Review Questions BB

The B gene is responsible for adding which sugar to the H antigen?

1. Galactose

Which of the following antigens is fully developed at birth?

1. Rh

Which of the following is not responsible for mixed field reactions in the forward ABO blood typing?

1. Lutheran Blood Group

An A positive individual possessing the Lewis gene (Le) but lacking the secretor gene (sese), would have which phenotype?

1. Le(a+b-)

Which of the following reduces steric hindrance to promote antibody uptake?

1. Enzymes

In which of the following would the saline replacement technique NOT be utilized?

1. 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?

1. No

Which of the following blood group systems is not affected by enzyme treatment?

1. Kell

Which of the following blood group systems does not show dosage?

1. Lewis

A patient with an antibody to the enhancement media will not show reactivity in:

1. DAT

Screening cells are what ABO group?

1. O

When performing an antibody screen, what occurs during the incubation phase?

1. Antibodies attach to the antigens on the RBC

Which special technique is used to investigate a positive DAT?

1. 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?

1. 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? *

1. Yes

Which of the following is not associated with RBC storage lesion?

1. Increase 2,3 DPG levels

Which of the following differs from the others in terms of storage temperature? *

1. Thawed Cryoprecipitate

Which product has the shortest expiration? *

1. Thawed Cryoprecipitate

Which of the following patients qualifies for a transfusion? *

1. Patient with platelet function defect going to surgery with platelet count of 150,000

The antibody implicated in most severe cases of HDN is?

1. Anti-D

Death is unlikely to occur from which of the following adverse reactions to transfusion?

1. Febrile transfusion reaction

Which of the following are required for an intrauterine transfusion?

1. All of the above

Which adverse reaction to transfusion is not typically experienced during the infusion?

1. Transfusion associated graft vs host disease

Most blood group antigens express what mode of inheritance?

1. Autosomal Codominant

Which word describes an individual having two different antigens at a given allele:

1. Heterozygous

At which phase do antigens cross-link to cause visible agglutination?

1. Agglutination

Zone of antigen excess is known as:

1. Postzone

Which immunoglobulin classes cross the placenta?

1. IgG

Which immunoglobulin class is most effective at activating complement:

1. IgM

Do babies have ABO antigens at birth?

1. Yes

Do babies have ABO antibodies at birth?

1. No

Most ABO antibodies belong to which class of immunoglobulin?

1. IgM

Which blood type possesses the most H antigen?

1. O

Most group A individuals belong to which subgroup?

1. A1

Commercial antisera is used in which part of the blood typing assay?

1. Foward typing

What is the most common black Rh phenotype?

1. R0r (Antigen type = Dce/dce)

Which Rh phenotype results in the formation of stomatocytes?

1. Rh null

How many identifiers are required to ID a patient for a blood bank sample?

1. Two

Which additive solutions act to decrease zeta potential?

1. LISS

2. Albumin

Ficin acts to enhance reactivity of all antibodies?

1. False

Which of the following antigens are missing from the cells of newborns?

1. I

2. Le

Someone with the secretor gene and Lewis gene would have which of the following in their saliva? *

1. ABH

2. LeA

3. LeB

Which antibody in the P blood group system causes spontaneous abortion and is IgG?

1. PP1Pk

Which of the following antigens are destroyed by enzyme treatment?

1. MNSs

2. Duffy

Which blood group system is known for antibodies that deteriorate and become undetectable?

1. Kidd

Which of the following antigens result in RBC morphology changes?

1. Rh null

2. Kx

% chance of HLA matching a sibling?

1. 25%

Transfusion Associated Graft vs Host disease can be prevented by proper irradiation of the blood product?

1. True

Platelets express which HLA antigens?

1. HLA-A

2. HLA-B

What immunizing events can cause formation of clinically significant alloantibodies?

1. Pregnancy

2. Transfusion

3. Needle sharing

Patient has history of anti-Jka, but currently has a negative antibody screen.

1. Do Jka - units need to be supplied?

   1. Yes

2. What type of crossmatch must you perform?

   1. AHG

Saline replacement technique is used to resolve which phenomenon?

