian, Chinese, and Japanese

67. The lack of Kx expression on RBCs and WBCs has been

62. This blood group was introduced in 1927 by Landsteiner
associated with:
and Levine. In their research for new antigens, they
injected rabbits with human RBC and produced an A. Myeloid leukemia
antibody, that divided human RBC into two groups: B. Mcleod phenotype
A. D+ and D C. CGD
B. M+ and N+ D. Both B and C
C. P+ and P
D. K and k RATIO:
-Kell antigen expression is dependent upon the presence of the
Xk protein 72. According to AABB standards, platelets prepared from
-The absence of Xk results in McLeod syndrome. It is also whole blood shall have at least:
associated with CGD (Chronic granulomatous disease) A. 5.5x1010 Platelets per unit in at least 75%
of the units tested
68. Which antibody is most commonly associated with delayed B. 6.5x1010 Platelets per unit in at least 75% of the
hemolytic transfusion reactions? units tested
A. Anti-S C. 7.5x1010 Platelets per unit in at least 100% of the
B. Anti- K units tested
C. Anti-Lu D. 8.5x1010 Platelets per unit in at least 95% of the
D. Anti- Jka units tested

69. Many warm reactive autoantibodies have a broad 73. The most frequent transfusion associated disease
specificity within which of the following blood groups? complicated of blood transfusion is:
A. Kell A. CMV
B. Duffy B. Syphilis
C. Rh C. Hepatitis
D. Kidd D. AIDS

70. In double RBC pheresis, the specifications for donors are 74. Which of the following transfusion reactions occurs after
based primarily on: infusions of only a few milliliters of blood and gives no
A. Weight history of fever?
B. Height A. Febrile
C. Hematocrit B. Circulatory overload
D. AOTA C. Anaphylactic
D. Hemolytic
RATIO: NOTE:
Anaphylactic transfusion reaction
Criteria Male Female Cause: Attributed to IgA deficiency or absolute IgA deficiency
(IgA levels less than 0.05 mg/dL) in patients who have
Weight developed anti-IgA antibodies by sensitization from transfusion
or pregnancy
Height
75. Which of the following is the most frequently transmitted
Hematocrit At least 40% At least 40% virus from mother to fetus?
A. HIV
B. Hepatitis
C. CMV
71. Which of the following is proper procedure for preparation
of platelets from whole-blood? D. EBV
A. Light spin followed by a hard spin
B. Light spin followed by two hard spins NOTE:
CMV = MOST COMMON CONGENITAL INFECTION
C. Two light spins
D. Hard spin followed by a light spin
76. The relative concentration of all antibodies capable of
crossing the placenta and causing HDN must be
RATIO: determined by antibody titration. In general, a titer of
Random donor platelet ____ is considered significant.
A. 2 to 4
▪ Prepared from Whole blood B. 4 to 8
▪ Contains at least 5.5 × 1010platelets
C. 8 to 12
▪ Plasma content: 40 TO 70ml
▪ Can raise platelet count by 5,000 to D. 16 to 32
10,000/ul
NOTE:
A Titer of 16 is considered as the critical/ significant titer

77. Kleihauker-Betke stain if a postpartum blood film revealed
0.3% fetal cells. What is the estimated volume (ml) of the
fetomaternal haemorrhage expressed as whole blood? A.
5 B. O, Rh negative RBC
B. 15
C. 25
D. 35
RATIO:
Volume of FMH = %fetal cells x 50
Volume of FMH = 0.3 x 50
Volume of FMH = 15
78. A mother is group A, with anti-D in her serum. What is the
preferred blood product if an intrauterine transfusion is
indicated?
A. O, Rh-negative Red blood cells
B. O, Rh-negative Red blood cells, irradiated
C. A, Rh-negative Red blood cells
D. A, Rh-negative red blood cells, irradiated
RATIO:
Aliquotted RBC product used for intrauterine transfusion must
be Fresh as possible (Less than 5 or 7 days old), Group O
negative, CMV negative, Hgb S negative, irradiated
79. Advantages of Cordocentesis:
1.allows measurement of fetal hemogobin and
hematocrit levels
2.allows direct transfusion of fetal circulation
3.allows antigen typing of fetal blood
4.Decrease risk of trauma to placenta
A. 1 and 3
B. 2 and 4
C. 1,2 and 3
D. All are correct
RATIO:
Cordocentesis / Percutaneous Umbilical cord Blood
sampling (PUBS) - A spinal needle is inserted into the
umbilical vein, and a sample of the fetal blood is
obtained. The fetal blood sample can then be tested for
hemoglobin, hematocrit, bilirubin, blood type, direct
antiglobulin test (DAT), and antigen phenotype and
genotype.
Cordocentesis, intrauterine transfusion, and
amniocentesis have several risks, including infection,
premature labor, and trauma to the placenta, which may
cause increased antibody titers because of antigenic
challenge to the mother through fetomaternal
hemorrhage
80. A 22 year old man is admitted to the emergency room in
shock following massive hemorrhage from knife wounds to
his chest and abdomen. An emergency transfusion is
required. Which of the following is the product of choice?
A. O, Rh positive RBC
C. O, Rh positive Whole blood
D. O, Rh negative Whole blood
81. A technologist removed 4 units of blood from the blood
ban ref and placed them on the counter. A clerk was
waiting to take the units for transfusion. As she checked
the paperwork, she noticed that one of the units was
leaking on the counter. What should she do?
A. Issue the unit if the red cell appears normal
B. Discard the unit
C. Reseal the unit
D. Call the medical director and ask for an option
RATIO:
Before compatibility testing, donor units should be
examined visually for unusual appearance, correct
labeling, and hermetic seal integrity. Donor units showing
abnormal color, turbidity, clots, incomplete or improper
labeling information, or leakage of any sort should be
returned to the collecting facility.
82. An ABO type on patent gives the following reaction
Anti A: 4+
Anti B: Neg
Anti A, B: 4+
A1 cells: Neg
B cells: 4+
O cells: 3+
Auto-control: Negative
The reactions above may be cause:
A. Patient is A2 with Anti-A1
B. Patient is A1 with potent Anti-H
C. Patient is a Bombay individual (Oh)
D. Group O newborn or elderly patient
NOTE:
Some A1 individual can produce anti-H
83. An ABO type on a patient gives the following reactions:
Anti –A: 4+
Anti- B: Negative
Anti A, B: 4+
A1 cells: 1+
B cells: 4+
O cells: Negative
Autocontrol: Negative
The reaction may be because:
 A. Patient is A2 with Anti A1
B. Patient is A1 with potent Anti-H 86. In a quality assurance program, at least 75 % of the bags
C. Patient is a Bombay individual (Oh) of Cryoprecipitate AHF must contain a minimum of how
many international units of factor VIII?
D. Group O newborn or elderly
A. 60
B. 70
NOTE:
1-8% of A2 population produces anti –A1 C. 80
D. 90
84. An ABO type on a patient gives the following reactions:
Anti –A : 4+ RATIO:
Anti- B: 4+ Components of cryoprecipitate:
Anti A,B: 4+ ▪ 80units of AHF (Factor VIII)
A1 cells: 2+ ▪ 150-250mg of Fibrinogen
B cells : 2+ ▪ Factor XIII
O cells : 2+ ▪ Von wille brand factor (vwf)
▪ Fibronectin
Autocontrol : 2+
The reaction may be because:

