Blood Banking (ASSESSMENT EXAM)

Can Rh positive blood can ever be transfused to an Rh negative person? A. Never; under no circumstances B. Only if Rh positive have been previously administered C. May be transfused to males or females past childbearing age D. Depends on the responder status of the individual

C

A crossmatch was performed on Oct. 16 and the blood was transfused on the same day. On what date can the original test sample still be found? A. Oct. 23 B. Oct. 24 C. Oct. 30 D. Nov. 1

A

A patient needing a blood transfusion is found to have anti-P1. According to the statistics, select the appropriate number of compatible units A. 1 of 4 units B. 1 of 10 units C. 2 of 3 units D. 3 of 4 units

A

A unit of packed RBCs is split using the open system. One of the half units is used. What may be done with the second half unit? A. Must be issued within 24 hours B. Must be issued within 48 hours C. Must be discarded D. Retains the original expiration date

A

FFP is appropriate replacement therapy for all of the following condition EXCEPT: A. Antithrombin III deficiency B. Liver disease C. Hypofibrinogenemia D. Factor IX deficiency

C

Given situation where cells, crossmatch, autocontrol and DAT (anti-IgG) are all positive, what procedure should be performed next? A. Absorption using rabbit stroma B. Antigen type the patients' cells C. Elution followed by a cell panel on the elute D.Cell panel

C

If a mother passes an antibody to her fetus through the placenta, what type of immunity does the fetus have? A. Naturally acquired active B. Artificially acquired active C. Naturally acquired passive D. Artificially acquire passive

C

Laboratories must check each negative antiglobulin test using red cells sensitized with IgG. After the addition of these cells, which of the following is NOT necessary true? A. Active antiglobulin serum was added B. Patient serum was added C. The washing phase was performed satisfactorily D. Antiglobulin serum has not reacted with the original red cells being tested

C

Screen cells crossmatch and patient autocontrol are positive in all phases of the crossmatch. Identify the problem. A. Specific cold alloantibodies B.Specific cold autoantibodies C. Abnormal protein or non-specific autoantibody D. Cold and warm alloantibody mixture

C

Six units are crossmatched. Five units are compatible, one unit is incompatible, and the recipient's antibody screen is negative. Identify the problem. A. Patient may have a high-frequency alloantibody B. Patient may have abnormal protein C. Donor unit may have a positive DAT D. Donor unit may have high-frequency antigen

C

The D antigen is responsible for the most frequent production of unexpected antibodies. Which other blood group antigen is responsible for a large percentage of unexpected antibody production? A. O antigen B. A antigen C. K antigen D. B antigen

C

What action is taken if packed RBCs and frozen RBCs arrive in wet ice? A. Return the frozen RBCs to the supplier B. Return the packed RBCs to the supplier\ C. Return all uinits to the supplier D. Place all units in the proper refrigerator/freezer

C

What component(s) is (are) indicated for patients who have anti-IgA antibodies? A. Whole blood B. packed RBCs C. Washed, leukocyte-poor, or frozen deglycerolized RBCs D. Granulocyte preparations

C

What is the disposition of a unit if a seal has been broken? A. Issue the unit if red cells appear normal B. Reseal the unit C. Discard the unit D. Call the medical director and ask for an opinion

C

What is true concerning the acquisition of K negative donor units? A. Blood must be provided by rare donor files. B. Close relatives must be screened as potential donors. C. 90% of donor units will be K negative. D. Depends upon the racial composition of the blood donors.

C

When severe HDN isn due to an unidentified antibody: A. No blood is acceptable for transfusion B. AB negative red cells and O negative plasma should be used for transfusion C. Mother's red cells may be used for transfusion D. NOTA

C

Which components provides a concentrated source of fibrinogen? A. Fresh or frozen RBCs and FFP B. FFP and cryoprecipitate C. cryoprecipitate D. Random-donor platelets and plasma

C

Which group of antibodies are commonly found as cold agglutinins? A. Anti-K, anti-k, anti-Js^b B. Anti-D, anti-e, anti-C C. Anti-M, anti-N D. Anti-Fy^a, Anti-Fy^b

C

All of the following are advantages to using single donor rather than random-donor platelet except: A. Less preparation time B. Less antigen exposure for patients C. May be HLA matched D. No pooling required

