RCS AND RCW High Yield Flashcards

Question: What is the primary purpose of a Red Cell Suspension?
A) To lyse red blood cells for analysis
B) To balance the ratio between cells and serum
C) To concentrate antibodies in plasma
D) To separate white blood cells from red blood cells

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

Question: What is the correct concentration range for the Zone of Equivalence in Red Cell Suspension?
A) 1–3%
B) 5–8%
C) 2–5%
D) 6–10%

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 happens when a Red Cell Suspension is too concentrated (>5%)?
A) Pro-zone effect causing false positive
B) Post-zone effect causing false negative
C) Pro-zone effect causing false negative
D) Zone of equivalence is maintained

Answer: B) Post-zone effect causing false negative

Question: What happens when a Red Cell Suspension is too diluted (<2%)?
A) Post-zone effect causing false negative
B) Zone of equivalence is achieved
C) Pro-zone effect causing false negative
D) Spontaneous agglutination occurs

Answer: C) Pro-zone effect causing false negative

Question: What is the formula for Red Cell Suspension percentage?
A) % RBC = (TV / PCV) x 100
B) % RBC = (PCV + NSS) x 100
C) % RBC = (PCV / TV) x 100
D) % RBC = (NSS / PCV) x 100

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

Question: Which solution is used in preparing Red Cell Suspension?
A) Distilled water
B) Normal Saline Solution
C) Phosphate buffered saline at pH 9
D) Lactated Ringer's solution

Answer: B) Normal Saline Solution

Question: What is the concentration of Normal Saline Solution used in RBC washing?
A) 0.45–0.5%
B) 1.0–1.5%
C) 0.85–0.9%
D) 0.3–0.45%

Answer: C) 0.85–0.9%

Question: Why must distilled water NEVER be used to wash RBCs?
A) It causes rouleaux formation
B) It will hemolyze the RBCs
C) It increases immunoglobulin levels
D) It causes crenation of RBCs

Answer: B) It will hemolyze the RBCs

Question: What type of solution is Normal Saline Solution in relation to RBCs?
A) Hypertonic
B) Hypotonic
C) Isotonic
D) Hyperosmotic

Answer: C) Isotonic

Question: What happens to RBCs placed in a hypertonic solution?
A) They swell and burst
B) They clump together
C) They shrink and crenate
D) They hemolyze immediately

Answer: C) They shrink and crenate

Question: What happens to RBCs placed in a hypotonic solution?
A) They shrink and crenate
B) They swell and burst
C) They form rouleaux
D) They undergo spontaneous agglutination

Answer: B) They swell and burst

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

Answer: C) 6–8 times

Question: Why are Cord RBCs washed more times than regular RBCs?
A) They contain more immunoglobulins
B) Wharton's Jelly causes spontaneous auto-agglutination
C) They have excess fibrinogen
D) They contain cold-reacting antibodies

Answer: B) Wharton's Jelly causes spontaneous auto-agglutination

Question: How are cold-reacting autoimmune antibodies removed during RBC washing?
A) Wash with distilled water at 4°C
B) Centrifuge at high speed and discard supernatant
C) Warm cells at 37°C then wash with warm saline
D) Add anti-IgG reagent to the suspension

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

Question: What condition does Multiple Myeloma cause that affects RBC testing?
A) Spontaneous auto-agglutination
B) Rouleaux formation
C) Hemolysis
D) Wharton's Jelly accumulation

Answer: B) Rouleaux formation

Question: What does rouleaux formation mimic in serologic testing?
A) True hemolysis
B) True agglutination
C) Zone of equivalence
D) Pro-zone phenomenon

Answer: B) True agglutination

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

Answer: C) Group 3

Question: What is the primary clinical use of Washed RBCs in transfusion medicine?
A) Prevention of febrile non-hemolytic transfusion reactions
B) Patients with severe allergic reactions to plasma proteins
C) Treatment of anemia in neonates
D) Reduction of leukocyte contamination

Answer: B) Patients with severe allergic reactions to plasma proteins

Question: Is washing an effective method for leukocyte reduction?
A) Yes, it removes all leukocytes
B) Yes, but only partially
C) No, washing is not an effective method of leukocyte reduction
D) Only when combined with irradiation

Answer: C) No, washing is not an effective method of leukocyte reduction

Question: What immunologic principle explains why IgA-deficient patients develop anti-IgA antibodies?
A) Presence of antigen → antibody present
B) Absence of antigen → no antibody formed
C) Absence of antigen → antibody present
D) High antigen load → tolerance induction

Answer: C) Absence of antigen → antibody present

Question: What is the temperature threshold that defines a Febrile Non-Hemolytic Transfusion Reaction (FNHTR)?
A) ≥0.5°C above normal
B) ≥1°C above normal
C) ≥2°C above normal
D) ≥3°C above normal

Answer: B) ≥1°C above normal

Question: How long after transfusion can FNHTR occur?
A) Up to 1 hour
B) Up to 2 hours
C) Up to 4 hours
D) Up to 8 hours