A. Rouleaux 87. Which of the following antigen/phenotype is/are absent in

B. Subgroup of A Rh Null ?
C. Group O newborn I. D
D. Bombay individual II. f
III. G
85. An ABO type on a patient gives the following reactions: IV. DCE
Anti –A : 0 a. 4 only
Anti- B: 0 b. 3 and 4
Anti A,B: 0 c. 1,2,3,4
A1 cells: 4+ d. 2,3,4
B cells : 4+ RATIO:
O cells : 4+
RH null phenotype: -/-
Autocontrol : NEG - absence of all RH antigens
The reaction may be because:

A. Patient is A2 with Anti A1

88. The following are characteristics of complement
B. Patient is A1 with potent Anti-H
components, except:
C. Patient is a Bombay individual (Oh)
1. Synthesized in the liver
D. Group O newborn or elderly
2. Present as active enzymes
3. Heat labile
RATIO:
4. Heat stable
BOMBAY INDIVIDUAL (Oh) 5. C3 hydrolysis occurs in the cell membrane of
▪ Do not inherit H gene the pathogen or infected cell
▪ Inherited as an autosomal recessive trait. The
a. 2 and 3 b. 2 and 4
underlying molecular defect is most often a
mutation in the gene FUT1 (H gene), producing c. 3 only d. 4 only
a silenced gene incapable of coding for the
enzyme, a-2-L-fucosyltransferase (H RATIO:
transferase).
▪ Genotype: H null or hh genotype
▪ Phenotype: Oh
▪ Lacks: A, B, H antigen
▪ Presence of: Anti-A, Anti-B, Anti-H
 ▪ Most plasma complement proteins are synthesized
in the liver, with the exception of C1
components, which are mainly produced by
intestinal epithelial cells, and factor D, which is
made in adipose tissue.
▪ They are naturally present in serum as inactive
enzymes that needs to be activated
▪ They are heat labile (can be inactivated by heating
serum at 56’C for 30 minutes)
Formation of a hybridoma in monoclonal antibody production. A
mouse is immunized, and Plasma or B cells from the
spleen of the mouse are removed. These cells are fused
with non-secreting myeloma cells and then plated in a
restrictive medium. Only the hybridoma cells will grow in this
medium, where they synthesize and secrete a monoclonal
immunoglobulin specific for a single determinant on an antigen.
Hybridoma An immortal cell capable of producing
indefinite sequence of nucleotides

Animal used Mouse

89. Which of the following is true regarding Acute phase Surfactant PEG (Polyethylene glycol)- for fusion
reactants? of plasma cell with myeloma cell
I. Serum amyloid A acts by cleaning/removing
cholesterol from cholesterol filled Selective Medium with HAT
macrophages at the site of tissue injury. It medium (Hypoxanthine, aminopterin,
has a role in cholesterol metabolism and thymidine
II. Ceruloplasmin is considered as a ferroxidase III.
APRs are produced mainly by many cells such as
lymphocytes
92. A blocking test in which an antigen is first exposed to
IV. Hepcidin is an example of APR unlabeled antibody, and is finally washed and examined. If
a. 1 and 2 the unlabeled and labeled antibodies are both homologous
b. 1,2,3,4 to the antigen, there should be no fluorescence. A. Direct
c. 1,2,4 fluorescent antibody
d. 1 only B. Indirect immunofluorescent assay
e. 1,3,4 C. Inhibition immunofluorescent assay
NOTE D. None of the above

▪ APRs are indicator of inflammation DFA Antibody that is conjugated with a

fluorescent tag is added directly to unknown
▪ APRs are produced by the _________________
antigen that is fixed to a microscope slide

IFA Involves TWO STEPS:

First is incubation of patient serum with a
90. Which of the following can used for paternity testing? known antigen attached to a solid phase.
I. ABO testing Second the slide is washed, and then
II. DNA testing an antihuman immunoglobulin
III. HLA testing containing a fluorescent tag is added.
a. 1 and 2
b. 2 and 3
c. 1 and 3 93. It is an indicative of relative concentration
d. 1,2,3 A. Molarity
B. Normality
NOTE: C. Concentration
DNA Testing is considered as the gold standard test for
D. Dilution
paternity testing
91. An immortal cell capable of producing indefinite
nucleotides: RATIO:
a. Hybridoma cells Molarity Molarity (M) is the amount of a
b. Myeloma cells substance in a certain volume of
c. Plasma cells solution. Molarity is
d. Cancer cells

RATIO:

HYBRIDOMA TECHNOLOGY
 defined as the moles of a solute per
liters of a solution. Molarity is also
known as the molar concentration of a
solution.
Normality It is defined as the number of gram
equivalent weights per 1 L of solution.
An equivalent weight is equal to the
gmw of a substance divided by its
valence
Concentration In chemistry, concentration refers to the
amount of a substance in a defined
space. Another definition is that
concentration is the ratio of solute in a
solution to
either solvent or total solution.
Concentration is usually expressed in
terms of mass per unit volume.
Routinely, concentration is expressed as
percent solution, molarity, molality, or
normality
94. When a suspected hemolytic transfusion reaction occurs,
the first thing to do is:
A. Slow the transfusion to stop the reaction
B. Administer medication to stop the reaction
C. First inform the laboratory to begin an
investigation
D. Stop the transfusion but keep the
intravenous line open with saline
95. A process whereby cells that are coated with antibody are
treated in such a manner as to disrupt the bonds between
the antigen and antibody:
a. Absorption
b. Elution
c. Neutralization
d. Disruption
RATIO:
Adsorption Providing an antibody with its
corresponding
antigen under optimal conditions so
that the antibody will attach to the
antigen, thereby removing the
antibody from the serum; often used
interchangeably with absorption.
Elution A process whereby cells that are coated
with antibody are treated in such a
manner as to disrupt the bonds between
the antigen and antibody. The freed
antibody is collected in an inert diluent
such as saline or 6% albumin. This
antibody serum then can be tested to
identify its specificity using routine
methods. The mechanism to free the
antibody may be physical (heating,
shaking) or chemical (ether, acid), and
the harvested antibody-containing fluid
is called an eluate.
Neutralization A process where Inactivating an
antibody by reacting it with an
antigen, against which it is directed.
96. Which of the following is/are true regarding to ABH
antigens in secretion?
I. Associated with type 1 precursor
II. They are glycoproteins
III. Found in gastric juices and bile
a. 1 only
b. 1 and 2
c. 1,2,3
d. 1and 3
RATIO:
ABH ANTIGENS ON SECRETION
• Secreted substances are glycoproteins.
• Secreted substances are primarily synthesized on
type 1 precursor chains.
• Type 1 chain refers to a beta-1 to 3 linkage in
which the number one carbon of the galactose is
attached to the number three carbon of the N
acetylglucosamine sugar of the precursor
substance.
• Found in Saliva, tears, urine, digestive juices, bile,
milk, amniotic fluid, Pathological fluids:
peritoneal, pleural, pericardial, and ovarian
cyst
97. What is a modified whole blood?
a. Whole blood that undergoes special processes
b. Whole blood without cryoprecipitate
antihemophilic factor
c. Whole blood that is both irradiated and filtered d.
Whole blood that is stored at 37’C for readily use
98. The purpose of the immediate spin IS) crossmatch is to:
a. Ensure survival of transfused RBCs
 b. Determine ABO compatibility between donor
-It is the supernatant remaining from the production
and recipient
of cryoprecipitate.
c. Detect cold-reacting unexpected antibodies
-It is relatively deficient in high molecular weight forms
of vWF but retains normal levels of the vWF-cleaving
RATIO: metalloprotease ADAMTS 13
▪ When no clinically significant unexpected antibodies -Used to treat patient with TTP
are detected and there are no previous records
of such antibodies, a serologic test to detect
ABO incompatibility is sufficient. This is
accomplished by mixing the recipient’s serum 100. Preparation of _____ red cell suspension (RCS) is
with donor RBCs and centrifuging required for DAT test
immediately(i.e., immediate spin). Absence of
a. 2 to 3 %
hemolysis or agglutination indicates
ABOcompatibility b. 1 to 3 %
c. 2 to 5%
▪ The type-and-screen procedure involves testing the d. 5 to 10%
patient’s blood sample for ABO, Rh, and clinically
significant unexpected antibodies. 101. The first retrovirus which has been associated with a
human disease and can be transmitted through blood
▪ The type and screen, coupled with an immediate transfusion is _____.
spin crossmatch, is referred to as an abbreviated a. CMV
crossmatch.
b. HIV
c. HAV
d. HTLV-1

