Question 1

Of the following antibodies, which one is most likely to be naturally occurring? 1) anti-Le(a)
2) anti-K
3)anti-Jk(a)
4)anti-D

Accepted Answer

anti-Le(a)

Question 2

Anti-P1 is usually found as a (an)
1) naturally occurring cold agglutinin
 	2)	immune antibody reacting at 37C
 	3)	naturally occurring antibody reacting at 37C
 	4)	immune antibody reacting in the indirect antiglobulin test

Accepted Answer

naturally occurring cold agglutinin

Question 3

Substances in which of the following blood group systems are found in saliva?
 	1)	the Rh blood group system
		2)	the Lewis blood group system
 	3)	the Duffy blood group system
 	4)	the Kell blood group system

Accepted Answer

the lewis blood group system

Question 4

Anti-C reacts with:
 	1)	R2R2 cells
 	2)	Ror cells
 	3)	r"r cells
		4)	R1R1 cells

Accepted Answer

R1R1 cells

Question 5

A positive direct antiglobulin test indicates
		1)	in vivo cell sensitization
 	2)	in vitro cell sensitization
 	3)	sensitization with IgM molecules
 	4)	cells coated with anti-D

Accepted Answer

in vivo cell sensitization

Question 6

Anti-I
 	1)	is a frequent cause of hemolytic disease of the newborn
 	2)	usually fails to react with adult cells
 	3)	reacts best at 37C
		4)	reacts weakly or not at all with cord cells

Accepted Answer

reacts weakly or not at all with cord cells

Question 7

Why must serum used for antibody screening and compatibility testing be less then 72 hours old?

Accepted Answer

to ensure the sample reflects the current immunologic status of the patient

Question 8

Select the blood group system associated with malaria:
 	1)	Rh
 	2)	I
 	3)	P
		4)	Duffy

Accepted Answer

Duffy

Question 9

In the crossmatch, the immediate spin phase is designed to detect:
		1)	IgM antibodies and ABO grouping errors
 	2)	IgG antibodies and warm auto-agglutinins
 	3)	IgA antibodies
 	4)	IgM and IgG antibodies, but not IgA antibodies

Accepted Answer

IgM antibodies and ABO grouping errors

Question 10

Crossmatching 5 units, 4 were compatible and both autocontrol and antibody screen neg. but 1 was weakly incompatible in the AHG, why?

Accepted Answer

The patient has an antibody to a low frequency antigen

Question 11

Of the following list of antibodies, which one differs from the others in optimal temperature of reaction?
 	1)	anti-I
 	2)	anti-M
		3)	anti-c
 	4)	anti-Lu(a)

Accepted Answer

anti-c

Question 12

The antibody screening cells were treated with the enzyme papain before using. An antibody directed against which of the following antigens would not be detected?
 	1)	D
		2)	Fy(a)
 	3)	K
 	4)	Jk(a)

Accepted Answer

Fy(a)

Question 13

Which laboratory result would NOT indicate the presence of an antibody?
 	1)	positive antibody screen
 	2)	positive crossmatch
		3)	rouleaux
 	4)	discrepancy in forward and reverse type

Accepted Answer

rouleaux

Question 14

In the AHG phase of testing, agglutination appears in both antibody screening tubes I and II. There is no agglutination in the crossmatch tube. What is the patient's problem?

Accepted Answer

The patient has an unexpected antibody, but the donor does not have the corresponding antigen.

Question 15

The Duffy antibodies are: 
1) 	clinically significant
 	2)	usually IgM
 	3)	not known to cause hemolytic disease of the newborn
 	4)	not known to cuase hemolytic transfusion reactions

Accepted Answer

clinically significant

Question 16

Which of the following corresponds to R1 in the Wiener shorthand nomenclature?
 	1)	dCe
 	2)	dcE
 	3)	Dce
		4)	DCe

Accepted Answer

DCe

Question 17

The indirect antiglobulin test is used to detect red cells that have been sensitized:
		1)	in vitro
 	2)	after elution techniques have been carried out
 	3)	in vivo
 	4)	with any IgM antibody

Accepted Answer

in vitro

Question 18

Which genotype would result from this mating:
Mother: dce/dce
Father: DCe/DCe
 	1)	Dce/dce
 	2)	dce/dce
 	3)	DCe/DCe
		4)	DCe/dce

Accepted Answer

DCe/dce

Question 19

Autoantibodies are:
 	1)	antibodies directed against an antigen lacking on the red blood cells
 	2)antibodies that bind complement
 	3)antibodies that are a common cause of HDN
		4)	antibodies directed against an individual's own specific antigens

Accepted Answer

antibodies directed against an individuals's own specific antigens

Question 20

What type of blood should be given in an emergency transfusion where there is not time to type the blood?
 	1)	O Negative, whole blood
 	2)	O Positive, whole blood
		3)	O Negative, packed red blood cells
 	4)	O Positive, packed red blood cells

