Blood bank

The addition of adenine in an anticoagulant-preservative formulation aids in

A. Maintaining ATP levels for red cell viability

B. Maintaining platelet function in stored blood

C. Reducing the plasma K+ levels during storage

D. Maintaining 2,3-BPG levels for oxygen release to the tissues

Maintaining ATP levels of RBC viability

In the gel test, what is a button of cells at the bottom of the well called?

negative

Once thawed, Fresh Frozen Plasma must be transfused within:

A. 4 hours

B. 8 hours

C. 12 hours

D. 24 hours

24 hours

What alternative type can be given to an O-positive person when group O RBCs are not available

None of the options

Hemolytic transfusion reactions are the most serious type of reactions to blood transfusion. The majority of hemolytic transfusion reactions are caused by ____ errors?

clerical

Which of the following blood components are appropriate for a patient with a fibrinogen deficiency?

Cryopercipitated AHF

Occasionally, patients have an anaphylactic reactions to a specific immunoglobulin class during a transfusion. Which immunoglobulin class is most often implicated?

IgA

A Kleihauer -Betke stain performed on a postpartum blood sample demonstrated 16 fetal cells in a field of 2000.What is the estimated blood volume of the fetomaternal hemorrhage? How many vials of RhIG are needed to cover the bleed?

40ml; 2 vials

Platelets play an important role in maintaining hemostasis. One unit of donor platelets derived from whole blood should yield how many platelets

5.5*10 ^10

What increment of platelets in an adult is expected to result from each single random donor hint of platelets

5,000-10,000

Which of the following is a potential complication of massive transfusions?

hypothermia due to 1-6 degree celsius storage temperature of red cells

Which of the following is true regarding interpretation of solid phase result

A tight button of cells at the bottom of the well would be interpreted as a negative reactions

What is the leading theory regarding the immunologic principle of Rhlg administration?

Anti-D attaches to Rh-positive cells of the infant in maternal circulation and is subsequently removed by cells of the reticuloendothelial system preventing sensitization

Ten days after the transfusion of 2 units, a patient had a 2 g/dl drop in hemoglobin and was slightly Jaundiced. No evidence of bleeding found. What tests would be helpful in determining whether the patient is experiencing a delayed hemolytic transfusion reaction?

Perform an antibody screen on the current posttransfusion sample

The most conclusive way to demonstrate the antibody that is causing a positive DAT in a newborn is to perform an antibody

panel using eluate from the baby's red cells

Blood transfusion to the fetus and premature infants for exchange transfusion should be ___ to prevent graft versus host disease

Irradiated

Which of the following is acceptable to be given intravenously with a blood transfusion

physiologic saline

FFP plasma from an A POSITIVE donor may be safely transfused to a patient who is group:

A neg

Which of the following patient histories might suggest future transfusion with saline-washed RBCs?

IgA-negative recipient with anti-IgA antibodies

In a delayed hemolytic transfusion reaction, the causitive antibody is generally too weak to be detected in routine compatibility testing and antibody screening tests, but is typically detectable at what point after transfusion?

2 days-2 weeks

A rosette test performed on a D-negative mother who delivered a D-negative baby demonstrated two rosettes per 4 fields observed. What is the correct course of action

Cancel the test after the technologist realized that RhIg is not indicated

An MLS pools 6 units of random donor platelets to fill an order requested for transfusion. She had to spike the bags in order to pool them together into a single does. All units that were pooled had an initial expiration date of 3 days at the time of modification. What is the new expiration date?

4 hours

Choose the correct storage and expiration limit for a unit of Fresh Frozen plasma.

Frozen at -18°C with in 24 hours after collection; good for 12 months

A patient has a hemoglobin value of 8.1g/dL. The surgeon wants to raise the hemoglobin to 10g/dL before surgery. How many units of RBCs are needed for this patient to raise the hemoglobin to this level?

2 units

Which unit should be selected for exchange transfusion if the newborn is A POS, and the mother is A POS with anti-c.

O, CDe/CDe

The purpose of performing antibody titers on serum from an immunized, pregnant woman is to:

identify candidates requiring additional fetal monitoring

Coughing, cyanosis, and difficult breathing are symptoms of which of the following transfusion reactions?

Circulatory Overload

During initial investigation of a suspected hemolytic transfusion reaction, it was observed that blood bank paperwork and patient sample and blood component labels were correct. The post-transfusion reaction plasma was straw-colored as was the pre-transfusion sample and the DAT from both samples was negative. Repeat ABO typing on the post-transfusion sample confirmed the pre-transfusion results and the donor segment re-type matched initial results as well. What is the next step in this investigation?

no further serological testing is necessary

A unit of blood has been irradiated. Choose the correct expiration for this unit.

