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Blood Banking 1
Practice for first Blood Banking test DelTech Owens
| Question | Answer |
|---|---|
| Who decided on the donor criteria in the Code of Federal Regulations? | Food and Drug Administration (FDA) |
| The donor history questionnaire was written to meet FDA requirements by the ? | AABB (American Association of Blood Banks) |
| What is the minimal amount of time you are allowed to wait between donations? | 56 days |
| What parties are protected by the questions and deferral policy during the donation screening process? | the donor and the recipient |
| What is the acceptable minimal limit for a patient's appearance? | in good health |
| To donate blood, a patient's hemoglobin must equal to or above ? | 12.5 g/dL (125 g/L)) |
| To donate blood, a patient's hematocrit must be equal to or above ? | 38% |
| To donate blood, a patient's blood pressure must be within ? | normal limits (probably less than 120/80) |
| To donate blood, a patient's body temp must be at or below ? | 37.5C or 99.5F |
| To donate blood, a patient's body weight can be no lower than ? | 100lbs (45kg) |
| If a donor weighs less than 110lbs, the amount of blood taken for donation must be adjusted. How is the adjustment made? | Maximum donation is 10.5 mL of blood per kg of donor weight. |
| What is the acceptable age for a donor to make a donation without parental consent? | 16 years old or per state law (18 in Delaware) |
| The bags, tubes, and registrations form used during a blood donation must all be __ and kept together. | labeled |
| The site of blood draw must be cleaned with __ aqueous iodophor solution followed by __ povidone-iodine. | .7% and 10% |
| What gauge of needle is used? | 16 (or 18) |
| If a donor experiences weakness, sweating, dizziness, pallor, nausea, or vomiting during a blood donation or blood draw, what should you do? | Remove needle and tourniquet. Elevate legs above head. Apply cold compresses to forehead and back of neck. |
| If a blood donor faints (syncope) what should you do to help them? | Put cold compresses on back of neck. |
| If a blood donor experiences twitching or muscle spasm, what should you tell them to do? | cough |
| If a blood donor gets a bruise (hematoma) from the procedure, what can you do to minimize the bruising? | Apply pressure for 7-10 mins, apply ice to area for 5 mins. Prof recommends having them hold up their arm while you press down on the area. |
| If a blood donor has convulsions, what should you do? | Call for help. Prevent donor from falling out of chair or injuring himself. Ensure donor can breath and has adequate airway. |
| If a blood donor has cardiac difficulties during a donation, you should begin ? | cardiopulmonary resuscitation. Call for help. |
| What 2 things should donors avoid after finishing their blood donation? | smoking or drinking |
| Donations for the general population are called ? | allogeneic donations |
| Donations for personal use are called ? | autologous donations |
| Donations made for a specific recipeint other than the donor are called ? | directed donations |
| When blood is drawn and stored before the date of an operation for the donor, this is what kind of autologous donation? | preoperative |
| Removing units at the beginning of surgery and reinfusing them at the end of surgery is what kind of autologous donation? | normovolemic |
| When a medical device is used to wash, filter, and concentrate blood during an operation, this is what kind of autologous donation? | blood recovery |
| When is it OK to accept a donation from a donor with a high-risk (deferral) condition? | preoperative autologous donation |
| When making a preoperative autologous donation, the patient's hemoglobin must be at least ? | 11 g/dL |
| When making a preoperative autologous donation, the patient's hematocrit must be at least ? | 33% |
| A patient making a preoperative autologous donation can donate UP TO how many hours before the actual surgery? | 72 |
| True or false: Directed donations are safer than allogeneic donations? | false |
