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BOC BLOODBANK #2
MLT BOC BLOODBANK #2
| Question | Answer |
|---|---|
| 187) A mother is Rh neg. and the father is Rh pos. their baby is Rh neg. It may be concluded that: a. the father is homozygous for D b. the mother is heterozygous for D c. the father is heterozygous for D d. at least 1 of the 3 Rh typings must be inco | c. the father is heterozygous for D |
| 188) Some blood group antibodies characteristically hemolyze appropriate red cells in the presence of: a. complement b. anticoagulants c. preservatives d. penicillin | a. complement a (Some blood group antibodies, in the presence of their corresponding antigen and complement, activate the complement cascade and demonstrate in-vitro hemolysis.) |
| 189) Review the following schematic diagram: patient serum + reagent group O cells --> incubate --> read for agglutination --> wash --> add AHG --> agglutination observed --> ? The next step would be: | a. add check cells as a confirmatory measure ***b. identify the cause of the agglutination c. perform an elution technique d. perform a DAT |
| 190) The following results were obtained in pre-transfusion testing: screen cell 1: @37 C = 0 | @IAT = 3+ screen cell 2: @37 C = 0 | @IAT = 3+ autocontrol: @37 C = 0 | @IAT = 3+ | b. a warm autoantibody b (Presence of agglutination at AHG phase with both screening cells and autocontrol is indicative of warm autoantibody.) |
| 191) A patient is typed as group O, Rh pos. and crossmatched with 6 units of blood. At the IAT phase of testing, both antibody screening cells and 2 crossmatched units are incompatible. What is the most likely cause of the incompatibility? | ***a. recipient alloantibody b. recipient autoantibody c. donors have pos. DAT's d. rouleaux The presence of an autoantibody would most likely react with all cells, including the autologous control or DAT.) |
| 193) a patient received 2 units of RBCs and had a delayed transfusion reaction. Pretransfusion antibody screening records indicate no agglutination except after the addition of IgG sensitized cells. Repeat testing of the pretransfusion specimen detected a | a. red cell were overwashed b. centrifuge time was prolonged ***c. patient's serum was omitted from the original test d. antiglobulin reagent was neutralized |
| 194) At the indirect antiglobulin phase of testing there is no agglutination between patient serum and screening cells. One of 3 donor units was incompatible. The most probable explanation for these findings is that the: | a. patient has an antibody directed against a high incidence antigen ***b. patient has an antibody directed against a low incidence antigen c. donor has an antibody directed against donor cells d. donor has a positive antibody screen |
| 195) The major crossmatch will detect a (an): a. group A patient mistyped as a group O b. unexpected red cell antibody in the donor unit c. Rh-neg donor unit mislabeled as Rh-pos d. recipient antibody directed against antigens on the donor red cells | d. recipient antibody directed against antigens on the donor red cells |
| 197) Which of the following would most likely be responsible for an incompatible antiglobulin crossmatch? | a recipients red cells possess a low frequency antigen b. anti-K antibody in donor serum c. recipients red cells are polyagglutinable ***d. donor red cells have a positive DAT |
| 198) A reason why a patient's crossmatch may be incompatible while the antibody screen is negative is: a. the patient has an antibody against a high incidence antigen b. the incompatible donor unit has a positive DAT | b. the incompatible donor unit has a positive DAT b ( the incompatibility is either due to donor cells with a positive DAT or the patient has an antibody to a low-incidence antigen that the donor's cells possess.) |
| 199) A blood specimen types as A, Rh-pos with a negative antibody screen. 6 units of group A, Rh-pos RBCs were crossmatched and 1 unit was incompatible in the antiglobulin phase. The same result was obtained when the test was repeated. | a. repeat the ABO grouping on the incompatible unit using a more sensitive technique b. test a panel of red cells that possesses low incidence antigens ***c. perform a DAT on the donor unit d. obtain a new specimen and repeat the crossmatch |
| 200) During emergency situations when there is no time to determine ABO group and Rh type on a current sample for transfusion, the patient is known to be A, Rh-neg. the technologist should: | c. release O Rh-neg RBC's c (Emergency release of blood cannot use previous records. Blood typing must be performed on the current sample. In this case, group O Rh-negative is the best choice since there is evidence the patient is Rh-negative.) |
