BB - Big

After thawing and pooling cryoprecipitate for transfusion to a patient, the product should be stored at:

Room temperature

If the IAT or DAT was not washed adequately, the AHG results could be falsely negative because the AHG:

May be neutralized by the unbound serum globulins

The purpose of saving the 'last wash' before performing an elution is to:

Ensure the washing process is done adequately

A directed donation must have which of the following done before transfusion to the patient?

Irradiation on donations from first-degree relatives

One use for the indirect antiglobulin test would be for determining

Weak D testing

A group A, D-negative obstetric patient with anti-D (titer 256) is carrying a fetus who needs an intrauterine transfusion. The blood needed should be:

Group O, D-negative RBC

Antibodies in the ABO blood group system:

Can activate complement and cause hemolysis

People with the Bombay (O_h) genotype

Inherited 2 recessive amorphic genes at the H locus

The signs/symptoms of a transfusion reaction are all of the following EXCEPT

Coughing up blood

The neonatal intensive care unit has requested fresh frozen plasma to be transfused STAT. No blood specimen is available. What blood type of FFP should be thawed for transfusion?

Group AB

The cell with the most amount of H antigen would be the blood group

A2

An autologous donor is defined as a person who gives blood for

His/her specific use only

Refrigerators for blood storage must have quality control performed:

On the high and low alarms at designated intervals

Before A and B antigens can be expressed, the precursor substance must have the terminal sugar _____________

L-fucose

Frozen red blood cells are prepared for transfusion by thawing at

37° C in a water bath and then washing with different concentrations of saline

An IgA-deficient patient with clinically significant anti-IgA requires:

Washed red blood cells

Cryoprecipitate is prepared by first thawing:

Fresh frozen plasma at 1° to 6° C and then doing a cold centrifugation to pack the cryoprecipitate to the bottom so the plasma may be removed

Upon receiving notification about a transfusion reaction, the technologist should:

Check immediately for clerical errors

How can IgG antibodies be removed from red cells?

Elution

Cell washers must have which of the following QC measures performed by the technologist at designated intervals?

All of the above

Dyspnea, severe headache, and peripheral edema occurring soon after transfusion are indicative of which type of transfusion reaction?

Circulatory overload

What plasma protein binds hemoglobin following intravascular hemolysis?

Haptoglobin

Which antibody can be neutralized with a specific reagent?

Anti-Lea

Check (Coombs control) cells:

Are added to every negative antiglobulin test

Of the following, which cell or cells carry a single dose (heterozygous) of the Jk^a antigen?

NOT Cells 1 and 3

Cell 1 only

According to Landsteiner's rule, if a patient has no ABO antibodies after serum testing, which ABO antigens are present on the patient's red blood cells?

Both a and b

The most common cause of HDFN is:

Anti-A, B

________ percent of the population secretes ABH substances in body secretions

80

What must a blood bank do when donor units of packed RBCs are received from the blood supplier?

Confirm ABO on all units and confirm Rh on units labeled as Rh negative

An end-point of tube testing other than agglutination that must also be considered a positive reaction is called:

Hemolysis

Two units of packed RBCs were AHG-crossmatch compatible with a sample from a patient who had a positive antibody screen with an identified anti-K. What additional testing is required?

AHG-crossmatch compatible donor units with reagent anti-K

The phenotype D+, C+, c-, E-, e+ would be equal to which genotype?

R₁R₁

What is meant by the term dosage effect?

The antibody will react more strongly when the cells have a double dose of the antigen on the cell

The number of genes encoding Rh antigens D, C, E, c, and e is(are):

Two

An epitope is also termed a(n):

NOT binding site

Antigenic determinant

Platelets must be kept in constant motion for which of the following reasons?

NOT Keep the platelets in suspension and prevent clumping of the platelets

(figure out)

Maintain the pH so the platelets will be alive before transfusion

Mimic what is going on in the blood vessels

Preserve the coagulation factors and platelet viability

A delayed transfusion reaction is defined as:

An adverse reaction to transfused blood product detected days, weeks, or months after the transfusion

An individual with a confirmed, positive HBsAg test:

NOT Has the disease

(figure out) 

Has the disease

Is a chronic virus carrier

Requires a temporary deferral of the donor

a and b

Hepatitis C

All of the above

Mixed-field reaction is characteristic of which A subgroup?

