Blood Banking Practice Questions

MEDICAL LABORATORY SCIENCE • BLOOD BANKING PRACTICE QUESTIONS • • • • • • • • • Yellow positive, blue negative: a. Group A b. Group B Anti-A pos, anti-B neg: a. Group A+ b. Group A Anti-A + Anti-B A cells B cells a. Group AB b. Group O c. Group A neonate The following results were obtained on a 51-year-old male with hepatitis C: What should be done next? a. Retype the patient’s sample to confirm group AB positive b. Repeat the Rh typing c. Run a saline control in forward grouping d. Report the patient as group AB, Rh positive Group AB patient is in need of FFP. No group-specific plasma is available. Which of the following can be given to this patient? a. Group A FFP b. Group B FFP c. Group O FFP d. All of the above e. None of the choices Determine the possible blood types of their children: Mother – homozygous A Father – heterozygous B • • • The technologist washed the patient’s cells with saline, and repeated the forward typing. A saline replacement technique was used with the reverse typing. The following results were obtained: • Determine the possible blood types of their children: Mother – heterozygous A Father – heterozygous A Determine the possible blood types of their children: Mother – Group A Father – Group O Which of the following blood types excludes paternity of a group B child? Mother – Group O Child – Group B a. Group B b. Group AB c. Group O d. All of these e. None of these Anti-A + Anti-B A1 cells B cells + O cells + a. A1 b. A2 Anti-A + Anti-B A1 cells + B cells + O cells a. A1 b. A2 Which typing results are most likely to occur when a patient has an “ACQUIRED B” antigen? a. Anti-A4 +, anti-B3 +, A1 cells negative, B cells negative b. Anti-A3 +, anti-B negative, A1 cells negative, B cells negative c. Anti-A4 +, anti-B1 +, A1 cells negative, B cells 4+ d. Anti-A4 +, anti-B4 +, A1 cells 2+, B cells negative The following reactions were obtained: • • The results are consistent with: a. Acquired immunodeficiency disease b. Bruton agammaglobulinemia c. Acquired B antigen d. Multiple myeloma Which of the following could be the possible cause of the given ABO discrepancy? a. Acquired B phenomenon b. A1 subgroup c. A2 subgroup d. Polyagglutination A patient has the following ABO typing results: Which of the following causes would be the BEST explanation for these results? a. Acquired B phenomenon b. A1 subgroup c. A2 subgroup d. Polyagglutination What is one possible genotype for a patient who develops anti-C antibody? a. R1r = DCe/dce b. R1R1 = DCe/dCe c. r’r = dCe/dce d. rr = dce/dce 1 • • • • • • • • • What antibodies could an R1R1 make if exposed to R2R2 blood? a. Anti-e and anti-C b. Anti-E and anti-c c. Anti-E and anti-C d. Anti-e and anti-c Which donor unit is selected for a recipient with anti-c? a. r´r b. R0R1 c. R2r´ d. r´ry Based on the following reactions, what is this person’s most probable genotype? ANTISERA (DcE) Anti-D Anti-C Anti-E Anti-c Anti-e + 0 + + 0 a. R1r b. R2R2 c. RzRz d. Ror If a group R1r marries a group O R2r woman, what percentage of the offspring can be expected to be D negative? a. 0% b. 25% c. 50% d. 75% Which offspring is not possible from a mother who is R1R2 and a father who is R1r? a. DcE/DcE b. DCe/DCe c. DcE/DCe d. DCe/dce Which of the following phenotypes will react with anti-f? a. R1R1 b. R2R2 c. R1R2 d. Rr If a D-positive person makes an anti-D, this person is probably: a. Partial D b. D-negative c. Weak D as position effect d. Weak D due to transmissible genes Which genotype usually shows the strongest reaction with anti-D? a. DCE/DCE b. Dce/dCe c. D--/D-d. -CE/-ce Can Rh positive blood be transfused to an Rh negative person? a. Never, under no circumstances b. Only if Rh positive blood has been previously administered c. May be transfused to males or females past childbearing age d. Depend on the responder status of the individual • • • • • • • • • • A Kleihauer-Betkeacid elution