| 201) A 29 year old male is hemorrhaging severely. He is AB, Rh-neg. 6 units of blood are required STAT. Of the following types available in the blood bank, which would be most preferable for crossmatch? | a. AB, Rh-pos ***b. A, Rh-neg c. A, Rh-pos d. O, Rh-neg |
| 202) A patient is group A2B, Rh-pos and has an antiglobulin reacting anti-A1 in his serum. He is in the operating room bleeding profusely and group A2B RBCs are not available. Which of the following blood types is first choice for crossmatching? | a. B, Rh-pos |
| 203) A 10% red cell suspension in saline is used in a compatibility test. Which of the following would most likely occur? | d. a false-negative result due to antigen excess |
| 205) A patient received 4 units of blood 2 years previously and now has multiple antibodies. He has not been transfused since that time. It would be most helpful to: | a. phenotype his cells to determine which additional alloantibodies may be produced |
| 206) Autoantibodies demonstrating blood group specificity in warm autoimmune hemolytic anemia are associated more often with which blood group system. a. Rh b. I c. P d. Duffy | a. Rh a (Warm autoantibodies often exhibit Rh specificity.) |
| 207) An antibody that causes in-vitro hemolysis and reacts with the red cells of 3 out of 10 crossmatched donor units is most likely: a. anti-Lea b. anti-s c. anti-k d. anti-E | a. anti-Lea a (Lewis antibodies may bind complement and fresh serum that contains anti-Lea may hemolyze Le[a+] red cells in vitro. Approximately 22% of the population is Le[a+].) |
| 212) In the process of identifying an antibody, the technologist observed 2+ reactions with 3 out of the 10 cells in a panel after the immediate spin phase. There was no reactivity after incubation at 37 C and after the anti-human globulin test phase. | b. anti-Lea b (Lewis antibodies are usually IgM and agglutinate saline suspended cells. Approximately 22% of the population is Le[a+], which would account for 3 out of 10 donor units being incompatible. |
| 213) Transfusion of Ch+ (Chido-positive) red cells to a patient with anti-Ch has been reported to cause: a. no clinically significant red cell destruction b. clinically significant immune red cell destruction c. decreased 51Cr red cell survivals d. fe | a. no clinically significant red cell destruction (Chido antibodies are considered clinically insignificant) |
| 217) Which characteristics are true of all 3 of the following antibodies: anti-Fya, anti-Jka and anti-K? | a. detected at IAT phase and may cause HDFN and transfusion reactions (All 3 antibodies can cause HDFN and delayed transfusion reactions. Anti-Jka is associated with showing dosage.) |
| 220) Which of the following tests is most commonly used to detect antibodies attached to a patient's red blood cells in-vivo? a. DAT b. complement fixation c. IAT d. immunofluorescence | a. DAT a ( The direct antiglobulin test [DAT] is used to identify red blood cells that have been coated with antibody in vivo. |
| 223) In DAT and IAT tests, false-negative reactions may result if the: | . addition of AHG is delayed for 40 minutes or more after washing the serum/cell mixture. (After washing cells for the DAT or IAT procedure, the AHG should be added immediately and read. Delay can cause a weakened or negative result due to dissociation o |
| 224) Polyspecific reagents used in the DAT test should have specificity for: a. IgG and IgA b. IgG and C3d c. IgM and IgA d. IgM and C3d | b. IgG and C3d |
| 225) In the direct antiglobulin test, the antiglobulin reagent is used to: d. detect preexisting antibodies on erythrocytes | d. detect preexisting antibodies on erythrocytes |
| 226) AHG control cells: a. can be used as a positive control for anti-C3d reagents b. can be used only for the IAT c. are coated only with IgG antibody d. must be used to confirm all positive antiglobulin reactions | . are coated only with IgG antibody (AHG control cells are IgG-sensitized cells that react with the anti-IgG in the AHG reagent to demonstrate AHG was added and not neutralized by insufficient washing of the tests prior to its addition.) |
| 227) A 56 year old female with cold agglutinin disease has a positive DAT. When the DAT is repeated using monospecific antiglobulin sera, which of the following is most likely to be detected? a. IgM b. IgG c. C3d d. C4a | c. C3d c (Cold agglutinin disease is associated with cold reactive antibodies that typically activate complement. Cells that do not undergo lysis due to complement activation have C3d attached to the red blood cells.) |
