MLT BOC BLOODBANK #2
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| show | c. the father is heterozygous for D
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| show | 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.)
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| show | a. add check cells as a confirmatory measure
***b. identify the cause of the agglutination
c. perform an elution technique
d. perform a DAT
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| show | b. a warm autoantibody
b (Presence of agglutination at AHG phase with both screening cells and autocontrol is indicative of warm autoantibody.)
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| 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? | show 🗑
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| show | 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
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| show | 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
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| show | d. recipient antibody directed against antigens on the donor red cells
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| show | 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
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| 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 | show 🗑
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| show | 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
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| 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: | show 🗑
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| 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? | show 🗑
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| 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? | show 🗑
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| 203) A 10% red cell suspension in saline is used in a compatibility test. Which of the following would most likely occur? | show 🗑
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| 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: | show 🗑
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| 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 | show 🗑
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| 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 | show 🗑
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| 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. | show 🗑
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| show | a. no clinically significant red cell destruction
(Chido antibodies are considered clinically insignificant)
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| show | 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.)
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| show | a. DAT
a ( The direct antiglobulin test [DAT] is used to identify red blood cells that have been coated with antibody in vivo.
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| show | . 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
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| 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 | show 🗑
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| 225) In the direct antiglobulin test, the antiglobulin reagent is used to: d. detect preexisting antibodies on erythrocytes | show 🗑
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| 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 | show 🗑
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| show | 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.)
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| 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 | show 🗑
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| show | 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.
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| 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 | show 🗑
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| show | 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.)
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| show | 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.)
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| 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 | show 🗑
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| show | 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.)
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| 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 | show 🗑
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| 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. | show 🗑
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| show | 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.)
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| show | 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.)
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| show | c. original reaction was due to true agglutination
(Rouleaux will readily disperse in saline whereas true agglutination will remain after saline replacement.)
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| 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 | show 🗑
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| show | 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
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| 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 | show 🗑
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| show | d. groupA1B, cde/cde
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| 258) The process of separation of antibody from its antigen is known as: a. diffusion b. adsorption c. neutralization d. elution | show 🗑
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| show | 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.)
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| show | 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.)
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| show | c. units of group O, Rh-neg RBC's
c (For emergency transfusions, group O- RBC units should be used.)
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| 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: | show 🗑
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| show | 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%.)
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| 268) Transfusion of plateletpheresis products for HLA-compatible donors is the preferred treatment for: | show 🗑
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| show | 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.
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| 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 | show 🗑
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| show | b. 5,000 - 10,000
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| show | b. RBCs, washed
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| show | 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.)
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| 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 | show 🗑
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| show | 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.)
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| 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. | show 🗑
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| 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 | show 🗑
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| show | d. delayed hemolytic transfusion reaction
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| 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? | show 🗑
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| 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 | show 🗑
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| 287) Severe intravascular hemolysis is most likely caused by antibodies of which blood group system? a. ABO b. Rh c. Kell d. Duffy | show 🗑
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| show | 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
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| 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 | show 🗑
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| 290) A trauma patient who has just received 10 units of blood may develop: a. anemia b. polycythemia c. leukocytosis d. thrombocytopenia | show 🗑
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| show | 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.)
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| 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 | show 🗑
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| show | 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.)
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| 295) Hemoglobinuria, hypotension and generalized bleeding are symptoms of which of the following transfusion reactions? a. allergic b. circulatory overload c. hemolytic d. anaphylactic | show 🗑
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| show | 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.)
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| 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? | show 🗑
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| show | 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.)
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| 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 | show 🗑
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| show | 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.)
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| 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? | show 🗑
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| 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 | show 🗑
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| show | c (Anaphylactic transfusion reactions are attributed to anti-IgA in IgA- deficient recipients.)
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| 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 | show 🗑
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| 308) Fever and chills are symptoms of which of the following transfusion reactions? a. citrate toxicity b. circulatory overload c. allergic d. febrile | show 🗑
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| 309) Hives and itching are symptoms of which of the following transfusion reactions? a. febrile b. allergic c. circulatory overload d. bacterial | show 🗑
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| show | . 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
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| 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: | show 🗑
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| 312) A sickle cell patient who has been multiply transfused experiences fever and chills after receiving a unit of RBCs. Transfusion investigation studies show: | show 🗑
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| show | d. TRALI
d (Noncardiogenic pulmonary edema, dyspnea, hypotension, and hypoxemia occurring within 6 hours of transfusion are clinical symptoms of TRALI.
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| show | 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
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| 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 | show 🗑
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| 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? | show 🗑
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| 319) Coughing, cyanosis and difficult breathing are symptoms of which of the following transfusion reactions? a. febrile b. allergic c. circulatory overload d. hemolytic | show 🗑
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| show | c. congestive heart failure
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| 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 | show 🗑
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| show | b. transfusion-associated circulatory overload (TACO)
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| show | 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.
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| show | 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].)
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| show | b. prevent graft-vs-host disease
b (Irradiation inhibits proliferation of T cells and subsequent GVHD.)
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| 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) | show 🗑
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| 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 | show 🗑
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| 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 | show 🗑
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| show | 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.)
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| show | 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.)
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| show | 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.)
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| show | b. 11g/dL
(Autologous donors have less stringent criteria than allogeneic donors. Donations must be collected at least 72 hours prior to surgery.)
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| 55) What is/are the minimum pretransfusion testing requirement(s) for autologous donations collected and transfused by the same facility? | show 🗑
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| 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 | show 🗑
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| 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 | show 🗑
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| show | c. methyldopa
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| show | d. agglutination with normal adult ABO compatible sera
d (Polyagglutination is a property of the red blood cells.
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| show |
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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