Blood Bank Exam Simulator Questions

An aliquot of AS-1 red blood cells is being prepare from an intact packed cell unit using sterile connection device. During the process of preparing an aliquot, the sterile device fails and blood drips onto the counter from the product tubing. What should be done with the primary unit? A) destroy the unit B) keep the original expiration date C) change the expiration date to 24 hours D) change the expiration date to 48 hours

C) change the expiration date to 24 hours

When performing a transfusion reaction investigation, what is the clerical check used to detect? A) type of reaction that occurred B) patient's hemoglobin and hematocrit C) error that may cause an ABO-incompatibility due to patient or donor unit mix up D) medication errors

C) error that may cause an ABO-incompatibility due to patient or donor unit mix up

Which of the following ABO blood groups has the highest number of H antigen sites on the RBC membrane? A) group A cells B) group B cells C) group O cells D) bombay phenotype

C) group O cells

Which of the following might cause a false positive indirected antiglobulin test (IAT)? A) failure to adequately wash cells B) delay in the addition of antiglobulin reagents C) over-centrifugation D) high concentration of IgG paraprotein in a patient's serum

C) over-centrifugation

Which of the following is considered an indication for Rh immune globulin (RhIG) administration in postpartum women? A) long term protection B) antibody blocking C) passive protection D) active immunity

C) passive protection

Bacterial contamination is MOST likely in which of the following blood products? A) Packed red blood cells B) Frozen red blood cells C) platelets D) fresh frozen plasma

C) platelets

Which one of the following blood components would be MOST appropriate for a 9-year old girl who is suspected of having idiopathic thrombocytopenic purpura (ITP), including a low platelet count and bleeding gums? A) packed red blood cells B) cryoprecipitate C) platelets D) fresh frozen plasma

C) platelets

What would be considered a common characteristic of anti-Jka and anti-Jkb?/ A) the immunoglobulin class is IgM B) agglutination reaction are best observed by DAT C) the antibodies show dosage of Kidd antigens on red cells D) the antibodies are naturally occurring

C) the antibodies show dosage of Kidd antigens on red cells

All of the following antibodies are detected at IS EXCEPT? A) Anti-P1 B) Anti-Jka C) Anti-A D) Anti-M

B) Anti-Jka - nonagglutinating IgG antibodies, and are generally detected during the antiglobulin phase

Which of the following blood group systems may show a cell typing change during pregnancy? A) Rh B) MNS C) Lewis D) Duffy

C) Lewis

A refrigerator used to store whole blood must be able to maintain a temperature in ranges of: A) 0-4C B) 2-4C C) 2-8C D) 1-6C

D) 1-6C

What is the increase in the risk percentage for developing antibodies against red cells antigens (alloimmunization) for patients who are characterized as chronically transfused patients? A) 1-4% B) 2-8% C) 5-10% D) 20-50%

D) 2-8%

A 300 ug dose of RhIG can suppress immunization of how many mL of D-positive whole blood? A) 15 ml B) 20 ml C) 25 ml D) 30 mL

D) 30 mL

The plant lectin obtained from the Dolichos biflorus plant will agglutinate which of the following? A) B cells B) O cells C) A2 cells D) A1 cells

D) A1 cells

Why would a unit of group O blood never be administered to a Bombay patient? A) Anti-A in donor B) Anti-B in donor C) Anti-H in donor D) Anti-H in recipient

D) Anti-H in recipient

Plasma exchange is the current treatment for all of these conditions EXCEPT: A) Warm autoimmune hemolytic anemia (WAIHA) B) Diarrhea-associated hemolytic uremia syndrome (HUS) C) Thrombotic thrombocytopenic purpura (TTP) D) Pernicious anemia

D) Pernicious anemia

In order to avoid repeating pretransfusion testing on a neonate during one hospital admission, all of the following must be true, EXCEPT: A) received only ABO-compatible blood B) received only Rh-compatible blood C) no unexpected antibodies in the serum or plasma D) has only received formula for nourishment

need to answer

Which of the following changes in titers would be considered significant when monitoring maternal antibodies using a doubling dilution? A) 16 to 32 B) 4 to 8 C) 8 to 32 D) 8 to 16

need to answer

Which of the following is generally considered equivalent to CMV seronegative RBCs for use in an exchange transfusion to a newborn? A) fresh RBCs less than 7 days old B) hemoglobin S negative RBCs C) frozen RBCs D) leukoreduced RBCs

A) fresh RBCs less than 7 days old

In order to detect the presence of antibodies fixed on the RBC's of newborns one should: A) perform a DAT on cord blood B) perform an IAT on cord blood C) test the baby's cells with typing antiserum D) look for agglutination in a mixture of mother's serum and baby's cells

A) perform a DAT on cord blood

Which type of blood component is most implicated in bacterial contamination? A) Platelets B) Packed Red Cells C) Fresh Frozen Plasma D) Cryoprecipitate

A) platelets

Kernicterus can cause brain damage in newborns suffering from severe HDFN. This is due to a buildup of: A) unconjugated bilirubin B) hematocrit C) haptoglobin D) hemoglobin

A) unconjugated bilirubin

Frozen red blood cells that have been thawed, deglycerolized and reconstituted in an open system must be used within________. A) 1 hour B) 24 hours C) 14 days D) 7 days

B) 24 hours

What percentage of glycerol is most commonly used when freezing red blood cell units? A) 70% B) 40% C) 10% D) 20%

B) 40%

Platelets that are not collected by an apheresis method must be prepared within _____________ of the collection of the whole blood. A) 30 minutes B) 8 hours C) 24 hours D) 48 hours

B) 8 hours

The lectin Dolichus biflorus agglutinates which types of cells? A) B cells B) A1B cells C) A2 cells D) both A1B and A2 cells

B) A1B cells

Units of A-negative, B-negative, and O-negative RBCs are shipped to your transfusion service. What testing MUST be performed by your facility prior to placing these units into you inventory? A) ABO B) ABO and Rh C) ABO, Rh, and antibody screen D) ABO, Rh, and Weak D to confirm negative status

B) ABO and Rh

Which of the following is the proper storage temperature for fresh frozen plasma (FFP)? A) 37 degrees C B) 4 degrees C C) -20 degrees C D) -10 degrees C

C) -20 degrees C

Antenatal RhIg is typically given at how many weeks gestation? A) 20 B) 24 C) 28 D) 32

C) 28

ABORh Anti-A: 4+ Anti-B: 4+ Anti-AB: 4+ A1 Cells: 1+ B Cells: 0 ABO Group Interpretation: ? A) Group AB B) Group O C) Group B D) Inconclusive, could be A2B with anti-A1 in the serum; further testing is necessary

D) Inconclusive, could be A2B with anti-A1 in the serum; further testing is necessary

Tube-based agglutination reactions in blood bank are graded from negative (0) to 4+. A reaction that has numerous small clumps in a cloudy, red background is:

1+

A2B is suspected when a patient's ABO typing has the following results: A) Patient's red cells forward types as AB with anti-A1 present in the patient's serum B) Patient's red cells forward types as A with anti-A1 and anti-B present in the patient's serum C) patient's red cells do not react with either anti-A nor anti-B and anti-A1 and anti-B are present in the patient's serum D) patient's red cells forward type as A with a mixed field reaction of the patient's red cells with Anti-A, and anti-B detected in the patient's serum

A) Patient's red cells forward types as AB with anti-A1 present in the patient's serum

When a unit of packed RBC's is split using the open system, each portion of the unit must be issued: A) within 24 hours B) within 48 hours C) within 30 days D) by the original expiration date

A) within 24 hours

What blood group usually reacts LEAST strongly with anti-H?

A1

What blood group reacts least strongly with anti-H?