| 229) Use of EDTA plasma prevents activation of the classical complement pathway by: a. causing rapid decay of complement components b. chelating Mg++ ions, which prevents the assembly of C6 c. chelating Ca++ ions, which prevents assembly of C1 | c. chelating Ca++ ions, which prevents assembly of C1 c (EDTA chelates calcium preventing blood to clot. This chelation of calcium also will stop the complement cascade. Calcium ions are necessary for C1 to attach to IgG on the red blood cells.) |
| 232) The drug cephalosporin can cause a positive DAT with hemolysis by which of the following mechanisms? | b. drug dependent antibodies reacting in the presence of a drug b (Second and third generation cephalosporins react when the drug is present in vitro. When serum, drug, and red cells are present, direct or indirect agglutination or lysis may be observed. |
| 233) Crossmatch results at the antiglobulin phase were negative. When 1 drop of check cells was added, no agglutination was seen. The most likely explanation is that the: a. red cells were over washed b. centrifuge speed was to high c. residual patient | c. residual patient serum inactivated the AHG reagent (A negative reaction after the addition of check cells indicates AHG serum was not present. |
| 234) Which of the following might cause a false-negative IAT? a. over-reading b. IgG coated screen cells c. addition of an extra drop of serum d. too heavy a cell suspension | d. too heavy a cell suspension d (Weak antibodies may be missed if there are excess RBC antigens as there may be too few antibodies to bind to red cell antigens.) |
| 235) The purpose of testing with anti-A,B is to detect: a. anti-A1 b. anti-A2 c. subgroups of A d. subgroups of B | c. subgroups of A Ax cells react more strongly with anti-A,B than with anti-A. If anti-A is nonreactive, Ax cells may be detected with anti-A,B.) |
| 236) What is the most appropriate diluent for preparing a solution of 8% bovine albumin for red cell control reagent? a. deionized water b. distilled water c. normal saline d. Alsever solution | c. normal saline c (A solution of 8% bovine albumin can be prepared by diluting the more concentrated solution with normal saline |
| 237) Which of the following antigens gives enhanced reactions with its corresponding antibody following treatment of the red cells with proteolytic enzymes? a. Fya b. E c. S d. M | b. E (Rh antibodies show enhanced reactivity with enzyme pretreated cells. Treatment of red cells with enzymes weakens reactivity with antibodies in the MNS and Duffy systems.) |
| 240) Of the following, the most useful technique in the identification and classification of high-titer, low-avidity antibodies is/are: a. reagent red cell panels b. adsorption and elution c. titration and inhibition d. cold autoadsorption | c. titration and inhibition (Soluble forms of some blood group antigens can be prepared from other sources and used to inhibit reactivity of the corresponding antibody, such as the HTLA antibodies anti-Ch and anti-Rg |
| 241) To confirm a serum antibody specificity identified as anti-P1, a neutralization study was performed and the following results obtained: serum + P1 substance = NEGATIVE serum + saline = NEGATIVE What conclusion can be made from these results. | d. anti-P1 cannot be confirmed due to the results of the negative control d (For neutralization studies to be valid, the saline dilutional control must be reactive |
| 246) An antibody screen performed using solid phase technology revealed a diffuse layer of RBCs on the bottom of the well. these results indicate: a. a positive reaction b. a negative reaction c. serum was not added d. red cells have a positive DAT | a. a positive reaction In the solid phase technology, the antibody screening cells are bound to the surface of the well.. A negative reaction would have manifested as a pellet of red blood cells in the bottom of the well.) |
| 247) On Monday a patient's K antigen typing result was positive. 2 days later the patient's K typing was negative. The patient was transfused with 2 units of FFP. The tech might conclude that the: | b. wrong patient was drawn b ( The K antigen is integral to the red cell membrane and would not change in a patient. Errors in typing or patient identification may be detected when discrepancies are found when comparing historical records.) |
| 249) While performing an antibody screen, a test reaction is suspected to be rouleaux. A saline replacement test is performed and the reaction remains. What is the best interpretation: | c. original reaction was due to true agglutination (Rouleaux will readily disperse in saline whereas true agglutination will remain after saline replacement.) |
| 251) Which of the following is useful for removing IgG from RBCs with a positive DAT to perform a phenotype? a. bromelin b. chloroquine c. LISS d. DTT | b. chloroquine (Two reagents used for removing IgG from red blood cells are chloroquine diphosphate [CDP] and EDTA glycine acid [EGA]. |