28 days after irradiation or the original expiration date; which ever comes first

Which blood product is recommend for transfusion to individuals with a history of febrile non hemolytic transfusion reactions?

Leukocyte-reduced Red Blood Cells

Which of the following antigens is most likely to be involved in HDFN?

Kell

What plasma protein functions to bind hemoglobin after intravascular hemolysis?

haptoglobin

A 44-year-old woman has a hemoglobin level of 6.1 g/dL. White blood cell and platelet counts are within normal levels. The patient is group O D-negative with a negative antibody screen. Crossmatches are compatible. However, 15 minutes after the first transfusion is started, she experiences erythema and hives. What type of transfusion reaction is occurring?

uricarial

What blood group system antibodies are more commonly associated with delayed hemolytic transfusion reactions?

Kidd

Biochemical changes occur during the shelf life of stored blood. Which of the following is a result of this " storage lesion "

Increase in plasma K+

Which type of transfusion reaction will be prevented by the use of plasma from only male donors for transfusion?

TRALI

An important determination of platelet viability following the recommend storage interval is the :

pH

A 12 year old female patient has been life-flighted to your hospital's trauma center with a pelvic fracture resulting in a liver laceration. She is experiencing a critical massive hemorrhage and the surgeon calls the blood bank for 6 units of emergency release packed Red Blood Cells and 6 units of FFP. Which blood type should you give this patient for the respective blood components?

RBC: ONeg

FFP: ABPos/Neg

What is the purpose of an elution?

To determine the specificity of the antibody on a patient's RBCs

To avoid a hemolytic transfusion reaction

During storage, the concentration of 2,3-diphosphoglycerate (2,32DPG) decreases in a unit of

Red Blood Cells

A sickle cell patient presents to your hospital experiencing a sickle cell crisis. She has no prior history at your hospital, but states she was transfused 2 weeks ago before re-locating to the area. You identify an anti-C and anti-S in her plasma. You need to phenotype her to verify the antibody identity. What is the appropriate next step?

perform hypotonic saline cell separation then phenotype

Which of the following antibodies carries no risk of HDFN

anti -Lea

A unit of pRBCs was split into two parts for patients who has severe CHF to be run slowly .What adverse reaction is the medical staff trying to avoid

TACO

Which disease has been treated effectively using plasmapheresis

TTP

What is the allowable shelf life for blood containing AS-3

42 days

A unit of pRBCs was split into two parts for a patient who has severe CHF. A sterile connecting device was not used, therefore the original unit and the spli unit went from a closed to open system. What is the new expiration date for these units?

24 hours

Which of the following transfusion reactions occurs after infusion of only a few milliliters of blood and does not cause fever?

anaphylactic

Therapeutic plasmapheresis is performed in order to:

treat patients with plasma abnormalities

A common strategy to reduce alloimmunization in chronically transfused patients with sickle cell disease is to provide red cell units matched for which of the following antigens?

C ,E ,K

Which of the following best describes the principle of the Kleihauer-Betke test?

Fetal hemoglobin is resistant to acid elution and remains in the cell to stain pink, whereas adult cells appear as ghost cells.

The Rh testing on a blood donor was negative at immediate spin. The tube was incubated at 37°C for 15 minutes. The tube was centrifuged and read macroscopically. The test was negative at 37°C. The tube was washed three times with saline, and two drops of AHG were added. After centrifugation, the tube yielded a 2+ reaction. Dat control was negative. How is this Rh type reported on the donor unit?

Rh positive

To determine the specificity of red blood cell antigens in the patient sample. What source of antibodies is selected?

commercial antisera

Which Fischer Race genotype is heterozygous for the C gene

DCe/ dce

A 40 year old man was admitted to the hospital with a ruptured appendix. During surgery, complication necessitated the need for transfusion. The physican ordered a type and screen with 2 unit of crossmatch. His ABo typing revealed the following

Anti-A:3

Anti-B:0

Anti-D:3

A1 cells:1

B cells:4

The 3+ reaction with anti-A and 1+ with A1 cells

Reverse grouping was performed on an Ab person. The technologist observed a very weak agglutination macroscopically. The cells appeared as " stacked coins" under a microscope. Which reagent should be added to the tube and re-centrifuged in an attempt to resolve the discrepancy

Saline

After the addition of IgG-coated RBCs (check cells)

to a negative AHG Weak D test, a negative result is observed. Which of the

following is a correct interpretation,

The Weak D test needs to be repeated

An elderly patient is documented as Type O. The forward grouping is negative with anti-A and anti-B . The reverse grouping showed no reactivity with A1 cells and B cells. What can be done to correct the discrepancy

Incubate patient serum and reagent cells for 15 minutes at room temperature

What are autosomes?

