BB Past exams and Quizzes

What vitals are required to be monitored when given a transfusion? Select all that apply.

Temperature

Blood Pressure

Pulse

Oxygen Saturation

Temperature

Blood Pressure

Pulse

Acute transfusion reactions include all of the following except?

TACO

TA-GVHD

Mild or severe allergic

AHTR

TA-GVHD

The definition of an acute transfusion reaction is _______________________.

A complication occurring within 24 hours of a transfusion

A complication occurring within 48 hours of transfuison

A complication occurring after 2 weeks

A complication occurring after 24 hours of a transfusion

A complication occurring within 24 hours of a transfusion

Review the results in table 1. Transfusion of which product is most likely the cause of these results?

Pre:

DAT: IgG negative; C3 negative; ctrl neg

Temperature: 37.0C

Blood Pressure: 130/85

Pulse: 77 bpm

Symptoms: stable

Post:

DAT: IgG positive; C3 positive; ctrl neg

Eluate: anti-A, -A,B

Temperature: 38.5C

Blood Pressure: 120/75

Pulse: 85 bpm

Symptoms: chills, rigors, fever

O positive platelets

A positive FFP

A positive platelets

O positive PRBCs

O positive platelets

While receiving a type compatible platelet, the patient started having urticarial rash around the transfusion site. The nurse stopped the transfusion, medicated the patient with antihistamine, and then continued transfusing the remaining product. The transfusion reaction was reported after completion of the product.

If an urticarial rash is the only symptom, treating the symptom and continuing to transfuse is acceptable

The nurse is going against FDA protocol by continuing transfusion

If another symptom was present, this still would have been the correct route of action

If an urticarial rash is the only symptom, treating the symptom and continuing to transfuse is acceptable

If urticaria was the only symptom, what is the required transfusion reaction workup?

ABORh, DAT, and ABID

ABORh and DAT on post transfusion sample

ABORh and DAT on pre and post sample

Clerical check only

Clerical check only

What product is the most likely cause of Transfusion Associated Sepsis?

Platelets

Cryo

FFP

PRBCs

Platelets

What is the minimum required dose of irradiation to prevent TA-GVHD?

15 grays to the center and rest of the product

50 grays to all of the product

15 grays to the center and 25 grays to the rest of the product

25 grays to the center and 15 grays to the rest of the product

25 grays to the center and 15 grays to the rest of the product

All of the following are complications associated with a massive transfusion except?

Increase in temperature

Hyperkalemia

Hypothermia

Chelation of calcium due to citrate

Increase in temperature

Leukocyte reduction can help in reducing which type of transfusion reaction?

TACO

FNHTR

AHTR

DHTR

FNHTR

Paroxymal Cold Hemoglobinuria (PCH) is associated with antibody specificity toward _____________.

Kidd blood group system antigens

I antigen

P antigen

MNS blood group system antigens

P antigen

Cold agglutinin syndrome (CAS or CAD) is associated with antibody specificity toward what antigen and what age group is it found in?

I antigen and >50 years old

M antigen and >50 years old

P antigen and <50 years old

I antigen and <50 years old

I antigen and >50 years old

Review the following lab results. What type of antibody does this patient have?

ABORh APositive

ABSC Positive both cells

ABID Pan-reactive including auto ctrl

DAT IgG positive; C3 positive; ctrl negative

Eluate Pan-reactive

Adsorption No underlying common allo-antibodies

multiple antibodies

antibody against a high frequency antigen

CAA

WAA

WAA

Anti-A/4+

Anti-B/0

Anti-D/4+

A1 cells/0

B cells/4+

SCI/2+

SCII/2+

Antibody ID/panel:

Panreactive

Auto control positive

Eluate positive

Warm treated pt cells panel: some reacted while others didn't at AHG.

is the patient making a clinically significant underlying alloantibody? Patient wasn't transfused and we had enough sample...

Yes

No

Yes

Which of the following is an immediate immune transfusion reaction?

Circulatroy Overload

Bacterial Contamination

Hemolytic Transfusion reaction

Damage to the red cells in the bag

Hemolytic Transfusion reaction

Which of the following is an immediate non-immune transfusion reaction?

