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BB Flashcards

1
Q

The key structural difference that distinguishes immunoglobulin subclasses is the:
A. Number of domains
B. Stereometry of the hypervariable region
C. The sequence of the constant regions
D. Covalent linkage of the light chains

A

C. The sequence of the constant regions

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2
Q

Immunoglobulin classes are differentiated according to the molecular structure of:
A. Light chains
B. Heavy chains
C. Fab fragment
D. Fc fragment

A

B. Heavy chains

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3
Q

A 54-year-old female previous smoker presents with a recent history of fever, swollen joints, and morning stiffness.
• Laboratory results indicate elevated C-reactive protein, positive cyclic citrullinated peptide of 205 units (cut-off: 20 units), speckled ANA pattern (titer 1:320), and negative rheumatoid factor.
What is the most likely diagnosis?
A. Reactive arthritis
B. Rheumatoid arthritis
C. Systemic sclerosis
D. Sjogren syndrome

A

B. Rheumatoid arthritis

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4
Q

Which of the following is used for the confirmation of infection with HIV-1?
A. Western blot (immunoblot) assay
B. ELISA
C. Complement fixation
D. p24 Antigen testing

A

A. Western blot (immunoblot) assay

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5
Q

Which technique is used for the confirmation of infection with HIV-1 and HIV-2?
A. Western blot (immunoblot) assay
B. ELISA
C. FDA-approved NAT
D. p24 Antigen testing

A

C. FDA-approved NAT

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6
Q

Clinical assays for tumor markers are most important for:
A. Screening for the presence of cancer
B. Monitoring the course of a known cancer
C. Confirming the absence of disease
D. Identifying patients at risk for cancer

A

B. Monitoring the course of a known cancer

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7
Q

In general, in which of the following situations is the analysis of a tumor marker most useful?
A. Testing for recurrence
B. Prognosis
C. Screening
D. Diagnosis

A

A. Testing for recurrence

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8
Q

The chemical composition of an antibody is:
A. Protein
B. Lipid
C. Carbohydrate
D. Glycoprotein

A

D. Glycoprotein

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9
Q

What is the most common clinical incident that results in alloantibody production?
A. Viral infection
B. Solid tumor
C. Red cell transfusion
D. Autoimmune disease

A

C. Red cell transfusion

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10
Q

What antibodies are present in polyspecific AHG reagent?
A. Anti-IgG
B. Anti-IgM and anti-1gG
C. Anti-IgG and anti-C3d
D. Anti-C3d

A

C. Anti-IgG and anti-C3d

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11
Q

Which of the following medications is most likely to cause production of AUTOANTIBODIES?
A. Penicillin
B. Cephalosporin
C. Methyldopa
D. Tetracycline

A

C. Methyldopa

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12
Q

Red cells from a recently transfused patient were DAT positive when tested with anti-lgG. Screen cells and a panel performed on a patient’s serum showed very weak reactions with inconclusive results. What procedure could help to identify the antibody?
A. Elution followed by a panel on the eluate
B. Adsorption followed by a panel on the adsorbed serum
C. Enzyme panel
D. Antigen typing the patient’s red cells

A

A. Elution followed by a panel on the eluate

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13
Q

The procedure that removes intact antibodies from the red cell membranes is:
A. Autoadsorption
B. Enzyme pretreatment
C. Neutralization
D. Elution

A

D. Elution

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14
Q

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?
A. IgM
B. IgG
C. C3d
D. C4a

A

C. C3d

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15
Q

A crossmatch is positive at AHG phase with polyspecific AHG reagent but is negative with
monospecific anti-lgG AHG reagent. This may indicate the antibody:

A. Is a weak anti-D
B. Is a clinically insignificant Lewis antibody
C. Can cause decreased survival of transfused RBCs
D. Is a Duffy antibody

A

B. Is a clinically insignificant Lewis antibody

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16
Q

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 overwashed
B. Residual patient serum inactivated the AHG reagent
C. Centrifuge speed was set too high
D. Laboratorian did not add enough check cells

A

B. Residual patient serum inactivated the AHG reagent

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17
Q

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. Fy

A

A. Rh

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18
Q

Which antibody is frequently seen in patients with
warm autoimmune hemolytic anemia?

