Immunohematology Second Half Quizzes

Why are platelets transfused?

Prophylactically to prevent bleeding

Therapeutically to treat bleeding

Both of the above

None of the above

Both of the above

What is the acceptable substitution for a group B Rh pos patient requiring fresh frozen plasma when there is no B plasma available?

A

O

AB

None

AB

Which of the following acute transfusion reactions is immune-mediated?

Bacterial contamination

Citrate toxicity

Physical red cell damage

Febrile

Febrile

A 72-year-old female received 2 units of RBCs and 1 unit of FFP. Two hours later she experienced dyspnea and hypoxia with a drop in blood pressure. Her lungs show pulmonary edema. What is the most likely cause of the symptoms? (she accepted 2 answers)

Acute hemolytic transfusion reaction

TRALI

TACO

Citrate toxicity

TRALI or TACO

Whole blood is the product of choice in which of the following situations?

Patient requiring volume expansion

Massive transfusion due to hemorrhage

Marrow failure due to chemotherapy

Bleeding due to low platelets

Massive transfusion due to hemorrhage

What are the two main indications for RBC transfusion?

Acute blood loss

Iron deficiency anemia, hemoglobin 8.5 g/dL

Hemoglobin lower than 9 g/dL

Symptomatic anemia

Acute blood loss

Symptomatic anemia

A patient transfused with 2 units of RBCs spiked a fever and chills 3 days after the transfusion. DAT was positive with IgG and a post transfusion panel should anti-Jka. What is the most likely cause fo this?

Anaphylactic response

Delayed hemolytic transfusion reaction caused by anamnestic response

DHTR cause by a primary alloimmunization

Delayed hemolytic transfusion reaction caused by anamnestic response

Of the following products, which is most suitable for transfusion of a patient with a fibrinogen of 75 mg/dL?

Fresh frozen plasma

Cryoprecipitate AHF

Plasma frozen within 24 hours

Apheresis platelets

Cryoprecipitate

One leukocyte-reduced RBC unit is transfused into a patient with a hemoglobin of 6.8 g/dL. What would you expect the hemoglobin to be after transfusion?

5.7

7.9

8.7

6.8

7.9

Fresh frozen plasma ordered for a 67 yo female in surgery. She is O pos. You have the following blood types available. Which of the following FFP would be compatible with the patient?

O neg

O pos

A neg

All of the above

All of the above

An immediate transfusion reaction is defined as occurring withing how many hours of transfusion?

8

16

24

48

24

What alternative type can be given to O pos person when O blood is not available?

None

A RBC

AB whole blood

B RBC

None

The most common cause of an acute transfusion reaction characterized by hives and itching is?

Acute hemolysis

Bacterial contamination

Allergic reaction

Febrile

Allergic reaction

What is a typical platelet count observed in a patient that requires a platelet transfusion to prevent bleeding? less than…

10-20,000/uL

50-100,000/uL

100,000/uL

None of the above

10-20,000/uL

Which of the following transfusion reactions present with a symptom of fever?

Febrile

Acute hemolytic

Septic

All of the above

All of the above

What is the typical reactivity of a DAT for a patient with an acute transfusion reaction with an alloantibody to an RBC antigen?

1+

3+

4+

negative

1+

Which of the following are common symptoms of an acute transfusion reaction?

Rash, itching

Dyspnea

Fever/chills

All of the above

All of the above

Which is the most common adverse reaction to transfusion?

Allergic

Febrile

TRALI

TACO

Allergic

A patient came into the ED bleeding profusely from an accident and has already received O neg blood uncrossmatched. They were found to be O neg, and they are getting worse and need 6 more units but you only have the following units.

10 O pos

10 A pos

2 B neg

2 O neg

2 AB pos

Which would you give?

O pos

A pos

O neg

AB neg

O pos

One 5-donor pool of cryoprecipitate is ordered for transfusion at 10 pm. After thawing it, the RN says they're going to do it in the morning instead. What temperature should you store thawed cryoprecipitate at?

1-6 C

20-24 C

1-10 C

20-24 C

Which of the following is the most common symptom of a transfusion reaction during blood administration?

Increased bp

Fever

Shortness of breath

Nausea

Fever

Which of the following temps should WBC reduced RBCs be stored at?

1-6 C

20-24 C

1-10 C

1-6 C

At which of the following temperatures are fresh frozen plasma stored?

less than…

-6 C

-18 C

-30 C

-37 C

less than -18 C

What important factors must be present for HDFN to occur?

Mother lacks antigen and produces an IgG antibody

Fetus possess the antigen

Antigen is well developed in utero and at birth

All of the above

All of the above

ABO HDFN is usually mild because"

ABO antigens are usually poorly developed at birth

ABO antibodies prevent disease

ABO antibodies easily cross the placenta

ABO incompatibility is rare

ABO antigens are usually poorly developed at birth

Class I HLA genes include which of the following loci present on nearly all cells in the body

HLA-A

HLA-B

HLA-C

All of the above

All of the above

Which of the following RBCs are appropriate for an intrauterine transfusion?

Group O, WBC reduced, CMV negative, irradiated

Group AB, WBC reduced, CMV negative, irradiated

Group O, CMV pos, irradiated

Group AB, CMV pos

Group O, WBC reduced, CMV negative, irradiated

Which of the following methods are a screening test to detect excessive fetal maternal hemorrhage?

Kleihauer-Bettke

Rosette

Flow cytometry

Chemiluminescence

Rosette

Rh immunoglobulin is indicated in which of the following circumstances?

Rh neg Mom and Rh neg infant

Rh neg Mom and Rh pos infant

Rh pos Mom and Rh neg infant

Rh pos Mom and Rh pos infant

Rh neg Mom and Rh pos infant

Ankylosing spondylitis is associated with which HLA?

