Donor Selection (from Harmening [7th ed.] | F)

Question 1

True or False

The selection of potential blood donors has become more rigorous in the last 5 yrs w/ congent additions to the medical history questionnaire and serologic testing

Answer 1

True

Question 2

True or False

The transfusion of blood to a pt in need is safer than it has ever been

Answer 2

True

Question 3

Safety and therapeutic benefit are dependent on what?

Answer 3

Guidelines established by U.S. Food and Drug Administration (FDA) and AABB

Question 4

What is done to the guidelines (established by U.S. FDA and AABB in terms of safety and therapeutic)?

Answer 4

These are carried out by the qualified and trained personnel in blood collection centers

Question 5

Who are the organizations / associations who wrote the guidelines and regulations for donor selection and serologic testing?

Answer 5

1) FDA

2) AABB

Question 6

While the purview of the 2 entities (/ guidelines and regulations [written by FDA and AABB]) may overlap in some areas of donor collection and donor testing, their institutional goals and national donation guidelines provide a what?

Answer 6

An effective framework of processes utilized by all blood donor centers across the U.S.

Question 7

What is the meaning of CAP?

Answer 7

College of American Pathologists

Question 8

What are the actions of CAP?

Answer 8

1) It conducts inspections of all clinical lab depts (including transfusion services, awarding accreditation to facilities that are deemed to be compliant w/ established stds)
2) It also provides a voluntary inspection and accreditation program (for its member institutions)

Question 9

What is U.S. FDA?

Answer 9

It is a regulating agency

Question 10

Where are the regulations (for donor screening) of U.S. FDA outlined?

Answer 10

These are outlined in the Code of Federal Regulations (CFR), Title 21, parts 211, 600-799

Question 11

Blood is regarded as what (under the auspices of the FDA)?

Answer 11

It is regarded both as a biologic and a drug

Question 12

What happened in 1988?

Answer 12

The Center for Biologics Evaluation and Research (CBER) was formed

Question 13

What are the actions of CBER?

Answer 13

1) It is responsible for regulating the collection of blood and blood cmpts (used for transfusion and for the manufacture of pharmaceuticals derived from blood and blood cmpts )
2) It develops and enforces quality stds
3) It inspects blood establishments
4) It monitors reports errors, accidents, and adverse clinical events

Question 14

What is the action of the FDA (in the early 1990s)?

Answer 14

It began to treat blood establishment the same as any drug manufacturer, requiring strict compliance w/ all aspects of transfusion medicine, including donor selection and screening

Question 15

What are the other actions of FDA?

Answer 15

1) It establishes and maintains the regulations
2) It inspects blood collection and processing centers
3) It is also responsible for licensing:
a. Collection and processing facilities
b. Blood products and derivatives
c. Rgnts (used in the processing | and testing of these products)
4) It provides recommendations and requirements (regarding infectious diseases as well as potential emerging diseases)

Question 16

What may be done by blood establishments?

Answer 16

They may adapt stricter requirements than those published by the FDA as written in the blood center’s standard operating procedure (SOP)

Question 17

The AABB is formerly known as what?

Answer 17

American Association of Blood Banks

Question 18

When is AABB established?

Answer 18

1947

Question 19

What is AABB?

Answer 19

It is an international association of blood centers, transfusion and transplantation services, and individuals involved in transfusion medicine

Question 20

What is the action of AABB?

Answer 20

It provides a voluntary inspection and accreditation program for its member institutions that meet the requirements of the Centers for Medicare and Medicaid Services (CMS) and the Clinical Laboratory Improvement Amendments of 1998 (CLIA)

Question 21

What is the mission of AABB?

Answer 21

To establish and provide the highest std of care for pts and donors in all aspects of transfusion medicine

Question 22

Did the AABB already published books on transfusion medicine throughout its existence?

Answer 22

Yes

Question 23

What are the 2 resources w/c are vital to donor screening procedures?

Answer 23

1) AABB Standards for Blood Banks and Transfusion Services

2) AABB Technical Manual

Question 24

What are discussed in the publications (/ books) published by the AABB?

Answer 24

The sp. guidelines for donor screening

Question 25

Since most transfusion services are part of the clinical lab depts in a hospital, what is done to those services?

Answer 25

Those services are included in a CAP inspection

Question 26

What are the states of CAP inspections (by CMS) as w/ the AABB inspections?

Answer 26

1) These are approved

2) These meet the CLIA requirements

Question 27

What is donor selection (what does it encompass)?

Answer 27

1) Medical history requirements (for the donor)
2) Physical examination (partial)
3) Serologic testing of the donor blood

Question 28

True or False

Any 1 of the areas (w/c are encompassed in donor selection) may preclude a potential donor from the donation process

Answer 28

True

Question 29

What are the 2 questions w/c are designed to be answered by the medical history information and physical examination?

Answer 29

1) Will a donation of approximately 450 mL of whole blood be harmful to the donor?
2) Could blood drawn from this donor at this time potentially transmit a disease to the recipient?

Question 30

As outlined in the AABB Standards, blood collection facilities must confirm what?

Answer 30

Donor identity

Question 31

What should be done by blood collection facilities (as outlined in the AABB Standards)?

Answer 31

Link the donor to existing donor records

Question 32

Most facilities (/ blood collection facilities) require a what (in terms of registration)?

Answer 32

A photographic identification

Question 33

What are the different photographic identification w/c are required to be used by most blood collection facilities (in terms of registration)?

Answer 33

1) Driver’s license
2) Passport
3) School identification card

Question 34

What must be done to prevent an ineligible donor from donating again (in relation w/ registration)?

Answer 34

Every donor must be checked against a permanent record of previously deferred donors

Question 35

What are the list of info used by the collection facility in the registration process and is kept on record by use of a single record form or electronically?

Answer 35

1) Name (first, last, MI)
2) Date and time of donation
3) Address
4) Telephone
5) Gender (self-identified and self-reported regarding transgender donors)
6) Age or date of birth

Question 36

What is the min. age (for a blood donor) for an allogeneic donation?

Answer 36

> or equal to 16 years (depending on individual state requirements)

Question 37

Is there an upper age limit in terms of blood donation (for the blood donor)?

