BB PART 1 - Blood Collection, Preservation, Processing, Component Preparation, and Quality Control

A woman wants to donate blood. Her physical examination reveals the following: weight—110 lbs, pulse—73 bpm, blood pressure—125/75 mm Hg, hematocrit—35%. Which of the following exclusions applies to the prospective donor?

A. Pulse too high

B. Weight too low

C. Hematocrit too low

D. Blood pressure too low

C. Hematocrit too low

A potential donor has no exclusions, but she weighs only 87 pounds. What is the allowable amount of blood (including samples) that can be drawn?

A. 367 mL

B. 378 mL

C. 415 mL

D. 473 mL

C. 415 mL

A donor at a blood drive becomes sweaty and agitated during the donation. She appears pale and limp. What is the best course of action for this situation?

A. Continue the donation

B. Withdraw the needle, lift her feet, and administer ammonia

C. Discontinue donation and provide a paper bag

D. Call ambulance

B. Withdraw the needle, lift her feet, and administer ammonia

How much anticoagulant would need to be removed from a 450 mL blood bag if a donor weighed 94 pounds?

A. 9 mL

B. 10 mL

C. 12 mL

D. 15 mL

A. 9 mL

Which of the following donors would be deferred indefinitely?

A. History of syphilis

B. History of gonorrhea

C. Accutane® treatment

D. Recipient of human growth hormone

D. Recipient of human growth hormone

Which of the following viruses resides exclusively in leukocytes?

A. Cytomegalovirus (CMV)

B. Human immunodeficient virus (HIV)

C. Hepatitis B virus (HBV)

D. Hepatitis C virus (HCV)

A. Cytomegalovirus (CMV)

A 47-year-old woman donated a unit of blood at a church blood drive. She meets all the physical criteria to donate but she takes a blood thinner and B12 injections. Is she an acceptable donor?

A. No, due to blood thinner

B. No, due to B12 injections

C. Yes, for platelets only

D. Yes, red cells only

D. Yes, red cells only

Which of the following best describes what must be done with a unit of blood drawn from a donor who is found to be at high risk of contracting acquired immune deficiency syndrome (AIDS)?

A. Hold unit in quarantine until donor diagnosis is clarified.

B. Use the blood for research dealing with AIDS.

C. Properly dispose of unit by autoclaving or incineration.

D. Use the plasma and destroy the red blood cells.

C. Properly dispose of unit by autoclaving or incineration.

Which of the following is least likely to transmit hepatitis?

A. Cryoprecipitate

B. RBC

C. Plasma protein fraction (PPF)

D. Platelets

C. Plasma protein fraction (PPF)

A pooled serum product from 16 donors has a repeatedly positive nucleic acid test (NAT) for HCV. The next action that should be taken is to:

A. permanently exclude all the donors in the pool.

B. test each donor in the pool for HCV.

C. label all the donors as HCV positive.

D. confirm the positive using a recombinant immunoblot assay.

B. test each donor in the pool for HCV.

Although cryoprecipitate has primarily been used for treatment of hypofibrinogenemia and hemophilia A, it contains other blood proteins useful in the treatment of coagulopathies. Which of the following is not found in cryoprecipitate?

A. Fibronectin

B. Factor XIII

C. Factor VIII:vW

D. Antithrombin III

D. Antithrombin III

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

D. Platelets

Blood needs to be prepared for intrauterine transfusion of a fetus with severe hemolytic disease of the newborn (HDN). The red blood cell unit selected is compatible with the mother’s serum and has been leukodepleted. An additional step that must be taken before transfusion is to:

A. add pooled platelets and fresh-frozen plasma.

B. check that the RBC group is consistent with the father’s.

C. irradiate the RBCs before infusion.

D. test the RBC unit with the neonate’s eluate.

C. irradiate the RBCs before infusion.

The addition of adenine in an anticoagulant-preservative formulation aids in which of the following?

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

A. Maintaining ATP levels for red cell viability

The pilot tubes for donor unit #3276 break in the centrifuge. What should be done to resolve this issue?

A. Label the blood using the donor’s previous records.

B. Discard the unit because processing procedures cannot be performed.

C. Discard the RBCs and salvage the plasma for fractionation.

D. Remove sufficient segments to complete donor processing procedures.

D. Remove sufficient segments to complete donor processing procedures.

A satellite bag containing 250 mL of fresh plasma is selected for quality control of cryoprecipitate production. Cryoprecipitate is prepared according to standard operating procedures. The final product has a total volume of 10 mL. The factor VIII assays are 1 IU/mL before and 9 IU/mL after preparation.

What is the percent yield of factor VIII in the final cryoprecipitate?

A. 11%

B. 25%

C. 36%

D. 80%

C. 36%

A satellite bag containing 250 mL of fresh plasma is selected for quality control of cryoprecipitate production. Cryoprecipitate is prepared according to standard operating procedures. The final product has a total volume of 10 mL. The factor VIII assays are 1 IU/mL before and 9 IU/mL after preparation.