Accepted Answer

O negative, packed red blood cells

Question 21

Anti-E would be expected to react with which of the following red blood cells?
 	1)	R1R1
		2)	R2R2
 	3)	RoRo
 	4)	rr

Accepted Answer

R2R2

Question 22

Which cells will react most strongly with an anti-M antibody that is showing the dosage effect?
 	1)	MN
 	2)	NN
		3)	MM
 	4)	MNSs

Accepted Answer

MM

Question 23

The crossout method in antibody identification refers to:

Accepted Answer

eliminating those antigens that may not have corresponding antibodies

Question 24

You are using an anti-Fy(a) reagent. Which of the following is the cell of choice for a positive control?
		1)	Fy(a+b+)
 	2)	Fy(a+b-)
 	3)	Fy(a-b+)
 	4)	Fy(a-b-)

Accepted Answer

Fy(a+b+)

Question 25

What will a compatibility test do?

Accepted Answer

detect most errors in the ABO groupings

Question 26

In addition to an antigen-antibody reaction, which of the following is required for red blood cell lysis?
 	1)	albumin
 	2)	glucose-6-phosphatase dehydrogenase
 	3)	T lymphocytes
		4)	complement

Accepted Answer

complement

Question 27

This class of antibody is capable of crossing the placenta:
		1)	IgG
 	2)	IgA
 	3)	IgM
 	4)	IgE

Accepted Answer

IgG

Question 28

Group ABO antibodies are predominately of this immunoglobulin class:
 	1)	IgG
 	2)	IgA
		3)	IgM
 	4)	IgE

Accepted Answer

IgM

Question 29

Both donor and recipient samples used in crossmatching must be stored for a minimum of _____ days following transfusion.
 	1)	3
		2)	7
 	3)	10
 	4)	21

Accepted Answer

7

Question 30

The majority of blood bank errors are:
 	1)	mistyped patients.
 	2)	mistyped donors.
		3)	clerical errors.
 	4)	false negative antibody screens.

Accepted Answer

clerical errors

Question 31

What is the relationship between zeta potential and agglutination?
 	decreased/decreased
decreased/enhanced
increased/enhanced or none of the above

Accepted Answer

zeta potential decreased and agglutination is enhanced

Question 32

An autocontrol is positive only in the AHG phase. What is this suggestive of?
 	1)	rouleaux
 	2)	positive weak D
 	3)	positive indirect antiglobulin test
		4)	positive direct antiglobulin test

Accepted Answer

positive direct antiglobulin test

Question 33

Anti-S
 	1)	has been sucessfully induced in rabbits.
		2)	is usually IgG.
 	3)	usually reacts more strongly at low temperatures.
 	4)	has never been implicated as the cause of hemolytic disease of the newborn.

Accepted Answer

usually IgG

Question 34

A patient developed an anti-Kell antibody five years ago. The antibody screen is negative now. Of the following, to obtain suitable blood for transfusion, the best procedure is to:

Accepted Answer

type the donor units for the Kell antigen and crossmatch the Kell negative units for the patient.

Question 35

In which procedure is an antibody removed from the serum?
 	1)	direct antiglobulin test
 	2)	elution procedure
 	3)	titration procedure
		4)	absorption procedure

Accepted Answer

absorption procedure

Question 36

Five minutes into a weak D test, the waterbath is found to be 45C. The technician should do which of the following?

Accepted Answer

Discontinue the test and repeat using a different waterbath.

Question 37

All of the following antibodies have been implicated as causes of hemolytic disease of the newborn, EXCEPT
 	1)	anti-K
 	2)	anti-C
		3)	anti-Le(a)
 	4)	anti-D

Accepted Answer

anti-Le(a)

Question 38

Anti-Jk(b)
		1)	is detectable using enzyme-treated cells
 	2)	never binds complement
 	3)	is clinically insignificant
 	4)	is naturally occurring

Accepted Answer

is detectable using enzyme-treated cells

Question 39

Antibodies to Rho(D) antigen are usually demonstrated:
 	1)	within a year of birth
 	2)	in pregnant women who are Rh-positive
		3)	as a result of immunization by red cells
 	4)	six months after birth

Accepted Answer

as a result of immunization by red cells

Question 40

Given the following test results, what is the patient's ABO type?

Red cell reactions with:
Anti-A: 4+
Anti-B: 0
Anti-A,B: 4+

Serum reactions with:
A1 Cells: 0
B Cells: 3+

Accepted Answer

A

Question 41

If a patient has a positive direct antiglobulin test, this is the best way of removing the antibody from the cells:
 	1)	absorption
 	2)	titration
		3)	elution
 	4)	washing

Accepted Answer

elution

Question 42

True or False: If a patient has a positive direct antiglobulin test, the autocontrol will also be positive.
		1)	True
 	2)	False

Accepted Answer

True

Question 43

True or false: If a patient has a positive direct antiglobulin test, the weak D test will be positive, no matter the patient's weak D status.
		1)	True
 	2)	False

Accepted Answer

True

Question 44

Given the following test results, what is this patient's ABO and Rh type?

