SBB Final Exam with 100% Correct Answers Latest | Q & A.

SBB Final Exam with 100% Correct Answers Latest | Q & A. 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 - correct 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 - correct 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. SBB Final Exam with 100% Correct Answers Latest | Q & A 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 - correct 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 antiD. 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 - correct 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 - correct 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 formed in the fluids and adsorbs onto the RBC. The antibody has weak reactivity and a low binding ability. The antigens are not fully developed at birth and the antibody is weak and not capable of causing HDFN. So you can rule out that antibody right away. In addition, you would likely see weaker reactions at AHG in the mom's serum tested with the antibody panel, and the infant DAT would be negative. Doa is an antigen that is expressed as a part of the RBC membrane, Anti-Doa can cause HTR, but does not typically cause HDFN. The antigen is present on about 65% of individuals from Northern European descent, so again, the antibody would likely react in a routine antibody ID panel.