BLOOD DONOR SELECTION / BLOOD COLLECTION Flashcards
Which of the following donors would be qualified to donate?
A. A 15 year old female; Hgb = 12.5 g/dL; BP = 100/80 mmHg; Hct = 39% collected by finger prick; heart rate = 60bpm
B. A 34 year old male; Hgb = 12.5 g/dL; BP = 100/80 mmHg; Hct = 39% collected by finger prick; heart rate = 80bpm
C. A 24 year old female; Hgb = 13.5 g/dL; BP = 120/80 mmHg; Hct = 40% collected by earlobe puncture; heart rate = 100 bpm
D. A 65 year old male; Hgb = 14 g/dL; BP = 120/80 mmHg; Hct = 39% collected by finger prick; heart rate = 60bpm
D. A 65 year old male; Hgb = 14 g/dL; BP = 120/80 mmHg; Hct = 39% collected by finger prick; heart rate = 60bpm
BP: systolic = 90 to 180 mmHg
Diastolic = 50 to 100 mmhg
Pulse 50 to 100 bpm
Hgb male = min 13 g/dL Hct 39%
Hgb female = min 12.5 g/dL Hct 38%
Capillary sample from earlobe is not acceptable to use to measure Hct
An apheresis RBC units should contain what level of Hgb as required by AABB standards? A. Greater than or equal to 50% B. Greater than or equal to 55% C. Greater than or equal to 80% D. Greater than or equal to 60%
D. Greater than or equal to 60%
What is the most common reason for blood donor deferrals at most donor centers? A. Travel history B. Low hgb/hct C. Mild Skin disorders D. History of risky sexual activity
B. Low hgb/hct
for mild skin disorders: only unless there are signs of local bacterial infection
True/false - The use of AABB DHQ by blood centers is mandated by the FDA
False
Currently it is not mandated but if any additional information is collected in alternative ways, it must be submitted and approved by the FDA.
True / false - the wording, order and text of the DHQ must not be changed but a blood center facility may make minor changes to the questions only if the change make it more restrictive.
True
True / false - the FDA has implemented regulations that ultimately results in deferral for donors with history of cancer.
False
Currently there are no federal regulations or professional standards regarding criteria to be used for donors with history of cancer
Which of the following donors with a history of cancer would be accepted / not deferred by blood collection facilities?
A. An individual with a history of solid organ malignancy
B. A potential donor with a history of hematologic malignancy (e.g childhood leukemia)
C. A potential donor with a history of superficial squamous cell carcinoma
D. An individual who has recovered from pancreatic cancer
C. A potential donor with a history of superficial squamous cell carcinoma
A - deferred for 1-5 years
B - permanently deferred, but some blood centers accept
D - this is an example of solid organ cancer; deferred
Which of the following donors with factor deficiency would be allowed to donate? A. Donor with FXII deficiency B. Donor with FVIII deficiency C. Donor with FV deficiency D. Donor with FX deficiency
A. Donor with FXII deficiency - not associated with bleeding and thrombosis
Which of the following individuals would be the most appropriate candidate for autologous blood donation?
A. A 67 year old man with Hgb = 8.0 g/dL who had myocardial infarction 2 months before surgery; has history of Anti-Jkb
B. A 30 year old female with ongoing symptoms of pulmonary disease; Hgb = 13.5 g/dL
C. A female with no history of heart disorder, has had 3 pregnancies; Hgb = 12 g/dL; no known antibodies
D. A male preop patient with a history of multiple alloantibodies against rare blood antigens; Hgb = 12.5 g/dL
D. A male preop patient with a history of multiple alloantibodies against rare blood antigens; Hgb = 12.5 g/dL
Ideal candidate:
- alloimmunized pt for whom compatible units arehard to collect
- who will undergo elective surgery and will likely require tx
- will have adequate time to replace Hgb lost from phlebotomy
Minimum hemoglobin concentration of
11 g/dL or hematocrit of 33%.
True / false - platelets are taken from whole blood after it has cooled down to 18C after donation.
False
Must be collected w/in 8 hrs, WB shoud not be cooled down below 20C
What are the three agents most commonly used to increase granulocyte yield in donors?