A3

Most blood group antigens are expressed as a result of which of the following?

Autosomal codominant inheritance

Based on the following antigram, which cell is heterozygous for M?

Cell 1

Which genes encode for Rh antigens?

Both b and c

For FDA licensure, polyspecific antihuman globulin must contain

Anti-IgG and anti-C3d

A newborn has a positive DAT. What is the best procedure to determine the antibody causing a positive DAT in this newborn?

An antibody panel on the mother's serum

A patient is group O Rh positive and requires transfusion of packed red blood cells Which blood group and type should you select for transfusion? The blood types are listed as first choice, second choice, third choice, and fourth choice. Choose the best answer for transfusion of this patient

O Rh positive, O Rh negative

Which of the following is true of antibodies to MNS blood group system antigens?

Anti-U is directed at a high-incidence antigen

The quality control required on random donor platelets is:

Platelet count greater than or equal to 5.5 × 10¹⁰ in 75% of the units tested

The elution procedure is used to:

NOT Remove antibodies coating the red cells (??)

(figure out) 

Enhance antibody reactions

Enhance the sensitization phase

Concentrate weak-reacting antibodies

An antibody-demonstrating dosage would mean that:

Homozygous cells were stronger

The phlebotomist drew a blood sample for compatibility testing but did not positively identify the patient. The blood was drawn from a group A individual, but the sample was labeled with the name of a patient previously typed as group O. What will happen when the blood is actually transfused to the intended patient?

An intravascular hemolytic transfusion reaction will occur

The best indication for transfusion of washed red blood cells is:

An IgA-deficient patient

Which of the following is the confirmatory test for a positive anti-HIV-1/2 screen?

Western Blot

Which genotype is heterozygous for C?

NOT RzRz

R1r

The most common cause of hemolytic disease of the fetus/newborn is:

Anti-A, B found in group A babies born to group O mothers

The purpose of performing an elution is to:

Remove antibodies for identification

 Based on the following reactions, what might you do next?

AA 0, AB 4+, A1 1+, B 0

Incubate the reverse group at room temperature for 15 minutes

Which product is least likely to transmit hepatitis?

Plasma protein fraction

Which is a cause for temporary deferral of a whole blood donor?

Rubella injection 2 weeks ago

What should be done first if a mother types as O and the baby types as AB?

Recheck all labels, get new samples if necessary, and retest

From the antibody screening cells below, which cell or cells carry a double dose of the (homozygous) M antigen?

Cell 2

Using known sources of reagent antisera (known antibodies) to detect ABO antigens on a patient's red blood cells is known as:

Forward grouping

A characteristic of the Xga antigen is that it:

Has a higher frequency in women than in men

The antibody screen:

Detects most clinically significant antibodies

The BEST next step for these reactions would be to:

AA 0, AB 0, AD 4+, A1 0, B 3+

NOT Incubate the reverse group at room temperature for 15 minutes

Redraw the patient sample and retest again (? maybe check)

Based on the following, which cell or cells can be used to perform the rule out step?

Cells 8 and 9

A nonbleeding adult of average height and weight with chronic anemia is transfused with 2 units of red blood cells. The pretransfusion Hgb is 7.0 g/dl. What is the expected posttransfusion Hgb?

9 g/dl

Which statement is not true concerning anti-Fya and anti-Fyb?

React well with enzyme-treated panel cells

Which of the following characteristics describes a clinical finding of delayed HTRs?

Positive antibody screen postreaction sample

A DAT performed on a clotted sample stored at 4° C may demonstrate:

In vitro complement attachment

Which of the following is a characteristic of the Kidd system antibodies?

The antibodies are often implicated in delayed hemolytic transfusion reactions

Given the following ABO typing results, what conclusion can be drawn?