▪ Studies of abbreviated crossmatch use show that it

is a safe and effective method of pretransfusion NOTE:
testing ▪ HTLV-I was the first retrovirus to be associated
with a human disease. That association was
with
▪ False reactions in IS may be seen in the presence of
other immediate spin-reactive antibodies (e.g.,
autoanti-I) or in patients with hyperimmune ABO
antibodies, or may be seen when the procedure is
not performed correctly (e.g., delay in centrifugation
adult T-cell lymphoma/ leukemia (ATL), a
or reading), when rouleaux is observed, or when
highly aggressive, mature T-cell non-
infants’ specimens are tested.
Hodgkin’s
lymphoma with a leukemic phase. HTLV-I is
▪ Adding ethylenediaminetetraacetic to the
also associated with the progressive
test system reportedly eliminates some of
neurological
the false-positive reactions
disorder known as HTLV-I-associated
myelopathy or tropical spastic paraparesis
(HAM/TSP).
▪ HTLV-II was the second retrovirus discovered.
99. Which of the following is/are true regarding
cryoprecipitate-reduced plasma?
I. Commonly known as cryopoor plasma
II. It comes from the supernatant plasma from the 102. EIA technique for the diagnosis of E. histolytica uses
preparation of cryoprecipitate which tag?
III. A Cryoprecipitate without a vWF a. FITC
a. 1 only b. EA50
b. 1 and 3 c. Alkaline phosphatase
c. 1 and 2 d. Horseradish peroxidase
d. 1,2,3
e. 2 and 3 103. MHC molecules are associated with which of the
following?
a. Anaphylactic shock
NOTE:
b. Parasitism
 c. Inflammatory disorder repacked and reissued if the blood products are still needed.
The cooler expiration time is noted on the outside of the
d. Autoimmune disease
cooler.
NOTE
Autoimmune disorders are commonly associated with MHC
Class II 106. The best preparation for blood units which will be
Example: SLE – associated with HLA-DR 3 used for a patient during open heart surgery is _____.
a. Whole blood with ACD

104. Which of the following is/are always found in the b. Citrated

blood as an alloantibody?
a. All three
b. Anti-D
c. Anti-A
d. Anti-B
RATIO:
-Alloantibodies that are produced during alloimmunization.
-Naturally occurring antibodies, such as ABO antibodies, does
not require alloimmunizaton to be produced
ALLO ANTIBODY – need pa ng exposure (either transfusion,
pregnancy, or transplantation) sa isang antigen na wala ka
bago yung katawan niyo mag produce ng antibody. Ito ay
isang antibody na nabubuo lamang pag nagkaroon ka ng
exposure sa isang antigen na wala ka.
NATURAL ANTIBODY- naturally present siya sainyo at hindi na
kailangan ng alloimmunization
c. SAG-M
d. Heparinized
RATIO:
Heparin
*natural anticoagulant
*Anticoagulant of choice in chemistry (lithium heparin)
*anticoagulant used for Cardiopulmonary bypass
107. Which of the following is correct about naturally
occurring ABO antibodies in a one yearold child? a.
Passively transferred from mother’s milk
b. Products of exposure to viruses
c. Products of exposure to bacteria and other
ABO-like substances
d. Formed after the first bout of fever after birth

immune which are produced in response to

alloantibodies RBC stimulation through RATIO:
transfusion, transplantation, or It has been postulated that bacteria, pollen particles, and other
pregnancy substances present in nature are chemically similar to A and B
Example: RH, and KIDD antigens. Bacteria are widespread in the environment, which
constantly exposes individuals to A-like and B-like antigens.
Naturally -produced without RBC stimulation This exposure serves as a source of stimulation of anti-A and
occurring -Result of exposure to anti-B.
alloantibodies environmental sources, such as
pollen, fungus, and bacteria, which
have structures similar to some 108. Which factor is NOT activated in the Alternative
RBC antigens pathway?
a. Factor D
Example: ABO antibodies
b. C3
c. C1
d. Factor B
105. How long can blood collected from donors during a RATIO:
ALTERNATIVE PATHWAY BYPASSES C1, C2, AND C4
mass collection, place in coolers with ice packs in plastic
bags and protected from direct contact with the ice, can
be kept before being transferred to the Blood bank 109. Which cell has an important role in allergic reaction
refrigerator? because it has granules which contain histamine? a.
a. Eight hours Mast cells
b. Six hours b. Small lymphocytes
c. Two hours c. Neutrophils
d. Four hours d. Monocytes
RATIO:
RATIO:
Blood can be stored in a Blood Bank validated cooler for up to
6 hours. The cooler must be returned to the Blood Bank prior
to the 6 hour cooler expiration time. The cooler will then be
 1.Not a leukocyte a. 130
2. Known as TISSUE BASOPHIL b. 150
3. Poor relatives of basophil c. 140
4. They originate from Mast cell progenitors on the BM d. 120
and spleen
5. KIT ligand (Stem cell factor) is responsible for
maturation and differentiation of mast cells 113. The first antibody produced in a PRIMARY reaction to an
6. Main function: Tissue Effector cells in allergic antigen is ___.
reaction 7. It is also an antigen presenting cell a. IgA
8. Acts as immunologic gate keepers b. IgG
c. IgM
d. IgD
110. Rapid staining of VZV can be made by staining of IgM Mauuna, Malamig, Malaki
samples using Romanowsky stains to look for ___. a. *first antibody produced in primary
Tzanck cells infection *predominant antibody in
acute/early infection
b. Encapsulated virus
c. Macrophages IgG *Predominant antibody produced in
d. Monocytes Anamnestic response or secondary exposure
RATIO: to the same antigen
*Predominant antibody in chronic, convalescent,
Tzanck smear - microscopic examination of smears to or past infection
reveal multinucleated giant cells called Tzanck cells.
Remember it can be used to diagnose HSV
(Herpes simplex virus) and VZV infections.
114. IL-1, IL-6 and TNF – a are responsible for ____. a.
Clonal expansion of CD4+ cells
b. Stimulate formation of colonies of macrophages c.
111. Translation of proteins from RNA happens ____. a.
Fever, pain and swelling of inflamed tissues d.
During meiosis
Inducing the growth of all white cell classes
b. On the nuclear membrane
c. On the ribosome in the cytoplasm of the
RATIO:
cell
▪ They are all pro-inflammatory cytokines
d. Inside the nucleolus of the cell
▪ Examples of major inflammatory cytokines: TNF-a ,
RATIO:
IL-1, IL-6, IFN-Gamma
TRANSLATION = the cellular process by which RNA
transcripts are turned into proteins and peptides, the
115. A chronic bleeder with recurrent allergic reaction from
structural and functional molecules of the cell. The
previous transfusion needs another transfusion. Which one
production of protein, according to the genetic code. An
is suitable?
enzymatic process occurring in the ribosomes, during
which a codon within messenger RNA (mRNA) is aligned a. Leukoreduced RBC
with an anticodon from the transfer RNA (tRNA), which b. Fresh frozen plasma
attaches a corresponding amino acid into the growing c. Irradiated blood
peptide chain.
d. FWB
Translation is a complicated process and involves three e. Washed RBC
major steps: initiation, elongation, and termination RATIO:

Translation takes place on the rough endoplasmic

reticulum (ER) in the cytoplasm. Also called the
rough ER, it is the site of the ribosomes, which are
organelles composed of proteins and ribosomal RNA
(rRNA).