Answer 37

None

Question 38

What is autologous donation?

Answer 38

Donating blood to be used for oneself

Question 39

Is there an age restriction for autologous donation (for the blood donor)?

Answer 39

None

Question 40

Since there is no age restriction for autologous donation (for the blood donor), what should be done?

Answer 40

Each donor-patient must be evaluated by the blood bank medical director

Question 41

In terms of consent to donate, what are the things that should be done (for the blood donor)?

Answer 41

1) Donors should be informed of the procedure for donating blood and its potential risks
2) The donors must also be given educational materials informing them of the signs and symptoms associated w/:
a. Human immunodeficiency virus [HIV] infection
b. Acquired immunodeficiency virus (AIDS)
c. Behaviors that put them at high risk of infection
d. A caution not to donate blood (as a means of getting an HIV test)

Question 42

At some point in the interview process, what must be done by the donors (in connection w/ consent to donate)?

Answer 42

They must sign a statement documenting that they have given consent to the donation

Question 43

When must donors sign a statement (w/c documents that they have given consent to the donation | in connection w/ consent to donate)?

Answer 43

This is typically done at the end of the donor history questionnaire (DHQ)

Question 44

What are the additional info that may be helpful in some cases?

Answer 44

1) The name of the pt for whome the blood is intended (directed donation)
2) Race of the donor for matching sp. phenotypes
3) Cytomegalovirus (CMV) status (some pt grps [such as neonates] require CMV-[-] blood in certain circumstances)

Question 45

True or False

Obtaining an accurate medical history of the donor is non-essential

Answer 45

False, because obtaining an accurate medical history of the donor is essential

Question 46

Why is obtaining an accurate medical history of the donor essential?

Answer 46

To ensure protection of the donor and benefit to the recipient

Question 47

What was developed by a task force (that included representatives from the AABB, the FDA, and the blood and plasma industry | in terms of obtaining an accurate medical history of the donor)?

Answer 47

A standardized medical history questionnaire (/ donor history questionnaire [DHQ])

Question 48

The questionnaire (/ standardized medical history questionnaire) was designed to be what?

Answer 48

To be self-administered by the donor

Question 49

The questionnaire (/ standardized medical history questionnaire) was designed to be self-administered, bu if preferred, what may be done (in terms of its administration)?

Answer 49

It may be administered by a trained doctor historian

Question 50

What must be done to self-administered questionnaires?

Answer 50

These must be reviewed by trained personnel before completing the screening process and prior to collecting blood

Question 51

What should be the characteristic of the interviewer (in terms of obtaining the medical history of the donor)?

Answer 51

He/she should be familiar w/ the questions

Question 52

Where should the interview (for obtaining the medical history of the donor) be done?

Answer 52

In a secluded area of the blood center or donor site

Question 53

What are the characteristics of the questions (present in the questionnaire | for obtaining the medical history of the donor)?

Answer 53

1) These are designed

2) A simple yes or no can be answered and elaborated, if indicated

Question 54

When should the medical history (/ obtaining of medical history of the donor) be conducted?

Answer 54

It should be conducted on the same day as the donation

Question 55

What are the 3 types of deferral?

Answer 55

1) Temporary deferral
2) Indefinite deferral
3) Permanent deferral

Question 56

What is temporary deferral?

Answer 56

The donor cannot donate for a specified time period

Question 57

Provide an ex of the application of temporary deferral (/ its principle)?

Answer 57

The donor cannot donate for 2 wks from receipt of the polio vaccine

Question 58

What is indefinite deferral?

Answer 58

The donor is prohibited from donating blood to another person for an unspecified period of time

Question 59

What is permanent deferral?

Answer 59

The donor may never donate blood to another person

Question 60

Can a donor also be deferred based on the mini-physical exam?

Answer 60

Yes, the donor may also be deferred

Question 61

Provide an ex in what aspect can the donor be deferred based on the mini-physical exam?

Answer 61

Abnormal hgb value

Question 62

What is the summary of DHQ questions (/ what are the questions [in summary] present in DHQ)?

Answer 62

1) Are you feeling healthy and well today?
2) Are you currently taking an antibiotic or taking any other medications for an infection?
3) Are you taking or have you ever taken any medications on the Medication Deferral List?
4) Have you read the educational materials?
5) In the past 48 hours, have you taken aspirin or anything with aspirin in it?
6) In the past 6 weeks, have you been pregnant or are you pregnant now?
7) In the past 8 weeks, have you donated blood, platelets, or plasma? In the past 16 weeks have you donated a double unit of red blood cells (RBCs) using an apheresis machine?
8) In the past 8 weeks, have you had any vaccinations or other shots? Have you had contact with someone who had a smallpox vaccination?
9) In the past 12 months have you had a blood transfusion; a transplant such as organ, tissue, or bone marrow; or a graft such as bone or skin?
10) In the past 12 months have you come in contact with someone else’s blood or had an accidental needle-stick injury? Had a tattoo? Had an ear or body piercing?
11) In the past 12 months, have you had sexual contact with anyone who has HIV/AIDS or has had a positive test for HIV/AIDS?
12) In the past 12 months, have you had sexual contact with a prostitute or anyone else who takes money or drugs or other payment for sex?
13) Male donors: Have you had sexual contact with another male in the past 12 months?
14) Female donors: Have you had sexual contact with a male who has ever had sexual contact with another male?
15) In the past 12 months, have you had sexual contact with a person who has hepatitis? Have you lived with a person who has hepatitis?
16) In the past 12 months, have you been treated for syphilis or gonorrhea?
17) Have you been in juvenile detention, lockup, or prison for more than 72 hours?
18) In the past 3 years, have you been outside of the United States or Canada?
a. Malaria
b. CJD and vCJD
c. Leishmaniasis
d. Received a blood transfusion in the UK or France
19) Have you ever had a positive test for HIV/AIDS virus?
20) Have you ever used needles to take drugs, steroids, or anything not prescribed by your doctor?
21) Have you ever used clotting factor concentrates?
22) Have you ever had hepatitis?
23) Have you ever Chagas disease? Had babesiosis?
24) Have you ever received a dura mater (or brain covering) graft?
25) Have you ever had any type of cancer, including leukemia?
26) Have you ever had any problems with your heart and lungs?
27) Have you ever had a bleeding condition or a blood disease?
28) Have you ever been in Africa?
29) Have you ever had sexual contact with anyone who has born or has lived in Africa?
30) Have any of your relatives had Creutzfeldt-Jakob disease (CJD)?
31) Have you ever received xenotransplantation?