A1B

What ABO phenotype will exist in an individual that inherits an A gene from one parent and a B gene from the other?

AB

What blood type is considered the universal recipient?

AB

What is the most important factor in determine the immediate outcomes of kidney transplant?

ABO compatibility

When processing umbilical cord blood samples for hematopoietic progenitor cells, what tests are performed on both mother's blood and cord blood?

ABO/Rh

What is the recommended routine testing to be performed on a newborn of a group B Rh positive female?

ABO/Rh, DAT and/or antibody screening are NOT routinely performed in this scenerio

Direct Antiglobulin Test

AHG detects antibody already sensitized to red cells

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 sample 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? A) Issue one vial of RhIg B) Perform a Kleihauer Betke stain C) Nothing - Mom is not at risk for Anti-D D) Perform a fetal bleed screen

D) Perform a fetal bleed screen

Anti-U antibodies can be produced by which of the following genotypes? A) M-N- B) S+s+ C)S+s- D) S-s-

D) S-s-

Which of the following consequences of severe hemolytic disease of the fetus and newborn (HDFN) is most associated with neonatal death before or shortly after birth? A) enlarged liver B) enlarged spleen C) cardiac failure D) hyperbilirubinemia

C) cardiac failure

What is the Kleihauer-Betke test used for? A) screen for sickle cell anemia B) screen for fetal hemoglobin C) differentiate between maternal and fetal red cells D) screen for hemoglobin A1c

C) differentiate between maternal and fetal red cells

For which of these reasons would a molecular method not be used? A) determine blood type when the DAT is positive B) complex Rh genotype (weak D expression) C) donor antibody screening D) type fetal blood

C) donor antibody screening

IgG coated red cells are added to negative antiglobulin tests to detect which of the following sources of error? A) delay in washing procedure B) improper resuspension of the red cells C) failure to add AHG D) improper incubation time or temperature

C) failure to add AHG

Which of these methods measure fetal hemoglobin or D positive red cells or both to evaluate fetomaternal hemorrhage? A) Rosette test B) Kleihauer-Betke Test C) Flow cytometry D) AHG testing

C) flow cytometry

Antibodies to which of the following blood components is the most frequent cause of febrile non-hemolytic transfusion reactions? A) Platelets B) packed red blood cells C) granulocytes D) plasma

C) granulocytes

Which symptoms of hemolytic disease of the fetus and newborn (HDFN) is associated with low levels of glucuronyl transferase? A) anemia B) increased reticulocyte count C) jaundice D) cardiac failure

C) jaundice

In HDFN which of the following antigen-antibody reactions is occurring? A) maternal antibodies is directed against fetal antibody B) maternal antigen is directed agains fetal antibody C) maternal antibody is directed against fetal antigen D) maternal antigen is directed against fetal antigen

C) maternal antibody is directed against fetal antigen

What should be done FIRST if a donor unit of RBCs is found to be incompatible at the antiglobulin phase but compatible at IS with several different recipients? A) repeat the ABO grouping on the incompatible unit using different sera B) do a panel made up of red cells having all low-frequency antigens C) perform a DAT on the donor unit D) obtain a new specimen and repeat the minor crossmatch

C) perform a DAT on the donor unit

Based on the following results obtained against a patient's red cells, what will the genotype look like in this example? Anti-C = 4+ Anti-c = 4+ Anti-E = 0 Anti-e = 4+ Anti-D = 0 A) R0R0 B) rr C) r'r D) R1R2

C) r'r

What two things are put together for the testing known as forward grouping (testing)? A) patient red cells and patient serum B) reagent red cells and patient serum C) reagent antisera and patient red cells D) patient serum and donor red cells

C) reagent antisera and patient red cells

What cluster of differentiation (CD) is used after for qualification of hematopoietic progenitor cells (HPC) after an HPC-apheresis collection?

CD34

Which of the following statements is correct regarding blood bank adverse event reporting to the FDA? A) All patient deaths while being transfused must be reported to the FDA, even when it has been confirmed that the death was not related to the transfusion B) When a transfusion reaction is the result of an error it must be reported to the FDA in writing C) A transfusion-related death must be reported to the FDA within 24 hours of the patient's death D) The initial notification to the FDA of a transfusion-related death must be made by fax, telephone, express mail, or electronically as soon as possible after the death is confirmed to be associated with the transfusion

D) The initial notification to the FDA of a transfusion-related death must be made by fax, telephone, express mail, or electronically as soon as possible after the death is confirmed to be associated with the transfusion

Which of the following choices is the basic technique used to detect unexpected antibodies with a commercial set of reagent cells? A) Polyclonal technique B) Direct antiglobulin test C) Enzyme technique D) Indirect antiglobulin test

D) Indirect antiglobulin test

An individual with group AB blood does not have which of the following antigens present on their red blood cells? A) A B) B C) H D) O

D) O

Which one of the ABO groups listed below has the MOST H antigens? A) A1 B) A1B C) B D) O

D) O group

What is the first step a transfusionist should take when a transfusion reaction is suspected? A) slow the transfusion and notify the physician B) administer medication to stop the reaction C) notify the laboratory of the reaction D) stop the transfusion, but keep the intravenous line open with saline

D) stop the transfusion, but keep the intravenous line open with saline

A delayed hemolytic transfusion reaction is most likely to be the result of what antibody?

Jka

Delayed hemolytic transfusion reaction are usually caused by antibodies directed against what blood group system?

Kidd

What blood group antigen is not expressed, or only weakly expressed on cord blood cells?

Leb

What antibodies are degraded by enzyme treatment of red cells?

MNS Duffy

An antibody screen utilizing polyethylene glycol (PEG) was performed. Reaction readings of this antibody screen are analyzed after immediate spin and again at 37°C incubation with subsequent centrifugation. How will the centrifugation of the tubes affect the patient's results?

false positives may be seen if PEG is added before centrifugation

Quantitative differences between A1 and A2 phenotypes

formation of anti-A1 in A subgroups amount of transferase enzymes the length of the precursor oligosaccharide chains

What blood component is most commonly used component for the replacement of multiple coagulation factor deficiencies in bleeding patients?

fresh frozen plasma

What is a situation that will cause a positive DAT in the newborn?

hemolytic disease of the fetus and newborn

What is the MOST frequent disease complication of blood transfusion?

hepatitis

LuB

high frequency antigen

The chief purpose of performing a standard crossmatch is to :

identify recipient antibodies against donor cells

False negative results at the indirect antiglobulin phase of an antibody screening test using a tube method are usually caused by what?

inadequate washing of red cells

What red blood cell component is indicated for patients who receive directed donations from immediate family to prevent TA-GVHD?

irradiated red blood cells

What 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

What symptoms of HDFN does phototherapy help prevent?

kernicterus

What is the required storage temperature for red blood cells? A) 1-6 C B) 5-15 C C) -18 C D) 20-24 C

A) 1-6C

A patient is group AB with one copy of the Se gene. What will they have in their secretions? A) A, B, H B) B and H C) A and H D) Only H

A) A, B, H

A sample has reactions occurring at IS and AHG in a panel that show varying reaction strengths. There is no obvious pattern that matches a particular panel cell or single antigen profile and the autocontrol was negative. Which of the following is the most likely cause? A) An IgM and an IgG antibody B) An IgG antibody only C) An IgM antibody only D) An autoantibody

A) An IgM and an IgG antibody

Lectin from the seeds of Dolichos biflorus is a source of which of the following? A) Anti-A1 B) Anti-A2 C) Anti-B D) Anti-H

A) Anti-A1

Given the Wiener and Fisher Race nomenclatures shown below, all of the following offsprings are possible from a mother who is R0R1 and a father who is R1r EXCEPT? A) DcE/DcE B) DCe/DCe C) DCe/dce D) Dce/dce