112. What is the minimum weight in pounds to qualify a

female donor for double RBC pheresis?
WASHED RBCs AND DEGLYCEROLIZED RBCs
▪ Patients who have severe allergic (anaphylactic) RATIO:
transfusion reactions to ordinary units of RBCs IgA can be found in secretions
may benefit from receiving washed RBCs
Subclass of IgA
▪ Washed RBCs are used for the rare patient who has
had moderate to severe allergic transfusion IgA1 IgA 2
reactions and has anti-IgA antibodies because of
IgA deficiency. Monomer Dimer held by a J chain
▪ the process to deglycerolize the RBCs removes mainly found in serum Mainly found in secretions
nearly all the plasma, these units, although more
expensive, can be used interchangeably with
washed RBCs
119. Which of the following is a primary reason for
exchange transfusion in neonates?
a. To increase hemoglobin
▪ The expected hematocrit increase for washed or b. The removal of bilirubin
deglycerolized RBCs is the same as that for
c. To increase immunity
regular RBC units.
d. To transfuse viable platelets

RATIO:
116. The cut-off titer for Negative RF Latex agglutination Exchange *Removal of infant RBCs coated
test is ____. Transfusion with maternal antibody and
a. 1:16 replacement with antigen
negative RBCs
b. 1:64 The use of
whole blood *Performed in neonatal period
c. 1:40
or *Sample for crossmatching:
d. 1:160 Mother’s serum , infant’s serum
equivalent to
replace the *Exchange transfusions are used
RATIO: neonate’s primarily to remove high levels of
When using RF latex tests, a titer of 80 or greater is generally circulating unconjugated bilirubin and thus
considered a positive reaction, a titer of 20 to 40 is considered blood. prevent kernicterus. Premature
a weakly positive reaction, and , if there is no agglutination at Exchange newborns are more likely than
1:20 , the specimen should be considered negative for RF, even transfusion is full-term infants to require exchange
if subsequent dilution shows agglutination . (Bryant p279) rarely required transfusions for elevated bilirubin
because of because their livers are less able to
117. Which of the following blood typing techniques uses advances in conjugate bilirubin. *Other
Microplates? phototherapy advantages of exchange transfusion
and the use of include the removal of part of the
a. Solid phase techniques IVIG. circulating maternal antibody,
b. Gel technique removal of sensitized RBCs, and
c. Flow cytometry replacement of incompatible RBCs
d. Immunochromatography with compatible RBC

RATIO: SELECTION OF RBCs

Currently, most labelled immunoassays use a solid-phase Fresh as possible (less than 5 or
vehicle for separation such as polystyrene test tubes, microtiter 7days old), Group O negative or
plates, glass or polystyrene beads, magnetic beads, and group specific ,CMV negative, Hgb S
cellulose membranes. negative ,irradiated
Examples of labelled immunoassays: ELISA, RIA, IFA, DFA

118. Naturally occurring antibodies found in saliva are

primarily ____. 120. The result of an RPR appears to be negative but with
some suspicious clumps, what should the Med. Tech. Do?
a. Monomers
a. Make a dilution of the serum and repeat testing
b. Pentamers
b. Do inactivation and repeat the test
c. Pentamers and monomers
c. Report as negative
d. Dimers
d. Repost as positive

121. A patient was given massive transfusion. Which of the
following complication might he suffer later?
a. Agranulocytosis
b. Anaphylactic shock
c. Iron overload
d. Aplastic anemia
RATIO:
Iron overload occurs due to long-term accumulation of iron in
the body tissues from multiple RBC transfusions. This causes
organ damage.- Harmening p.388
Iron overload / Cause: Iron overload is a
Transfusioninduc delayed, nonimmune
ed complication of
Hemosiderosis transfusion, presenting with
multiorgan (i.e., liver, heart,
endocrine organs) damage
secondary to excessive iron
accumulation
-Population at risk: sickle cell
anemia, hemoglobinopathies,
thalassemia, patient who are
transfusion
dependent
Note: Each unit of red blood
cells contains approximately
250 mg of iron. After 10 to 15
red cell
transfusions, excess iron is present
in the liver, heart, and endocrine
organs
Signs and Symptoms: Muscle
weakness, weight loss, mild
jaundice, fatigue, cardiac
arrhythmias, mild diabetes, and
multi-organ failure
Prevention and Treatment:
1. Administration of Iron
chelating agent such as
deferroxamine or
desferioxamine
2. Transfusion of neocytes
(young RBCs)
122. The major immunoglobulin class of Anti-A in a group B
individual is/are ____.
a. IgM and IgA
b. IgA
c. IgG
d. IgM
RATIO:
In people whose blood type are B and A may have Anti-A
and anti –B correspondingly, predominantly are IgM
In patient with blood type O, Anti-A, Anti-B, Anti-AB may
be seen and predominantly are IgG
123. The carrier particles in RF Slide Agglutination Test are
cells sensitized with ___.
a. Regain
b. Cardiolopin
c. IgG
d. IgM
RATIO:
Manual agglutination tests for RF uses charcoal or
latex particles coated with IgG.
WAG MALITO
Yung reagent merong IgG nakadikit sa latex
particles. Ang hahanapin natin sa Patient serum ay
IgM na
BALIKAN!! WHAT IS A RHEUMATOID FACTOR??
Rheumatoid factor= an IgM directed to the Fc region of
IgG
124. Which of the following has greatly reduced the risk of
acquiring Hepatitis through transfusion?
a. Screening of donors
b. Filtration of blood
c. Screening of blood units
d. Immunization of donor before phlebotomy
RATIO:
Prevention consists of worldwide screening of blood and blood
products; destruction or sterilization of needles and surgical or
dental instruments; universal precautions; and education about
the risks.
125. Which is/are the commonly used mono-specific
Antiglobulin Reagent?
a. AOTA
b. Anti-IgG
c. Anti-C3d
d. Anti-C3b
RATIO:
Monospecific AHG reagents contain only one antibody
specificity: either anti-IgG or antibody to specific complement
components such as C3b or C3d(i.e.,anticomplement).Licensed
monospecific AHG reagents in common use are anti-IgG and
anti-C3b-C3d.

