MLS Summative #06 (Ratio)

MEDICAL LABORATORY SCIENCE 7. SUMMATIVE EXAM REVIEW QUESTIONS #06 + ANSWERS & RATIONALIZATIONS 1. 2. 3. 4. 5. 6. Plastic bag overwraps are recommended when thawing units of FFP in 37°C water baths because they prevent: a. The FFP bag from cracking when it contacts the warm water b. Water from slowly dialyzing across the bag membrane c. The entry ports from becoming contaminated with water d. The label from peeling off as the water circulates in the bath Which of the following anticoagulant preservative provides a storage time of 35 days at 1°C to 6°C for units of whole blood and prepared RBCs if an additive solution is not added? a. ACD b. CP2D c. CPD d. CPDA-1 Appropriate preservative for modified whole blood: a. ACD b. CPD c. CPDA-1 d. All of these → When cryoprecipitated AHF has been removed for the unit of whole blood, WB is referred to as whole blood modified. All of the following are requirements for the tag on the crossmatched donor unit, EXCEPT: a. ABO and Rh type b. Name of the donor c. Unit expiration date d. Interpretation of the crossmatch → Requirements for the tag on the crossmatched donor unit: ▪ Patient’s full name and second independent identifier ▪ Name of blood product ▪ Unique donor unit number or pool number ▪ Unit expiration date and ABO and D phenotype ▪ Interpretation of crossmatch ▪ Technologist’s identification What is the expected therapeutic effect in the recipient’s hematocrit after the transfusion of 1 unit of RBCs? a. Increase of 0.5% b. Increase of 1% c. Increase of 2% d. Increase of 3% How many units of red blood cells are required to raise the hematocrit of a 70 kg nonbleeding man from 24% to 30%? a. 1 b. 2 c. 3 d. 4 8. 9. 10. 11. 12. 13. 14. A 42-year-old male of average body mass has a history of chronic anemia requiring transfusion support. Two units of red blood cells are transfused. If the pretransfusion hemoglobin was 7.0 g/dL, the expected posttransfusion hemoglobin concentration should be: a. 8.0 g/dL b. 9.0 g/dL c. 10.0 g/dL d. 11.0 g/dL Washed Red Blood Cells are indicated in which of the following situations? a. An IgA-deficient patient with a history of transfusionassociated anaphylaxis b. A pregnant woman with a history of hemolytic disease of the newborn c. A patient with a positive DAT and red cell autoantibody d. A newborn with a hematocrit of <30% According to AABB Standards, leukoreduced red cells is a product in which the absolute WBC count in the unit is reduced to ___, and contains at least ___ of the original RBC mass. a. 1 x 1010, 85% b. 3.0 x 1011, 85% c. 5.5 x 1010, 85% d. 5 x 106, 85% A unit of packed cells is split into 2 aliquots under closed sterile conditions at 8 AM. The expiration time for each aliquot is now: a. 4 PM on the same day b. 8 AM the next morning c. 8 PM on the same day d. The original date of the unsplit unit → Sterile docking devices allow entry into donor units without affecting the expiration date of the product. A unit of Red Blood Cells expiring in 35 days is split into 5 small aliquots using a sterile pediatric quad set and a sterile connecting device. Each aliquot must be labeled as expiring in: a. 6 hours b. 12 hours c. 5 days d. 35 days 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 percentage of red cells recovered after thawing and deglycerolization of frozen blood is: a. 35% b. 50% c. 70% d. 80% Frozen and thawed RBCs processed in an open system can be stored for how many days/hours? a. 3 days b. 6 hours c. 24 hours d. 15 days 1 15. For apheresis donors who donate platelets, a platelet count must be performed prior to the procedure and be at least: a. 150 x 109/L b. 250 x 109/L c. 200 x 109/L d. 300 x 109/L 16. Which of the following precludes acceptance of a plateletpheresis donor? a. Platelet count of 75 × 109/L in a donor who is a frequent platelet donor b. Plasma loss of 800 mL from plasmapheresis 1 week ago c. Plateletpheresis performed 4 days ago d. Aspirin ingested 7 days ago 17. An important determinant of platelet viability during storage is: a. Plasma potassium concentration b. Plasma pH c. Prothrombin time d. Activated partial thromboplastin time 18. What is the lowest allowable pH for a platelet component at outdate? a. 6 b. 5.9 c. 6.2 d. 6.8 19. 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 20. According to AABB Standards, Platelets prepared from Whole Blood shall have at least a. 5.5 x 1010 platelets per unit in at least 90% of the units tested b. 6.5 x 1010 platelets per unit in 90% of the units tested c. 7.5 x 1010 platelets per unit in 100% of the units tested d. 8.5 x 1010 platelets per unit in 95% of the units tested 21. The optimum storage temperature for platelets is: a. - 20ºC b. - 12ºC c. 4ºC d. 22ºC 22. If a platelet bag is broken or opened, the platelets must be transfused within ______ when stored at 20 to 24 °C a. 4 hours b. 24 hours c. 5 days d. 7 days 23. What increment of platelets/uL (platelets/L), in the typical 70-kg human, is expected to result from each single unit of random donor platelets (RDP) to recipient? a. 3,000 – 5,000 b. 5,000 – 10,000 c. 20,000 – 25,000 d. 25,000 – 30,000 → RDP vs SDP 24. 