sbb final Exam Questions With
Solved Solutions
A peripheral smear with increased polychromasia, schistocytes and
spherocytes is indicative of which condition?
A. Aplastic anemia
B. Iron deficiency anemia
C. Hemolytic anemia
D. Megaloblastic anemia - ANSWER>>C. Hemolytic anemia
Megaloblastic anemia would show larger, less mature RBCs on the smear.
Iron deficiency anemia would show hypochromasia, and a lower RBC count.
Aplastic anemia would show very little amounts of mature RBCs on the
smear
Hemolytic anemia results in misshapen RBCs and inconsistent RBC
appearance because of the rapid RBC destruction. Because the RBCs have
as shortened survival, pieces of the membrance can break off resulting in
spherocytes and schistocytes.
Which of the following treatments is useful when distinguishing between
anti-D and anti-Lw?
A. Choloroquine
B. Cord cells
C. Ficin
D. Dithiothreitol - ANSWER>>ANSWER: Dithiothreitol (DTT)
,LW antigens require divalent cations (e.g., Mg2+) for expression and have
intramolecular disulfide bonds that are sensitive to dithiothreitol (DTT)
treatment.
DTT treatment is helpful to differentiate anti-LW from anti-D, because the
D antigen is resistant to DTT while LW antigen is sensitive to DTT.
LW antigens are expressed equally well on group O D-positive and D-
negative cord blood red cell.
expected reaction with O- cord RBCsexpected reaction with O+ DTT treated
RBCsanti-LW+-anti-D-+
The best ANSWER is DTT.
Cord cells are not considered a treatment and often used in conjunction
with DTT results to confirm the presence of either antibody.
ficin (breaks down proteins) and chloroquine (dissociates bound antibody
from RBCs/ destroys HLA antigens) do not disrupt disulfide bonds.
Therapeutic plasma exchange is most useful in treating patients with:
A. Circulating immune complexes
B. Autoimmune diseases
C. high titer IgG anti-D
D. Hyperimmune synromes - ANSWER>>Correct: Circulating Immune
Complexes
Plasma exchange is used to help a temporary condition. So an autoimmune
disease is better treated with the use of steroids and other medicines that
will suppress the autoantibody production.
,A patient with high titer anti-D is actively producing anti-D. So these
patients will also not benefit from plasma exchange since their immune
system is just going to produce more anti-D.
Patients with hyperimmune syndromes are also actively producing harmful
substances, so removing them won't be effective since more will be
produced as soon as the procedure is completed.
Circulating immune complexes are a condition that is caused by antigen-
antibody reaction due to a short lived condition, so the use of plasma
exchange is very effective in removing those large complexes. With
additional treatment, we can prevent more immune complexes from
forming so once the exchange is complete, the condition is most often
resolved.
Which of the following donors is eligible to donate?
A. Wife of a patient with active Hepatitis ; they are living together; last
sexual contact was 18 months ago.
B. Former prostitute; married with no high-risk behavior for 10 years
C. Male who had sex with another male 11 months ago
D. Male jailed for 7 days, 15 months ago - ANSWER>>Correct: Male jailed
for 7 days, 15 months ago
AABB standards (32nd ed):
Incarceration for more than 72 consecutive hours defers the donor for 12
months from the date of release. Because this donor was released 15
months ago, he is eligible.
A person living with an individual with active Hepatitis is deferred. There
would also be deferral for 12 months from the date of the last sexual
, contact. Once the infection is no longer present, the donor is eligible 12
months from the date the spouse's infection is deemed as no longer
present.
Potential donors who have taken money or drugs for sex since 1977 are
indefinitely deferred.
Males who have had sexual relations with other males are deferred for 12
months after the last date of sexual contact. (recently changed due to
COVID-19, however ASCP is currently using pre-pandemic donor
requirements!)
A Native American woman who is group A Positive delivered a group O Rh
positive infant. The baby was noted to be jaundiced 6 hours after birth and
had a 3+ DAT. The mother's antibody screen had been negative before
delivery and an eluate prepared from the infant's cells was also non-
reactive with a routine antibody ID panel, A1 and B cells.
Which of the following cells should be tested to possibly assist in
identification of the antibody?
A. Doa
B. Dia
C. Cha
D, Coa - ANSWER>>Correct: Dia
The clues here are as follows: You want to look for an antibody that is
capable of causing a significant HDFN.
Anti-Cha is an antibody with high titer, low avidity (HTLA) characteristics.