| Directed donors must meet the __ donation criteria as allogeneic donors. | same |
| The 56 day interval between donations can be waived with the approval of the ? | medical director |
| When a donor's blood components are separated and the remaining blood is returned to the donor, this is known as ? | apheresis |
| When a donor's white blood cells are removed and the rest of his blood is returned, this is known as ? | leukapheresis |
| When a donor's platelets are removed during plateletpheresis, donations must be made at least __ hours apart and no more than how many times a week? | 48 hours apart, no more than twice per week |
| Before a donor can undergo plateletpheresis, his platelet count must be at least ? | 150,000/uL |
| Infrequent plasmapheresis must be done no more than ? | once every 4 weeks |
| During frequent plasmapheresis (where donations are made less than every 4 weeks) what levels must be monitored? | Immunoglobulin G and M |
| If height and weight requirements are met, how many units of RBCs may be donated during red cell apheresis? | 2 |
| How long is a patient to be deferred after RBC apheresis? | 16 weeks |
| Donor tests can be divided into what 2 categories? | 1. Immunohematologic testing (ABO and D/Rh testing) 2. Infectious disease screening |
| When testing blood for the presence of hepatitis, we are looking for what 4 things? | 1. HBsAG antigen 2. Anti-HCV antibodies 3. Anti-HBc antibodies 4. HCV NAT/nucleic acid testing |
| When testing blood for the presence of HIV-1/2, we are looking for what 2 things? | 1. anti-HIV-1/2 antibodies 2. HIV NAT |
| When testing blood for a cancer causing retro virus, we are looking for ? | antibodies to the human T-lymphotropic virus type 1/2 (HTLV-I/II) |
| When testing for Chagas disease (Trypanosoma cruzi) we are looking for what in the blood? | IgG antibody to T. cruzi |
| To determine the ABO and D phenotype, red cells are tested with reagent ? | anti-A and anti-B |
| D typing (for Rh) for donors involves testing with anti-D. If the test is negative, what additional test is performed? | weak D |
| Antibody screening tests for antibodies other than A or B. Who MUST undergo this test before donating? | Those exposed to transfusions or who have been pregnant |
| If clinically significant antibodies are found in a donor's blood after antibody screening, what blood components cannot be used? Which can be used? | 1. plasma and platelets cannot be used 2. RBCs can be used so long as they are the correct ABO type |
| Syphilis is caused by ? | Treponema pallidum |
| What is the screening test for reagin in serum that detects syphilis? | Rapid plasma reagin (RPR) (NOTE: it can create false positives.) |
| The term "reagin" means that this test does not look for antibodies against the actual bacterium, but rather for antibodies against substances ? | released by cells when they are damaged by T. pallidum. |
| The RBCs used during the hemagglutination test for T. pallidum/syphilis come from where? | chickens |
| The RPR and hemagglutination tests for syphilis can be confirmed with what test? | Fluorescent treponemal antibody adsorption test |
| An enzyme-linked immunosorbent assay (EIA) detects what using what? | Detects antigens to antibodies using a solid object, like a plastic bead, coated with antigens or antibodies to the thing being tested for. |
| An indirect EIA detects __, while a sandwich EIA detects __. | indirect=antibodies, sandwich=antigens |
| The conjugate in an EIA test is an __ labeled antibody or antigen. | enzyme (usually horseradish peroxidase) |
| The substrate used during an EIA test is the ? | color developer, usually o-phenylenediamine |
| NAT (nucleic acid testing) amplifies nucleic acids of __ __ and identifies viral RNA. | infectious agents |
| NAT can detect low numbers of viral copies in plasma even before what appears? | antibodies to the virus |
| 3 RNA viruses often tested for using NAT are ? | 1. HIV 2. Hepatitis C virus 3. West Nile |
| What do we call the emission of light from a chemical reaction that is often used in tests? | chemiluminescence |