126. The wearing of masks is a precaution to prevent

infection due to ____.
a. Gram negative organisms
b. Gram positive organisms
c. Droplet nuclei
d. Viruses

127. Which of the following places is/are known to be

endemic for Malaria?
a. All three
b. Puerto Princesa, Palawan
c. Tanay, rizal
d. San Jose del Monte, Bulacan

SOURCE: PHILIPPINE STAR (APRIL 27, 2019)

MANILA, Philippines — Four provinces remain endemic for
malaria as the Philippines races to be declared malaria-free by
2030, Health Secretary Francisco Duque III said yesterday.
These provinces are Palawan, Sulu, Occidental Mindoro and
Sultan Kudarat. -DOH

128. Packed RBC prepared in a closed system and

transferred in satellite bags should have hematocrit of 129. Which of the following is a psychrophilic Gram negative
between ____. bacteria, though they rarely cause contamination of
a. 70-80% stored blood, can cause death to the recipient? a.
b. 40-50% Streptococci
c. 50-60% b. Pseudomonas
d. 80-90% c. Gonococci
d. Tubercle bacilli

130. A quality problem about the blood bank is almost

always due to _____.
a. No written job description
b. Insufficient training of personnel
c. An individual employee’s fault
d. Faulty process

RATIO:
Quality begins and ends with people. A quality problem is
seldom an individual employee’s fault. Rather, a quality problem
is almost always due to a faulty work process.
–Harmening 6thedition, page 513

131. Which of the following are produced by patients with

infectious mononucleosis?
a. All of these
b. VCAIgM
 c. EAIgM
▪ The RPR is a modified VDRL test involving
d. VCAIgG macroscopic agglutination.
▪ The cardiolipin-containing antigen suspension is
132. Which of the following component of natural immunity bound to charcoal particles, which make the
protects the body by “cleaning up” through the removal test easier to read.
of cholesterol from cholesterol filled ▪ The reagent = an antigen consists of cardiolipin,
macrophages? cholesterol lecithin with the addition of
a. Haptoglobin EDTA, Thimerosal, and Choline Chloride
b. C-reactive protein
c. Serum Amyloid A
d. Ceruloplasmin
▪ Specimen Used: 50 ul or 0.05ml serum that does
not have to be heat-inactivated
133. In the Rapid Slide test for bacterial antigens,
▪ Test is performed on a Plastic card
macroscopic agglutination of 50% is graded as
____. a. 2 plus
b. Negative
c. Non-reactive
135. Which of the following may cause a FALSE POSITIVE
d. 50 units
RPR?
Grade Description a. SLE
b. Infectious mononucleosis
Cells Supernate
c. Pregnancy
0 No agglutinates Dark, d. All these
turbid,
homogeno RATIO:
us Non-treponemal tests are subjective to biologic false positive
result such as in cases of IM, Pregnancy, older individual,
W+ Many tiny agglutinates Dark, turbid
Rheumatoid arthritis, SLE, Leprosy, chicken pox, infectious
Many free cells
hepatitis, ricketssial disease, trypanosomiasis, leptospirosis,
May not be visible without
rheumatic fever, pneumococcal pneumonia and Malaria
microscope

1+ Many small agglutinates Turbid 136. A sharp rise in the concentration of AFP is generally
(25%) Many free cells suggestive of which condition?
a. Acute myelogenous leukemia
2+ Many medium-sized Clear
b. Primary hepatic carcinoma
(50%) agglutinates Moderate
c. Cancer of the prostate
number of free cells
d. Myocardial infarction

3+ Several large agglutinates Clear INCREASED Hepatocarcinoma

ALPHA Testicular cancer
(75%) Few free cells
FETO
Germ cell tumors/ Choriocarcinoma
4+ One large, solid agglutinate Clear PROTEIN
Neural tube defects such as
(100%) No free cells anencephaly and spina bifida
Polyembryony

DECREASED DOWN SYNDROME

134. Which of the following is a component of RPR antigen ALPA FETO
which facilitates the macroscopic reading of result? a. PROTEIN
Acridin
b. Charcoal
c. Latex
137. What is seen microscopically in fecal smear that is a
d. Cholesterol
common indicator in Helminthic parasitism?
RATIO:
a. Pus cells
b. Charcot-Leyden Crystals
 c. Ferritin granules 141. When a test is said to have high predictive value,
which of the following is CORRECT?
d. Plasma cells
a. Majority of positives are True positives
b. It is not used as a screening test
NOTE:
Charcot–leyden crystal if found in: c. True Positives vary with population
a. stool = indicates parasitic infection d. All Negatives are true negative
b. Sputum = Indicates bronchial asthma RATIO:
c. Urine= Acute interstitial nephritis Bishop 7th edition
Positive predictive value: Chance of an individual
138. What is the International color code for Anti-human having a given disease or condition if the test
globulin Reagent?
is abnormal.
a. Colorless
Negative predictive value: Chance an individual
b. Yellow
does not have a given disease or condition if
c. Pale blue
the test is within the reference interval.
d. Pale green
Rodak’s 6th edition
-The positive predictive value predicts the probability that an
139. Given the following results after phenotyping, which is individual with a positive assay result has the disease or
the correct genotype? condition.
Anti-D Anti-C Anti-E Anti-c Anti-e -The negative predictive value predicts the probability that an
individual with a negative assay result does not have the
(-) (+++) (+++) (+++) (+) disease or condition

142. Which of the following phenotypes is associated with

poor expression of Kell antigens?
a. Dce/dce a. Leach
b. DCE/dce b. MER2
c. DCE/dcE c. LW (a-b-)
d. CE/ce
d. Co (a-b-)

140. For what disease was the test developed by the

Venereal Disease Research Laboratory? RATIO:

a. Herpes ▪ Depressed Kell antigens are seen on RBCs with the rare
b. Syphilis Gerbich-negative phenotypes Ge: –2, –3, 4 and Ge:
–2, –3, –4.
c. Hepatitis ▪ Patients with autoimmune hemolytic anemia, in which
d. Gonorrhea the autoantibody is directed against a Kell antigen,
may have depressed expression of that antigen.
RATIO:
VDRL (Venereal Disease Research Laboratory Test) •
Both a qualitative and quantitative slide flocculation 143. Which of the following cells produce CRP? a.
test for serum and CSF Cytotoxic T cells
• Reagent: An Antigen consists of b. Hepatic cells
0.03% cardiolipin- Main reacting agent c. Pancreatic cells
0.9% cholesterol- Enhances reactive surface of d. T helper cell
cardiolipin
0.21% lecithin- Removes anticomplementary of 144. Which of the following factors is NOT critical to the
cardiolipin storage of platelets?
• Specimen: 50 ul or 0.05 mL serum heated at 56oC for a. Constant agitation
30 minutes to inactive complements
b. Temperature
• Flocculation is examined UNDERL LPO
c. Preservative
(MICSROSCOPICALLY)
d. Exposure to light
• Uses Slides with ceramic rings

145. Which of the following causes the release of

histamines?
 a. IgE
b. IgM
c. IgD and IgE
d. IgG and IgE
RATIO:
IgE
• Binds strongly to a receptor on MAST CELLS and
BASOPHILS and together with antigen, mediates the
release of histamine and heparin from these cells.
• Mediates some types of hypersensitivity ( allergic)
reactions allergies, and anaphylaxis and is generally
responsible for an individual’s immunity to invading
parasites
146. Which of the following group of reagents do Albumin,
Polyethyline glycol, and LISS belong?
a. Proteolytic enzymes
b. Lectins
c. AHG Reagents
d. Enhancement media
RATIO:
One of the key ways to enhance the detection of IgG
antibodies is to increase their reactivity. Many of the
commercially available enhancement media accomplish
this by reducing the zeta potential of RBC membranes.
The net negative charge surrounding RBCs (zeta
potential) in a cationic media is part of the force that
repels RBCs from each other and is due to sialic acid
molecules on the surface of RBCs
To discover the presence of IgG antibodies, there are
many enhancement techniques or potentiators available
lymphopoiesis
148. A unit of FWB was divided using an open system and
one half was transferred to a sterile bag with no
preservative was used for a pediatric patient. What is the
disposition for the remaining half?
a. Store until the original expiration date
b. Use within 48 hours
c. Dispose immediately
d. Use within 24 hours
NOT SURE ABOUT THIS. IF MAY IBANG TINURO YUN PO
149. To which kind of antibody does C3 component have
affinity?
a. IgM
b. IgG
c. IgA
d. IgD
RATIO:
Certain naturally occurring antibodies stimulate
alternative complement pathway C3b deposition. We
propose that only
those IgG antibodies stimulate alternative complement
pathway which have an affinity for C3. Their weak
binding to C3 in plasma increases the probability that
covalently linked C3b-IgG complexes are formed during
C3 activation. Such complexes are known to be much
more efficient than C3b in mediating positive feedback
of C3 activation, since they are more stable against
inactivation by factor I and H.

