RCS AND RCW Flashcards

*Question: What is the primary purpose of a Red Cell Suspension?
A) To increase hemoglobin concentration
B) To balance the ratio between cells and serum
C) To stimulate antibody production
D) To preserve red blood cells for storage

*Answer: B) To balance the ratio between cells and serum

*Question: What is the Zone of Equivalence for Red Cell Suspension concentration?
A) 1–3%
B) 5–10%
C) 2–5%
D) 0.5–2%

*Answer: C) 2–5%

*Question: What color should a properly prepared Red Cell Suspension appear?
A) Dark maroon
B) Pale pink
C) Cherry red
D) Bright orange

*Answer: C) Cherry red

*Question: What formula is used to calculate Red Cell Suspension percentage?
A) % RBC = (TV / PCV) x 100
B) % RBC = (PCV / TV) x 100
C) % RBC = (NSS / PCV) x 100
D) % RBC = (PCV x TV) / 100

*Answer: B) % RBC = (PCV / TV) x 100

*Question: What does PCV stand for in the Red Cell Suspension formula?
A) Plasma Cell Volume
B) Platelet Cell Volume
C) Packed Cell Volume
D) Peripheral Cell Value

*Answer: C) Packed Cell Volume

*Question: A Red Cell Suspension that is too concentrated (>5%) results in what kind of error?
A) False Positive
B) True Negative
C) False Negative
D) True Positive

*Answer: C) False Negative

*Question: A Red Cell Suspension that is too diluted (<2%) results in what kind of error?
A) True Positive
B) False Negative
C) False Positive
D) True Negative

*Answer: B) False Negative

*Question: What zone phenomenon occurs when the suspension is too concentrated (>5%)?
A) Pro-zone
B) Zone of Equivalence
C) Post-zone
D) Goldilocks zone

*Answer: C) Post-zone

*Question: What zone phenomenon occurs when the suspension is too diluted (<2%)?
A) Post-zone
B) Pro-zone
C) Zone of Equivalence
D) Hyper-zone

*Answer: B) Pro-zone

*Question: What solution is used in preparing Red Cell Suspension?
A) Distilled water
B) Lactated Ringer's solution
C) Normal Saline Solution
D) Dextrose solution

*Answer: C) Normal Saline Solution

*Question: What is the concentration of Normal Saline Solution (NSS)?
A) 0.45–0.6%
B) 1.0–1.2%
C) 0.85–0.9%
D) 0.1–0.3%

*Answer: C) 0.85–0.9%

*Question: What happens to RBCs if a hypotonic solution is used during washing?
A) They crenate
B) They swell and burst
C) They stack together
D) They form rouleaux

*Answer: B) They swell and burst

*Question: What happens to RBCs if a hypertonic solution is used during washing?
A) They hemolyze
B) They swell
C) They shrink and crenate
D) They agglutinate

*Answer: C) They shrink and crenate

*Question: Why should distilled water NEVER be used to wash RBCs?
A) It causes rouleaux formation
B) It causes RBCs to crenate
C) It causes RBCs to hemolyze
D) It promotes bacterial growth

*Answer: C) It causes RBCs to hemolyze

*Question: What is Wharton's Jelly and where is it found?
A) A plasma protein found in adult blood
B) A viscous substance found in the umbilical cord of fetuses
C) A coagulation factor found in stored blood
D) An immunoglobulin found in cord blood

*Answer: B) A viscous substance found in the umbilical cord of fetuses

*Question: How many times should Cord RBCs be washed due to Wharton's Jelly?
A) 1–2x
B) 3–5x
C) 6–8x
D) 10–12x

*Answer: C) 6–8x

*Question: What problem does Wharton's Jelly cause in serologic testing?
A) Hemolysis
B) Rouleaux formation
C) Spontaneous auto-agglutination
D) False negative reactions

*Answer: C) Spontaneous auto-agglutination

*Question: How are cold-reacting autoimmune antibodies managed before serologic testing?
A) Freeze the cells at -20°C then wash with cold saline
B) Warm the cells at 37°C then wash with warm saline
C) Add distilled water to dilute the antibodies
D) Centrifuge at high speed to remove antibodies

*Answer: B) Warm the cells at 37°C then wash with warm saline

*Question: What condition does Multiple Myeloma cause that interferes with serologic testing?
A) Hemolysis
B) Spontaneous auto-agglutination
C) Rouleaux formation
D) Wharton's Jelly contamination

*Answer: C) Rouleaux formation

*Question: What does Rouleaux formation involve?
A) Clumping of platelets
B) Stacking of RBCs
C) Lysis of white blood cells
D) Aggregation of plasma proteins

*Answer: B) Stacking of RBCs

*Question: Fibrinogen in elevated amounts can cause what serologic problem?
A) Hemolysis
B) Pro-zone effect
C) Rouleaux formation leading to false positive results
D) Cold agglutination

*Answer: C) Rouleaux formation leading to false positive results

*Question: Elevated fibrinogen levels can lead to which type of ABO discrepancy?
A) Group 1
B) Group 2
C) Group 3
D) Group 4

*Answer: C) Group 3

*Question: Hemolyzed RBCs release what substance that interferes with testing?
A) Fibrinogen
B) Free hemoglobins
C) Immunoglobulins
D) Complement fragments