A. Anti-Jka
B. Anti-e
C. Anti-K
D. Anti-Fy®

A

B. Anti-e

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19
Q

Many enhancement media used in the blood bank promote hemagglutination in the presence of IgG antibodies by reducing which of the following?
A. Hydrophilic forces
B. Low ionic potential
C. van der Waals forces
D. Zeta potential

A

D. Zeta potential

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20
Q

Low ionic strength saline (LISS) acts as an enhancement medium and facilitates antibody uptake by:
A. Activating complement
B. Increasing flexibility in hinge region
C. Removing water molecules
D. Reducing zeta potential

A

D. Reducing zeta potential

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21
Q

Which antibody would not be detected by group
O screening cells?
A. Anti-N
B. Anti-A1
C. Anti-Dia
D. Anti-k

A

B. Anti-A1

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22
Q

Screening cells, major crossmatch, and patient autocontrol are positive in all phases. Identify the problem.
A. Specific cold alloantibody
B. Specific cold autoantibody
C. Abnormal protein or nonspecific autoantibody
D. Cold and warm alloantibody mixture

A

C. Abnormal protein or nonspecific autoantibody

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23
Q

What corrective action should be taken when rouleaux causes positive test results?
A. Perform a saline replacement technique
B. Perform an autoabsorption
C. Run a panel
D. Perform an elution

A

A. Perform a saline replacement technique

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24
Q

Screening cells and major crossmatch are positive on IS only, and the autocontrol is negative. Identify the problem.
A. Cold alloantibody
B. Cold autoantibody
C. Abnormal protein
D. Antibody mixture

A

A. Cold alloantibody

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25
Q

Which of the following describes the expression of most blood group inheritance?
A. Dominant
B. Sex-linked
C. Recessive
D. Codominant

A

D. Codominant

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26
Q

Which genotype(s) will give rise to the Bombay phenotype?
A. HH only
B. HH and Hh
C. Hh and hh
D. hh only

A

D. hh only

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27
Q

What should be done if all forward and reverse ABO results as well as the autocontrol are positive?
A. Wash the cells with warm saline, autoadsorb the serum at 4°C,
B. Retype the sample using a different lot number of reagents
C. Use polyclonal typing reagents
D. Report the sample as group AB

A

A. Wash the cells with warm saline, autoadsorb the serum at 4°C,

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28
Q

patient types as AB positive. Two units of blood have been ordered by the physician. Currently, the inventory shows no AB units, 10 A-positive units, 1 A-negative unit, 5 B-positive units, and 20 O-positive units. Which should be set up for the major crossmatch?
A. A-positive units
B. O-positive units
C. B-positive units
D. Call another blood supplier for type-specific blood 4 shares

A

A. A-positive units

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29
Q

A physician orders 2 units of leukocyte-reduced red blood cells. The patient is a 55-year-old male with anemia. He types as an AB negative, and his antibody screen is negative. There is only 1 unit of AB negative in inventory. What is the next blood type that should be given?
A. AB positive (patient is male)
B. A negative
C. B negative
D. O negative

A

B. A negative

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30
Q

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
B. Anti-d
C. Anti-e
D. Anti-E

A

A. Anti-c

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31
Q

What antibodies could an R1R1 make if exposed to R2R2 blood?
A. Anti-e and anti-C
B. Anti-E and anti-c
C. Anti-E and anti-c
D. Anti-e and anti-c

A

C. Anti-E and anti-c

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32
Q

What techniques are necessary for weak D testing?
A. Saline + 22°C incubation
B. Albumin or LISS + 37°C incubation
C. Saline + 37°C incubation
D. 37°C incubation + IAT

A

D. 37°C incubation + IAT

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33
Q

Rhig (Rhogam) is indicated for:
A. Mothers who have anti-D
B. Infants who are Rh-negative
C. Infants who have anti-D
D. Mothers who are Rh-negative

A

D. Mothers who are Rh-negative

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34
Q

RhIG should be administered within how many hours of delivery?
A. 4
B. 48
C. 72
D. 96

A

C. 72

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35
Q

Which of the following antigens is poorly expressed on cord blood cells?
А. К
B. М
C. Leb
D. D

A

C. Leb

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36
Q

Which of the following is characteristic of anti-i?
A. Often associated with hemolytic disease of the newborn
B. Reacts best at 37°C
C. Reacts best at room temperature or 4°C
D. D. Is usually IgG

A

C. Reacts best at room temperature or 4°C

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37
Q

PAROXYSMAL COLD HEMOGLOBINURIA (PCH) is associated with antibody specificity toward which of the following?
A. Kell system antigens
B. Duffy system antigens
C. Pantigen
D. antigen

A

C. Pantigen

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38
Q

In the DONATH-LANDSTEINER TEST, patient’s serum are incubated at various temperatures with:
A. Group O RBCs that express the P antigen
B. Group O RBCs that express the P1 antigen
C. Group AB RBCs that express the P antigen
D. Group AB RBCs that express the P1 antigen

A

A. Group O RBCs that express the P antigen

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39
Q

Excluding ABO, _ is rated second only to D in immunogenicity.
A. Kell
B. Cellano
C. Duffy
D. Kidd

A

A. Kell

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40
Q

The K (KEL1) antigen is:
A. Absent from the red cells of neonates
B. Strongly immunogenic
C. Destroyed by enzymes
D. Has a frequency of 50% in the random population

A

B. Strongly immunogenic

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41
Q

The k (Cellano) antigen is a high-frequency antigen and is found on most red cells. How often would one expect to find the corresponding antibody?
A. Often
B. Rarely
C. It depends upon the population
D. Impossible to determine without consulting regional blood group antigen charts

