Review Questions BB
The B gene is responsible for adding which sugar to the H antigen?
Galactose
Which of the following antigens is fully developed at birth?
Rh
Which of the following is not responsible for mixed field reactions in the forward ABO blood typing?
Lutheran Blood Group
An A positive individual possessing the Lewis gene (Le) but lacking the secretor gene (sese), would have which phenotype?
Le(a+b-)
Which of the following reduces steric hindrance to promote antibody uptake?
Enzymes
In which of the following would the saline replacement technique NOT be utilized?
AHG Crossmatch
A patient has anti-E. A compatible AHG crossmatch is obtained. The unit types as E positive using commercial antisera. Should the unit be used for transfusion?
No
Which of the following blood group systems is not affected by enzyme treatment?
Kell
Which of the following blood group systems does not show dosage?
Lewis
A patient with an antibody to the enhancement media will not show reactivity in:
DAT
Screening cells are what ABO group?
O
When performing an antibody screen, what occurs during the incubation phase?
Antibodies attach to the antigens on the RBC
Which special technique is used to investigate a positive DAT?
Elution
A crossmatch order is received for a patient with a prior history of anti-Fya. The patient currently has a negative antibody screen. What testing needs to be done?
AHG crossmatch Fy(a-) units since there is a prior history of anti-Fya
A blood donation is routinely tested for anti-HBc, per FDA protocol. Two of the three tests run were negative. Is the unit able to be used for transfusion? *
Yes
Which of the following is not associated with RBC storage lesion?
Increase 2,3 DPG levels
Which of the following differs from the others in terms of storage temperature? *
Thawed Cryoprecipitate
Which product has the shortest expiration? *
Thawed Cryoprecipitate
Which of the following patients qualifies for a transfusion? *
Patient with platelet function defect going to surgery with platelet count of 150,000
The antibody implicated in most severe cases of HDN is?
Anti-D
Death is unlikely to occur from which of the following adverse reactions to transfusion?
Febrile transfusion reaction
Which of the following are required for an intrauterine transfusion?
All of the above
Which adverse reaction to transfusion is not typically experienced during the infusion?
Transfusion associated graft vs host disease
Most blood group antigens express what mode of inheritance?
Autosomal Codominant
Which word describes an individual having two different antigens at a given allele:
Heterozygous
At which phase do antigens cross-link to cause visible agglutination?
Agglutination
Zone of antigen excess is known as:
Postzone
Which immunoglobulin classes cross the placenta?
IgG
Which immunoglobulin class is most effective at activating complement:
IgM
Do babies have ABO antigens at birth?
Yes
Do babies have ABO antibodies at birth?
No
Most ABO antibodies belong to which class of immunoglobulin?
IgM
Which blood type possesses the most H antigen?
O
Most group A individuals belong to which subgroup?
A1
Commercial antisera is used in which part of the blood typing assay?
Foward typing
What is the most common black Rh phenotype?
R0r (Antigen type = Dce/dce)
Which Rh phenotype results in the formation of stomatocytes?
Rh null
How many identifiers are required to ID a patient for a blood bank sample?
Two
Which additive solutions act to decrease zeta potential?
LISS
Albumin
Ficin acts to enhance reactivity of all antibodies?
False
Which of the following antigens are missing from the cells of newborns?
I
Le
Someone with the secretor gene and Lewis gene would have which of the following in their saliva? *
ABH
LeA
LeB
Which antibody in the P blood group system causes spontaneous abortion and is IgG?
PP1Pk
Which of the following antigens are destroyed by enzyme treatment?
MNSs
Duffy
Which blood group system is known for antibodies that deteriorate and become undetectable?
Kidd
Which of the following antigens result in RBC morphology changes?
Rh null
Kx
% chance of HLA matching a sibling?
25%
Transfusion Associated Graft vs Host disease can be prevented by proper irradiation of the blood product?
True
Platelets express which HLA antigens?
HLA-A
HLA-B
What immunizing events can cause formation of clinically significant alloantibodies?
Pregnancy
Transfusion
Needle sharing
Patient has history of anti-Jka, but currently has a negative antibody screen.
