UAMS Blood Bank Exam #1 UPDATED
ACTUAL Questions and CORRECT
Answers
Confirming patient ID - CORRECT ANSWER - What is the most important step when
drawing blood on a patient?
The study of blood group antigens and antibodies to successfully provide safe and effective
blood components for treatment. - CORRECT ANSWER - What is the study of Blood
Bank/Immunohematology and what is the main purpose?
The transfused cells or plasma survive to supplement what the patient is lacking. Examples: O2
for chronic anemia, volume for acute blood loss, platelets or FFP for cryoprecipitate. ABO
typing is essential because red cells do no good in a transfusion if they are destroyed by the
recipient's immune system. - CORRECT ANSWER - What is the main point to a blood
transfusion?
Protecting the body from disease and foreign invaders. The body must recognize foreign and non
self antigens. Antibodies are produced against these to cause their destruction. Transfused RBCs
can also be destroyed if they carry non-self antigens. - CORRECT ANSWER - What is
immunology the process of?
The cell membrane is destroyed by the complement instead of the antibody inside the blood
vessel. These AGNs are associated with IgM, because it can fix the complement and activate the
membrane attack complex.
Intravascular hemolysis causes immediate problems. Cells are destroyed and the kidneys are
damaged by RBC fragments. Intravascular is much more serious than extravascular. -
CORRECT ANSWER - What is intravascular hemolysis in blood banking?
AGNs are coated with IgG; ABY is attached to cell membrane. Complex is removed by the
spleen. Examples include delayed transfusion reactions and hemolytic disease of the newborn.
Less severe than intravascular hemolysis. - CORRECT ANSWER - What is extravascular
hemolysis?
,Humoral - ABY or B cell mediated; involves the production of ABYs by B lymphocytes that are
converted to plasma cells. Macrophages ingest and process foreign AGN, which reacts with T
cells to stimulate B cell transformation. Consists of fluid; found in plasma, saliva, and other
bodily secretions. Once a cell is coated with ABY, it is destroyed by phagocytosis, complement,
or spleen.
Cellular - T cell mediated; Involves the direct interaction of T lymphs with foreign cells; T cells
produce a variety of substances such as chemotactic factors and mediators of inflammation, CD4
helper cells to transform B cells into plasma cells, CD8 suppressor cells to suppress ABY
formation to auto AGNs, and natural killer cells to cause death by lysis. Macrophages, T cells,
and dendritic cells; involves the production of cytokines and chemokines with cellular activation.
Examples include delayed hypersensitivity and transplant immuno - CORRECT
ANSWER - What are the 2 types of immune responses?
Lyses ABY coated cells and serves to mediate opsonization to prepare for phagocytosis by
neutrophils and macrophages. C1. C3b. C5-9. - CORRECT ANSWER - What does the
complement do? What is the recognition unit? What attaches to the RBC membrane and can be
an indicator that the complement has been activated? What is the membrane attack complex?
Substances capable of inducing a specific immune response, composed of protein, carb, or lipid.
Usually bound to RBCs. AGNs can stick out from the surface of the cell or be an integral part of
the cell membrane. Those that stick out tend to be more antigenic. ABO and Rh. - CORRECT
ANSWER - What are AGNs or immunogens? What are they composed of? What are they
usually bound to? Where are AGNs located on a cell? What are the most antigenic and what are
examples?
Epitope, also referred to as the antigenic determinant. This needs to be a good fit for binding
purposes. Through injection, inhalation, or ingestion. - CORRECT ANSWER - What is
the portion of the AGN where the ABY combines? What does this need to be? How can an AGN
be acquired?
Avidity. Affinity of ABY, valency, and non-covalent attractive forces. - CORRECT
ANSWER - What is the overall strength of reaction between several epitopes and ABYs.
What is this dependent upon?
, Proteins synthesized by plasma cells. They are produced following direct interaction of an AGN
with a macrophage. Macrophage bound AGNs interact with T cells that induce T cell
transformation and plasma cell / B cell activation. Plasma cells produce ABYs that then combine
with the AGNs that stimulated the ABY production. - CORRECT ANSWER - What are
ABYs or immunoglobulins? How and when are they produced?
Alloantibody - ABY to foreign substance
Autoantibody - ABY to self - CORRECT ANSWER - What are the different types of
ABYs?
2 polypeptide chains - one heavy and one light joined by a disulfide bond. Heavy chains - Mu
(IgM) and gamma (IgG). A monomer is formed with 2 identical halves. ABYs are classified
based on heavy chain composition.
Light chains - kappa and lambda
Heavy chain, light chain, Fab portion (binds to the epitope), Fc portion (binding site for
complement and macrophage Fc receptors), Hinge region (allows flexibility for immunoglobulin
to attach to AGN), and enzyme cleavage (enzymes pepsin and papain split ABY at hinge region
resulting in one Fc and two Fabs) - CORRECT ANSWER - What is the structure of an
immunoglobulin relating to their classification? What is the overall immunoglobulin structure?
IgG and IgM.
IgG - gamma heavy chain, 1 monomer, can cross the placenta, warm ABY (37C), seen with
secondary immune response, can sometimes fix the complement, is not naturally occurring (can
only be built after previous exposure by blood transfusion or pregnancy), requires an enhancer to
form visible agglutination lattice, and has 2 AGN binding sites.
IgM - mu heavy chain, 5 monomers, cannot cross the placenta, cold ABY (4-25C), seen with
primary immune response, can always fixes complement, naturally occurring, does not need an
enhancer to form visible lattice, and 10 AGN binding sites.
IgG because it can cross the placenta - CORRECT ANSWER - What are the 2 classes of
ABY found in Blood Bank? What are the characteristics of each? Which is associated with
hemolytic disease of the newborn?