Hydroxyethyl starch (HES)
Corticosteroids
Growth factors
What is the optimal therapeutic dose of a granulocyte component (for adults) as required by AABB Standards? A. 1 x 10^10 B. 2.5 x 10^10 C. 10-15 ml/kg D. 15 - 25 ml/kg
A. 1 x 10^10
10 - 15 ml/ kg is the dosage for infants
Which of the following statement applies to granulocyte components?
A. The component must be from a donor of the same blood type as the recipient (ABO matching)
B. Compatibility crossmatching is not necessary for a granulocyte component cpntaining a maximum of 2ml RBCs as long as the component is ABO compatible to the recipient
C. Granulocyte components must be irradiated before transfusion
D. A microaggregate filter should be used during transfusion of granulocyte components
C. Granulocyte components must be irradiated before transfusion
A - component must be ABO compatible with recipient’s plasma
B - XM for Rh and HLA compatibility is needed if >2ml of RBCs is present
D - microaggregate and LR filters will remove the granulocytes
As per AABB requirement, which of the following component is the most suitable unit to be transfused to reduce the risk of transfusion related acute lung injury (TRALI)?
A. Platelet collected from a female with a history of two pregnancies, HLA status unknown
B. Plasma collected from a female with no history of pregnancy, has been tested negative for HLA antibodies
C. Platelet collected from a male, HLA status unknown
D. Plasma collected from a pregnant female, has been tested negative for HLA antibodies
C. Platelet collected from a male, HLA status unknown
Components must be from males
NEVER from a pregnant female
Can be from parous female donors who test negative for HLA antibodies
\_\_\_\_\_\_\_\_\_ is a by product of cryoprecipitate preparation A. Recovered plasma B. Liquid plasma C. Plasma cryoprecipitate reduced D. Cryoprecipitate
C. Plasma cryoprecipitate reduced`
Which of the following does not apply to Plasma cryoprecipitate reduced?
A. Fibirinogen levels remain at ~200mg/dL
B. vWF and vWF activity are decreased
C. Level of Factor V are reduced
D. Fibrinogen levels are decreased
C. Level of Factor V are reduced
This component has:
- normal level of factor V (85%), Factor I, Factor VII, Factor X
- normal levels of antiplasmin, antithrombin, Protein C, Protein S
- Fibrinogen levels are reduced but remain at ~200mg
- decreased FVIII, vWF antigen and activity, and FXIII
Which of the following statements regarding FVIII and fibrinogen content is cryoprecipitate is true?
A. Must have 170 units/bag of FVIII, 60 units/bag of fibrinogen
B. Must contain at least 100 IU of FVIII, 150mg of fibrinogen
C. Must contain at least 80 IU of FVIII, and at least 388mg of fibrinogen
D. Must have at least 80 IU of FVIII, 150mg of fibrinogen
D. Must have at least 80 IU of FVIII, 150mg of fibrinogen
Other content:
- 170 units/bag of vWF ristocetin factor
- 60 units/ bag FXIII
- 388 mg/unit is the current median level of fibrinogen
At what pH must platelets be maintained at to ensure adequate in-vivo recovery?
~ 6.5 pH, must not be below 6.2 pH
As per FDA requirement, how much leukocytes and RBCs must remain in a leukoreduced whole blood component?
<5.0 x 10^6 residual leukocytes/ unit and must have 85% of original red cell content
As per FDA requirement, how much leukocytes, platelets and pH level must a leukoreduced apheresis platelet component contain?
- <5 x 10^6 leukocytes (95% of units)
- contain >3 x 10^ 11 platelets (75% of units)
- > or = 6.2 pH
6 whole blood derived plt (pooled) = 1 apheresis plt
1 WBD plt = 5.5x 10^ 6
How much irradiation dose should a blood component recieve?