A

All of the following would be used to test the reactivity of AHG reagent except: A. Diluted anti-K antisera B. Diluted anti-D antisera C. Check cells D. 6% albumin

A

All of then following reasons for conducting compatibility testing EXCEPT: A. Prevent recipient alloimmunization B. Verify ABO and Rh C. Ensure proper issue of blood products D. Detect recipiet antibodies

A

Can crossmatching be performed on October 14, using a patient sample drawn on october 12? A. Yes, a new sample would not be needed B. Yes, but only if the previous sample has no alloantibodies C. No, a new sample is needed because the two-day limit has expired D. No, a new sample is needed for each testing

A

How can IgG antibodies be removed from red cells? A. ZZAP B. Cold elution C. Thiol reagent D. AET

A

If a patient requiring a blood transfusion has an anti-e (hr") approximately what percent of donor blood tested would be compatible? A. 2% B. 15% C. 20% D. 80%

A

In the immediate spin phase, what reaction pattern would fit anti-I? A. A1 cells, 3+ B cells, 3+ SC I, 2+ SC II, 2+ A/C, 2+ Cord, neg B. A1 cells, neg B cells, neg SC I, 1+ SC II, 1+ A/C, neg Cord, 1+ C. A1 cells, 2+ B cells, neg SC I, neg SC II, neg A/C, 1+ Cord, 2+ D. A1 cells, neg B cells, neg SC I, 1+ SC II, 1+ A/C, neg Cord, 1+

A

Lewis antibody are clinically significant when they react: A. Above 30 C B. At room temperature C. Below 30 C D. At 4 C

A

Screen cells and crossmatch are positive on immediate spin only and the autocontrol is negative. Identify the problem A. Cold alloantibodies B. Cold autoantibodies C. Abnormal protein D. Antibody mixture

A

Testing media for antigen-antibody reaction include: 1. isotonic saline 2. LISS 3. albumin 4. Enzymes A. 1 and 3 B. 2 and 4 C. 1,2 and 3 D. 1, 2, 3 and 4

A

Two of 4 units of packed RBCs were used in the OR at 3 pm. Can the remaining 2 units be returned to the blood bank at 5 pm? A. Yes, if the 2 units have been kept under the proper storage conditions. B. Yes, but only id the units are to be used for the same patients. C. No, units may ha become contaminated outside the blood bank. D. No, units have been out of the blood bank for longer than 1 hour

A

What are the characteristics of the Donath-Landsteiner antibody? A. Attaches to RBC at 4 C and causes hemolysis at 37 C. B. Attaches to RBC at 37 C and causes agglutination at the IAT phase. C. Attaches to RBC at 22 C and causes hemolysis at 37 C D. Attaches to RBC and causes agglutination at the IAT phase.

A

What components can be shipped together with FFP? A. Frozen RBCs and cryoprecipitate B. Platelets C. Packed RBCs and granulocuytes D. No other component can be shipped with FFP

A

What corrective action should be taken when rouleaux causes positive test results? A. Wash cells and dilute serum B. Perform an autoabsorption C. Run a panel D. Perform an elution

A

What hematocrit is acceptable for packed RBCs in a closed system? A. 78% B. 83% C. 88% D. 93%

A

What is the minimum testing required for a massively transfused patient? A. Immediate spin crossmatch or forward typing ABO B. ABO, Rh, crossmatch C. ABO, forward and reverse typing D. Antibody screen and ABO typing

A

What is the most common of the Rh negative genotypes? A. cde/cde B. Cde/cde C. cde/cdE D. cdE/cde

A

What may be done to RBCs before transfusion to a patient with a cold agglutinin disease? A. Irradiate to prevent GVHD B. Wash with 0.9% saline C. Warm to 37 C with a blood warmer D. Transport so that the temperature is maintained at 20-24 C

A

What sample that required to perform compatibility testing? A. Patient serum and donor cells B. Donor serum and donor cells C. Patient serum and donor serum D. Patient cells and donor cells

A

What should be done when one incompatibe crossmatch occurs out of a total of six units crossmatched? A. Perform a DAT on the incompatible unit B. Antigen type the unit for high-frequency antigens C. Wash donor cells and use the washed cell for testing D. Perform a panel on the incompatible unit

A

What type of red cells are acceptable to transfuse to an AB negative patient? A. A neg, B neg, or AB neg or O neg B. O neg only C. AB neg only D. AB neg, A neg, B neg only