| 252) A patient's serum contains a mixture of antibodies. One of the antibodies is identified as anti-D. Anti-Jka, Fya, and possibly another antibody are present. What technique may be helpful to identify the other antibody? | a. enzyme panel: select cell panel a (Anti-Fya would not react with enzyme pretreated cells; a select cell panel would allow for individual reactivity of the remaining 2 antibodies |
| 253) A sample gave the following results: cells: anti-A = 3+ | anti-B = 4+ serum: A1 cells = 2+ | B cells = 0 Which lectin should be used first to resolve the discrepancy? a. Ulex europaeus b. Arachis hypogaea c. Dolichos biflorus d. Vicia graminea | c. Dolichos biflorus When properly diluted, it can distinguish between A1 donor cells and all other subgroups of A) |
| 254) The serum of a group O, Cde/Cde donor contains anti-D. In order to prepare a suitable anti-D reagent from this donor's serum, which of the following cells would be suitable for the adsorption? | d. groupA1B, cde/cde |
| 258) The process of separation of antibody from its antigen is known as: a. diffusion b. adsorption c. neutralization d. elution | d. elution d (An elution is the process of removal of antibody from red blood cells. The product of the elution method is an eluate. The eluate contains the antibody and can be used in antibody identification methods.) |
| 260) One of the most effective methods for the elution of warm autoantibodies from RBCs utilizes: a. 10% sucrose b. LISS c. change in pH d. distilled water | c. change in pH c (Antibody-antigen complexes are dependent upon a neutral pH. Extremes in pH causes dissociation. Both auto and alloantibodies are recovered in eluates prepared by reagent kits that alter the pH.) |
| 261) How would the hematocrit of a patient with chronic anemia be affected by the transfusion of a unit of Whole Blood containing 475 mL of blood versus 2 units of RBCs, each with a total volume of 250 mL? | b. RBC's would provide twice the increment in hematocrit as the Whole Blood (Each unit of Whole Blood or RBCs will increase the hematocrit by 3%-5%, so 2 units of RBCs will increase the hematocrit by twice as much as 1 unit of Whole Blood.) |
| 262) After checking the inventory, it was noted that there were no units on the shelf marked "May Issue Uncrossmatched: For Emergency Only" Which of the following should be place on this shelf? | c. units of group O, Rh-neg RBC's c (For emergency transfusions, group O- RBC units should be used.) |
| 264) A 42 year old male of average body mass has a history of chronic anemia requiring transfusion support. 2 units of RBCs are transfused. If the pretransfusion hemoglobin was 7.0 g/dL, the expected posttransfusion hemoglobin concentration should be: | b. 9.0 g/dL (90 g/L) b (Each unit of RBCs is expected to increase the hemoglobin level by 1-1.5 g/dL [10-15 g/L].) |
| 265) How many units of RBCs are required to raise the hematocrit of a 70 kg nonbleeding man from 24% to 30% a. 1 b. 2 c. 3 d. 4 | b. 2 (Each unit of RBCs is expected to increase the hematocrit level by 3%-5%, so it would take 2 units to raise the level 6%.) |
| 268) Transfusion of plateletpheresis products for HLA-compatible donors is the preferred treatment for: | d. severely thrombocytopenic patients, known to be refractory to random donor platelets d (Class I HLA antigens on platelets are a known cause for platelet refractoriness. |
| 270) Which of the following is consistent with standard blood bank procedure governing the infusion of FFP? | d. group A may be administered to both A and O recipients d (FFP should be ABO compatible with the recipient's RBCs. Avoid FFP with antibodies to A or B antigens the patient may have. |
| 271) A patient who is group AB, Rh-neg needs 2 units of FFP. Which of the following units of plasma would be most acceptable for transfusion? a. group O, Rh-neg b. group A, Rh-neg c. group B, Rh-pos d. group AB, Rh-pos | d. group AB, Rh-pos d (FFP should be ABO compatible with the recipient's RBCs. Avoid FFP with ABO antibodies to A or B antigens the patient may have.) |
| 272) What increment of platelets/uL in the typical 70-kg human, is expected to result from each single unit of platelets transfused to a non-HLA sensitized recipient? a. 3,000 - 5,000 b. 5,000 - 10,000 c. 20,000 - 25,000 d. 25,000 - 30.000 | b. 5,000 - 10,000 |
| 275) A patient received about 15 mL of compatible blood and developed severe shock, but no fever. If the patient needs another transfusion, what kind of RBC component should be given? | b. RBCs, washed |