Minimum dose in fully loaded canister is 15Gy in all parts of the component
Minimun 25 Gy - 50 Gy max to the midplane of container
How much FVIII and fibrinogen content does 4 units of four pooled cryoprecipitate contain? A. 320 IU FVIII, 600 mg fibrinogen B. 80 IU FVIII, 150 mg fibrinogen C. 100 IU FVIII, 200 mg fibrinogen D. 80 IU FVIII, 200 mg fibrinogen
A. 320 IU FVIII, 600 mg fibirnogen
Assuming each individual unit in the pool has 80 IU FVIII and 150 mg fibrinogen, multiplied each by # of pooled units
80 IU x 4 = 320 IU FVIII
150 mg fibrinogen. = 600 mg fibrinogen
The use of ISBT 128 label in blood components is a requirement by which agency / body of organization? A. FDA B. AABB Standards C. ICCBBA D. CLIA
B. AABB Standards
Required by AABB, approved to use by FDA
Which of the following is added to a unit of apheresis platelet, which reduces the amount of plasma in the component? A. AS-3 B. PAS C. Glycerol D. CPD
B. PAS
Platelet Additive Solution
Which of the following is false regarding deglycerolization of RBCs?
A. Glycerol must be removed using a sodium chloride solution
B. The final suspension of RBCs must contain 0.2% Dextrose
C. Deglycerolized whole blood RBCs must be free from anticoagulants
D. Deglycerolized whole blood RBCs can be stored up to 14 days at 4C
C. Deglycerolized whole blood RBCs must be free from anticoagulants
- must add AS-3 after thawing
Remember that it is whole blood, containing plasma (has clotting factors) and platelets
How much platelets are in a unit of:
A) whole blood component?
B) an apheresis platelet component?
Whole blood: > or = 5.5 x 10^10 platelets
Apheresis platelets: 3 x 10^11 platelets
A unit of pRBc will increase and adult recipient's Hgb and Hct by how much? A. 1g/dL Hgb, 3% Hct B. 1g/dL Hgb, 5% Hct C. 3g/dL Hgb, 1% Hct D. 3g/dL Hgb, 5% Hct
A. 1g/dL Hgb, 3% Hct
As per AABB circular
As per AABB circular, how much residual leukocyte is expected to be contained in a leukocyte reduced packed red cell unit? A. None B. <1.0 x 10^6 C. <3.0 x 10^6 D. <5.0 x 10^6
D. <5.0 x 10^6
Also, component should contain equal to or greater than 85% of the original red cell content
As per AABB circular, approximately how much hemoglobin is contained in a unit of pRBCs collected by apheresis? A. 50 g B. 60 g C. 70 g D. 80 g
B. 60 g
According to the AABB circular, which of the ff is a suitable alternative to CMV seronegative transfusion? A. Irradiated components B. Washed components C. Leukocyte reduced components D. Volume reduced components
C. Leukocyte reduced components
Mr Trump donated whole blood on February 14. When will he be eligible to donate whole blood again? A. March 14 B. After 2 weeks C. March 28 D. April 11
D. April 11
8 week deferral / 56 days
Kim Kardashian, a college student, has just finished her treatment for gonorrhea. She is interested in donating blood but is not sure when she will be eligible because of the recent STI. Is Kim eligible to donate?
A. No, she is permanently deferred.
B. No, she is deferred indefinitely
C. Yes, but she is deferred for 3 months after completion of treatment
D. Yes, but she is deferred for 6 months after completion of treatment
C. Yes, but she is deferred for 3 months after completion of treatment
Mrs Doubtfire received blood transfusion during her recent 2 month hospital stay in the city. She wants to give back to the community by donating her own blood. Is Mrs Doubtfire eligible to donate?
A. No, she is permanently deferred because of her recent transfusion.
B. No, she is indefinitely deferred because of her recent transfusion.
C. Yes, she will be eligible to donate 12 months after she received transfusion.
D. Yes, she will be eligible to donate 6 months after she received transfusion
C. Yes, she will be eligible to donate 12 months after she received transfusion.
Mr DeSantis is interested in donating platelets by apheresis so he stopped taking his aspirin medication 5 days ago. Will Mr DeSantis be eligible to donate today?
A. No, he is deferred for 7 days after his last dose of aspirin
B. No, he is deferred for 10 days after his last dose of aspirin
C. Yes, he can donate 48 hours after his last dose of aspirin
D. Yes, he can donate 3 days after his last dose of aspirin
D. Yes, he can donate 3 days after his last dose of aspirin
While preparing to donate blood at the blood center, Ms Jane Doe disclosed that she had a risky sexual contact during a girls trip in Las Vegas last week. She is then told that she would not be allowed to donate today, but she can always try again later. How long does Jane need to wait until she can donate blood?