A) DcE/DcE

When performing an antibody panel, which one of the following antigens will be destroyed by enzyme treatment? A) Fya B) Jka C) E D) Lua

A) Fya

What blood group are the RBC screening cells for antibody screens? A) Group O B) Group A C) Group B D) Group AB

A) Group O

Which is the first marker (antigen or antibody) which will become positive after exposure to Hepatitis B)? A) HBsAg B) Anti-HBs C) Anti-HBe D) IgG anti-HBc

A) HBsAg

The majority of Lewis antibodies are of which immunoglobulin class? A) IgM B) IgG C) IgA D) IgE

A) IgM

In which system are DR antigens are found? A) Kell system B) HLA system C) Duffy system D) ABO system

B) HLA system

Which of the following statements best describes Rh antibodies? A) naturally occurring, IgM B) immune, IgG C) naturally occurring, IgG D) immune, IgM

B) Immune, IgG

Following a major trauma event, a family of four walked into your donor center hoping to donate blood. Which one of the following individuals may donate blood today? A) 14 y/o girl who received an ear piercing 6 weeks ago B) 53 y/o man who worked and resided in the UK from 1983-1989 C) 49 y/o woman who donated whole blood 5 weeks ago D) 22 y/o woman using oral contraceptives

D) 22 y/o woman using oral contraceptives

All of the following are the reacting substances that may be in the Coombs sera (antihuman globulin) EXCEPT: A) monoclonal antibody sources B) polyclonal antibody sources C) complement antibodies D) Anti-IgM sources

D) Anti-IgM sources

Essential components of compatibility testing includes all of the following EXCEPT: A) antibody screen on recipient's serum B) Major crossmatch or computer crossmatch C) ABO and Rh typing of recipient D) Direct Antiglobulin Test (DAT)

D) Direct Antiglobulin Test (DAT)

Which of the following packed RBCs could be transfused to a group O patient? A) Group A B) Group B C) Group AB D) Group O

D) Group O

ABO blood groups were discovered by: A) Drew B) Lindeman C) Hicks D) Landsteiner

D) Landsteiner

What is the most common (highest probability percentage) possible phenotype of the mating between a mother who has an AB genotype and a father who has an AO genotype? A) AB B) B C) A D) O

need an answer

If the parents are group A and B respectively, what are the possible blood groups of their children? A) A and B only B) A and B and AB only C) A and B and O only D) A and B and AB and O

need to answer

The concentration of sodium chloride in an isotonic solution is A) 8.5% B) 0.85% C) 0.08% D) 85%

B) 0.85%

What is the acceptable temperature range for maintaining red blood cell components during transport? A) 1-6C B) 1-10C C) 10-15C D) 20-24C

B) 1-10C

Approximately what percent of the Caucasian population is Rh negative? A) 10% B) 15% C) 25% D) 35%

B) 15%

One standard 300ug vial of RhIg contains enough anti-D to protect against what amount of whole blood exposure? A) 15 mL B) 30 mL C) 1 L D) 5 mL

B) 30 mL

If an Rh group (DCe/dce) man marries an Rh group (dce/dce) woman, what is the probability that their first child will be D negative? A) 25% B) 50% C) 75% D) 100%

B) 50%

If parents have the blood group genotypes AA and BO, what is the possibility of having a child with a blood type of A? A) 25% B) 50% C) 75% D) 100%

B) 50%

What is the cause of MOST severe acute hemolytic transfusions reactions? A) Rh incompatibility B) ABO incompatibility C) Cold agglutinins D) delayed hypersensitivity

B) ABO incompatibility

Which of the following methods are a noninvasive way to reliably predict anemia in the fetus? A) antibody titer B) Color Doppler middle cerebral artery peak systolic velocity (MCA-PSV) C) cordocentesis D) aminocentesis

B) Color Doppler middle cerebral artery peak systolic velocity (MCA-PSV)

When AHG or Coombs serum is used to demonstrate that red cells are antibody coated in vivo, the procedure is termed: A) Indirect technique B) Direct technique C) Hemagglutinin technique D) Hemolysis

B) Direct Technique

Which organism is MOST likely responsible for septic reactions associated with red blood cell transfusions? A) Yersinia enterocolitica B) Escherichia coli C) Enterobacter species D) Streptococcus species

B) Escherichia coli

What would be the best way to determine how much RhIg should be given to a postpartum female who received RhIg antenatally and demonstrates the anti-D antibody at delivery? A) Antibody titration B) Flow cytometry C) Rosette test D) Kleihauer-Betke acid elution

B) Flow cytometry

What kind of immunoglobulins are predominantly found in Rh immune globulin? A) IgM anti-D B) IgG anti-D C) IgM anti-A,B D) IgG anti-A,B

B) IgG anti-D

A DAT can be used to detect all of the following EXCEPT: A) HDFN B) IgG antibodies in the patient's serum C) hemolytic transfusion reactions D) autoimmune hemolytic anemia

B) IgG antibodies in the patient's serum

Proteolytic enzyme techniques may be useful in identifying which of the following antigen groups: A) Kell system B) Kidd System C) MNS System D) Duffy System

B) Kidd System

Which of the following tests is suitable for quantifying the size of fetomateral hemorrhage (FMH)? A) DAT B) Kleihauer-Betke test C) Rosette test D) IAT

B) Kleihauer-Betke test

Which of the following accurately represents reverse typing? A) performed using known reagents antisera to detect ABO antigens on the patient's red blood cells B) performed using known reagent red blood cells to detect ABO antibodies in the patient's serum or plasma C) performed using known reagent screening cells to detect clinically significant antibodies in the patient's serum or plasma D) performed using known reagent antisera to phenotype donor red blood cells for clinically significant antigens

B) performed using known reagent red blood cells to detect ABO antibodies in the patient's serum or plasma

Cold agglutinin disease (CAD) is most often associated with which antibody? A) Anti-D B) Anti-M C) Autoanti-I D) Autoanti-i

C) Autoanti-I

Which of the following antigen groups is closely related to the ABO antigen on the red cell membrane? A) Rh B) Kell C) I, i D) Duffy

C) I, i

An O positive patient has no reaction at IS but both screen cells are positive and all antibody panel cells are reacting 1+ at AHG. The autocontrol is 1+. What would you suspect to be the cause? A) Cold autoantibody B) Warm autoantibody C) Anti-Lea D) Anti-K

B) warm autoantibody

What is the principle of the Kleihauer-Betke test? A) Fetal cells present in the mother's blood smear contain fetal hemoglobin (HbgF). When treated with acid the fetal cells are sensitive and become ghost cells. B) Fetal cells present in the mother's blood smear contain fetal hemoglobin (HbgF). When treated with acid the fetal cells resistant and will stain pink with the counter stain C) Maternal red blood cells contain fetal hemoglobin (Hgb F). When treated with acid the maternal cells are resistant and will stain pink with the counter stain. D) Paternal cells present in the mother's blood smear are stained pink with an acid treatment.