150. If 250 ml of blood is to be collected, the ratio of

147. Which of the following is a primary lymphoid organ? a. anticoagulant to blood is ___.
Thymus a. 1:16
b. Liver b. 1:10
c. Spleen c. 1:8
d. Lymph node d. 1:4

RATIO: RATIO:

Primary Bone marrow, Thymus

lymphoid tissues -Site for antigen independent
lymphopoiesis

Secondary Lymph nodes, Tonsils, Spleen,

lymphoid tissues CALT, Appendix, Peyer’s patches,
MALT -Site for antigen
DEPENDENT

STANDARD BLOOD BAG UNIT
▪ 450ml blood + 63 ml anticoagulant
▪ RATIO OF 7:1 (7 parts of blood and 1 part of
anticoagulant)
In this situation, just divide 250ml of blood to the
standard amount of anticoagulant, which is 63
Equation: 250 / 63 = 3.97 round off → 4
The ratio of anticoagulant to blood will now become 1:4
151. Which is NOT a component of a Blood Bank
information system?
a.People
b.Validation
c.Hardware
d.Software
152. Which is the last step in the correct procedure for
handwashing?
a. Dry hands naturally by shaking them in the air
b. Apply 70% alcohol after handwashing
c. Turn off faucet with a clean paper towel d.
Dry hands with a clean paper towel
RATIO:
CDC Hand Washing Procedure
1. Wet hands with warm water
2. Apply anti-microbial soap
3. Rub from a lather, create friction, and loosen
debris.
4. Thoroughly clean between fingers, including
thumbs, under fingernails and rings, and up to
the wrist, for at least 15/20 seconds.
5. Rinse hands in a downward position
6. Dry with a paper towel
7. Turn off faucets with a clean paper towel to
prevent recontamination

RATIO:
SYSTEM COMPONENTS
153. Which of the following is a correct statement about
1.Hardware the use of tachometer?
Hardware components include a central system unit,
a. It is used for calibrating the centripetal force of the
sometimes referred to as the box, and several different
centrifuge
peripheral devices that send or receive information
through the system unit. Peripheral devices include b. It measures the speed of the centrifuge in
display terminals, keyboards, bar-code readers, revolution per minute
scanners and wands, pointing devices such as mice, c. It computes the centrifugal force of the centrifuge d.
printers, and modems. The hardware components and It measures the speed of a centrifuge in term of
the way in which they are connected to each other is revolution per second
the system configuration.
154. Primary biliary cirrhosis is frequently associated with
2.Software _____ antibodies.
Software tells the computer what to do with all of the a. Anti-mitochondrial
information it has received. Minimally, every computer
b. Anti-DNA
system has two kinds of software—operating system
software and application software. Some systems may c. Anti-smooth muscles
also use interface software, which allows the system to d. Anti-HAV
communicate with other computer systems.
155. Which of the following have been identified as the
most common cause of Immune hemolytic transfusion
reaction?
3.People a. Anti-Fy b
The human components of a blood bank information b. Anti-A
system are the users and at least one person designated c. Anti-H
as the system manager. Users have access to the d. Anti-D
technical applications needed to perform daily blood 156. If a patient’s platelet count before transfusion was
bank operations. System managers require access to a 10,000/ul and he was given 3 units of platelets, his actual
wider range of applications, including system platelet count should at least be ____/ul after transfusion.
maintenance functions a. 50,000
b. 30,000
c. 25,000
d. 40,000
 Random donor platelet b. TRALI
c. HDN
Prepared from Whole blood d. DHTR

Contains at least 5.5 × 1010 platelets

Plasma content: 40-70ml RATIO:

Cause: Anti-leukocyte antibodies, Anti-HLA class I, and
Can raise platelet count by 5000 to 10,000/ul Anti neutrophil antigen that are present in plasma of the
transfusedunit.
Transfusion-related acute lung injury (TRALI) consists of
an acute transfusion reaction presenting with respiratory
157. How long is the deferral for donors who had been distress and severe hypoxemia during or within 6 hours of
treated for gonorrhea? (years after treatment) transfusion in the absence of other causes of acute lung
injury (e.g., aspiration, pneumonia, toxic inhalation, lung
a. 3
contusion, near drowning, severe sepsis, shock, multiple
b. 5 trauma, burn injury, acute pancreatitis, cardiopulmonary
c. 1 bypass, drug overdose).
d. 2
This syndrome is now considered the leading cause of
158. In 1927, Levine and Lansteiner used serum of rabbits transfusion-associated fatalities, surpassing ABO
incompatibility and bacterial contamination
injected with human blood as antisera to divide the
population into two distinct types. Which of these? a. P+ (Harmening, 6th edition)
and P
b. P and PK Signs and Symptoms: Chills, fever, non-productive
c. I+ and I cough, acute respiratory distress including dyspnea,
cyanosis, bilateral pulmonary edema on chest x-ray,
d. Rho+ and Rho
severe hypoxemia, tachycardia, hypotension

