BLOOD BANK FINAL

A potential donor has no exclusions, but she weighs only 95 pounds. What is the allowable amount of blood (including samples) that can be drawn?

The calculation for a 95-lb donor is95lb / 2.2 lb/kg= 43.2 kg43.2 kg X 10.5 mL/kg= 453.6 mL

If less than 300 mL is to be collected, the anticoagulant must be reduced proportionately.

Donors are allowed to donate no more than 10.5 mL/kg of their body weight

Donors who have received blood or blood products with in 12 months of when they desire to donate are deferred to protect the recipient because

Blood could have transmitted hepatitis (HBV or HCV) or HIV

Which of the following donors would be deferred indefinitely?

a. History of syphylis

b. History of gonorrhea

c. Accutane treatment

d. recipient of GH

Recipient of human growth hormone

Which of the following viruses resides exclusively in leukocytes?

a. CMV

b. HIV

c. HBV

d. HCV

CMV

Which of the following is LEAST likely to transmit hepatitis?

A. CRYOPRECIPITATE

B. RBC

C. PLASMA PROTEIN FRACTION

D. PLATELETS

Plasma protein fraction (PPF)

Although cryoprecipitate has primarily been used for the 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 cryoprecipate?

A. FIBRONECTIN

B. FACTOR VIII: vW

C. FACTOR XIII

D. ANTITHROMBIN III

Antithrombin III

One unit of donor platelets should yield _____ platelets.

A. 5.5 X 10^6

B. 5 X 10^8

C. 5.5 X 10^10

D. 5 X 10^10

5.5 X 10^10

Anti-E will react with which of the following cells?

R2R2

Which of the following antigens is considered low incidence?

Cw, V, Kpa, Jsa.

Of the following, which genotypes would result in the B phenotype?

BB and BO

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

Anti-U is directed at a high-incidence antigen

Which of the following blood groups reacts LEAST strongly with an anti-H produced in an A1B individual

Group A1

How many genes encode the following Rh antigens: D,C,E,c,e?

2

A Bombay individual's blood specimen can be differentiated from blood specimens of normal group O persons by the

A negative reaction with Ulex europaeus lectin

The secretor locus is linked to which blood group locus?

H blood group // lutheran

If a person has the genetic makeup Hh, AO, LeLe, sese, what substance will be found in the secretions?

Lea substance

The following results were obtained when typing a patient's blood sample.

Anti-A: 4+, Anti-B: 2+, A1 cells: 0, B cells: 4+

The CLS suspects that this is a case of an acquired B antigen. Which of the following would support this suspicion?

Group 2 descripency

Bacterial infection due to E.coli and P. Vulgaris

Modification of A antigen to Pseudo B antigen

Which of the following sugars must be present on a precursor substance for A and B antigenic activity to be expressed?

L-fucose

A white female's RBCs gave the following reactions upon phenotyping: D+C+E-c+e+

Which of the following is the most probable Rh genotype?

R1r DCe/dce

A black patient has the following phenotype: D+C+E+c+e+

Which of the following is the most probable Rh genotype?

DCe/DcE=

R1, R2

If a patient has the Rh genotype DCe/DCe and receives a unit RBCs from a DCe/dce individual, What Rh antibody might the patient develop?

Anti-c

Which of the following is a characteristic of the Xga blood group system?

Higher in women than in men

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

She cannot donate because has a low hct. It needs a min of 38%

Which of the following conditions would contraindicate autologous presurgical donation?

Mild bacteremia

A woman who regularly donates only plasma wished to donate. All donor requirements are met; however, she tells the phlebotomist that she returned from a trip to Venezuela 3 months ago. Malaria is endemic in Venezuela, and she was not taking any preventative medications. Can she donate at this time?

no she is deferred for one year

A patient had an anti-E identified in his serum 5 years ago. His antibody screening test is now negative. From the following, choose the best procedure to obtain suitable blood for transfusion

type the donor for the E ag and crossmatch E negative units

Which of the following best describes what can or should be done with units of blood drawn from donors who are found to be at high risk of contracting AIDS?

