BOC BB QUESTIONS Flashcards
The minimum hemoglobin concentration in a fingerstick from a male blood donor is:
- 0 g/dL (120 g/L)
- 5 g/dL (125 g/L)
- 5 g/dL (135 g/L)
- 0 g/dL (150 g/L)
All donors, regardless of sex, requrire a minimum hemoglobin of 12.5 g/dL (125 g/L). The value must not be performed on an earlobe stick.
A cause for permanent deferral of blood donation is:
- Diabetes
- Residence in an endemic malarial region
- History of jaundice of uncertain cause
- History of therapeutic rabies vaccine
Jaundice is a sign of liver impairment, which might be due to HBV or HCV. Infection with HBV and HCV is a cause for indefinite deferral.
Which of the following prospective donors would be accepted for donation?
32-year-old woman who received a transfusion in a complicated delivery 5 months previously
19-year-old sailor who has been stateside for 9 months and stopped taking his anti-malarial medication 9 months previously
22-year-old college student who has a temperature of 99.2F (37.3C) and states that he feels well, but is nervous about donating
45-year-old woman who has just recovered from a bladder infection and is still taking antibiotics
The receipt of blood products is a 6 month deferral, the deferral for travel to areas endemic for malaria is 12 months regardless of antimalarial prophylaxis, and a person taking antibiotics may have bacteremia. The requirement for temperature is not over 37.5C or 99.5F.
Which one of the following constitutes permanent rejection status of a donor?
A tattoo 5 months previously
Recent close contact with a patient with viral hepatitis
2 units of blood transfused 4 months previously
Confirmed positive test for HBsAg 10 years previously
A positive test for HbsAg at anytime is an indefinite deferral.
According to AABB standards, which of the following donors may be accepted as a blood donor?
Traveled to an area endemic for malaria 9 months previously
Spontaneous abortion at 2 months of pregancy, 3 months previously
Resides with a known hepatitis patient
Received a blood transfusion 22 weeks previously
A woman who had a spontaneous abortion at 2 months of pregancy, 3 months previously would be acceptable. A donor is acceptable if she has not been pregnant in the previous 6 weeks.
Below are the results of the history obtained from a prospective female blood donor:
Age: 16
Temperature: 99.0F (37.2C)
Hct: 36%
History: Tetanus toxoid 1 week previously
How many of the above results excludes this donor from giving a routine blood transfusion?
a. None
b. 1
c. 2
d. 3
The Hct must be >38%. A donor may be 16 unless state law differs. Temperature must not exceed 99.5F/37.5C, blood pressure must be be <180mm Hg systolic <100 mm Hg diastolic, pulse 50-100 unless an athlete (which can be lower). Toxoids and vaccines from synthetic or killed sources have no deferral.
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:
150 x 103/μL (150 x 109/L)
200 x 103/μL (200 x 109/L)
250 x 103/μL (250 x 109/L)
300 x 103/μL (300 x 109/L)
The minimum platelet count required for frequent repeat donors is 150x103/μL (150 x 109/L). A platelet count is not required prior to the first donation of if the interval between donations is at least 4 weeks.
Prior to blood donation, the intended venipuncture site must be cleaned with a scrub solution containing:
Hypochlorite
Isopropyl alcohol
10% acetone
PVP iodine complex
The scrub must use iodine, eg, PVP iodine complex. Donors who are sensitive to iodine can have the area cleaned with a preparation of 2% chlorhexidine and 70% isopropyl alcohol.
All donor blood testing must include:
Complete Rh phenotyping
anti-CMV testing
Direct antiglobulin test
Serological test for syphilis
Testing for syphilis was the first mandated donor screening test for infectious disease and is still part of donor screening.
During the preparation of Platelet Concentrates from Whole Blood, the blood should be:
Cooled towards 6C
Cooled towards 20-24C
Warmed to 37C
Heated to 57C
Platelets are prepared and stored at 20-24C for optimum function.
