Blood bank exam simulator

Which of the following is the proper storage temperature for fresh frozen plasma (FFP)?

- 20 degrees Celsius

A unit of red blood cells that was collected on 15 June 2009 and frozen with glycerol at -80° C on 20 June 2009 will expire on what date?

15 June 2019; 10 years from collecting date.

Acute blood loss of

20% or less, in many cases, doesn't cause clinical symptoms at rest.

How soon must granulocyte concentrates be administered after donation?

24 hours

Antibody identification interpretations would be considered correct 95% of the time or have a P value of 0.05 (5% probability that the result is due to chance) if you have:

3 positive reactions to rule in an antibody and 3 negative reactions to rule out an antibody

What is the expected life span of a normal red blood cell?

3-4 months; 120 days

Severe blood loss causing circulatory collapse and shock usually first occurs when what percentage of blood is lost?

30 to 40%

The mean average life span of an RBC in premature infants isa

35 to 50 days.

he recommended interval between removing the RBC unit from refrigeration and placing the glycerolized cells in the freezer should not exceed

4 hours

If an average-weight adult male patient with a 7 g/dL hemoglobin is given two units of packed cells, what would be the approximate new hemoglobin value (assuming there is no active bleeding or other predisposing factors that would shorten the survival of the blood cells)?

9.0 g/dL

The direct antiglobulin test (DAT) detects .

antibodies coating RBCs. -In transfusion reactions, It detects recipient antibody coating donor RBCs -In autoimmune hemolytic anemia, the IT detects autoantibody coating an individual's RBCs. -In hemolytic disease of the newborn, IT detects maternal antibody coating fetal red cells.

The life span of RBCs in fetuses is

between 60 and 70 days.

Digestion with urea and mercaptoethanol will

remove all disulfide bonds leaving free units of light and heavy chains

The S antigen has an antithetical relationship with

s antigen.

Alloantibodies are primarily detected in the

serum

Which antibodies which can be destroyed or weakened by enzyme treated panels

the MNS group (though S can be variable), Duffy, and Xga.

Which of the following immunoglobulins are capable of fixing complement by the classical pathway?

IgG and IgM IgA can fix complement via the alternative pathway. IgD is not able to fix complement.

The O antigen is recessive to

A and B antigens -A person must inherit the O antigen in the homozygous form, OO, in order to demonstrate it phenotypically.

A patient is group AB with one copy of the Se gene. What antigens will they have in their secretions?

A, B, & H

The serum of which of the following individuals may agglutinate group A1 cells?

A2 individual An A1B or an A1 individual would not be expected to produce anti-A1. A newborn would not typically have yet formed any naturally occurring ABO antibodies.

Which of the following is the most important factor in determining the immediate outcomes of kidney transplants?

ABO compatibility

When preparing platelet concentrates from whole blood, after the second spin and excess plasma has been expressed from the platelets, what is the next step in platelet preparation?

Allow the platelets to rest for 1-2 hours at 20-24°C.

Which is in the correct order from the lowest concentration of H antigen to the highest concentration of H antigen?

Bombay, A1B, A1, A2B, B, A2, O

Persons who have received a dura mater transplant are not eligible to donate blood and are permanently deferred. This is due to an increased risk of which of the following?

CJD or vCJD

In the ABO blood group system, the A antigen is inherited in what relation to the B antigen?

Codominant -meaning that a person who inherits the A antigen from one parent and the B antigen from the other will demonstrate both the A and B antigens.

Which one of the following tests BEST correlates with the severity of hemolytic disease of the fetus and newborn (HDFN)?

Color Doppler ultrasonography -determine the severity of fetal anemia. Before the development of this technology, the severity of HDFN was measured by amniocentesis.

A D-positive mother with a D-negative fetus eliminates the possibility of HDFN due to the:

D antigen

A Rh negative individual has produced an anti-D antibody. Which situation has the ability to stimulate this production of anti-D?

Delivering a Rh positive baby.

The use of the direct antiglobulin test is indicated in all the following EXCEPT:

Detection of alloantibodies in serum

For which of these reasons would a molecular method not be used?

Donor antibody screening

The major crossmatch is performed using:

Donor's red cells and recipient's serum or plasma

In which of the following cases should Rh Immune Globulin (RhIG) be given?

Ectopic pregnancy

When testing for the quality of platelet concentrates, all of the following must be included EXCEPT? pH Platelet count Bacterial detection Gas production

Gas production

Splenomegaly, or an enlarged spleen, may be found in

Gaucher's disease or in polycythemia vera.

Many red blood cell (RBC) processes, such as binding, transporting, and releasing oxygen, do NOT require energy. Energy however, is required for cellular viability. How does the RBC obtain most of it's energy?

Glycolytic pathways

Antibodies to which of the following blood components is the most frequent cause of febrile nonhemolytic transfusion reactions?

Granulocytes

What section of an immunoglobulin molecule is responsible for the differences between immunoglobulin classes?

Heavy chains

What should be done if all forward and reverse ABO results are NEGATIVE?

Incubate at room temperature or 4°C to enhance weak expression.

Which of the following activities would require that a label be added to the blood label indicating the name and location of a second manufacturer?