A27

B17

B27

A29

B27

The procedure for removing IgG antibodies from a patient's plasma is

Elution

Absorption

Adsorption

Neutralization

Adsorption

Acid elution was performed and 1000 cells were counted and 15 were would to be fetal cells. Their RhIg only covers 20 mL and the round and add standardly. How much RhIg should be given at this case?

1

2

3

4

5

4

Which of the following antibodies causes HDFN by suppressing erythropoiesis?

Anti-Jka

Anti-K

Anti-D

Anti-E

Anti-K

Which of the following would you preform a weak D test on? Multiple may apply

Pretransfusion testing

Blood donor

Cord blood of Rh neg mother

Prenatal patient

Blood donor and Cord blood of Rh neg mother

An infant is found to be jaundiced, but the mother's panel came back negative. The mother is O neg, and this is her first pregnancy. The infant is A pos. What is the likely cause of the baby's elevated bilirubin?

ABO HDFN

Rh HDFN

Other HDFN

ABO HDFN

A Kleihauer-Betke is reported at 1.3%. What is the total volume of FMH if the mother's blood volume is 5000 ml

6.5 ml

13 ml

26 ml

65 ml

65 ml

If there is a 65 ml FMH in a mother's blood volume of 5000 ml. How many doses of RhIg should be given?

1

2

3

4

3

Which of the following antibodies is most often associated with significant HDFN?

Anti-S

Anti-c

Anti-Lea

Anti-M

Anti-c

Mothers of infants with ABO HDFN are usually of which blood group?

A

B

AB

O

All are equally likely

O

Histocompatibility testing for kidney transplantation requires which of the following?

HLA typing

HLA antibody assessment

Crossmatching

All of the above

All of the above

A pregnant person's serum has hemolytic anti-Lea. The father is Le(a+b-). What is the chance the fetus will develop immune-mediated HDFN?

100%

50%

25%

0%

0%

What does HLA mean?

Human lymphocyte antigen

Hairy leukocyte antibody

Human leukocyte antibody

Human leukocyte antigen

Human leukocyte antigen

What does an * mean in HLA nomenclature in regards to testing methods?

Serological

Molecular

Cellular

None of the above

Molecular

HLA typing is NOT useful in which of the following situations?

Matched platelet transfusions

Hemolytic transfusion reaction investigation

Disease association

Hematopoietic stem cell transplantation

Hemolytic transfusion reaction investigation

Which of the following is an acceptable blood donor?

Someone who had viral hepatitis 30 years ago

Someone whose spouse has Hep A one year prior

Someone who was tattooed 5 months ago

Someone who received Hepatitis Immune Globulin two years ago

All of the above

All of the above

Which of the following is a requirement of blood donors?

Not having any tattoos

Weighing at least 100 lbs

Being in good general health

Hemoglobin of 12 g/dL

Being in good general health

Therapeutic plasma exchange is MOST efficient in treating patients with?

Hyperviscosity syndrome

Autoimmune syndromes

Immune complex disorders

IgG antibodies

immune complex disorders

What is the minimum age for blood donors in most states with parental consent?

16

17

18

2

16

Therapeutic red cell exchange is MOST often used for?

Hyperviscosity syndrome

Sickle cell disease

immune complex disorders

cold agglutinin disease

sickle cell disease

Is a woman with a hemoglobin of 12.6 g/dL, bp 114/72, and a pulse of 72 BPM eligible to donate whole blood?

Yes

Is a 78 yo man with a 14 g/dL hemoglobin, bp 140/85, and a pulse of 68 BPM eligible to donate whole blood?

Yes

Which of the following diagnoses would require as white cell exchange/leukodepletion?

CLL

CMV pneumonia

CML

AML

AML

A 3 yo patient has a hemoglobin of 8 g/dL, a positive DAT 1+ to IgG, and the panel was positive at IS, negative at 37 C and positive at IAT. He also has recurrent ear infections. Which of the tests are most likely to be ordered next?

Thermal amplitude study

Donath-Landsteiner Test

Prewarm IAT

Adsorption to remove autoantibody

Donath-Landsteiner Test (for PCH)

The procedure for removing IgG from RBCs is called?

Elution

Absorption

Adsorption

Neutralization

Elution

Which of the following is true in the evaluation of a 72 yo patient with a strong positive DAT due to IgG and a 3+ IAT with all of the panel cells reacting, including the autocontrol?

Test results are consistent with cold agglutinin disease

Cross matches will be compatible

An underlying alloantibody may be present

The patient should move to Florida

An underlying alloantibody may be present

What is the primary reason for performing an adsorption procedure?

To confirm it's a warm autoantibody

They're fun!

To make sure the antibody binds to the red cells

To rule-out underlying alloantibodies

To rule-out underlying alloantibodies

In which of the following situations would you FOR SURE perform an elution?

88 yo woman with a positive DAT to complement

21 yo male with a positive DAT due to IgG and a 15 g/dL hemoglobin

62 yo woman with a positive DAT due to IgG and complement and a 6 g/dL hemoglobin

55 yo woman with a negative DAT

62 yo woman with a positive DAT due to IgG and complement and a 6 g/dL hemoglobin

The following DAT results were found on a patient:

DAT 1+

IgG 1+

C3b 0

Which of the following is the most likely cause of the result?

Transfusion reaction

Cold agglutinin disease

Warm autoantibody

Transfusion reaction

Which of the following should be assess when a positive DAT is obtained?

Patient's transfusion history

Patient's diagnoses

Patient's medication history

All of the above

All of the above