Acute hemolytic transfusion reaction

Febrile, non-hemolytic transfusion reaction

Urticarial / Anaphylactic transfusion reaction

Circulatory Overload

Circulatory Overload

Which of the following is a delayed immune transfusion reaction?

Graft vs host disease (GVHD)

Iron overload / hemosiderousis

infections: parasites, viruses, prions

TRALI

Graft vs host disease (GVHD)

A patient with two or more documented febrile nonhemolytic transfusion reactions (FNHTRs) should receive __________ blood components.

Leukocytes reduced

hemoglobin S- negative

Cytomegalovirus-negative

Irradiated

Leukocytes reduced

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

What time of day was the donor unit collected?

How many milliliters of red blood cells were transfused?

What was the donor unit hematocrit?

What methodology was used for serologic testing?

How many milliliters of red blood cells were transfused?

What measure can be taken to prevent transfusion-associated hypothermia?

Premedication with calcium gluconate

Close monitoring of patient vital signs

Transfusion of product using a blood warmer

Prudent use of platelet concentrates

Transfusion of product using a blood warmer

Persons with a documented history of anaphylactic reactions should be transfused with _________ blood products.

washed

leukodepleted

irradiated

IgE-deficient

washed

Negative direct antiglobulin test (DAT) is found in all of the following transfusion reactions except:

Febrile nonhemolytic transfusion reaction

Acute immune hemolytic transfusion reaction

Transfusion-associated sepsis

Acute nonimmune hemolytic transfusion reaction

Acute immune hemolytic transfusion reaction

An acute hemolytic transfusion reaction occurs greater than 24 hours after the start of transfusion.

True

False

False

Which of the following is the most common transfusion reaction reported to blood banks?

Extravascular hemolytic reaction

Febrile reaction

Intravascular hemolytic reaction

Anaphylactic reaction

Febrile reaction

A delayed hemolytic transfusion reaction is most often the result of:

a unit of packed cells infected with hepatitis B virus.

an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy.

bacterial-contaminated red blood cells.

hemosiderosis in a massively transfused patient.

an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy.

What is the most frequent cause of circulatory overload?

Transfusion of a partially deglycerolized unit

Transfusion of a unit at too fast a rate

Transfusion of a unit at too slow a rate

Transfusion of a type incompatible platelet

Transfusion of a unit at too fast a rate

All of the following are clinical manifestations of cold hemagglutinin disease (CHD) except:

Acrocyanosis of the hands and feet

hepatosplenomegaly.

Agglutination of red cells in capillaries.

Raynaud's phenomena

hepatosplenomegaly

Refer to the following lab data on a patient without previous transfusions:

Hgb is7.4

Retics 22%

DAT; 3+ with Poly, 3+ with anti-IgG, Neg with anti-complement; neg ctrl

Eluate is postive with panagglutinin

Screen is 3+ on cell l and ll at AHG

What clinical condition do you think is most consistent with these results?

Cold hemagglutinin

ABO-medicated hemolytic transfusion reaction

Autoimmune hemolytic anemia

Penicillin-induced hemolytic anemia

Autoimmune hemolytic anemia

Autoantibodies are generally directed against which antigens?

ABO

Low-frequency

High-frequency

Duffy

High-frequency

A drug is suspected to be the cause of a patient's positive DAT. The patient's serum and eluate react with all cells tested in the absence of the drug.

Which drug is most likely the cause of this phenomenon?

Aldomet/methyldopa

Quinidine

Penicillin

Cephalosporin

Aldomet/methyldopa

What is the drug most commonly associated with the immune complex mechanism of drug-induced positive DAT?

Penicillin

Neosporin

Aldomet/Methyldopa

Quinidine

Quinidine

A patient is in critical need of a transfusion but initial pretransfusion testing seems to indicate a warm autoantibody reacting with all cells tested. What is your primary concern at this point?

To titer the autoantibody, in order to determine if it is clinically significant

To neutralize the autoantibody

To identify the autoantibody

To determine whether there are underlying significant alloantibodies present

To determine whether there are underlying significant alloantibodies present

What percentage of AIHA cases are caused by warm reactive autoantibodies?

