MLT BOC BLOODBANK #2
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| show | c. the father is heterozygous for D
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| 188) Some blood group antibodies characteristically hemolyze appropriate red cells in the presence of: a. complement b. anticoagulants c. preservatives d. penicillin | show 🗑
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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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| 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+ | show 🗑
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| show | ***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.)
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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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| show | 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.)
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| 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. | show 🗑
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| show | 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.)
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| show | a. AB, Rh-pos
***b. A, Rh-neg
c. A, Rh-pos
d. O, Rh-neg
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| show | a. B, Rh-pos
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| show | d. a false-negative result due to antigen excess
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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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| show | a. Rh
a (Warm autoantibodies often exhibit Rh specificity.)
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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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| 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 | show 🗑
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| 217) Which characteristics are true of all 3 of the following antibodies: anti-Fya, anti-Jka and anti-K? | show 🗑
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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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| 223) In DAT and IAT tests, false-negative reactions may result if the: | show 🗑
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| show | b. IgG and C3d
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| show | d. detect preexisting antibodies on erythrocytes
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| show | . 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.)
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| 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 | show 🗑
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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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| 232) The drug cephalosporin can cause a positive DAT with hemolysis by which of the following mechanisms? | show 🗑
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| show | c. residual patient serum inactivated the AHG reagent
(A negative reaction after the addition of check cells indicates AHG serum was not present.
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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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| show | c. normal saline
c (A solution of 8% bovine albumin can be prepared by diluting the more concentrated solution with normal saline
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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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| 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: | show 🗑
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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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| 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? | show 🗑
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| show | c. Dolichos biflorus
When properly diluted, it can distinguish between A1 donor cells and all other subgroups of A)
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| show | d. groupA1B, cde/cde
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| show | 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.)
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| 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 | show 🗑
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| 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? | show 🗑
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| 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? | show 🗑
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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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| 270) Which of the following is consistent with standard blood bank procedure governing the infusion of FFP? | show 🗑
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| show | 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.)
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| show | b. 5,000 - 10,000
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| show | b. RBCs, washed
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| 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 | show 🗑
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| show | 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.)
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| 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 | show 🗑
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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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| show | c. hemolytic
c (Symptoms of hemolytic transfusion reactions are fever, chills, flushing, chest and back pain, hypotension, nausea, dyspnea, shock, renal failure, and DIC.
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| show | d. delayed hemolytic transfusion reaction
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| show | b. 3-7 days
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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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| show | a. an error in ABO grouping
(ABO antibodies activate complement and may cause intravascular hemolysis
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| show | d. thrombocytopenia
d (Patients receiving >1 blood volume replacement often develop thrombocytopenia and require platelet transfusion.)
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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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| show | d. no further serological testing is necessary
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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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| show | c. hemolytic
c (Clinical signs of a hemolytic transfusion reaction include fever and chills, and, in severe cases, DIC.
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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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| show | 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
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| 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 | show 🗑
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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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| show | 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.)
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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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| show | 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.)
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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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| show | 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
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| show | d. white cells or cytokines
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| 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 | show 🗑
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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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| show | c. circulatory overload
(Transfusion-associated circulatory overload [TACO] is hypervolemia manifested by coughing, cyanosis, and pulmonary edema.)
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| 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 | show 🗑
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| show | d. circulatory overload
(Transfusion-induced hypervolemia causing edema and congestive heart failure is a feature of transfusion-associated circulatory overload [TACO].
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| 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? | show 🗑
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| 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 | show 🗑
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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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| 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 | show 🗑
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| show | 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.)
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| show | d. accurately identify the donor unit and recipient
d (The major cause of transfusion associated fatalities is transfusion of blood to the wrong patient.)
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| show | d. 35 days
d (Sterile docking devices allow entry into donor units without affecting the expiration date of the product.)
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| 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 | show 🗑
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| 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 | show 🗑
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| 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 | show 🗑
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| 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) | show 🗑
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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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| 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 | show 🗑
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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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