Blood Bank Week 2 SQ

AHG

In the antibody screening test, at what phase of reactivity is it most important to read the reactions for detection of clinically significant antibodies? Please select the single best answer 4°C Immediate spin 37°C AHG

Asians

In which group is Type B blood found in higher frequency? Please select the single best answer African Americans Caucasians Asians Hispanics

21 CFR 640.25 Platelets - General Requirements

In which of the following sections of CFR Title 21, Good manufacturing practices, would you find requirements for quality control testing of donor units of platelets? Please select the single best answer 21 CFR 211.22 Responsibilities of a Quality Control Unit 21 CFR 211.80 Control of Components, Drug Product Containers and Closures 21 CFR 606.140 Laboratory Controls 21 CFR 640.25 Platelets - General Requirements

Prevention of Graft-Versus-Host (GVH) disease

In which situation is gamma irradiation of cellular blood components required? Please select the single best answer Prevention of post-transfusion purpura Prevention of Graft-Versus-Host (GVH) disease Sterile components Prevention of non-cardiogenic pulmonary edema

A1B

Which of the following blood groups reacts least strongly with anti-H? Please select the single best answer O A2 A1 A1B

Thrombocytopenia

Which of the following clinical findings characterizes post-transfusion purpura (PTP)? Please select the single best answer Increased hemoglobin Pancytopenia High ferritin levels Thrombocytopenia

Anti-A1

Lectin from the seeds of Dolichos biflorus is a source of which of the following? Please select the single best answer Anti-A1 Anti-A2 Anti-B Anti-H

AHG (anti-human globulin) detects antibody already sensitized to red cells

Which of the following best describes the direct antiglobulin (DAT) test principle? Please select the single best answer AHG (anti-human globulin) detects antibody already sensitized to red cells AHG (anti-human globulin) prevents antibody from sensitizing red cells AHG (anti-human globulin) is directed against cell antigens AHG (anti-human globulin) is directed against plasma antibodies

Fya

Which of the following blood group antigens are most susceptible to destruction by the action of enzymes? Please select the single best answer D Jka Lea Fya

Cold agglutinin disease

Which of the following conditions is MOST frequently associated with anti-I? Cold agglutinin disease Hemolytic transfusion reaction Delayed transfusion reaction Infectious mononucleosis

Irradiated

Which of the following criteria for donor RBC should be used for an exchange transfusion related to both HDFN due to anti-D and ABO HDFN? Please select the single best answer Reconstituted with group O fresh frozen plasma Negative for hemoglobin F Reconstituted with cryoprecipitate Irradiated

Leukoreduced RBC

Which of the following is generally considered equivalent to CMV seronegative RBCs for use in an exchange transfusion to a newborn? Please select the single best answer Fresh RBC less than 7 days old Hemoglobin S negative RBC Frozen RBC Leukoreduced RBC

Anti-A, Anti-B, Anti-A, B

Which of the following is the cause of the most severe life-threatening hemolytic transfusion reactions? Please select the single best answer Anti-D Anti-M Anti-A, Anti-B, Anti-A, B Anti-Fya

Warm autoimmune hemolytic anemia.

Which of the following is the most common type of autoimmune hemolytic anemia? Please select the single best answer Warm autoimmune hemolytic anemia. Cold agglutinin disease. Paroxysmal cold hemoglobinuria. Drug-induced immune hemolytic anemia.

