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1. Incorrect statement about naturally occurring antibodies: 7. Which of the following are the RBC equivalents of human leukocyte antigens
a. React best in saline (HLA)?
b.React best at room temperature or at 4OC a. Kpa, Kpb, Kpc
c. They are usually IgG b. Jsa, Jsb
d. Do not usually cross the placenta c. Doa, Dob
d. Bga, Bgb, Bgc
2. Which antibody is most likely to be involved in hemolytic disease of the newborn?
a. Anti-E 8. Which of the following does not belong to the high titer low avidity antibodies?
b. Anti-Lea a. Anti-Ch
c. Anti-M b. Anti-Yka
d.Anti-Jsa c. Anti-Co
d. Anti-JMH

3. What blood type is not possible for an offspring of AO and BO persons?

a. AB
b. A or B 9. Incorrect statement about Kell blood group:
c. O a. 90% of the population is Kell negative
d. All are possible b. Anti-K reacts best in saline at room temperature
c. Anti-K can cause hemolytic disease of the newborn
4. Nature of ABO antibodies: d. Next to Rh (D), the Kell (K) antigen is the most immunogenic
a. IgM
b. IgG and IgM 10. Adults who have the Le, Se, and H genes will exhibit which Lewis antigen on their
c. IgA red cells?
d. IgG, IgM and IgA a. Lea
b. Leb
5. Waldenström’s macroglobulinemia, multiple myeloma and increased levels of c. Lea and Leb
fibrinogen is associated with what ABO discrepancy? d. None
a. Group I
b. Group II 11. Given the following reactions, identify the cause of discrepancy:
c. Group III Cell Typing: Serum Typing:
d. Group IV Anti-A = 4+ A1 cells = 0
Anti-B = 2+ B cells = 4+
6. In which of the following blood group systems may the RBC typing change during a. Hypogammaglobulinemia
pregnancy? b. Hodgkin’s lymphoma
a. Kidd c. Cold agglutinins
b. Lewis d. Acquired B phenomenon
c. MNS
d. Kell 12. Which of the following is a contraindication for accepting a donor for
plateletpheresis?
a. 72 hours since the last apheresis
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b. Plasmapheresis of 800mL 1 week ago d. Room temperature without agitation