The antigen is not an integral part of the RBC membrane but rather is
Solved Solutions
A peripheral smear with increased polychromasia, schistocytes and
spherocytes is indicative of which condition?
A. Aplastic anemia
B. Iron deficiency anemia
C. Hemolytic anemia
D. Megaloblastic anemia - ANSWER>>C. Hemolytic anemia
Megaloblastic anemia would show larger, less mature RBCs on the smear.
Iron deficiency anemia would show hypochromasia, and a lower RBC count.
Aplastic anemia would show very little amounts of mature RBCs on the
smear
Hemolytic anemia results in misshapen RBCs and inconsistent RBC
appearance because of the rapid RBC destruction. Because the RBCs have
as shortened survival, pieces of the membrance can break off resulting in
spherocytes and schistocytes.
Which of the following treatments is useful when distinguishing between
anti-D and anti-Lw?
A. Choloroquine
B. Cord cells
C. Ficin
D. Dithiothreitol - ANSWER>>ANSWER: Dithiothreitol (DTT)
,LW antigens require divalent cations (e.g., Mg2+) for expression and have
intramolecular disulfide bonds that are sensitive to dithiothreitol (DTT)
treatment.
DTT treatment is helpful to differentiate anti-LW from anti-D, because the
D antigen is resistant to DTT while LW antigen is sensitive to DTT.
LW antigens are expressed equally well on group O D-positive and D-
negative cord blood red cell.
expected reaction with O- cord RBCsexpected reaction with O+ DTT treated
RBCsanti-LW+-anti-D-+
The best ANSWER is DTT.
Cord cells are not considered a treatment and often used in conjunction
with DTT results to confirm the presence of either antibody.
ficin (breaks down proteins) and chloroquine (dissociates bound antibody
from RBCs/ destroys HLA antigens) do not disrupt disulfide bonds.
Therapeutic plasma exchange is most useful in treating patients with:
A. Circulating immune complexes
B. Autoimmune diseases
C. high titer IgG anti-D
D. Hyperimmune synromes - ANSWER>>Correct: Circulating Immune
Complexes
Plasma exchange is used to help a temporary condition. So an autoimmune
disease is better treated with the use of steroids and other medicines that
will suppress the autoantibody production.
,A patient with high titer anti-D is actively producing anti-D. So these
patients will also not benefit from plasma exchange since their immune
system is just going to produce more anti-D.
Patients with hyperimmune syndromes are also actively producing harmful
substances, so removing them won't be effective since more will be
produced as soon as the procedure is completed.
Circulating immune complexes are a condition that is caused by antigen-
antibody reaction due to a short lived condition, so the use of plasma
exchange is very effective in removing those large complexes. With
additional treatment, we can prevent more immune complexes from
forming so once the exchange is complete, the condition is most often
resolved.
Which of the following donors is eligible to donate?
A. Wife of a patient with active Hepatitis ; they are living together; last
sexual contact was 18 months ago.
B. Former prostitute; married with no high-risk behavior for 10 years
C. Male who had sex with another male 11 months ago
D. Male jailed for 7 days, 15 months ago - ANSWER>>Correct: Male jailed
for 7 days, 15 months ago
AABB standards (32nd ed):
Incarceration for more than 72 consecutive hours defers the donor for 12
months from the date of release. Because this donor was released 15
months ago, he is eligible.
A person living with an individual with active Hepatitis is deferred. There
would also be deferral for 12 months from the date of the last sexual
, contact. Once the infection is no longer present, the donor is eligible 12
months from the date the spouse's infection is deemed as no longer
present.
Potential donors who have taken money or drugs for sex since 1977 are
indefinitely deferred.
Males who have had sexual relations with other males are deferred for 12
months after the last date of sexual contact. (recently changed due to
COVID-19, however ASCP is currently using pre-pandemic donor
requirements!)
A Native American woman who is group A Positive delivered a group O Rh
positive infant. The baby was noted to be jaundiced 6 hours after birth and
had a 3+ DAT. The mother's antibody screen had been negative before
delivery and an eluate prepared from the infant's cells was also non-
reactive with a routine antibody ID panel, A1 and B cells.
Which of the following cells should be tested to possibly assist in
identification of the antibody?
A. Doa
B. Dia
C. Cha
D, Coa - ANSWER>>Correct: Dia
The clues here are as follows: You want to look for an antibody that is
capable of causing a significant HDFN.
Anti-Cha is an antibody with high titer, low avidity (HTLA) characteristics.
The antigen is not an integral part of the RBC membrane but rather is