stain is reported 1.3% on an Rh negative mother postpartum. What is the total volume of fetal-maternal hemorrhage? a. 6.5 mL b. 14 mL c. 26 mL d. 65 mL How many vials of a standard 300 µg dose of RhIgshould be administered within 72 hours to the mother with this amount of bleed? a. 1 vial b. 2 vials c. 3 vials d. 4 vials The rosette test will detect a fetomaternalhemorrhage (FMH) as small as: a. 10 mL b. 15 mL c. 20 mL d. 30 mL A fetal screen yielded negative results on a mother who is O negative and infant who is O positive. What course of action should be taken? a. A. Perform a Kleihauer–Betke test b. Issue one full dose of RhIg (correct answer) c. Perform a DAT on the infant d. Perform an antibody screen on the mother Anti-LW will not react with which of the following? a. Rh-positive RBCs b. Rh-negative RBCs c. Rh null RBCs d. Rh:33 RBCs LW, G, f, V and vs antigens are associated with: a. Rh blood group system b. Lewis system Inheritance of sese and the Lewis gene produces which of the following phenotype: a. Le (a+ b-) b. Le (a+b+) c. Le (a-b+) d. Le (a-b-) Inheritance of Sese and the Lewis gene produces: a. Le (a+ b-) b. Le (a+b+) c. Le (a-b+) d. Le (a-b-) If a person has the genetic makeup Hh, AO, LeLe and sese, what substance will be found in his secretions? a. A and H substances b. Lea substance c. Leb substance d. None of these What substances would be found in the saliva of a group B secretor who also has Lele genes? a. H, Lea b. H, B, Lea c. H, B, Lea, Leb d. H, B, Leb 2 • • • • • • • • • • In what way do the Lewis antigens change during pregnancy? a. Lea antigen increases only b. Leb antigen increases only c. Lea and Leb both increase d. Lea and Leb both decrease The Lewis phenotype that is most commonly associated with Helicobacter pylori infection is: a. Le (a+b-) b. Le (a-b+) c. Le (a-b-) d. Le (a-x+) An individual has been sensitized to the k antigen and has produced anti-k. What is her most probable Kell system genotype? a. KK b. Kk c. kk d. K0K0 The dosage effect means: a. Greater reactivity when more serum is used b. Greater reactivity when a greater number of cells are used c. Stronger reactions with homozygous cells than heterozygous cells d. Reaction with heterozygous cells only All of the following exhibit dosage effect, except: a. Duffy b. Kidd c. Lewis d. MNS Anti-M reacts strongest with: a. M+ Nb. M+ N+ c. M- N+ d. M- NWhich of the following is the most common antibody seen in the blood bank after ABO and Rh antibodies? a. Anti-Fya b. Anti-k c. Anti-Jsa d. Anti-K Which blood group system is associated with resistance to P. vivax malaria? a. P b. Kell c. Duffy d. Kidd Which of the following Duffy phenotypes is prevalent in blacks but virtually nonexistent in whites? a. Fy (a+b+) b. Fy (a–b+) c. Fy (a–b–) d. Fy (a+b–) Which antibody is enhanced by acidifying the patient serum? a. Anti-D b. Anti-Fya c. Anti-M d. Anti-Jka • • • • • • • • • Which autoantibody specificity is found in patients with paroxysmal cold hemoglobinuria? a. Anti-I b. Anti-i c. Anti-P d. Anti-P1 A patient with an Mycoplasma pneumonia infection will most likely develop a cold autoantibody with specificity to which antigen? a. I b. i c. P d. P1 Which procedure would help to distinguish between an anti-e and anti-Fya in an antibody mixture? a. Lower the pH of test serum b. Run an enzyme panel c. Use a thiol reagent d. Run a LISS pane An antibody shows strong reactions in all test phases. All screen and panel cells are positive. The serum is then tested with a cord cell and the reaction is negative. What antibody is suspected? a. Anti-I b. Anti-i c. Anti-H d. Anti-P Which of the following antigens are carried on a component of complement? a. Kx b. Lutheran c. Chido/Rodgers d. Diego The antigens were shown to be located on COMPLEMENT RECEPTOR 1 (CR1): a. Diego b. Knops c. Indian d. Cromer What is the name of the Knops system serologic null phenotype? a. Gregory b. Leach c. Helgeson