How many of the above results excludes this donor from giving blood for a routine transfusion?
D. 1
For apheresis donors who donate platelets more frequently than every 4 weeks, a platelet count must be performed prior to the procedure and be at least:
C. 150 x 10^3/uL (150 x 10^9/L)
Prior to blood donation, the intended venipuncture site must be cleaned with a scrub solution containing:
D. PVP iodine complex
All donor blood testing must include:
A. serological test for syphilis
During the preparation of Platelet Concentrates from Whole Blood, the blood should be:
D. cooled towards 20o-24oC
The most common cause of posttransfusion hepatitis can be detected in donors by testing for:
B. HBsAg
The Western blot is a confirmatory test for the presence of:
A. anti-HIV-1
The test that is currently used to detect donors who are infected with the AIDS virus:
A. anti-HIV 1,2
A commonly used screening method for anti-HIV-1 detection is:
D. enzyme-labeled immunosorbent assay (ELISA)
Rejuvenation of a unit of Red Blood Cells is a method used to:
C. restore 2,3-DPG and ATP to normal levels
A unit of packed cells is split into 2 aliquots under closed sterile conditions at 8 AM. The expiration time for each aliquot is now:
D. the original date of the unsplit unit
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:
C. 35 days
When platelets are stored on a rotator set on an open bench top, the ambient air temperature must be recorded:
A. every 4 hours
Which of the following is the correct storage temperature for the component listed?
C. Fresh Frozen Plasma (FFP), -20oC
A unit of Red Blood Cells is issued at 9:00 AM. At 9:10 AM the unit is returned to the Blood Bank. The container has not been entered, but the unit has not been refrigerated during this time span. The best course of action for the technologist is to:
A. record the return and place the unit into inventory
The optimum storage temperature for Red Blood Cells, Frozen is:
B. -80oC
The optimum storage temperature for Red Blood Cells is:
C. 4oC
If the seal is entered on a unit of Red Blood Cells stored at 1oC to 6oC, what is the maximum allowable storage period, in hours?
A. 24
The optimum storage temperature for cryoprecipitated AHF is:
D. -20oC
Cryoprecipitated AHF must be transfused within what period of time following thawing and pooling?
B. 4 hours
Platelets prepared in a polyolefin type container, stored at 22o-24oC in 50 mL of plasma, and gently agitated can be used for up to:
C. 5 days
The optimum storage temperature for platelets is:
C. 22oC
According to AABB standards, Fresh Frozen Plasma must be infused within what period of time following thawing?
C. 24 hours
Cryoprecipitated AHF, if maintained in the frozen state at -18oC or below, has a shelf life of:
D. 12 months
Once thawed, Fresh Frozen Plasma must be transfused within:
C. 24 hours
An important determinant of platelet viability following storage is:
D. plasma pH
In the liquid state, plasma must be stored at:
A. 1o-6oC
During storage, the concentration of 2,3-diphosphoglycerate (2,3-DPG) decreases in a unit of:
D. Red Blood Cells
Cryoprecipitated AHF:
D. is indicated for fibrinogen deficiencies
Which apheresis platelets product should be irradiated?
C. a directed donation given by a mother for her son
Irradiation of a unit of Red Blood Cells is done to prevent the replication of donor:
C. lymphocytes
Plastic bag overwraps are recommended when thawing units of FFP in 37oC water baths because they prevent:
A. the entry ports from becoming contaminated with water
Which of the following blood components must be prepared within 8 hours after phlebotomy?
D. Fresh Frozen Plasma
Cryoprecipitated AHF contains how many units of Factor VIII?
D. 80
Which of the following blood components contains the most Factor VIII concentration relative to volume?
C. Cryoprecipitated AHF
The most effective component to treat a patient with fibrinogen deficiency is:
B. Cryoprecipitated AHF
A blood component prepared by thawing Fresh Frozen Plasma at refrigerator temperature and removing the fluid portion is:
B. Cryoprecipitated AHF
Upon inspection, a unit of platelets is noted to have visible clots, but otherwise appears normal. The technologist should:
C. quarantine for Gram stain and culture
According to AABB Standards, at least 90% of all Apheresis Platelets units tested shall contain a minimum of how many platelets?
D. 3.0 x 10^11
According to AABB Standards, Platelets prepared from Whole Blood shall have at least:
C. 5.5 x 10^10 platelets per unit in at least 90% of the units tested
Which of the following is proper procedure for preparation of Platelets from Whole Blood?
C. light spin followed by a hard spin
According to AABB Standards, what is the minimum pH required for Platelets at the end of the storage period?
D. 6.2
According to AABB Standards, Platelets must be:
D. gently agitated if stored at room temperature
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
Platelets prepared by apheresis should contain at least:
A. 3 x 10^11 platelets
Leukocyte-Reduced Red Blood Cells are ordered for a newly diagnosed bone marrow candidate. What is the best way to prepare this product?
D. transfuse through a Log3 leukocyte-removing filter
Of the following blood components, which one should be used to prevent HLA alloimmunization of the recipient?
A. Leukocyte-Reduced Red Blood Cells
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 donor. This method of Platelet collection is known as:
C. apheresis
To qualify as a donor for autologous transfusion a patient's hemoglobin should be at least:
C. 11g/dL (110g/L)
What is/are the minimum pretransfusion testing requirement(s) for autologous donations collected and transfused by the same facility?
A. ABO and Rh typing only
In a quality assurance program, Cryoprecipitated AHF must contain a minimum of how many international units of Factor VIII?
A. 80
An assay of plasma from a bag of Cryoprecipiated AHF yields a concentration of 9 international units (IU) of Factor VIII per mL of Cryoprecipitated AHF. If the volume is 9mL, what is the Factor VIII content of the bag in IU?