The most common cause of posttransfusion hepatitis can be detected in donors by testing for:
anti-HCV
HBsAg
anti-HAV IgM
anti-HBe
The most common posttransfusion hepatitis is hepatitis B. The estimated risk of transmission is 1:220,000 units transfused. The risk of hepatitis C transmission is 1:1,800,000 units. Hepatitis B surface antigen (HBsAg) is a required donor test for detection of acute or chronic HBV infection.
The Western blot is a confirmatory test for the presence of:
CMV antibody
Anti-HIV-1
HBsAg
Serum protein abnormalities
Western blot uses purified HIV proteins to confirm reactivity in samples whose screening test for anti-HIV is positive.
The test that is currently used to detect donors who are infected with the AIDS virus is:
anti-HBc
anti-HIV 1,2
HBsAg
ALT
The causative agent for AIDs is the human immunodeficiency virus types 1 and 2.
A commonly used screening method for anti-HIV-1 detection is:
Latex agglutination
Radioimmunoassay (RIA)
Thin-layer-chromatography (TLC)
enzyme -labeled immunosorbent assay (ELISA)
The enzyme-labeled immunosorbent assay (ELISA) method is a very sensitive method employed to screen donors for markers of transfusion-transmitted viruses.
Rejuvenation of a unit of Red Blood Cells is a method used to:
- Remove antibody attached to RBC’s
- Inactive viruses and bacteria
- Restore 2,3 DPG and ATP to normal levels
- Filter blood clots and other debris
Rejuvenation of RBCs uses additives to restore or enhance 2,3-DPG and ATP levels.
unit of packed cells is split into 2 aliquots under closed sterile conditions at 8am. The expiration time for each aliquot is now:
- 4pm on the same day
- 8pm on the same day
- 8am the next morning
- The original date of the unsplit unit.
Sterile docking devices allow entry into donor units without affecting the expiration date of the product.
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:
- 6 hours
- 12 hours
- 5 days
- 35 days
Sterile docking devices allow entry into donor units without affecting the expiration date of the product.
When platelets are stored on a rotator set on a open bench top, the ambient air temperature must be recorded:
- Once a day
- Twice a day
- Every 4 hours
- Every hour
If storage devices do not have automated temperature recording, temperature must be manually monitored every 4 hours.
Which of the following in the correct storage temperature for the component listed?
- Cryoprecipitated AHF, 4C
- Fresh Frozen Plasma (FFP), -20C
- Red Blood Cells, Frozen, -40C
- Platelets, 37C
Fresh Frozen Plasma is stored at -18C or below for 12 months.
A unit of Red Blood Cells is issued at 9:00am. At 9:10am 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:
- Culture the unit for bacterial contamination
- Discard the unit if not used within 24 hours
- Store the unit at room temperature
- Record the return and place the unit back into inventory
Blood may be returned to the blood bank after issue provided that 1) the container has not been entered, 2) at least 1 sealed segment is attached to the container, 3) visual inspection of the unit is satisfactory and documented, and 4) the unit has been maintained at the appropriate storage or transport temperature. Studies have shown that refrigerated components retain an acceptable temperature of <10C for up to 30 minutes after removal from the refrigerator.
The optimum storage temperature for Red Blood Cells, Frozen is:
- -80C
- -20C
- -12C
- 4C
Red Blood Cells, Frozen with 40% glycerol are stored at -65C or lower.
The optimum storage temperature for Red Blood Cells is:
- -80C
- -20C
- -12C
- 4C
Red Blood Cells are stored at 1-6C
If the seal is entered on a unit of Red Blood Cells stored at 1C to 6C, what is the maximum allowable storage period, in hours?
- 6
- 24
- 48
- 72
If the seal is broken during processing, components are considered to be prepared in an open system, rather than a closed system. The expiration time for Red Blood Cells in an open system is 24 hours.
