BB EXAM 4
All of the following anticoagulants have been approved for blood bank use in the United States except Answers: ACD CPD CPDA-1 CP3D
CP3D
In the United States, transfusion-associated fatalities must be reported to which regulatory agency? Answers: American Medical Association Centre for Biologics Evaluation and Research Food and Drug Administration Haemovigilance network
Centre for Biologics Evaluation and Research
Separation of blood components during apheresis is achieved through: Washing Aliquoting Centrifugation Dilution
Centrifugation
ISBT 128 blood component labeling guidelines require all of the following except: Donor identification number Blood type Product expiration date Recipient name
Recipient name
. All of the following are true about leukoreduction except Answers: Can be achieved by using a specialized filter Removes red blood cells from whole blood or blood components Reduces the undesirable effects that white blood cells have on blood components Reduces the risk of adverse reactions in patients receiving blood components
Removes red blood cells from whole blood or blood components
All of the following are true about leukoreduction except Answers: Can be achieved by using a specialized filter Removes red blood cells from whole blood or blood components Reduces the undesirable effects that white blood cells have on blood components Reduces the risk of adverse reactions in patients receiving blood components
Removes red blood cells from whole blood or blood components
Over half the hypotensive transfusion reactions reported have been associated with which type of treatment? Answers: ACE inhibitor Angiotensin Antihistamine Antipyretic
ACE inhibitor
How much residual plasma remains in a component of cryoprecipitated AHF that is prepared from whole blood? 100 mL 70 mL 30 mL 15 mL
15 mL
In order for a blood product to be designated as leukoreduced, the product must have less than _____ white blood cells per unit. 5.0 x 1010 1.0 x 106 5.0 x 106 3.0 x 106
5.0 x 106
The acceptable number of residual WBCs in a leukoreduced blood product is no greater than: 5.0 x 106/L 5.0 x 1010/L 1.0 x 106/L 1.0 x 1010/L
5.0 x 106/L
A full written report of a transfusion-associated fatality must be reported to the Centre for Biologics Evaluation and Research CBER within ___ days of the incident. 3 7 10 14
7
One unit of cryoprecipitated AHF prepared from whole blood contains a minimum of how many international units IU of Factor VIII? 40 80 120 180
80
Hypotensive transfusion reactions are identified as a drop in blood pressure of Answers: >10 mm Hg >20 mm Hg >30 mm Hg >40 mm Hg
>30 mm Hg
. How can anaphylactic and anaphylactoid transfusion reactions be distinguished from other reactions with a similar clinical presentation? Absence of IgA Absence of fever Presence of respiratory distress Shock
Absence of fever
Fever is a common symptom in which types of transfusion reactions? Answers: Acute hemolytic, allergic, febrile nonhemolytic Acute hemolytic, febrile nonhemolytic, transfusion-related acute lung injury Allergic, febrile nonhemolytic, transfusion-associated circulatory overload Anaphylactic, febrile nonhemolytic, transfusion-related immunomodulation
Acute hemolytic, febrile nonhemolytic, transfusion-related acute lung injury
Which of the following preservative constituents serves to maintain ATP levels during blood storage? Citric acid Dextrose Adenine Sodium phosphate
Adenine
The use of recombinant proteins includes all of the following advantages except: Availability Predictability Affordability Risk reduction
Affordability
Regarding febrile, nonhemolytic transfusion reactions (FNHTR), all of the following statements are true except Answers: After an initial reaction, recurrence is uncommon. Onset of symptoms occurs during or up to 4 hours after transfusion. Prestorage filtration has been shown to be effective in reducing incidences. Symptoms cause discomfort but are not life-threatening.
After an initial reaction, recurrence is uncommon.
The first protein to be fractionated and isolated form human plasma was: Albumin Immune globulin Coagulation protein Prothrombin complex
Albumin
Which of the following statements is true about granulocyte component production? Answers: A whole blood unit generally yields 5 × 106 granulocytes. Apheresis collection is used more often than whole blood separation. Granulocyte units are stored at 68-75.2° F (20-24° C) for up to 5 days. Hydroxyethel starch is added and then the blood is centrifuged.