*Answer: B) Free hemoglobins

*Question: What type of result does free hemoglobin from hemolyzed RBCs cause?
A) True negative
B) True positive
C) False negative
D) False positive

*Answer: D) False positive

*Question: What is the primary clinical use of washed RBCs in transfusion medicine?
A) For patients with febrile reactions only
B) For patients with severe allergic reactions to plasma proteins
C) For patients with iron deficiency anemia
D) For neonates undergoing routine transfusions

*Answer: B) For patients with severe allergic reactions to plasma proteins

*Question: According to the basic immunologic principle, what happens when an antigen is absent?
A) No antibody is produced
B) Antibody is present
C) Complement is activated
D) Auto-agglutination occurs

*Answer: B) Antibody is present

*Question: IgA-deficient patients may develop which antibody?
A) Anti-IgG
B) Anti-IgM
C) Anti-IgA
D) Anti-IgE

*Answer: C) Anti-IgA

*Question: What is FNHTR defined as?
A) An increase of ≥1°C above normal body temperature during or up to 4 hours after transfusion
B) A decrease of ≥1°C below normal body temperature during transfusion
C) An allergic skin reaction occurring 24 hours after transfusion
D) A hemolytic reaction caused by ABO incompatibility

*Answer: A) An increase of ≥1°C above normal body temperature during or up to 4 hours after transfusion

*Question: Which cytokines are implicated as causes of FNHTR?
A) IL-2, IL-4, IL-10
B) IL-1, IL-6, IL-8, TNF
C) IL-3, IL-5, IL-7
D) IL-9, IL-11, IL-13

*Answer: B) IL-1, IL-6, IL-8, TNF

*Question: Which complement fragments are associated with FNHTR?
A) C1q and C4b
B) C2a and C3b
C) C3a and C5a
D) C4a and C5b

*Answer: C) C3a and C5a

*Question: Is washing an effective method of leukocyte reduction?
A) Yes, it is the primary method
B) No, it is not an effective method
C) Yes, but only for platelets
D) Yes, when combined with irradiation

*Answer: B) No, it is not an effective method

*Question: What is the PRIMARY use of washed RBCs?
A) FNHTR prevention
B) Leukocyte reduction
C) Allergic reactions
D) Hyperkalemia management

*Answer: C) Allergic reactions

*Question: Why are washed RBCs indicated for neonates with renal failure?
A) To prevent rouleaux formation
B) To reduce the risk of hyperkalemia from potassium leakage in stored blood
C) To remove Wharton's Jelly from cord blood
D) To prevent FNHTR in neonates

*Answer: B) To reduce the risk of hyperkalemia from potassium leakage in stored blood

*Question: What cardiac complication can hyperkalemia cause in neonates?
A) Bradycardia
B) Cardiac arrhythmias
C) Myocardial infarction
D) Heart block

*Answer: B) Cardiac arrhythmias

*Question: What is the most commonly used method of RBC washing in the Philippines?
A) Automated cell processor
B) Continuous-flow centrifugation
C) Manual washing
D) Apheresis

*Answer: C) Manual washing

*Question: What type of specimen is required for RBC washing?
A) Blood in a red-top tube
B) Blood in a gold-top tube
C) Blood in an EDTA tube
D) Blood in a sodium citrate tube

*Answer: C) Blood in an EDTA tube

*Question: Why is clotting not allowed in the specimen tube for RBC washing?
A) Clotting removes plasma proteins needed for testing
B) Clotted blood cannot be washed with saline
C) Clotted specimens prevent proper RBC separation and serologic testing
D) Clotting activates complement factors

*Answer: C) Clotted specimens prevent proper RBC separation and serologic testing

*Question: At what RPM should the centrifuge be set during the RBC washing procedure?
A) 1,000 rpm
B) 2,000 rpm
C) 3,400 rpm
D) 5,000 rpm

*Answer: C) 3,400 rpm

*Question: How many times is the standard RBC washing procedure repeated?
A) 1–2x
B) 3–5x
C) 6–8x
D) 10x

*Answer: B) 3–5x

*Question: How do you determine when to stop the RBC washing procedure?
A) After exactly 3 washes regardless of appearance
B) When the supernatant becomes clear
C) When the packed cells turn bright red
D) After the RBCs have been washed 8 times

*Answer: B) When the supernatant becomes clear

*Question: How much pRBC is aspirated and transferred into the WRC tube?
A) 0.5 mL
B) 1 mL
C) 2 mL
D) 5 mL

*Answer: C) 2 mL

*Question: To make a 2% RCS using 0.1 mL of pRBC, how much NSS is needed?
A) 1.9 mL
B) 2.4 mL
C) 3.2 mL
D) 4.9 mL

*Answer: D) 4.9 mL

*Question: What is the total volume (TV) when making a 3% RCS using 0.1 mL pRBC?
A) 2.5 mL
B) 3.3 mL
C) 4.0 mL
D) 5.0 mL

*Answer: B) 3.3 mL

*Question: Which immunologic condition makes a patient vulnerable to plasma-related transfusion reactions requiring washed RBCs?
A) IgG deficiency
B) IgM deficiency
C) IgA deficiency
D) IgE deficiency

*Answer: C) IgA deficiency

*Question: What is the serum-to-cell ratio important for maintaining?
A) Zone of post-equivalence
B) Zone of Equilibrium
C) Pro-zone effect
D) Antibody titer

*Answer: B) Zone of Equilibrium