The optimum storage temperature for cryoprecipitated AHF is:
- -20C
- -12C
- 4C
- 22C
Cryoprecipitated AHF is stored at -18C or lower
Cryoprecipitated AHF must be transfused within what period of time following thawing and pooling?
- 4 hours
- 8 hours
- 12 hours
- 24 hours
Cryoprecipitate must be transfused with 4 hours of pooling.
Platelets prepared in a polyolefin type container, stored at 22-24C in 50 mL of plasma, and gently agitated can be used for up to:
- 24 hours
- 48 hours
- 3 days
- 5 days
Whole blood-derived platelets are stored at 20-24C with continuous gentle agitation. Platelets prepared by the PRP method may be stored for up to 5 days.
The optimum storage temperature for platelets is:
- -20C
- -12C
- 4C
- 22C
The required temperature for storage of platelets is 20-24C
According to AABB standards, Fresh Frozen Plasma must be infused within what period of time following thawing?
- 24 hours
- 36 hours
- 48 hours
- 72 hours
Per AABB standards, thawed FFP should be stored at 1-6C for no more than 24 hours
Cryoprecipitated AHF, if maintained in the frozen state at -18C or below, has a shelf life of:
- 42 days
- 6 months
- 12 months
- 36 months
Cryoprecipitate has a shelf life of 12 months in the frozen state
Once thawed, Fresh Frozen Plasma must be transfused within:
- 4 hours
- 8 hours
- 12 hours
- 24 hours
Once thawed, FFP is stored at 1-6C for up to 24 hours.
An important determination of platelet viability following storage is:
- Plasma potassium concentration
- Plasma pH
- Prothrombin time
- Activated partial thromboplastin time
The pH of platelets should be maintained at 6.2 or above throughout the storage period
In the liquid state, plasma must be stored at:
- 1-6C
- 22C
- 37C
- 56C
The required temperature for storage of thawed plasma is 1-6C.
During storage, the concentration of 2,3-DPG deceases in a unit of:
- Platelets
- Fresh Frozen Plasma
- Red Blood Cells
- Cryoprecipitated AHF
2,3 DPG declines during storage of Red Blood Cells, causing a “shift to the left” in the oxygen dissociation curve and an impaired ability to deliver oxygen to the tissues.
Cryoprecipitated AHF:
- Is indicated for fibrinogen deficiencies
- Should be stored at 4C prior to administration
- Will not transmit hepatitis B virus
- Is indicated for the treatment of hemophilia B
Cryoprecipitate is used primarily for fibrinogen replacement. It is stored at room temperature (20-24C) after thawing and must be infused within 6 hours. If pooled with other cryo units, it must be infused within 4 hours.
Which apheresis platelets product should be irradiated?
- Autologous unit collected prior to surgery
- Random stock unit going to a patient with DIC
- A directed donation given by a mother for her son
- A directed donation given by an unrelated family friend
Blood products from blood relatives containing viable lymphocytes must be irradiated to inhibit the proliferation of T cells and subsequent GVHD.
Irradiation of a unit of Red Blood Cells is done to prevent the replication of donor:
- Granulocytes
- Lymphocytes
- Red cells
- Platelets
Irradiation inhibits proliferation of T lymphocytes
Plastic bag overwraps are recommended when thawing units of FFP in 37C water baths because they prevent:
- The FFP bag from cracking when it contacts the warm water
- Water from slowly dialyzing across the bag membrane
- The entry ports from becoming contaminated with water
- The label from peeling off as the water circulates in the bath
FFP thawed in a water bath should be protected so that entry ports are not contaminated with water. One may use a plastic overwrap or keep ports above water level.
Which of the following blood components must be prepared within 8 hours after phlebotomy?
- Red Blood Cells
- Fresh Frozen Plasma
- Red Blood Cells, frozen
- Cryoprecipitated AHF
Fresh Frozen Plasma (FFP) must be separated and frozen within 8 hours of Whole Blood collection.