Apheresis collection is used more often than whole blood separation.
Which of the following statements is true about granulocyte component production? Answers: A whole blood unit generally yields 5 × 106 granulocytes. Apheresis collection is used more often than whole blood separation. Granulocyte units are stored at 68-75.2° F (20-24° C) for up to 5 days. Hydroxyethel starch is added and then the blood is centrifuged.
Apheresis collection is used more often than whole blood separation.
Which of the following statements is true of delayed hemolytic reactions? Answers: Are associated with complement-mediated intravascular hemolysis. Are associated with extravascular hemolysis. Are the most common reactions to occur during blood transfusion. Occur immediately after exposure to a transfused component.
Are associated with extravascular hemolysis.
Who coined the term "blood bank"? Answers: Bernard Fantus Francis Rous JR Turner Richard Weil
Bernard Fantus
Which of the following clinical findings best differentiates TRALI from TACO? X-ray evidence of pulmonary edema Brain natriuretic peptide BNP level Central venous pressure CVP level Presence of hypoxia
Brain natriuretic peptide BNP level
All of the following are true about platelet storage containers except Answers: Are made from nonpolyvinylchloride plastic Contain plasticizers that stabilize the platelet membrane Decrease carbon dioxide buildup Have high gas permeability
Contain plasticizers that stabilize the platelet membrane
All of the following are true about platelet storage containers except Answers: Are made from nonpolyvinylchloride plastic Contain plasticizers that stabilize the platelet membrane Decrease carbon dioxide buildup Have high gas permeability
Contain plasticizers that stabilize the platelet membrane
The appropriate blood product for a person with mild hemophilia is: RBCs FFP Cryoprecipitate Platelets
Cryoprecipitate
Patient John Smith is receiving a transfusion of 1 unit of RBCs for an anemic condition. Upon taking vital signs, his nurse suspects he might be having an adverse reaction to the transfusion. What is her first course of action? Elevate the patient to sitting position Inform his next of kin Administer IV furosemide STAT Discontinue the transfusion
Discontinue the transfusion
Which of the following statements regarding transfusable plasma is true? FFP is processed within 8 hours of collection and contains both stable and labile proteins FP24 is processed within 8 hours of collection and contains both stable and labile proteins Liquid plasma is processed within 24 hours of collection and contains only stable proteins Thawed plasma prepared from FFP, thawed at 33.8-42.8 C (1-6 C) and contains only stable proteins
FFP is processed within 8 hours of collection and contains both stable and labile proteins
Which of the following is the most commonly reported complication associated with transfusion? Answers: Acute hemolytic transfusion reaction Delayed hemolytic transfusion reaction Febrile nonhemolytic transfusion reaction Immune-mediated hemolytic transfusion reaction
Febrile nonhemolytic transfusion reaction
All of the following statements are true about transfusion-related immunomodulation (TRIM) except Answers: Cause remains unproven. First recognized in liver transplant recipients. Possible deleterious effects include increased recurrence of cancer. Refers to immune suppression following transfusion of allogeneic blood products.
First recognized in liver transplant recipients.