70%

25%

12%

18%

70%

Some drugs can cause changes to the RBC membrane, resulting in non-specific protein adsorption. Which of the following are most likely associated with this mechanism of a drug-induced positve DAT?

Aldomet/Methdopa

Quinidine

Penicillin

Cephalosporin

Cephalosporin

Which of the following findings apply to PCH? (Choose all the apply)

Often appears to be anti-P

Antibody is IgG

mild or benign in course, rarely see anemia as a consequence

Acts as a biphasic hemolysin

mild or benign in course, rarely see anemia as a consequence

Warm autoantibodies may seem to be directed against common blood group antigens, in this case they may be referred to as "mimicking" specificities. Often, these appear to be directed against antigens in which system:

MN

ABO

Rh

Duffy

Rh

The specificity most frequently encountered in cases involving cold autoantibodies may be directed against which of the antigen systems below?

Kell

I/i

Lewis

ABO

I/i

EGA reagent works by disassociating antibodies from the cells allowing them to be antigen typed at the AHG phase.

True

False

True

Patient has a hx of anti-E and anti-Fyb and has received 2 RBCs/week for the past 4 months. RBCs were sent over that were antigen matched and XM compatible through AHG. Patient received one of the two units and had a reaction including the following symptoms: tachycardia, fever greater than 2 degrees F from pre-transfusion temperature, and rigors. A post transfusion specimen was immediately collected and the remainder of the RBC was sent to the blood bank. Transfusion reaction clerical check was resulted as no clerical errors identified. Serologic transfusion reaction testing results were as follows:

DAT IgG (pre neg, post pos)

DAT C3 (pre neg, post pos)

What is the most likely cause of the reaction, what testing should be performed next, and can the doctor give the remaining RBC unit?

Patient reacted severely to the preservative in the RBC, no further testing required, and yes, give the other unit

Patient developed another antibody, perform an eluate, and no, the other unit cannot be given

Patient had a febrile, non hemolytic transfusion reaction. Give leukoreduced RBCs.

Patient developed another antibody, perform an eluate, and no, the other unit cannot be given

The enzyme L-fucosyl transferase adds fucose to Precursor Substance 2 on the RBC membrane. With no further modification of the H chain, these cells would phenotype as:

B

Rh positive

O

A

O

Choose the SINGLE best answer from the choices given.

If the ABO testing on a cord blood sample is uncertain (mixed field, etc.), the infant's type may be most rapidly and efficiently investigated by:

A Kleihauer-Betke stain

ABO grouping on mother and father, using their results to predict the likely type(s)

Repeating testing on a heel-stick specimen from the infant

ABO reverse grouping on a cord-blood specimen

Repeating testing on a heel-stick specimen from the infant

Which apheresis platelet should be irradiated? What is the minimum required grays to be considered and irradiated product?

directed unit from an unrelated friend; 25 grays to the entire product

autologous unit; 15 grays to the middle of the product and 25 grays to the rest of the product

HLA matched unit; 25 grays to the middle and 15 grays to the rest of the product

allogeneic unit; 25 grays to the center of the product and 15 grays to the middle of the product

HLA matched unit; 25 grays to the middle and 15 grays to the rest of the product

Post Transfusion Purpura is usually caused by _______?

anti-A

white cell antibodies

anti-P1

anti-HPA-1a

anti-HPA-1a

Which of the following transfusion reactions is characterized by high fever, shock, and hypotension that could lead to renal failure and DIC?

transfusion associated circulatory overload

transfusion associated acute lung injury

transfusion associated sepsis

febrile non-hemolytic

transfusion associated sepsis

A patient is readmitted to the ED 3 weeks post transfusion of 2 RBCs with a hemoglobin level of 7 g/dL. What do you expect to see in the DAT?

positive due to complement only

negative

mixed field positive

mixed field negative

mixed field positive

The most important step in safe transfusion of blood is to _______?

accurately identify the donor unit and recipient

select only qualified donors

get an accurate medication list

perform pre-transfusion testing accurately

accurately identify the donor unit and recipient

In a quality assurance program, Cryoprecipitated AHF must contain a minimum of how many international units? How many IU in a pooled Cryo?