Question 63

Where can more info regarding the questionnaire (/ DHQ questions) and interpretation of the questions be read / accessed?

Answer 63

1) AABB Technical Manual

2) FDA website

Question 64

Donors should appear what (in relation w/ the DHQ question “are you feeling healthy and well today?”)?

Answer 64

Donors should appear to be in good health w/out obvious signs or symptoms of:

1) Colds
2) Flu
3) Or other illness

Question 65

Are donors who currently taking antibiotics for an infection or for prophylaxis after dental surgery deferred (in relation w/ the DHQ question “are you currently taking an antibiotic or taking any other medications for an infection?”)?

Answer 65

Yes, they may be deferred temporarily

Question 66

Until when are the donors deferred if they are currently taking antibiotics for an infection or for prophylaxis after dental surgery (in relation w/ the DHQ question “are you currently taking an antibiotic or taking any other medications for an infection?”)?

Answer 66

Until the donor has completed the prescribed medication regimen and the infection has cleared up

Question 67

Are donors who have taken tetracycline or other antibiotics used to treat acne acceptable for donation (in relation w/ the DHQ question “are you currently taking an antibiotic or taking any other medications for an infection?”)?

Answer 67

Yes

Question 68

What must be done to all drugs and medications (in relation w/ the DHQ question “are you currently taking an antibiotic or taking any other medications for an infection?”)?

Answer 68

These must be cleared by the blood collection facility or blood bank medical director

Question 69

What must be done by the investigator (during the process of obtaining the pt’s medical history) if the donor’s response to the question (“are you currently taking an antibiotic or taking any other medications for an infection?”) is yes?

Answer 69

He/she must investigate further

Question 70

The Medication Deferral List was developed along w/ what? (in relation w/ the DHQ question “are you taking or have you ever taken any medications on the Medication Deferral List?”)

Answer 70

DHQ

Question 71

True or False

The Medication Deferral List is not recommended to be used in conjunction w/ the DHQ (in relation w/ the DHQ question “are you taking or have you ever taken any medications on the Medication Deferral List?”)

Answer 71

False, because the Medication Deferral List is recommended to be used in conjunction w/ the DHQ

Question 72

Where can the Medication Deferral List along w/ other donor history documents be found (in relation w/ the DHQ question “are you taking or have you ever taken any medications on the Medication Deferral List?”)?

Answer 72

On the FDA website

Question 73

What is the responsibility of each facility’s medical director (in relation w/ the DHQ question “are you taking or have you ever taken any medications on the Medication Deferral List?”)?

Answer 73

He/she is responsible for determining if any other medications require a deferral

Question 74

Most centers have what (in relation w/ the DHQ question “are you taking or have you ever taken any medications on the Medication Deferral List?”)?

Answer 74

A predetermined list of medications and their deferral requirements

Question 75

What must be done to the prospective donors (prior ro beginning the DHQ | in relation w/ the DHQ question “have you read the educational materials?”)

Answer 75

They must be provided info (about the collection procedure and many risks involved)

Question 76

How must the prospective donors be informed (in relation w/ the DHQ question “have you read the educational materials?”)?

Answer 76

They must be informed in a language they can understand

Question 77

The prospective donors must also be informed about what (in relation w/ the DHQ question “have you read the educational materials?”)?

Answer 77

About high-risk behavior related to the AIDS virus

Question 78

The prospective donors must be given what (in relation w/ the DHQ question “have you read the educational materials?”)?

Answer 78

They must be given the opportunity to ask questions regarding any aspect of the collection procedure

Question 79

True or False

The donor does not need to acknowledge that he/she has read and understands all of the material (in relation w/ the DHQ question “have you read the educational materials?”)

Answer 79

False, because the donor needs to acknowledge that he/she has read and understands all of the material

Question 80

How can the donor acknowledge that he/she has read and understand all of the material (in relation w/ the DHQ question “have you read the educational materials?”)?

Answer 80

This is generally done by having the donor sign a statement (indicating that they have read and understand the materials, have answered the health history questions honestly, have been informed of the risks of donation, and give their consent to the donation)

Question 81

Who are the donors who may not be a suitable donor for PLT apheresis (in relation w/ the DHQ question “in the past 48 hours, have you taken aspirin or anything with aspirin in it?”)

Answer 81

1) Donors who have taken piroxicam
2) Donors who have taken aspirin
3) Donors who have taken anything w/ aspirin in it
* all within 3 days of donation

Question 82

Why are donors who have taken piroxicam, aspirin, or anything w/ aspirin in it (within 3 days of donation) may not be suitable for PLT apheresis (in relation w/ the DHQ question “in the past 48 hours, have you taken aspirin or anything with aspirin in it?”)?

Answer 82

Because these medications inhibit PLT fxn

Question 83

Is there a restriction for whole blood (WB) donation (in relation w/ the DHQ question “in the past 48 hours, have you taken aspirin or anything with aspirin in it?”)?

Answer 83

None

Question 84

What may be preped if WB is collected (in relation w/ the DHQ question “in the past 48 hours, have you taken aspirin or anything with aspirin in it?”)?

Answer 84

Random donor PLTs

Question 85

Can random donor PLTs be used as a sole source of PLTs (if the donor answered yes to this question “in the past 48 hours, have you taken aspirin or anything with aspirin in it?”)?

Answer 85

No, it may not be used as a sole source of PLTs

Question 86

What is the deferral time for female donors (if the donor have been pregnant | in relation w/ the DHQ question “in the past 6 weeks, have you been pregnant or are you pregnant now?”)?

Answer 86

Temporary deferral (6 wks)

Question 87

If complications are anticipated at delivery, what can be made by the blood bank medical director (for an autologous donation | (in relation w/ the DHQ question “in the past 6 weeks, have you been pregnant or are you pregnant now?”)?

