IMMUNOLOGY AND HEMATOLOGY MIDTERM 2024-2025

1. Which of the following Rh antigens is the most Immunogenic?

a. c
b. D
c. e
d. C
2. The following are the results of typing with Rh antisera: anti-D (+), anti-C (+), anti-E(+)
anti-c(-), anti-e(-). What is the phenotype?
a. Ro
b. R1
c. r^y
d. Rz
3. Which of these characterizes the reaction of Rh negative phenotype?
a. Negative to both anti-D and weak D test
b. Negative to anti-D test
c. Negative to anti-D, positive to weak D test
d. Positive to weak D test
4. The Rh genes occupy a locus on:
a. Chromosome 1
b. Chromosome 5
c. Chromosome 6
d. Chromosome 9
5. Blood typing for the ABO system and one of the following is necessary for blood
transfusion:
a. Bombay
b. MNS
c. P
d. Rh
6. If a D-positive person makes an anti-D, this person is probably:
a. D-negative
b. Partial D
c. Weak D as position effect
d. Weak D due to transmissible genes
7. The weak D phenotype is considered:
a. Rh positive
b. Rh negative
c. Either of these
d. Neither of these
8. How many genes encode the following Rh antigens: D. C, E, c, e?
a. One
b. Two
c. Three
d. Four
9. Individuals who do not have the Rh (D) factor are classified as:
a. Rhnull
b. Du
c. Rh negative
 d. Rh positive
10. The anti-rhesus produced in laboratory animals by Landsteiner and Weiner defined a
new antigen system called:
a. LW
b. Lewis
c. Rh
d. Kidd
11. If a group DCe/dce man marries a dce/dce woman. What percentage of their offspring
can be expected to be D-negative?
a. 25%
b. 50%
c. 75%
d. 100%
12. …. of the Rh system are the following EXCEPT:
a. Anti-C
b. Anti- c
c. Anti- d (wala man diba small d sa Rh)
d. Anti-E
13. The weak D may be created when the D gene is:
a. Absent on both chromosomes
b. Inherited from only one parent
c. In trans position to the C gene
d. Present on both chromosomes
14. What is the function of Rh immunoglobulin (RhIg) in a Rh-negative pregnant woman?
a. It stimulates the production of the Rh antigen
b. It helps prevent the formation of antibodies against Rh-positive blood cells
c. It treats hemolytic disease of the newborn
d. It improves the mother's blood clotting ability
15. An Rh-negative person can develop antibodies against Rh-positive blood if:
a. They receive an Rh-negative blood
transfusion
b. They receive an Rh-positive blood
transfusion
c. They are exposed to the A antigen
d. They are exposed to the O antigen
16. Which of the following scenarios is most likely
to cause hemolytic disease of the new born (HDN)?
a. An Rh(+) mother carrying an Rh(-) baby
b. An Rh(-) mother carrying an Rh(+) baby
c. An Rh(-) mother carrying an Rh(-) baby
d. An Rh(+) mother carrying an AB(+) baby
17. What is the potential outcome for a second pregnancy of an Rh-negative woman who
has not received Rhig after her first Rh-positive pregnancy?
a. No effect
b. Risk of hemolytic disease of the newborn (HDN)
c. Increased risk of miscarriage
d. Increased risk of high blood pressure
18. Which of the following antigens is part of the Lewis blood group system
 a. A antigen
b. B antigen
c. Le^a and Le^bantigens
d. Rh antigen
19. The Lewis blood group antigens are primarily found on which cells?
a. Red blood cells
b. White blood cells
c. Platelets
d. Epithelial cells
20. Which antigen in the Lewis blood group system is found on the majority of red blood
cells?
a. Le^a
b. Le^b
c. A antigen
d. D antigen
21. The presence of the Le^b antigen requires the presence of which of the following
factors?
a. The Le gene and the Se gene
b. The Le gene and the Rh gene
c. The Se gene and the ABO gene
d. The Le gene alone
22. What is the most likely consequence if an individual with anti-Le^a antibodies receives a
blood transfusion with Le^a positive blood?
a. There would be no reaction.
b. A hemolytic transfusion reaction could occur.
c. Severe hemolysis would occur immediately.
d. A severe allergic reaction would occur.
23. If a person has the genetic makeup Hh, AO, LeLe, sese, what substance will be found in
the secretions?
a. A substance
b. H substance
c. Le^asubstance
d. Le^b substance
24. Which antigen is primarily associated with the P blood group system?
a. P1 antigen
b. P antigen
c. Pk antigen
d. P1 and Pk antigens
25. Which of the following individuals would most likely have the P1 antigen on their red
blood cells?
a. Individuals with blood group O
b. Individuals with blood group AB
c. Individuals who are heterozygous for P1
d. Individuals who lack P1 antigen entirely
26. The P1 antigen is most commonly found in which population group?
a. People of Asian descent
b. People of European descent
c. People of African descent
 d. People of Native American descent
27. P antigens are found on the surface of red blood cells as well as in which other bodily
fluid?