d. McLeod Which antigen is the receptor for Haemophilus influenzae? a. AnWj b. PEL c. FORS d. Kna The antibody to this high-prevalence antigen demonstrates mixed-field agglutination that appears shiny and refractile under the microscope. a. Dia b. JMH c. Sc2 d. Sda 3 • • • • • • • • • Anti-Sda has been identified in patient. What substance would neutralize this antibody and allow detection of other alloantibodies? a. Saliva b. Hydatid cyst fluid c. Urine d. Human breast milk A previously named HLA antigen that is not uncommonly detected on erythrocytes is: a. Dia b. Sda c. Bga d. Coa What techniques can be used to remove the reactivity of Bg antigens? a. EDTA/glycine-HCL b. Platelet adsorption c. Chloroquine treatment d. All of the above Anti-K and anti-c were found in a patient with colon cancer. How many units of red cells would need to be screened to find two compatible units for surgery? The antigen negative frequency for K and c are 0.91 and 0.20, respectively. a. 5 units b. 2 units c. 7 units d. 11 units The most serious hemolytic transfusion reactions are due to incompatibility in which of the following blood group systems? a. ABO b. Rh c. MN d. Duffy Severe intravascular hemolysis is most likely caused by antibodies of which blood group system? a. ABO b. Rh c. Kell d. Duffy Which of the following blood group systems is most commonly associated with delayed hemolytic transfusion reactions? a. Lewis b. Kidd c. MNS d. I The phenotype Fy(a-b-) is very prominent among blacks (nearly 100% among African blacks). What special trait accompanies those individuals who are Fy(a-b-)? a. Resistance to typhoid fever b. Cells are usually Rh negative c. Resistance to malaria d. Cells are usually Rh positive If during a DONATH-LANDSTEINER TEST there is hemolysis in both the test and the control tube at the conclusion of the test, which of the following possible conclusions is most applicable? a. The test is positive b. The test is negative c. The test is invalid d. The test is false negative • • • • • • • • • All of the following are microbially associated forms of polyagglutination, EXCEPT: a. T polyagglutination b. Th polyagglutination c. Tk polyagglutination d. Tn polyagglutination Patients with in vivo polyagglutination should be given transfusions of: a. Whole blood b. Washed red blood cells c. Packed cells d. Fresh frozen plasma HEMPAS red blood cells are characterized by: a. Increased amount of i antigen b. Increased amount of H antigen c. Resistance to Plasmodiumsp. d. Increased amount of sialic acid A positive DAT may be found in which of the following situations: a. A weak D positive patient b. Hemolytic disease of the newborn c. A patient with anti-K d. An incompatible crossmatch Which antibodies to a component of complement are contained in the rabbit POLYSPECIFIC antihuman globulin reagent for detection of in vivo sensitization? a. Anti-IgG and anti-C3a b. Anti-IgG and anti-C3d c. Anti-IgG and anti-IgM d. All of these options A technologist is having great difficulty resolving an antibody mixture. One of the antibodies is anti-Lea. This antibody is not clinically significant in this situation, but it needs to be removed to reveal the possible presence of an underlying antibody of clinical significance. What can be done? a. Perform an enzyme panel b. Neutralize the serum with saliva c. Neutralize the serum with hydatid cyst fluid d. Use DTT (dithiothreitol) to treat the panel cells How can interfering anti-P1 antibody may be removed from a mixture of antibodies? a. Neutralization with saliva b. Combination with urine c. Agglutination with human milk d. Neutralization with hydatid cyst fluid Predict compatibility or incompatibility for the following situation. Assume that the patient has a negative antibody screen and auto-control. Patient: group A positive Donor: group O positive a. Compatible major side crossmatch b. Incompatible major side crossmatch c. Compatible minor side crossmatch d. Not enough information to predict Can crossmatching be performed on October 14th using a patient sample drawn on October 12th? 