Transfusion Services - Blood Bank - Quiz 1

Employee training takes place:

(a or d) .after hiring and following implementation of new procedures.

All of the following are true regarding competency testing except:

(b or c.) it is required only if the technologist has no experience.

Several units were released to a hospital by mistake before all viral marker testing was completed. What is the appropriate course of action?

(c or d) .The error is reportable, and the Food and Drug Administration must be contacted.

A technologist in training noticed that the person training her had not recorded the results of a test. To be helpful, she carefully recorded the results she saw at a later time, using the technologist's initials. Is this an acceptable procedure?

(d. or a.) No; she should have brought the error to the technologist's attention.

A laboratory technologist decided she would like to bring her lab coat home for laundering because it had too many wrinkles when returned by the laboratory's laundry service. Is this practice acceptable?

B. No, because the laboratory is a biosafety level 2, and lab coats may not be removed

Match the government or accrediting agencies with the description that best fits their purpose. FDA OSHA CDC AABB CAP

Ensures the safety and efficacy of biologics, drugs, and devices Ensures safe and healthful working conditions Makes recommendations to the Occupational Safety and Health Administration regarding the prevention of disease transmission Professional organization that accredits blood banks and transfusion services Provides peer-reviewed accreditation for hospital laboratories

Quality control is the same as quality assurance.

FALSE

Select the term from the list below that best fits the definitions. Variable region of an immunoglobulin Imparts flexibility to the immunoglobulin molecule Part of the antigen that the immunoglobulin binds to The type of immunoglobulins determined by the heavy chain One of the two types of light chains

Idiotype Hinge region Epitope Isotype Kappa

Select the immunoglobulin class from the list below that best fits the characteristic described. Each class can be used more than once. Found in secretions, such as breast milk Able to cross the placenta Associated with intravascular cell destruction Associated with allergic reactions and mast cell activation Efficient in activation of the complement cascade Has the highest serum concentration Associated with immediate-spin in vitro reactions Has the highest number of antigen binding sites

IgA IgG IgM IgE IgM IgG IgM IgM

Match the following descriptions with the appropriate terms. Root cause analysis Recall Accuracy Validation Calibration Quality control Proficiency test Competency assessment Change control Audit Preventive maintence

Investigation and identification of the factors that contributed to an error Removal of products from the market that might compromise the safety of the recipient Degree to which a measurement represents the true value Establishing that a specific process produces an expected result Process of standardizing an instrument against a known value Testing to determine the accuracy and precision of reagents and equipment The CAP survey is an example Evaluation of an employee's ability to perform a specific skill System to plan and implement changes to prevent problems Systematic evaluations to determine whether procedures are being followed Maximizes the duration of equipment and increases the reliability of the equipment

All accidents, even minor ones, must be reported to a supervisor.

TRUE

The Occupation Safety and Health Administration does not require the routine use of gloves by phlebotomists working with healthy prescreened donors or changing unsoiled gloves between donors.

TRUE

What is the potential effect in a tube agglutination test if a red cell suspension with a concentration greater than 5% is used?

a. False negatives

Which of the following is true regarding good manufacturing practices (GMPs)?

a. GMPs are legal requirements established by the Food and Drug Administration.

A patient's record indicated that he had a history of an antibody to HPA-1a. What is the significance of this antibody if this patient requires a platelet transfusion? Select one:

a. The patient would require HPA-1a negative platelets, which are relatively rare.

In safety training, employees must become familiar with all of the following except:

a. how to perform cardiopulmonary resuscitation on a donor or other employee.

Which class of HLA antigens would be typed when matching patient and donors for platelet transfusion?

a.Class I only

Select the portion of the antibody molecule that imparts the antibody's unique class function.

a.Constant region of the heavy chain

Select the substance that regulates the activity of other cells by binding to specific receptors.

a.Cytokines

Which of the following organizations are involved in the regulation of blood banks?

a.Food and Drug Administration

Select the term that is associated with the B-cell response to antigens.

a.Humoral immunity

What immunoglobulin class reacts best at room temperature at immediate spin?

a.IgM

A facility does not validate a refrigerator before use. What is a potential outcome?

a.The facility is in violation of current good manufacturing practices and could be cited by the Food and Drug Administration.

A patient's record indicated that he had a history of an antibody to HPA-1a. What is the significance of this antibody if this patient requires a platelet transfusion?

a.The patient would require HPA-1a negative platelets, which are relatively rare.

Select the region of the antibody molecule responsible for imparting unique antibody specificity.

a.Variable region

An antigen that originates from the individual is termed:

a.autologous

Which of the following is an example of an unacceptable record-keeping procedure?

b. Using dittos in columns to save time

All of the following are responsibilities of the quality assurance department of a blood bank except:

b. performing quality control.

Opsonization is a term to describe what process?

b.Binding to cells or antigens

In a routine audit of a facilities blood collection area, the quality assurance department found that the blood bags used on that particular day had expired. What is the appropriate course of action?

b.Initiate a root cause analysis and quarantine the blood collected in the expired bags.

A poor response to platelet transfusion that can be caused by antibodies to human leukocyte antigens is known as:

b.refractoriness.

What portion of the antibody molecule binds to receptors on macrophages and assists in the removal of antibody bound to red cells?

c. Fc fragment

In a serologic test, the term prozone is also known as:

c. antibody excess.

Extravascular destruction of blood cells occurs in the:

c. spleen.

Select the cell involved in humoral immunity.

c. B lymphocytes

Blood irradiators require all of the following safety procedures except:

c. that the user have a degree in radiology.

After adding antigen and antibody to a test tube, one large agglutinate was observed. How should this reaction be graded?

c.4+

At what point in the employment process should safety training take place?

c.Before independent work is permitted and annually thereafter

In the complement cascade, lysis of the target cell is mediated by which of the following components?

c.C5 to C9

Which of the following agencies administers the Clinical Laboratory Improvement Amendments?

c.Centers for Medicare and Medicaid Services

Hemolysis was observed at room temperature when testing a patient's serum with reagent red cells used for screening. When this test was repeated using the patient's plasma, no hemolysis was observed. What was the most likely explanation for the different reactions?

c.Complement activation was inhibited by calcium in the plasma sample.

Which of the following will cause an antigen to elicit a greater immune response?

c.Size greater than 10,000 daltons

The major histocompatibility complex is located on chromosome 6 and is important in all the following immune functions except:

c.hemolysis.

In a lymphocytotoxicity test, cells that take on the dye:

d. are recognized by a specific antibody.

HLA matching between the donor and recipient is important for progenitor cell transplantation to avoid:

d.A and B.

Personal protective equipment includes:

d.All of the above

Unacceptable quality control results for the antiglobulin test performed in test tubes may be noticed if:

d.All of the above

Which of the following is responsible for the activation of the classic pathway of complement?

d.Antibody bound to antigen

What immunoglobulin class is capable of crossing the placenta?

d.IgG

In order to enhance the reaction of an antibody in vitro, it may be necessary to adjust which of the following?

d.Increase the incubation time in the incubator

It was observed that an antibody identified in the transfusion service appeared to be reacting stronger following the second exposure to an antigen from a transfusion. The most likely explanation of this is:

d.all of the above.

Plans that provide the framework for establishing quality assurance in an organization are:

d.continuous quality improvement plan.

The standard operating procedure is a document that:

d.helps achieve consistency of results.

The mixed lymphocyte culture (MLC) is a procedure that has been used in HLA testing to determine:

e. B and D.