A. 81
Refer to the following diagram:
Given the most probable genotypes of the parents, which of the following statements best describes the most probable Rh genotypes of the 4 children?
C. 2 are R1r, 2 are R1R1
The linked HLA genes on each chromosome constitute a(n):
D. haplotype
An individual's red blood cells give the following reactions with Rh antisera:
anti-D anti-C anti-E anti-c anti-e Rh control 4+ 3+ 0 3+ 3+ 0 The individual's most probable genotype is:
A. DCe/dce
A blood donor has the genotype: hh, AB. What is his red blood cell phenotype?
C. O
An individual has been sensitized to the k antigen and has produced anti-k. What is her most probable Kell system genotype?
D. KK
Given the following typing results, what is this donor's racial ethnicity?
Le(a-b-); Fy(a-b-); Js(a+b+)
B. African American
A mother has the red cell phenotype D+C+E-c-e+ with anti-c (titer of 32 at AHG) in her serum. The father has the phenotype D+C+E-c+e+. The baby is Rh-negative and not affected with hemolytic disease of the newborn. What is the baby's most probable Rh genotype?
A. r'r'
In an emergency situation, Rh-negative red cells are transfused into an Rh-positive person of the genotype CDe/CDe. The first antibody most likely to develop is:
A. anti-c
Most blood group systems are inherited as:
A. autosomal codominant
The mating of an Xg(a+) man and an Xg(a-) woman will only produce:
C. Xg(a-) sons and Xg(a+) daughters
Refer to the following data:
anti-C anti-D anti-E anti-c anti-e + + + + +
Given the reactions above, which is the most probable genotype?
D. R1R2
A patient's red cells type as follows:
anti-D anti-C anti-E 4+ + +
Which of the following gentype would be cosnistent with these results?
a. R0R0 b. R1r
c. R1R2 d. Rzr
a. R0R0
The red cells of a nonsecretor (se/se) will most likely type as:
C. Le(a+b-)
Whcih of the following phenotypes will react with anti-f?
D. rr
A patient's red blood cells gave the following reactions:
Anti-N is identified in a patient's serum. If random crossmatches are performed on ten donor units, how many would be expected to be compatible?
B. 3
A woman types as Rh-positive. She has an anti-c titer of 32 at AHG. Her baby has a negative DAT and is not affected by hemolytic disease of the newborn. What is the father's most likely Rh phenotype?
C. R1r
Which of the following red cell typings are commonly found in the African American donor population?
D. Fy(a-b-)
Four units of blood are needed for elective surgery. The patient's serum contained anti-c, anti-e, anti-Fya and anti-Jkb. Which of the following would be the best source of donor blood?
C. rare donor file
A donor is tested with Rh antisera with the following results:
Which of the following is the best source of HLA-compatible platelets?
B. siblings
A patient is group O, Rh-negative with anti-D and anti-K in her serum. What percentage of the general Caucasian donor population would be compatible with this patient?
D. 6.0
The observed phenotypes in a particular population are:
phenotype Number of persons
Jk(a+b-) 122
Jk(a+b+) 194
Jk(a-b+) 84
What is the gene frequency of Jka in this population?
A. 0.55
In a random population, 16% of the people are Rh-negative (rr). What percentage of the Rh-positive population is heterozygous for r?
B. 48%
In relationship testing, a "direct exclusion" is established when a genetic marker is:
B. present in the child, but absent in the mother and alleged father
Relationship testing produces the following red cell phenotyping results:
ABO Rh alleged father: B D+C-c+E+e- mother: O D+C+E-c-e+ child: O D+C+E-c+e+
What conclusions may be made?
C. paternity may be excluded on the basis of Rh typing
In the relationship testing case, the child has a genetic marker that is absent in the mother and cannot be demonstrated in the alleged father. What type of paternity exclusion is this known as?
D. direct
A patient is typed with the following results:
Patient's cells with Patient's serum with anti-A 0 A1 red cells 2+ anti-B 0 B red cells 4+ anti-A,B 2+ Ab screen 0
The most probable reason for these findings is that the patient is group:
A. Ax; with an anti-A1
Human blood groups were discovered around 1900 by:
D. Karl Landsteiner
Cells of the A3 subgroup will:
A. give a mixed-field reaction with anti-A,B
The enzyme responsible for conferring H activity on the red cell membrane is alpha-:
C. L-fucosyl transferase
Even in the absence of prior transfusion or pregnancy, individuals with the Bombay phenotype (Oh) will always have naturally occurring:
D. anti-H
The antibody in the Lutheran system that is best detected at lower temperatures is:
A. anti-Lua
Which of the following antibodies is neutralizable by pooled human plasma?
D. anti-Ch
Anti-Sda is strongly suspected if:
B. the agglutinates are mixed-field and refractile
HLA antibodies are:
A. induced by multiple transfusions
Genes of the major histocompatibility complex (MHC):
B. contribute to the coordination of cellular and humoral immunity
Isoimmunization to platelet antigen HPA-1a and the placental transfer of maternal antibodies would be expected to cause newborn:
B. thrombocytopenia
Saliva from which of the following individuals would neutralize an auto anti-H in the serum of a group A, Le(a-b+) patient?
A. group O, Le(a-b+)
Inhibition testing can be used to confirm antibody specificity for which of the following antibodies?
D. anti-Lea
Which of the following Rh antigens has the highest frequency in Caucasians?