B) Fetal cells present in the mother's blood smear contain fetal hemoglobin (HbgF). When treated with acid the fetal cells resistant and will stain pink with the counter stain

What are the possible ABO genotypes of offspring from parents whose genotypes are OO and AB? A) AB and OO B) OA and OB C) AB D) OO

B) OA and OB

The term used to describe patients with absence of Rh antigen is: A) Rh mod B) Rh null C) partial D D) D el

B) Rh null

It's a busy Friday evening in the blood bank and you have been receiving a steady stream of type and screen specimens from the emergency room. Several of them have positive antibodies screens which require further workup. One fo these patients is a 46 y/o male whose hemoglobin has dropped from 8.4 g/dl to 4.6 g/dl in the previous 8 hours (normal HgB for this patient demographic would be ~14 g/dl). Your work up reveals a group O patient with the following antibodies: anti-K, anti-Fya. The prevalence of K negative in your donor population is 91% while the prevalence of Fya negative donors is 37%. Two units of cross-matched RBCs are requested by the physician. How many units of group O RBC units should you phenotype in order to fulfill the request for two cross-matched units? A) 2 units of type O RBC units B) 3 units of type O RBC units C) 6 units of type O RBC units D) 12 units of type O RBC units

C) 6 units of type O RBC units

Which of the following represents the approximate percentage of the Caucasian population that is RH positive? A) 35% B) 65% C) 85% D) 95%

C) 85%

IF a child's phenotype is Group O, the phenotype of the mother of the child is Group A and the phenotype of the father is group B, what are the possible genotypes of both parents? A) AA and BO B) AO and BB C) AO and BO D) AA and BB

C) AO and BO

Of the following blood group antibodies, which has been most frequently associated with severe cases of hemolytic disease of the fetus and newborn? A) Anti-AB B) Anti-Lea C) Anti-K D) Anti-M

C) Anti-K

After frozen RBCs have been thawed and washed, they must be used within how many hours? A) 6 hours B) 12 hours C) 24 hours D) 48 hours

C) 24 hours

What is the shelf-life of whole blood collected in CPDA-1? A) 21 days B) 28 days C) 35 days D) 48 days

C) 35 days

A primary immune response is generally associated with which antibody? A) IgG B) IgA C) IgM D) IgD

C) IgM

Can an autologous donor donate blood at 4PM on Monday if she is having surgery at 10 AM on Wednesday? A) No, the minimal allowable time between the last donation and surgery is 72 hours B) No, the minimal allowable time between the last donation and surgery is eight weeks C) Yes, the patient can donate, but only half a units D) Yes, an autologous donor can donate up to 24 hours prior to surgery

A) No, the minimal allowable time between the last donation and surgery is 72 hours

How soon must granulocyte concentrates be administered after donation?

24 hours

What is the expiration and storage temperature of rejuvenated (non-frozen) RBCs?

24 hours 1-6C

What is the maximum interval during which a recipient sample may be used for compatibility testing if the patient has recently been transfused or was pregnant within the past 3 months?

3 days

Antibody identification interpretations would be considered correct 95% of the time or have a P value of 0.05 if you have:

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

How long after potential donors have been diagnosed with malaria should they be deferred from doing a blood donation?

3 years

Delayed hemolytic transfusion reaction usually occur within what time period?

3-7 days after transfusion

How many milliliters of Rh positive whole blood is one dose of Rh immune globulin capable of neutralizing?

30 ml

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

30-40%

Red cell units containing CPDA-1 as an anticoagulant preservative may be stored for how long prior to transfusion?

35 days

What is the proper temperature to use when crossmatching in the presence of a cold antibody?

37C

In order to prevent a loss of viability in platelet concentrates during storage, the pH must be maintained at or above what level?

6.2

Donor and recipient blood samples must be kept for at least how long after transfusion?

7 days

How long after collection can a patient's sample be used for compatibility testing

72 hours

In the Kleihauer-Betke test, a maternal blood smear is treated with acid and then stained with counterstain. The fetal cells contain fetal hemoglobin, which is resistant to acid and will remain pink. Since the calculated volume of fetomaternal hemorrhage is an estimate. how many additional RhIg vials need to be added for the dose? A) 1 B) 1.5 C) 2 D) 3

A) 1

What is the minimum hemoglobin concentration required for autologous blood donation? A) 11 g/dL B) 10 g/dL C) 13 g/dL D) 12.5 g/dL

A) 11 g/dL

FFP that has been thawed at 30 - 37oC and maintained at 1 - 6oC must be transfused within ___________ after it has been thawed. A) 24 hours B) 8 hours C) 12 hours D) 5 days

A) 24 hours

The serum of which of the following individuals may agglutinate group A1 cells? A) A2 individuals B) A1B individuals C) A1 individuals D) Newborns

A) A2 individuals

The DAT is most unreliable when diagnosing hemolytic disease of the fetus and newborn due to which blood group system? A) ABO B) Duffy C) Rh D) Kidd

A) ABO

For which of the following antibodies is the DAT most likely to be NEGATIVE when testing a newborn for possible HDFN? A) Anti-A,B B) Anti-c C) Anti-D D) Anti-K

A) Anti-A,B

Group O blood cannot be transfused to a person with "Bombay blood" type because the Bombay individual produces which of the following? A) Anti-H B) Anti-A C) Anti-B D) H substance on his cells

A) Anti-H

Which of the following tests BEST correlates with the severity of hemolytic disease of the fetus and newborn? A) Color Doppler Ultrasonography B) an antibody screen of mother's blood C) amniotic fluid bilirubin D) antibody titer of mother's blood

A) Color Doppler Ultrasonography

Which component can be shipped with fresh frozen plasma (FFP)? A) Cryoprecipitate B) Platelets C) Packed Red Blood Cells D) Whole Blood

A) Cryoprecipitate

A D-positive mother with a D-negative fetus eliminates the possibility of HDFN due to the: A) D Antigen B) ABO antigen system C) Lewis Antigen System D) Rh antigen system

A) D antigen

When performing the rosette test to screen for Fetal Maternal Hemorrhage, what is considered the correct combination to avoid false positive and/or false negatives? A) Fetal cells D positive and mother is D negative B) Fetal cells D positive and mother is weak D positive C) fetal cells weak D positive and mother is D negative D) any combination could cause false positive and/or false negative results with the rosette test

A) Fetal cells D positive and mother is weak D negative

Which antibody class is best described with that characteristic that it is the only one capable of residing in mucosal linings? A) IgA B) IgM C) IgG D) IgE

A) IgA

A secondary immune response is generally associated with which of the following antibodies? A) IgG B) IgA C) IgM D) IgD

A) IgG

Which of the following is the predominant immunoglobulin class for anti-A and anti-B antibodies in group B and group A individuals? A) IgM B) IgG C) IgA D) IgE

A) IgM

Which of the following characteristics is consistent with the Kidd blood group system? A) Jk (a-b-) red cells are resistant to lysis in 2M urea B) Kidd antigens are destroyed by ficin C) antibodies to Kidd antigens react best at immediate spin D) Anti-Jka activity may not react well in a LISS test system

A) Jk (a-b-) red cells are resistant to lysis in 2M urea

A 40 y/o female receives two units of RBCs during a special procedure. The patient has no prior history of transfusion. Seven days later, she presents with extensive bruising of the extremities and bleeding of the gums, with no additional symptoms. Her platelet count is 5 x 10^9 (reference interval 150-400 x 10^9/L). What is the most likely diagnosis? A) Post transfusion purpura (PTP) B) Acute hemolytic transfusion reaction (AHTR) C) Transfusion-related acute lung injury (TRALI) D) allergic reaction

A) Post transfusion purpura (PTP)

A ficin (enzyme) treated panel can be a useful tool for determining the identify of an antibody. On a ficin-treated panel, reactions with which system would be enhanced? A) Rh B) Duffy C) MNS D) Kell

A) Rh

Which of the following transfusion reaction can a diagnosis be more firmly established by evaluating B-type natriuretic peptide (BNP) levels before and after transfusion? A) Transfusion Associated Circulatory Overload (TACO) B) Delayed Hemolytic Transfusion Reactions C) Transfusion Associated Sepsis D) Allergic Transfusion Reaction

A) Transfusion Associated Circulatory Overload (TACO)

Which of the following is true of the classic Bombay phenotype? A) Two h genes are inherited at the H locus B) H substance is present C) A antigen is present D) B antigen is present

A) Two h genes are inherited at the H locus

When preparing platelet concentrates from whole blood, after the second spin and excess plasma has been expressed from the platelet, what is the next step in platelet preparation? A) allow the platelets to rest for 1-2 hours at 20-24C B) agitate the platelets vigorously for 1-2 hours at 20-24C C) pool several platelet concentrates together immediately and irradiate D) freeze the platelet concentrate immediately at < 18C

A) allow the platelets to rest for 1-2 hours at 20-24C Platelet concentrates are not frozen!