IgM

Which of the following is the predominant immunoglobulin class for anti-A and anti-B antibodies in group B and group A individuals? Please select the single best answer IgM IgG IgA IgE

4 degrees Celsius

Which of the following is the proper storage temperature for whole blood? Please select the single best answer - 20 degrees Celsius - 12 degrees Celsius 12 degrees Celsius 4 degrees Celsius

Two h genes are inherited at the H locus

Which of the following is true of the classic Bombay phenotype? Please select the single best answer Two h genes are inherited at the H locus H substance is present A antigen is present B antigen is present

Doctor's name and patient room number

Which is NOT a requirement for information on the donor tag once the appropriate compatibility testing has been completed and the unit or units are suitable for transfusion? Please select the single best answer Patient's full name and identification number Name of the product and donor number ABO & D phenotype of the unit Doctor's name and patient room number

Cryoprecipitated AHF

Which is the best component to treat a patient with fibrinogen deficiency? Please select the single best answer Red Blood Cells Platelet Concentrate Fresh Whole Blood Cryoprecipitated AHF

Irradiating a unit of red cells or platelets

Which of the following activities would require that a label be added to the blood label indicating the name and location of a second manufacturer? Please select the single best answer Irradiating a unit of red cells or platelets Shipping a unit to another facility Thawing a unit of plasma Receiving a unit from another facility

Anti-Fya

Which of the following antibodies is detected primarily in the antiglobulin phase of the crossmatch? Please select the single best answer Anti-Fya Anti-M Anti-B Anti-P1

I, i

Which of the following antigen groups is closely related to the ABO antigens on the red cell membrane? Please select the single best answer Rh Kell I, i Duffy

Known antigen used to detect ABO antibodies.

Which of the following best describes reverse typing? Please select the single best answer Known antisera used to detect ABO antigens. Known antigen used to detect ABO antibodies. Known antigen used to detect ABO antigens. Known antisera used to detect ABO antibodies.

Unexplained bleeding from surgical site

Which of the following signs and symptoms may be associated with immediate transfusion reaction, but is NOT usually associated with delayed hemolytic transfusion reaction? Please select the single best answer Fever and chills Unexplained bleeding from surgical site Unexplained drop in hemoglobin Transient jaundice

Low pH of saline

Which of the following sources of error will give a false negative result in antihuman globulin testing? Please select the single best answer Low pH of saline Dirty glassware Samples collected in gel separator tubes Refrigerated specimen

Anti-H reacts more strongly with group A2 cells than with group A1 cells

Which of the following statements are true about anti-H? Please select the single best answer Anti-H does not react with group O cells Anti-H reacts more strongly with A1 cells than with O cells Anti-H never reacts with group A cells Anti-H reacts more strongly with group A2 cells than with group A1 cells

HLA system

In which system are DR antigens are found? Please select the single best answer Kell system HLA system Duffy system ABO system

Kidd system antibodies

A delayed hemolytic reaction occurring a week later is MOST likely caused by: Please select the single best answer Volume overload Kidd system antibodies Iron overload ABO incompatibility

An increase in temperature of >1°C above 37°C during transfusion

A febrile nonhemolytic transfusion reaction is characterized by which of the following? Please select the single best answer An increase in temperature of >1oC above 37oC during transfusion Appearance of hives Fever above 37oC which develops 24 hours later A decrease in temperature of < 2oC below 37oC following transfusion

Autologous donation

A patient's serum reacts with all reagent red cell samples. The autocontrol is negative. An alloantibody to a high incidence antigen is suspected. Which of the following would most likely be a compatible donor? Please select the single best answer Patient's parents Patient's siblings Patient's children Autologous donation

IgM

A primary immune response is generally associated with which antibody? Please select the single best answer IgG IgA IgM IgD

2 vials

An Rh negative mother has just given birth to an Rh positive baby. Her physician suspects that she has experienced a fetal-maternal hemmorhage since her rosette test was positive. Upon performing the Kleihauer-Betke stain procedure, the percentage of fetal cells is found to be 0.85%. The mother's total blood volume is 4,565 mL. What dose of Rh Immune Globulin (RhIG or RhoGam) should be administered to the mother? Please select the single best answer 1 vial 2 vials 3 vials 4 vials

Change the expiration date to 24 hours

An aliquot of AS-1 red blood cells is being prepared from an intact packed cell unit using a 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? Please select the single best answer Destroy the unit. Keep the original expiration date Change the expiration date to 24 hours Change the expiration date to 48 hours