D. e
Anti-D and anti-C are identified in the serum of a transfused pregnant woman, gravida 2, para 1. Nine months previously she received Rh immune globulin (RhIG) after delivery. Tests of the patient, her husband, and the child revealed the following:
The most likely explanation for the presence of anti-C is that this antibody is:
C. actually anti-G
The phenomenon of an Rh-positive person whose serum contains anti-D is best explained by:
C. missing antigen epitopes
When the red cells of an individual fail to react with anti-U, they usually fail to react with:
C. anti-S
Which of the following red cell antigens are found on glycoprotein-A?
B. M, N
Paroxysomal cold hemoglobinuria (PCH) is associated with antibody specificity toward which of the following?
C. P antigen
Which of the following is a characteristic of anti-i?
D. found in the serum of patients with infectious mononucleosis
In case of cold autoimmune hemolytic anemia, the patient's serum would most likely react 4+ at immediate spin with:
A. all cells of a group O cell panel and his own cells
Cold agglutinin syndrome is associated with an antibody specificity toward which of the following?
B. I
Which of the following is a characteristic of anti-i?
C. reacts best at room temperature or 4oC
The Kell (K1) antigen is:
B. strongly immunogenic
In chronic granulomatous disease (CGD), granulocyte function is impaired. An association exits between this clinical condition and a depression of which of the following antigens?
B. Kell
The antibodies of the Kidd blood group system:
C. react best by the indirect antiglobulin test
Proteolytic enzyme treatment of red cells usually destroys which antigen?
D. Fya
Anti-Fya is:
A. capable of causing hemolytic transfusion reactions
Resistance to malaria is best associated with which of the following blood groups?
D. Duffy
What percent of group O donors would be compatible with a serum sample that contained anti-X and anti-Y if X antigen is present on red cells of 5 of 20 donors, and Y antigen is present is present on red cells of 1 of 10 donors?
B. 68.0
How many Caucasians in a population of 100,000 will have the following combination of phenotypes?
System Phenotype Frequency (%) ABO O 45 Gm Fb 48 PGM1 2-1 37 EsD 2-1 18
C. 1,438
What is the approximate probability of finding compatible blood among random Rh-positive units for a patient who has anti-c and anti-K? (Consider that 20% of Rh-positive donors lack c and 90% lack K)
D. 18%
A 25-year-old Caucasian woman, gravida 3, para 2, required 2 units of Red Blood Cells. The antibody screen was positive and the results of the antibody panel are shown below:
What is the most probable genotype of this patient?
B. R1R1
A man suffering from gastrointestinal bleeding has received 20 units of Red Blood Cells in the last 24 hours and is still oozing post-operatively. The following results were obtained:
What blood product should be administered?
a. Fresh Frozen Plasma
b. Red Blood Cells
c. Factor VIII Concentrate
d. Platelets
Transfusion of which of the following is needed to help correct hypofibrogenemia due to DIC?
D. Cryoprecipiated AHF
A blood component used in the treatment of hemophilia A is:
B. Factor VIII Concentrate
Which of the following blood components is most appropriate to transfuse to an 8-year-old male hemophiliac who is about to undergo minor surgery?
D. Factor VIII Concnetrate
A unit of Fresh Frozen Plasma was inadvertently thawed and then immediately refrigerated at 4oC on Monday morning. On Tuesday evening this unit may still be transfused as a replacement for:
D. Factor IX
A newborn demonstrates petechiae, ecchymosis and mucosal bleeding. The preferred blood component for this infant would be:
B. Platelets
Which of the following would be the best source of Platelets for transfusion in case of alloimmune neonatal thrombocytopenia?
C. mother
An obstetrical patient has had 3 previous pregnancies. Her first baby was healthy, the second was jaundiced at birth and required an exchange transfusion, while the third was stillborn. Which of the following is the most likely cause?
B. Rh incompatibility
A specimen of cord blood is submitted to the transfusion service for routine testing. The following results are obtained:
It is known that the father is group B, with the genotype of cde/cde. Of the following 4 antibodies, which 1 is the most likely cause of the positive direct antiglobulin test?
B. anti-c
ABO-hemolytic disease of the newborn:
A. is usually seen only in the newborn of group O mothers
Which of the following antigens is most likely to be involved in hemolytic disease of the newborn?
D. Kell
ABO hemolytic disease of the fetus and newborn (HDFN) differs from Rh HDFN in that:
C. Rh HDFN is clinically more severe than ABO HDFN
The following results were obtained:
Which of the following is the most probable explanation for these results?
C. Rh hemolytic disease of the fetus and newborn, infant has a false-negative Rh typing
A group A, Rh-positive infant of a group O, Th-positive mother has a weekly positive direct antiglobulin test and a moderately elevated bilirubin 12 hours after birth. The most likely cause is:
B. ABO incompatibility
In suspected cases of hemolytic disease of the newborn, what significant information is based on the amniotic fluid:
D. determination of the presence of spherocytes
The Liley method of predicting the severity of hemolytic disease of the newborn is based on the amniotic fluid:
C. change in optical density measured at 450 nm
These laboratory results were obtained on maternal and cord blood samples:
C. yes, the DAT and cord hemoglobin level both support HDN
The main purpose of performing antibody titers on serum from prenatal immunized women is to:
A. identify candidates for amniocentesis or percutaneous umbilical blood sampling
Which unit should be selected for exchange transfusion is the newborn is group A, Rh-positive and the mother is group A, Rh-positive with anti-c?
B. A, CDe/CDe
A mother is group A, with anti-D in her serum. What would be the perfect blood product if an intrauterine transfusion is indicated?
A. O, Rh-negative Red Blood Cells, Irradiated
Laboratory studies of maternal and cord blood yield the following results:
Maternal blood Cord Blood O, Rh-negative B, Rh-positive anti-E in serum DAT = 2+ anti-E in eluate
If exchange transfusion is necessary, the best choice of blood is:
C. O, Rh-positive, E-
A blood specimen from a pregnant woman is found to be group B, Rh-negative and the serum contains anti-D with a titer of 512. What would be the most appropriate type of blood to have available for a possible exchange transfusion for her infant?