A

B. Rarely

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42
Q

An individual has been sensitized to the k antigen and has produced anti-k. What is her most probable Kell system genotype?
А. КК
B. Kk
C. kk
D. КОКО

A

А. КК

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43
Q

An antibody commonly associated with delayed transfusion reactions is:
A. Anti-Lua
B. Anti-s
C. Anti-Jkb
D. Anti-M

A

C. Anti-Jkb

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44
Q

What blood group system antibodies are commonly associated with delayed hemolytic transfusion reactions?
A. Rh
B. MNS
С. ABO
D. Kidd

A

D. Kidd

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45
Q

What procedure would help to distinguish between an anti-Fy? and anti-Jka in an antibody mixture?

A. Lowering the pH of the patient’s serum
B. Using a thiol reagent
C. Testing at colder temperatures
D. Ficin-treated panel cells

A

D. Ficin-treated panel cells

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46
Q

Which of the following antibodies characteristically gives a refractile mixed-field appearance?
A. Anti-K
B. Anti-Dia
C. Anti-Sda
D. Anti-s

A

C. Anti-Sda

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47
Q

A patient has symptoms indicating a possible hemolytic transfusion reaction. What should be done immediately?
A. Stop the transfusion and discard the unit
B. Contact the patient’s doctor to ask if the transfusion should be stopped
C. Stop the transfusion and call the patient’s doctor to report the reaction
D. Have patient blood samples sent to the lab to investigate the reaction

A

C. Stop the transfusion and call the patient’s doctor to report the reaction

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48
Q

FATAL TRANSFUSION reactions are mostly caused by?
A. Serologic errors
B. Improper storage of blood
C. Clerical errors
D. Improper handling of the product

A

C. Clerical errors

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49
Q

Some blood group antibodies characteristically hemolyze appropriate red cells in the presence of:
A. Complement
B. Anticoagulants
C. Preservatives
D. Penicillin

A

A. Complement

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50
Q

PAIN AT INFUSION SITE and hypotension are observed with what type of reaction?
A. Acute hemolytic transfusion reaction
B. Allergic reaction
C. Delayed hemolytic transfusion reaction
D. Febrile nonhemolytic reaction

A

A. Acute hemolytic transfusion reaction

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51
Q

Hypotension, nausea, flushing, fever and chills are symptoms of which of the following transfusion reactions?
A. Allergic
B. Circulatory overload
C. Hemolytic
D. Anaphylactic

A

C. Hemolytic

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52
Q

The most serious hemolytic transfusion reactions are due to incompatibility in which of the following blood group
systems?
A. ABO
B. Rh
C. MN
D. Duffy

A

A. ABO

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53
Q

What would be the result of group A blood given to an O patient?
A. Nonimmune transfusion reaction
B. Immediate hemolytic transfusion reaction
C. Delayed hemolytic transfusion reaction
D. Febrile nonhemolytic transfusion reaction

A

B. Immediate hemolytic transfusion reaction

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54
Q

A patient has a hemolytic reaction to blood transfused 8 days ago. What is the most likely cause?
A. Immediate, nonimmunologic probably due to volume overload
B. Delayed immunologic, probably due to an antibody such as anti-Jka
C. Delayed nonimmunologic, probably due to iron overload
D. Immediate, immunologic, probably due to clerical error,
ABO incompatibility

A

C. Delayed nonimmunologic, probably due to iron overload

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55
Q

The K (KEL1) antigen is:
A. Absent from the red cells of neonates
B. Strongly immunogenic
C. Destroyed by enzymes
D. Has a frequency of 50% in the random population

A

B. Strongly immunogenic

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56
Q

What blood group system antibodies are commonly associated with delayed hemolytic transfusion reactions?
A. Rh
B. MNS
C. ABO
D. Kidd

A

D. Kidd

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57
Q

What procedure would help to distinguish between an anti-Fy? and anti-Jka in an antibody mixture?
A. Lowering the pH of the patient’s serum
B. Using a thiol reagent
C. Testing at colder temperatures
D. Ficin-treated panel cells

A

D. Ficin-treated panel cells

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58
Q

Hemoglobinuria, hypotension and generalized bleeding are symptoms of which of the following transfusion reactions?
A. Allergic
B. Circulatory overload
C. Hemolytic
D. Anaphylactic

A

C. Hemolytic

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59
Q

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?
A. 3 - 6 hours
B. 3 - 7 days
C. 60 - 90 days
D. After 120 days

A

B. 3 - 7 days

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60
Q

An unexplained fall in hemoglobin and mild jaundice in a patient transfused with Red Blood Cells 1 week previously would most likely indicate:
A. Paroxysmal nocturnal hemoglobinuria
B. Posttransfusion hepatitis infection
C. Presence of HLA antibodies
D. Delayed hemolytic transfusion reaction

A

D. Delayed hemolytic transfusion reaction

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61
Q

Fever and chills are symptoms of which of the

following transfusion reactions?

