Blood Bank

An antibody to which platelet antigen is most commonly encountered in blood bank?

HPA-1a

Which adsorption technique removes cold (IgM) antibodies, particularly anti-I specificities?

Rabbit erythrocyte stroma (RESt)

An urticarial transfusion reaction is characterized by which of the following?

Rash and hives

In the Coombs phase of a crossmatch, what is the proper procedure to follow if the Check Cells give a negative reaction?

Repeat procedure with new AHG reagent and check the cell washer.

Which of the following best describes the direct antiglobulin (DAT) test principle?

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

A D-negative mother gives birth to a baby that tests as D-negative in the immediate spin phase. What step should be performed next?

Perform a weak D test

In the Kleihauer-Betke test, a maternal blood smear is treated with acid and then stained with counterstain. The fetal cells contain fetal hemoglobin, which is resistant to acid and will remain pink. Since the calculated volume of fetomaternal hemorrhage is an estimate, how many additional RhIg vials need to be added for the dose?

1

Tube-based agglutination reactions in blood bank are graded from negative (0) to 4+. A reaction that has numerous small clumps in a cloudy, red background is:

1+

In blood banking, the Direct Antiglobulin Test (DAT) is used in the investigation of which of the following clinical conditions? 1. Hemolytic Disease of the Fetus and Newborn (HDFN) 2. IgA deficiency 3. Hemolytic Transfusion Reaction (HTR) 4. Zika virus infection

1, 3

Antibody identification interpretations would be considered correct 95% of the time or have a P value of 0.05 (5% probability that the result is due to chance) if you have:

3 positive reactions to rule in an antibody and 3 negative reactions to rule out an antibody

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

30

A 300 µg dose of RhIg (Rh immune globulin) can suppress immunization to how many mL of D-positive whole blood?

30 mL

A potential apheresis platelet donor must be deferred for how long following the use of aspirin?

48 hours

Using the information provided in the table below, interpret the correct ABO blood type. Red Cells Tested With Known Antisera Anti-A 4+ Anti-B 4+ Anti-A,B 4+ Serum Tested With Known Red Cells A1 Cells 0 B Cells 0 Interpretation of ABO Group ?

AB

What is the correct blood group for the patient based on the reactions below? Forward (Cell) Typing Anti-A 4+ Anti-B 4+ Reverse (Serum) Typing A1 Cells 0 B Cells 0

AB

Red Cells Tested With Known Antisera Anti-A 4+ Anti-B 4+ Serum Tested With Known Red Cells A1 Cells NT B Cells NT Interpretation of ABO Group? Given the above results, what is the newborn's ABO group? (NT = not tested)

AB Feedback The newborn has a forward ABO blood group testing result of Group AB. The newborn's ABO blood group is valid. Most laboratories will not do reverse testing on newborn samples because newborns do not produce ABO antibodies until 4 to 6 months and any antibodies present are likely to be of maternal origin.

Which of the following fresh frozen plasma ABO types would be suitable for transfusion to an AB negative patient?

AB negative and AB positive only.

Of the following, what is the recommended routine testing to be performed on a newborn of a group B Rh positive female?

ABO/Rh, DAT and/or antibody screening are NOT routinely performed in this scenario.

Which listed transfusion reaction is MOST OFTEN associated with transfused patient's lacking IgA?

Anaphylaxis

Which of the following is the cause of the most severe life-threatening hemolytic transfusion reactions?

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

Group O blood cannot be transfused to a person with "Bombay blood" type because the Bombay individual produces which of the following?

Anti-H

A former patient had an anti-E four years ago, but her antibody panel is now negative. Since she now needs blood for surgery, what should the blood bank do?

Crossmatch E-negative units.

Antibodies to the Kidd blood group system are MOST commonly associated with:

Delayed hemolytic transfusion reactions

The major crossmatch is performed using:

Donor's red cells and recipient's serum or plasma

A patient experiences a mild allergic reaction to a transfusion, including urticaria, erythema (skin redness), and itching. What is the most likely source of the allergen?

Drugs or food consumed by the blood donor

At what frequency should quality control testing be performed on each lot of anti-human globulin to be in compliance with the FDA's current good manufacturing practices requirements?

Each day of use

When testing for the quality of platelet concentrates, all of the following must be included EXCEPT?

Gas production

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.

In vivo sensitization

Which occurrence is a medical error?

Incompatible blood is transfused into a patient during surgery.

Transfusion-related acute lung injury (TRALI) is a serious blood transfusion complication that can be characterized by all of the following EXCEPT:

Increased central venous pressure

A delayed hemolytic reaction occurring a week later is MOST likely caused by:

Kidd system antibodies

Which of the following is generally considered equivalent to CMV seronegative RBCs for use in an exchange transfusion to a newborn?

Leukoreduced RBC

Acute transfusion reactions are divided into categories based on all of the following symptoms EXCEPT:

Liver failure

For granulocyte concentrations, all of the following laboratory tests must be performed on the unit by the donor center EXCEPT

Lymphocyte enumeration

What is the first line treatment for moderate to severe hemophilia A?

Lyophilized Factor VIII concentrate

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

O

Which of the following packed red blood cell ABO types would be appropriate for transfusion to an O negative patient of child-bearing age?

O negative only.

You receive a call in the blood bank, reporting a transfusion reaction. You ask the nurse to stop the red blood cell transfusion immediately and return the unit of blood and all related forms to the blood bank. You also ask for a new patient blood specimen to be drawn and sent to the blood bank. You receive the requested items 15 minutes later. What will you do FIRST as part of your investigation?

Perform a clerical check, centrifuge the pre-transfusion and post-transfusion patient specimens and examine the plasma for hemolysis and icterus.

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 a cold autoantibody

A2B is suspected when a patient's ABO typing has the following results:

Patient's red cells forward types as AB with anti-A1 present in the patient's serum.

In order to detect the presence of antibodies fixed on the RBC's of newborns one should:

Perform a direct antiglobulin test (DAT) on the cord blood

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

What is the first step a transfusionist should take when a transfusion reaction is suspected?

Stop the transfusion, but keep the intravenous line open with saline.

What must be true for the antiglobulin phase of the serologic crossmatch to be omitted (i.e., immediate spin crossmatch is done)?

The antibody screen must be negative and there is not history of detection of unexpected antibodies.

In an emergency release, why do blood bankers seldom encounter patients who have experienced hemolytic transfusion reactions (HTR) from transfusion of uncrossmatched packed RBCs? Select the best response.

The incidence of unexpected red blood cell antibodies is relatively low.

Acute intravascular hemolysis as the result of a blood transfusion is most often associated with which of the following causes?

Transfusion of ABO incompatible red blood cells

What is considered the cause of urticarial transfusion reactions?

Transfusion of certain food allergens or drugs in plasma products

HLA antibodies are responsible for which of the following transfusion reactions?

Transfusion-related acute lung injury (TRALI)

Which of the following signs and symptoms may be associated with immediate transfusion reaction, but is NOT usually associated with delayed hemolytic transfusion reaction?

Unexplained bleeding from surgical site

Which of the following is the most commonly encountered presenting sign of a delayed hemolytic transfusion reaction (DHTR)?

Unexplained decrease in hemoglobin or hematocrit