A. O, Rh-negative
Blood selected for exchange transfusion must:
B. lack red blood cell antigens corresponding to maternal antibodies
When the main objective of an exchange transfusion is to remove the infant's antibody-sensitized red blood cells and to control hyperbilirubinemia, the blood product of choice is ABO compatible:
A. RBC suspended in Fresh Frozen Plasma
To prevent graft-vs-host disease, Red Blood Cells prepared for infants who have received intrauterine transfusions should be:
D. irradiated
Which of the following is the preferred specimen for the initial compatibility testing in exchange transfusion therapy?
B. maternal serum
Rh-Immune Globulin is requested for an Rh-negative mother who has the following results:
What is the most likely explanation:
D. mother had a fetomaternal hemorrhage of D+ cells
The following results are seen on amaternal postpartum sample:
The most appropriate course of action is to:
D. investigate for a fetomaternal hemorrhage
What is the most appropriate interpretation for the laboratory data given below when an Rh-negative woman has an Rh-positive child?
A. mother needs 1 vial of RhIg
Refer to the following information: What is the best interpretation for the laboratory data given above?
D. mother has had a fetal-maternal hemorrhage
A weakly anti-D is detected in a postpartum specimen from an Rh-negative woman. During her prenatal period, all antibody screening tests were negative. These findings indicate:
A. a need for further investigation to determine candidacy for Rh immune globulin
The results of a Kleihauer-Betke stain indicate a fetomaternal hemorrhage of 35 mL of whole blood. How many vials of Rh immune globulin would be required?
D. 2
A fetomaternal hemorrhage of 35 mL of fetal Rh-positive packed RBCs has been detected in an Rh-negative woman. How many vials of Rh immune globulin should be given?
C. mother has not been previously immunized to the D antigen
While performing routine postpartum testing for an Rh immune globulin (RhIG) candidate, a weakly positive antibody screening test was found. Anti-D was identified. This antibody is most likely the result of:
D. antenatal admission of Rh immune globulin at 28 weeks gestation
Rh immune globulin administration would not be indicated in an Rh-negative woman who has a(n):
B. anti-D titer of 1:4,096
A Kleihauer-Betke stain of a postpartum blood film revealed 0.3% fetal cells. What is the estimated volume (mL) of the fetomaternal hemorrhage expressed as whole blood?
D. 15
Based upon Kleihauer-Betke test results, which of the following formulas is used to determine the volume of fetomaternal hemorrhage expressed in mL of whole blood?
D. % of fetal cells present x 50
An acid elution stain was made using a 1-hour post-delivery maternal blood sample. Out of 2,000 cells that were counted, 30 of them appeared tocontain fetal hemoglobin. It is the policy of the medical center to add 1 vial of Rg immune globulin to the calculated dose when the estimated volume of the hemorrhage exceeds 20 mL of whole blood. Calculate the number of vials of Rh immune globulin that would be indicated under these circumstances.
A. 4
The rosette test will detect a fetomaternal hemorrhage (FMH) as small as:
D. 10 mL
A 10 mL fetal maternal hemorrhage in an Rh-negative woman who delivered an Rh-positive baby means that the:
B. rosette test will be positive
Mixed leukocyte culture (MLC) is a biological assay for detecting which of the following?
A. HLA-D antigens
A 40-year-old man with autoimmune hemolytic anemia due to anti-E has a hemoglobin level of 10.8 g/dL (108 g/L). This patient will most likely be treated with:
D. no transfusion
A patient in the immediate post bone marrow transplant period has a hematocrit of 21%. The red cell product of choice for this patient would be:
C. irradiated
HLA antigen typing is important in screening for:
A. a kidney donor
DR antigens in the HLA system are:
D. significant in organ transplantation
Anti-E is identified in a panel at the antiglobulin phase. When check cells are added to the tubes, no agglutination is seen. The most appropriate course of action would be to:
B. quality control the AHG reagent and check cells and repeat the panel
A serological centrifuge is recalibrated for ABO testing after major repairs.
Given the data above, the centrifuge time for this machine should be:
A. 20 seconds
Which of the following represents an acceptably identified patient for sample collection and transfusion?
C. a handwritten band with patient's name and hospital identification number affixed to the patient's leg
Samples from the same patient were received on 2 consecutive days. Test results are summarized below:
How should the request for crossmatch be handled?
C. collect a new sample and repeat the tests
The following test results are noted for a unit of blood labeled group A, Rh-negative:
What should be done next?
A. notify the collecting facility
What information is essential on patient blood sample labels drawn fro compatibility testing?
D. unique patient medical number
Granulocytes for transfusion should:
D. be ABO compatible with the recipient's serum
A neonate will be transfused for the first time woth group O red blood cells. Which of the following is appropriate compatibility testing?
B. no crossmatch is necessary if initial plasma screening is negative
A group B, Rh-negative patient has a positive DAT. Which of the following situations would occur?
B. the weak D test and control would be positive
The following reactions were obtained:
The technologist washed the patient's cells with saline, and repeated the forward typing. A saline replacement technique was used with the reverse typing. The following results were obtianed:
The results are consistent with:
C. multiple myeloma
What is the most likely cause of the following ABO discrepancy?
D. obtained from a heel stick of a 2-month old baby
Which of the following patient data best reflects the discrepancy seen when a person's red cells demonstrate the acquired-B phenotype?
A. B
Which of the following is characteristic of Tn polyagglutinable red cells?
A. if group O, they may appear to have acquired a group A antigen
Mixed field agglutination encountered in ABO grouping with no history of transfusion would most likely be due to:
C. A3 red cells
Which of the following is a characteristic of polyagglutinable red cells?