A. 3 months from last (risky) sexual contact
B. 6 months from last (risky) sexual contact
C. 8 weeks from last (risky) sexual contact
D. 4 weeks from last (risky) sexual contact
A. 3 months from last (risky) sexual contact
Mr Bean volunteered to donate blood for a family member who is about to undergo a major surgery. He remembered the time he contracted malaria while visiting Africa 20 years ago, and wondered if he will be able to donate. Is Mr Bean eligible?
A. Yes, a long as he has been asymptomatic for at least 3 years
B. Yes, a long as he has been asymptomatic for at least 5 years
C. No, he is deferred permanently
D. No, he is deferred indefinitley
A. Yes, a long as he has been asymptomatic for at least 3 years
Dr Who is one of the many frontliners who were sent to Africa to treat people with Ebola during the outbreak in 2016. He was infected, and fortunately recovered from the virus. Will Dr Who be eligible to donate blood?
A. Yes, a long as he has been asymptomatic for at least 3 years
B. Yes, a long as he has been asymptomatic for at least 5 years
C. No, he is deferred permanently
D. No, he is deferred indefinitley
D. No, he is deferred indefinitley
What is the correct ratio of anticoagulant-whole blood for donor collection?
A. 10 ml anticoagulant for every 100 ml whole blood
B. 10 ml anticoagulant for every 50 ml whole blood
C. 14 ml anticoagulant for every 100 ml whole blood
D. 25 ml anticoagulant for every 100 ml whole blood
C. 14ml anticoagulant for every 100 ml whole blood
Which of the ff does not apply to whole blood collection?
A. Whole blood is collected from donors with minimum hematocrit of 35%
B. A 450ml bag of whole blood typically has 63ml of anticoagulant
C. A 500 ml bag of whole blood typically has 70 ml of anticoagulant
D. A whole blood collected in ACD-A has a shelf life of 21 days
A. Whole blood is collected from donors with minimum hematocrit of 35%
Min hct of 38%
Which of the ff anticoagulants has a shelf life of 35 days? A. ACD-A B. CP2D C. CPDA-1 D. CPD
C. CPDA-1
Other choices have a 21 day shelf life
Kanye West donated a bag of whole blood on January 1st. The unit had CP2D as an anticoagulant. It was processed into pRBCs and 2 days later, additive solution AS-3 was added into the unit. This unit was eventually delivered to NYP Cornell where it was irradiated on January 22nd. What is the expiration date of this unit? A. January 22 B. January 29 C. January 31 D. February 12
D. February 12
In this scenario, the addition of AS-3 extended shelf life to 42 days, expiring on February 12 (original outdate). Irradiation decreases shelf life up to 28 days from the time of irradiation (February 19) or original outdate, whichever comes first.
A unit of pRBCs was labeled with additive solution AS-1 but was originally drawn in a 450ml bag with CPDA-1. If the unit was drawn on March 15th, and irradiated on March 17th, what is its expiration date?
A. April 5
B. April 14
C. April 19
D. April 21
B. April 14
The addition of AS-1 give the unit a shelf life of 42 days (up to April 26). Irradiation decreased its shelf life to 28 days FROM the irradiation date, which is on April 14th.
What is the correct sequence for platelet component manufacturing from whole blood?
WB->soft spin->separate PRP from RBC -> hard spin ->separate plasma from platelet pellet at the bottom -> rest for 1 hour ->store at 20-24C
What is the correct sequence for cryo manufacturing from whole blood?
Thaw FFP at 1-6C ->Hard spin at 4C -> remove supernatant plasma from the cryo -> freeze within 1 hour
Which of the following is not an indication of cryo as a primary form of treatment?
a. FXIII deficiency
b. Hyperfibrinogenemia
c. vWD and Hemophilia A
d. ADAMTS13 deficiency
c. vWD and Hemophilia Aq
A unit of plasma contains approximately how much fibrinogen per 100ml and activity/ml of each stable clotting factors?
300 mg fibrinogen / 100 ml
1 unit activity / ml
True or False: FDA mandates blood centers to have a quality control process in place for plasma products.
False
No QC needed, just need to have accurate scales and testing mandates