70 IU and 350 IU FVIII

80 IU FVIII and 150 mg fibrinogen

80 IU FVIII and 760 mg fibrinogen

80 IU and 400 IU FVIII

80 IU and 400 IU FVIII

Based on the following results, is mom still a candidate for RhIg? Consider her future pregnancies.

Baby:

ABORh: ABNeg

ABSC: Pos

DAT: Neg

Mom:

ABORh: ANeg

ABSC: Pos

ABID: anti-D passively acquired

Yes, anti-D is passive

No, mom has anti-D

No, baby has positive ABSC

Yes, mom has anti-C

Yes, anti-D is passive

Patient received 2 units of PRBCs 2 weeks ago and is back in the ED with a H/H of 6.5 g/dL and 19% hct. Her ABSC is now positive and the repeat ABSC of her old sample is still negative. An ABID was performed and anti-c (little) was identified. What type of transfusion reaction is this and what panel cell would you need to run in order to get a homozygous big E rule out?

AHTR and RzRz

DHTR and RzRz

DHTR and R2R2

DHTR and RzR1

DHTR and RzRz

What is the most likely cause of this ABO discrepancy?

anti-A / 3+mf

anti-B / 0

anti-D / 3+mf

A cell / 0

B cell / 3+

Type OPos patient transfused with ONeg PRBCs

Type ANeg patient transfused with APos PRBCs

Type APos patient transfused with OPos PRBCs

Type APos patient transfused with ONeg PRBCs

Type APos patient transfused with ONeg PRBCs

RhIg evaluation arrives with a sample on mom and baby. Review the following results and make a recommendation as to how many doses of RhIg the mom needs.

Baby

Type: APos

DAT: Pos

Mom

Type: ONeg

ABSC: Neg

FS: Pos

HgF Quantitation = 3%

6 doses of 300ug RhIg

4 doses of 300ug RhIg

6 doses of 50ug RhIg

5 doses of 300ug RhIg

6 doses of 300ug RhIg

Review the following lab results. What mechanism(s) of DIIHA (drug induced immune hemolytic anemia) could be represented? Select all that apply.

TestResult

ABORh BPos

ABSC negative

DAT Positive IgG, C3 positive, ctrl neg

EluateNegative

Drug adsorption (rarely)

Membrane modification mechanism

Immune complex mechanism

Induced Autoimmune

Drug adsorption (rarely)

Membrane modification mechanism

Immune complex mechanism

Referring to table 2 in a previous question, what drug(s) could be responsible for the reactivity? Select all that apply.

Methydopa/Aldemet

Cephalosporin

Penicillin

Quinidine

Cephalosporin

Penicillin

Quinidine

What is the test for a patient who has paroxymal cold hemoglobinuria (PCH) called?

Lui Freeze Thaw

Donath Lansteiner

Thermal Amplitude study

Short cold panel

Donath Lansteiner

In regards to the Donath Landsteiner test being represented in table 3:

What reagent cells are used and at what % cell suspension?

Type O, P1 antigen negative (presumably P positive), 70% cell suspension

Type O, P1 antigen positive (presumably P positive), 2-3% cell suspension

Type O, P1 antigen positive (P positive), packed cells no suspension

Type O, P1 antigen positive (presumably P positive), 50% cell suspension

In a WAA workup, if the patient has been transfused in the past 3 months which adsorption method should be used? How many passes would be recommended if the DAT strength was 2+?

Autologous adsorption with one pass

Allogeneic adsorption with at least 3 passes

Allogeneic adsorption with at least two pass

Autologous adsorption with at least 3 passes

Allogeneic adsorption with at least 3 passes

Which is more common?