C. are agglutinated by most adult sera
Consider the following ABO typing results:
What is the most likely cause of this discrepancy?
A. cold autoantibody
Consider the following ABO typing results:
What should be done next?
B. perform serum type at 37oC
The following results were obtained on a patient's blood sample during routine ABO and Rh testing:
Select the course of action to resolve this problem:
B. perform antibody screening procedure at immediate spin using group O cells
Which of the following explains an ABO discrepancy caused by problems with the patient's red blood cells?
A. Tn activation
The test for weak D is performed by incubating patient's red cells with:
B. anti-D serum followed by washing and antiglobulin serum
Refer to the following data:
Which of the following antibody screen results would you expect with the ABO discrepancy seen above?
B. positive with all screen cells at the RT phase; autocontrol is negative
The following results were obtained when testing a sample from a 20-year-old, first-time blood donor:
What is the most likely cause of this ABO discrepancy?
C. weak subgroup of A
A mother is Rh-negative and the father is Rh-positive. Their baby is Rh-negative. It may be concluded that:
B. the father is heterozygous for D
Some blood group antibodies characteristically hemolyze appropriate red cells in the presence of:
A. complement
Review the following schematic diagram:
The next step would be to:
D. identify the cause of the agglutination
The following results were obtained in pretransfusion testing:
The most probable cause of these results is:
B. a warm autoantibody
A patient is typed as group O, Rh-positive and crossmatched with 6 units of blood. At the indirect antiglobulin (IAT) phase of testing, both antibody screening cells and 2 crossmatched units are incompatible. What is the most likely cause of the incompatibility?
C. recipient alloantibody
Refer to the following data:
Which clinical condition is consistent with the lab results shown above?
D. warm autoimmune hemolytic anemia
A patient received 2 units of Red Blood Cells 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 an antibody at the antiglobulin phase. What is the most likely explanation for the original results?
A. patient's serum was omitted from the original testing
At the indirect antiglobulin phase of testing, there is no agglutination between patient serum and screening cells. One of 3 donor units was incompatible.
B. patient has an antibody directed against a low incidence antigen
The major crossmatch will detect a(n):
D. recipient antibody directed against antigens on the donor red cells
A 42-year-old female is undergoing surgery tomorrow and her physician requests that 4 units of Red Blood Cells be crossmatched. The following results were obtained:
What is the most likely cause of the incompatibility of donor 1?
B. single alloantibody
Which of the following would most likely be responsible for an incompatible antiglobulin crossmatch?
A. donor red cells have a positive direct antiglobulin test
A reason why a patient's crossmatch may be incompatible while the antibody screen is negative is:
B. the incompatible donor unit has a positive direct antiglobulin
A blood specimen types as A, Rh-positive with a negative antibody screen. 6 units of group A, Rh-positive Red Blood Cells were crossmatched and 1 unit was incompatible in the antiglobulin phase. The same result was obtained when the test was repeated. Which should be done first?
B. perform a direct antiglobulin test on the donor unit
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-negative. The technologist should:
C. release O Rh-negative Red Blood Cells
A 29-year-old male is hemorrhaging severely. He is AB, Rh-negative. 6 units of blood are required STAT. Of the following types available in the blood bank, which would be most preferable for crossmatch?
D. A, Rh-negative
A patient is group A2B, Rh-positive and has an antiglobulin- reacting anti-A1 in his serum. He is in the operating room bleeding profusely and group A2B Red Blood Cells are not available. Which of the following blood types is first choice for crossmatch?
C. B, Rh-positive
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
A patient serum reacts with 2 of the 3 antibody screening cells at the AHG phase. 8 of the 10 units crossmatched were incompatible at the AHG phase. All reactions are markedly enhanced by enzymes. These results are most consistent with:
B. anti-c
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
Autoantibodies demonstrating blood group specificity in warm autoimmune hemolytic anemia are associated more often with which blood group system?
A. Rh
An antibody that causes in vitro hemolysis and reacts with the red cells of 3 out of ten crossmatched donor units is most likely:
D. anti-Lea
A patient's serum reacted weakly positive (1+w) with 16 of 16 group O panel cells at AHG test phase. The autocontrol was negative. Tests with ficin-treated panel cells demonstrated no reactivity at the AHG phase. Which antibody is most likely responsible for these results?
C. anti-Ch
An antibody identification study is performed with the 5-cell panel shown below:
An antibody against which of the following antigens could not be excluded?
C. 1
A 25-year-old Caucasian woman, gravida 3, para 2, required 2 units of Red Blood Cells. The antibody screen was positive and the results of the antibody panel are shown below:
Which of the following antibodies may be the cause of the positive antibody screen?
A. anti-c and anti-E
A 25-year-old Caucasian woman, gravida 3, para 2, required 2 units of Red Blood Cells. The antibody screen was positive and the results of the antibody panel are shown below:
Which common antibody has not been ruled out by the panel?
A. anti-E
In the process of identifying an antibody, the technologist observed 2+ reactions with 3 of the 10 cells in a panel after the immediate spin phase. There was no reactivity after incubation at 37oC and after the anti-human globulin test phase. The antibody most likely is:
D. anti-Lea
Transfusion of Ch+ (Chido-positive) red cells to a patient with anti-Ch has been reported to cause:
D. no clinically significant red cell destruction
Results of a serum sample tested against a panel of reagent red cells gives presumptive evidence of an alloantibody directed against a high incidence antigen. Further investigation to confirm the specificity should include which of the following?