Decreased levels of ____ during blood storage results in impaired oxygen release by red blood cells after the blood is transfused. Potassium Sodium 2,3-DPG Hemoglobin F
Hemoglobin F
What is the main consequence of elevated citrate levels in transfusion recipients? Hypocalcemia Hypoproteinemia Hypokalemia Hypomagnesium
Hypocalcemia
Biochemical changes that can occur during blood storage include: Increase in plasma hemoglobin level Increase in pH level Increase in ATP level Increase in 2, 3-DPG levels
Increase in plasma hemoglobin level
Initial laboratory investigation of a suspected transfusion reaction includes all of the following except Answers: ABO testing of post-transfusion blood specimen Clerical check of label and tags on transfused component Direct antiglobulin test on post-transfusion blood specimen Inspection for visible hemolysis in pretransfusion urine specimen
Inspection for visible hemolysis in pretransfusion urine specimen
Hemosiderosis is caused by excessive exposure to ____. Citrate Calcium Potassium Iron
Iron
To prevent engraftment of donor lymphocytes, cellular blood products should be: Washed Volume-reduced Irradiated Pooled
Irradiated
How does gamma irradiation of blood products prevent TA-GVHD? It reduces the number of donor lymphocytes in the transfused product It destroys non-nucleated cells such as RBCs and platelets It inhibits the proliferative capability of donor lymphocytes It increases HLA compatibility between donor and recipient
It inhibits the proliferative capability of donor lymphocytes
All of the following are signs and symptoms of an acute hemolytic transfusion reaction except Answers: Fever Muscle cramps Chest pain Dyspnea
Muscle cramps
The primary populations that benefit from aliquoting blood products are: Fetuses and neonates Neonatal and pediatric patients Pediatric and adolescent patients Adolescents and adults
Neonatal and pediatric patients
Which of the following statements is true regarding the benefits and risks of peripheral blood stem cell PBSC collection and bone marrow collection? PBSC requires insertion of a catheter, which reduces risk of infection Bone marrow collection has a shorter engraftment period than PBSC Bone marrow collection carries a lower risk for the donor PBSC carries a higher incidence of graft versus host disease GVHD
PBSC carries a higher incidence of graft versus host disease GVHD
Which of the following components is not prepared from whole blood? Red blood cells Fresh frozen plasma Cryoprecipitate Platelets apheresis
Platelet apheresis
Which of the following production methods for preparing platelet components from whole blood is recommended for pediatric transfusion? Buffy coat B/C Platelet-rich plasma PRP Soft spin Hard spin
Platelet-rich plasma PRP
Which blood product is most commonly implicated in hypotensive transfusion reactions? Platelets Whole blood Packed RBCs FFP
Platelets
Which of the following statements regarding blood storage conditions is incorrect? CPDA-1 RBCs stored for 35 days at 33.8-42.8 F (1-6 C) Platelets are stored for 5 days at 33.8-42.8 F (1-6 C) with gentle agitation Cryoprecipitated AHF is stored for 1 year at -0.4 F (-18 C) Granulocytes are stored for 24 hours at 68-75.2 F (20-24 C) with no agitation
Platelets are stored for 5 days at 33.8-42.8 F (1-6 C) with gentle agitation
What causes allergic transfusion reactions? Answers: Patient antibodies that are directed against antigens present on the transfused red blood cells. Patient antibodies to non-ABO red blood cell antigens. Preformed plasma antibodies that react with protein-based allergens. Pulmonary infiltrates caused by antibodies to HLA antigens.
Preformed plasma antibodies that react with protein-based allergens.
Prevention of Rh immunization is achieved through transfusion of which of the following products? RhIg Plateletpheresis 22% Albumin IVIG
RhIG
The most important consideration for the transport of blood components between sites is: Use of disposable devices Shipping temperature Shipping container Insulation of the transport vehicle
Shipping temperature
All of the following assist in the precipitation of proteins during plasma fractionation EXCEPT: Addition of ethanol Regulation of pH Temperature change Solvent detergent treatment
Solvent detergent treatment
What can be done to prevent transfusion-associated circulatory overload (TACO) in at-risk patients? Answers: Irradiate blood products before transfusion Split a red blood cell product in half and transfuse each half over 4 hours Transfuse only leukoreduced blood products Wait several hours after medication is given before starting a transfusion
Split a red blood cell product in half and transfuse each half over 4 hours
Which of the following defines hyperhemolysis? The patient's red blood cells are destroyed in addition to transfused donor cells. The patient's white blood cells are destroyed in addition to transfused donor cells. The presence of hemoglobin in the patient's urine. The presence of free hemoglobin in the patient's plasma.
The patient's red blood cells are destroyed in addition to transfused donor cells.