Answer 87

Exceptions can be made

Question 88

Is a first-trimester or second-trimester abortion or miscarriage a cause for deferral (in relation w/ the DHQ question “in the past 6 weeks, have you been pregnant or are you pregnant now?”)?

Answer 88

No

Question 89

What is the deferral time if the woman received a transfusion during her pregnancy (in relation w/ the DHQ question “in the past 6 weeks, have you been pregnant or are you pregnant now?”)?

Answer 89

12 mos

Question 90

What is the time interval between allogeneic WB donations (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 90

8 weeks or 56 days

Question 91

How many hrs must pass prior to donating WB if the prospective donor has participated in an apheresis donation (PLTs, leukocytes, / granulocytes | in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 91

At least 48 hrs

Question 92

The FDA limits PLT apheresis procedures to no more than what in a calendar yr (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 92

24

Question 93

The FDA limits PLT apheresis procedures to no more than 24 in a calendar yr unless what (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 93

Unless approved by the blood bank (BB) medical director

Question 94

How many times may an apheresis donor donate in a period of 7 days for a double or triple apheresis donation (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 94

Twice

Question 95

How many times may an apheresis donor donate in 7 days for a double or triple apheresis donation (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 95

Once

Question 96

What is the deferral time required by infrequent plasma apheresis (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 96

4 wks

Question 97

What is an infrequent plasma apheresis (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 97

It can be defined as undergoing the procedure no more frequently than once every 4 wks

Question 98

What is serial plasma apheresis program (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 98

It is structured so that the donor undergoes the procedure more frequently than once every 4 wks

Question 99

What is the deferral time for a double RBC apheresis donation (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 99

16 wks

Question 100

Why is the deferral time for a double RBC apheresis donation 16 wks (in relation w/ the DHQ question “in the past 8 weeks, have you donated blood, platelets, or plasma? in the past 16 weeks have you donated a double unit of red blood cells [RBCs] using an apheresis machine”)?

Answer 100

Due to the additional volume of RBCs that are donated

Question 101

What is the deferral time if a potential donor has received a live attenuated or bacterial vaccine (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 101

2 wks

Question 102

What are the live attenuated or bacterial vaccines that can be received by a potential donor resulting to a 2-week deferral (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 102

1) Measles (rubeola)
2) Mumps
3) Oral polio
4) Typhoid
5) Yellow fever

Question 103

What is the deferral time if the donor has received a live attenuated vaccine for German measles (rubella) or chickenpox (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 103

4 wks

Question 104

There is no deferral if the donor received what vaccines (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 104

Toxoids or killed or synthetic viral, bacterial, or rickettsial vaccines such as:

1) Diphtheria
2) Hepatitis A
3) Hepatitis B
4) Influenza
5) Lyme disease
6) Pneumococcal polysaccharide
7) Polio injection (Salk)
8) Anthrax
9) Cholera
10) Pertussis
11) Plague
12) Paratyphoid
13) Rabies
14) Rocky Mountain spotted fever
15) Tetanus
16) Typhoid injection (if the donor is symptom-free and afebrile)

Question 105

What is the deferral time if donor received smallpox vaccination (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 105

14 - 21 days or until the scab has fallen off

Question 106

Are donors who have been in close contact w/ someone who has recently vaccinated (w/ smallpox) at risk of possible infection as well (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 106

Yes

Question 107

Accdg to FDA, is close contact (to the vaccination site) considered as a form of exposure (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 107

Yes

Question 108

How is close contact (in relation w/ smallpox vaccination) done (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 108

Exposure to:

1) Vaccination site
2) Bandages
3) Clothing
4) Towels
5) Bedding (that have been in contact w/ the vaccination site)

Question 109

What is the additional question that could be posed to the prospective donor (in relation w/ smallpox | in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 109

“If you have had the smallpox vaccine, has the scab fallen off by itself?”

Question 110

Does the recipients who have received smallpox vaccine need to be quarantined (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 110

No

Question 111

Why are the recipients who have received smallpox vaccine does not need to be quarantined (in relation w/ the DHQ question “in the past 8 weeks, have you had any vaccinations or other shots? have you had contact with someone who had a smallpox vaccination”)?

Answer 111

Because the vaccinia virus is inactivated in the manufacturing process

Question 112

Who are the individuals who are known to be possible sources of bloodborne pathogens (in relation w/ the DHQ question “in the past 12 months have you had a blood transfusion; a transplant such as organ, tissue, or bone marrow; or a graft such as bone or skin?”)?

Answer 112

Donors who during the preceding 12 mos have received a transfusion of:

1) Blood
2) Or blood cmpts
3) Or other human tissues
a. Organ
b. Tissue
c. Bone marrow transplannt
d. Bone
e. Skin graft

Question 113

What is the deferral time for donors who during the preceding 12 mos have received a transfusion of blood or its components or other human tissues (in relation w/ the DHQ question “in the past 12 months have you had a blood transfusion; a transplant such as organ, tissue, or bone marrow; or a graft such as bone or skin?”)?

Answer 113

12 mos (from the time of receiving the blood product / graft)

Question 114

What is the deferral time if the donor (in the past 12 mos) had come in contact with someone else’s blood od had an accidental needle-stick injury, had a tattoo, / had an ear or body piercing (in relation w/ the DHQ question “in the past 12 months have you come in contact with someone else’s blood od had an accidental needle-stick injury? had a tattoo? had an ear or body piercing?”)?

Answer 114

12 mos

Question 115

Why are donors (in the past 12 mos) who had come in contact w/ someone else’s blood or had an accidental needle-stick injury, had a tattoo, or had an ear or body piercing deferred for 12 mos (in relation w/ the DHQ question “in the past 12 months have you come in contact with someone else’s blood od had an accidental needle-stick injury? had a tattoo? had an ear or body piercing?”)?

Answer 115

Due to potential exposure to substances known to be sources of bloodborne pathogens

Question 116

When is exposure assumed (in relation w/ the DHQ question “in the past 12 months have you come in contact with someone else’s blood od had an accidental needle-stick injury? had a tattoo? had an ear or body piercing?”)?