Properly dispose of the unit by autoclaving or incinerations

Heparin is a natural anticoagulant. Occasionally donor blood is collected in heparin; this blood must be used within

24-48 hours

The addition of adenine in the CPDA-1 formulation aids in

Provides substrate for ATP production

The pilot tubes for donor unit # 3276 break in the centrifuge. You Would

Remove the sufficient segments to complete donor processing procedure

Following plasmapheresis, how long must a person wait before being eligible to donate a unit of whole blood?

48 hours

What is the deferral period for individuals taking antibiotics for an infection before donating blood?

Temporary until treatment is completed and infection has cleared up.

How long must a person wait to donate blood after taking aspirin?

3 days

What is the deferral period after receiving a smallpox vaccination?

14-21 days or until the scab has fallen off

What is the deferral period after receiving a live attenuated vaccine such as measles, mumps, polio, typhoid, or yellow fever?

2 weeks

What is the deferral period after receiving rubella or chicken pox vaccination?

4 weeks

How often can someone donate blood after a plasma, blood, or platelet donation in the past 8 weeks?

Can only donate every 56 days/8 weeks

What is the deferral period for a pregnant individual or someone who was pregnant in the past 6 weeks?

6 weeks following termination; 12 month deferral if pregnant pt had a transfusion

What is the deferral period for someone who has had malaria?

3 years following treatment

What is the deferral period for someone who has received a blood transfusion, organ/tissue/bone marrow transplant, or bone/skin graft in the last 12 months?

12 months

Severe intravascular hemolysis is most likely caused by antibodies of which blood group?

ABO blood group

Under extreme emergency conditions, when there is no time to determine ABO group for transfusion, the technologist should:

Release O rh negative red blood cells

With regard to inheritance, most blood group systems are:

autosomal codominant

The optimum storage temperature for Platelets is __ ºC

22 C or room temperature with constant agitation.

A group B, Rh-negative patient has a positive DAT. Which of the following situations would occur?

The Du test and control would be positive

After checking the inventory, it was noted that there were no units on the shelf marked

"May issue as uncrossmatched: For emergency Use Only." Which of the following should the CLS now place on their shelf?

Units of group O, Rh-negative Red blood cells

The ABO typing of a patient's sample yields the following results:

Anti-A Anti-B A1 cells B cells

x x x+ x+

The patient's blood group is

blood group O

The results of D typing on a patient using a high-protein anti-D reagent are

more than likely an invalid D test

What is the action of AHG reagent?

AHG react with human global molecules bound to RBCs or free in serum

Cross-links red cells that have become sensitized with antibody or complement

Which of the following is the correct interpretation of this saliva neutralization testing?

Indicator cells A B O

Saliva plus anti-A + 0 0

Saliva plus anti-B 0 + 0

Saliva plus anti-H 0 0 0

group O secretor

A 10 year-year-old girl was hospitalized because her urine has a distinct red color. The patient had recently recovered from an upper respiratory infection and appeared very pale and lethargic. Tests were performed with the following results:

paroxysmal cold hemoglobinuria (PCH)

PCH is best associated with which of the following blood groups?

p antigen

Antibody screening cells will detect all of the following antibodies EXCEPT:

Anti-A, Anti-B and Anti-AB, low frequency antigens, Kpa, maybe Jsa

A unit of packed cells is split into two aliquots under closed sterile conditions at X AM. The expiration time for each aliquot is now:

The original date of the unspilt unit

When should an IS crossmatch be performed?

When there is no history of antibodies and the current antibody screen in negative

Can crossmatching be performed on October 15 using a patient sample drawn on Oct 12?

yes, no sample not needed, can be done within 72 hrs

Six units are crossmatched. Five units are compatible, one unit is incompatible, and the recipient's antibody screen is negative. Identify the problem

Donor unit may have positive DAT

A unit of whole blood is collected at 10:00 am and stored at 20 - 24 C. What is the last hour platelet concentrates may be made from this unit?