A

Which procedure would probably require only a type and screen? A. Open heart surgery B. Kidney transplant C. Kidney transplant D. Colostomy

C/B

A Trauma patient had a severe hemolytic reaction following a blood transfusion. What is the most likely cause? A. Immediate, nonimmunological: probably due to volume overload B. Delayed Immunological: probably due to an antibody such as anti-Jk^a C. Delayed nonimmunological: probably due to iron overload D. Immediate, nonimmunological: probably due to clerical error, ABO incompatibility

D

Which of the following errors would cause the most severe reaction? A. Group A blood given to group O patient B. Group O blood given to group A patient C. Group B blood given to group AB patient D. Group O blood given to group B patient

A

A 56 C water bath is commonly used for: 1. crossmatching 2. preparing eulates 3. inactivating sera 4. thawing frozen cell A. 1 and 4 B. 2 and 3 C. 1,2 and 3 D. 1, 2, 3 and 4

B

A crossmatch and screen cells are 2+ at immediate spin, 1+ at 37 C, and negative at the IAT phase. Identify the problem. A. Combination of antibodies B. Cold antibodies C. Rouleaux D. Test error

B

A patient has died because of transfusion reaction. What should be done? A. Nothing more can be done B. Notify the FDA C. Perform an autopsy on the patient D. File the records

B

A patient has hemolytic reaction transfused 8 days ago. What is the most likely cause? A. Immediate, nonimmunological: probably due to volume overload B. Delayed Immunological: probably due to an antibody such as anti-Jk^a C. Delayed nonimmunological: probably due to iron overload D. Immediate, nonimmunological: probably due to clerical error, ABO incompatibility

B

A rare type RBC unit has expired on Tuesday. what can be done with this unit on Thursday? A. Unit may be frozen B. Unit may be rejuvenated, then used or frozen C. Unit may be discarded D. Unit may be washed

B

A shipment of packed RBCs contains only the units. What should be done? A. Place the units in the 1-6 C blood bank refrigerator B. Reject the shipment, there is no wet ice on the container. C. Prepare the units for freezing D. Check all units for labels and proper volume

B

A unit of packed RBCs leaves the lab at 7:15 am. Can it be return, unused at 8 am? A. Yes, the unit may be returned if not transfused. B. No, the unit has been out of the ref for more than 30 minutes. C. No, any unit cannot be returned after it has left the blood bank. D. Yes, the unit may be returned to the blood bank up to 1 hour later.

B

All of the following are characteristics of anti-Jk^a except: A. Immune IgG antibody B. Not detected with enzyme-treated cells C. Requires the IAT technique for detection D. May show dosage effect

B

All of the following are required on a label for packed RBCs EXCEPT: A. ABO and Rh type B. Complete antigen type C. Type of anticoagulant D. Expiration date

B

All of the following test should be done if a hemolytic transfusion has taken place except: A. Recrossmatch and repeat the antibody screen B. Absorption using pre and post transfusion samples C. Gram stain and culture of the unit D. chemistry, coagulation and urine tests

B

Can an autologous donation of RBCs frozen in 1989 be used in 1994? A. No, frozen red cells are good for only 18 months. B. Yes, frozen red cells are good for 10 years. C. No, proper serological tests were not available. D. Yes, but only if units do not need to be shipped over 50 miles.

B

Can frozen RBCs thawed and washed at 9 am be transfused at 11 am the next day? A. Yes, issue the units B. No, units now have expired C. Yes, wash units again then issue D. No, return units to the blood supplier

B

Hemolytic disease of the newborn can occur when: A. The infant lacks the antigen the mother possesses B. The mother lacks an antigen the infant possesses C. The mother possesses an antigen the father lacks D. NOTA

B

How can IgM antibodies be separated from IgG antibodies? A. Warm elution B. Thiol reagents C. Absorption with antigen-specific red cells D. Impossible to separate

B

If an R2R2 patient is transfused with R1R1 blood, it would be possible for him to form which of the following antibodies? A. Anti-E B. Anti-Ce C. Anti-ce D. Anti-c

B

If red cells give positive reactions when tested with anti-Rho, anti-rh', anti-hr' and give a negative reaction with anti-rh", which of the following genotype is IMPOSSIBLE? A. R1r B. R1R2 C. R1Ro D. Ro r'

