Blood Bank

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

30 mL

If possible, what is the recommended time interval for Rh immune globulin administration to the Rh negative mother following the delivery of an Rh positive or weak-D positive infant? 72 hours One week Two weeks Prior to another pregnancy

72 hours

The A1 subgroup represents approximately what percentage of group A individuals? 25 - 30% 50 - 60% 75 - 80% 95 - 98%

75 - 80%

Platelets that are not collected by an apheresis method must be prepared within ________ of the collection of whole blood. 30 minutes 8 hours 24 hours 48 hours

8 hours

Which of the following is true regarding the Lutheran blood group system? Anti-Lu(a) most often is IgG Anti-Lu(b) is always IgM Lu(a) is a high frequency antigen Lu(b) is a high frequency antigen

Lu(b) is a high frequency antigen

Which test is NOT used as a screen for retroviruses in donated blood? 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

Nucleic acid testing for HCV

The presence of hemolysis in a post-transfusion blood sample is best associated with which of the following? Rh incompatibility Circulatory overload ABO incompatibility Dehydration

ABO incompatibility

If the unit is going to be transfused within the collection facility, autologous blood must always be tested for which of the following before transfusion? ABO, Rh ABO, Rh, HBsAg ABO, Rh, HIV ABO, Rh, HBsAg, HIV

ABO, Rh

A false-negative reaction while performing the DAT technique may be the result of: Red cell/AHG tube is over centrifuged Blood collected in tube containing silicone gel Saline used for wash stored in glass or metal container AHG addition delayed for 40 or more minutes

AHG addition delayed for 40 or more minutes

Red Cells Tested With Known Antisera Anti-A: 0 Anti-B: 4+ Serum Tested With Known Red Cells A1 Cells: 4+ B Cells: 0 Interpretation of ABO Group: ? Using the information provided above, what is the patient's correct ABO group? A B AB O

B

Which of the following blood components contains the most factor VIII concentration relative to the unit volume? Whole Blood Cryoprecipitated AHF Fresh Frozen Plasma Platelet Concentrate

Cryoprecipitated AHF

An antibody screen demonstrates a mixed field agglutination pattern. To which blood group system will this antibody most likely belong? Lewis Lutheran Kell Kidd

Lutheran

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

Patient has a cold autoantibody

When performing an antibody screen, both the screen cells are 4+ at immediate spin and W+ at AHG. The antibody panel shows 4+ reactions at immediate spin and W+ reactions at AHG and there is no specific match to the reaction pattern. The auto control is negative. What would be a logical next step? Have patient redrawn Repeat testing using warmed patient sample/reagent and just do AHG reading Run an enzyme panel Use acidified reagents

Repeat testing using warmed patient sample/reagent and just do AHG reading

Donated red cell units contain which substance to stabilize the pH of the unit during storage? Dextrose Adenine Citrate Sodium biphosphate

Sodium biphosphate

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

Rh negative fetus

Why is Weak D testing not performed on pregnant women? Weak D testing should be performed on pregnant women. Weak D testing is not required as part of a prenatal evaluation, as it is not possible to differentiate weak D from partial D serologically. Weak D testing is no longer used in blood banking. Weak D testing is not reliable in pregnant women.

Weak D testing is not required as part of a prenatal evaluation, as it is not possible to differentiate weak D from partial D serologically.

Which blood component is the most commonly used component for the replacement of multiple coagulation factor deficiencies in bleeding patients? Fresh Frozen Plasma Red Blood Cells Cryoprecipitate Whole Blood

Fresh Frozen Plasma

The immediate spin phase of an indirect antiglobulin test (antibody screen and antibody identification) could most likely lead to the detection of which of the following? Clinically significant warm antibodies Clinically significant cold antibodies Clinically insignificant warm antibodies Clinically insignificant cold antibodies

Clinically insignificant cold antibodies

ABO antibodies are classified as which of the following two immunoglobulin classes? IgG and IgM IgM and IgA IgA and IgG IgE and IgM

IgG and IgM

What blood system is often tested to either establish or dispute paternity? HLA ABO Rh Duffy

HLA

Which blood group is most frequently associated with Cold Agglutinin Disease (CAD)? Kell Kidd Duffy I

I

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

15 June 2019

What is the required storage temperature for thawed cryoprecipitate? 4 - 8 ºC. 20 - 24 ºC. 35 - 37 ºC. -20 ºC or colder

20 - 24 ºC.

Frozen red blood cells that have been thawed, deglycerolized and reconstituted in an open system must be used within _______. 1 hour 24 hours 14 days 7 days

24 hours

Rh Immune Globulin (RhIG) is used to prevent the active immunization to the D antigen in women who are Rh negative carrying an Rh positive fetus. One dose of RhIG (equal to 300 µg of World Health Organization reference material) contains enough anti-D to protect against: 50 mL of whole blood 50 mL of packed red cells 30 mL of whole blood 20 mL of packed red cells

30 mL of whole blood

Which of the following is a possible type for an offspring from the mating of an O and an AB (non-cis) individual? AB AO BB OO

AO

Antibodies directed against granulocyte antigens have been implicated for all of the following EXCEPT? Febrile transfusion reactions Acute hemolytic transfusion reactions Transfusion-related acute lung injury (TRALI) Neonatal alloimmune neutropenia (NAN)

Acute hemolytic transfusion reactions

Which one of the following may cause a FALSE-NEGATIVE result with antiglobulin techniques? Dust or dirt is present in the glass tubes used for antiglobulin testing. Patient or donor blood specimen was collected in silicone gel tubes. Patient or donor blood specimen has a positive DAT. Addition of AHG reagent is delayed for 40 minutes or more after final saline wash.