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 2 day limit has expired d. No, a new sample is needed for each testing 4 • • • • • • • • • How long a recipient sample must be kept in the blood bank following transfusion? a. 3 days b. 5 days c. 7 days d. 10 days The poorest ABO choice for an AB recipient is: a. Group A b. Group B c. Group AB d. Group O During emergency situations when there is no time to determine ABO group and Rh type on a current sample for transfusion, the patient is known to be A, Rh-negative. The technologist should: a. Refuse to release any blood until the patient’s sample has been typed b. Release A Rh-negative Red Blood Cells c. Release O Rh-negative Red Blood Cells d. Release O Rh-positive Red Blood Cells What is the maximum volume of blood that can be collected from a 110-lb donor, including samples for processing? a. 450 mL b. 500 mL c. 525 mL d. 550 mL How much anticoagulant would have to be removed from the collection bag given a donor who weighs 90 lb? a. 12 mL b. 15 mL c. 20 mL d. 23 mL A 22-year-old female with a cousin with AIDS who had taken aspirin the day before and with needle marks on both arms presents to donate whole blood. Based on this information, would you accept, permanently defer (PD), or temporarily defer (TD) the donor? a. PD, needle marks on both arms b. TD, needle marks on both arms c. PD, cousin with AIDS d. TD, because of the aspirin Which of the following would be cause for deferral? a. Temperature of 99.2°F b. Pulse of 90 beats per minute c. Blood pressure of 110/70 mm Hg d. Hematocrit level of 37% When using a standard 450 mL collection bag, what is the acceptable range for the volume of whole blood collected? a. 350 to 550 mL b. 400 to 500 mL c. 405 to 495 mL d. 425 to 475 mL Which of the following is an acceptable time in which a unit of whole blood is collected? a. 33 minutes b. 25 minutes c. 20 minutes d. 13 minutes • • • • • • • • • A 63-year-old man with a hemoglobin value of 130 g/dL and pulse of 80 beats/min, who received human pituitary growth hormone (PGH) when he was 10 years old, presents for whole blood donation. Based on this information, would you accept, permanently defer (PD,) or temporarily defer (TD) the donor? a. Accept the donor b. TD, because of the human PGH c. PD, because of the human PGH d. PD, because of the high hemoglobin value Which of the following would be cause for permanent deferral? a. History of hepatitis after 11th birthday b. Positive hepatitis C test result c. Positive anti-HBc test result d. All of the above Immunization for rubella would result in a temporary deferral for: a. 2 weeks b. 4 weeks c. 6 months d. 1 year Persons who have received HBIG must wait ___ to donate blood to be sure they were not infected since hepatitis B can be transmitted through transfusion to a patient. a. 6 weeks b. 8 weeks c. 12 months d. Indefinitely A whole-blood donor currently on clopidogrel (Plavix) is precluded from donating which product? a. Platelets b. Red blood cells c. FFP d. Cryoprecipitate The most common anticoagulant used for apheresis procedures is: a. Heparin b. Sodium fluoride c. Warfarin d. Citrate Donor criteria for DOUBLE RED CELL APHERESIS: a. Hematocrit b. Hematocrit and weight c. Weight and height d. Hematocrit, weight and height All of the following apply to a double red cell unit apheresis collection except: a. The hematocrit must be at least 38% b. The weight for a female is at least 150 lb c. The height for a male is at least 5 ft1 in. d. The deferral period following collection is 16 weeks Which of the following can be given to an apheresis donor to increase the number of circulating granulocytes? a. DDAVP b. Hydroxyethyl starch (HES) c. Immune globulin d. G-CSF 5 • • • • • • • • • For apheresis donors who