Red cells reactions with:
Anti-A: 0
Anti-B: 0
Anti-A,B: 0
Anti-D: 3+
Rh Control: 0

Serum reactions with:
A1 Cells: 4+
B Cells: 4+

Accepted Answer

O and Rh positive

Question 45

Red cells reactions with:
Anti-A: 4+
Anti-B: 0
Anti-A,B: 4+
Anti-D: 0
Rh Control: 0
Weak D Test: 0
Weak D Control: 0

Serum reactions with:
A1 Cells: 0
B Cells: 4+

Accepted Answer

A Rh negative

Question 46

Red cells reactions with:
Anti-A: 0
Anti-B: 4+
Anti-A,B: 4+
Anti-D: 3+
Rh Control: 0

Serum reactions with:
A1 Cells: 3+
B Cells: 0

Accepted Answer

B Rh positive

Question 47

Red cells reactions with:
Anti-A: 3+
Anti-B: 0
Anti-A,B: 4+
Anti-D: 3+
Rh Control: 0

Serum reactions with:
A1 Cells: 0
B Cells: 0

Accepted Answer

Rh positive; can't report out ABO discrepancy; further testing must be done

Question 48

Red cells reactions with:
Anti-A: 0
Anti-B: 4+
Anti-A,B: 4+
Anti-D: 0
Rh Control: 0
Weak D Test: 2+
Weak D Control: 2+

Serum reactions with:
A1 Cells: 3+
B Cells: 0

Accepted Answer

B; can't report out Rh type until further testing is done.

Question 49

Red cells reactions with:
Anti-A: 4+
Anti-B: 4+
Anti-A,B: 4+
Anti-D: 0
Rh Control: 0
Weak D Test: 2+
Weak D Control: 0

Serum reactions with:
A1 Cells: 0
B Cells: 0

Accepted Answer

AB Rh positive

Question 50

A 20-year-old female patient, requiring a transfusion, types as a B Rh-negative. There is no blood of this type available. Which of the following packed red blood cells may be transfused as an alternative?

Accepted Answer

O Rh negative

Question 51

The genotype of a patient is DCe/dce. 
1. What Rh antigens are present on this patient's red cells?
2. What Rh antigens are absent from this patient's red cells?

Accepted Answer

1. This patient's red cells possess the D, C, c, and e antigens.
2. This patient's red cells are negative for the E antigen.
Note: the "d" antigen is an amorph, and does not exist.

Question 52

List all of the steps performed in an antibody screen (antibody detection) test.
10 steps and on the next 4 cards.....

Accepted Answer

1. Label three tubes: "I", "II", and "Auto", with patient's initials.
2. Add two drops of patient's serum/plasma to each tube.

Question 53

3. Add one drop of Selectogen I to the "I" tube, one drop of Selectogen II to the "II" tube, and one drop of washed 5% patient RBCs to the "Auto" tube.
4. Mix, spin, and read and record agglutination for IS phase.

Accepted Answer

5. Add two drops of enhancement medium to each tube. Mix.
6. Place in 37C incubator for 15-30 min.

Question 54

7. After incubation, spin, read and record agglutination for 37C phase.
8. Wash each tube 3x in saline, decanting well after the last wash.

Accepted Answer

9. Add two drops AHG to each tube. Mix, spin, read and record agglutination macroscopically and microscopically for each tube. This is the AHG phase.
10. To each negative tube, add one drop of Coombs Cells (Check Cells). Mix, spin read and rec'd agglutin

Question 55

Why is it important to check the patient's transfusion record in pretransfusion testing?

Accepted Answer

to detect the possibility of any antibodies the patients serum may have from previous blood they received, to ensure compatibility

Question 56

1.  What information must be included on the label of a patient's blood bank specimen?
2. At what point in the collection procedure is the patient's specimen labeled?

Accepted Answer

1. patients names, ID number, date, time collected, my initials
2. after collected and before leaving the patient

Question 57

Which blood component's main purpose is to restore an individuals oxygen-carrying capacity, keeping organs and tissues oxygenated and healthy?

Accepted Answer

RBC's

Question 58

What type of blood components are given to patients who are diagnosed with thrombocytopenia?

Accepted Answer

platelets

Question 59

Why is fresh frozen plasma (FFP) usually transfused to patients?

Accepted Answer

To help stop the bleeding in patients with coagulopathies; such as DIC or massive blood trauma injuries

Question 60

Cryoprecipitated antihemophilic factor implies the component contains which clotting factor to treat the bleeding disorder Hemophilia A?

Accepted Answer

VIII

Question 61

What are blood components that have the majority of WBCs removed called?

Accepted Answer

leuko reduced RBC's

Question 62

Why are leuko-reduced blood products usually administered to patients?