A. Citrate toxicity
B. Circulatory overload
C. Allergic
D. Febrile

A

D. Febrile

62
Q

Symptoms of dyspnea, hypoxemia, and pulmonary edema within 6 hours of transfusion is most likely which type of reaction?
A. Anaphylactic
B. Hemolytic
C. Febrile
D. TRALI

A

D. TRALI

63
Q

What may be found in the serum of a person who is exhibiting signs of TRALI (transfusion-related acute lung injury)?
A. Red blood cell alloantibody
IgA antibody
C. Anti-leukocyte antibody
D. Allergen

A

C. Anti-leukocyte antibody

64
Q

Hives and itching are symptoms of which of the following transfusion reactions?
A. Febrile
B. Allergic,
C. Circulatory overload
D. Bacterial

A

B. Allergic

65
Q

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

A

C. Anaphylactic

66
Q

Anaphylactic reactions to transfusion are usually caused by:
A. Anti-gA in an IgA-deficient recipient
B. Anti-IgG in an IgA-deficient
C. IgA deficiency
D. IgG deficiency

A

A. Anti-gA in an IgA-deficient recipient

67
Q

Which of the following transfusion reactions is characterized by high fever, shock, hemoglobinuria, DIC and renal failure?
A. Bacterial contamination
B. Circulatory overload
C. Febrile
D. Anaphylactic

A

A. Bacterial contamination

68
Q

Coughing, hypoxemia and difficult breathing are symptoms of which of the following transfusion reactions?
A. Febrile
B. Allergic
C. TACO
D. Hemolytic

A

C. TACO

69
Q

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. TACO

A

D. TACO

70
Q

Which of the following patient groups is at risk of developing graft-versus-host disease?
A. Full-term infants
B. Patients with history of febrile transfusion reactions
C. Patients with a positive direct antiglobulin test
D. Recipients of blood donated by immediate family members

A

D. Recipients of blood donated by immediate family members

71
Q

The most frequent transfusion-associated disease complication of blood transfusions is:
A. Cytomegalovirus (CMV)
B. Syphilis
C. Hepatitis
D. HIV-1/2

A

C. Hepatitis

72
Q

When evaluating a possible delayed hemolytic reaction, what is the best sample to use for bilirubin determination?
A. 6 hours posttransfusion
B. 12 hours posttransfusion
C. 24 hours posttransfusion
D. 48 hours posttransfusion

A

A. 6 hours posttransfusion

73
Q

What is the primary reason that infectious agents can be transmitted following blood transfusion?

A. Pathogen reduction technology failure
B. Donor in the window period of early infection
C. Leukocyte-reduction failure
D. Donor history questionnaire not completed

A

B. Donor in the window period of early infection

74
Q

What may be done to RBCs before transfusion to a patient with cold agglutinin disease in order to reduce the possibility of a transfusion reaction?
A. Irradiate to prevent graft-versus-host-disease (GVHD)
B. Wash with 0.9% percent saline
C. Warm to 37°C with a blood warmer
D. Transport so that temperature is maintained at 20 to 24°C

A

C. Warm to 37°C with a blood warmer

75
Q

Which of the following is an acceptable time in which a unit of whole blood is collected?
A. 33 minutes
B. 25 minutes
C. 20 minutes
D. 13 minutes

A

D. 13 minutes

76
Q

The minimum hemoglobin concentration in a finger stick from a female blood donor is:
A. 12.0 g/dL (120 g/L)
B.12.5 g/dL (125 g/L)
С. 13.0 g/dL (135 g/L)
D. 15.0 g/dL (150 g/L)

A

B.12.5 g/dL (125 g/L)

77
Q

Which of the following donors could be accepted for whole-blood donation?
VA. A construction worker who was incarcerated for opiate abuse
B. A triathlete with a pulse of 45
C. A man who is currently taking finasteride (Propecia)
D. A woman in her 14th week of pregnancy

A

B. A triathlete with a pulse of 45

78
Q

How often can a blood donor donate whole blood?
A. Every 24 hours
B. Once a month
C. Every 8 weeks
D. Twice a year

A

C. Every 8 weeks

79
Q

A donor who has just donated 2 units of Apheresis Red Blood Cells will be deferred from further blood donation for a minimum of how many weeks?
A. 8
B. 12
C. 16
D. 24

A

C. 16

80
Q

All of the following apply to a double red cell unit apheresis collection except:

A. The hematocrit must be at least 38%
B. The weight for a female is at least 150 Ibs
C. The height for a male is at least 5 ft 1 in.
D. The deferral period following collection is 16 weeks

A

A. The hematocrit must be at least 38%

81
Q

To qualify as a donor for autologous transfusion a
patient’s hemoglobin should be at least:

A. 8 g/dL
B. 11 g/dL
c. 13 g/dL
D. 15 g/dL

A

B. 11 g/dL

82
Q

Which one of the following constitutes permanent deferral status of a donor?
A. A tattoo 5 months previously
B. Recent close contact with a patient with viral hepatitis
C. 2 units of blood transfused 4 months previously

D. Confirmed positive test for HBsAg 10 years previously

A

D. Confirmed positive test for HBsAg 10 years previously

83
Q

Donors who have received HBIG must wait _ months to donate blood to be sure they were not infected since hepatitis B can be transmitted through transfusion to a patient.
A. 2 weeks
B. 1 month
C. 3 months
D. 12 months

A

D. 12 months

84
Q

Which of the following vaccinations carries no deferral period?
A. Rubella
B. Varicella zoster
C. Recombinant HPV
D. Smallpox

A

C. Recombinant HPV

85
Q

A donor bag is half filled during donation when the blood flow stops. Select the correct course of action.

A. Closely observe the bag for at least 3 minutes; if blood flow does not resume, withdraw the needle
B. Remove the needle immediately and discontinue the donation
C. Check and reposition the needle if necessary; if blood flow does not resume, withdraw the needle
D. Withdraw the needle and perform a second venipuncture in the other arm

A

C. Check and reposition the needle if necessary; if blood flow does not resume, withdraw the needle

86
Q

A woman begins to breathe rapidly while donating blood. Choose the correct course of action.
A. Continue the donation; rapid breathing is not a reason to discontinue a donation
B. Withdraw the needle, raise her feet, and administer ammonia
C. Discontinue the donation and provide a paper bag
D. Tell her to sit upright and apply a cold compress to her forehead

A

C. Discontinue the donation and provide a paper bag

87
Q

A unit tests positive for syphilis using the rapid plasma reagin test (RPR). The microhemagglutinin assay-Treponema pallidum
(MHA-TP) on the same unit is negative. What is the disposition

A. The unit may be used to prepare components
B. The donor must be contacted and questioned further; if the
RPR result is most likely a false positive, then the unit may be
used
C. The unit must be discarded
D. Cellular components may be prepared but must be irradiated
before issue

A

A. The unit may be used to prepare components

88
Q

John Smith donated a unit of whole blood in May. Red blood cells made from the whole blood were transfused to a recipient of a community hospital in June with no apparent complications. The blood supplier notified the medical director of the hospital that the donor reported HIGH-RISK BEHAVIOR with another male in April, although viral tests remain negative and the donor is healthy. What course of action should be taken?
A. No action should be taken
B. The recipient’s physician should be notified
C. The recipient’s physician and the recipient should be notified
D. The recipient should be notified

A

B. The recipient’s physician should be notified

89
Q

Rejuvenation of a unit of Red Blood Cells is a method used to:
A. Remove antibody attached to RBCs
B. Restore 2,3-DPG and ATP to normal levels
C. Inactivate viruses and bacteria
D. Filter blood clots and other debris

A

B. Restore 2,3-DPG and ATP to normal levels

90
Q

A technologist removed 4 units of blood from the blood bank refrigerator and placed them on the counter. A clerk was waiting to take the units for transfusion. As she checked the paperwork, she noticed that one of the units was leaking onto the counter. What should she do?
A. Issue the unit if the red cells appear normal
B. Reseal the unit
C. Discard the unit
D. Call the medical director and ask for an opinion

A

C. Discard the unit

91
Q

What should be done if a noticeable clot is found in an RBC unit?
A. Issue the unit; the blood will be filtered
B. Issue the unit; note the presence of a clot on the release form
C. Filter the unit in the blood bank before issue
D. Do not issue the unit

A

D. Do not issue the unit

92
Q

Upon inspection, a unit of Apheresis Platelets is noted to have visible clots, but otherwise appears normal.
The technologist should:
A. Issue without concern
B. Filter to remove the clots
C. Centrifuge to express off the clots
D. Quarantine for Gram stain and culture

A

D. Quarantine for Gram stain and culture

93
Q

Plastic bag overwraps are recommended when thawing units of FFP in 37°C water baths because they prevent:
A. The FFP bag from cracking when it contacts the warm
water
B. Water from slowly dialyzing across the bag membrane
C. The entry ports from becoming contaminated with water
D. The label from peeling off as the water circulates in the bath

A

C. The entry ports from becoming contaminated with water

94
Q

Which of the following anticoagulant preservative provides a storage time of 35 days at 1°C to 6°C for units of whole blood and prepared RBCs if an additive solution is not added?
A. ACD
B. CP2D
C. CPD
D. CPDA-1

A

D. CPDA-1

95
Q

Appropriate preservative for modified whole blood:
A. ACD
B. CPD
C. CPDA-1
D. All of these

A

D. All of these

96
Q

All of the following are requirements for the tag on the crossmatched donor unit, EXCEPT:

A. ABO and Rh type
B. Name of the donor
C. Unit expiration date
D. Interpretation of the crossmatch

A

B. Name of the donor

97
Q

What is the expected therapeutic effect in the recipient’s hematocrit after the transfusion of 1 unit of RBCs?
A. Increase of 0.5%
B. Increase of 1%
C. Increase of 2%
D. Increase of 3%

A

D. Increase of 3%

98
Q

How many units of red blood cells are required to raise the hematocrit of a 70 kg nonbleeding man from 24% to 30%?
A. 1
B. 2
C. 3
D. 4

A

B. 2

99
Q

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, the expected posttransfusion hemoglobin concentration should be:
A. 8.0 g/dL
B. 9.0 g/dL
C. 10.0 g/dL
D. 11.0 g/dL

A

B. 9.0 g/dL

100
Q

Washed Red Blood Cells are indicated in which of the following situations?
A. An IgA-deficient patient with a history of transfusion-associated anaphylaxis
B. A pregnant woman with a history of hemolytic disease of the newborn
C. A patient with a positive DAT and red cell autoantibody
D. A newborn with a hematocrit of <30%

A

A. An IgA-deficient patient with a history of transfusion-associated anaphylaxis

101
Q

According to AABB Standards, LEUKOREDUCED RED CELLS is a product in which the absolute WBC count in the unit is reduced to _and contains at least of the original RBC mass.

A. 1 × 1010, 85%
в. 3.0 × 101, 85%
С. 5.5 × 1010, 85%
D. 5 x 106, 85%

A

D. 5 x 10^6, 85%

102
Q

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:
A. 4 PM on the same day
B. 8 AM the next morning
C. 8 PM on the same day
D. The original date of the unsplit unit

A

D. The original date of the unsplit unit

103
Q

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

A

D. 35 days

104
Q

A unit of packed RBCs is split using the OPEN SYSTEM.
One of the half units is used. What may be done with the second half unit?

A. Must be issued within 24 hours
B. Must be issued within 48 hours
C. Must be irradiated
D. Must retain the original expiration date

A

A. Must be issued within 24 hours

105
Q

The percentage of red cells recovered after thawing and deglycerolization of frozen blood is:
А. 35%
B. 50%
C. 70%
D. 80%

A

D. 80%

106
Q

Frozen and thawed RBCs processed in an open system can be stored for how many days/hours?

A. 3 days
B. 6 hours
C. 24 hours
D. 15 days

A

C. 24 hours

107
Q

For apheresis donors who donate platelets, a platelet count must be performed prior to the procedure and be at least:
А. 150 x 10 ^9/L
B 250 x 10^9/L
C. 200 x 10^9/L
D.b300 x 109/L

A

А. 150 x 10 ^9/L

108
Q

Which of the following precludes acceptance of a plateletpheresis donor?
A. Platelet count of 75 × 10°/L in a donor who is a frequent platelet donor
B. Plasma loss of 800 mL from plasmapheresis 1 week ago
C. Plateletpheresis performed 4 days ago
D. Aspirin ingested 7 days ago

A

A. Platelet count of 75 × 10°/L in a donor who is a frequent platelet donor

109
Q

An important determinant of platelet viability during storage is:

A. Plasma potassium concentration
B. Plasma pH
C. Prothrombin time
D. Activated partial thromboplastin time

A

B. Plasma pH

> pH 6.2

110
Q

What is the lowest allowable pH for a platelet component at outdate?
A. 6
B. 5.9
C. 6.2
D. 6.8

A

C. 6.2

111
Q

Platelets must be kept in constant motion for which of the following reasons?
A. Maintain the pH so the platelets will be alive before transfusion
B. Keep the platelets in suspension and prevent clumping of the platelets
C. Mimic what is going on in the blood vessels
D. Preserve the coagulation factors and platelet viability

A

A. Maintain the pH so the platelets will be alive before transfusion

112
Q

According to AABB Standards, Platelets prepared from Whole Blood shall have at least
A. 5.5 x 1010 platelets per unit in at least 90% of the units tested
B. 6.5 x 1010 platelets per unit in 90% of the units tested
C. 7.5 x 1010 platelets per unit in 100% of the units tested
D. 8.5 x 1010 platelets per unit in 95% of the units tested

A

A. 5.5 x 1010 platelets per unit in at least 90% of the units tested

113
Q

The optimum storage temperature for platelets is:
A. - 20°C
В. - 12°C
C. 4°C
D. 22°C

A

D. 22°C

114
Q

If a platelet bag is broken or opened, the platelets must be transfused within when stored at 20 to 24 °C
A. 4 hours
B. 24 hours
C. 5 days
D. 7 days

A

A. 4 hours

115
Q

What increment of platelets/pL (platelets/L), in the typical 70-kg human, is expected to result from each single unit of random donor platelets (RDP) to recipient?
A. 3,000 - 5,000
В. 5,000 - 10,000
C. 20,000 - 25,000
D. 25,000 - 30,000

A

В. 5,000 - 10,000

116
Q

A 70-kg man has a platelet count of 15,000/uL, and there are no complicating factors such as fever or HLA sensitization. If he is given a platelet pool of 6 units, what would you expect his post-
(SDP) to 60,000/uL transfusion count to be?