Does this product meet AABB Standards for cryoprecipitate production?

A. Yes

B. No; the percent recovery is too low.

C. No; the final factor VIII level is too low.

D. Data are insufficient to calculate.

A. Yes

What should be done with a unit of RBCs that was irradiated twice?

A. Change expiration date and then issue the unit.

B. Note on unit that it has been irradiated twice.

C. Discard the unit.

D. Issue immediately.

C. Discard the unit.

What is the expiration date/time of pooled cryoprecipitate?

A. 30 minutes

B. 2 hours

C. 4 hours

D. 8 hours

C. 4 hours

Which of the following is most accurate regarding platelet apheresis criteria?

A. The minimum platelet count must be 3.0 x 10¹¹, pH must be ≥6.0.

B. The minimum platelet count must be 3.0 x 10¹⁰, pH must be ≤6.2.

C. The minimum platelet count must be 3.0 x 10¹¹, pH must be ≥6.2.

D. The minimum platelet count must be 5.5 x 10¹⁰, pH must be ≤6.0.

C. The minimum platelet count must be 3.0 x 10¹¹, pH must be ≥6.2.

Which of the following lists the correct shelf life?

A. Frozen RBCs at -65°C = 7 years

B. Fresh frozen plasma (FFP) at -18°C = 1 year

C. Fresh frozen plasma (FFP) at -65°C = 1 year

D. Platelets at 6°C = 5 days

B. Fresh frozen plasma (FFP) at -18°C = 1 year

When 2,3-BPG levels drop in stored blood, which of the following occurs as a result?

A. RBC K+ increases.

B. RBC ability to release O₂ decreases.

C. Plasma hemoglobin is stabilized.

D. ATP synthesis increases.

B. RBC ability to release O₂ decreases.

The last unit of autologous blood for an elective surgery patient should be collected no later than ____ hours before surgery.

A. 24

B. 36

C. 48

D. 72

D. 72

For which of the following patients would autologous donation not be advisable?

A. Patients with an antibody against a high incidence antigen

B. Patients with uncompensated anemia

C. Open heart surgery patients

D. Patients with multiple antibodies

B. Patients with uncompensated anemia

What marker is the first to appear in hepatitis B virus infection?

A. HBsAg

B. Anti-HBc IgM

C. Anti-HBs IgG

D. Anti-HBc IgG

A. HBsAg

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

A. Increase in pH

B. Increase in plasma K+

C. Increase in plasma Na+

D. Decrease in plasma hemoglobin

B. Increase in plasma K+

It has been determined that a patient has posttransfusion hepatitis and received blood from eight donors. There is nothing to indicate that these donors may have been likely to transmit hepatitis. What action must be taken initially?

A. Defer all donors indefinitely from further donations.

B. Repeat all hepatitis testing on a fresh sample from each donor.

C. Notify the donor center that collected the blood.

D. Interview all implicated donors.

C. Notify the donor center that collected the blood.

The temperature range for maintaining RBCs and whole blood during shipping is:

A. 0–4°C

B. 1–6°C

C. 1–10°C

D. 5–15°C

C. 1–10°C

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

A. 5.5 x10⁶

B. 5 x 10⁸

C. 5.5 x 10¹⁰

D. 5 x 10¹¹

C. 5.5 x 10¹⁰

Which component is recommended for patients with anti-IgA antibodies?

A. Packed RBCs

B. Washed RBCs

C. Fresh plasma

D. Leukoreduced RBCs

B. Washed RBCs

During preparation of platelet concentrate, the hermetic seal of the primary bag is broken. The red blood cells:

A. must be discarded.

B. may be labeled with a 21-day expiration date if collected in CPD.

C. must be labeled with a 24-hour expiration date.

D. may be glycerolized within 6 days and stored frozen.

C. must be labeled with a 24-hour expiration date.

The transfusion services’ procedure manual must be:

A. revised annually.

B. revised after publication of each new edition of the AABB Standards.

C. reviewed prior to a scheduled inspection.

D. reviewed annually by an authorized individual.

D. reviewed annually by an authorized individual.

Previous records of patients’ ABO and Rh types must be immediately available for comparison with current test results for:

A. 6 months.

B. 12 months.

C. 10 years.

D. Indefinitely.

B. 12 months.

Which of the following weak D donor units should be labeled Rh-positive?

A. Weak D due to transmissible genes

B. Weak D as position effect

C. Weak partial

D. All choices are appropriate.

D. All choices are appropriate.

In order to meet the current AABB Standards for leukocyte reduction to prevent human leukocyte antigen (HLA) alloimmunization or CMV transmission, the donor unit must retain at least __________ of the original RBCs and leukocytes must be reduced to less than ___________.