A febrile nonhemolytic transfusion reaction is characterized by which of the following? A) an increase in temperature of >1C above 37C during transfusion B) appearance of hives C) fever above 37C which develops 24 hours later D) a decrease in temperature of <2C below 37C following transfusion

A) an increase in temperature of >1C above 37C during transfusion

All of the following are cause for donor deferral EXCEPT? A) an individual weighs 115 pounds at the time of donor screening B) potential donor is currently pregnant in her second trimester C) donated a whole blood product within the last 30 days D) He/she lived in the UK for a consecutive 12-month period between 1980-1996

A) an individual weighs 115 pounds at the time of donor screening

One risk associated with patients that require chronic transfusions is: A) iron overload B) fear of needles C) transfusion associated graft-versus-host disease (TA-GVHD) D) increased antigen production

A) iron overload

A patient with a documented history of febrile nonhemolytic transfusion reactions should receive__________ blood components. A) leukoreduced B) irradiated C) cytomegalovirus (CMV) negative D) hemoglobin S negative

A) leukoreduced

Which of the following sources of error will give a false negative result in antihuman globulin testing? A) low pH of saline B) dirty glassware C) samples collected in gel separatory tubes D) refrigerated specimen

A) low pH of saline

Antibodies in the Rh system typically exhibit which of the following characteristics? A) reacts best at 37C and AHG B) reacts best at room temperature C) shows hemolysis better than agglutination D) reacts best at 4C

A) reacts best at 37C and AHG

What type of antibody can cause HDFN in any pregnancy, but is usually limited to less severe symptoms?

Anti-A,B (found in group O)

What antibody is best described as common autoantibody that can be found in virtually all sera?

Anti-I

What antibodies usually show enhanced agglutination with the use of proteolytic enzymes?

Anti-Jka, Jkb, C, and E

If detected in antibody testing, which antibody is NOT considered clinically significant in prenatal patients?

Anti-Leb not indicated in HDFN

The serum from a patient of African-American descent is reactive with all screening and panel cells. Which antibody directed to a high incidence antigen is most likely present?

Anti-U

Which of these units of Red Blood cells, that has been issued and returned to the blood bank, can be returned to inventory and is acceptable to use? A) a unit of RBCs that was issued 1 hour previously but not transfused and kept at room temperature B) a unit of RBCs that was not transfused but stored in a temperature-controlled remote refrigerator in the operating room for 2 hours C) a unit of RBCs that was issued 15 minutes previously, but returned unused with one of the sterile ports opened D) a unit of RBCs that was issued to the ER with other units in a temperature controlled blood bank emergency cooler, returned to the blood bak 5 hours after issue, with internal temperature of the system reading 15C

B) a unit of RBCs that was not transfused but stored in a temperature-controlled remote refrigerator in the operating room of 2 hours

What is the IAT usually used to detect? A) antibodies coating red cells B) antibodies in the plasma C) antigens coating red cells D) antigens in plasma

B) antibodies in the plasma

Which of the following choices best describes the primary function of antibodies? A) protection of B-lymphocytes B) binds with antigen C) fixes complement D) stimulates the immune response

B) binds with antigen

What is the prinicple of the Kleihauer-Betke test? A) capitalizes on the resistance of fetal hemoglobin to alkaline treatment B) capitalizes on the resistance of fetal hemoglobin to acid treatment C) capitalizes on the resistance of fetal hemoglobin to enzymatic treatment D) capitalizes on the resistance of fetal hemoglobin to radiation treatment

B) capitalizes on the resistance of fetal hemoglobin to acid treatment

Which procedure used to obtain a fetal blood sample to monitor severity of hemolytic disease of the fetus and newborn (HDFN) can also be used to deliver intrauterine transfusions? A) aminocentesis B) cordocentesis C) doppler sonography D) exchange transfusion via maternal circulation

B) cordocentesis

What is a characteristic of a person who is weak D? A) Types as D negative and produces anti-D when exposed to D antigen B) demonstrates a reduced number of D antigens sites on the surface of the red cell C) types as D positive and produces anti-D when exposed to D antigen D) someone who is defined as being D negative

B) demonstrates a reduced number of D antigens sites on the surface of the red cell

What is considered the definition of allogenic blood? A) donated by the donor for self-use B) donated by a donor for a recipient other than the donor to use C) blood salvaged during surgery D) blood collected through normovolemic hemodilution

B) donated by a donor for a recipient other than the donor to use

An error was made in a handwritten blood bank record. Which of the following method is acceptable for correcting the error to remain in compliance with current good manufacturing practices requirements? A) use white correction fluid to completely cover the error B) draw a single line through the error so that it can still be read and add your initials next to it C) erase the error as much as possible and write the correction on top of the obliterated results D) use black marker to black out the incorrect text and write the correction on top of the obliterated text

B) draw a single line through the errors so that it can still be read and add your initials next to it

What additional information is required on a label or tie tag of an autologous unit? A) name of the ordering physician B) identification of the recipient C) location of the collection facility D) the statement "For Emergency Use Only"

B) identification of the recipients

All of the following are advantages of performing the computer crossmatch EXCEPT? A) greater flexibility in staffing B) one determination of recipient's ABO group is made C) better management of blood bank inventory D) reduced volume of sample needed on large crossmatch orders

B) one determination of recipient's ABO group is made

A patient front-grouped as AB but back-grouped as O. The screening cells and autocontrol were positive. If the testing was performed correctly, what is the most likely cause of this discrepancy? A) Patient has two distinct cell populations B) patient has a cold autoantibody C) patient has missing or weakly expressed antigens D) Patient has leukemia

B) patient has a cold autoantibody

In blood bank agglutination reactions, the zeta potential (a force exerted by ions in the saline solution that causes repulsion between red blood cells in the saline suspension) can be reduced by treating the sensitized cells with: A) polyclonal antibody reagents B) polyethylene glycol (PEG), albumin, proteolytic enzymes C) monoclonal antiglobulin reagents D) coombs check cells

B) polyethylene glycol (PEG), albumin, proteolytic enzymes

Why is RhIg administered within 72 hours of delivery to an Rh negative mother if the newborn is found to be D positive or weak D positive? A) prevent future children from producing antibodies B) prevent fetal cells from initially sensitizing the mother C) prevent antibody response in a previously sensitized mother D) neutralizing any natural antibodies present

B) prevent fetal cells from initially sensitizing the mother

Rh Immune Globulin (RhIg) is used to: A) prevent the formation of anti-E B) prevent the formation of anti-D C) prevent the formation of anti-c D) prevent the formation of antibodies to all Rh antigens

B) prevent the formation of anti-D

All of the following are benefits of autologous donations EXCEPT: A) reduces exposure of infectious diseases B) readily available in case of an unexpected emergency C) reduces demand for homologous blood transfusion D) eliminates sensitization to cellular blood components

B) readily available in case of an unexpected emergency

When performing an antibody screen, both the screen cells are 4+ at IS and W+ at AHG. The antibody panel shows 4+ reactions at IS and W+ at AHG and there is no specific match to the reaction pattern. The auto control is negative. What would be a logical next step? A) have patient redrawn B) repeat testing using warmed patient sample/reagent and just do an AHG reading C) run an enzyme panel D) use acidification reagents