donate platelets more frequently, a platelet count must be performed prior to the procedure and be at least: a. 150 x 109/L b. 200 x 109/L c. 250 x 109/L d. 300 x 109/L The minimum interval allowed between plateletpheresis component collection procedures is: a. 1 day b. 2 days c. 7 days d. 8 weeks Four units of platelets were pooled and issued at 2:00 pm. At 7:00pm, the ward called, informing they had never transfused the platelets, and wanted to know if the platelet pool could still be used? a. No, they outdated at 6:00 pm b. No, the platelets, were not refrigerated on ward c. Yes, they won’t outdate until 8:00 pm d. Yes, they are good for 24 hours after pooling Pre-storage pooled platelets can be stored for: a. 4 hours b. 24 hours c. 5 days d. 7 days A 70-kg man has a platelet count of 15,000/µL, and there are no complicating factors such as fever or HLA sensitization. If he is given a platelet pool of 6 units, what would you expect his post-transfusion count to be? a. 21,000-27,000/µL b. 25,000-35,000/µL c. 45,000-75,000/µL d. 75,000-125,000/µL Once defrosted, cryoprecipitate must be administered within how many hours of thawing? a. 2 hours b. 4 hours c. 6 hours d. 12 hours What is the expiration of cryoprecipitate once pooled? a. 4 hours b. 6 hours c. 8 hours d. 24 hours 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 irradiated d. Must retain the original expiration date The temperature range for storage of RBCs and whole blood is: a. 1-6 °F b. 20 -24 °F c. 2 - 5 °C d. 20 - 24 °C • • • • • • • • • The temperature range for maintaining red blood cells and whole blood during shipping is a. 0-4 °C b. 1-6 °C c. 1-10 °C d. 5-15 °C A male cancer patient with a hemoglobin of 6 g/dL was admitted to the hospital with acute abdominal pain. Small bowel resection was indicated, but the attending physician wanted to raise the patient’s hemoglobin to 12 g/dL before surgery. How many units of RBCs would most likely be required to accomplish this? a. 2 b. 3 c. 6 d. 8 What component(s) is (are) indicated for patients who have anti-IgA antibodies? a. Whole blood b. Packed RBCs c. Washed RBCs d. Granulocytes What percentage of red cells must be retained in leukocyte reduced red cells? a. 75% b. 80% c. 85% d. 100% Which component has the longest expiration date? a. Cryoprecipitate b. FFP c. Frozen RBCs d. Platelet concentrates What is the number of white blood cells permitted in a unit of leukoreduced red cells? a. <5 ×1010 b. <5 ×106 c. <8.3 ×105 d. <8.3 ×106 Which of the following viruses resides exclusively in leukocytes? a. CMV b. HIV c. HBV d. HCV In preparing platelets from a unit of whole blood, the correct order of centrifugation is: a. Hard spin followed by a hard spin b. Light spin followed by a light spin c. Light spin followed by a hard spin d. Hard spin followed by a light spin Platelets play an important role in maintaining hemostasis. One unit of donor platelets derived from whole blood should yield platelets. a. 5.5 x 106 b. 5 x 108 c. 5.5 x 1010 d. 5 x 1010 6 • • • • • • • • • Which of the following is true regarding apheresis platelets? a. The minimum platelet count must be 3.0 ×1011, pH must be ≥6.0 b. The minimum platelet count must be 3.0 ×1010, pH must be ≤6.2 c. The minimum platelet count must be 3.0 ×1011, pH must be ≥6.2 d. The minimum platelet count must be 5.5 ×1010, pH must be ≤6.0 Even though it is properly collected and stored, which of the following will fresh frozen plasma (FFP) not provide? a. Factor V b. Factor VIII c. Factor IX d. Platelets Fresh frozen plasma must be thawed at which temperature? a. 1 to 6 °C b. Room temperature c. 37 °C d. 40 °C or higher After thawing and pooling cryoprecipitate for transfusion to a patient, the product should be stored at: a. Room temperature b. 1 to 6 °C c. 37 °C d. 0 °C What is the component of choice for a patient with chronic granulomatous disease (CGD)? a. FFP b. Granulocytes c. Cryoprecipitate d. RBCs