False positives may be seen

An antibody screen utilizing polyethylene glycol (PEG) was performed. Reaction readings of this antibody screen are analyzed after the immediate spin and again at 37°C incubation with subsequent centrifugation. How will the centrifugation of the tubes affect the patient's results? Please select the single best answer Reactions will be enhanced No effect will be seen False positives may be seen False negatives may be seen

O

An individual with group AB blood does not have which of the following antigens present on their red blood cells? Please select the single best answer A B H O

15%

Approximately what percent of the Caucasian population is Rh negative? Please select the single best answer 10 % 15 % 25 % 35 %

Acute hemolytic transfusion reactions

Both hemoglobinuria and hemoglobinemia will be present in what type of reactions? Please select the single best answer Delayed hemolytic transfusion reactions Acute hemolytic transfusion reactions Transfusion related acute lung injury Anaphylactic transfusion reactions

Group O

Which of the following packed RBCs could be transfused to a group O patient? Please select the single best answer Group A Group B Group AB Group O

Bacterial contamination

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? Please select the single best answer The unit was frozen Donor had DIC Viral contamination Bacterial contamination

Anti-A,B

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

Anti-H

Group O blood cannot be transfused to a person with "Bombay blood" type because the Bombay individual produces which of the following? Please select the single best answer Anti-H Anti-A Anti-B H substance on his cells

30 mL

How many milliliters of Rh positive whole blood is one dose of Rh immune globulin capable of neutralizing? Please select the single best answer 15 30 45 450

24 hours

How soon must granulocyte concentrates be administered after donation? Please select the single best answer 12 hours 24 hours 3 days 30 days

Antibodies sensitizing red cells

The Direct Antiglobulin Test (DAT) is used to detect: Please select the single best answer Antibodies sensitizing red cells Antibodies in the plasma Antigens coating red cells Antigens in the plasma

Kell

The McLeod phenotype is associated with which of the following antigen systems? Please select the single best answer Rh P Kell MNSs

30

The appropriate dosage of Rh immune globulin (RhIg) to administer post-delivery to an Rh-negative mother delivering an Rh-positive child is calculated based on the estimated volume of fetal bleed. What is the value of x in the formula given below that is used to calculate RhIg dosage? Number of vials of 300 µg RhIg = volume of fetal bleed/x mL Please select the single best answer 10 30 100 300

Identify recipient antibodies against donor cells

The chief purpose of performing a serologic crossmatch is to: Please select the single best answer Identify antibodies in donor blood Identify antibodies in recipient red blood cells Identify recipient antibodies against donor cells Identify donor antibodies against recipient cells

Antigens are a structural component of the red cell membrane

The following statements are true regarding the Lewis blood group EXCEPT: Please select the single best answer Antigen expression is influenced by secretor status Antigens are adsorbed onto the red cells from the plasma Antigens are a structural component of the red cell membrane ABO group affects antigen expression

IgG

The immunoglobulin class responsible for the etiology of Hemolytic Disease of the Fetus and Newborn (HDFN) is: Please select the single best answer IgM IgG IgD IgE

IgG and IgM

The most significant blood group antibodies belong to which immunoglobulin classes? Please select the single best answer IgA and IgD IgA and IgM IgE and IgD IgG and IgM

A2 individual

The serum of which of the following individuals may agglutinate group A1 cells? Please select the single best answer A2 individual A1B individual A1individual Newborn

AABB

Which of the following is/are considered an accrediting agency(ies) for quality and safety in the blood industry? Please select the single best answer FDA CMS AABB ASCP

Do not issue the product.

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? Please select the single best answer Issue the product as you normally would but with a filter. Issue the product, but note the presence of the clot in the computer records. Filter the product prior to issue and record the process. Do not issue the product.