Accepted Answer

To reduce the chances of febrile transfusion reactions.

Question 63

Irradiated blood components are usually indicated to prevent what disease in a patient?

Accepted Answer

GVHD (graft vs. host diesase)

Question 64

Neonatal and pediatric patients receiving exchange transfusion should receive blood that is less than how many days old?

Accepted Answer

<5 days old

Question	Answer
Of the following antibodies, which one is most likely to be naturally occurring? 1) anti-Le(a) 2) anti-K 3)anti-Jk(a) 4)anti-D	anti-Le(a)
Anti-P1 is usually found as a (an) 1) naturally occurring cold agglutinin 2) immune antibody reacting at 37C 3) naturally occurring antibody reacting at 37C 4) immune antibody reacting in the indirect antiglobulin test	naturally occurring cold agglutinin
Substances in which of the following blood group systems are found in saliva? 1) the Rh blood group system 2) the Lewis blood group system 3) the Duffy blood group system 4) the Kell blood group system	the lewis blood group system
Anti-C reacts with: 1) R2R2 cells 2) Ror cells 3) r"r cells 4) R1R1 cells	R1R1 cells
A positive direct antiglobulin test indicates 1) in vivo cell sensitization 2) in vitro cell sensitization 3) sensitization with IgM molecules 4) cells coated with anti-D	in vivo cell sensitization
Anti-I 1) is a frequent cause of hemolytic disease of the newborn 2) usually fails to react with adult cells 3) reacts best at 37C 4) reacts weakly or not at all with cord cells	reacts weakly or not at all with cord cells
Why must serum used for antibody screening and compatibility testing be less then 72 hours old?	to ensure the sample reflects the current immunologic status of the patient
Select the blood group system associated with malaria: 1) Rh 2) I 3) P 4) Duffy	Duffy
In the crossmatch, the immediate spin phase is designed to detect: 1) IgM antibodies and ABO grouping errors 2) IgG antibodies and warm auto-agglutinins 3) IgA antibodies 4) IgM and IgG antibodies, but not IgA antibodies	IgM antibodies and ABO grouping errors
Crossmatching 5 units, 4 were compatible and both autocontrol and antibody screen neg. but 1 was weakly incompatible in the AHG, why?	The patient has an antibody to a low frequency antigen
Of the following list of antibodies, which one differs from the others in optimal temperature of reaction? 1) anti-I 2) anti-M 3) anti-c 4) anti-Lu(a)	anti-c
The antibody screening cells were treated with the enzyme papain before using. An antibody directed against which of the following antigens would not be detected? 1) D 2) Fy(a) 3) K 4) Jk(a)	Fy(a)
Which laboratory result would NOT indicate the presence of an antibody? 1) positive antibody screen 2) positive crossmatch 3) rouleaux 4) discrepancy in forward and reverse type	rouleaux
In the AHG phase of testing, agglutination appears in both antibody screening tubes I and II. There is no agglutination in the crossmatch tube. What is the patient's problem?	The patient has an unexpected antibody, but the donor does not have the corresponding antigen.
The Duffy antibodies are: 1) clinically significant 2) usually IgM 3) not known to cause hemolytic disease of the newborn 4) not known to cuase hemolytic transfusion reactions	clinically significant
Which of the following corresponds to R1 in the Wiener shorthand nomenclature? 1) dCe 2) dcE 3) Dce 4) DCe	DCe
The indirect antiglobulin test is used to detect red cells that have been sensitized: 1) in vitro 2) after elution techniques have been carried out 3) in vivo 4) with any IgM antibody	in vitro
Which genotype would result from this mating: Mother: dce/dce Father: DCe/DCe 1) Dce/dce 2) dce/dce 3) DCe/DCe 4) DCe/dce	DCe/dce
Autoantibodies are: 1) antibodies directed against an antigen lacking on the red blood cells 2)antibodies that bind complement 3)antibodies that are a common cause of HDN 4) antibodies directed against an individual's own specific antigens	antibodies directed against an individuals's own specific antigens
What type of blood should be given in an emergency transfusion where there is not time to type the blood? 1) O Negative, whole blood 2) O Positive, whole blood 3) O Negative, packed red blood cells 4) O Positive, packed red blood cells	O negative, packed red blood cells
Anti-E would be expected to react with which of the following red blood cells? 1) R1R1 2) R2R2 3) RoRo 4) rr	R2R2
Which cells will react most strongly with an anti-M antibody that is showing the dosage effect? 1) MN 2) NN 3) MM 4) MNSs	MM
The crossout method in antibody identification refers to:	eliminating those antigens that may not have corresponding antibodies
You are using an anti-Fy(a) reagent. Which of the following is the cell of choice for a positive control? 1) Fy(a+b+) 2) Fy(a+b-) 3) Fy(a-b+) 4) Fy(a-b-)	Fy(a+b+)
What will a compatibility test do?	detect most errors in the ABO groupings
In addition to an antigen-antibody reaction, which of the following is required for red blood cell lysis? 1) albumin 2) glucose-6-phosphatase dehydrogenase 3) T lymphocytes 4) complement	complement