Answer 116

If the blood came in contact w/ an open wound / any nonintact skin / mucous membranes (such as nose, mouth, and eyes)

Question 117

What are also considered as causes of deferral (and provide exs | in relation w/ the DHQ question “in the past 12 months have you come in contact with someone else’s blood od had an accidental needle-stick injury? had a tattoo? had an ear or body piercing?”)?

Answer 117

Skin penetrating injuries from instruments, equipment, needles, and so forth that are nonsterile and contaminated w/ blood or body fluids other than the donor’s own

Includes tattoos, permanent makeup, and ear and body piercings (unless applied by a state-regulated organization where sterile needles and ink are not reused)

Question 118

What is the deferral time if the donor had sexual contact w/ anyone who has HIV/AIDS or has had a (+) test for HIV/AIDS (in relation w/ the DHQ question “in the past 12 months have you had sexual contact with anyone who has HIV/AIDS or has had a positive test for HIV/AIDS?”)?

Answer 118

12 mos (from the time of sexual contact w/ a person w/ clinical or lab evidence of HIV infection or who is at high risk for infection)

Question 119

What is the deferral time if the donor had sexual contact w/ a prostitute or anyone else who takes money or drugs or other payment for sex (in relation w/ the DHQ question “in the past 12 months have you had sexual contact with a prostitute or anyone else who takes money or drugs or other payment for sex?”)?

Answer 119

12 mos (from the time of sexual contact)

Question 120

What is the deferral time (as mandated by the FDA) if the donor had sex w/ any person who is a past / present IV drug user (in relation w/ the DHQ question “in the past 12 months have you had sex with anyone who has ever used a needle to take drugs or steroids or anything not prescribed by their doctor? in the past 12 months, have you ever had sex with anyone who has hemophilia or has used clotting factor concentrates?”)?

Answer 120

12 mos

Question 121

What is the deferral time if the donor had sex w/ any person w/ hemophilia or a related blood disorder who has received factor concentrates (in relation w/ the DHQ question “in the past 12 months have you had sex with anyone who has ever used a needle to take drugs or steroids or anything not prescribed by their doctor? in the past 12 months, have you ever had sex with anyone who has hemophilia or has used clotting factor concentrates?”)?

Answer 121

12 mos

Question 122

What is the meaning of MSM (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 122

Gay, Bisexual and Other Men who have Sex with Men

Question 123

Can males who had sex w/ another male (MSM) may donate WB (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 123

Yes

Question 124

When does males who had sex w/ another male (MSM) may donate WB (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 124

1) If they meet all other donor eligibility requirements

2) If have not had sex w/ another male in the past 1 yr

Question 125

What happened in 1985 (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 125

The FDA began instituting an indefinite deferral for MSM since 1977, even if the sexual contact only happened once, to safeguard the public from transfusion-transmitted HIV (TT-HIV)

Question 126

W/ more sensitive testing protocols and viral inactivation measures, what did the Department of Health and Human Services done (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 126

They initiated public discussion toward a revision of policy

Question 127

What are the multiple factors involved in the revision of policy (initiated by the Department of Health and Human Services | in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 127

1) Operational assessment
2) DHQ studies
3) The Retrovirus Epidemiology Donor Study II (REDS II)
4) REDS III
5) Supportive data from other countries

Question 128

What is the result of doing operational assessment (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 128

It was determined that quarantine release errors involving HIV contributed minimally to the risk of TT-HIV

Question 129

The quarantine release errors involving HIV (w/c contributed minimally to the risk of TT-HIV is largely due to what | in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 129

Has been largely due to computerized inventory management in w/c a barcode reader is utilized to identify quarantined units

Question 130

Who are the participants in a DHQ study that was conducted in 2011 (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 130

Donors who had sex w/ the opposite sex and MSM were interviewed

Question 131

What was found in the DHQ study that was conducted in 2011 (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 131

It was found that answering questions related to sexual behavior was more effective when they approached the question from the standpoint of their blood being safe

Question 132

What does the participants recommend (in the DHQ study that was conducted in 2011 | in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 132

1) They also recommended shorter donor educational materials
2) They also recommended the option to answer the question w/ “I don’t know”

Question 133

What are the 4 viral markers that are evaluated in the REDS II study (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 133

1) Hepatitis B virus (HBV)
2) Hepatitis C virus (HCV)
3) Human immunodeficiency virus (HIV)
4) Human T-cell lymphotropic virus I and II (HTLV-I and II)

Question 134

The 4 viral markers that are evaluated by / in the REDS II study in the context of behavioral risk factors are associated w/ what (in relation w/ the DHQ question “have you had sexual contact with another male in the past 12 months [for male donors]?”)?

Answer 134

Associated w/ donations that were (+) for 1 or more of the viruses

Question 134

What is the key finding of the pilot study (REDS II study)?

Answer 134

For each viral infection, the behavioral risk factor was aligned to the epidemiology for each infection validating the current donor deferral criteria

Question 135

According to the pilot study (REDS II study), a donor that had sex w/ an HIV-(+) partner was associated w/ how many folds of increase in risk of being HIV (+)?

Answer 135

132-fold increase

Question 136

According to the pilot study (REDS II study), a history of MSM contact was associated w/ how many folds of increase in risk of becoming HIV (+)?

Answer 136

62-fold increase

Question 137

Who are the participants in the REDS III study conducted?

Answer 137

MSM community

Question 138

How are data gathered from the participants in the REDS III study?

Answer 138

Through surveys (that were web based)

Question 139

How many percent of the MSM (in the REDS III study) thought that the donation deferral should change?

Answer 139

90%

Question 140

How many percent of MSM (in the REDS III study) said that they would comply w/ the change to a 1 yr deferral?

Answer 140

59%

Question 141

True or False

Some participants (in the REDS III study) thought the policy was discriminatory toward MSM

Answer 141

True

Question 142

How many percent is the prevalence of HIV infection in MSM (in the REDS III study) who classified themselves as blood donors?

Answer 142

0.25%

Question 143

In the REDS III study, are countries such as Australia also had a volunteer blood donor program and an MSM population were analyzed?

Answer 143

True

Question 144

What is the change of deferral that happened in Australia (in connection w/ male donors who had sexual contact with another male in the past 12 months)?