All of the following statements about anaphylactoid transfusion reactions are true except Answers: They are serious and life-threatening They are triggered by IgE class antibodies that release mediators from mast cells They can be caused by reaction between a protein allergen and its corresponding antibody They can be caused by IgA in the transfused blood product reacting with anti-IgA in the patient's plasma
They are triggered by IgE class antibodies that release mediators from mast cells
A blood donor with a history of hepatitis B should be excluded: Answers: a. permanently. b. only if liver function tests are abnormal. c. only if they are jaundiced. d. only if the disease has been active for the last 5 years.
a. permanently.
Immediate transfusion reaction procedures consist of all of the following except: Answers: a. serum haptoglobin. b. DAT. c. visual check. d. clerical check.
a. serum haptoglobin.
In which country is the platelet-rich plasma method mostly widely used? Answers: Brazil Canada United Kingdom United States
United States
A patient who recently stopped taking clopidogrel (Plavix) needs to donate platelets. How long must the patient defer donation after completing the medication? Answers: a. 24 hours b. 14 days c. 48 hours d. 7 days
b. 14 days
Which of the following is an indicator of acute immune hemolytic transfusion reaction? Answers: a. Increased hemoglobin b. Increased bilirubin c. Decreased LDH d. Increased haptoglobin
b. Increased bilirubin
The blood component expiration date must always be changed to 24 hours when using which of the following blood component modification procedures? Aliquoting RBCs using a sterile connecting device Washing RBCs in an open system Pooling platelets Leukoreduction of whole blood
Washing RBCs in an open system
If a prospective blood donor has participated in a pheresis donation (platelets, plasma, granulocytes), at least how much time must pass before they can donate whole blood? Answers: a. 48 hours b. 56 days c. 24 hours d. 4 weeks
a. 48 hours
Normally what percentage of 35-day-old red blood cells should be circulating 24 hours after transfusion? Answers: a. 70% b. 100% c. 50% d. 65% Selected
a. 70%
A patient transfused with 2 units of packed red blood cells demonstrated signs of a transfusion reaction just before the second unit was completely infused. Hypotension, fever, and back pain are the immediate symptoms. Blood work reveals a 3% drop in hematocrit and prolonged PT. What therapy is given to correct the PT? Answers: a. FFP b. Mannitol c. Platelet concentrates d. Dopamine
a. FFP
A world traveler came in to do a directed donation for his sister when he found out she needed surgery for her hip. After spending 5 weeks in Europe, he traveled extensively throughout Africa. How should his case be handled? Answers: a. He meets all the criteria for being a directed donor, so would be able to donate without any problem. b. Because he is donating to his sister, and she signed consent, he may donate for her. c. He could donate, but only with the consent of the medical direct and physician. d. He would not be able to donate, because all directed donors must meet the same criteria as allogeneic donors.
d. He would not be able to donate, because all directed donors must meet the same criteria as allogeneic donors.
Which of the following results when large excesses of free hemoglobin are released into the blood? Answers: a. Hemosiderinuria b. Hemoglobinuria c. Hematuria d. Hemoglobinemia
d. Hemoglobinemia
Ringer's lactate is characterized as a: Answers: a. albumin derivative. b. colloid. c. antithrombotic. d. crystalloid.
d. crystalloid.
Plasma fractionation produces what three categories of protein concentrates? Answers: Albumin, beta globulins, and coagulation factors Albumin, immune globulins, and coagulation factors Haptoglobin, immune globulins, and coagulation factors Haptoglobin, immune globulins, and complement factors
Albumin, immune globulins, and coagulation factors
Components that may be collected by apheresis include: Red blood cells Platelets Granulocytes All of the above.
All of the above
Which statement about the blood storage lesion is false? Answers: All the changes are irreversible. Changes affect all components of the blood. Stored red blood cells continue to metabolize. White blood cells release cytokines and enzymes.
All the changes are irreversible.
Which statement about the blood storage lesion is false? Answers: All the changes are irreversible. Changes affect all components of the blood. Stored red blood cells continue to metabolize. White blood cells release cytokines and enzymes.
All the changes are irreversible.