B. serum testing against red cells known to lack high incidence antigens
Refer to the following data:
The ABO discrepancy seen above is most likely due to:
A. anti-H
Refer to the following panel:
aBased on the results of the above panel, the most likely antibodies are:
B. anti-E, anti-Jka and anti-K
Which characteristic are true of all 3 of the following antibodies: anti-Fya, anti-Jka, and anti-K?
C. detected at IAT phase and may cause hemolytic disease of the fetus and newborn (HDFN) and transfusion reactions
Refer to the following cell panel:
aBased on these results, which of the following antibodies is most likely present?
B. anti-C
A pregnant woman has a positive antibody screen and the panel results are given below:
aWhat is the association of the antibody(ies) with hemolytic disease of the newborn (HDFN)?
D. may cause HDFN
Which of the following tests is most commonly used to detect antibodies attached to a patient's red blood cells in vivo?
A. direct antiglobulin
Anti-I may cause a positive direct anti globulin test (DAT) because of:
C. C3d bound to the red cells
Which direct antiglobulin test results are associated with an anamnestic antibody response in a recently transfused patient?
C. result A
In the direct (DAT) and indirect (IAT) antiglobulin tests, false-negative reactions may result if the:
D. addition of AHG is delayed for 40 minutes or more after washing the serum/cell mixture
Polyspecific reagents used in the direct antiglobulin test should have specificty:
C. IgG and C3d
In the direct antiglobulin test, the antiglobulin reagent is used to:
A. detect preexisting antibodies on erythrocytes
AHG (Coombs) control cells:
A. are coated only with IgG antibody
A 56-year-old female with cold agglutinin disease has a positive direct antiglobulin test (DAT). When the DAT is repeated using monospecific antiglobulin sera, which of the following is most likely to be detected?
D. C3d
The mechanism that best explains hemolytic anemia due to penicillin is:
C. drug-dependent antibodies reacting with drug-treated cells
Use of EDTA plasma prevents activation of the classical complement pathway by:
B. chelating Ca++ ions, which prevents assembly of C1
Which of the following medications is most likely to cause production of autoantibodies?
D. methyldopa
Serological results on an untransfused patient were:
antibody screen: negative at AHG direct antiglobulin test: 3+ with anti-C3d eluate: negative
These results are most likely due to:
C. cold agglutinin syndrome
The drug cephalosporin can cause a positive direct antiglobulin test with hemolysis by which of the following mechanisms?
B. drug-dependent antibodies reacting in the presence of a drug
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:
C. residual patient patient serum inactivated the AHG reagent
Which of the following might cause a false-negative indirect antiglobulin test (IAT)?
A. too heavy a cell suspension
The purpose of testing with anti-A,B to detect:
A. subgroups of A
What is the most appropriate diluent for preparing a solution of 8% bovine albumin for a red cell control reagent?
A. normal saline
Which of the following antigens gives enhanced reactions with its corresponding antibody following treatment of the red cells with proteolytic enzymes?
C. E
In a prenatal workup, the following results were obtained:
ABO discrepancy was thought to be due to an antibody directed against a component of the typing sera. Which test would resolve this discrepancy?
B. wash patient's RBCs and repeat testing
Refer to the following panel:
Based on the results of the above panel, which technique would be most helpful in determining antibody specificity?
A. proteolytic enzyme treatment
Of the following, the most useful technique(s) in the identification and classification of high-titer, low-avidity (HTLA) antibodies is/are:
A. titration and inhibition
To confirm a serum antibody specificity identified as anti-P1, a neutralization study was performed and the following results obtained:
What conclusion can be made from these results?
A. anti-P1 cannot be confirmed due to the results of the negative control
What happens to an antibody in neutralization study when a soluble antigen is added to the test?
B. inhibition
To confirm the specificity of anti-Leb, an inhibition study using Lewis substance was performed with the following results:
What conclusion can be made from these results?
D. anti-Leb is confirmed because the tubes with Lewis substance are negative
Which of the following is the correct interpretation of this saliva neutralization testing?
A. group O secretor
A person's saliva incubated with the following antibodies and tested with the appropriate A2, O, and B indicator cells, gives us the following test results:
The person's red cells ABO phenotype is:
D. B
An antibody screen performed using solid phase technology revealed a diffuse layer of red blood cells on the bottom of the well. These results indicate:
D. a positive reaction
On Monday, a patient's K antigen typing result was positive. Two days later, the patient's K typing was negative. The patient was transfused with 2 units of Fresh Frozen Plasma. The tech might conclude that the:
A. wrong patient was drawn
Which one of the following is an indicator of polyagglutination?
C. agglutination with normal adult ABO compatible sera
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?
A. original reaction was due to true agglutination
A 10-year-old girl was hospitalized because her urine had a distinct red color. The patient had recently recovered from an upper respiratory infection and appeared very pale and lethargic. Tests were performed with the following results:
The patient probably has:
C. paroxysmal cold hemoglobinuria (PCH)
Which of the following is useful for removing IgG from red blood cells with a positive DAT to perform a phenotype?
a bromelin
b. chloroquine
c. LISS
d. DTT
b. chloroquine
A patient's serum contains a mixture of antibodies. One of the antibodies is identified as anti-D. Anti-Jka, anti-Fya and possibly another antibody are present. What technique(s) may be helpful to identify the other antibody(ies)?
B. enzyme panel; select cell panel
A sample gives the following results:
Which lectin should be used first to resolve this discrepancy?
A. Dolichos biflorus
The serum of 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?