| 276) FFP from a group A, Rh-pos donor may be safely transfused to a patient who is group: a. A, Rh-neg b. B, Rh-neg c. AB, Rh-pos d. AB, Rh-neg | a. A, Rh-neg a (FFP should be ABO compatible with the recipient's RBCs. Avoid FFP with ABO antibodies to A or B antigens the patient may have. Rh type is not significant.) |
| 277) A patient admitted to the trauma unit requires the emergency release of FFP. His blood donor card states that he is group AB, Rh-pos. Which of the following blood groups of FFP should be issued? a. A b. B c. AB d. O | c. AB (FFP should be ABO compatible with the recipient's RBCs. If patient's type has not been determined [currently], plasma lacking anti-A and anti-B should be given.) |
| 278) Fresh Frozen Plasma: a. contains all labile coagulative factors except cryo AHF b. has a higher risk of transmitting hepatitis than does Whole Blood c. should be transfused within 24 hours of thawing d. need not be ABO compatible | c. should be transfused within 24 hours of thawing (FFP contains all factors, including cryoprecipitate. It must be transfused within 24 hours of thawing and must be ABO compatible.) |
| 279) 10 units of group A platelets were transfused to a group AB patient. The pretransfusion platelet count was 12 x 10^3/uL and the posttransfusion count was 18 x 10^3/uL. | c. has developed antibodies to the transfused platelets c (Each unit of platelets should increase the count 5,000-10,000 platelets/uL [5,000- 10,000/L]. Platelet antibodies can diminish this expected increment.) |
| 280) Hypotension, nausea, flushing, fever and chills are symptoms of which of the following transfusion reactions? a. allergic b. circulatory overload c. hemolytic d. anaphylactic | c. hemolytic c (Symptoms of hemolytic transfusion reactions are fever, chills, flushing, chest and back pain, hypotension, nausea, dyspnea, shock, renal failure, and DIC. |
| 284) An unexplained fall in hemoglobin and mild jaundice in a patient transfused with RBCs 1 week previously would most likely indicate: | d. delayed hemolytic transfusion reaction |
| 285) In a delayed transfusion reaction the causative antibody is generally too weak to be detected in routine compatibility testing and antibody screening tests, but is typically detectable at what point after transfusion? | b. 3-7 days |
| 286) The most serious hemolytic transfusion reactions are due to incompatibility in which of the following blood group systems? a. ABO b. Rh c. MN d. Duffy | a. ABO |
| 287) Severe intravascular hemolysis is most likely caused by antibodies of which blood group system? a. ABO b. Rh c. Kell d. Duffy | a. ABO a (ABO antibodies activate complement and may cause intravascular hemolysis. Rh, Kell, and Duffy antibodies are primarily associated with extravascular hemolysis.) |
| 288) Which of the following blood group systems is most commonly associated with delayed hemolytic transfusion reactions? a. Lewis b. Kidd c. MNS d. I | b. Kidd b (Antibodies in the Kidd system activate complement and may cause intravascular hemolysis. The antibodies often decline in vivo, are weak, show dosage, and are difficult to detect in vitro, making them prime candidates for causing anamnestic del |
| 289) After receiving a unit of RBCs, a patient immediately developed flushing, nervousness, fever spike of 102*F, shaking, chills and back pain. The plasma hemoglobin was elevated and there was hemoglobinuria. Laboratory investigation of this adverse reac | a. an error in ABO grouping (ABO antibodies activate complement and may cause intravascular hemolysis |
| 290) A trauma patient who has just received 10 units of blood may develop: a. anemia b. polycythemia c. leukocytosis d. thrombocytopenia | d. thrombocytopenia d (Patients receiving >1 blood volume replacement often develop thrombocytopenia and require platelet transfusion.) |
| 292) The most appropriate laboratory test for early detection of acute posttransfusion hemolysis is: | a.a visual inspection for free plasma hemoglobin (Free hemoglobin released from destruction of transfused donor red cells will impart a distinct pink or red color in the posttransfusion sample plasma.) |
| 293) During initial investigation of a suspected hemolytic transfusion reaction, it was observed that the posttransfusion serum was yellow in color and the DAT was negative. Repeat ABO typing on the posttransfusion sample confirmed the pretransfusion resu | d. no further serological testing is necessary |
| 294) Which of the following transfusion reactions is characterized by high fever, shock, hemoglobinuria, DIC, and renal failure? a. bacterial contamination b. circulatory overload c. febrile d. anaphylactic | a. bacterial contamination a (In septic transfusion reactions, patients experience fever >101 [38.3 C], shaking chills, and hypotension. In severe reactions, patients develop shock, renal failure, hemoglobinuria, and DIC.) |