Answer 144

From lifetime deferral to 1 yr deferral

Question 145

What is the result of change in deferral in Australia (in connection if a male donor had sex w/ another male in the past 12 mos)?

Answer 145

Resulting in no change in risk to their blood supply 5 yrs before the change and 5 yrs after the change in policy

Question 146

What are the other countries that have adopted a 1 yr deferral policy (in connection if a male donor had sex w/ another male in the past 12 mos)?

Answer 146

1) Argentina
2) Brazil
3) Hungary
4) Japan
5) Sweden
6) UK

Question 147

What is the most effective way to do in aligning w/ current serologic testing and epidemiology of the HIV virus?

Answer 147

The decision to adopt a time-based deferral policy since last sexual encounter involving MSM

Question 148

Did the 1977 benchmark had become less effective over time (in connection if a male donor had sex w/ another male in the past 12 mos)?

Answer 148

Yes

Question 149

What is the option that was done (since the 1977 benchmark had become less effective over time)?

Answer 149

Eliminate all HIV-related deferrals and rely just on current testing

Question 150

Is the option done in replacement w/ the 1977 benchmark accepted or rejected?

Answer 150

Rejected

Question 151

Why is the option that replaced 1977 benchmark rejected?

Answer 151

Because of possible new cases of HIV that may go undetected

Question 152

What is the deferral time for women who have had sex w/ an MSM in the past 12 mos (in relation w/ the DHQ question “have you had sexual contact with a male who has ever had sexual contact with another male?” (for female donors)?)?

Answer 152

12 mos

Question 153

What is the deferral time if the donor had sexual contact / living w/ a person (close contact) who has acute / chronic hepatitis B (test [+] for HBsAg / HIV) or who has symptomatic hepatitis C or other hepatitis virus (in relation w/ the DHQ question “in the past 12 months, have you had sexual contact with a person who has hepatitis? have you lived with a person who has hepatitis?”)?

Answer 153

12 mos (following discontinuation of being in close contact)

Question 154

What is the deferral time for prospective donors w/ a history of syphilis or gonorrhea or treatment for either, a reactive screening test for syphilis, or where no confirmatory test was performed (in relation w/ the DHQ question “in the past 12 months, have you been treated for syphilis or gonorrhea?”)?

Answer 154

12 mos (after completion of therapy)

Question 155

What is the causative agent for syphilis (in relation w/ the DHQ question “in the past 12 months, have you been treated for syphilis or gonorrhea?”)?

Answer 155

Treponema pallidum

Question 156

What are the characteristics of Treponema pallidum (in relation w/ the DHQ question “in the past 12 months, have you been treated for syphilis or gonorrhea?”)?

Answer 156

1) It may live for 1 - 5 days (in cold storage)

2) It thrives very well (in RT)

Question 157

What is the effect of the characteristic of Treponema pallidum w/c it may live for 1 - 5 days in cold storage (in relation w/ the DHQ question “in the past 12 months, have you been treated for syphilis or gonorrhea?”)?

Answer 157

Only a fresh unit of RBCs may transmit infection

Question 158

What is the effect of the characteristic of Treponema pallidum w/c that it thrives well in RT (in relation w/ the DHQ question “in the past 12 months, have you been treated for syphilis or gonorrhea?”)?

Answer 158

It places PLT concentrates above RBCs as potentially supporting transfusion-transmitted syphilis

Question 159

How many cases of transfusion-transmitted syphilis have been documented as of today (in relation w/ the DHQ question “in the past 12 months, have you been treated for syphilis or gonorrhea?”)?

Answer 159

3

Question 160

What must be done by donor centers in relation w/ T. pallidum (in relation w/ the DHQ question “in the past 12 months, have you been treated for syphilis or gonorrhea?”)?

Answer 160

They must use a screening test for T. pallidum (w/c should be / has been licensed by the FDA)

Question 161

What is the deferral time if the donor had been in juvenile detention, lockup, or prison for 72 hrs > (in relation w/ the DHQ question “have you been in juvenile detention, lockup, or prison for more than 72 hours?”)?

Answer 161

12 mos (from the last date of incarceration)

Question 162

What is the aim of this question (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 162

This question is general and is used to detect a donor who may have an increased risk of exposure to malaria, Creutzfeldt-Jakob disease or variant Creutzfeldt-Jakob disease (CJD or vCJD), and more recently, leishmaniasis

Question 163

What is the deferral time for prospective donors who have been diagnosed w/ malaria (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 163

3 yrs (after becoming asymptomatic, irrespective of the receipt of antimalarial prophylaxis)

Question 164

What is the deferral time for individuals who have lived 5 consecutive yrs > in countries considered malaria-endemic by the Malarial Branch, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 164

3 yrs (after departure from malaria-endemic countries)

Question 165

What is the deferral time for individuals who have lived longer than 5 yrs in malaria-endemic countries and who have been a resident in nonendemic countries for < 3 consecutive yrs (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 165

3 yrs (after the 3-yr deferral period, the donor may be eligible to donate, provided the donor has been free from malaria during this period and meets all other donor eligibility criteria)

Question 166

What is the deferral time for individuals who have traveled to an area where malaria is endemic (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 166

12 mos (after departure from the malaria-endemic area)

Question 167

What is the deferral time if a prior resident of a malaria-endemic country returns to a malaria-endemic area after residence for 3 yrs consecutively in a nonendemic country (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 167

1 yr (from the time that they return to the nonendemic country)

Question 168

What are CJD and vCJD (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 168

These are members of a grp of neurological disorders known as transmissible spongiform encephalopathies (TSE)

Question 169

What is the other term for TSE (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 169

Prion diseases

Question 170

TSE affects what (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 170

1) Sheep
2) Cows
3) Humans

Question 171

CJD results in what (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 171

1) Progressive dementia

2) Spongiform alterations in the brain (and is rapidly fatal)

Question 172

CJD may be transmitted by what (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 172

1) Corneal transplants
2) Human dura mater grafts
3) Pituitary-derived human growth hormone
4) Neurosurgical instruments

Question 173

Can humans also be infected by CJD (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 173

Yes

Question 174

How can humans be infected by CJD (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 174

By eating beef contaminated w/ prions, abnormal proteins found in the brain tissue of diseased cattle, w/c led to the term “mad cow disease”