| Chemiluminescent __ are attached to an antigen or antibody where the highest light intensity emitted is measured. | labels |
| What kinds of hepatitis can be transmitted through blood transfusions? | B, C, D |
| What does HBsAg stand for? | Hepatitis B surface antigen |
| What does anti-HBc stand for? | Antibody to hepatitis B core antibody |
| What is HBsAG (heptatitis B surface antigen)? | a protein on the surface of the hepatitis B virus |
| The anti-HBc (antibody to hepatitis B core antibody) appears after HBsAG but before ? | symptoms |
| When is the antibody to HCV (hepatitis C virus) detectable? | 10 weeks after infection |
| A retrovirus contains reverse __, which allows the virus to convert RNA to DNA and then integrate the DNA into the cell. | transcriptase |
| Name 3 subfamilies of human retroviruses. | 1. Lentivirus (HIV 1/2) 2. Oncovirus (HTLV 1/2/4) 3. Spumavirus (not a human disease) |
| HIV 1/2 causes AIDS by infecting what? | CD4+ T lymphocytes (T helper cells) |
| An antibody to HIV 1/2 develops how long after an infection? | 22-25 days |
| A NAT test for which kind of HIV is required on all blood donated? | HIV 1 |
| Donated blood is tested for HTLV-I (human T-lymphotropic virus type 1) because it is associated with with what? | adult T-cell leukemia |
| Donated blood is tested for HTLV-II (human T-lymphotropic virus type 2) because it is associated with what? | large granular lymphocyte leukemia |
| What kind of test is confirmatory for the antibody to HIV 1/2 and HTLV 1/2? | Western Blot Test |
| During the Western Blot Test, antibodies in the serum are tested for a reaction with individual __ __ on strips containing antigens to the antibodies. | protein bands |
| Two out of 3 specific bands must be positive on the Western Blot Test for the patient to be positive for HIV or HTLV. Name the 3 bands. | 1. p24 2. gp41 3. gp120/160 |
| Donors are screened for West Nile Virus using ? | NAT |
| Look-back investigations must be performed when a donor is found positive for what diseases? | 1. hepatitis 2. HIV 3. HTLV 4. WNV |
| What mononucleosis-like virus is also tested on donate blood? | cytomegalovirus |
| CMV-negative blood is given to __ or anyone who is __. | infants, immunocompromised |
| Chagas disease is caused by Trypanosoma cruzi and transmitted by the ? | reduviid bug |
| Blood collection facilities in areas with many __ immigrants perform EIA test on donated blood for chagas disease. | latino |
| Apheresis platelets and platelet concentrates must be tested for __ contamination. | bacterial |
| Donated blood is collected in a primary bag containing __ and __. | anticoagulants and preservatives |
| The blood collection set is sterile and considered a __ system. | closed |
| If ports in the blood collection set are exposed to __, it is considered an open system. | air |
| Donated blood stored in a closed system is usually good for about how long? | 42 days |
| Donated blood stored in an open system is good for about how long? | 24 hours |
| Blood stored using citrate-phosphate-dextrose (CPD) is good for how long? | 21 days |
| Blood stored using citrate-phosphate-2-dextrose (CP2D) is good for how long? | 21 days |
| Blood stored using citrate-phosphate-dextrose-adenine (CPDA-1) is good for how long? | 35 days |
| To get donated blood to last a full 42 days, a solution must be added within how many hours? | 72 |
| How long do RBCs live in your body? | about 120 days |
| What blood component is expelled into a satellite bag when blood is centrifuged at a light (slow) spin? | platelet-rich plasma (PRP) |
| During a light spin, an additive solution is added to RBCs followed by an optional __ filtration process. | leukoreduction |
| When platelet rich plasma (PRP) is centrifuged at a heavy (faster) spin, platelets are separated from plasma. The plasma can then be further processed as ? | fresh frozen plasma (FFP) |
| Fresh frozen plasma (FFP) can be processed into ? | cryoprecipitate |
| The minimum quality control requirements for RBC blood components is a hematocrit of at least __ and storage in __ units. | 80% hematocrit, CPDA-1 units (lasting 35 days or 42 with further additives) |