A. 21,000 to 27,000/pL
B. 25,000 to 35,000/pL
С. 45,000 to 75,000/uL
D. 75,000 to 125,000/uL

A

С. 45,000 to 75,000/uL

117
Q

SHELF-LIFE OF FRESH FROZEN
PLASMA stored at -65°C:
A. 24 hours
B. 5 days
C. 1 year
D. 7 years

A

D. 7 years

118
Q

According to AABB standards, FRESH FROZEN PLASMA must be infused within what period of time FOLLOWING THAWING?

A. 24 hours
B. 36 hours
C. 48 hours
D. 72 hours

A

A. 24 hours

119
Q

FFP can be transfused without regard for:
A. ABO type
B. Rh type
C. Antibody in product
D. All of these options

A

B. Rh type

120
Q

A blood component prepared by thawing Fresh Frozen Plasma at refrigerator temperature and removing the fluid portion is:
A. Plasma Protein Fraction
B. Cryoprecipitate
C. Factor IX Complex
D. FP24

A

B. Cryoprecipitate

121
Q

Cryoprecipitate contains how many units of Factor VIII?
A. 40
B. 80
C. 130
D. 250

A

B. 80

122
Q

Cryoprecipitate may be used to treat all of the

following, except:

A. von Willebrand’s disease
B. Hypofibrinogenemic
C. Idiopathic thrombocytopenic purpura (ITP)
D. Factor XIlI deficiency

A

C. Idiopathic thrombocytopenic purpura (ITP)

123
Q

Although ABO compatibility is preferred, ABO incompatibility is acceptable for which of the following components?
A. PF24
B. Cryoprecipitated AHF
C. Apheresis Granulocytes
D. Apheresis Platelets

A

B. Cryoprecipitated AHF

124
Q

The optimum storage temperature for cryoprecipitate is:
A. - 20 °C
B. -12°C
C. 4°C
D. 22°C

A

A. - 20 °C

125
Q

Cryoprecipitate maintained in the frozen state of -
-18 °C or below, has a shelf life of:
A. 42 days
B. 6 months
C. 12 months
D. 36 months

A

C. 12 months

126
Q

Cryoprecipitate must be transfused within what period of time FOLLOWING THAWING AND POOLING?
A. 4 hours
B. 8 hours
C. 12 hours
D. 24 hours

A

A. 4 hours

127
Q

The primary indication for GRANULOCYTE TRANSFUSION is:

A. Prophylactic treatment for infection
B. Additional supportive therapy in those patients who are responsive to antibiotic therapy
C. Clinical situations where bone marrow recovery is not anticipated
D. Severe neutropenia with an infection that is nonpresponsive to antibiotic therapy

A

D. Severe neutropenia with an infection that is nonpresponsive to antibiotic therapy

128
Q

Irradiation of a unit of Red Blood Cells is done to prevent the replication of donor:

A. Granulocytes
‘B. Lymphocytes
C. Red cells
D. Platelets

A

B. Lymphocytes

129
Q

The purpose of a low-dose IRRADIATION of blood components is to:
A. Prevent posttransfusion purpura
B. Sterilize components
C. Prevent graft-vs-host (GVH) disease
D. Prevent noncardiogenic pulmonary edema

A

C. Prevent graft-vs-host (GVH) disease

130
Q

A cancer patient recently developed a severe infection.
The patient’s hemoglobin is 8 g/dL owing to’ chemotherapy with a drug known to cause bone marrow depression and immunodeficiency. Which blood products are indicated for this patient?
A. Liquid plasma and cryoprecipitate
B. Crossmatched platelets and washed RBCs
C. Factor IX concentrates and FFP
D. Irradiated RBCs, platelets, and granulocytes

A

D. Irradiated RBCs, platelets, and granulocytes

131
Q

All Blood Collection Units (BCUs) shall achieve and maintain _
voluntary blood donation. The key function of the BCU is effective donor recruitment and safe blood collection.
А. 10%
B. 50%
C. 70%
D. 100%

A

D. 100%

132
Q

Whole blood collected in BCUs shall be stored immediately after collection and validation in a blood bank refrigerator or
COLD BOX, at 1 to 6 °C. As much as possible, blood should be submitted to the Blood Bank/Center within collection.
A. 6 hours
B. 8 hours
C. 12 hours
D. 24 hours

A

D. 24 hours

133
Q

The blood warmer should have automatic temperature control with an alarm that will sound if the blood is warmed over.
A. 30 °C
B. 37 °C
C. 40 °C
D. 42 °C