6:00PM NEED TO PREPARE WITHIN 8 HOURS OF COLLECTION

The following whole blood donors regularly give blood. Which donor may donate on September 10?

A 28 year old man who had plateletphresis on august 24th

Is there a discrepancy between the following blood typing and secretor study results?

No the sample is from a group a secretor

Anti-K and anti-c were found in a patient with colon cancer. How many units of red cells would need to be screened to find two compatible units for surgery? (c= 80%, K = 9%)

11 units

Which of the antigens below is considered a high incidence?

anti-k, anti-Kpb, anti-Jsb, anti-Lub

A Kleihauer-Betke acid elution test identifies 40 fetal red cells in 2000 maternal red cells. How many doses of RhIG are indicated?

Formula is % *50/ 30 +1

40/2000 * 5,000= 3+1=4

A fetal screen yielded negative results on a mother who is O-negative and infant who is O-positive. What course of action should be taken?

Issue one vial of RHIG.

What may be found in the serum of a person who is exhibiting signs of TRALI

Anti-leukocyte antibody

All of the following are part of the preliminary evaluation of a transfusion reaction

EXCEPT

Panel on pre and post transfusion sample

A cord blood workup was ordered on baby boy Jones. The mother is O-negative.

Results on the baby are as follows:

Yes, the baby's Rh type cannot be determined due to the positive DAT

Alloimmunization is categorized as what type of transfusion reaction?

Delayed non-hemolytic

A patient undergoing transfusion of packed red blood cells became hypotensive and cyanotic 30 minutes into the transfusion. The nurse also noted a 0.8°C increase in temperature. The transfusion was stopped and post-blood specimens were sent down to the laboratory for a transfusion reaction investigation. The donor serum was tested against screening cells (3-vials) and was reactive at AHG in all vials. A panel was performed, and anti-Bga was identified. What special blood component should this patient now receive?

none of the above (leukopoor, deglycerized, washed)

OR Leukopoor????

What should be done in the transfusion process when the patient temperature spikes from 37.5°C to 38.5°C within 30 minutes of transfusion?

Stop the transfusion and keep the intravenous line open

A 41-year-old multiparous woman was rushed to the emergency room after being shot in the chest. She received 8 units of packed red blood cells and 5 units of platelets. The hemoglobin and hematocrit determinations stabilized after 6 hours in surgery, but the platelet counts remained less than 50,000 per µL. She had received additional units of platelets at 48-hour intervals with little efficacy. Her serum was tested for platelet antibodies. She was placed on corticosteroids to control chest wound bleeding. Anti-PLA1 was identified in the patient's serum. This case is representative of what type of transfusion reaction?

Post transfusion purpura

Which of the following questions should be asked when investigating a transfusion reaction?

How many milliliters of red blood cells were transfused?

A postpartum woman was crossmatched for 2 units of packed red blood cells. The first unit was issued at 3:15 a.m. At 3:45 a.m., the nurse called the blood bank and stated the patient was developing red hives and pruritus (itching). The transfusion was stopped and a post-transfusion specimen was drawn. The unit and identification tags were returned to the blood bank. The DAT on the specimen was negative, and hemolysis was absent. All visual and clerical checks were satisfactory. The pathologist ordered the treatment of diphenhydramine (Benadryl) for all subsequent transfusions. What type of transfusion reaction has occurred in this patient?

urticarial

If a patient has an A2 ABO grouping, which of the following statements is true?

-Dolichos biflorus lectin generally does not agglutinate A2 RBCs

-Ulex europaeus lectin may agglutinate some A2 RBCs

-If anti-A1 is made, it is usually clinically insignificant

-Most A2 individuals have the same form of anti-B as A1 individuals

All of the above

A recently transfused patient has a 3+ reactive DAT with anti-IgG. Which procedure should be used to identify the specificity of the IgG antibody attached to the red cells?

elution

An Rh phenotyping shows the following results:Anti-D: 4+, Anti-C: 2+, Anti-E: 0, Anti-c: 0, Anti-e: 3+

What is the most likely Rh genotype?