A. 85%, 5 x 10⁸

B. 80%, 5 x 10⁶

C. 75%, 5 x 10⁵

D. 70%, 5 x 10⁴

B. 80%, 5 x 10⁶

Which of the following tests is not performed during donor processing?

A. ABO and Rh grouping

B. HbsAg

C. HIV-1-Ag

D. HBsAb

D. HBsAb

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 six units, what would you expect his posttransfusion 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

C. 45,000–75,000/µL

Which of the following tests on donor RBCs must be repeated by the transfusing facility when the blood was collected and processed by a different facility?

A. Confirmation of ABO group and Rh type of blood labeled D-negative

B. Confirmation of ABO group and Rh type

C. Weak D on D-negatives

D. Antibody screening

A. Confirmation of ABO group and Rh type of blood labeled D-negative

Red blood cells, liquid

A. 1–6°C

B. 20–24°C

C. -18°C or colder

D. -65°C or colder

A. 1–6°C

Red blood cells, frozen

A. 1–6°C

B. 20–24°C

C. -18°C or colder

D. -65°C or colder

D. -65°C or colder

Fresh-frozen plasma

A. 1–6°C

B. 20–24°C

C. -18°C or colder

D. -65°C or colder

C. -18°C or colder

Cryoprecipitate

A. 1–6°C

B. 20–24°C

C. -18°C or colder

D. -65°C or colder

C. -18°C or colder

Platelet concentrate

A. 1–6°C

B. 20–24°C

C. -18°C or colder

D. -65°C or colder

B. 20–24°C

Red blood cells in citrate phosphate dextrose adenine-1 (CPDA-1)

A. 24 hours

B. 5 days

C. 35 days

D. 1 year

C. 35 days

Fresh-frozen plasma

A. 24 hours

B. 5 days

C. 35 days

D. 1 year

D. 1 year

Cryoprecipitate

A. 24 hours

B. 5 days

C. 35 days

D. 1 year

D. 1 year

Fresh-frozen plasma, thawed

A. 24 hours

B. 5 days

C. 35 days

D. 1 year

A. 24 hours

Platelet concentrate in PL-732 bags (with agitation)

A. 24 hours

B. 5 days

C. 35 days

D. 1 year

B. 5 days

Citrate phosphate dextrose (CPD)

A. 21 days

B. 35 days

C. 42 days

D. Not an approved anticoagulant

A. 21 days

Citrate phosphate dextrose adenine (CPDA-1)

A. 21 days

B. 35 days

C. 42 days

D. Not an approved anticoagulant

B. 35 days

AS-1 (Adsol®)

A. 21 days

B. 35 days

C. 42 days

D. Not an approved anticoagulant

C. 42 days

EDTA

A. 21 days

B. 35 days

C. 42 days

D. Not an approved anticoagulant

D. Not an approved anticoagulant

A 65-year-old man whose birthday is tomorrow.

A. Defer temporarily

B. Defer for 12 months

C. Defer indefinitely

D. Accept

D. Accept

A 45-year-old woman who donated a unit during a holiday appeal 54 days ago

A. Defer temporarily

B. Defer for 12 months

C. Defer indefinitely

D. Accept

A. Defer temporarily

A 50-year-old man who had sex with another man in 1980

A. Defer temporarily

B. Defer for 12 months

C. Defer indefinitely

D. Accept

C. Defer indefinitely

A 25-year-old man who says he had yellow jaundice right after he was born

A. Defer temporarily

B. Defer for 12 months

C. Defer indefinitely

D. Accept

D. Accept

An 18-year-old with poison ivy on his hands and face

A. Defer temporarily

B. Defer for 12 months

C. Defer indefinitely

D. Accept

D. Accept

A woman who had a baby 2 months ago

A. Defer temporarily

B. Defer for 12 months

C. Defer indefinitely

D. Accept

D. Accept

A 35-year-old runner (pulse 46 bpm)

A. Defer temporarily

B. Defer for 12 months

C. Defer indefinitely

D. Accept

D. Accept

Patients with warm autoimmune hemolytic anemia (AIHA) due to a-methyldopa (Aldomet®) with hemoglobin of 8.5 g/dL or above

A. Platelet concentrate

B. RBC

C. Leukocyte-reduced RBCs

D. Transfusion not indicated

D. Transfusion not indicated

Patients requiring transfusion with RBCs that will not transmit cytomegalovirus (CMV)

A. Platelet concentrate

B. RBC

C. Leukocyte-reduced RBCs

D. Transfusion not indicated

C. Leukocyte-reduced RBCs

Patients with normovolemic anemia

A. Platelet concentrate

B. RBC

C. Leukocyte-reduced RBCs

D. Transfusion not indicated

B. RBC

Patients who are thrombocytopenic secondary to the treatment of acute leukemia

A. Platelet concentrate

B. RBC

C. Leukocyte-reduced RBCs

D. Transfusion not indicated

A. Platelet concentrate