Question 175

What are the characteristics of prions (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 175

Highly resistant to:

1) Heat
2) Ultraviolet (UV) light

Question 176

What happens to bacteria and viruses when exposed to UV light (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 176

They are killed

Question 177

What is the action of prions in TSE (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 177

They induce abnormal folding of normal proteins

Question 178

What is the result of the action by prions in TSE (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 178

It leads to neurological symptoms and death

Question 179

What happens to humans when they ingest contaminated beef from a diseased cow (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 179

They can develop vCJD

Question 180

How many pts have been diagnosed w/ clinical vCJD as of 2015 (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 180

228

Question 181

What are the countries involved w/ the cases of clinical vCJD as of 2015 (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 181

1) UK
2) U.S.
3) Canada
4) France
5) Austria
6) Belgium
7) Czech Republic
8) Denmark
9) Finland
10) Germany
11) Greece
12) Ireland
13) Italy
14) Liechtenstein
15) Luxembourg
16) The Netherlands
17) Poland
18) Portugal
19) Spain
20) Switzerland
21) Sweden
22) Israel
23) Japan

Question 182

What is the deferral time for anyone diagnosed w/ CJD or vCJD or if the donor received a dura mater transplant or pituitary GH from a human cadaver (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 182

Permanent deferral

Question 183

What is the deferral time to anyone who is a blood relative of someone diagnosed w/ CJD or vCJD (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 183

Indefinite deferral

Question 184

What is the deferral time if the donor spent 3 or more mos in the UK from 1980 - 1996 and/or 5 yrs or more in France from 1980 to the present (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 184

Indefinite deferral

Question 185

What is the deferral time for persons who served in the U.S. military specifically for those who spent 6 mos or more in Northern Europe (Germany, UK, Belgium, and the Netherlands) from 1980 - 1990 or spent 6 mos or more from 1980 - 1996 in Greece, Turkey, Spain, Portugal, or Italy (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 185

Indefinite deferral

Question 186

What is the deferral time if a donor received a blood transfusion in the UK from 1980 to the present (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 186

Indefinite deferral

Question 187

What is the deferral time if the donor received bovine insulin since 1980 (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 187

Indefinite deferral (unless the bovine insulin did not come from the UK)

Question 188

What are Leishmania spp. (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 188

These are intracellular protozoan parasites that cause leishmaniasis

Question 189

Where are Leishmania spp. endemic (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 189

In tropical and subtropical areas such as:

1) Middle East
2) Mediterranean coast
3) Africa
4) Central and South America
5) Asia

Question 190

How are Leishmania spp. transmitted (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 190

These are transmitted to humans (by the sand fly [Phlebotomus] infected w/ Leishmania

Question 191

What are the clinical manifestations of Leishmaniasis (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 191

It ranges from cutaneous lesions to visceral infections (that may be fatal)

Question 192

How many cases of transfusion-transmitted Leishmaniasis have been reported in the literature, primarily involving Leishmania donovani (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 192

15

Question 193

What is the deferral time for people who are deployed of military and National Guard troops in Iraq in 2003 (in relation w/ the DHQ question “in the past 3 years, have you been outside of the United States or Canada?”)?

Answer 193

12 mos (from the date of departure from the area was instituted for any military personnel stationed in Iraq and any civilian and contract personnel who have visited the country)

Question 194

What is the deferral time for those who have received a transfusion of blood, PLTs, plasma, cryoppt, or granulocytes in the UK or France since 1980 (in relation w/ the DHQ question “in the past 3 years, have you received a blood transfusion in the UK or France?”)?

Answer 194

Indefinite deferral

Question 195

What is the deferral time for any person w/ clinical or lab dx of HIV infection (in relation w/ the DHQ question “have you ever had a positive test for HIV/AIDS virus?”)?

Answer 195

Indefinite deferral

Question 196

What should be done to the donor’s arms (in relation w/ the DHQ question “have you ever used needles to take drugs, steroids, or anything not prescribed by your doctor?”)?

Answer 196

These should be checked for evidence of scars or punctures indicating self administration of self-injected drugs or for presence of any skin lesions in the venipuncture site

Question 197

What is the deferral time for donors w/ evidence of past / present nonprescription drug use (in relation w/ the DHQ question “have you ever had a positive test for HIV/AIDS virus?”)?

Answer 197

Indefinite deferral

Question 198

Should prospective donors w/ hemophilia or other bleeding disorders and who receive clotting factor concentrates be deferred from donating blood or cmpts (in relation w/ the DHQ question “have you ever used clotting factor concentrates?”)?

Answer 198

Yes (unless otherwise approved by the medical director because there is a high risk of bleeding following venipuncture)

Question 199

What is the deferral time if there is a receipt of clotting factor concentrates, such as receipt of blood transfusions (in relation w/ the DHQ question “have you ever used clotting factor concentrates?”)?

Answer 199

12 mos

Question 200

What is the deferral time for donors w/ a (+) test for HBsAg (in relation w/ the DHQ question “have you ever had hepatitis?”)?

Answer 200

Permanent deferral

Question 201

What is the deferral time if a donor reacted positively for anti-HBc on more than 1 occasion (in relation w/ the DHQ question “have you ever had hepatitis?”)?

Answer 201

Indefinite deferral

Question 202

What is the deferral time if donors had a (+) HBV nucleic acid testing (NAT) (in relation w/ the DHQ question “have you ever had hepatitis?”)?

Answer 202

Indefinite deferral

Question 203

What is the deferral time if a donor has a clinical history / dx of viral hepatitis at age 11 or later (in relation w/ the DHQ question “have you ever had hepatitis?”)?

Answer 203

Permanent deferral

Question 204

What is the deferral time if the donor was diagnosed w/ viral hepatitis before age 11 (in relation w/ the DHQ question “have you ever had hepatitis?”)?