c. Platelet count of 100 x 109/L
d. Aspirin ingestion 7 days ago 19. Cryoprecipitated antihemophilic factor is not recommended for the treatment:
a. Hemophilia A
13. Which of the following donors could be accepted for blood donation? b. von Willebrand’s disease
a. 18-year old woman with a hematocrit value of 38% c. Hemophilia B
b. 45-year old man with a blood pressure of 180/100 d. Hypofibrinogenemia
c. 60-year old man with history of Babesiosis
d. 30-year old man who had been vaccinated for rabies 6 months ago 20. What is the purpose of adding rejuvenating solutions to RBC products?
a. To restore ATP and 2,3-DPG
14. All of the following donors can be accepted for donating blood EXCEPT: b. To stabilize RBC membrane
a. 30-year old female who had a rubella vaccination 6 weeks ago c. To prevent lysis of RBCs during storage at cold temperature
b. 20-year old male with a body temperature of 99.4OF d. To increase the harvest of WBCs
c. 50-year old man with night sweats and skin lesions
d. 45-year old woman who was a recipient of recombinant growth hormone 21. Prothrombin complex concentrates are used to treat which of the following?
a. Hemophilia A
15. A man turns pale and complains of dizziness while donating blood. What is the b. Hemophilia B
best course of action? c. Hemophilia C
a. Continue the donation d. von Willebrand’s disease
b. Withdraw the needle, raise his feet and administer ammonia spirits
c. Discontinue the donation and provide a paper bag 22. What is the purpose of adding citric acid to blood bag preservatives?
d. Tell him to sit upright and not have a reaction until the donation is finished a. To prevent coagulation
b. To restore ATP levels
16. What would be the cause of jet-like pulsating bleeding with bright red blood during c. To improve survival of red cells
blood donation? d. To prevent caramelization
a. Increased vacuum from the blood bag
b. The donor is hypertensive 23. Fresh frozen plasma stored at -65OC would have a shelf-life of:
c. Brachial artery was punctured a. 1 year
d. The donor is a chronic smoker b. 5 years
c. 7 years
17. Red blood cells stored in CPDA-2 blood bag would have a shelf-life of: d. 10 years
a. 21 days
b. 35 days 24. Each unit of cryoprecipitate prepared from whole blood should contain
c. 2 days approximately how many units of factor VIII?
d. 42 days a. 40
b. 80
18. What is the proper storage protocol for granulocyte concentrates? c. 150
a. 1-6OC d. 200
b. -18OC
c. Room temperature with agitation 25. Quality control for RBCs requires a maximum hematocrit level of:
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a. 75% c. 1, 3 and 4
b. 80% d. 1, 2, 3 and 4
c. 85%
d. 90% 32. Hepatitis B virus remains infectious on environmental surfaces for:
a. 7 days
26. Cryoprecipitate that has been thawed must be transfused within ___ hours b. 1 month
a. 6 c. 1 year
b. 8 d. 3 days
c. 4
d. 24 33. HBV is transmitted most frequently:
a. By unknown methods
27. Platelets prepared from a whole blood donation require which of the following? b. Through blood transfusion
a. A light spin followed by a heavy spin c. By needle sharing among IV drug abusers
b. Two light spins d. By sexual activity
c. A hard spin followed by a light spin
d. Two heavy spins
34. Which of the following blood-borne pathogens is destroyed under prolonged cold
28. A single unit of granulocyte concentrate should contain at least ____ WBCs temperature storage?
a. 1.0 x 109 a. Babesia microti
b. 1.0 x 1010 b. Trypanosoma cruzi
c. 3.0 x 1011 c. Treponema pallidum
d. 5.5 x 1010 d. Plasmodium falciparum

29. Which of the following antibodies is most responsible for immediate hemolytic 35. What procedure would help to distinguish between an anti-C and anti-Fy b in an
transfusion reactions? antibody mixture?
a. Anti-N a. Use a thiol reagent
b. Anti-D b. Run an enzyme panel
c. Anti-B c. Lower the pH of test serum
d. Anti-Leb d. Run a regular panel
30. When a suspected hemolytic transfusion reaction occurs, the first thing to do is:
a. Slow the transfusion rate and call the physician 36. What samples are required to perform compatibility testing?
b. Administer medication to stop the reaction a. Patient serum and donor serum
c. First inform the laboratory to begin an investigation b. Patient serum and donor cells
d. Stop the transfusion but keep the intravenous line open with saline c. Donor serum and patient cells
d. Donor cells and patient cells
31. Transfusion reactions can be caused by: 37. What is the minimum testing required for a massively transfused patient?
1. Overheated donor blood 3. Hypokalemia a. Immediate spin crossmatch or forward typing ABO
2. Bacterial contamination 4. Citrate toxicity b. ABO, Rh, crossmatch
a. 1, 2 and 4 c. ABO, forward and reverse typing
b. 2, 3 and 4 d. Antibody screen and ABO typing
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b. Screened for CMV