This class of antibody is capable of crossing the placenta: 1) IgG 2) IgA 3) IgM 4) IgE	IgG
Group ABO antibodies are predominately of this immunoglobulin class: 1) IgG 2) IgA 3) IgM 4) IgE	IgM
Both donor and recipient samples used in crossmatching must be stored for a minimum of _____ days following transfusion. 1) 3 2) 7 3) 10 4) 21	7
The majority of blood bank errors are: 1) mistyped patients. 2) mistyped donors. 3) clerical errors. 4) false negative antibody screens.	clerical errors
What is the relationship between zeta potential and agglutination? decreased/decreased decreased/enhanced increased/enhanced or none of the above	zeta potential decreased and agglutination is enhanced
An autocontrol is positive only in the AHG phase. What is this suggestive of? 1) rouleaux 2) positive weak D 3) positive indirect antiglobulin test 4) positive direct antiglobulin test	positive direct antiglobulin test
Anti-S 1) has been sucessfully induced in rabbits. 2) is usually IgG. 3) usually reacts more strongly at low temperatures. 4) has never been implicated as the cause of hemolytic disease of the newborn.	usually IgG
A patient developed an anti-Kell antibody five years ago. The antibody screen is negative now. Of the following, to obtain suitable blood for transfusion, the best procedure is to:	type the donor units for the Kell antigen and crossmatch the Kell negative units for the patient.
In which procedure is an antibody removed from the serum? 1) direct antiglobulin test 2) elution procedure 3) titration procedure 4) absorption procedure	absorption procedure
Five minutes into a weak D test, the waterbath is found to be 45C. The technician should do which of the following?	Discontinue the test and repeat using a different waterbath.
All of the following antibodies have been implicated as causes of hemolytic disease of the newborn, EXCEPT 1) anti-K 2) anti-C 3) anti-Le(a) 4) anti-D	anti-Le(a)
Anti-Jk(b) 1) is detectable using enzyme-treated cells 2) never binds complement 3) is clinically insignificant 4) is naturally occurring	is detectable using enzyme-treated cells
Antibodies to Rho(D) antigen are usually demonstrated: 1) within a year of birth 2) in pregnant women who are Rh-positive 3) as a result of immunization by red cells 4) six months after birth	as a result of immunization by red cells
Given the following test results, what is the patient's ABO type? Red cell reactions with: Anti-A: 4+ Anti-B: 0 Anti-A,B: 4+ Serum reactions with: A1 Cells: 0 B Cells: 3+	A
If a patient has a positive direct antiglobulin test, this is the best way of removing the antibody from the cells: 1) absorption 2) titration 3) elution 4) washing	elution
True or False: If a patient has a positive direct antiglobulin test, the autocontrol will also be positive. 1) True 2) False	True
True or false: If a patient has a positive direct antiglobulin test, the weak D test will be positive, no matter the patient's weak D status. 1) True 2) False	True
Given the following test results, what is this patient's ABO and Rh type? Red cells reactions with: Anti-A: 0 Anti-B: 0 Anti-A,B: 0 Anti-D: 3+ Rh Control: 0 Serum reactions with: A1 Cells: 4+ B Cells: 4+	O and Rh positive
Red cells reactions with: Anti-A: 4+ Anti-B: 0 Anti-A,B: 4+ Anti-D: 0 Rh Control: 0 Weak D Test: 0 Weak D Control: 0 Serum reactions with: A1 Cells: 0 B Cells: 4+	A Rh negative
Red cells reactions with: Anti-A: 0 Anti-B: 4+ Anti-A,B: 4+ Anti-D: 3+ Rh Control: 0 Serum reactions with: A1 Cells: 3+ B Cells: 0	B Rh positive
Red cells reactions with: Anti-A: 3+ Anti-B: 0 Anti-A,B: 4+ Anti-D: 3+ Rh Control: 0 Serum reactions with: A1 Cells: 0 B Cells: 0	Rh positive; can't report out ABO discrepancy; further testing must be done
Red cells reactions with: Anti-A: 0 Anti-B: 4+ Anti-A,B: 4+ Anti-D: 0 Rh Control: 0 Weak D Test: 2+ Weak D Control: 2+ Serum reactions with: A1 Cells: 3+ B Cells: 0	B; can't report out Rh type until further testing is done.
Red cells reactions with: Anti-A: 4+ Anti-B: 4+ Anti-A,B: 4+ Anti-D: 0 Rh Control: 0 Weak D Test: 2+ Weak D Control: 0 Serum reactions with: A1 Cells: 0 B Cells: 0	AB Rh positive
A 20-year-old female patient, requiring a transfusion, types as a B Rh-negative. There is no blood of this type available. Which of the following packed red blood cells may be transfused as an alternative?	O Rh negative
The genotype of a patient is DCe/dce. 1. What Rh antigens are present on this patient's red cells? 2. What Rh antigens are absent from this patient's red cells?	1. This patient's red cells possess the D, C, c, and e antigens. 2. This patient's red cells are negative for the E antigen. Note: the "d" antigen is an amorph, and does not exist.
List all of the steps performed in an antibody screen (antibody detection) test. 10 steps and on the next 4 cards.....	1. Label three tubes: "I", "II", and "Auto", with patient's initials. 2. Add two drops of patient's serum/plasma to each tube.
3. Add one drop of Selectogen I to the "I" tube, one drop of Selectogen II to the "II" tube, and one drop of washed 5% patient RBCs to the "Auto" tube. 4. Mix, spin, and read and record agglutination for IS phase.	5. Add two drops of enhancement medium to each tube. Mix. 6. Place in 37C incubator for 15-30 min.