| 295) Hemoglobinuria, hypotension and generalized bleeding are symptoms of which of the following transfusion reactions? a. allergic b. circulatory overload c. hemolytic d. anaphylactic | c. hemolytic c (Clinical signs of a hemolytic transfusion reaction include fever and chills, and, in severe cases, DIC. |
| 296) When evaluating a suspected transfusion reaction, which of the following is the ideal sample collection time for a bilirubin determination? a. 6 hrs. posttransfusion b. 12 hrs. posttransfusion c. 24 hrs. posttransfusion d. 48 hrs. posttransfusion | a. 6 hrs. posttransfusion a (Bilirubin is a marker for red cell hemolysis. Bilirubin peaks at 5-7 hours after transfusion and is back to pretransfusion levels at 24 hours if liver function is normal.) |
| 297) A patient's records show a previous anti-Jkb, but the current antibody screen is negative. What further testing should be done before transfusion? | d. give Jkb neg crossmatch compatible blood |
| 298) A posttransfusion blood sample from a patient experiencing chills and fever show distinct hemolysis. The DAT is positive (mixed field). What would be the most helpful to determine the cause of the reaction? | b. elution and antibody ID b (If the direct antiglobulin test is positive in a transfusion reaction investigation, the antibody should be eluted from the red cells and identified.) |
| 300) In a delayed hemolytic transfusion reaction, the DAT is typically: a. negative b. mixed-field positive c. positive due to complement d. negative when the antibody screen is negative | b. mixed field positive (Delayed hemolytic transfusion reactions are associated with extravascular hemolysis, rather than intravascular. Alloantibody coats the transfused antigen-positive donor cells in the recipient's circulation, producing a mixed-fi |
| 302) For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment goal should be to: a. prevent alloimmunization b. diminish chills and fever c. prevent hemoglobinemia d. reverse hypotension and minimize renal disease | d. reverse hypotension and minimize renal disease (Treatment of acute hemolytic transfusion reactions focuses on supportive measures and control of DIC, hypotension, and acute renal failure.) |
| 303) A patient multiply transfused with RBCs developed a headache, nausea, fever and chills during his last transfusion. What component is most appropriate to prevent this reaction in the future? | c. RBCs, leukocyte reduced c (Red Blood Cells, Leukocyte-Reduced should be chosen, because febrile nonhemolytic transfusion reactions are either due to chemokines released from leukocytes in nonleukoreduced blood components or to patient antibodies dir |
| 305) Leukocyte-poor RBCs would most likely be indicated for patients with a history of : a. febrile transfusion reaction b. iron deficiency anemia c. hemophilia A d. von Willebrand disease | a. febrile transfusion reaction a (Leukocyte antibodies are a primary cause of febrile transfusion reactions. Leukocyte-reduced blood components reduce the risk of febrile nonhemolytic reactions.) |
| 306) Posttransfusion anaphylactic reactions occur most often in patients with: a. leukocyte antibodies b. erythrocyte antibodies c. IgA deficiency d. Factor VIII deficiency | c (Anaphylactic transfusion reactions are attributed to anti-IgA in IgA- deficient recipients.) |
| 307) Which of the following transfusion reactions occurs after infusion of only a few milliliters of blood and gives no history of fever? a. febrile b. circulatory overload c. anaphylactic d. hemolytic | c. anaphylactic (Two distinguishing features or anaphylactic transfusion reactions are that symptoms occur with transfusion of only small amounts of blood, and the patient has no fever.) |
| 308) Fever and chills are symptoms of which of the following transfusion reactions? a. citrate toxicity b. circulatory overload c. allergic d. febrile | d. febrile (Febrile nonhemolytic transfusion reactions are defined as fever of 1C or greater [over baseline temperature] during or after transfusion, with no other reason for the elevation than transfusion, and no evidence of hemolysis in the transfusi |
| 309) Hives and itching are symptoms of which of the following transfusion reactions? a. febrile b. allergic c. circulatory overload d. bacterial | b. allergic Allergic reactions are a type 1 immediate hypersensitivity reaction to an allergen in plasma. Most are mild reactions shown by urticaria [hives, swollen red wheals] which may cause itching.) |
| 310) A temperature rise of 1 C or more occurring in association with a transfusion, with no abnormal results in the transfusion reaction investigation. usually indicates which of the following reactions? | . febrile (Febrile nonhemolytic transfusion reactions are defined as fever of 1C or greater [over baseline temperature] during or after transfusion, with no other reason for the elevation than transfusion, and no evidence of hemolysis in the transfusio |