38. What is the major advantage of gel technology? c. Gamma-irradiated
a. No cell washing steps d. More than 7 days old
b. Specialized equipments 44. What should be done if Wharton’s jelly cannot be removed from cord cells?
c. Standardization a. Collect a heelstick sample
d. Use of IgG-coated control cells b. Wash cells with 0.6N HCl
c. Obtain another cord sample
39. The purpose of immediate spin crossmatch is: d. Test cells using saline typing reagents
a. To ensure survival of transfused RBCs
b. To determine ABO compatibility between donor and recipient 45. Cold AIHA is sometimes associated with infection by:
c. Detect cold-reacting unexpected antibodies a. Staphylococcus aureus
d. Meet computer crossmatch requirements b. Mycoplasma pneumoniae
c. Escherichia coli
40. Blood donor and recipient samples used in crossmatching must be stored for a d. Streptococcus pyogenes
minimum of how many days following transfusion?
a. 2 46. Cephalosporin given in massive doses has been associated with RBC hemolysis.
b. 5 Which of the classic mechanisms is involved in the hemolytic process?
c. 7 a. Membrane modification
d. 10 b. Drug adsorption
c. Immune complex formation
41. After the addition of IgG-coated RBCs to a negative AHG reaction during an d. Autoantibody formation
antibody screen, a negative result is observed. Which of the following is a correct
interpretation? 47. Backup copies of the information system:
a. The antibody screen is negative a. Can be used to restore the information system data and software
b. Reactive AHG reagent was added b. Are used to maintain hardware components
c. The saline washings were adequate c. Are performed once a month
d. AHG reagent was neutralized d. Are created any time changes are made to the system

48. User passwords should be:

a. Shared with others
b. Never changed
42. RBCs must be washed in saline at least three times before the addition of AHG c. Kept confidential
reagent to: d. Posted at each terminal
a. Wash away any hemolyzed cells
b. Neutralize any excess AHG reagent 49. All of the following items should be checked quarterly EXCEPT:
c. Increase the antibody binding to antigen a. Cell washers
d. Remove traces of free serum globulins b. Centrifuge timers
c. Blood warmers
43. Blood for intrauterine transfusion should be all of the following EXCEPT: d. Platelet incubators
a. Compatible with maternal serum
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50. What is the principle involved in the gel technology? b. B lymphocytes

a. Hemadsorption c. T lymphocytes
b. Hemagglutination-inhibition d. Phagocytes
c. Hemagglutination
d. Precipitation 57. T cells are involved in:
51. Which of these match(es) is(are) correct? a. Humoral immunity
1. Karl Landsteiner – ABO blood group 3. Rosalyn Yallow - ELISA b. Wheal and flare reaction
2. Elie Metchnikoff – Phagocytosis 4. Jules Bordet – Complement fixation c. Cell-mediated immunity
a. 1, 2 and 3 d. Antibody production
b. 1, 2 and 4
c. 2, 3 and 4 58. What is the major component of natural humoral immunity?
d. 1, 2, 3 and 4 a. Immunoglobulins
b. Complement
52. When was T cell receptor gene discovered? c. B cells
a. 1979 d. Cytokines
b. 1987 59. Interferon can be produced by which of the following?
c. 1984 1. Macrophages 3. Virus-infected cells
d. 1981 2. T lymphocytes 4. All of these
a. 1 and 2 c. 2 and 3
53. Cytokine produced mainly by macrophages: b. 1 and 3 d. 4
a. IL-1
b. IL-2 60. Which of the following IgG subclasses does not cross the placenta?
c. IL-6 a. IgG1
d. IL-12 b. IgG2
c. IgG3
54. It is a non-specific indicator of inflammation believed to be an antibody to the C- d. IgG4
polysaccharide of pneumococci:
a. Alpha1-antitrypsin 61. What is the major amino acid component of the hinge region of an immunoglobulin
b. C-reactive protein molecule?
c. Serum amyloid A a. Lysine
d. Ceruloplasmin b. Glutamine
c. Proline
55. Acquired immunodeficiency syndrome (AIDS) shows a change in the ratio of: d. Tryptophan
a. T/B cells
b. B1/B2 cells 62. What region determines the immunoglobulin class?
c. Albumin/Globulin a. Fc
d. CD4+/CD8+ cells b. CH
c. VL
56. Hybridomas are formed from: d. CL
a. Antibodies
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63. Marker for NK cells: d. Chromosome 17