How is an febrile nonhemolytic transfusion reaction FNHTR best defined? Answers: a. A 2°C temperature rise associated with transfusion and pneumonia b. A 1°C temperature rise associated with transfusion that has no medical explanation other than blood component transfusion c. A 1°C temperature rise associated with transfusion and inflammation of the colon d. A 2°C temperature rise associated with transfusion that has no medical explanation other than component transfusion
b. A 1°C temperature rise associated with transfusion that has no medical explanation other than blood component transfusion
A woman received a transfusion of packed RBCs while delivering her baby. Six months later she wanted to donate a unit of blood back to the American Red Cross. If the woman meets all other criteria for donation, is she allowed to donate at this time? Answers: a. No, she needs to wait 3 more months. b. No, she needs to wait 6 more months. c. Yes, she can donate at this time. d. No, she should be on permanent deferral.
b. No, she needs to wait 6 more months.
How can depletion and dilution of coagulation factors be avoided in a massively transfused patient? Answers: a. Prudent use of colloid replacement solutions b. Prudent use of platelets and fresh frozen plasma (FFP) c. Whole blood infusions d. None of the above
b. Prudent use of platelets and fresh frozen plasma (FFP)
Physical or chemical damage of the transfused red blood cells can result in: Answers: a. sepsis. b. intravascular hemolysis. c. pulmonary edema. d. extravascular hemolysis.
b. intravascular hemolysis.
What is the minimum hemoglobin level for a potential autologous donor? Answers: a. 12.5 g/dL b. 14 g/dL c. 11 g/dL d. 12 g/dL
c. 11 g/dL .
Leukoreduced packed RBCs must have an absolute white blood cell count of less than and contain at least what percent of original RBC mass? Answers: a. 5 ´ 106/80 b. 5 ´ 108/85 c. 5 ´ 106/85 d. 5 ´ 108/80
c. 5 ´ 106/85
Methods of preparation of platelet concentrates from single units of whole blood must produce a product that yields a minimum of: Answers: a. 5.5 ´ 1011 platelets per unit in 50% of units tested. b. 5.5 ´ 1011 platelets per unit in 75% of units tested. c. 5.5 ´ 1010 platelets per unit in 75% of units tested. d. none of the above.
c. 5.5 ´ 1010 platelets per unit in 75% of units tested.
The following blood donors regularly give blood. Which donor may donate on September 11th? Answers: a. A 40-year-old woman who last donated on July 25th b. A 23-year-old woman who made a direct donation for her aunt on August 14th c. A 28-year-old man who had plateletpheresis on August 24th d. A 52-year-old man who made an autologous donation on September 9th
c. A 28-year-old man who had plateletpheresis on August 24th
Which of the following should be collected immediately from a patient exhibiting signs of a septic reaction to blood products? Answers: a. Urine sample b. DAT c. Blood cultures d. Complete blood count (CBC)
c. Blood cultures
What treatment is recommended following a bacterial contamination reaction? Answers: a. Plasma protein fraction (PPF) b. Aspirin c. Broad-spectrum antibiotics d. Epinephrine
c. Broad-spectrum antibiotics
What is the first step in the initial blood bank laboratory investigation of a suspected transfusion reaction? Repeat ABO testing Visual inspection for hemolysis DAT Clerical check
Clerical check
Which of the following is the most common transfusion reaction reported to blood banks? Answers: a. Intravascular hemolytic reaction b. Extravascular hemolytic reaction c. Febrile reaction d. Anaphylactic reaction
c. Febrile reaction
Nucleic acid amplification testing (NAT) is performed for which of the following? Answers: a. HIV, HBV, WNV b. HIV, HCV, HBV c. HIV, WNV, HCV d. HIV, HTLV I,II, HCV
c. HIV, WNV, HCV
Alloimmunization may result from which of the following? Answers: a. Circulatory overload b. Bacterial contaminated red blood cells c. Prior exposure to donor blood components d. Transfusing an O-positive recipient with A-negative packed cells
c. Prior exposure to donor blood components
A delta check was noted for potassium after a surgical patient was transfused with 2 units of packed red blood cells. The pre-transfusion potassium was 3.1 mmol/L and the post-transfusion specimen was 6.2 mmol/L. What could be the reason for this sudden increase? Answers: a. Coagulation factors were diluted out of patient plasma. b. Red blood cells were washed prior to infusion. c. Red blood cells spent maximum time in storage. d. None of the above
c. Red blood cells spent maximum time in storage.