| 311) A 65 yr. old woman experienced shaking, chill, and a fever of 102 F (38.9 C) approximately 40 minutes following the transfusion of a second unit of RBCs. The most likely explanation for the patient's symptoms is: | d. febrile transfusion reaction d (Febrile nonhemolytic transfusion reactions occur in about 1% of transfusions, making it one of the most common types of reaction |
| 312) A sickle cell patient who has been multiply transfused experiences fever and chills after receiving a unit of RBCs. Transfusion investigation studies show: | d. white cells or cytokines |
| 315) Symptoms of dyspnea, cough, hypoxemia, and pulmonary edema within 6 hrs. of transfusion is most likely which type of reaction? a. anaphylactic b. hemolytic c. febrile d. TRALI | d. TRALI d (Noncardiogenic pulmonary edema, dyspnea, hypotension, and hypoxemia occurring within 6 hours of transfusion are clinical symptoms of TRALI. |
| 316) A patient with a coagulopathy was transfused with FP24 (FFP within 24 hrs. of collection). After infusion of 15 mL, the patient experienced hypotension, shock, chest pain and difficulty in breathing. The most likely cause of the reaction is: | a. anti-IgA a (Anaphylactic transfusion reactions are severe reactions that occur after infusion of a small amount of donor blood. Symptoms are hypotension, shock, respiratory distress dyspnea, and substernal pain. Anaphylactic reactions are usually caus |
| 317) To prevent febrile transfusion reactions, which RBC product should be transfused? a. RBCs irradiated b. CMV-neg RBC's c. RBCs, leukocyte reduced d. IgA-deficient donor blood | c. RBCs, leukocyte reduced c (Leukoreduction of blood products reduces the risk of febrile nonhemolytic transfusion reactions, which are caused by leukoagglutinins or cytokines from white cells.) |
| 318) During the issue of an autologous unit of Whole Blood, the supernatant plasma is observed to be dark red in color. What would be the best course of action? | d. quarantine the unit for further testing |
| 319) Coughing, cyanosis and difficult breathing are symptoms of which of the following transfusion reactions? a. febrile b. allergic c. circulatory overload d. hemolytic | c. circulatory overload (Transfusion-associated circulatory overload [TACO] is hypervolemia manifested by coughing, cyanosis, and pulmonary edema.) |
| 320) Which of the following is a nonimmunologic adverse effect of a transfusion? a. hemolytic reaction b. febrile nonhemolytic reaction c. congestive heart failure d. urticaria | c. congestive heart failure |
| 321) Congestive heart failure, severe headache and/or peripheral edema occurring soon after transfusion is indicative of which type of transfusion reaction? a. hemolytic b. febrile c. anaphylactic d. circulatory overload | d. circulatory overload (Transfusion-induced hypervolemia causing edema and congestive heart failure is a feature of transfusion-associated circulatory overload [TACO]. |
| 322) A patient with severe anemia became cyanotic and developed tachycardia, hypertension, and difficulty breathing after receiving 3 units of blood. No fever or other symptoms were evident. this is most likely what type of reaction? | b. transfusion-associated circulatory overload (TACO) |
| 323) A patient became hypotensive and went into shock after receiving 50 mL of a unit of RBCs. She had a shaking chill and her temperature rose to 104.8 F (40.0 C). A transfusion reaction investigation was initiated but no abnormal results were seen. What | a. gram stain and culture of the donor unit a (Septic transfusion reactions due to contaminated blood products are manifested by high fever, chills, hypotension, shock, nausea, diarrhea, renal failure, and DIC. |
| 324) The most frequent transfusion-associated disease complication of blood transfusion is: a. cytomegalovirus (CMV) b. syphilis c. hepatitis d. AIDS | c. hepatitis c (Hepatitis transmission is unlikely, but has a higher risk of transmission through blood transfusion than CMV [rare], syphilis [no transfusion-transmitted cases reported in >30 years], or HIV [1:2,300,000 units].) |
| 325) The purpose of a low-dose irradiation of blood components is to: a. prevent posttransfusion purpura b. prevent graft-vs-host disease c. sterilize components d. prevent noncardiogenic pulmonary edema | b. prevent graft-vs-host disease b (Irradiation inhibits proliferation of T cells and subsequent GVHD.) |