| RBCs must be stored at what temperature and shipped at what temperature? | stored: 1-6C shipped: 1-10C |
| Frozen RBCs must be stored at what temperature and expire after how long? | Stored: -65C or less Expire after: 10 years |
| Sometimes donated blood is irradiated to prevent __ especially in immunocompromised patients. | graft VS host disease |
| Irradiated RBCs must be stored at what temp and expire how long after irradiation? | Stored: 1-6C Expire: 28 days or at original expiration date (whichever comes first) |
| Leukoreduced blood must be stored at what temp? Expiration time is the same as whole blood depending on anticoagulant and preservative. | 1-6C |
| Donated platelets must be stored at what temp and expire after how long? | Stored: 20-24C Expire: 5 days |
| How long can fresh frozen plasma remain viable when stored at -18C? What if stored at -65C? | -18C: 1 year -65C: 7 years |
| Whole blood, which contains ALL blood components, is only given to patients under what 2 conditions? | 1. actively bleeding due to massive trauma 2. undergoing exchange transfusion |
| A whole blood or RBC transfusion will increase the recipient's hemoglobin by what? | 1 g/dL |
| A transfusion of one unit of whole blood or RBCs will increase the recipient's hematocrit by ? | 3% |
| Whole blood transfusions must by __ identical and __. | ABO identical and crossmatched |
| 1 unit of blood is about __ mLs. | 450-500 |
| Patients undergoing chemotherapy or irradiation treatment would be given what kind of transfusion? | RBC components |
| Reactions to leukocytes in blood can cause what 3 symptoms? | 1. fever 2. shaking 3. chills |
| __ produced by leukocytes can cause febrile reactions. | Cytokines |
| Trauma victims would receive which kind of blood transfusion? | RBC components |
| Patients undergoing cardiac, orthopedic, or other surgeries would receive what kind of blood transfusion? | RBC components |
| An __ filter removes most leukocytes before storage. | in-line |
| Patient's with end stage renal disease would receive which kind of blood transfusion? | RBC components |
| Leukoreduction removes what kind of virus which resides in WBCs? | cytomegalovirus (CMV) |
| True or false: Removal of WBCs does NOT prevent GVH disease? | True |
| Premature infants in need of blood would receive which kind of blood transfusion? | RBC components |
| Patients with sickle cell would receive which kind of blood transfusion? | RBC componenets |
| After filtration, the final unit of donated blood must contain less than how many WBCs? | 5x10^6 (5,000,000) |
| You may donate 1 unit of apheresis RBCs ever __ weeks. 2 units are allowed over twice that length of time. | 8 |
| What replaces the lost fluid in the donor after RBC apheresis takes place? | saline |
| After collection, donated apheresis RBCs must have a hemoglobin of __g and a minimum volume of __mL. | 51g, 153mL |
| RBCs frozen with the high-glycerol method should have a concentration of glycerol at what percent? | 40% |
| RBCs frozen with the low-glycerol method should have a glyercol concentration of what percent? | 20% |
| RBCs frozen with the high-glycerol method should be frozen at what temp? | between -65C and -80C |
| RBCs frozen with the low-glycerol method should be frozen at what temp? | -196C |
| RBCs frozen with the high-glycerol method should be stored at what temp? | -65C |
| RBCs frozen with the low-glyercol method should be stored at what temp? | -120C max |
| Both low and high-glycerold frozen RBCs can stored for how long? | 10 years |
| Which is the more common method of freezing RBCs: low-glyercol or high-glycerol? | high-glycerol is more commonly used |
| After thawing, a unit of frozen RBCs is washed with what to remove the glycerol? | saline solutions |
| Frozen RBCs are stored in what kind of system? | open system |
| Once washed, RBCs must be within how long? | 24 hours |
| Washing with normal saline may remove __ __ that cause allergic, febrile, or anaphylactic reactions. | plasma proteins |
| Irradiating RBCs prevents transfusion-related __ disease. | graft VS host (GVH) disease |