7. After incubation, spin, read and record agglutination for 37C phase. 8. Wash each tube 3x in saline, decanting well after the last wash.	9. Add two drops AHG to each tube. Mix, spin, read and record agglutination macroscopically and microscopically for each tube. This is the AHG phase. 10. To each negative tube, add one drop of Coombs Cells (Check Cells). Mix, spin read and rec'd agglutin
Why is it important to check the patient's transfusion record in pretransfusion testing?	to detect the possibility of any antibodies the patients serum may have from previous blood they received, to ensure compatibility
1. What information must be included on the label of a patient's blood bank specimen? 2. At what point in the collection procedure is the patient's specimen labeled?	1. patients names, ID number, date, time collected, my initials 2. after collected and before leaving the patient
Transfusion Therapy quiz
Which blood component's main purpose is to restore an individuals oxygen-carrying capacity, keeping organs and tissues oxygenated and healthy?	RBC's
What type of blood components are given to patients who are diagnosed with thrombocytopenia?	platelets
Why is fresh frozen plasma (FFP) usually transfused to patients?	To help stop the bleeding in patients with coagulopathies; such as DIC or massive blood trauma injuries
Cryoprecipitated antihemophilic factor implies the component contains which clotting factor to treat the bleeding disorder Hemophilia A?	VIII
What are blood components that have the majority of WBCs removed called?	leuko reduced RBC's
Why are leuko-reduced blood products usually administered to patients?	To reduce the chances of febrile transfusion reactions.
Irradiated blood components are usually indicated to prevent what disease in a patient?	GVHD (graft vs. host diesase)
Neonatal and pediatric patients receiving exchange transfusion should receive blood that is less than how many days old?	<5 days old
Donation of a unit of one's own blood is known as what type of donation?	autologous
Briefly define massive transfusion.	Transfusion of 10 or more units of blood to a patient within a 24-hour period.
For what clinical condition is an intrauterine transfusion correcting?	anemia
How many donors are involved in platelets prepared by plateletpheresis?	one
One vial of Rh immune globulin (RhIg) will neutralize the anti-D present in how much RBCs or whole blood?	15 mls of RBCs or 30 mls of whole blood
What whole blood component contained in a granulocyte concentrate warrants crossmatching of this product? white blood cells red blood cells platelets plasma	RBC's
Which of the following Rh-negative patients may permit transfusion of Rh-positive units when few O-negative units are available in an emergency? pregnant woman middle-aged male 25-year-old female newborn baby	middle-aged male
Leukopoor filters reduce the risk of ___________. hepatitis B Epstein-Barr virus (EBV) HIV cytomegalovirus (CMV)	cytomegalovirus (CMV)
Which intravenous solution is not recommended for dilution of blood components because of red cell damage? dextrose 0.9% saline 5% albumin plasma	Dextrose
A patient with paroxysmal cold hemoglobinuria (PCH) would require _________________ in the event of a blood transfusion. I-negative blood irradiated RBCs a blood warmer a leukopoor filter	a blood warmer
Adverse Effects of Blood Transfusion Quiz
This type of transfusion reaction can occur anywhere from 3-7 days after administration of blood or blood products: allergic delayed hemolytic immediate hemolytic febrile nonhemolytic	Delayed hemolytic
This type of transfusion reaction is described as a 1oC or more rise in temperature: allergic delayed hemolytic immediate hemolytic febrile nonhemolytic	Febrile nonhemolytic
This type of transfusion reaction usually results from a patient having an anti-IgA antibody: transfusion-associated graft-vs.-host disease anaphylactic hemolytic allergic	anaphlylactic
Which of the following is considered a nonimmune type of transfusion reaction? bacterial anaphylactic hemolytic allergic	bacterial
This type of transfusion reaction results from the transfusion of ABO incompatible blood: bacterial anaphylactic hemolytic allergic	hemolytic
All of the following diseases can be transmitted through the transfusion of blood or blood products, except: HIV Hepatitis Syphilis Measles	measles
The first step of the initial transfusion reaction investigation involves: a repeat of the ABO/Rh type a repeat of the antibody screen a repeat of the crossmatch a clerical check	a clerical check
True or false: Febrile nonhemolytic transfusion reactions are the only ones in which the patient has a fever.	false
What is the most frequent cause of circulatory overload? transfusion of a unit at too slow a rate massive transfusion of blood components transfusion of a unit at too fast a rate transfusion of a unit partially deglycerolized	transfusion of a unit at too fast a rate