Irradiating a unit of red cells or platelets

An 82-year-old male is a long-time resident of a local nursing facility. He has been to your hospital multiple times over the years and has historically demonstrated antibodies against the K and Fya antigens. He has returned to your hospital following a 2-year absence, and his antibody screen is as follows. Which of the following red blood cells would you crossmatch for this patient?

K negative; Fya negative Any patient with a history of unexpected clinically significant antibodies requires antigen-negative units, even if the corresponding antibodies are not currently reacting in routine testing.

Which antibodies show no effect from enzyme treatment.

Kell and Lutheran

Almost all individuals possess which Lutheran antigen profile?

Lu(a-b+)

The Lu6 antigen has an antithetical relationship with

Lu9.

In HDFN which of the following antigen-antibody reactions is occurring?

Maternal antibody is directed against fetal antigen.

Compared to the primary immune response, the secondary immune response typically demonstrates:

More antibodies produced

Which of the following situations warrants postpartum administration of Rh immune globulin (RhIg)?

Mother: D negative; Cord: D positive

In immunohematology, an antithetical relationship exists between M antigen and which of these antigens?

N antigen

Both the A and B antigens are inherited in a dominant fashion over the

O antigen

A pregnant female has been injected with Rh Immune Globulin (RhIG) antenatally (28 weeks gestation) and has a positive antibody screen at delivery. The antibody has been confirmed as anti-D alone and reacts only weakly (1+ in the indirect antiglobulin test). This antibody may be the result of:

Passive anti-D (RhIg) received at 28 weeks.

What should be done FIRST if a donor unit of red blood cells is found to be incompatible at the antiglobulin phase but compatible at immediate spin with several different recipients?

Perform a direct antiglobulin test (DAT) on the donor unit

While working at a blood bank laboratory, you hear chimes over the hospital loudspeaker system announcing the birth of a baby. Thirty minutes later, you receive a cord blood specimen that you identify as O positive. You previously received the mother's specimen and she was O negative with a negative antibody screen. What is the next action?

Perform a fetal bleed screen

Which finding best distinguishes immune hemolytic anemia from other hemolytic anemias?

Positive DAT

following can be indications of anemia and the potential need for a transfusion of packed red cells

Pulse rate greater than 100 beats per minute Respiration rate greater than 30 breaths per minute Hemoglobin of 7 g/dL or less decreased haptoglobin

which one of the Rh genotypes listed below is heterozygous for the C antigen?

R1r

Antibodies in the Rh system typically exhibit which one of the following characteristics?

Reacts best at 37ºC and AHG

A ficin (enzyme) treated panel can be a useful tool for determining the identity of an antibody. On a ficin-treated panel, reactions with which system would be enhanced?

Rh

Which of the following antibodies are enhanced using enzyme panels during antibody identification in the blood bank?

Rh

Who would be a candidate, at 28 weeks gestation and had a negative antibody screen, to be injected with Rh immune globulin (RhIg)?

Rh negative mother with Rh positive fetus

Ficin treatment alters the surface of red blood cells such that interactions with

Rh, Lewis and Kidd system antibodies are enhanced.

In the evaluation of a positive DAT result, all of the below techniques can be used to dissociate the antibody(ies) form the RBCs EXCEPT:

Saline replacement

Donated red cell units contain which substance to stabilize the pH of the unit during storage?

Sodium biphosphate

Which antibodies can show an enhanced reaction when analyzed with enzyme treated panels

The Rh system antibodies along with Lewis, Kidd, ABO, I and P blood group

Which of the following clinical findings characterizes post-transfusion purpura (PTP)?

Thrombocytopenia (decreased hemoglobin). Platelet counts in PTP are typically less than 10,000/uL. Patients usually present with purpura, bleeding of the mucosal membrane, gastrointestinal, and/or urinary tract bleeding. Febrile reactions (or fever)

Following the treatment of an IgG molecule with papain, which of the following will remain?

Two Fab fragments each with a light chain and a partial heavy chain attached with a disulfide bond

Which of the following is the most commonly encountered presenting sign of a delayed hemolytic transfusion reaction (DHTR)?

Unexplained decrease in hemoglobin or hematocrit

Antithetical is the term used to describe

a pair of antigens that are coded by different alleles on a single gene.

Digestion with pepsin will

cut below the disulfide bond, leaving one unit of two partial heavy chains and two light chains all attached with a disulfide bond.

what does molecular testing in blood bank include

donor antigen screening -Other applications include determining blood type when the DAT is positive, identifying complex Rh genotypes, and typing fetal blood.

Group A patients who are secretors will

have both A and H substances secreted.

Group B patients who are secretors will

have both B and H substances secreted.

Alloantibodies are detected by the

indirect antiglobulin test (IAT).

Pancytopenia

is indicated in transfusion-associated graft-versus-host-disease (TA-GVHD). High ferritin levels have been noted in cases of iron overload. PTP, TA-GVHD, and iron overload are all categorized within delayed transfusion reactions.

Rouleaux

is the formation of red cells that are stacked and appear like a stack of coins This is a characteristic finding in multiple myeloma.

The K antigen has an antithetical relationship with

k antigen.

The O antigen is amorphic

meaning that it does not produce any demonstrable antigen.

Granulocyte concentrates are used only in conditions where the patient has

neutropenia and current bacterial or fungal infection(s) that are not responsive to antibiotics or other treatment.

Group O secretors will

only secrete H substance.