Do Jka - units need to be supplied?
Yes
What type of crossmatch must you perform?
AHG
Saline replacement technique is used to resolve which phenomenon?
Rouleaux
DAT detects in vivo or in vitro bound antibody?
In vivo
Name three lab tests results that are indicative of hemolysis?
Elevated bilirubin
Elevated LDH
Reticulocytes
Spherocytes
Hemoglobinemia
Decrease serum haptoglobin
Donor requirements are set to protect whom?
Donor
Recipient
What is the minimum hemoglobin level for a volunteer blood donor?
12.5 g/dl for females
13 g/dl for males
How long is a donor deferred after a single unit, whole blood donation?
8 weeks
How long for a double unit apheresis RBC donation?
16 weeks
What is the purpose of a diversion pouch on a donor blood bag set?
Decrease chance of bacterial contamination in unit
Used for testing samples
A unit stored in which of the following anticoagulants/preservatives has the longest shelf life?
Adsol
At what temperature is Fresh Frozen Plasma stored?
-18 C
What is the expiration of Fresh Frozen Plasma?
12 months
At what temperature are platelets stored?
20 - 20 C
What is the expiration of platelets?
5 days
What is the cryoprotectant used for frozen RBCs?
Glycerol
What is the storage temperature for frozen RBCs?
-65 C
What is the expiration frozen RBCs?
10 years
Cryoprecipitate is prepared at what temperature?
1 - 6 C
At what temperature is cryoprecipitate stored?
-18 C
What is the expiration of cryoprecipitate?
12 months from draw
Blood centers are considered drug manufacturers
True
Donor infectious disease screening tests are less sensitive than diagnostic tests
False
What processing step is performed to prevent TA-GVHD?
Irradiation
Criteria for accepting a unit back into the bank after issued in the hospital?
Within temperature
Segments attached
Ports unopened
What component is indicated for transfusion if the patient has an INR >1.5 and is scheduled for surgery? *
FFP
What component is indicated for transfusion if the patient has a fibrinogen of 80mg/dl?
Cryoprecipitate
What is the transfusion trigger for an RBC transfusion in a non-cardiac patient?
7 g/dl
Lactated Ringers is an RBC transfusion compatible infusion fluid?
False
How long must the RN remain with the patient after starting a blood transfusion?
15 minutes
What is the maximum amount of time a unit of blood may be infused?
4 hours
Two reasons for mixed field reaction in forward blood typing?
A3 subgroup
Transfusion with non type specific RBCs
What can cause an incompatible IS crossmatch in a patient with a negative antibody screen?
Wrong donor ABO group selected
Cold reactive allo or autoantibody
Rouleaux
What can cause an incompatible AHG phase crossmatch in a patient with a negative antibody screen?
Allo antibody where donor unit has more antigen sites than screening cells
Patient has antibody to low incidence antigen present on donor cells
In which trimester is a pregnant mom most likely to have a fetal bleed?
Third
What is the critical titer for anti-D?
16
What is the critical titer for anti-K?
8
On which infants is a weak D test performed?
Infants born to Rh Negative mothers
What is the standard dose of RhIG?
300 ug
1500 IU
What is the calculation to determine % fetal cells in KBT? *
# fetal cells/# maternal cells x 100
What are the requirements for the donor unit used in an intrauterine transfusion?
Group O
Hgb S negative
CMV negative
Irradiated
Less than 7 days old
What are the requirements to be a post-partum RhIG candidate?
Delivered Rh positive baby
Mom is Rh positive
Steps RN takes upon recognition of a reaction?
Stop transfusion
Call physician
Call Blood Bank
Perform clerical check
What testing is done on the post transfusion blood sample in a reaction workup?
Visual check for hemolysis/icterus
ABO/Rh
Allergic reactions are not life threatening
False
Which adverse recipient event is nearly always fatal?
Transfusion Associated Graft vs Host Disease
Which two transfusion reactions usually appear early in the transfusion?
Febrile
TRALI
Which transfusion reaction manifests itself with very high fever?