Identification of the recipient

What additional information is required on a label or tie tag of an autologous unit? Please select the single best answer Name of the ordering physician Identification of the recipient Location of the collection facility The statement "For Emergency Use Only"

Bombay phenotype

What does the hh genotype gives rise to? Please select the single best answer H substance H secretors Bombay phenotype h antibodies

Differentiate between maternal and fetal red cells

What is the Kleihauer-Betke test used for? Please select the single best answer Screen for sickle cell anemia Screen for fetal hemoglobin Differentiate between maternal and fetal red cells Screen for hemoglobin A1c

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? Please select the single best answer 25% 50% 75% 100%

Binding complement.

All of the following serological test results may occur in a patient experiencing a hemolytic transfusion reaction due to the presence of a clinically significant Rh antibody such as anti-c EXCEPT: Please select the single best answer Optimal reaction at 37°C or AHG phase. Preference to react with RBCs possessing a double-dose of Rh antigen. Binding complement. Positive DAT result.

O

Which one of the ABO groups listed below has the MOST H antigen? Please select the single best answer A1 A1B B O

Passive anti-D from RhIG given at 28 weeks.

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. Which of the following is the most likely cause of the positive antibody screen? Please select the single best answer Passive anti-D from RhIG given at 28 weeks. Anti-D formed during delivery Anti-D in neonate False positive result

A delayed hemolytic transfusion reaction

A patient transfused with two units of packed cells spiked a fever of 99.5oF and complained of chills five days after transfusion. The direct antiglobulin test (DAT) was positive with anti-IgG, but negative with anti-C3d. Compatibility testing was performed on the pre- and post-transfusion specimens. The post-transfusion specimen was incompatible with one of the donor units transfused. An antibody screen was done on both the pre- and post-transfusion specimens. An antibody was detected in the post-transfusion specimen only and identified by panel studies as anti-Jka. This transfusion reaction is most likely: Please select the single best answer Post-transfusion purpura An anaphylactic response An acute hemolytic transfusion reaction A delayed hemolytic transfusion reaction

IgG

A secondary immune response is generally associated with which of the following antibodies? Please select the single best answer IgG IgA IgM IgD

Anti-C, anti-K, anti-E

A technologist performing an antibody identification in the blood bank has recorded the following results found in the worksheet below. Which antibody(ies) listed below cannot be ruled out? Please select the single best answer Anti-N, anti-c, anti-C Anti-C, anti-K, anti-E Anti-k, anti-e, anti-c Anti-e, anti-N, anti-k

Transfusion of ABO incompatible red blood cells

Acute intravascular hemolysis as the result of a blood transfusion is most often associated with which of the following causes? Please select the single best answer Transfusion of ABO incompatible red blood cells Allergic reaction Passively transfused antibodies to HLA antigens Transfusion-associated graft-versus-host disease

Liver failure

Acute transfusion reactions are divided into categories based on all of the following symptoms EXCEPT: Please select the single best answer Fever Liver failure Allergic reaction Pulmonary involvement

One determination of recipient's ABO group is made

All of the following are advantages of performing the computer crossmatch EXCEPT? Please select the single best answer Greater flexibility in staffing One determination of recipient's ABO group is made Better management of blood bank inventory Reduced volume of sample needed on large crossmatch orders

Rh negative fetus

All of the following are indications for administering Rh immune globulin (RhIg) to an Rh negative woman, EXCEPT? Please select the single best answer Therapeutic abortion Ectopic pregnancy Rh positive fetus Rh negative fetus

AO and BO

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? Please select the single best answer AA and BO AO and BB AO and BO AA and BB

OO only

If an individual has blood type O, which of the following are possible genotypes? Please select the single best answer AO and OO BO and OO OO only AO, BO, and OO

Group O, Rh negative blood

In an extreme emergency, if the ABO and Rh type are unknown, which of the following should be given to the patient? Please select the single best answer Group O, Rh positive blood Group AB, Rh negative blood Group O, Rh negative blood Any blood type is OK