a. CD19
b. CD45 70. For an antibody-coated antigen to be phagocytized, what part of the antibody
c. CD34 molecule fits into a receptor on the phagocytic cell?
d. CD56 a. Fab region
b. Hinge region
64. How are cytotoxic T cells and NK cells similar? c. Variable region
a. Effective against virally infected cells d. Fc region
b. Recognize antigen in association with HLA Class II markers
c. Do not bind to infected cells 71. These are substances added to a vaccine to enhance the immune response:
d. Require antibody to be present a. Haptens
b. Mitogens
65. Which immunology cross-links mast cells to release histamine? c. Adjuvants
a. IgG d. Immunogens
b. IgM
c. IgE 72. The alternative pathway of the complement cascade is initiated by:
d. IgA 1. IgG and IgM 3. Yeast cell wall 5. Lipopolysaccharides
2. Aggregates of IgA 4. Mannose group 6. Cobra venom factor
66. Humoral immunity is due to: a. 1, 2 and 3
a. Macrophage activity b. 2, 3, 5 and 6
b. Suppressor T lymphocytes c. 3, 4, 5 and 6
c. B lymphocytes that transform into plasma cells d. 1, 2, 3 and 5
d. Lymphokines
73. Deficiency of C3 complement component is associated with:
67. The predominant antibody in an anamnestic response is: a. Paroxysmal nocturnal hemoglobinuria
a. IgG b. Hereditary angioneurotic edema
b. IgM c. Gonococcal or meningococcal infection
c. IgA d. Severe recurrent bacterial infection
d. IgD
74. Fetus in a mother’s womb is considered a(n):
68. The binding strength of an antibody for an antigen is referred to as its: a. Allograft
a. Specificity b. Autograft
b. Affinity c. Heterograft
c. Avidity d. Syngeneic graft
d. Titer
75. HLA-B27 is most commonly associated with:
69. The HLA complex is located primarily on: a. Systemic lupus erythematosus
a. Chromosome 3 b. Rheumatoid arthritis
b. Chromosome 6 c. Ankylosing spondylitis
c. Chromosome 9 d. Graves’ disease
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d. Neither
76. If the interval between heating the serum for the VDRL test and testing exceeds
4 hours, the serum should be reheated at: 82. What is the first antibody to be produced in a patient with hepatitis B virus
a. 37OC for 30 minutes infection?
b. 37OC for 10 minutes a. Anti-HBs
c. 56OC for 30 minutes b. Total anti-HBc
d. 56OC for 10 minutes c. IgM anti-HBc
d. Anti-HBe

83. What is the first antibody to be produced in a patient with HIV infection?
a. Antibody to p24
77. Patients with syphilis develop an antibody response to a substance known as: b. Antibody to gp41
a. Reagin c. Antibody to gp120
b. Complement d. Antibody to p15
c. Cardiolipin
d. Hemolysin 84. Among the following congenital infections, which one is the most common?
a. Congenital syphilis
78. The fluorescein-antihuman gamma globulin used in the FTA-ABS test: b. Rubella infection
a. Makes the antigen-antibody reaction visible c. Cytomegalovirus infection
b. Is added to the serum before the antigen is added d. Herpes virus infection
c. Is added to the antigen before the serum is added
d. Makes the antibody visible

79. The reactions on DNA-methyl green substrates when testing for the presence of 85. In the exoantigen test for Histoplasma capsulatum, which bands are present in a
anti-DNase are: positive result?
a. (+) Blue, (-) Yellow a. A
b. (+) Red, (-) Orange b. H and/or M
c. (+) Green, (-) Colorless c. 1, 2, 3
d. (+) Purple, (-) Yellow d. HS, HL, F

80. The Widal and Weil-Felix reactions are examples of techniques to detect: 86. If only anti-HBs is positive, which of the following can be ruled out?
a. Heterophil antibodies a. HBV vaccination
b. Febrile agglutinins b. Distant past infection with HBV
c. Reagin c. HBIG injection
d. Forssman antigen d. Chronic HBV infection