Sepsis
The B gene is responsible for adding which sugar to the H antigen?
Galactose
Which of the following antigens is fully developed at birth?
Rh
Which of the following is not responsible for mixed field reactions in the forward ABO blood typing?
Lutheran Blood Group
An A positive individual possessing the Lewis gene (Le) but lacking the secretor gene (sese), would have which phenotype?
Le(a+b-)
Which of the following reduces steric hindrance to promote antibody uptake?
Enzymes
In which of the following would the saline replacement technique NOT be utilized?
AHG Crossmatch
A patient has anti-E. A compatible AHG crossmatch is obtained. The unit types as E positive using commercial antisera. Should the unit be used for transfusion?
No
Which of the following blood group systems is not affected by enzyme treatment?
Kell
Which of the following blood group systems does not show dosage?
Lewis
A patient with an antibody to the enhancement media will not show reactivity in:
DAT
Screening cells are what ABO group?
O
When performing an antibody screen, what occurs during the incubation phase?
Antibodies attach to the antigens on the RBC
Which special technique is used to investigate a positive DAT?
Elution
A crossmatch order is received for a patient with a prior history of anti-Fya. The patient currently has a negative antibody screen. What testing needs to be done?
AHG crossmatch Fy(a-) units since there is a prior history of anti-Fya
A blood donation is routinely tested for anti-HBc, per FDA protocol. Two of the three tests run were negative. Is the unit able to be used for transfusion? *
Yes
Which of the following is not associated with RBC storage lesion?
Increase 2,3 DPG levels
Which of the following differs from the others in terms of storage temperature? *
Thawed Cryoprecipitate
Which product has the shortest expiration? *
Thawed Cryoprecipitate
Which of the following patients qualifies for a transfusion? *
Patient with platelet function defect going to surgery with platelet count of 150,000
The antibody implicated in most severe cases of HDN is?
Anti-D
Death is unlikely to occur from which of the following adverse reactions to transfusion?
Febrile transfusion reaction
Which of the following are required for an intrauterine transfusion?
All of the above
Which adverse reaction to transfusion is not typically experienced during the infusion?
Transfusion associated graft vs host disease
Most blood group antigens express what mode of inheritance?
Autosomal Codominant
Which word describes an individual having two different antigens at a given allele:
Heterozygous
At which phase do antigens cross-link to cause visible agglutination?
Agglutination
Zone of antigen excess is known as:
Postzone
Which immunoglobulin classes cross the placenta?
IgG
Which immunoglobulin class is most effective at activating complement:
IgM
Do babies have ABO antigens at birth?
Yes
Do babies have ABO antibodies at birth?
No
Most ABO antibodies belong to which class of immunoglobulin?
IgM
Which blood type possesses the most H antigen?
O
Most group A individuals belong to which subgroup?
A1
Commercial antisera is used in which part of the blood typing assay?
Foward typing
What is the most common black Rh phenotype?
R0r (Antigen type = Dce/dce)
Which Rh phenotype results in the formation of stomatocytes?
Rh null
How many identifiers are required to ID a patient for a blood bank sample?
Two
Which additive solutions act to decrease zeta potential?
LISS
Albumin
Ficin acts to enhance reactivity of all antibodies?
False
Which of the following antigens are missing from the cells of newborns?
I
Le
Someone with the secretor gene and Lewis gene would have which of the following in their saliva? *
ABH
LeA
LeB
Which antibody in the P blood group system causes spontaneous abortion and is IgG?
PP1Pk
Which of the following antigens are destroyed by enzyme treatment?
MNSs
Duffy
Which blood group system is known for antibodies that deteriorate and become undetectable?
Kidd
Which of the following antigens result in RBC morphology changes?
Rh null
Kx
% chance of HLA matching a sibling?
25%
Transfusion Associated Graft vs Host disease can be prevented by proper irradiation of the blood product?
True
Platelets express which HLA antigens?
HLA-A
HLA-B
What immunizing events can cause formation of clinically significant alloantibodies?
Pregnancy
Transfusion
Needle sharing
Patient has history of anti-Jka, but currently has a negative antibody screen.