Once collected, Granulocytes MUST be administered within: a. 6 hours b. 24 hours c. 7 days d. 35 days What should be done if a noticeable clot is found in an RBC unit? a. Issue the unit; the blood will be filtered b. Issue the unit; note the presence of a clot on the release form c. Filter the unit in the blood bank before issue d. Do not issue the unit A technologist removed 4 units of blood from the blood bank refrigerator and placed them on the counter. A clerk was waiting to take the units for transfusion. As she checked the paperwork, she noticed that one of the units was leaking onto the counter. What should she do? a. Issue the unit if the red cells appear normal b. Reseal the unit c. Discard the unit d. Call the medical director and ask for an opinion Platelets must be kept in constant motion for which of the following reasons? a. Maintain the pH so the platelets will be alive before transfusion b. Keep the platelets in suspension and prevent clumping of the platelets c. Mimic what is going on in the blood vessels d. Preserve the coagulation factors and platelet viability • • • • • • • • • • What component is most frequently involved with transfusion-associated sepsis? a. Plasma b. Packed red blood cells c. Platelets d. Whole blood Fatal transfusion reactions are mostly caused by: a. Serologic errors b. Improper storage of blood c. Clerical errors d. Improper handling of the product What blood group system antibodies are commonly associated with delayed hemolytic transfusion reactions? a. Rh b. ABO c. MNS d. Kidd A patient has experienced two febrile nonhemolytic reactions after RBC transfusion. What is the preferred blood component if future transfusions are necessary? a. Leukocyte-reduced RBCs b. Irradiated RBCs c. Cytomegalovirus-negative RBCs d. Group O, D-negative RBCs The use of plasma from only male donors for transfusion is a preventive method for which type of transfusion reaction: a. Febrile b. TRALI c. Allergic d. TACO Which transfusion reaction presents with fever, maculopapular rash, watery diarrhea, abnormal liver function, and pancytopenia? a. Transfusion-associated sepsis b. Transfusion-related acute lung injury c. Transfusion-associated graft-versus host disease d. Transfusion-associated allergic reaction Which of the following adverse complications of transfusion is prevented by irradiation of blood components? a. TRALI b. Hyperkalemia c. Febrile d. TA-GVHD What is the cause of transfusion-induced hemosiderosis? a. Excess citrate b. HPA-1a antigen c. Iron overload d. Circulatory overload The most severe form of HDN is associated with: a. Anti-A b. Anti-B c. Anti-D d. Anti-K EXCHANGE TRANSFUSIONS are used primarily to: a. Provide antigen negative RBCs b. Remove antibody c. Remove antibody coated RBCs d. Remove high levels of unconjugated bilirubin and thus prevent kernicterus 7 • • • • • Blood products are tested for which virus before being transfused to newborns? a. EBV b. HTLV-II c. CMV d. Hepatitis D virus The advantages of cordocentesis include all of the following except: a. Allows measurement of fetal hemoglobin and hematocrit levels b. Allows antigen typing of fetal blood c. Allows direct transfusion of fetal circulation d. Decreases risk of trauma to the placenta Saline suspension of RBCs is used for most serologic testing procedures: a. 1 to 2% b. 2 to 5% c. 5 to 10% d. 10 to 20% Commonly used blood bank antisera should be routinely stored at ____ °C when not in use. a. 2 to 6 °C b. 0 to 2 °C c. -10 to 0 °C d. -20 to -10 °C Compatible gel test: a. Solid band of agglutinated red cells at the top of the gel column. b. Predominant amount of agglutinated red cells towards the top of the gel column with a few agglutinates staggered below the thicker band. c. Red cell agglutinates dispersed throughout gel column with few agglutinates at bottom of microtubes. d. Red cells forming a well-delineated pellet in the bottom of the microtube. 8