81. Forssman antibodies are adsorbed by: 87. This test will detect parasitic lactate dehydrogenase enzyme present in malarial
a. Beef erythrocytes organisms:
b. Guinea pig kidney cells a. Optimal
c. Both b. Malaquick
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c. Monospot b. 1, 2 and 3
d. Streptozyme c. 3 and 4
d. 1, 2 and 4
88. Which is most likely a positive Western blot result for infection with HIV?
a. Band at p24 94. Not true regarding hCG:
b. Bands at gp160 a. Beta subunit confers immunogenic specificity
c. Bands at p24 and p31 b. Used to confirm pregnancy
d. Band at p24 and gp120 c. Used as a tumor marker
d. Found in hepatoma
89. Which disease might be indicated by antibodies to smooth muscle?
a. Myasthenia gravis 95. What immune elements are involved in a reaction to poison ivy?
b. Primary biliary cirrhosis a. IgE antibodies
c. Chronic active hepatitis b. NK cells and IgG antibody
d. Hashimoto’s thyroiditis c. B cells and IgM antibody
d. T cells and macrophages
90. Which immunofluorescent pattern indicates the need for further testing by
Ouchterlony double diffusion? 96. Needles used to deliver VDRL antigen should be checked:
a. Solid a. Monthly
b. Mottled b. Bimonthly
c. Rim c. Daily or every time tests are performed
d. Nucleolar d. Weekly

91. What disease is indicated by a high titer of anti-centromere antibodies? 97. When preparing monoclonal antibodies:
a. Scleroderma a. Inject an animal with an antigen
b. Sclerodactyly b. Fuse B lymphocytes with a malignant cell
c. MCTD c. Remove the B lymphocytes
d. SLE d. All of the above

92. Which of the following is a sialylated Lewis blood group antigen associated with 98. The air temperature throughout the serology laboratory is 20OC. How will this
colorectal carcinoma? affect RPR test result?
a. CA 19-9 a. No effect – the acceptable test range is 20-24OC
b. CEA b. Weaken reactions so that false negatives occur
c. CA 549 c. Strengthen reactions so that positive titers appear elevated
d. CA 15-3 d. Increase the number of false positives from spontaneous clumping

99. A device used to measure radioactivity in radioimmunoassay:

93. Associated with increased serum alpha1-fetoprotein level: a. Spectrophotometer
1. Testicular cancer 3. Pancreatic carcinoma b. Scintillation counter
2. Hepatocellular carcinoma 4. Prostatic carcinoma c. Fluorometer
a. 1 and 2 d. None of these
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28. B
100. Most commonly used label in ELISA: 29. C
a. HRP 30. D
b. FITC 31. A
c. Tritiated hydrogen 32. A
d. G6PD 33. D
34. C
35. B
36. B
ANSWER KEY: ISBB 37. A
38. C
39. B
40. C
1. C 41. D
2. A 42. D
3. D 43. D
4. D 44. A
5. C 45. B
6. B 46. A
7. D 47. A
8. C 48. C
9. B 49. D
10. B 50. C
11. D 51. B
12. C 52. C
13. A 53. A
14. C 54. B
15. B 55. D
16. C 56. B
17. D 57. C
18. D 58. B
19. C 59. D
20. A 60. B
21. B 61. C
22. D 62. B
23. C 63. D
24. B 64. A
25. B 65. C
26. A 66. C
27. A 67. A
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68. C
69. B
70. D
71. C
72. B
73. D
74. A
75. C
76. D
77. C
78. A
79. C
80. B
81. B
82. C
83. A
84. C
85. B
86. D
87. A
88. D
89. C
90. B
91. B
92. A
93. B
94. D
95. D
96. C
97. B
98. B
99. B
100. A