a. Urine
b. Saliva
c. Plasma
d. Cerebrospinal fluid
28. Autoanti-P is associated with which of the following?
a. Infectious mononucleosis
b. Paroxysmal cold hemoglobinuria
c. Cold agglutinins
d. Hemolytic disease of the newborn
29. The l antigen is present on red blood cells in which of the following states?
a. In most adults
b. Only in children
c. In people with rare genetic conditions
d. Only in individuals with Rh-negative blood
30. The i antigen in the I blood group system is considered to be a precursor of which
antigen?
a. A antigen
b. B antigen
c. D antigen
d. I antigen
31. Which of the following is true about the l blood group system in infants and young
children?
a. The l antigen is fully developed at birth
b. The l antigen is expressed weakly at birth and becomes more prominent with age
c. The I antigen is absent in early childhood but develops later
d. The l antigen is present at birth but decreases with age
32. Which of the following conditions can lead to the production of cold agglutinins (anti-l
antibodies)?
a. Mycoplasma pneumonia
b. Hepatitis B
c. Influenza
d. Tuberculosis
33. Which of the following factors is known to affect the expression of the I antigen on red
blood cells?
a. Age
b. Blood group type (A, B, AB, or O)
c. Rh factor
d. The presence of blood transfusions
34. Which of the following statements best describes the role of anti-i antibodies in cold
agglutinin disease?
a. Anti-I antibodies bind to red blood cells at lower temperatures, leading to
agglutination and hemolysis
b. Ant-I antibodies enhance the function of the immune system to fight infections.
c. Anti-I antibodies cause clotting of red blood cells in the veins.
d. Anti-I antibodies are produced during pregnancy and have no clinical effect
35. Which of the following antigens are part of the MNS blood group system?
a. M, N. S, and s
b. A, B. O. and Rh
c. Lea, Leb, P1, and P
d. M. N. S, and Rh
36. The M and N antigens in the MNS blood group system are located on?
a. Glycoproteins on red blood cell membranes
b. Lipid molecules on red blood cells
c. Nucleic acids on red blood cells
d. Platelet membranes
37. Which of the following is true about the inheritance of MNS blood group antigens?
a. The M and N antigens are inherited as a single genetic locus with two alleles.
b. The S and & antigens are inherited independently of the M and N antigens.
c. A MNS blood group antigens are inherited in a co-dominant fashion.
d. M and N antigens are always inherited together.
38. The S and s antigens in the MNS system are located on which type of glycoprotein?
a. Glycophorin A
b. Glycophorin B
c. Rh glycophorin
d. Blood group A glycophorin
39. Individuals with the genotype MN will express which of the following antigens?
a. Only M antigen
b. Only N antigen
c. Both M and N antigens
d. Neither M nor N antigen
40. The MNS blood group system has been studied in relation to susceptibility to which of
the following diseases?
a. Autoimmune hemolytic anomia (AIHA)
b. Malaria
c. Hypertension
d. Asthma
41. Which antigen is the most clinically significant in the Kell blood group system?
a. K antigen
b. k antigen
c. Kx antigen
d. K3 antigen
42. Anti-K antibodies are most commonly associated with which of the following conditions?
a. Hemolytic disease of the newborn (HDN)
b. Transfusion reactions
c. Autoimmune hemolytic anemia
d. All of the above
43. What is the primary clinical consequence of a deficiency in the Kx antigen (as seen in
McLeod syndrome)?
a. Increased risk of transfusion reactions
b. Hemolytic disease of the newborn
c. Muscular weakness and neurological defects
d. Increased susceptiblity to infections
44. What is the clinical significance of the Duffy blood group system?
 a. It plays a significant role in the susceptibility to malaria
b. It is primarily associated with hemolytic disease of the newbom.
c. It has no clinical significance in blood transfusions.
d. It causes clotting disorders in affected individuals.
45. Individuals with the Fy(a-b-) phenotype are most commonly found in which population?
a. They have increased susceptibility to Plasmodium vivax malaria.
b. They are immune to infection by Plasmodium vivax malaria.
c. They are immune to all types of malaria.
d. They have a higher risk of hemolytic transfusion reactions.
46. Which of the following antigens are part of the Kidd blood group system?
a. Jka and Jkb
b. K and k
c. Fya and Fyb
d. Lea and Lab
47. Wrich of the following antibodies is most commonly associated with the Kidd blood group
system
a. Anti- Jka
b. Anti-Fya
c. Anti- K
d. Anti-D
48. Which of the following phenotypes is most likely to show stronger reaction to anti-jka
antibodies in a blood test?
a. Jk(a+b-)
b. Jk(a+b+)
c. Jk(a-b+)
d. Jk(a-b-)
49. Which of the following antigens are part of the Lutheran blood group system?
a. Lua and Lub
b. Lea and Leb
c. Jka and Jkb
d. K and k
50. Anti-Lua antibodies are known to cause which following?
a. Hemolytic disease of the newborn (HDN)
b. Transfusion reactions
c. No clinical significance
d. Chronic autoimmune hemolytic anemia