Any chromosome that is not a sex chromosome

The direct antiglobulin test is useful for which of the following?

The detection of the HDFN

The O gene has no detectable product and is therefore termed:

amorphic

Hemagglutination in antigen-antibody reaction is influenced by

A. isotonic strength of the system

B. pH

C. incubation time

ANSWER IS ALL OF THE ABOVE

The immunodominant sugar that confers A blood group specificity is

N-acetylgalactosamine

A principle of the antiglobulin test is:

AHG reacts with human globulin molecules bound to RBCs antigen

A patient has the following ABO typing results:

Anti-A: 4+

Anti-B:0

Anti-A,B= 4+

A1c: 1+

B cell= 4+

subgroup of A

Which of the following Rh genotype would be positive for the compound antigen f

rr due to relating to c e

The immunodominant sugar that confers B blood group specificity is

d-galactose

Group O red blood cells are used as a source of commercial screening cells because:

ABO antibodies do not react with group O cells

Alternate forms of a gene that can occur at a single chromosome locus are referred to as

alleles

A patient types as B positive. Which of the following packed red blood cells units would be the best choice to give him if he needed blood

B

What immunoglobulin class reacts best at immediate spin

IgM

Which reagent increase the rate of antibody uptake

LISS

Interpret the following test result

Anti-A= 0

Anti-B= 2+ mf

Anti-D= 4 +

A1c= 4+

B cells=0

B transfused with O

In the procedure for the Weak D test. What reagent is used to determine if a negative reaction at AHG is valid

Coombs check cells

A patient is type as AB positive = what type of plasma would be the best choice for this patient to receive?

Type AB

Rh system antibodies characteristically give

reactions that are enhanced with enzymes

What is the purpose of including a patient control when interpreting group AB, D positive red cells

to confirm D typing results

to confirm ABO typing results

to detect false positive agglutination reactions

ANSWER IS ALL OF THE ABOVE

Why do IgM antibodies, such as those formed against the ABO antigens, have the ability to directly agglutinate red blood cells (RBCs) and cause visible agglutination?

IgM antibodies are larger molecules and have the ability to bind more antigen

A patient sample is tested with Anti-D, Result is 0. A weak D test is performed and the result is 2+. Concurrently, a control is tested. The result is 2+. How do you interpret the results of the weak D and rh Status of the patient?

Invalid; unable to interpret

Which genotype below will give rise to the bombay phenotype

hh only

An example of a technical error that can result in an ABO discrepancy is

Cell suspension might be too heavy or too light

To determine the presence of a red cell antibody in a patient sample, what source of antigen is selected

Commercial reagent red cells

Anti-D is clinically significant antibody because

It can cause hemolytic transfusion reactions

What Rh type does a mother have to be to produce antibodies to Rh(D) from an Rh-positive infant?

Rh negative

Polyspecific AHG reagents contains

Anti-IgG and anti- C3d

Which of the following is responsible for the activation of the Classic Complement Pathway

antigen bound to antibody

Which blood group has the least amount of H antigen

A1B

Which antibody is produced rapidly in the highest amount during secondary response

IgG

Which of the following Rh antigen is the most immunogenic

D

At what age do infants began to produce their own antibodies

6 months

Which of the following is not true of the H antigen

The antibody directed toward the H antigen ( anti-H) is naturally occurring in the plasma of most adult patients

A patient has the following ABO type results

Anti-A: 4+

Anti-B: 0

Anti- A, B: 4+

Anti- D= 2+

A1c=0

B cell= 2

A positive

The major immunoglobulin class of anti-B in a group A individual is (are):

IgM

Genes inherited in the cis position

two or more genes on the same chromosome

An individual has the following genotype: DcE/dce. What is the correct Weiner terminiology

R2r

What reagents are derived from plant extracts

lectin

A group A man marries a group AB woman. What genotype offspring is not possible from this marriage

OO

A patient was previously typed as a blood group O. Forward grouping was negative with anti-A and anti-B. Reverse grouping showed reactivity with A1 cells and B cells. The technologist reported this patient's type as A. What technical error occurred

Sample misidentification

An AB male mates with an AB female. What could be the genotype of the offspring?

AB

AA

BB

ANSWER IS ALL OF THE ABOVE

Which of the following describes the expression of most blood group antigens?

codoiminant

Which of the following may not be detected in the antibody screen

anti-V