Answer: C) Up to 4 hours

Question: Which cytokines are implicated in FNHTR?
A) IL-2, IL-4, IL-10, and TGF-β
B) IL-1, IL-6, IL-8, and TNF
C) IL-3, IL-5, IL-7, and IFN-γ
D) IL-9, IL-11, IL-13, and GM-CSF

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

Question: Which complement fragments contribute to FNHTR?
A) C1q and C4b
B) C2a and C3b
C) C3a and C5a
D) C4a and C5b

Answer: C) C3a and C5a

Question: Why are washed RBCs important for neonates with renal failure?
A) To prevent rouleaux formation
B) To remove excess potassium and reduce risk of hyperkalemia
C) To eliminate Wharton's Jelly from cord blood
D) To prevent IgA-related reactions

Answer: B) To remove excess potassium and reduce risk of hyperkalemia

Question: What cardiac complication can result from hyperkalemia in neonates receiving unwashed RBCs?
A) Myocardial infarction
B) Ventricular hypertrophy
C) Cardiac arrhythmias
D) Pericardial effusion

Answer: C) Cardiac arrhythmias

Question: What is the most commonly used method of RBC washing in the Philippines?
A) Automated cell processor
B) Centrifugal apheresis
C) Manual washing
D) Membrane filtration

Answer: C) Manual washing

Question: Which type of blood collection tube is used as specimen for RBC washing procedures?
A) Red top (no additive)
B) Green top (heparin)
C) EDTA tube
D) Citrate tube

Answer: C) EDTA tube

Question: At what speed and duration should the centrifuge be run during RBC washing?
A) 1,500 rpm for 10 minutes
B) 3,400 rpm for 5 minutes
C) 2,000 rpm for 3 minutes
D) 5,000 rpm for 2 minutes

Answer: B) 3,400 rpm for 5 minutes

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

Answer: B) 3–5 times

Question: When should you stop repeating the RBC washing procedure?
A) After exactly 3 washes regardless of appearance
B) When the supernatant becomes cloudy
C) When the supernatant is clear
D) After the packed cells change color

Answer: C) When the supernatant is clear

Question: How much of the WRC tube should be filled with normal saline during washing?
A) 1/4 full
B) 1/2 full
C) 3/4 full
D) Completely full

Answer: C) 3/4 full

Question: What volume of packed RBCs is aspirated and transferred to the WRC tube?
A) 0.5 mL
B) 1 mL
C) 2 mL
D) 5 mL

Answer: C) 2 mL

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

Answer: D) 4.9 mL NSS

Question: To prepare a 5% RCS using 0.1 mL PRBC, what is the total volume?
A) 1 mL
B) 2 mL
C) 3.3 mL
D) 5 mL

Answer: B) 2 mL

Question: To prepare a 3% RCS using 0.2 mL PRBC, how much NSS is needed?
A) 3.2 mL
B) 4.8 mL
C) 6.4 mL
D) 9.8 mL

Answer: C) 6.4 mL

Question: What is the serum-to-cell ratio important for maintaining?
A) Optimal centrifuge speed
B) The Zone of Equilibrium
C) Rouleaux prevention
D) NSS isotonicity

Answer: B) The Zone of Equilibrium

Question: Why is hemolyzed RBC problematic in serologic testing?
A) It causes rouleaux formation
B) It releases free hemoglobin which may cause false positive results
C) It activates complement causing false negative results
D) It increases serum viscosity

Answer: B) It releases free hemoglobin which may cause false positive results

Question: What is the primary role of Red Cell Suspensions as an antigen source?
A) To detect coagulation factor deficiencies
B) To detect clinically significant antibodies in the patient's serum
C) To identify leukocyte antigens
D) To measure platelet antibody titers

Answer: B) To detect clinically significant antibodies in the patient's serum

Question: For the Determination of Hemolysis procedure, how long is the centrifugation step?
A) 30 seconds
B) 1 minute
C) 5 minutes
D) 10 minutes

Answer: B) 1 minute

Question: Which tube label is NOT part of the standard labeling in the RBC washing procedure?
A) WRC – Surname
B) 2% RCS – Surname
C) Plasma – Surname
D) Serum – Surname

Answer: D) Serum – Surname

Question: What is the secondary role of washed RBCs in transfusion medicine?
A) Leukocyte reduction
B) FNHTR prevention and management
C) Platelet supplementation
D) Coagulation factor replacement

Answer: B) FNHTR prevention and management

Question: Which patients are primarily recommended to receive washed RBCs?
A) Patients with thrombocytopenia
B) Recipients with a history of plasma-related transfusion reactions
C) Patients with sickle cell disease
D) Patients undergoing chemotherapy

Answer: B) Recipients with a history of plasma-related transfusion reactions

Question: What substance found in cord blood causes spontaneous auto-agglutination due to its viscosity?
A) Fibrinogen
B) Cold-reacting IgM antibodies
C) Wharton's Jelly
D) Excess immunoglobulins

Answer: C) Wharton's Jelly