159. Which of the following is NOT neutrophil movement

Prevention and Treatment: Use of proper donor
related chemical?
selection and Use of leuko-poor RBCs unit
a. Histamines
b. Chemokines
c. Selectin
d. Integrin 162. The monomeric units of IgM are held together by a
___.
RATIO: a. Light chain
b. S-S Bonds (disulfide bonds)
▪ Selectins and integrins are important adhesion
c. J chain
molecules for Leukocytes
▪ Chemokines: A large family of homologous d. V chain
cytokines that promote migration of white
blood cells through chemotaxis 163. What temperature is fresh whole blood stored? a.
8-10 °C
b. 1-6 °F
c. 22-25 °C
160. Types 1 hypersensitivity immune response include d. 2-5 °C
____.
RATIO:
a. Transfusion reaction
b. Transplant rejection FWB (Fresh whole blood)
c. Bronchial asthma ▪ Storage temp: 1 to 6degree celcius
▪ Transport temp: 1 to 10 degree celsius
d. Serum sickness
161. Which of the following is a serious blood transfusion ▪ Shelf life:
complication characterized by the acute onset of non -It depends in the anticoagulant (closed
cardiogenic pulmonary edema after transfusion of blood system) -24 hours if open system
products?
a. DIC
164. What are the two types of light chain in an
immunoglobulin?
a. Alpha1 and Alpha2
b. Alpha and Omega
c. Alpha and Beta
d. Kappa and Lambda
165. Which of the following is TRUE about NK cells? a.
They form Memory cells
b. They recognize a lack of MHC proteins
c. They are formed mainly in the lymph nodes d.
They have very similar characteristics with B cells
166. Four hours after transfusion was completed, Mrs. So
had a temperature of 38.5 °C, which transfusion
complication is this?
a. Febrile, non-hemolytic reaction
b. Hemolytic transfusion
c. Allergic reaction type 1
d. Anaphylactic shock
RATIO:
FNHTR
Cause: Anti-leukocyte antibody
-Another mechanism is closely related to platelet storage
changes, which involve the production and release of
biologically active cytokines by the white cells present in
the component during storage
Sign and Symptoms: A febrile transfusion reaction is
defined as a rise in temperature of 1° C or greater,
possibly accompanied by chills rigor, nausea or vomiting ,
tachycardia, increase BP, and tachypnea
Prevention and Treatment:
1. Transfuse of leukocyte reduced products to
patients who have experienced two or
more
FNHTR.
2. Administer antipyretics to resolve fever
3. Meperidine – to resolve rigor but it must be
caused with extreme caution
167. Which antigens are arranged CORRECTLY in the order of
immunogenicity from highest to lowest?
a. ABO, D, K Le a
b. D, ABO, K, Le a
c. ABO, Le a, D, K
d. K, D, ABO, Le a
RATIO:
Order: ABO > RH> KELL > DUFFY/ KIDD
168. Which of the following is labeled single donor platelet
component?
a. Pooled platelets collected from several donors b.
Aliquoted platelets in quadripacks obtained from a
single donor
c. Expressed platelets component from one unit of
fresh whole blood
d. Platelet component prepared by apheresis
RATIO:
Single donor Platelet
Prepared from apheresis
Contains at least 3 × 1011 platelets
(equivalent to 6 to 8 RDP)
Plasma content: 300ml
Can raise platelet count by 30,000 to 60,000/ul
169. The specimen used for the performance of HLA class 1
typing is purified ____.
a. Neocytes
b. B-lymphocytes
c. T-lymphocytes
d. Plasma cells
RATIO:
Serological method for Detection of HLA Antigens ▪ Test:
Microlymphocytotoxicity testing / Complement
dependent cell cytotoxicity
▪ A test for both MHC class I and II detection
▪ Usage of inverted phase contrast microscope
▪ Usage of polyspecific AHG reagent
▪ Anticoagulant used: ACD or phenol free- heparinized
blood
▪ Purified T cells can be used for the detection of MHC
class I
▪ Purified B cell suspension is used for the detection of
MHC class II
▪ Preparation of B-lymphocyte suspension:
a. Nylon wool separation (B cells will adhere to
nylon wool from which they can be eluted)
b. Fluorescent labeling
c. Magnetic beads –method of choice
170. Which of the following antigens of the Kell system
and can cause severe HTR?
a. Anti-Le a
 b. Anti-K Graft-versus-host disease (GVHD) can be an
c. Anti-Lu a unintentional consequence of blood transfusion or
d. Anti-Lu b transplantation in severely immunocompromised or
immunosuppressed patient. When immunocompetent T
lymphocytes are transfused from a donor to an
171. What is the basic difference of HDFN caused by ABO immunodeficient or immunosuppressed recipient, the
antibodies to that caused by Rh antibodies? They differ in transfused or grafted lymphocytes recognize that the
their reaction to _____. antigens of the host are foreign and react
a. Kleuhauer-Bettke test immunologically against them Instead of the usual
b. Amniotic fluid OD test transplantation reaction of host against graft, the
reverse graft-versus-host reaction occurs and produces
c. Direct Antiglobulin test an
d. Rossetting test

inflammatory response.
YUNG MISMONG T CELLS NI DONOR ANG NAGREACT
OR NANIRA SA PATIENT. NANGYAYARI ITO PAG SI
PATIENT AY IMMUNOCOMPROMISED OR MAHINA NA
ANG IMMUNESYSTEM

174. Which of the following is NOT a part of the processes

involved in inflammatory reactions?
a. Increase in the permeability of capillaries
b. Migration of lymphocytes
c. Increase in Haptoglobin
d. Increase in CRP
CRP and Haptoglobin are both APR, thus they
increase during inflammation
REMEMBER That the HDFN type induced by the RH antibodies
is severe in contrast to ABO HDFN which is milder.

Amniotic O.D 450 is a test for Bilirubin levels, the higher the 175. Which of the following is a tumor marker for cancer of
bilirubin level the higher the result, and the more severe the the Thyroid gland?
HFDN. a. Calcitonin
b. CEA
172. Enzyme Linked Immunosorbent Assay is the c. AFP
formation of antigen-antibody complex___. d. Ca 19-9
a. Bound to a solid phase support
b. Utilization of a radioactive market NOTE:
c. Facilitated by latex beads and agitation Calcitonin = marker for medullary thyroid cancer
d. In a semi-solid medium Procalcitonin - marker for bacterial infections and sepsis

173. What disease is an effect of the infusion or 176. Which of the following are expressed by a mature B
transplantation of immune cells from the donor to the cells?
recipient?
a. Surface IgM
a. FNHTR
b. Surface IgE
b. anaphylactic shock
c. Surface IgM, surface IgD and MHC
c. Creutzfeld-Jacobs
d. MCH and Surface IgG
d. GVHD

RATIO:
RATIO:
 Immature B cells= only IgM is expressed on cells surface c. III
d. IV
Mature B cells = both IgM and IgD are expressed on
cells surface together with MHC proteins 181. What is the cause of this discrepancy?
a. Increased paraproteins
b. Increased incidence of unexpected antibody
c. Decreased gammaglobulin
177. Polyspecific AHG reagent contained _____. a.
Anti-IgM and Anti-IgG d. Decreased antigens in red cells

b. Anti-IgG and Anti-C3d

182. Discrepancies of this type should be investigated by: a.
c. Anti-IgG
Red cell adsorption and elution
d. Anti-Rho and anti-A, B
b. Incubate at 4◦C for 15 minutes
c. Enzyme treatment of the red cells then typing d.
SITUATIONAL
2x red cell suspension
Situation 1 – a 90 year old patient, scheduled for transfusion
because of low hemoglobin has the following results in his
blood typing
Anti Anti A B O Autocontrol 183. An instrument used to measure humidity in the blood
A B cells cells cells bank refrigerator:
A. Hygrometer
0 0 0 0 0 0 B. Tachometer
C. Barometer
D. None of the ABOve
RATIO:
178. Based on the results of the tests done, what is the
blood type of the patient? Tachometer used to measure the speed of
a. Cannot be determined centrifuge (RPM)
b. Bombay
Barometer used to measure air pressure
c. Subgroup of A
d. Type O
Possible -Group O newborn or elderly patient
cause -Patient may have
agammaglobulinemia/Hypogammaglobuline 184. This is diagnostical prenatal test in which sample of
mia -Patient may be taking the baby’s blood is removed from the umbilical cord for
testing:
immunosuppressive drugs
A. Cordocentesis
Resolution Check age and diagnosis of patient and B. PUBS
immunoglobulin levels; if possible, C. Both
incubate at RT for 30 min or at 4°C for 15 D. Neither
min; include group O and autologous cells
at 4°C
RATIO:
Cordocentesis / Percutaneous Umbilical cord Blood
sampling (PUBS)
179. From what population the above results can be
observed? ▪ Using high-resolution ultrasound with color Doppler
a. Whites enhancement of blood flow, the umbilical vein is
b. Middle aged patient visualized at the level of the cord insertion into
the placenta. A spinal needle is inserted into the
c. All Bombay types
umbilical vein, and a sample of the fetal blood is
d. Geriatric patient obtained
▪ The fetal blood sample can then be tested for
180. What is type of ABO discrepancy is this case? a. hemoglobin, hematocrit, bilirubin, blood type,
I direct antiglobulin test (DAT), and antigen
phenotype and genotype.
b. II
 ▪ Developed by Kary Mullis
▪ is capable of amplifying tiny quantities of nucleic
185. All of the following items should be checked quarterly, acid up to levels that can be later detected with
EXCEPT various strategies, usually involving a
hybridization reaction using nucleic acid probes
A. Cell washers
B. Centrifuge timers
Components for Reaction
C. Blood warmers
a. Thermostable DNA polymerase (from
D. Platelet incubators
bacterium Thermus aquaticus, thus “Taq
RATIO: polymerase”
Daily When Heating blocks, Water Baths, Donor unit b. Deoxynucleotides of each base (dNTPs)
in Use agitators, Scales, Balances, c. DNA of interest containing target sequence d.
Hemoglobinometer, Microhematocrit Oligonucleotide primers- short segments of DNA
centrifuges, Refrigerator and
Freezers(continuous monitoring)
CYCLES AND TEMPERATURE SET UP
Monthly Alarm activation(freezers and 1. Denaturation : 90-96’C for 20-60seconds
refrigerators), centrifuge 2. Annealing : 50-70’C , 20-90seconds
temperature(refrigerated) 3. Extension: 68-75’C, 10-20seconds