B. group A1B, cde/cde cells
A 26-year-old female is admitted with anemia of undetermined origin. Blood samples are received with a crossmatch request for 6 units of Red Blood Cells. The patient is group A, Rh-negative and has no history of transfusion or pregnancy. The following results were obtained in pretransfusion testing:
The best way to find compatible blood is to:
A. perform a warm autoadsorption
A patient's serum was reactive 2+ in the antiglobulin phase of testing with all cells on a routine panel including their own. Transfusion was performed 6 months previously. The optimal adsorption method to remove the autoantibody is:
D. autoadsorption using the patient's ZZAP-treated red cells
In a cold autoadsorption procedure, pretreatment of the patient's red cells with which of the following reagents is helpful?
B. ficin
The process of separation of antibody from its antigen is known as:
C. elution
Which of the following is most helpful to confirm a weak ABO subgroup?
A. adsorption-elution
One of the most effective methods for the elution of warm autoantibodies from RBCs utilizes:
A. change in pH
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, vs 2 units of Red Blood Cells each with a total volume of 250 mL?
D. Red Blood Cells would provide twice the increment in hematocrit as the Whole Blood
After checking the inventory, it was noted that there were no units on the shelf marked "May Issue as Uncrossmatched: For Emergency Only." Which of the following should be placed on this shelf?
D. units of group O, Rh-negative Red Blood Cells
The primary indication for granulocyte transfusion is:
A. severe neutropenia with an infection that is nonresponsive to antibiotic therapy
A 42-year-old male of average body mass has a history of chronic anemia requiring transfusion support. Two units of Red Blood Cells are transfused. If the pretransfusion hemoglobin was 7.0 g/dL (70 g/L), the expected posttransfusion hemoglobin concentration should be:
C. 9.0 g/dL (90 g/L)
How many units of Red Blood Cells are required to raise the hematocrit os a 70 kg nonbleeding man from 24% to 30%?
A. 2
For which of the following transfusion candidates would CMV-seronegative blood be most likely indicated?
B. bone marrow and hematopoietic recipients
Although ABO compatibility is preferred, ABO incompatible product may be administered when transfusing:
A. Cryoprecipitated AHF
Transfusion of plateletpheresis products from HLA-compatible donors is the preferred treatment for:
A. severely thrombocytopenic patients, known to be refractory to random donor platelets
Washed Red Blood Cells are indicated in which of the following situations?
D. an IgA-deficient patient with a history of transfusion-associated anaphylaxis
Which of the following is consistent with standard blood bank procedure governing the infusion of fresh frozen plasma?
A. group A may be administered to bot A and O recipients
A patient who is group AB, Rh-negative needs 2 units of Fresh Frozen Plasma. Which of the following units of plasma would be most acceptable for transfusion?
D. group AB, Rh-positive
What increment of platelets/uL (platelets/L), in the typical 70-kg human, is expected to result from each single unit of Platelets transfused to a non-HLA-sensitized recipient?
A. 5,000-10,000
Platelet transfusions are of most value in treating:
C. functional platelet abnormalities
Washed Red Blood Cells would be the product of choice for a patient with:
A. anti-IgA antibodies
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 red blood cell component should be given?
C. Red Blood Cells, Washed
Fresh Frozen Plasma from a group A, Rh-positive donor may be safely transfused to a patient who is group:
D. A, Rh-negative
A patient admitted to the trauma unit requires emergency release of Fresh Frozen Plasma (FFP). His blood donor card states that he is group AB, Rh-positive. Which of the following blood groups of FFP should be issued?
C. AB
Fresh Frozen Plasma:
C. should be transfused within 24 hours of thawing
Ten units of group A platelets were transfused to a group AB patient. The pretransfusion platelet count was 12 x 103/uL (12 x 109/L) and the posttransfusion count was 18 x 103/uL (18 x 109/L). From this information, the laboratorian would most likely conclude that the patient:
C. has developed antibodies to the transfused platelets
Hypotension, nausea, flushing, fever and chills are symptoms of which of the following transfusion reactions?
D. hemolytic
A patient has become refractory to platelet transfusion. Which of the following are probable causes?
A. development of antibodies to HLA antigen
A poor increment in the platelet count 1 hour following platelet transfusion is most commonly caused by:
D. alloimmunization to HLA antigens
Posttransfusion purpura is usually caused by:
D. anti-HPA-1a (P1A1)
an unexplained fall in hemoglobin and mild jaundice in a patient transfused with Red Blood Cells 1 week previously would most likely indicate:
C. delayed hemolytic transfusion reaction
In delayed transfusion reeaction, the causative antibody is generally too weak to be detected in routine compatibility testing and antibody screening tests, but its typically detectable at what point after transfusion?
A. 3-7 days
The most serious hemolytic transfusion reactions are due to incompatibility in which of the following blood group systems?
B. ABO
Severe intravascular hemolysis is most likely caused by antibodies of which blood group system?
D. ABO
Which of the following blood group systems is most commonly associated with delayed hemolytic transfusion reactions?
C. Kidd
After receiving a unit of Red Blood Cells, a patient immediately developed flushing, nervousness, fever spike of 102oF (38.9oC), shaking, chills and back pain. The plasma hemoglobin was elevated and there was hemoglobinuria. Laboratory investigation of this adverse reaction would most likely show:
C. an error in ABO grouping
A trauma patient who has just received ten units of blood may develop:
D. thrombocytopenia
Five days after transfusion, a patient becomes mildly jaundiced and experiences a drop in hemoglobin and hematocrit with no apparent hemorrhage. Below are the results of the transfusion reaction workup:
In order to reach a conclusion, the technician should first:
D. identify the antibody in the serum and eluate from the posttransfusion sample
The most appropriate laboratory test for early detection of acute posttransfusion hemolysis is:
C. a visual inspection for free plasma hemoglobin
During initial investigation of a suspected hemolytic transfusion reaction, it was observed that the posttransfusion serum was yellow in color and the direct antiglobulin test was negative. Repeat ABO typing on the posttransfusion sample confirmed the pretransfusion results. What is the next step in this investigation?