Which of the following therapies is not advocated in circulatory overload? Answers: a. Whole blood units b. Washed red blood cells c. Transfusing at too fast a rate d. Therapeutic phlebotomy
c. Transfusing at too fast a rate
Which organism is responsible for transmitting Chagas disease? a. Yersinia enterocolitica b. Plasmodium vivax c. Trypanosoma cruzi d. Treponema pallidum
c. Trypanosoma cruzi
All of the following statements are true about transfusion-related immunomodulation (TRIM) except Answers: Cause remains unproven. First recognized in liver transplant recipients. Possible deleterious effects include increased recurrence of cancer. Refers to immune suppression following transfusion of allogeneic blood products.
First recognized in liver transplant recipients.
Signs and symptoms of transfusion-related acute lung injury (TRALI) include all of the following except Answers: Acute onset of respiratory symptoms during or within 6 hours of transfusion Bilateral infiltrates on chest radiography Evidence of left atrial hypertension Hypoxemia
Evidence of left atrial hypertension
What global standard provides requirements for the information that must be present on a blood component label? Answers: ISBT 128 ISBT 240 ISO 9000 ISO 9001
ISBT 128
All of the following are signs and symptoms of an acute hemolytic transfusion reaction except Answers: Fever Muscle cramps Chest pain Dyspnea
Muscle cramps
Patients at a greater risk for transfusion-associated graft versus host disease (TA-GVHD) include all the following except Answers: Fetuses Older adults Patients with Hodgkin's disease Hematopoietic stem cell transplant recipients
Older adults
A postpartum woman was crossmatched for 2 units of packed red blood cells. The first unit was issued at 3:15 a.m. At 3:45 a.m., the nurse called the blood bank and stated the patient was developing red hives and pruritus (itching). The transfusion was stopped and a post-transfusion specimen was drawn. The unit and identification tags were returned to the blood bank. The DAT on the specimen was negative, and hemolysis was absent. All visual and clerical checks were satisfactory. The pathologist ordered the treatment of diphenhydramine (Benadryl) for all subsequent transfusions. What type of transfusion reaction has occurred in this patient? Answers: a. Alloimmunization b. Anaphylactic c. Urticarial d. Post-transfusion purpura
c. Urticarial
The presence of intact red blood cells in microscopic urinalysis examination indicates: Answers: a. hemolysis. b. bilirubinemia. c. bleeding. d. hemosiderinuria.
c. bleeding.
The most important initial step in evaluating a suspected hemolytic transfusion reaction is to: Answers: a. perform a CBC and urinalysis. b. perform a DAT. c. reconfirm the patient's identity and reexamine all pre-transfusion testing. d. recheck the compatibility testing, using a pre- and post-sample.
c. reconfirm the patient's identity and reexamine all pre-transfusion testing.
Which of the following can be added to blood prior to or during transfusion? Answers: a. Ringer's lactate b. Antibiotics c. Mild antihistamines d. 0.85% sodium chloride solution (USP grade)
d. 0.85% sodium chloride solution (USP grade)
What is the expiration time for platelet concentrates that have been pooled? Answers: a. 48 hours b. 6 hours c. 24 hours d. 4 hours
d. 4 hours
What is the minimal pH required for platelets? Answers: a. 7.0 b. 6.0 c. 7.2 d. 6.2
d. 6.2
An autologous unit should be donated what time period prior to the patients surgery/need? Answers: a. 48 hours b. 24 hours c. 1 week d. 72 hours
d. 72 hours
Packed RBCs must have a final hematocrit of less than or equal to: Answers: a. 85%. b. 38%. c. 70%. d. 80%.
d. 80%.