B) repeat testing using warmed patient sample/reagent and just do an AHG reading

A mother's serologic results. Her newborn types as group A Rh positive with a (1+) positive DAT. Which of the following investigative tests would be most useful to resolve the cause of the positive DAT and should be done first? A) test an eluate prepared from newborn's red cells against an antibody identification panel by IAT B) test newborn's plasma against group A1 red cells and group O antibody screens by IAT C) test newborn's plasma against mother's red cells by IAT D) test newborn's plasma against father's red cells by IAT

B) test newborn's plasma against group A1 red cells and group O antibody screens by IAT

A Bombay individual's blood specimen can be differentiated from a blood specimen of a group O person by which of the following? A) cells giving a negative reaction with Anti-A,B B) testing with anti-H lectin (Ulex europaeus) C) reveres typing with A1 and B cells would give different reactions D) testing with Dolichos biflorus

B) testing with anti-H lectin (Ulex europaeus)

An exchange transfusion has been ordered for a low birth weight infant. The physician has ordered irradiated RBCs for this purpose. Why is is necessary to irradiate the blood products for this patient? A) to prevent alloimmunization of the patient B) to prevent transfusion-associated graft versus host disease (TA-GVHD) C) to kill bacteria and viruses present in the RBCs D) to allow the cells to have a longer half-life

B) to prevent transfusion-associated graft versus host disease (TA-GVHD)

Which of the following signs and symptoms may be associated with immediate transfusion reaction, but is NOT usually associated with delayed hemolytic transfusion reaction? A) Fever and chills B) unexplained bleeding from surgical site C) unexplained drop in hemoglobin D) Transient jaundice

B) unexplained bleeding from surgical site

Which of the following is the most commonly encountered presenting sign of a delayed hemolytic transfusion reaction? A) active bleeding B) unexplained decrease in hemoglobin or hematocrit C) renal failure D) abnormal liver function

B) unexplained decrease in hemoglobin or hematocrit

Glycine HCL/EDTA treatment of red cells can destroy what antigens, allowing for confirmation of a suspected antibody and detecting additional antibodies?

Bg and Kell

Platelets should be stored at what temperature? A) 1-6 C B) less than -18 C C) 20-24 C D) 34-37C

C) 20-24 C

Which of the following fresh frozen plasma ABO types would be suitable for transfusion to an AB negative patients? A) AB negative only B) O negative only C) AB negative and AB positive D) O negative and O positive only

C) AB negative and AB positive

AABB Standards for Blood Banks and Transfusion Services requires a control system for antiglobulin tests interpreted as negative. What is done for this control system? A) Running tests in duplicate B) adding an extra incubation C) Adding IgG sensitized red cells D) preforming a minimum of 3 extra washes

C) Adding IgG sensitized red cells

Which of the following is the cause of the most severe life-threatening hemolytic transfusion reaction? A) Anti-D B) Anti-M C) Anti-A, Anti-B, Anti-A,B D) Anti-Fya

C) Anti-A, Anti-B, Anti-A,B

If an R1r patient received R2R2 blood, which of these antibodies could be produced? A) Anti-c B) Anti-D C) Anti-E D) Anti-ce

C) Anti-E

In which group is Type B blood found in higher frequency? A) African Americans B) Caucasians C) Asians D) Hispanics

C) Asians

What does the hh genotype give rise to? A) H substance B) H secretors C) bombay phenotype D) h antibodies

C) Bombay phenotype

A rosette test to screen for fetomaternal hemorrhage (FMH) is indicated in all of the following situations, EXCEPT: A) weak D-positive infant B) D-positive infant C) D-positive mother D) D-negative mother

C) D-positive mother

The Rh nomenclature which uses the letters DCE is found in which of the following genetic models? A) Wiener B) Shorthand C) Fisher-Race D) Rosenfield

C) Fisher Race

A spectrophotometric scan of amniotic fluid may be valuable in the determination of which of the following conditions: A) Neural tube defects B) Maternal Hypertension C) Hemolytic Disease of the Newborn D) Maternal diabetes

C) Hemolytic Disease of the Newborn

Which class of antibody can agglutinate erythrocytes (RBCs) after antihuman globulin (AHG) is added to the test tube? A) IgA B) IgE C) IgG D) IgM

C) IgG

Which of the following immunoglobulins are capable of fixing complement by the classical pathway? A) IgG and IgA B) IgM and IgA C) IgG and IgM D) IgG and IgD

C) IgG and IgM

Lewis Blood Group System is human blood group unlike most others. The antigen is produced and secreted by exocrine glands, eventually adsorbing to the surface of red blood cells. Its expression is based on the genetic expression of the Lewis and Secretor genes. Based on the following genotype (Le)(sese), what would you predict the Lewis antigen phenotypic expression to be? A) Le (a-b-) B) Le (a+b+) C) Le (a+b-) D_ Le (a-b+)

C) Le (a+b-)

Lewis Blood Group System is human blood group unlike most others. The antigen is produced and secreted by exocrine glands, eventually adsorbing to the surface of red blood cells. Its expression is based on the genetic expression of the Lewis and Secretor genes. Based on the following genotype (Le)(Se), what would you predict the Lewis antigen phenotypic expression to be? A) Le (a-b-) B) Le (a+b+) C) Le (a-b+) D) Le (a+b-)

C) Le (a-b+)

Which of the following situations warrants postpartum administration of Rh immune globulin (RhIg)? A) Mother: D postive Cord: D Negative B) Mother: D negative Cord: D negative C) Mother: D negative Cord: D Positive D) Mother: D positive Cord: D Positive

C) Mother: D negative Cord: D Positive

Which specific immunodominant sugar is reponsible for A (blood group A) antigenic specificity? A) L-fucose B) D-galactose C) N-acetyl-D-galactosamine D) Glucose

C) N-acetyl-D-galactosamine

To prevent Rh alloimmunization in pregnancy between mother and fetus, it is recommended to initiate RhIg prophylaxis when? A) Rh-positive pregnant females, postpartum B) Rh-negative pregnant females, antenatal in the first trimester C) Rh-negative pregnant females, antenatal in the third trimester D) Rh-positive pregnant females after delivery of an Rh-positive infant

C) Rh-negative pregnant females, antenatal in the third trimester

What is the correct description for Group II discrepancies? A) These discrepancies between forward and reverse grouping are due to miscellaneous problems B) These discrepancies between forward and reverse groupings are caused by protein or plasma abnormalities C) These discrepancies between forward and reverse groupings are due to weakly reacting or missing antigens D) These discrepancies between forward and reverse grouping are due to weakly reacting or missing antibodies

C) These discrepancies between forward and reverse grouping are due to weakly reacting or missing antigens

Which one of these physical exam results would cause a donor to be deferred? A) hemoglobin 13.0 g/dL B) pulse of 75 bpm C) diastolic blood pressure of 110 mmHg D) temperature of 99.3F

C) a diastolic blood pressure of 110 mm Hg

What to the two and/or three reagent cells used for antibody screening detect? A) antibodies to most white cell antigens B) Antibodies to red cell A and B antigens C) Antibodies to common alloantigens D) Antibodies to most private (low incidence) red cell antigens

C) antibodies to common alloantigens

A unit of red blood cells that was collected on 15 June 2009 and frozen with glycerol at -80C on 20 June 2009 will expire on what date? A) 14 June 2010 B) 15 June 2010 C) 20 June 2019 D) 15 June 2019

D) 15 June 2019

Which of the following donors could be accepted for blood donation? A) 22-year female who is currently pregnant B) 40-year old who lived in London from 1988-1995 C) 44-year old male who used a needle to administer nonprescription drugs D) 24 year old man who had a tooth extraction 2 months ago