D. no further serological testing is necessary
Which of the following transfusion reactions is characterized by high fever, shock, hemoglobinuria, DIC and renal failure?
D. bacterial contamination
Hemoglobinuria, hypotension and generalized bleeding are symptoms of which of the following transfusion reactions?
D. hemolytic
When evaluating a suspected transfusion reaction, which of the following is the ideal sample collection time for a bilirubin determination?
B. 6 hours posttransfusion
A patient's record shows a previous anti-Jkb, but the current antibody screen is negative. What further testing should be done before transfusion?
D. give Jkb negative crossmatch compatible blood
A posttransfusion blood sample from a patient experiencing chills and fever shows distinct hemolycic. The direct antiglobulin test is positive (mixed field). What would be most helpful to determine the cause of the reaction?
D. elution and antibody identification
A patient is readmitted to the hospital with a hemoglobin level of 7 g/dL (70 g/L) 3 weeks after receiving 2 units of red cells. The initial serological tests are:
ABO/Rh: A+ antibody screen: negative DAT: 1 + mixed field
Which test should be performed next?
B. perform an elution and identify the antibody in the eluate
In a delayed hemolytic transfusion reaction, the direct antiglobulin test is typically:
B. mixed-field positive
A patient has had massive trauma involving replacement of 1 blood volume with Red Blood Cells and crystalloid. She is currently experiencing oozing from mucous membranes and surgical incisions. Laboratory values are as follows:
PT: normal APTT: normal bleeding time: prolonged platelet count: 20 x 10^3/uL (20 x 10^9/L) hemoglobin: 11.4 g/dL (114 g/L)
What is the blood component of choice for this patient?
A. Platelets
For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment goal should be to:
C. reverse hypotension and minimize renal damage
A patient multiply transfused with Red Blood Cells developed a headache, nausea, fever and chills during his last transfusion. What component is most appropriate to prevent this reaction in the future?
A. Red Blood Cells, Leukocyte-Reduced
The use of Leukocyte-Reduced Red Blood Cells and Platelets is indicated for which of the following patient groups?
D. patients with history of febrile transfusion reactions
Leukocyte-Poor Red Blood Cells would most likely be indicated for patients with a history of:
B. febrile transfusion reaction
Posttransfusion anaphylactic reactions occur most often in patients with:
A. IgA deficiency
Which of the following transfusion reactions occurs after infusion of only a few milliliters of blood and gives no history of fever?
A. anaphylactic
Fever and chills are symptoms of which of the following transfusion reactions?
B. febrile
Hives and itching are symptoms of which of the following transfusion reactions?
D. allergic
A temperature rise of 10C or more occurring in association with a transfusion, with no abnormal results in the transfusion reaction investigation, usually indicates which of the following reactions?
D. febrile
A 65-year-old woman experienced shaking, chills, and a fever of 102oF (38.9oC) approximately 40 minutes following the transfusion of a second unit of Red Blood Cells. The most likely explanation for the patient's symptoms is:
A. febrile transfusion reaction
A sickle cell patient who has been multiply transfused experiences fever and chills after receiving a unit of Red Blood Cells. Transfusion investigation studies show:
DAT: negative plasma hemolysis: no hemolysis observed
The patient is most likely reacting to:
C. white cells or cytokines
Use of only male donors as a source of plasma intended for transfusion is advocated to reduce which type of reaction?
B. TRALI
Platelets are ordered for a patient who has a history of febrile reactions following red cell transfusions. What should be done to reduce the risk of another febrile reaction?
D. give Leukocyte-Reduced Platelets
Symptoms of dyspnea, cough, hypoxia, and pulmonary edema within 6 hours of transfusion is most likely which type of infection?
C. TRALI
A patient with a coagulopathy was transfused with FP24 (plasma frozen within 24 hours 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
To prevent transfusion reactions, which Red Blood Cell product should be transfused?
A. Red Blood Cells, Leukocyte-Reduced
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?
B. quarantine the unit for further testing
Coughing, cyanosis and difficult breathing are symptoms of which of the following transfusion reactions?
B. circulatory overload
Which of the following is a nonimmunologic adverse effect of a transfusion?
A. congestive heart failure
Congestive heart failure, severe headache and/or peripheral edema occurring soon after transfusion is indicative of which type of transfusion reaction?
D. circulatory overload
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?
C. transfusion-associated circulatory overload
A patient became hypotensive and went into shock after receiving 50 mL of a unit of Red Blood Cells. She had a shaking chill and her temperature rose to 104.8oF (40.4oC). A transfusion reaction investigation was initiated but no abnormal results were seen. What additional testing should be performed?
B. Gram stain and culture of the donor unit
The most frequent transfusion-associated disease complication of blood transfusions is:
C. hepatitis
The purpose of a low-dose irradiation of blood components is to:
D. prevent graft-vs-host (GVH) disease
Which of the following patient groups is at risk of developing graft-vs-host disease?
A. recipients of blood donated by immediate family members
Irradiation of donor blood is done to prevent which of the following adverse affects of transfusion?
D. transfusion associated graft-vs-host disease
Therapeutic plasmapharesis is performed in order to:
B. treat patients with plasma abnormalities
Plasma exchange is recommended in the treatment of patients with macroglobulinemia in order to remove:
C. excess IgM
The most important step in the safe administration of blood is to:
A. accurately identify the donor unit and recipient
Author
mbailey585
ID
225575
Card Set
Blood Bank ASCP BOC
Description
Blood Bank ASCP BOC: 1-57 Blood Products, 58-118 Blood Group Systems, 119-165 Physiology and Pathophysiology, 166-260 Serology, and 260-330 Transfusion Practice.