| 327) Irradiation of donor blood is done to prevent which of the following adverse effects of transfusion? a. febrile transfusion reaction b. CMV c. transfusion associated graft-vs-host disease d. transfusion related acute lung injury (TRALI) | c. transfusion associated graft-vs-host disease c (Gamma irradiation of blood products prevents donor lymphocytes from replicating after transfusion and causing transfusion associated graft-vs-host disease in susceptible patients.) |
| 330) The most important step in the safe administration of blood is to: a. perform compatibility testing accurately b. get an accurate patient history c. exclude disqualified donors d. accurately identify the donor unit and recipient | d. accurately identify the donor unit and recipient d (The major cause of transfusion associated fatalities is transfusion of blood to the wrong patient.) |
| 17) A unit of Red Blood Cells expiring in 35 days is split into 5 small aliquots using a sterile pediatric quad set and a sterile connecting device. Each aliquot must be labeled as expiring in: a. 6 hours b. 12 hours c. 5 days d. 35 days | d. 35 days d (Sterile docking devices allow entry into donor units without affecting the expiration date of the product.) |
| 49) A unit of Whole Blood-derived (random donor) Platelets should contain at least: a. 1.0 x 10^10 platelets b. 5.5 x 10^10 platelets c. 5.5 x 10^11 platelets d. 90% of the platelets from the original unit of Whole Blood | b. 5.5 x 10^10 platelets b (Whole blood-derived [random donor] Platelets should contain at least 5.5 x 10^10 platelets, be stored with continuous agitation at 20-24 C, and have a pH of 6.2 or higher when tested at the end of the storage period.) |
| 50) Platelets prepared by apheresis should contain at least: a. 1 x 10^10 platelets b. 3 x 10^10 platelets c. 3 x 10^11 platelets d. 5 x 10^11 platelets | c. 3 x 10^11 platelets c (Apheresis [single donor] Platelets should contain at least 3.0 x 10^11 platelets, be stored with continuous agitation at 20-24 C, and have a pH of 6.2 or higher when tested at the end of the storage period.) |
| 53) A father donating platelets for his son is connected to a continuous flow machine, which uses the principle of centrifugation to separate platelets from whole blood. As the platelets are harvested, all other remaining elements are returned to the dono | a. apheresis a (The apheresis process is to remove whole blood, the desired component removed, and the remaining portion of blood returned to the donor/patient.) |
| 54) To qualify as a donor for autologous transfusion a patient's hemoglobin should be at least: a. 8 g/dL (80 g/L) b. 11 g/dL (110 g/L) c. 13 g/dL (130 g/L) d. 15 g/dL (150 g/L) | b. 11g/dL (Autologous donors have less stringent criteria than allogeneic donors. Donations must be collected at least 72 hours prior to surgery.) |
| 55) What is/are the minimum pretransfusion testing requirement(s) for autologous donations collected and transfused by the same facility? | . ABO and Rh typing only (Only ABO and Rh is required with the patient's sample. Each autologous unit must be confirmed for ABO and Rh from an integrally attached segment.) |
| 86) A patient is typed with the following results: The most probable reason for these findings is that the patient is group: a. O; confusion due to faulty group O antiserum b. O; with an anti-A1 c. Ax; with an anti-A1 d. A1; with an anti-A | c. Ax; with an anti-A1 |
| 221) Anti-I may cause a positive direct antiglobulin test (DAT) because of: a. anti-I agglutinating the cells b. C3d bound to the red cells c. T-activation d. C3c remaining on the red cells after cleavage of C3b | b. C3d bound to the red cells (In cold agglutinin syndrome, anti-I acts as a complement binding antibody with a high titer and high thermal amplitude. the complement cascade is activated and C3d remains on the red cell membrane of circulating cells.) |
| 230) Which of the following medications is most likely to cause production of autoantibodies? a. penicillin b. cephalothin c. methyldopa d. tetracycline | c. methyldopa |
| 248) Which one of the following is an indicator of polyagglutination? a. RBCs typing as weak D+ b. presence of red cell autoantibody c. decreased serum bilirubin d. agglutination with normal adult ABO compatible sera | d. agglutination with normal adult ABO compatible sera d (Polyagglutination is a property of the red blood cells. |
| 304) The use of Leukocyte-Reduced Red Blood Cells and Platelets is indicated for which of the following patient groups? a. CMV-seropositive postpartum mothers b. victims of acute trauma with massive bleeding c. patients with history of febrile transfus | c. patients with history of febrile transfusion reactions c (Leukocyte-Reduced RBCS and Platelets can be used to prevent further nonhemolytic transfusion reactions.) |
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