| Graft versus host disease is a reaction toward __ on T cells. | HLAs (human leukocyte antigens) |
| Donated RBCs and platelets must be irradiated in what 3 circumstances? | 1. donation is from a blood relative 2. unit is HLA matched 3. patient immunocompromised |
| Irradiated RBCs expire after how many days? | 28 |
| Platelets maintain vascular integrity and stabilize platelet plugs by contributing to __ formation. | fibrin |
| Platelet concentration should contain at least ? | 5.5 x 1010 (5555) platelets |
| One unit of platelets increases the platelet count by how many uL? | 5000 to 10,000 |
| Pooled platelets are an open system that expires after how many hours? | 4 |
| Each unit of apheresis platelets must contain at least how many platelets? | 3 x 1011 (3033) |
| Leukoreduced platelets prevent febrile reactions and __ alloimmunization. | HLA |
| Fresh frozen plasma and plasma frozen within 24 hours all coagulation factors. But PF24 may have less factor ? | VIII or 8 |
| FFP and PF24 may be given to patients in needs of what coag factors when concentrates are not available? | II, V, X, XI |
| FFP and PF24 may be given to patients taking __ who are bleeding. | warfarin |
| FFP and PF24 may be given to patients with __ disease and factor deficiencies. | liver |
| FFP and PF24 maybe be given to patients with what potentially fatal coagulation disorder when fibrinogen is less than 100mg/dL? | DIC |
| FFP and PF24 will thaw in how many mins? | 30-45 |
| FFP and PF24 must be transfused within how long? | 24 hours |
| If FFP and PF24 are not transfused within 24 hours of thawing, they must be relabeled at "thawed plasma" and can be stored up to 5 days if kept at what temp? | 1C-6C |
| Thawed plasma CANNOT be used to replace what factor? | VIII or 8 |
| How many mL/kh of FFP or PF24 is given for factor replacement? | 10-20 mL/kg |
| What do we call the cold precipitate that forms when FFP is thawed between 1C and 6C? | CRYO (cryoprecipitated antihemophilic factor) |
| CRYO (cryoprecipitated antihemophilic factor) is refrozen within 1 hour or preparation and stored at what temp for up to 1 year? | -18C |
| CRYO (cryoprecipitated antihemophilic factor) must have __ mg of fibrinogen and __ international units of factor VIII per unit. | 150 mg fibrinogen, 80 IU of factor VIII |
| What 5 things can be found in CRYO (cryoprecipitated antihemophilic factor)? | 1. VWF 2. Fibrinogen 3. factor VIII 4. fibronectin 5. factor XIII |
| CRYO is a secondary treatment for __ and __ disease. | hemophilia A and von Willebrand's disease |
| The plasma left over after removing CRYO is called ? | CRYO-reduced plasma |
| CRYO-reduced plasma can be removed with __ hours of removing CRYO. | 24 hours |
| Once thawed, CRYO (cryoprecipitated antihemophilic factor) can be stored at what temp for up to how many days? | 1-6C, 5 days |
| TTP (thrombotic thrombocytopenia purpura) can be treated with ? | CRYO (cryoprecipitated antihemophilic factor) |
| Pooled CRYO is kept at room temp and administered within 4 hours, unless it is stored in a closed system. Then it can be given every __ hours. | 6 |
| CRYO is mixed with __ to control surface bleeding after surgery. | thrombin |
| Apheresis granulocytes contain leukocytes and ? | platelets (plus some RBCs) |
| Apheresis granulocytes should be stored, without agitation, at what temp for 24 hours? | 20D-24C |
| Apheresis granulocytes must be __ before use. | irradiated |
| How should autologous units of donated blood be labeled? | "for autolgous use only" - duh |
| Pooled blood components must have the final __ listed and the name of the facility preparing the pool on them. | volume |
| Irradiated blood components must have the name of the __ performing the irradiation. | facility |
| Stored blood should be examined for __ and abnormal color or clots. | hemolysis |
| Whole blood or RBCs should be kept at what tempt when transported? | 1C-10C |
| Frozen units of blood are shipped on ? | dry ice |
| When transported, platelets are kept at what temp? | 20C-24C |
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IsaacJ
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