D) 24 year old man who had a tooth extraction 2 months ago

An Rh negative mother has just given birth to an Rh positive baby after 18 hours of strenuous labor. her rosette test was positive. Upon performing the Kleihauer-Betke stain procedure, the percentage of fetal cells is found to be 1.9%. The mother's total blood volume is 5,000mL. What dose of RhIg should be administered to the mother? A) 1 vial B) 2 vials C) 3 vials D) 4 vials

D) 4 vials

In an antibody screening test, at what phase of reactivity is it most important to read the reactions for detection of clinically significant antibodies? A) 4C B) Immediate Spin C) 37C D) AHG

D) AHG

Red blood cells with a positive DAT cannot be tested accurately with blood typing reagents that require an indirect antiglobulin technique unless they have been treated with all of the following (to dissociate IgG from the RBC membrane) EXCEPT: A) Chloroquine disphosphate B) Ficin C) ZZAP D) Albumin

D) Albumin

Which of the following antibodies causes the MOST severe cases of hemolytic disease of fetus and newborn (HDFN)? A) Anti-I B) Anti-N C) Anti-AB D) Anti-D

D) Anti-D

The following results were obtained at delivery for a pregnant woman who received antenatal RhIg. anti-A = 0 anti-B = 0 A1 cells = 4+ B cells = 4+ anti-D = 0 SC1 = w+ SC2 = 1+ Which of the following are possible causes of the positive antibody screen? A) Anti-D (passive, from RhIg administration) or an antibody other than anti-D B) Anti-D (immune) or Anti-D (passive, from RhIg administration) C) Antibody other than anti-D D) Anti-D (immune) or Anti-D (passive, from RhIg administration) or an antibody titer other than anti-D

D) Anti-D (immune) or Anti-D (passive, from RhIg administration) or an antibody titer other than anti-D

Which antibody identified in prenatal specimens is never a cause of hemolytic disease of the fetus and newborn? A) Anti-D B) Anti-c C) Anti-E D) Anti-I

D) Anti-I

Which of the following antibodies is most often implicated as a cause of a delayed hemolytic transfusion reaction? A) Anti-S B) Anti-M C) Anti-Fya D) Anti-Jka

D) Anti-Jka

Which is the best component to treat a patient with fibrinogen deficiency? A) Red Blood Cells B) Platelet Concentrates C) Fresh Whole Blood D) Cryoprecipitated AHF

D) Cryoprecipitated AHF

The use of the direct antiglobulin test is indicated in all the following EXCEPT: A) Transfusion Reactions B) Autoimmune hemolytic anemia C) Hemolytic disease of the newborn D) Detection of alloantibodies

D) Detection of alloantibodies

Which is NOT a requirement for information on the donor tag once the appropriate compatibility testing has been completed and the unit or unit are suitable for transfusion? A) Patient's full name and identification number B) Name of the product and donor number C) ABO and D phenotype of the unit D) Doctor's name and patient room number

D) Doctor's name and patient room number

The parents' blood types are AB and O. What could be the only possible blood type(s) of their children? A) Group A only B) Group B only C) Group O only D) Group A or B only

D) Group A or B only

Which of the following antigens is classified as a Major Histocompatibility Complex Class II antigen (MHCII)? A) HLA-A B) HLA-B C) HLA-C D) HLA-DR

D) HLA-DR

Which blood group is most frequently assocaited with Cold Agglutinin Disease (CAD)? A) Kell B) Kidd C) Duffy D) I

D) I

A 54 y/o woman has just braved a winter storm in North Dakota to see her doctor for a general checkup. She indicates no complaints but does mention how difficult the cold weather is for her. The doctor notices the bluish coloring of her ears and fingers. She states that this has been happening for years whenever it is cold and that the problem subsides during the warm summer months. What abnormal test results might be noted in this patient's blood tests? A) negative Donath-Lansteiner Test B) agglutination on blood smear C) positive direct antiglobulin test (DAT) D) agglutination on blood smear and positive DAT

D) agglutination on blood smear and positive DAT

If an Rh negative patient is administered a unit of R1R1 packed red cells, which one of the following antibodies would be most likely to develop: A) anti-C B) anti-E C) anti-e D) anti-D

D) anti-D

During routine inspection, a unit of unexpired blood was noticed to have a black color with numerous small clots. What is the likely cause for this observation? A) the unit was frozen B) donor had DIC C) viral contamination D) bacterial contamination

D) bacterial contamination

Which of the following would be a possible cause of a positive direct antiglobulin test (DAT)? A) Transfusion reaction and warm autoimmune disease only B) warm autoimmune disease and clot tube stored at 4C only C) clot tube stored at 4C and transfusion reaction only D) clot tube stored at 4C, transfusion reaction, and warm autoimmune disease

D) clot tube stored at 4C, transfusion reaction, and warm autoimmune disease

Which of the following blood components will provide the best source of fibrinogen for a patient with hypofibrinogenemia? A) whole blood B) fresh frozen plasma C) platelets D) cryoprecipitate

D) cryoprecipitate

What action should be taken if a large clot is noticed in a red blood cell unit while the product is being prepared for release to the patient? A) issue the product as you normally would but with a filter B) issue the product, but note the presence of the clot in the computer records C) filter the product prior to issue and record the process D) do not issue the product

D) do not issue the product

Which of the following is a common cause of febrile non-hemolytic transfusion reactions? A) bacterial contamination of blood B) antibody to a platelet antigen C) reaction to plasma proteins D) immune response to leukocytes

D) immune response to leukocytes

Transfusion Related Acute Lung Injury (TRALI) is a serious transfusion complication that can be characterized by all of the following EXCEPT: A) respiratory distress B) pulmonary edema C) acute onset D) increased central venous pressure

D) increased central venous pressure

Which test is NOT used as a screen for retroviruses in donated blood? A) Antibody to HIV type 1 and type 2 B) nucleic acid testing to detect HIV-1 RNA C) Antibody to HTLV type I and II D) nucleic acid testing for HCV

D) nucleic acid testing for HCV

All of the following are required to be in a machine-readable format on a blood component label, EXCEPT: A) ABO/Rh of the donor B) product code C) collection facility D) outdate

D) outdate

Which of the following reagents is often used to perform DAT to determine if either IgG or complement (or both) is attracted to a patient's red cells? A) low-ionic strength solution (LISS) B) polyethylene glycol (PEG) C) Anti-C3d D) polyspecific AHG

D) polyspecific AHG

Rh antibodies generally: A) react best at 4C B) react best at room temperature C) generally do not react at any temperature D) react best at 37C

D) react best at 37C

Which characteristic best describes IgG antibodies produced against red blood cells? A) are naturally occurring B) cannot be identified using the AHG test C) react best at room temperature D) reacts best at 37 C

D) reacts best at 37C

What may result in a false negative reaction when performing Rh typing?

failure to follow manufacturer's directions precisely

An elution is a technique that is used to release, concentrate, and purify antibodies that are bound to red blood cells. In preparing red cells for any elution method, one must be particularly careful to: A) leave a small amount of serum in the test system so complement will be present B) add albumin to decrease zeta potential C) pretreat the cells with enzymes D) thoroughly wash sensitized red cells

D) thoroughly wash sensitized red cells

What is considered the cause of urticarial transfusion reaction? A) IgA deficient individuals receiving plasma products containing IgA B) IgG or IgM antibody along with complement C) tissue damage from the formation of immune complexes D) transfusion of certain food allergens or drugs in plasma products

D) transfusion of certain food allergens or drugs in plasma products

Which of the following noninfectious complications of blood transfusions is prevented by the irradiation of blood components? A) anaphylactic reactions B) febrile non-hemolytic reactions C) transfusion-related acute lung injury (TRALI) D) transfusion-associated graft versus host disease (TA-GVHD)

D) transfusion-associated graft versus host disease (TA-GVHD)

HLA antibodies are responsible for which of the following transfusion reactions? A) allergic transfusion reactions B) transfusion-associated sepsis C) transfusion-associated circulatory overload D) transfusion-related acute lung injury

D) transfusion-related acute lung injury (TRALI)

What is the most common Rh halotype among whites?