Rabbit erythrocyte stroma (RESt)

Which adsorption technique removes cold (IgM) antibodies, particularly anti-I specificities? Please select the single best answer Cold auto adsorption Warm auto adsorption Differential (allogeneic) Rabbit erythrocyte stroma (RESt)

React best at 37o Celsius

Which characteristic best describes IgG antibodies produced against red blood cells? Please select the single best answer Are naturally occurring Cannot be identified using the AHG test React best at room temperature React best at 37o Celsius

IgG

Which class of antibody can agglutinate erythrocytes (RBCs) after anti-human globulin (AHG) is added to the test tube? Please select the single best answer IgA IgE IgG IgM

Transfusion of certain food allergens or drugs in plasma products

What is considered the cause of urticarial transfusion reactions? Please select the single best answer IgA deficient individuals receiving plasma products containing IgA IgG or IgM antibody along with complement Tissue damage from the formation of immune complexes Transfusion of certain food allergens or drugs in plasma products

Check for clerical errors in all steps of the pre- and post processes.

What is the FIRST thing blood bank staff should do when investigating a transfusion reaction? Please select the single best answer Perform an IAT on the post-transfusion sample and DAT on the patient sample. Check for clerical errors in all steps of the pre- and post processes. Repeat ABO and Rh typing of the patient and donor unit. Perform an antibody screen on pre- and post-transfusion samples.

Bacteria

What is the MOST common infective agent to be transmitted through blood transfusion that results in morbidity and mortality? Please select the single best answer Bacteria Human immunodeficiency virus (HIV) Hepatitis A virus (HAV) Malarial parasites

Placing the FFP in a 37º C water bath

What is the acceptable way to thaw Fresh Frozen Plasma? Please select the single best answer Leaving it at room temperature away from agitation Refrigerating the FFP on a bottom rack Placing the FFP in a 37º C water bath Placing the FFP in a 121º C or higher in a steam sterilizer

ABO incompatibility

What is the cause of MOST severe acute hemolytic transfusions reactions? Please select the single best answer Rh incompatibility ABO incompatibility Cold agglutinins Delayed hypersensitivity

The baby's antibodies are undeveloped.

What is the explanation for a discrepancy in the following front type and back type in a newborn? Anti-A = neg Anti-B = neg A1 cells = neg B cells = neg Please select the single best answer Red cells are totally coated with antibody. The newborn is missing antigens. The baby's antibodies are undeveloped. Unable to determine.

Lyophilized Factor VIII concentrate

What is the first line treatment for moderate to severe hemophilia A? Please select the single best answer Platelets Lyophilized Factor VIII concentrate Factor IX complex Cryoprecipitated AHF

30% or greater

What is the increase in the risk for developing antibodies against red cell antigens (RBC alloimmunization) for patients who are characterized as chronically transfused patients? Please select the single best answer 1% - 4% 2% - 8% 5% - 10% 30% or greater

rr

What is the most frequent genotype among Rho (D) negative persons? Please select the single best answer r'r r'r" rr r"r

1-6 degrees Celsius

What is the required storage temperature for red blood cells? Please select the single best answer 1-6 degrees Celsius 5-15 degrees Celsius -18 degrees Celsius 20-24 degrees Celsius

Reverse typing

What procedure is used by the laboratory personnel to confirm ABO typing by using cells with known blood groups? Please select the single best answer DAT Forward typing Reverse typing Antibody identification panel

Heavy chains

What section of an immunoglobulin molecule is responsible for the differences between immunoglobulin classes? Please select the single best answer Fc Fab Heavy chains Light chains

Reagent antisera and patient red cells

What two things are put together for the testing known as forward grouping (testing)? Please select the single best answer Patient red cells and patient serum Reagent red cells and patient serum Reagent antisera and patient red cells Patient serum and donor red cells

The antibodies show dosage with Kidd antigens on red cells.