A patient requires the transfusion of 2 units of RBCs. The patient has a history of severe febrile nonhemolytic transfusion reactions during RBC transfusion. What would be the most effective way to prevent the reaction?	administering the RBC's as leuko-reduced RBC's
When a suspected hemolytic transfusion reaction occurs, the first thing that must be done is what? slow transfusion rate call/the attending physician, administer medication to stop the transfusion reaction, stop the transfusion, begin clerical check	stop the transfusion
Which of the following is consistent with bacterial contamination reactions? Organism is a fastidious anaerobe. Organism thrives in warm temperatures. Organism thrives in cold temperatures. Organism exhibits motility.	Organism thrives in warm temps
The organism that causes syphilis: Plasmodium spp. Treponema pallidum Epstein-Barr virus Parvovirus B19	Treponema pallidum
The best way in which to prevent transfusion-associated GVHD is: use leuko-reduced blood and blood products premedicate the patient use irradiated blood and blood products give only type specific blood and blood products	use irradiated blood and blood products
Which transfusion reaction is char'zd by leukocytes aggregating in lung tissue, leading to respiratory distress? transfusion-associated acute lung injury, transfusion-associated circulatory overload, transfusion-assoc. GVHD, post-transfusion purpura	Transfusion-associated acute lung injury
What is the pathophysiologic mechanism of a febrile nonhemolytic transfusion reaction?	HLA antibody in patient plasma that is directed against antigens present on donor WBC's
Which of the following transfusion reactions is characterized by a rapid onset of thrombocytopenia due to anamnestic production of platelet antibody? transfusion related graft-versus-host disease urticarial anaphylactic post-transfusion purpur	post-transfusion purpura
What is a common finding in a delayed hemolytic transfusion reaction? desseminated intravascular coagulation (DIC) jaundice renal failure hypotension	jaundice
All of the following can be implicated in a physically or chemically induced transfusion reaction, except: bacterial contamination of donor unit, heat damage from blood warmer, mech damage by roller pumps in bld pump, donor RBCs frozen during shipping	bacterial contamination of donor unit
Donor testing is available for all of the following transfusion-transmitted diseases, except: Hepatitis B, Hepatitis C, HTLV-I, Malaria	Malaria
Immediate transfusion reaction procedures consist of all of the following, except: clerical check, serum bilirubin on post-transfusion tube, direct antiglobulin test on post-transfusion EDTA tube, visual check for hemolysis on post-transfusion EDTA tube	Serum bilirubin on post transfusion clot tube (EDTA)
Knowing what you do about the cause of immediate hemolytic transfuson reactions, which antibodies is MOST likely to be responsible for one? anti-Le(a), anti-M, anti-D, anti-A	anti-A....is associated with the ABO blood group typing. ABO incompatibility is usally the cause of an immediate hemolytic transfusion reaction
Hemolytic Disease of the Newborn Quiz
List the three possible types of HDN.	ABO HDN, Rh HDN, & Other (IgG) HDN
All of the following are necessary for HDN to occur, except: mother exposed to foreign antigen, exposure of mother must result in immunization, antibody formed in response to antigen must be able to cross placenta, fetus must develop the antibody	fetus must develop the antibody
For an antibody to cause HDN, it must be of which immunoglobulin class?	IgG becuz it must cross the placenta
Rh immune globulin (RhIg) is effective in prevention of HDN due to which of the following antibodies? anti-C anti-K anti-D all of the above	anti-D
The direct antiglobulin test (DAT) detects what type of sensitization of the RBCs?	in vivo
A single full dose of RhIg (RhoGam) will protect against a fetal-maternal hemorrhage equivalent to: 10 ml of whole blood 15 ml of whole blood 30 ml of whole blood 50 ml of whole blood	30 ml of whole blood
Kernicterus and jaundice are evidenced by what routine chemistry test?	Bilirubin
Any blood group system capable of producing what type of immunoglobulins has the potential to cause HDN?	IgG immunoglobulins, because these immunoglobulins can cross the placenta
What is the term used for RhIg administered at 28 weeks gestation?	antenatal administration
When a woman receives RhIg (RhoGam) during pregnancy, testing of her serum postpartum may exhibit anti-D reactivity. This reactivity is known as: passive anti-D active anti-D immune response anti-D none of the above	passive anti-D
What is the name of the semi-quantitative test used to detect fetal-maternal hemorrhge (FMH)? Kleihauer-Betke test fetal bleed screen antibody titer none of the above	fetal blood screen
Blood for an exchange transfusion of an infant should meet all of the following requirements:	blood should be anti-CMV negative, should be irradiated to prevent GVHD, and should be 5-7 days old