B

Mixed field agglutination is observed under the microscope as clumps or agglutinates of cells among many free cells. Which of the following is the MOST COMMON REASON for mixed field agglutination? A. Twin chimeras B. Transfused cells mingling with patient cells C. Weak subgroups of A or B D. Antigen strength altered in disease states

B

Select the incorrect statement: A. Anti-I is often the causative antibody in cases of cold hemagglutinin disease (CHAD) B. Anti-I reacts best with cord blood cells C. Anti-I can be found as weak cold agglutinin in the serum of normal individuals D. Anti-I agglutinin are usually clinically insignificant; however, they make mask more significant antibodies, such as anti-P1, anti-M and Anti-Le

B

What are the possible ABO blood types of children to the union of a man who has blood type AB and a woman who has blood type O? A. A only B. A and B only C. A, B and AB only D. A, B ,AB and O E. O only

B

What can be done to prevent contamination of FFP during thawing? A. Thaw in a clean water bath B. Seal in an outer, separate prior to placing in the water bath C. Thaw at 1-6 C D. When half-thawed, transfer FFP to another bag

B

What components may not be prepared if whole blood is spun at 1-6 C? A. Packed red cells B. Platelet C. Leukocyte-poor red cells D. FFP

B

What is the expiration date for FFP prepared on October 30, 1993? A. February 30, 1994 B. October 30, 1994 C. November 4, 30, 1995 D. October 30, 2002

B

What is the first step in a crossmatch after identification of a patient antibodies? A. Perform a DAT on patient cells and donor units. B. Antigen type patient cells and donor units. C. Absorb any antibodies from the patient serum D. Obtain a different enhancement medium for testing

B

What is the first step in the laboratory investigation of a transfusion reaction? A. DAT on the post-transfusion sample B. Check for clerical error C. Repeat ABO and Rh typing of patient and donor unit. D. Antibody screen on the post-transfusion sample.

B

What is the most likely explanation when screen cells, panel cells are positive and the autocontrol is negative? A. Nonspecific alloantibodies B. High frequency alloantibodies or mixture of all alloantibodies C. Specific IgG and IgM antibodies D. Autoantibodies or abnormal proteins

B

What is the proper condition for thawing FFP? A. 65 C water bath B. 37 C water bath C. RT, 20-24 C D. 1-6 C wet ice

B

What is the purpose of adding antibody-coated red cells to all negative AHG tubes? A. To ensure proper tube reading. B. To ensure proper cell washing and addition of AHG reagent. C. To check for hemolysis or reaction of complement. D. To check for attachment of additional antibody.

B

What procedure would help to distinguish between an anti-e and anti-Fy^a in an antibody mixture? A. Lower pH of test serum B. Run an enzyme panel C. Use a thiiol reagent D. Run a regular panel

B

What sample is the best for detecting complement-dependent antibodies? A. Plasma Stored at 4 C for no longer than 24 hours B. Serum stored at 4 C for no longer than 48 hours C. Either serum or plasma stored at 20-24 C for no longer than 6 hours D. Serum heated at 56 C for 30 minutes

B

What should be done if the Rh test and Rh negative control are both positive A. Obtain fresh cells and repeat testing. B. Retest using saline antisera and/ or wash patient cells. C. Repeat using new bottle of Rh negative control. D. Nothing, report patient as Rh positive.

B

What substance can neutralize anti-Le? A. Urine B. Saliva C. Hydatid cyst fluid D. Human milk

B

What type of red cells are acceptable to transfuse to an O negative patient? A. A neg, B neg, or AB neg or O neg B. O neg only C. AB neg only D. AB neg, A neg, B neg only

B

When my anti-P1 antibodies be clinically significant? A. Rarely, Because they are IgM, saline reacting B. In cases of cold surgery C. When found as antibody mixture D. When complement is fixed by the antigen-antibody reaction

B

Which antibody does not usually give a mixed field reaction? A. Anti-Lu^a B. Anti-Di^a C. Anti-SD^a D. A3 cells with anti-A

B

Which antibody would give a positive antibody screen and crossmatch in the IAT phase with a negative autocontrol? A. Anti-H B. Anti-S C. Anti-Kp^a D. Anti-k

B

Which antibody would not be detected by group O screen cells? A. Anti-N B. Anti-A1 C. Anti-Dj^a D. Anti-k