Addition of AHG reagent is delayed for 40 minutes or more after final saline wash.

Which of the following individuals is a candidate to receive RhIg? An Rh positive mother upon delivery of her 3rd child. An Rh negative mother upon delivery of her first child. An Rh negative mother who had previously developed anti-D. An Rh positive mother who miscarried after 2 months.

An Rh negative mother upon delivery of her first child.

All of the following are cause for donor deferral EXCEPT? An individual weighs 115 pounds at the time of donor screening. Potential donor is currently pregnant in her second trimester. Donated a whole blood product within the last 30 days. He/she lived in the United Kingdom (UK) for a consecutive 12-month period between 1980 - 1996.

An individual weighs 115 pounds at the time of donor screening.

Which type of antibody can cause HDFN in any pregnancy (first or subsequent), but is usually limited to less severe symptoms? Anti-A,B Anti-D Anti-E Anti-K

Anti-A,B

If a patient is determined to have type A blood, what antibody would be found in his/her serum? Anti-A Anti-B Anti-A and Anti-B Anti-O

Anti-B

The following results were obtained at delivery for a pregnant woman who received antenatal RhIg. ABO and Rh typing ABO Forward Group anti-A: 0 anti-B: 0 ABO Reverse Group A1 cells: 4+ B cells: 4+ Rh anti-D*: 0 Antibody screen Cells Gel IAT* Screen cell l (R1R1): w+ Screen cell ll (R2R2): 1+ Screen cell lll (rr): 0 * IAT = indirect antiglobulin test Which of the following are possible causes of the positive antibody screen? Anti-D (passive, from RhIg administration) or an antibody other than anti-D Anti-D (immune) or Anti-D (passive, from RhIg administration) Antibody other than anti-D Anti-D (immune) or Anti-D (passive, from RhIg administration) or an antibody other than anti-D

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

A 27-year-old female presents to her physician after suffering a spontaneous abortion. Though rare, which antibody may be the etiological agent? Anti-P1 Anti-P Anti-PP1Pk Anti-P2

Anti-P

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

Antibodies sensitizing red cells

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: 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.

Binding complement.

What is the FIRST thing blood bank staff should do when investigating a transfusion reaction? 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.

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

The use of the direct antiglobulin test is indicated in all the following EXCEPT: Transfusion reactions Autoimmune hemolytic anemia Hemolytic disease of the newborn Detection of alloantibodies in serum

Detection of alloantibodies in serum

Which of the prospective donors below would be an acceptable blood donor? Donor number 1: Blood pressure: 90/55 Pulse: 105 Temperature: 36.4ºC (97.6 ºF) Donor number 2: Blood pressure: 200/90 Pulse: 72 Temperature: 37ºC (98.6 ºF) Donor number 3: Blood pressure: 110/72 Pulse: 66 Temperature: 37.2ºC (99.0 ºF) Donor number 4: Blood pressure: 100/70 Pulse: 98 Temperature: 38.3 (101.0 ºF)

Donor number 3: Blood pressure: 110/72 Pulse: 66 Temperature: 37.2ºC (99.0 ºF)

Which of the following contains all the possible phenotypes that could be the result of parents who are group O and group A? Groups A or O only Group A only Group O only All possible blood groups

Groups A or O only

Marcus had a transfusion of packed RBC's 8 months ago following a surgery after a car accident. He is fully recovered and is otherwise healthy. How soon can Marcus donate a unit of blood? He can never donate a unit of blood. He can donate in 12 months. He can donate in 4 months. He can donate today.

He can donate in 4 months.

Certain clinical conditions such as Hemolytic Disease of the Fetus and Newborn (HDFN), Hemolytic Transfusion Reaction (HTR), and Autoimmune Hemolytic Anemia (AIHA) result from the attachment of antibodies or complement to human RBCs. What is this process called? Desensitization Non-sensitization In vitro sensitization In vivo sensitization

In vivo sensitization

While ABO, Rh, Kell, Duffy, Kidd, SsU are clinically significant, which of the following antibodies generally react at only the Coombs phase (also known as Antihuman Globulin phase)? Rh and Kell antibodies ABO antibodies Kell, Duffy and Kidd antibodies SsU and Kidd antibodies

Kell, Duffy and Kidd antibodies

Which procedure should be followed when one cross-matched unit out of five is INCOMPATIBLE at the antiglobulin (AHG) phase? 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

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

While working at a blood bank laboratory, you hear chimes over the hospital loudspeaker system announcing the birth of a baby. Thirty minutes later, you receive a cord blood specimen that you identify as O positive. You previously received the mother's specimen and she was O negative with a negative antibody screen. What is the next action? Issue one vial of RhIg Perform a Kleihauer Betke stain Nothing - Mom is not at risk for anti-D Perform a fetal bleed screen

Perform a fetal bleed screen

Which subset of effector lymphocytes is predominantly responsible for regulation of antibody production? TH1 TH2 TH17 CD8+

TH2

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 Red cells are totally coated with antibody. The newborn is missing antigens. The baby's antibodies are undeveloped. Unable to determine.

The baby's antibodies are undeveloped.

Which of the following statements is correct regarding blood bank adverse event reporting to the FDA? 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.

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.

If an autologous blood component is shipped from the donor center without the completion of infectious disease testing, the unit must be labeled with: A blue sticker indicating which tests are in process. The phrase "Donor Untested". A statement from the ordering physician requesting the release. A red warning tag.

The phrase "Donor Untested".