Quiz 5 - Compatibility Testing

True or false? D-negative person who is accidentally transfused with a D-positive blood product containing red cells should receive FFP to prevent sensitization to the D antigen

False

Transfusion reactions involving red cell products are likely to be most severe in which of the following?

a. ABO incompatibility

b. Rh incompatibility

a. ABO incompatibility

A patient developed an anti-Jka antibody 5 years ago. The antibody screen is currently negative. To obtain suitable blood for transfusion, which procedures apply?

a. type the patient for the Jka antigen as an added part to the crossmatch procedure

b. crossmatch random donors with the patient plasma, and release the compatible units for transfusion to the patient

c. type the patient and donor units for the Jka antigen and then crossmatch Jka negative units with patient plasma

d. computer crossmatch Jka negative donor units

c. type the patient and donor units for the Jka antigen and then crossmatch Jka negative units with patient plasma

You have just received a request and sample for pretransfusion testing. Which is the most appropriate to do first?

a. perform the ABO and RH

b. perform the crossmatch

c. perform the antibody screen to see if the patient is going to be a problem

d. check the records for prior type and screens results on the patient

d. check the records for prior type and screens results on the patient

Which of the following solutions may safely be added to red cells during administration of blood?

a. Ringer’s lactate

b. 0.9% saline

c. D5W with added ionic calcium

d. distilled water

b. 0.9% saline

Which of these items are required to be confirmed before blood products are issued for transfusion to a patient care area—

a. patient’s name on attached compatibility record and pick up request

b. donor unit # on product and attached compatibility record

c. ABO/Rh type of donor on product and attached compatibility record

d. patient’s identification number on attached compatibility record

e. expiration date od product

f. name of collection facility

g. name of product

h. birthdate of patient

i. appearance of product

all but name of collection facility and patient birthdate

Whenever a 2^oC rise in temperature occurs during transfusion, the following steps should be taken immediately and before anything else—

a. stop the transfusion, keep the IV line open, and report the event to patient’s physician

b. monitor the patient to see if more severe signs occur

c. call the blood bank and inform them that a transfusion reaction has occurred

d. call the blood bank and tell them to crossmatch additional units for transfusion

a. stop the transfusion, keep the IV line open, and report the event to patient’s physician

True or false? The biologic systems that may be activated by an immediate hemolytic reaction are complement, coagulation, and kinin.

True

True or false? An adverse reaction due to ABO incompatibility between donor cells and recipient plasma results in extravascular hemolysis.

False

The only presenting sign most often accompanying a delayed hemolytic transfusion reaction is?

a. renal failure

b. unexplained decrease in hemoglobin

c. active bleeding

d. hives

b. unexplained decrease in hemoglobin

True or false? An anamnestic response of antibody may result in a delayed reaction to transfusion.

False

Which of the following is prevented by irradiation?

a. circulatory overload

b. hyperkalemia

c. iron overload

d. graft vs. host disease

d. graft vs. host disease

Enhancement media used for compatibility testing includes—

a. low ionic strength solutions

b. polyethylene glycol

c. polymerized albumin

d. all of the above

d. all of the above

Patients with clinically significant antibodies—

a. should receive antigen negative blood crossmatch through AHG phase

b. should not be transfused

c. should receive D negative blood

d. may receive blood crossmatched only at the immediate spin phase

a. should receive antigen negative blood crossmatch through AHG phase

Severe life threatening hemolytic reactions to transfusion are most commonly caused by—

a. clerical errors dealing with patient identification issues during sample collection or blood administration

b. technical laboratory errors involved with testing the donor

c. technical laboratory errors that occur during compatibility testing

d. heating of the blood prior to transfusion

a. clerical errors dealing with patient identification issues during sample collection or blood administration

According to the AABB standards for blood banks and transfusion services, donor and recipient samples must be stored for how many days following transfusion?

a. 3

b. 7

c. 5

d. 10

b. 7

Cross match incompatible blood —

a. Should never be given

b. May be given in emergency situations prior to identification of the antibody

c. May be given to patients with autoantibodies or HTLA antibodies

d. May be given only in cases of severe HDFN

b. May be given in emergency situations prior to identification of the antibody

Acceptable substitutions for transfusions of blood to a 15-year-old AB negative female patient when type specific units are not available include—

a. A positive whole blood

b. O positive red cells

c. A negative red cells

d. O negative whole blood

c. A negative red cells

One immediate spin incompatible crossmatch detected out of two crossmatches performed on a group B patient could be explained by—

a. Patient has anti-Kpa

b. Patient has anti-A1

c. Unit has positive DAT

d. Patient has anti-M

d. Patient has anti-M

If all crossmatches and screening cells react uniformly with a patient’s plasma at saline immediate spin and 37°C LISS phases of testing, but are negative at AHG phase, and explanation could be presence of—

a. Rouleaux

b. Warm autoantibody

c. Antibody to acriflavin dye

d. Antibody to sodium caprylate

a. Rouleaux

True or false? For a patient who demonstrates no clinically significant antibodies present and who has no history of such antibodies, a serologic test to detect ABO incompatibility is sufficient testing prior to transfusion

True

True or false? When performed on a validated system, electronic (computer) crossmatches that compare recent donor and recipient ABO are as safe as serologic testing and eliminate many of the biohazards and false positives associated with serologic testing.

True

True or false? The term crossmatch is synonymous with compatibility testing because the two terms define the same thing.

False

True or false? The immediate spin crossmatch is a final check of ABO compatibility.

True

True or false? Current AABB “Standards” require performance of AHG crossmatch on all potential transfusion recipients during pre transfusion testing events

False