1. Rouleaux

DAT detects in vivo or in vitro bound antibody?

1. In vivo

Name three lab tests results that are indicative of hemolysis?

1. Elevated bilirubin

2. Elevated LDH

3. Reticulocytes

4. Spherocytes

5. Hemoglobinemia

6. Decrease serum haptoglobin

Donor requirements are set to protect whom?

1. Donor

2. Recipient

What is the minimum hemoglobin level for a volunteer blood donor?

1. 12.5 g/dl for females

2. 13 g/dl for males

How long is a donor deferred after a single unit, whole blood donation?

1. 8 weeks

How long for a double unit apheresis RBC donation?

1. 16 weeks

What is the purpose of a diversion pouch on a donor blood bag set?

1. Decrease chance of bacterial contamination in unit

2. Used for testing samples

A unit stored in which of the following anticoagulants/preservatives has the longest shelf life?

1. Adsol

At what temperature is Fresh Frozen Plasma stored?

1. -18 C

What is the expiration of Fresh Frozen Plasma?

1. 12 months

At what temperature are platelets stored?

1. 20 - 20 C

What is the expiration of platelets?

1. 5 days

What is the cryoprotectant used for frozen RBCs?

1. Glycerol

What is the storage temperature for frozen RBCs?

1. -65 C

What is the expiration frozen RBCs?

1. 10 years

Cryoprecipitate is prepared at what temperature?

1. 1 - 6 C

At what temperature is cryoprecipitate stored?

1. -18 C

What is the expiration of cryoprecipitate?

1. 12 months from draw

Blood centers are considered drug manufacturers

1. True

Donor infectious disease screening tests are less sensitive than diagnostic tests

1. False

What processing step is performed to prevent TA-GVHD?

1. Irradiation

Criteria for accepting a unit back into the bank after issued in the hospital?

1. Within temperature

2. Segments attached

3. Ports unopened

What component is indicated for transfusion if the patient has an INR >1.5 and is scheduled for surgery? *

1. FFP

What component is indicated for transfusion if the patient has a fibrinogen of 80mg/dl?

1. Cryoprecipitate

What is the transfusion trigger for an RBC transfusion in a non-cardiac patient?

1. 7 g/dl

Lactated Ringers is an RBC transfusion compatible infusion fluid?

1. False

How long must the RN remain with the patient after starting a blood transfusion?

1. 15 minutes

What is the maximum amount of time a unit of blood may be infused?

1. 4 hours

Two reasons for mixed field reaction in forward blood typing?

1. A3 subgroup

2. Transfusion with non type specific RBCs

What can cause an incompatible IS crossmatch in a patient with a negative antibody screen?

1. Wrong donor ABO group selected

2. Cold reactive allo or autoantibody

3. Rouleaux

What can cause an incompatible AHG phase crossmatch in a patient with a negative antibody screen?

1. Allo antibody where donor unit has more antigen sites than screening cells

2. 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?

1. Third

What is the critical titer for anti-D?

1. 16

What is the critical titer for anti-K?

1. 8

On which infants is a weak D test performed?

1. Infants born to Rh Negative mothers

What is the standard dose of RhIG?

1. 300 ug

2. 1500 IU

What is the calculation to determine % fetal cells in KBT? *

1. # fetal cells/# maternal cells x 100

What are the requirements for the donor unit used in an intrauterine transfusion?

1. Group O

2. Hgb S negative

3. CMV negative

4. Irradiated

5. Less than 7 days old

What are the requirements to be a post-partum RhIG candidate?

1. Delivered Rh positive baby

1. Mom is Rh positive

Steps RN takes upon recognition of a reaction?

1. Stop transfusion

2. Call physician

3. Call Blood Bank

4. Perform clerical check

What testing is done on the post transfusion blood sample in a reaction workup?

1. Visual check for hemolysis/icterus

2. ABO/Rh

Allergic reactions are not life threatening

1. False

Which adverse recipient event is nearly always fatal?

1. Transfusion Associated Graft vs Host Disease

Which two transfusion reactions usually appear early in the transfusion?

1. Febrile

2. TRALI

Which transfusion reaction manifests itself with very high fever?

1. Sepsis