CAA

Single alloantibody

WAA

Multiple alloantibodies

Single alloantibody

When you see the term "acquired B" antigen, what part of the body do you immediately think of:

Brain

Bowel

Bladder

Big Toe

Bowel

How many of the following errors can contribute to an ABO discrepancy? Choose all that apply.

failure to follow the manufacturer's instructions on

how to use the reagent

failure to add AHG reagent

clerical error in recording your results

cell suspension is too heavy or too light

failure to follow the manufacturer's instructions on

how to use the reagent

clerical error in recording your results

cell suspension is too heavy or too light

In cases of HDN, the mother produces antibody against an antigen that is expressed on her baby's RBC. The antigen is:

must be inherited from both parents (dosage effect)

inherited from mother, not found on the father's cells

inherited from the father, not found on mother's cells

a paternal antigen also found on the mother's cells

inherited from the father, not found on mother's cells

ABO HDFN:

always occurs in the firstborn child

usually requires an exchange transfusion

frequently results in stillbirth

is most often seen in group A or B newborns of group O mothers

is most often seen in group A or B newborns of group O mothers

Antibodies formed against the antigens M, N, S and s are typically all cold reactive and not generally clinically significant.

True

False

False

Laboratory studies of a mother and newborn baby sample yield the following results:

Mother: O, Rh neg, AB screen positive, Anti-E in serum

Baby: B, Rh pos, DAT= 2+, Anti-E in eluate made from cord cells

If you have to do an exchange transfusion, the best choice of blood would be _________?

O, Rh neg, E pos

B, Rh pos, E pos

O, Rh pos, E neg

B, Rh neg, E pos

O, Rh pos, E neg

you don't want to transfuse with blood that mom has antibody for

Blood used for intrauterine transfusion should have all of the following attribute(s). Select all that apply.

compatible with any maternal antibodies present

greater than 7 days old

ABO Rh compatible with mom and baby, usually O negative

HgbS positive

Irradiated

compatible with any maternal antibodies present

greater than 7 days old

ABO Rh compatible with mom and baby, usually O negative

Irradiated

Anti-U is clinically significant in pregnancies and transfusions.

True

False

True

Rh Immune Globulin (RhIg) is given to:

Rh negative mothers, not yet immunized to D antigen

Rh positive mothers, HDN not present

infants who are Rh negative

mothers who have already formed anti-D during their pregnancies

Rh negative mothers, not yet immunized to D antigen

When assessing whether an Rh-negative mother is a candidate for Rh Immune Globulin, if you do not know baby's Rh type (as in cases of miscarriage, etc.) it is:

best to draw sample from the father and do family studies to predict the most likely Rh type, then treat mom accordingly

safer to assume the baby is Rh negative; don't give the mother RhIg

Safer to assume the baby is Rh positive; give the mother RhIg

Safer to assume the baby is Rh positive; give the mother RhIg

You are performing a post delivery Rh Immune Globulin workup. The mother is Rh negative. Her baby is Rh positive and has a negative DAT. What additional test is indicated, before you issue the RhIg?

an antibody screen must be performed on the mother

an antibody screen on the baby's sample

a fetal screen (rosette) test for fetal maternal hemorrhage

weak D test on the baby

a fetal screen (rosette) test for fetal maternal hemorrhage

A patient is type OPos and has an anti-E and anti-Fya. Select the best RBC for this patient. Keeping in mind both frequency of phenotypes and inventory availability.

Type O, R1r, Fy(a-b+)

Type O, R2r, Fy(a-b+)

Type O, R2R2, Fy(a-b+)

Type A, R1R1, Fy(a+b-)

Type O, R1r, Fy(a-b+)

What patient population is likely to have an antibody

against a Lewis antigen?

Cardiac patients

Pregnant patients

Dialysis patients

Pediatric patients

Pregnant patients

Which statement best describes the fetal screen (rosette) test? It is:

confirmatory test, which proves that no fetal bleed has occurred and therefore no RhIg is indicated

a quantitative test, it tells you the exact amount of fetal bleed

a qualitative test, indicating that a fetal bleed occurred.

This test requires follow up to determine exact amount of fetal bleed.

a qualitative test, indicating that a fetal bleed occurred.

This test requires follow up to determine exact amount of fetal bleed.

The same donor from question #1 (17 year old male) comes back to donate after 6 weeks. Can he donate?

No

A 17 year old male presents at his high school's blood drive with the following vitals. Can he donate whole blood?