R1R1 or R1r'

A 59-year-old male came through the ER department of a community hospital complaining of dizziness and fatigue. History included no transfusions and a positive rheumatoid factor 1 year ago. His CBC confirmed anemia. A sample was sent the blood bank for a type and cross. Upon receipt of the sample in the blood bank, the MLS noticed the EDTA sample appeared very viscous. Fearing the sample would clog the Pro Vue (solid phase analyzer), testing was performed using the tube method. Initial results revealed the following:

Anti-A 0, Anti-B 0, Anti-D 4+, Rh control 2+, A1 cells 4+, B cells 4+

Perform a saline replacement for the crossmatch

The following results were obtained on a 41-year-old male with hepatitis C

Anti A 4+ Anti-B 4+ Anti-D 3+ A1 cells 0 B cells 0

What should be done next?

Do an auto control (rhcontrol)

or

Run a saline control in forward grouping

An obstetric patient, 34 weeks pregnant, shows a positive antibody screen at the indirect antiglobulin phase of testing. She is group B, Rh negative. This is her first pregnancy. She has no prior history of transfusion. What is the most likely explanation for the positive antibody screen?

She received an antenatal dose of RhIg

Anti-M reacts strongly through all phases of testing. Which of the following techniques would NOT contribute to removing this reactivity so that more clinically significant antibodies may be revealed?

Acidifying the serum

A patient's serum contains a mixture of antibodies. One of the antibodies is identified as anti-D. anti-Jka or Fya and possibly another antibody are present. What technique(s) may be helpful to identify the other antibody(s)?

Enzyme panel; select cell panel

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

hemolysis

Mixed-field agglutination can be observed in the:

DAT ON A PERSON UNDERGOING DELAYED HEMOLYTIC TRANSFUSION REACTION

What is the most important consideration in patients suffering from a life threating anemia and whose serum contains warm autoantibodies?

exclude the presence of alloantibody

An antibody screen was performed on a 25-yer-old male referred to the hospital for elective surgery.

Refer to the gel reactions below seen in an antibody screen test

Which of the following is the correct interpretation of the reaction in SCI?

2+

An antibody screen was performed on a 25-yer-old male referred to the hospital for elective surgery.

Refer to the gel reactions below seen in an antibody screen test

What has happened to the matrix in SCI that caused a difference in its apperance from the of SCII?

Antibody-coated cells have been trapped in the gel matrix of SC I.

When should quality control be performed on routein blood typing reagents?

once daily

The temperature of a blood bank refrigerator without a continous recording device shoule be recorded:

every four hours

Each unit of blood must be tested for all of the following except

ANTIGEN TO HCV

List 3 pre-analytical errors that can occur in blood banking.

-Patient preparation errors. Incorrect sampling time.

-Blood collection errors. Patient identification errors. Sampling errors. ...

-Sample handling and transport errors.

-Inadequate sample mixing

List 3 analytical errors that can occur in blood banking.

-expired reagents

-improper procedure

-not trained personnel/ experience

-not writing reactions immediately

- expired/ contaminated reagant

- Over-reading

List 3 post-analytical errors that can occur in blood banking.

- transcription error

- calculation error

- incorrect results reported

-Turnaround time

Rh-immune globulin is of no benefit after a person has been actively immunized and formed anti-D

True

The antibody titer of maternal antibody and its proportionality to severity of HDFN.

False

If Rh-negative recipients who are transfused with as little as 1 mL of Rh-positive cells will develop anti-D

false

If a person with acute hepatitis B infection is immune to infection from other hepatitis viruses

false

CPD

21 days

CPDA-1 whole blood

35 days

Heparin

4 weeks (7 days)

EDTA