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 25. Shelf-life of fresh frozen plasma stored at -65°C: a. 24 hours b. 5 days c. 1 year d. 7 years → Shelf-life for Fresh Frozen Plasma 26. According to AABB standards, fresh frozen plasma must be infused within what period of time following thawing? a. 24 hours b. 36 hours c. 48 hours d. 72 hours 27. FFP can be transfused without regard for: a. ABO type b. Rh type c. Antibody in product d. All of these options 28. A blood component prepared by thawing Fresh Frozen Plasma at refrigerator temperature and removing the fluid portion is: a. Plasma Protein Fraction b. Cryoprecipitate c. Factor IX Complex d. FP24 29. Cryoprecipitate contains how many units of Factor VIII? a. 40 b. 80 → greatest amount of FVIII relative to volume c. 130 d. 250 30. Cryoprecipitate may be used to treat all of the following, EXCEPT: a. von Willebrand’s disease b. Hypofibrinogenemia c. Idiopathic thrombocytopenic purpura (ITP) d. Factor XIII deficiency 2 31. Although ABO compatibility is preferred, ABO incompatibility is acceptable for which of the following components? a. PF24 b. Cryoprecipitated AHF → not type specific c. Apheresis Granulocytes d. Apheresis Platelets 32. The optimum storage temperature for cryoprecipitate is: a. – 20 ºC → 18ºC or colder for 1 year b. –12ºC c. 4ºC d. 22ºC 33. Cryoprecipitate maintained in the frozen state of -18 °C or below, has a shelf life of: a. 42 days b. 6 months c. 12 months d. 36 months 34. Cryoprecipitate must be transfused within what period of time following thawing and pooling? a. 4 hours b. 8 hours c. 12 hours d. 24 hours → Cryoprecipitate shelf-life 35. The primary indication for granulocyte transfusion is: a. Prophylactic treatment for infection b. Additional supportive therapy in those patients who are responsive to antibiotic therapy c. Clinical situations where bone marrow recovery is not anticipated d. Severe neutropenia with an infection that is nonpresponsive to antibiotic therapy 36. Irradiation of a unit of Red Blood Cells is done to prevent the replication of donor: a. Granulocytes b. Lymphocytes c. Red cells d. Platelets 37. The purpose of a low-dose irradiation of blood components is to: a. Prevent posttransfusion purpura b. Sterilize components c. Prevent graft-vs-host (GVH) disease d. Prevent noncardiogenic pulmonary edema 38. A cancer patient recently developed a severe infection. The patient’s hemoglobin is 8 g/dL owing to chemotherapy with a drug known to cause bone marrow depression and immunodeficiency. Which blood products are indicated for this patient? a. Liquid plasma and cryoprecipitate b. Crossmatched platelets and washed RBCs c. Factor IX concentrates and FFP d. Irradiated RBCs, platelets, and granulocytes 39. All Blood Collection Units shall achieve and maintain ___ voluntary blood donation. Their key function is the effective donor recruitment and safe blood collection. a. 10% b. 50% c. 70% d. 100% 40. Whole blood collected in BCUs shall be stored immediately after collection and validation in a blood bank refrigerator or cold box at 1 to 6 °C. As much as possible, blood should be submitted to the Blood Bank/Center within ___ after collection. a. 6 hours b. 8 hours c. 12 hours d. 24 hours 41. The blood warmer should have automatic temperature control with an alarm that will sound if the blood is warmed over ___ °C. a. 30 °C b. 37 °C c. 40 °C d. 42 °C 42. Leukocyte-poor red blood cells would most likely be indicated for patients with a history of: a. Febrile transfusion reaction b. Hemophilia A c. Iron deficiency anemia d. von Willebrand disease 43. The type of cell most frequently responsible for febrile transfusion reactions is the: a. Erythrocyte b. Lymphocyte c. Granulocyte d. Platelets 44. With or without documentation of the existence of specific antibodies, the AABB recommends leukocytepoor preparations only after a patient has had at least ___ febrile nonhemolytic transfusion reactions. a. One b. Two c. Three d. Four 45. A transfusion reaction that usually appears rapidly during transfusion termed “WARM” and may result in fever, shock, or death is which one of the following listed reactions? a. Hemolytic b. Bacterial contamination → usually Y. enterocolitica c. TACO d. Allergic 46. An emergency trauma patient requires transfusion. Six units of blood are ordered stat. There is no time to draw a patient sample. O-negative blood is released. When will compatibility testing be performed? a. Compatibility testing must be performed before blood is issued b. Compatibility testing will be performed when a patient sample is available c. Compatibility testing may be performed immediately using donor serum d. Compatibility testing is not necessary when blood is released in emergency situations 3 47. Phototherapy is most useful for which of the following antibodies: a. Anti-A → mild HDN; tx: phototherapy b. Anti-D → severe HDN; tx: intrauterine/exchange transfusion c. Anti-K d. Anti-S 48. Advantages of Cordocentesis: 1. Allows measurement of fetal hemoglobin and hematocrit levels 2. Allows antigen typing of fetal blood 3. Allows direct transfusion of fetal circulation 4. Decreases risk of trauma to the placenta a. b. c. d. → 1 and 3 2 and 4 1, 2 and 3 1, 2, 3 and 4 Cordocentesis is also known as Percutaneous Umbilical Blood Sampling (PUBS) 49. The Liley method of predicting the severity of hemolytic disease of the newborn is based on the amniotic fluid: a. Bilirubin concentration by standard method b. Rh determination c. Change in optical density measured to 450 nm d. Ratio of lecithin to sphingomyelin 50. Which of the following is the preferred specimen for the initial compatibility testing in exchange transfusion therapy? a. Maternal serum b. Paternal serum c. Eluate prepared from infant’s red blood cells d. Infant’s post-exchange serum 4