What would be considered a common characteristic of anti-Jka and anti-Jkb? Please select the single best answer The immunoglobulin class is IgM. Agglutination reactions are best observed by DAT. The antibodies show dosage with Kidd antigens on red cells. The antibodies are naturally occurring.

Patient has no history of clinically significant antibodies detected and the antibody screen on the current sample is negative

When is a computer crossmatch acceptable? Please select the single best answer Patient has a history of anti-Jka but the antibody screen on the current sample is negative Patient has a positive antibody screen and anti-D is detected Patient has no history of clinically significant antibodies detected and the antibody screen on the current sample is negative Patient has a history of anti-Fya but the antibody screen on the current sample is negative

Testing for weak D on potential transfusion recipient samples.

When is testing for weak D optional (not required)? Please select the single best answer Testing for weak D on potential transfusion recipient samples. Testing on donor red blood cells. Testing cord blood on infants born to Rh-negative moms Testing for Rh immune globulin workups.

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 statements is correct regarding blood bank adverse event reporting to the FDA? Please select the single best answer 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. When a transfusion reaction is the result of an error it must be reported to the FDA in writing. A transfusion-related death must be reported to the FDA within 24 hours of the patient's death. 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.

Clot tube stored at 4oC, transfusion reaction, and warm autoimmune disease

Which of the following would be a possible cause of a positive direct antiglobulin test (DAT)? Please select the single best answer Transfusion reaction and warm autoimmune disease only Warm autoimmune disease and clot tube stored at 4°C only Clot tube stored at 4oC and transfusion reaction only Clot tube stored at 4oC, transfusion reaction, and warm autoimmune disease.

Anti-K

Which one of the following antibodies has been implicated in hemolytic disease of the fetus and newborn (HDFN)? Please select the single best answer Anti-I Anti-K Anti-Lea Anti-Leb

Cryoprecipitate

Which one of the following blood components contains the MOST factor VIII concentration per mL? Please select the single best answer Plasma Cryoprecipitate Fresh frozen plasma Platelet concentrate

Yersinia enterocolitica

Which organism is MOST likely responsible for septic reactions associated with red blood cell transfusions? Please select the single best answer Yersinia enterocolitica Escherichia coli Enterobacter species Streptococcus species

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

Which procedure should be followed when one cross-matched unit out of five is INCOMPATIBLE at the antiglobulin (AHG) phase? Please select the single best answer Perform a direct antiglobulin test (DAT) on the incompatible unit Check for high-frequency antigens Wash the donor cells and use the washed cells for testing Perform an antibody panel using donor serum

Kernicterus

Which symptom of HDFN does phototherapy help prevent? Please select the single best answer Anemia Kernicterus Enlarged spleen Hydrops

Look-back

Which term listed below refers to the process that must be followed when notification is received that a donor of a unit transfused now tests positive for an infectious disease? Please select the single best answer Look-back Donor notification Minor crossmatch Major crossmatch

Nucleic acid testing for HCV

Which test is NOT used as a screen for retroviruses in donated blood? Please select the single best answer Antibody to HIV type 1 or type 2 Nucleic acid testing to detect HIV-1 RNA Antibody to HTLV types I and II Nucleic acid testing for HCV

Rh negative mother with Rh positive fetus

Who would be a candidate, at 28 weeks gestation and had a negative antibody screen, to be injected with Rh immune globulin (RhIg)? Please select the single best answer Rh positive mother with Rh negative fetus Rh positive mother with Rh positive fetus Rh negative mother with Rh negative fetus Rh negative mother with Rh positive fetus

The patient's anti-A would destroy the donor's cells with severe consequences to the patient.

Why is it dangerous to transfuse a blood group O person with a unit of blood group A? Please select the single best answer The patient will make antibodies to the type A blood. The group A blood may become the prominent blood group. The patient's Anti-O would destroy the donor's cells with severe consequences to the patient. The patient's anti-A would destroy the donor's cells with severe consequences to the patient.