DCe

What is the most common reagent source for anti-A1?

Dolichos biflorous seed extracts (lectins)

What is the best technique for monitoring the severity of hemolytic disease of the fetus and newborn?

Doppler ultrasound

In the evaluation of a positive DAT result, what techniques can be used to dissociate the antibodies from the RBCs

EDTA-glycine chloroquine diphosphate murine monoclonal antibodies

The antigen marker most closely associated with transmission of HBV infection is:

HBeAg

What tests have been recommended by the FDA to replace HIV-1 p24 antigen test in the screening of donated blood for infectious diseases?

HIV-1 NAT

Blood Donor Requirements

Hgb >12.5 Body Temp <99.5 BP less than or equal to 180/110

What immunoglobulin class is responsible for HDFN?

IgG

The most significant blood group antibodies belong to which immunoglobulin classes?

IgG and IgM

Coombs control check cells used to verify negative reactions at the antiglobulin (IAT) phase are coated with

IgG antibodies

In immunohematology, an antithetical relationship exists between M antigen and what other antigen?

N antigen

What blood type is considered the universal donor?

O

If an individual has blood type O, what are the possible genotypes?

OO only O gene is considered an amorph

What antibodies are enhanced by enzyme treatment of red cells?

Rh Lewis Kidd ABO

After birth, what is the biggest concern for a newborn infant suffering from HDFN?

accumulation of bilirubin

What condition increases the risk of HbS polymerization?

acid pH dehydration increased levels of 2,3-DPG

When would unexpected positive reactions be encountered during ABO forward typing?

acquired B antigen

What refers to the most common procedure for donating whole blood for use by general population?

allogeneic donation

Anti-H

anti-H is not produced in the human body, a seed extract called a lectin w/ anti-H properties is used Anti-H reacts more strongly with group A2 than with group A1 cells

How are antibodies to the ABO blood group antigens unique?

antibodies are naturally occurring to antigens that are absent from the red cell membrane

DAT is used to detect

antibodies sensitizing red cells

What is the most prudent step to follow to select units for crossmatch after recipient antibodies have been identified?

antigen type patient cells and any donors cells to be crossmatched

The immediate spin phase of an indirect antiglobulin test (antibody screen and identification) could most likely lead to the detection what type of antibody?

clinically insignificant cold antibodies

What condition is MOST frequently associated with Anti-I?

cold agglutinin disease

Anti-A and Anti-B reagents

contain monoclonal antibodies antibodies are highly specific they produce an expected 3+ or 4+ reaction with the corresponding antigens

Antibodies to the Kidd blood group system are MOST commonly associated with:

delayed hemolytic transfusion reactions

After performing an antibody panel and a selected cell panel, you still can't rule out S and Fyb. It appear that the patient has anti-e and anti-Jka, but they are only reacting microscopically. What technique woul dbe the best way to strengthen the suspected antibodies?

enzyme panel

Describe Reverse Typing

known antigen used to detect ABO antibodies

Platelet specific antigens, aka human platelet antigens, are expressed on what?

membrane glycoproteins

An Rh-negative pregnant female has produced anti-D and the doctor has decided to use molecular typing to determine if the fetus is at risk. What test results make fetal DNA testing a recommended second step?

molecular genotyping demonstrates that the father is heterozygous for RHD allele

What blood group antibodies would you find in a group AB person?

none

Testing for the quality of platelet concentrates includes:

pH platelet count bacterial detection

A maternal sample is collected 2 hours after delivery and a type and screen is performed. The screen is weakly positive and an anti-D is identified. What is most likely the cause of the positive antibody screen?

passive anti-D from RhIG given at 28 weeks

What procedure should be followed when one cross-matched unit out of five is incompatible at the AHG phase?

perform a DAT on the incompatible unit

A D-negative mother gives birth to a baby that tests as D-negative in the immediate spin phase. What step should be performed next?

perform a weak D test

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

positive DAT

Why is gamma irradiation of cellular blood components required?

prevention of GVH disease

An urticarial transfusion reaction is characterized by:

rash and hives

In the coombs phase of a crossmatch, what is the proper procedure to follow if the check cells gives a negative reaction?

repeat procedure with new AHG reagent and check the cell washer

What procedure is used by laboratory personnel to confirm ABO typing by using cells with known blood groups?

reverse typing

What is the most frequent genotype among Rho(D) negative persons?

rr

When administering fresh frozen plasma (FFP), what is considered standard blood bank practice?

should be ABO compatible with the recipient's red blood cells

Hapten

small molecule that has to bind to a larger molecule to form an antigen usually do not elicit an immune response on their own; are not considered clinically significant

Antibodies are ruled out using panel cells that are homozygous for the corresponding antigen because:

stronger reactions are seen with homozygous cells

In vivo sensitization

take place inside the patient

After irradiating a unit of packed red blood cells, how is the expiration date affected?

the expiration date shortens to 28 days from the date of irradiation or the original expiration date, whichever is first

If an autologous blood component is shipped from the donor center without the completion of infectious disease testing, the unit must be labeled with:

the phrase "donor untested"

What are indications for administering Rh immune globulin to an Rh negative woman?

therapeutic abortion ectopic pregnancy Rh positive fetus

What is a clinical finding characteristic of post-transfusion purpura (PTP)?

thrombocytopenia

Coombs test

to validate test, ensure true negatives

Treatment of an IgG with papain, what will remain?

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

What is the most common type of autoimmune hemolytic anemia?

warm autoimmune hemolytic anemia

If Jka is showing dosage, how might reactions on an antibody panel appear?

weaker if heterozygous

How is a platelet concentrate prepared?

whole blood centrifuged at low speed plasma separated then centrifuged at high speed

Which of the following packed red blood cells ABO types would be appropriate for transfusion to an O negative patient of child-bearing age? A) O negative only B) AB negative and O negative only C) AB negative, A negative, B negative only D) AB negative, A negative, B negative, and O negative

A) O negative only

Which of the following is the most prevalent blood type found in the US? A) O positive B) A positive C) B positive D) O negative

A) O positive

In an emergency release, why do blood bankers seldom encounter patients who have experienced hemolytic transfusion reactions from transfusion of uncrossmatched packed RBCs? A) The incidence of unexpected red blood cell antibodies is relatively low B) They usually receive group O Rh-negative red blood cells; a hemolytic transfusion reaction will never occur if Rh-negative red blood cells are transfused C) they hemorrhage so severely that incompatible donor red blood cells "bleed out" before a reaction occurs D) some patients have cold-reactive antibodies that will not react at body temperature

A) the incidence of unexpected red blood cell antibodies is relatively low

At what frequency should quality control testing be performed on each lot of anti-human globulin to be in compliance with the FDA's current good manufacturing practices requirements? A) at the beginning of each work shift B) each day of use C) only at the time of receipt D) by each new user

B) each day of use

All of the following would be included in a hemolytic transfusion reaction investigation, EXCEPT: A) ABO/Rh check of post transfusion sample B) leukocyte antigen studies C) DAT on post-transfusion sample D) clerical check

B) leukocyte antigen studies

False negative results may occur with indirect antiglobulin tests as a result of all of the following EXCEPT: A) under centrifugation B) delay in adding antiglobulin reagent C) failure to adequately wash cells D) red blood cells have a positive DAT

D) red blood cells have a positive DAT