A

D. 42 °C

134
Q

LEUKOCYTE-POOR RED BLOOD CELLS would most likely be indicated for patients with a history of:

A. Febrile transfusion reaction
B. Hemophilia A
C. Iron deficiency anemia
D. von Willebrand disease

A

A. Febrile transfusion reaction

135
Q

The type of cell MOST FREQUENTLY RESPONSIBLE FOR FEBRILE TRANSFUSION REACTIONS is the:
A. Erythrocyte
B. Lymphocyte
C. Granulocyte
D. Platelets

A

C. Granulocyte

136
Q

With or without documentation of the existence of specific antibodies, the AABB recommends leukocyte-poor preparations only after a patient has had at least febrile nonhemolytic transfusion reactions.
A. One
B. Two
C. Three
D. Four

A

B. Two

137
Q

A transfusion reaction that usually appears rapidly during transfusion termed “WARM” and may result in fever, shock, or death is which one of the following listed reactions?
A. Hemolytic
B. Bacterial contamination
C. TACO
D. Allergic

A

B. Bacterial contamination

138
Q

An emergency trauma patient requires transfusion. Six units of blood are ordered stat. There is no time to draw a patient sample. O-negative blood is released. When will compatibility testing be performed?

A. Compatibility testing must be performed before blood is issued
B. Compatibility testing will be performed when a patient sample is available
C. Compatibility testing may be performed immediately using donor serum
D. Compatibility testing is not necessary when blood is released in emergency situations

A

B. Compatibility testing will be performed when a patient sample is available

139
Q

PHOTOTHERAPY is most useful for which of the following antibodies:
A. Anti-A
B. Anti-D
C. Anti-K
D. Anti-s

A

A. Anti-A

140
Q

Advantages of CORDOCENTESIS:
1. Allows measurement of fetal hemoglobin and hematocrit levels
2. Allows antigen typing of fetal blood
3. Allows direct transfusion of fetal circulation
4. Decreases risk of trauma to the placenta
A. 1 and 3
B. 2 and 4
C. 1, 2 and 3
D. 1, 2, 3 and 4

A

C. 1, 2 and 3

141
Q

The LILEY METHOD of predicting the severity of hemolytic disease of the newborn is based on the amniotic fluid:

A. Bilirubin concentration by standard method
B. Rh determination
C. Change in optical density measured to 450 nm
D. Ratio of lecithin to sphingomyelin

A

C. Change in optical density measured to 450 nm

142
Q

Which of the following is the preferred specimen for the initial compatibility testing in exchange transfusion therapy?

A. Maternal serum
B. Paternal serum
С.Eluate prepared from infant’s red blood cells
D. Infant’s post-exchange serum

A

A. Maternal serum

143
Q

EXCHANGE TRANSFUSIONS are used primarily to:
A. Provide antigen negative RBCs
B. Remove antibody
C. Remove antibody coated RBCs
D. Remove high levels of unconjugated bilirubin and thus prevent kernicterus

A

D. Remove high levels of unconjugated bilirubin and thus prevent kernicterus

144
Q

All of the following are routinely performed on a cord blood sample except:

A. Forward ABO typing
B. Antibody screen
C. Rh typing
D. DAT

A

B. Antibody screen

145
Q

Infants do not require crossmatching during:

A. The first 4 months
B. The first 6 months
C. The first year
D. An indefinite period if a parent’s blood is used

A

A. The first 4 months

146
Q

Preliminary blood bank testing for neonates <4 months of age must include:

A. ABO forward typing and ABO reverse typing
B. ABO reverse typing and testing for K antigen
C. ABO reverse typing and antibody detection testing
D. ABO forward typing and Rh testing for D antigen

A

D. ABO forward typing and Rh testing for D antigen

147
Q

Recommended speed of the SEROFUGE

for agglutination grading:

A. 500 g
B. 800 g
C. 1,000 g
D. 2,000 g

A

C. 1,000 g

148
Q

Heavy spin centrifugation:
A. 2, 000 xg for 2 to 3 minutes
B. 5, 000 xg for 5 minutes
C. 10,000 xg for 5 minutes
D. 15,000 xg for 10 minutes

A

B. 5, 000 xg for 5 minutes

149
Q

All blood banks as mandated by law must have a:

A. Water fountain
B. Written laboratory safety program
C. BSC
D. Foot-operated hand wash

A

B. Written laboratory safety program

150
Q

One of the best ways to protect employees and keep a safe laboratory environment is to provide employees with:
A. Health insurance
B. Safety education
C. Rest breaks
D. Fluid-repellent laboratory coats

A

B. Safety education

151
Q

What is the purpose of competency assessment?
A.Identify employees in need of retraining
B. Evaluate an individual’s level of knowledge during a job interview
C. Identify employees who need to be fired
D.All of the above

A

A.Identify employees in need of retraining

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