For protection against miscarriage or abortion, a microdose of RhIg can be administered up until how many weeks of gestation?	12 weeks of gestation
Why is reverse ABO blood typing omitted on cord blood samples?	Reverse ABO blood typing is omitted on cord blood samples because the baby's immune system is immature. The antibodies that would be detected if a reverse ABO blood typing werre to be done would be maternal antibodies.
Why should cord blood samples be washed with saline a minimum of 6-8 times?	Wharton's jelly (a proteinous substance) can interfere with testing if not completely removed. This substance is used during delivery.
What are the three phases of the indirect antiglobulin test (IAT)?	1. room temperature, immediate spin 2. 37C incubation with enhancement 3. AHG
Explain how HDN occurs. (Be specific)	Maternal IgG antibody crosses the placenta and attacks the corresponding antigen that the fetus possesses. This causes hemolysis of fetal RBCs = anemia. Hemolysis also releases bilirubin = jaundice.
A positive DAT on a cord blood sample indicates what?	RBCs have been sensitized--(something is coating the RBCs)
If a clinically significant antibody is found during routine screening of an expectant mother, what additional testing must be performed? Why?	antibody titering. The strength of the IgG antibody must be monitored throughout the pregnancy to ensure the safety of the fetus. A rise in antibody titer, could imply a troubled pregnancy.
Autoimmune Hemolytic Anemias Quiz
Generally, through which blood bank procedure are autoimmune hemolytic anemias detected?	DAT
What is extravascular hemolysis?	Breakdown of RBCs outside the blood vessels
The type of autoantibody that normally causes warm AIHA is of what immunoglobulin class?	IgG
What does DAT stand for?	Direct Antiglobulin Test
What is the purpose of an elution?	Elution is to disassociate the antibody from the RBC to id the antibody for id'ing
How does complement cause hemolyis of RBCs?	causes IgG or IgM to fix to the RBC which will cause the blood cell to hemolyze
The autoantibody often known as the Donath-Landsteiner antibody is:	auto anti-P
All of the following are considered a category of drug-induced hemolytic anemia, except: membrane modification immune complex syndrome IgM autoantibody activation drug adsorption	IgM autoantibody activation
Autoantibodies implicated in warm AIHA appear to have specificity towards which major blood group?	Rh blood group system
This type of drug-induced hemolytic anemia forms a complex before attaching to the RBC membrane and causing hemolysis:	immune complex syndrome
The autoantibody implicatd in paroxysmal cold hemoglobinuria (PCH) is a/an:	cold reacting IgG antibody
DAT testing should be preformed on EDTA specimens. Why?	anticoagulants like EDTA prevent in vitro activation of complement, therefore any positive DAT with this type of specimen, it can be assumed that the sensitization of the RBCs took place within the body, not the EDTA tube
Why can't adsorptions be performed on an individual who has been transfused within the last 3 months? Be specific.	If an individual has been transfused within the last 3-4 months, specific alloantibodies could possibly be removed from the serum if the donor RBCs in the patient's circulation contain the corresponding antigen.
What is the purpose of the prewarming technique?	to prevent cold antibodies from attaching to the RBCs
What is an autoimmune hemolytic anemia (AIHA)?	this is a condition where an individual has developed an antibody against an antigen found on their own RBCs. This antigen-antibody complex causes hemolysis, and the hemolysis causes anemia.
In cold hemagglutinin disease, describe the mechanism of the cold autoantobody. Be specific.	IgM antoantibody agglutinates the RBC's and activates circulating RBC's to the areas like hands and feet that aren't as warm. The complement will then hemolysis causing intravascular hemolysis
Why is warm AIHA considerd more serious than cold AIHA?	warm AIHA reacts at body temperatures, cold AIHA does not
Characteristics of benign cold autoantibodies (3)	1.autoantibodies react best with ficin-treated cells 2. autoantibodies are of the IgM class and autoantibodies can activated complement in vitro
How can cold autoantibody interference with ABO grouping be avoided?	wash cells with normal saline warmed to 37C
Polyspecific antihuman globulin contains what two components?	anti-IgG and anti-C3d (anti-complement)
DATs are used in the all of the following situations, except: HDN investigation weak D procedure investigation of drug-induced immune hemolytic anemia transfusion reaction investigation	weak D procedure
A positive DAT was obtained on an EDTA specimen from a patient who received a transfusion 11 months ago. The following results were obtained: Polyspecific AHG: positive Monospecific anti-IgG: positive Can an eluate can be performed on this specimen?	An eluate can be performed on an EDTA sample with a positive DAT due to IgG coating the RBCs, but not if only complement is detected.

BBank II

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