Blood Pressure: 110/70

Pulse: 67 BPM

Temperature: 37C

Hgb: 14.5 g/dL

Yes

Joey made a series of poor decisions which led to his incarceration with tentative sentence of 6 months. He was released last week for good behavior after serving 4 months. As part of his transformation in becoming a law abiding citizen he wanted to donate. His vitals are listed below, can he donate?

BP: 120/85

Pulse: 78 BPM

Temperature: 98.9F

Hgb: 15.5 g/dL

No

What is the only process that can prevent transfusion associated graft verses host disease?

Irradiation

What is the maximum transfusion time for any blood product?

8 hours

6 hours

4 hours

2 hours

4 hours

Jamie was born in the 1960's and lived through the era of the first discovery of HIV/AIDS and lost many friends. She is skeptical of the safety of blood transfusions and wants to donate for herself in preparation for her hip surgery the following week. Select the best answer for the autologous donation.

Must donate at least 72 hours prior to surgery

Must have a Hgb >11.0 g/dL

Temperature must not be

>99.5F

All options are correct

all options are correct

To manufacture whole blood derived platelets, whole blood must be cooled towards 20-24C and then centrifuged in what order?

soft spin, soft spin

hard spin, hard spin

soft spin, hard spin

hard spin, soft spin

soft spin, hard spin

To be considered leukocytes reduced, a product must have less than what number of leukocytes?

<3.0x10^11

< 5.0 x10^6

>5.0 x 10^6

>5.5x10^5

< 5.0 x10^6

How many IU's of FVIII must be present in a pool of 5 single cryo?

a minimum of 400 IU FVIII

True or False: Type O whole blood can be used interchangeably with type O packed RBCs.

False

Apheresis platelets must contain a minimum of 3.0x10^11 platelets per bag.

True

False

True

Adding additive solution to a unit of packed RBCs will lengthen the expiration date of the unit to ___________?

35 days

6 hours

42 days

365 days

42 days

Match the following products to their appropriate SHIPPING temperatures.

1-10C

20-24 C

<-18 C

PRBCs

Platelets

FFP

thawed plasma

PRBCs 1-10C

Platelets 20-24C

FFP <-18C

thawed plasma 1-10C

While performing a routine postpartum Rh Immune Globulin workup, you find a very weak anti-D in the mother's serum. This is most likely the result of ______?

the mother has a positive DAT

massive fetal-maternal hemorrhage at the time of delivery

antenatal administration of Rh Immune Globulin at 28 weeks gestation, providing passive immunization in the mother

contamination of the mother's sample with Wharton's Jelly

antenatal administration of Rh Immune Globulin at 28 weeks gestation, providing passive immunization in the mother

Reviewing antibodies: After you've done a panel, performed your ruling out process, and identified what antibody most likely present in a patient sample, what test should you generally do on the patient's RBC?

Enzyme treatment

Neutralization

Adsorption

Antigen/Phenotype

Antigen/Phenotype

The following results are seen in a sample from a 20-year old, healthy blood donor: Anti-A=0, Anti-B=0, Anti-D=4+, A1 cell=0, B cell=3+

Of the options given below, what is the most likely cause of the discrepancy?

very weak subgroup of A

Bombay phenotype

loss of A antigen due to a disease process

aquired B phenotype

very weak subgroup of A

Consider these ABO typing results:

Anti-A=4+, Anti-B=0, Anti-D=3+, A1 cells=1+, B cells=4+

You decide to look at the "extra" reaction in the A1 cell. You do some additional testing, a short cold panel:

A1 cell: IS=1+, Rm T=2+, 4C=4+

A2 cell: IS=1+, Rm T=2+, 4C=4+

B cell: IS=4+, Rm T=4+, 4C=4+

Screen cell I: IS=1+, Rm T=2+, 4C=4+

Screen cell II: IS=1+, Rm T=2+, 4C=4+

Auto control: IS=1+, Rm T=2+, 4C=4+

Cord cell: IS=0, Rm T=0, 4C=0

What is the most likely source of this

The patient is exhibiting acquired A antigen

The patient is A2B with anti-A1

The patient has a cold alloantibody like anti-M

The patient has a cold autoantibody

The patient has a cold autoantibody

You identify an anti-M in the serum during a workup on a patient which has caused an ABO discrepancy. This identifies the antibody / problem but it does not give you a front type and back type that are complementary. So: How will you perform the reverse type, to confirm/resolve this ABO?

use A1 and/or B cells which are negative for the M antigen

type the patient for M

you don't need the reverse type for ABO confirmation

adsorb and elute anti-M from his RBC

use A1 and/or B cells which are negative for the M antigen

You ran an antibody ID panel and identified anti-Fya; everything else was ruled out. RBCs have been requested. Your next steps include ____? Select all that apply.