ACTUAL Questions and CORRECT
Answers
Confirming patient ID - CORRECT ANSWER - What is the most important step when
drawing blood on a patient?
The study of blood group antigens and antibodies to successfully provide safe and effective
blood components for treatment. - CORRECT ANSWER - What is the study of Blood
Bank/Immunohematology and what is the main purpose?
The transfused cells or plasma survive to supplement what the patient is lacking. Examples: O2
for chronic anemia, volume for acute blood loss, platelets or FFP for cryoprecipitate. ABO
typing is essential because red cells do no good in a transfusion if they are destroyed by the
recipient's immune system. - CORRECT ANSWER - What is the main point to a blood
transfusion?
Protecting the body from disease and foreign invaders. The body must recognize foreign and non
self antigens. Antibodies are produced against these to cause their destruction. Transfused RBCs
can also be destroyed if they carry non-self antigens. - CORRECT ANSWER - What is
immunology the process of?
The cell membrane is destroyed by the complement instead of the antibody inside the blood
vessel. These AGNs are associated with IgM, because it can fix the complement and activate the
membrane attack complex.
Intravascular hemolysis causes immediate problems. Cells are destroyed and the kidneys are
damaged by RBC fragments. Intravascular is much more serious than extravascular. -
CORRECT ANSWER - What is intravascular hemolysis in blood banking?
AGNs are coated with IgG; ABY is attached to cell membrane. Complex is removed by the
spleen. Examples include delayed transfusion reactions and hemolytic disease of the newborn.
Less severe than intravascular hemolysis. - CORRECT ANSWER - What is extravascular
hemolysis?
,Humoral - ABY or B cell mediated; involves the production of ABYs by B lymphocytes that are
converted to plasma cells. Macrophages ingest and process foreign AGN, which reacts with T
cells to stimulate B cell transformation. Consists of fluid; found in plasma, saliva, and other
bodily secretions. Once a cell is coated with ABY, it is destroyed by phagocytosis, complement,
or spleen.
Cellular - T cell mediated; Involves the direct interaction of T lymphs with foreign cells; T cells
produce a variety of substances such as chemotactic factors and mediators of inflammation, CD4
helper cells to transform B cells into plasma cells, CD8 suppressor cells to suppress ABY
formation to auto AGNs, and natural killer cells to cause death by lysis. Macrophages, T cells,
and dendritic cells; involves the production of cytokines and chemokines with cellular activation.
Examples include delayed hypersensitivity and transplant immuno - CORRECT
ANSWER - What are the 2 types of immune responses?
Lyses ABY coated cells and serves to mediate opsonization to prepare for phagocytosis by
neutrophils and macrophages. C1. C3b. C5-9. - CORRECT ANSWER - What does the
complement do? What is the recognition unit? What attaches to the RBC membrane and can be
an indicator that the complement has been activated? What is the membrane attack complex?
Substances capable of inducing a specific immune response, composed of protein, carb, or lipid.
Usually bound to RBCs. AGNs can stick out from the surface of the cell or be an integral part of
the cell membrane. Those that stick out tend to be more antigenic. ABO and Rh. - CORRECT
ANSWER - What are AGNs or immunogens? What are they composed of? What are they
usually bound to? Where are AGNs located on a cell? What are the most antigenic and what are
examples?
Epitope, also referred to as the antigenic determinant. This needs to be a good fit for binding
purposes. Through injection, inhalation, or ingestion. - CORRECT ANSWER - What is
the portion of the AGN where the ABY combines? What does this need to be? How can an AGN
be acquired?
Avidity. Affinity of ABY, valency, and non-covalent attractive forces. - CORRECT
ANSWER - What is the overall strength of reaction between several epitopes and ABYs.
What is this dependent upon?
, Proteins synthesized by plasma cells. They are produced following direct interaction of an AGN
with a macrophage. Macrophage bound AGNs interact with T cells that induce T cell
transformation and plasma cell / B cell activation. Plasma cells produce ABYs that then combine
with the AGNs that stimulated the ABY production. - CORRECT ANSWER - What are
ABYs or immunoglobulins? How and when are they produced?
Alloantibody - ABY to foreign substance
Autoantibody - ABY to self - CORRECT ANSWER - What are the different types of
ABYs?
2 polypeptide chains - one heavy and one light joined by a disulfide bond. Heavy chains - Mu
(IgM) and gamma (IgG). A monomer is formed with 2 identical halves. ABYs are classified
based on heavy chain composition.
Light chains - kappa and lambda
Heavy chain, light chain, Fab portion (binds to the epitope), Fc portion (binding site for
complement and macrophage Fc receptors), Hinge region (allows flexibility for immunoglobulin
to attach to AGN), and enzyme cleavage (enzymes pepsin and papain split ABY at hinge region
resulting in one Fc and two Fabs) - CORRECT ANSWER - What is the structure of an
immunoglobulin relating to their classification? What is the overall immunoglobulin structure?
IgG and IgM.
IgG - gamma heavy chain, 1 monomer, can cross the placenta, warm ABY (37C), seen with
secondary immune response, can sometimes fix the complement, is not naturally occurring (can
only be built after previous exposure by blood transfusion or pregnancy), requires an enhancer to
form visible agglutination lattice, and has 2 AGN binding sites.
IgM - mu heavy chain, 5 monomers, cannot cross the placenta, cold ABY (4-25C), seen with
primary immune response, can always fixes complement, naturally occurring, does not need an
enhancer to form visible lattice, and 10 AGN binding sites.
IgG because it can cross the placenta - CORRECT ANSWER - What are the 2 classes of
ABY found in Blood Bank? What are the characteristics of each? Which is associated with
hemolytic disease of the newborn?