B

Which of the following is not true of Anti-Le? A. Occurs in Le (a-b-) individuals B. Is commonly implicated in HDN C. Is neutralized by Lewis blood group substance D. Is composed mostly of IgM molecules

B

Which of the following phenotypes would show dosage effect? A. MM B. MN C. NN D. SS

B

Which reaction would assist in the identification of anti-I? A. Positive with cord cells B. Negative or weak positive with cord cells C. Equal strength positive reaction with both adult and cord cells D. No reaction with either adult or cord cells

B

All of the condition below would require elution to identify antibodies coating the red cells EXCEPT: A. HDN B. Hemolytic anemia C. Multiple Myeloma D. Transfusion reaction

C

All of the following are advantages of using packed RBCs instead of whole blood EXCEPT: A. MInimizes circulatory overload B. Minimizes exposure to large volumes of electrolytes C. Decreases transfusion time D. Minimizes exposure to large volumes of electrolytes

C

Transfusion of irradiated blood products is indicated in all of the following condition except: A. Exchange transfusion B. Bone marrow transplant C. HIV patient D. Warm autoimmune hemolytic anemia (WAIHA)

D

What is Rh control is acceptable if using monoclonal typing reagents? A. Patient autocontrol B. ABO test C. Patient cells in 6-8% albumin D. All of the above are acceptable controls

D

What is needed for detection of some drug-induced antibodies? A. Panel cells B. Polyspecific Coombs sera C. Enzyme-treated cells D. Drug-coated cells

D

What is the disposition of a donor unit that contains an antibody? A. The unit must be discarded. B. Only the plasma can be used to make components. C. The antibody must be absorbed from the unit. D. Label the unit indicating that it contains antibody; release into inventory.

D

What is the most likely explanation for screen cells, panel cells, and autocontrol all being positive? A. Nonspecific alloantibodies B. High frequency alloantibodies or mixture of all alloantibodies C. Specific IgG and IgM antibodies D. Autoantibodies or abnormal proteins

D

What may be used if frozen RBCs, fresh frozen plasma (FFP), and platelets were shipped on dry ice? A. All components B. No components C. Frozen RBCs and platelet only D. FFP and frozen RBCs only

D

What reagent or procedure is used to distinguish Kidd and Kell antibodies? A. Enzyme panel B. Cholroquine C. LISS media D. AET (2-Aminoethylisothiouronium bromide)

D

What should be done if a noticable clot found in RBC unit? A. Issue the unit; blood will be filtered B. Issue the unit; note presence of a clot on the release form C. Filter the unit in the blood bank before issue D. Do not issue the unit

D

What testing is performed after blood has been issued on emergency release? A. Perform only a three-cell screen immediate spin B. Set up a panel to quickly identify alloantibodies C. Nothing, the blood has been really been issused D. Continue the crossmatch ; report antibodies or incompatibilities

D

Which Lewis phenotype produces the most common Lewis antibody, anti-Le? A. Le(a+b+) B. Le(a+b-) C. Le(a-b+) D. Le(a-b-)

D

All of the following are part of the preliminary evaluation of a transfusion reaction except: A. Check pre and post transfusion samples for the color of the serum. B. Perform ABO and Rh recheck C. DAT on the post transfusion reaction sample D. Panel on pre and post transfusion sample

D

All of the following are the reasons for performing an absorption except: A. Separation of mixtures of antibodies B. Removal of interfering antibodies C. Confirmation of weak antigen on red cells D. Identification of antibodies causing positive DAT

D

How can interfering anti-P1 antibody be removed from a mixture of antibodies? A. Neutralization with saliva B. Agglutination with human milk C. Combination with urine D. Neutralization with hydatid cyst fluid

D

In the mating of R1r x R2r genotypes, which of the following is probably NOT that of the offspring? A. CDe/cDE B. cde/cde C. CDe/cde D. CDe/cdE

D

The direct antiglobulin test (DAT) using polyspecific antihuman globulin serum is NOT of value in the: A. Diagnosis of the hemolytic disease of the newborn B. Diagnosis of hemolytic transfusion reaction C. Diagnosis of drug-induced hemolytic anemia D. Differentiation of cell surface coating (complement or IgG)

D

What gives a 2+ reaction in undiluted and diluted samples? A. High incidence B. Low incidence C. High titer low aditivity (HTLA) D. HLA

c

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