Do an enzyme panel to prove that it is really -Fya

Phenotype the patient for Fya: He should be Fya-

Phenotype units and perform AHG crossmatches on the Fya- units

Do a prewarm technique to abolish the reactions you saw

Phenotype the patient for Fya: He should be Fya-

Phenotype units and perform AHG crossmatches on the Fya- units

Rh Immune Globulin has been requested for an Rh negative mother who has the following test results:

anti D=0, Weak D test= w+ m.f., Weak D ctrl/CC =0/2+, DAT/CC = 0/2+

What is the most likely explanation of her positive weak D test?

mom is weak D positive

the anti-D reagent is contaminated with an atypical antibody

the mother's RBCs are coated with IgG

there has been a fetal maternal hemorrhage of fetal D+ cells, which have been detected in mom's circulation in your weak D test

there has been a fetal maternal hemorrhage of fetal D+ cells, which have been detected in mom's circulation in your weak D test

What is the most appropriate interpretation/ evaluation for the results given below?

Mom: anti-D= neg, weak D test=neg, DAT=neg, Fetal Screen=neg

Baby: anti-D=neg, weak D test=neg, DAT=neg

mother is not a candidate for Rh Immune Globulin (RhIg)

mother needs 2 doses of 300ug RhIg

mother needs 1, 300ug dose of RhIg

a Kleihauer-Betke stain is needed to determine the amount of RhIg needed

mother is not a candidate for Rh Immune Globulin (RhIg)

What is the first (BEST) step you should perform, if an ABO discrepancy is obtained?

Repeat the testing from the beginning

Short cold panel

Interpret the ABO based on the most probable type

Prewarm incubation

Repeat the testing from the beginning

An eluate is performed after a positive DAT IgG to identify possible specificities of the antibody(ies) coating the patient's PRBCs. What circumstances would lead you to performing a DAT? Select all that apply.

Cord study in an RhIg evaluation

pretransfusion testing on a neonate

1 of 6 AHG XMs are incompatible

the auto control in an ABID panel is reactive

Cord study in an RhIg evaluation

1 of 6 AHG XMs are incompatible

the auto control in an ABID panel is reactive

Kleihauer-Betke stain results on a postpartum mother indicate that there has been a fetal maternal bleed; 1% of the cells counted are fetal cells. Assuming the woman has a blood volume of 5000mL, please calculate the proper RhIg dosage.

1 mini dose

3 full doses

2 full doses

1 full dose

3 full doses

A type and screen is performed on a 49-year-old woman who is scheduled for a hysterectomy in 1 week. Her blood type is A-positive, and her antibody screen was positive. There are 3 PRBCs preoperatively ordered. What must be done before her surgery date?

Identify antibody and phenotype units

Phenotype the patient

Identify antibody and phenotype platelets

Identify antibody

Identify antibody and phenotype units

A strongly positive Fetal bleed screen could be due to the baby's blood being tested by mistake.

True

False

True

How can the ABO and Rh of the fetus be determined in utero?

percutaneous umbilical cord sampling

All of the options are correct

amniocentesis

chorionic villus sampling

All of the options are correct

A patient has an antibody that is reactive against every cell where Jka or Jkb or both Jka and Jkb antigens are present and is non-reactive when there are no Kidd antigens present. This patient most likely has what antibody and where cold appropriate units be located?

anti-Jk3 and Pacific Islanders

anti-Fy3 and Africans

anti-Lu3 and Caucasians

anti-Ku and Italians

anti-Jk3 and Pacific Islanders

Rh-immune globulin should be given within how many hours after delivery?

24

72

48

36

72