Quarterly Blood warmers, Cell washers(speed,

timer) , Centrifuge speed timer SOME INHIBITORS
1. Heparin
Annually Mercury thermometers 2. Hemoglobin /heme
3. EDTA
Every 4 hours Platelet incubators (enclosed, monitored
chambers)

187. Crossmatch results at the antiglobulin phase were

negative. When 1 drop of check cells was added, no
186. PCR technology can be used to:
agglutination was seen. The most likely explanation is A.
A. Amplify small amounts of RNA Red cells were over-washed
B. Clone fragments of RNA
B. Residual patient serum inactivated the AHG
C. Digest genomic DNA into small fragments reagent
D. Repair broken pieces of DNA C. Centrifuge speed was set too high
D. Laboratorian did not add enough check cells
AHG RESULT INTERP REASONS
REACTI AFTER RET
ON ADDITION ATION
OF CHECK
CELLS

Negative NO Invalid 1.AHG reagent

agglutination test(false was
negative) neutralized
and
inactivated
2.Expired AHG
reagent
3. AHG
reagent was
not
added/Omitted
 Negative Agglutination Valid test The test was undetectable
(true done properly
negative) and the is no
sensitization
of patient’s 191. The serological test for the detection of mannan and
antigen or anti-mannan aid in the diagnosis of what fungal infection?
RBC
A. Aspergillosis
B. Candidiasis
C. Crytococcal infection
188. A 42 year old male of average body mass has a D. Coccidoidomycosis
history of chronic anemia requiring transfusion support.
Two units of red blood cells are transfused. If the
pretransfusion hemoglobin was 7.0g/dl , the expected 192. During donor bleeding, the venipuncture site is identified,
and the area is scrubbed at least 4 cm in all directions
post transfusion hemoglobin concentration should be:
from the site for a minimum of _____ A. 1minute
A. 8.0g/dl B. 30 seconds
B. 9.0 g/dl C. 2 minutes
C. 10 g/dl D. 5 minutes
D. 11 g/dl
193. Which is true related to aliquoted blood product? I.
RATIO: Used for transfusion during neonatal period II. Shelf life
For every 1 blood bag unit – it raises hemoglobin level by 1 depends with the anticoagulant used III. Less than 7
g/dl (range of 1 to 1.5g/dl) days old and CMV negative
A. 1,2,3
189. How many units of red blood cells are required to raise B. 2 AND 3
the hematocrit of a 70kg nonbleeding man from 24% to C. 1 AND 3
30%? D. 1 AND 2
A. 1
RATIO:
B. 2
C. 3 Aliquoted red cell is the product most often transfused
during the neonatal period or in infants younger than 4
D. 4
months of age. It has a shelf life of 24hrs and should
be stored at 1 to 6 ‘C
RATIO: • Less than 7 days old, unless infused slowly
For every 1 blood bag unit- it raises hematocrit level by 3% • O-negative or compatible with mother and
(range 3 to 5 %) infant • CMV-negative or leukocyte-reduced
• Hemoglobin S–negative for hypoxic newborns
190. The phenotype of any newborn will include which of
the following:
1. Le (a-b-)
194. AHTR or IHTR is defined as transfusion reaction with
2. Le (a+b-) sign or symptoms within ____ hours of transfusion A. 1 hr
3. Le (a-b+) B. 24 hours
4. I- , i+ C. 3 days
5. I+ , i D. 1 week
A. 1 AND 4 correct
195. Which of the following can be given to an apheresis
B. 1 and 5 correct donor to increase the number of circulating granulocytes
C. 2 and 4 correct and HPCs?
D. 3 and 5 correct A. DDAVP (1-Deamino-[8-D-arginine]-vasopressin)
RATIO: B. HES (Hydroxyl ethyl starch)
C. Immune globulin
Cord blood and red cells from newborn D. G-CSF
/infants phenotype as Le(a-b-)
Decrease in expression on red cells from RATIO:
many pregnant women, thus typed as Le(a-b-)
DDAVP Used to treat mild or moderate factor
- The Le(a–b–) phenotype is found more
VIII deficiency (hemophilia A)
frequently among Africans.
At birth, infant red cells are rich in i ; I is almost
 B. Transition
HES A common RBC sedimenting agent
C. Missense
used to facilitate leukocyte
withdrawal during leukapheresis D. Non sense
During centrifugation, it allows RATIO:
better separation of layers, resulting Point The simplest type of mutation is the point
in an improved WBC yield with mutation mutation, in which only one nucleotide in the
reduced RBC contamination. DNA sequence is changed. Point mutations
include substitutions, insertions, and
deletions.

196. A type of mutation in which purine is substituted for a

pyrimidine or a pyrimidine for a purine
A. Transversion

Transition one purine is substituted for another

purine, or one pyrimidine is substituted for
another pyrimidine.

Transversion A type of mutation in which purine is

substituted for a pyrimidine or a pyrimidine
for a purine

Missense A missense mutation results in a change in a

mutation codon, which alters the amino acid in the
corresponding peptide.

Non sense A very specific type of serious mutation, called a

mutation nonsense mutation, results when a point change
in one of the nucleotides of a DNA
sequence causes one of the three possible
stop codons to be formed

Frameshift results in a nonfunctional transferase protein that

mutation is seen phenotypically as the O blood group

197. The anticoagulant most often used for neonate transfusions is

A. ACD
B. CPDA-1
C. CP2D
D. Heparin

198. What is the equivalent grams of a 400ml whole blood? A.

400g
B. 424g
C. 450g
D. 500g
Conversion factor = 1.06

199. What is the universal color of LISS reagent? A.

Yellow
B. Green
C. Colorless
D. Blue

RATIO:
 Type Color

22%Albumin Colorless

LISS Colorless

AHG Green

200. A blood typing was performed; there was an

agglutination on blue reagent and no agglutination on
yellow reagent. What is the blood type?
A. A
B. A +
C. B
D. B +

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