AA 4+, AB 4+, A1 1+, B 0

Discrepant results; patient has A antigen on red blood cells with anti-A in serum

Chagas disease is caused by:

Trypanosoma cruzi

 Molecules that promote the uptake of bacteria for phagocytosis are:

Opsonins

A 34-year-old male is scheduled for surgery this afternoon. A type and screen is ordered. The patient types as A Rh positive with the antibody screen results as follows. What additional testing is required?

SC 1 0, SC2 2+, SC 3 0

Perform antibody panel

An 18-year-old female with a hematocrit of 38%, temperature of 37° C, and blood pressure of 175/90 mm Hg presents for whole blood donation. Based on this information, would you accept, permanently defer (PD), or temporarily defer (TD) the donor?

Accept

_______ molecules are usually not good antigenic substances.

NOT Carbohydrate

Lipid 

The steps for issuing blood or components for transfusion include all of the following EXCEPT:

Verify that the phlebotomist identification is on the compatibility tag

One indication for transfusion of thawed/pooled cryoprecipitate would be replacement of which of the following?

Fibrinogen

Blood for exchange transfusion was requested for a newborn baby with a bilirubin of 18 mg/dl. The mother is O negative with anti-D. The newborn is A positive with a 4+ direct antiglobulin test due to anti-D. If an exchange transfusion is requested, the unit will be crossmatched with:

NOT serum/plasma from the mother

(figure out)

Serum/plasma from the mother or eluate from the baby's red cells

An electronic crossmatch as the unit is ABO compatible with the mother and the baby

Serum/plasma from the neonate

An O-negative mother gave birth to an O-positive baby. Her rosette test was positive. Which of the following is true?

A Kleihauer-Betke test should be performed to quantify the fetal maternal hemorrhage

For lysis of red blood cells to occur after antigen-antibody reaction, which compound is required?

Complement

A recently transfused patient's serum has a positive antibody screen. The panel performed at IS, in LISS at 37° C, and at AHG shows a strong anti-Fy^a and a weak possible anti-c. To confirm the anti-c, you would perform an

Enzyme panel

Autologous presurgical donations are not allowed for which of the following patients?

With bacteremia

Red blood cells must be stored at ________, while platelets are stored at ______

1-6° C; room temperature (20-24° C)

If a patient has the Rh genotype DCe/DCe and receives a unit of red blood cells from a DCe/dce individual, what Rh antibody might the patient develop?

Anti-c

Testing for the D antigen was conducted at the IAT phase. A control was included in the testing. Both the patient's red cells and the control tube reacted at 4+. How would you interpret this test?

The test is invalid because the control tube was positive

HTLV-I/II is:

All of the above

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

ABO antibodies do not react with group O cells

Blood used for exchange transfusion:

Must be compatible with the mother and the baby

The Lewis system is unusual because it is the only blood group that:

Is absorbed on the red cell from the plasma

Which of the following is an example of a record-keeping error?

All of the above

The neutralization technique was performed on a sample containing an anti-Le^b. The control and the Lewis-neutralized serum were both negative when retested with panel cells. How should this test be interpreted?

NOT The anti-Le^b was successfully neutralized, and no underlying antibodies were found

(figure out)

The panel cells were not washed sufficiently

The sample was probably diluted

The antibody originally identified was probably not anti-Le^b

A patient's ABO blood type is determined by which of the following?

Genetic Inheritance 

IgG reagent is made by:

A monoclonal process

Which antibody is typically considered to be an autoantibody if found in the serum of an adult?

Anti-I

Which of the following situations may produce ABO discrepancies in serum testing?

All of the above

In the regulator type of Rh_null, which of the following genes is mutated?

NOT RHD

(figure out)

RHAG

RHCE

The use of EDTA samples for the direct antiglobulin test prevents activation of the classical complement pathway by:

Chelating Ca2+ ions, preventing assembly of C1

The BEST next step for these reactions would be to:

AA 4+, AB 0, AD 4+, A1 1+, B 4+

Determine if the reverse grouping is due to anti-A₁ or other IgM antibody