When checking out a unit of blood to the floor: Answers: a. the nurse must provide a piece of paper with at least two patient identifiers and preferably, depending on the system, a unique blood bank band number b. you must visually check and document that the unit is free from hemolysis or possible bacterial contamination c. you must document who is checking out the blood and transporting it d. All of the above
d. All of the above
Which of the following are approved preservative solutions for blood storage at 1°C to 6°C for 21 days? Answers: a. ACD b. CPD c. CP2D d. All of the above
d. All of the above
Which of the following is compromised by iron overload? Answers: a. Heart b. Liver c. Endocrine glands d. All of the above
d. All of the above
Which of the following statements explains why bacterial contamination of blood is rarely a problem? Answers: a. Regulated procedures for arm preparation prevent most bacteria contamination from occurring during collection. b. Citrate in the anticoagulant is not conducive to bacterial growth. c. The cold storage of blood is not conducive to bacterial growth. d. All of the above
d. All of the above
The new international bar code system that most blood banks are converting to is: Answers: a. Codabar 128. b. Eian 12. c. Codabar. d. ISBT.
d. ISBT.
What groups are at risk for graft-versus-host disease (GVHD) as a result of transfusion? Answers: a. Polycythemia vera patients undergoing a therapeutic phlebotomy b. Fetuses receiving an intrauterine transfusion c. Patients receiving a directed donation from a first-degree relative d. Options B and C
d. Options B and C
A 41-year-old multiparous woman was rushed to the emergency room after being shot in the chest. She received 8 units of packed red blood cells and 5 units of platelets. The hemoglobin and hematocrit determinations stabilized after 6 hours in surgery, but the platelet counts remained less than 50,000 per µL. She had received additional units of platelets at 48-hour intervals with little efficacy. Her serum was tested for platelet antibodies. She was placed on corticosteroids to control chest wound bleeding. Anti-PLĀ was identified in the patient's serum. This case is representative of what type of transfusion reaction? Answers: a. Circulatory overload b. Alloimmunization c. Graft-versus-host disease d. Post-transfusion purpura
d. Post-transfusion purpura
Which of the following is consistent with bacterial contamination reactions? Answers: a. The organism thrives in warm temperatures. b. The organism exhibits motility. c. The organism is a fastidious anaerobe. d. The organism thrives in cold temperatures.
d. The organism thrives in cold temperatures.
A whole blood donor who has taken Tegison should be: a. deferred for 6 months. b. accepted. c. deferred for 3 months. d. permanently deferred.
d. permanently deferred.
In the buffy coat production method the whole blood is first subjected to a Answers: automated spin hard spin soft spin top spin
hard spin
What measure can be taken to prevent transfusion-associated hypothermia? Answers: a. Transfusion of product using a blood warmer b. Premedication with calcium gluconate c. Prudent use of platelet concentrates d. Close monitoring of patient vital signs
a. Transfusion of product using a blood warmer
A delayed hemolytic transfusion reaction is most often the result of: Answers: a. an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy. b. bacterial-contaminated red blood cells. c. a unit of packed cells infected with hepatitis B virus. d. hemosiderosis in a massively transfused patient.
a. an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy.
In a DHTR, patient antibody attaches to the specific foreign donor red blood cell antigen, causing sensitization of red blood cells, which are removed by the: Answers: a. reticuloendothelial system (RES). b. complement system. c. MHC complex. d. kidneys.
a. reticuloendothelial system (RES).
How could a potential alloimmunizaton due to Anti-K be prevented? Answers: a. Matching of donor and recipient red blood cell phenotype b. Use of washed red blood cells c. Use of third-generation bedside leukocyte filters d. Use of apheresed platelets
a. Matching of donor and recipient red blood cell phenotype
What should be done in the transfusion process when the patient temperature spikes from 37.5°C to 38.5°C within 30 minutes of transfusion? Answers: a. Stop the transfusion and keep the intravenous line open. b. Affix a leukocyte filter to transfusion line. c. Treat with diphenhydramine (Benadryl). d. Continue the transfusion.
a. Stop the transfusion and keep the intravenous line open.