Do Jka - units need to be supplied?
Yes
What type of crossmatch must you perform?
AHG
Saline replacement technique is used to resolve which phenomenon?
Rouleaux
DAT detects in vivo or in vitro bound antibody?
In vivo
Name three lab tests results that are indicative of hemolysis?
Elevated bilirubin
Elevated LDH
Reticulocytes
Spherocytes
Hemoglobinemia
Decrease serum haptoglobin
Donor requirements are set to protect whom?
Donor
Recipient
What is the minimum hemoglobin level for a volunteer blood donor?
12.5 g/dl for females
13 g/dl for males
How long is a donor deferred after a single unit, whole blood donation?
8 weeks
How long for a double unit apheresis RBC donation?
16 weeks
What is the purpose of a diversion pouch on a donor blood bag set?
Decrease chance of bacterial contamination in unit
Used for testing samples
A unit stored in which of the following anticoagulants/preservatives has the longest shelf life?
Adsol
At what temperature is Fresh Frozen Plasma stored?
-18 C
What is the expiration of Fresh Frozen Plasma?
12 months
At what temperature are platelets stored?
20 - 20 C
What is the expiration of platelets?
5 days
What is the cryoprotectant used for frozen RBCs?
Glycerol
What is the storage temperature for frozen RBCs?
-65 C
What is the expiration frozen RBCs?
10 years
Cryoprecipitate is prepared at what temperature?
1 - 6 C
At what temperature is cryoprecipitate stored?
-18 C
What is the expiration of cryoprecipitate?
12 months from draw
Blood centers are considered drug manufacturers
True
Donor infectious disease screening tests are less sensitive than diagnostic tests
False
What processing step is performed to prevent TA-GVHD?
Irradiation
Criteria for accepting a unit back into the bank after issued in the hospital?
Within temperature
Segments attached
Ports unopened
What component is indicated for transfusion if the patient has an INR >1.5 and is scheduled for surgery? *
FFP
What component is indicated for transfusion if the patient has a fibrinogen of 80mg/dl?
Cryoprecipitate
What is the transfusion trigger for an RBC transfusion in a non-cardiac patient?
7 g/dl
Lactated Ringers is an RBC transfusion compatible infusion fluid?
False
How long must the RN remain with the patient after starting a blood transfusion?
15 minutes
What is the maximum amount of time a unit of blood may be infused?
4 hours
Two reasons for mixed field reaction in forward blood typing?
A3 subgroup
Transfusion with non type specific RBCs
What can cause an incompatible IS crossmatch in a patient with a negative antibody screen?
Wrong donor ABO group selected
Cold reactive allo or autoantibody
Rouleaux
What can cause an incompatible AHG phase crossmatch in a patient with a negative antibody screen?
Allo antibody where donor unit has more antigen sites than screening cells
Patient has antibody to low incidence antigen present on donor cells
In which trimester is a pregnant mom most likely to have a fetal bleed?
Third
What is the critical titer for anti-D?
16
What is the critical titer for anti-K?
8
On which infants is a weak D test performed?
Infants born to Rh Negative mothers
What is the standard dose of RhIG?
300 ug
1500 IU
What is the calculation to determine % fetal cells in KBT? *
# fetal cells/# maternal cells x 100
What are the requirements for the donor unit used in an intrauterine transfusion?
Group O
Hgb S negative
CMV negative
Irradiated
Less than 7 days old
What are the requirements to be a post-partum RhIG candidate?
Delivered Rh positive baby
Mom is Rh positive
Steps RN takes upon recognition of a reaction?
Stop transfusion
Call physician
Call Blood Bank
Perform clerical check
What testing is done on the post transfusion blood sample in a reaction workup?
Visual check for hemolysis/icterus
ABO/Rh
Allergic reactions are not life threatening
False
Which adverse recipient event is nearly always fatal?
Transfusion Associated Graft vs Host Disease
Which two transfusion reactions usually appear early in the transfusion?
Febrile
TRALI
Which transfusion reaction manifests itself with very high fever?
Sepsis