Answer 204

Temporary deferral (blood and blood cmpts collected from the donor must not be used for further manufacture until the clinical circumstances are thoroughly reviewed by medical personnel)

Question 205

What is the deferral time if the donor has a history of Chagas disease or babesiosis (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 205

Indefinite deferral

Question 206

Chagas disease is also known as what (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 206

American trypanosomiasis

Question 207

What is the causative agent for Chagas disease (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 207

Trypanosoma cruzi (a protozoan parasite)

Question 208

What is the vector responsible for transmitting Trypanosoma cruzi (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 208

The hematophagous bug

Question 209

To w/c family does the hematophagous bug belong (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 209

Reduvidae

Question 210

How does transmission of hematophagous bug occur (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 210

When mucous membranes or breaks in the skin are contaminated w/ feces of infected hematophagous bugs

2) It may also be transmitted congenitally by:
a. Breastfeeding
b. Organ transplants
c. Blood transfusion

Question 211

Where is Chagas disease endemic (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 211

In parts of Central and South America and Mexico

Question 212

How many estimated number of persons are infected w/ Trypanosoma cruzi in the countries where Chagas disease is endemic (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 212

Estimated 11 M persons

Question 213

How many persons approximately residing in the U.S. and Canada may be infected w/ Trypanosoma cruzi (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 213

Approx 300,000 persons

Question 214

How many cases of transfusion-associated transmission of Chagas disease have been documented in the past 20 yrs (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 214

7 (all occurring in immunosuppressed recipients)

Question 215

How many are known spp. of Babesia (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 215

70

Question 216

How many spp. of Babesia are identified to infect humans (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 216

At least 5

Question 217

What is the Babesia sp. that is capable to infect human (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 217

Babesia microti

Question 218

How does Babesia microti infect humans (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 218

They utilize the vector Ixodes scapularis to infect the human and transmit the parasite

Question 219

What is the mechanism of infection of Babesia microti, once it already infected a human (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 219

It penetrates the RBC where the trophozoite multiplies; upon lysis, the RBC merozoites are released into the blood where they are free to infect other RBCs

Question 220

What is the incubation period for transfusion-associated infection w/ Babesia (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 220

2 - 8 wks

Question 221

What are the symptoms for babesiosis due to Babesia microti (in relation w/ the DHQ question “have you ever had Chagas disease? had babesiosis?”)?

Answer 221

1) Malaise
2) Fatigue
3) Anorexia
4) Arthralgia
5) Nausea
6) Vomiting
7) Abdominal pain
8) Fever (reaching 40 DC)

Question 222

What is the deferral time for prospective donors w/ a history of a dura mater graft (in relation w/ the DHQ question “have you ever received a dura mater (or brain covering) graft?”)?

Answer 222

Permanent deferral (due to an increased risk of exposure to CJD and vCJD)

Question 223

What is the deferral time if the donor has a history of cancer, leukemia, or lymphoma (in relation w/ the DHQ question “have you ever had any type of cancer, including leukemia?”)?

Answer 223

Indefinite deferral

Question 224

What should be done to any donor presenting w/ a history of cancer (in relation w/ the DHQ question “have you ever had any type of cancer, including leukemia?”)?

Answer 224

He/she should be evaluated by the BB medical director

Question 225

What are the exceptions for deferral if the donor has a history of cancer, leukemia, or lymphoma (in relation w/ the DHQ question “have you ever had any type of cancer, including leukemia?”)?

Answer 225

1) Basal or squamous cell cancer
2) Carcinoma in situ of the cervix
3) Papillary thyroid carcinoma (w/c has been surgically removed)

Question 226

Is it a cause for deferral if the donor has a history of cardiovascular, coronary, / rheumatic heart disease (in relation w/ the DHQ question “have you ever had any problems w/ your heart or lungs?”)?

Answer 226

Yes (usually)

Question 227

When may the donor be accepted on a case-by-case basis by the BB medical director (in relation w/ the DHQ question “have you ever had any problems w/ your heart or lungs?”)?

Answer 227

If there is an absence of disability or restrictions by the pt’s physician

Question 228

If the donor has active pulmonary TB / other active pulmonary disease, is it a cause for deferral (in relation w/ the DHQ question “have you ever had any problems w/ your heart or lungs?”)?

Answer 228

Yes

Question 229

What must be done to donors indicating a history of a bleeding problem following surgery, invasive dental procedures, cuts, or abrasions (in relation w/ the DHQ question “have you ever had a bleeding condition or a blood disease?”)?

Answer 229

They must be further evaluated by the BB medical director

Question 230

What can be the blood diseases and condition that the donor can have that is a cause for deferral (in relation w/ the DHQ question “have you ever had a bleeding condition or a blood disease?”)?

Answer 230

1) Hemophilia
2) von Willebrand disease (vWD)
3) Sickle cell anemia
4) Thalassemia
5) Kaposi’s sarcoma
6) Polycythemia

Or history of receiving clotting factor concentrates

Question 231

What is the deferral time if the donor has blood disease/s or has a history of receiving clotting factor concentrates (in relation w/ the DHQ question “have you ever had a bleeding condition or a blood disease?”)?

Answer 231

Indefinite deferral

Question 232

Where is HIV-1 grp O virus endemic (in relation w/ the DHQ question “have you ever been in Africa?”)?

Answer 232

In central and west regions of Africa

Question 233

What is the deferral time if the donor who was born or lived in any of the African countries on the FDA list of countries w/ HIV-1 grp O risk since 1997 (in relation w/ the DHQ question “have you ever been in Africa?”)?

Answer 233

Indefinite deferral

Question 234

What is the deferral time if the prospective donor has traveled to any of the countries on the FDA list since 1977 and received a blood transfusion or other medical treatment w/ a blood product

Answer 234

Indefinite deferral

Question 235

What is the deferral time if the prospective donor indicates having had sex w/ a person who was born in any of the African countries targeted w/ increased risk of HIV-1 grp O infection (in relation w/ the DHQ question “have you ever had sexual contact with anyone who was born or has lived in Africa?”)?

Answer 235

Indefinite deferral

Question 236

What can be done to the questions concerning residence in or travel to sp. African countries or sexual contact w/ persons from those countries if the collecting facility has implemented testing for HIV-1/2 or testing that has been licensed for use in detecting Abs to HIV-1 grp O (in relation w/ the DHQ question “have you ever had sexual contact with anyone who was born or has lived in Africa?”)?

Answer 236

These may be omitted

Question 237

What can be done to donors who were previously deferred prior to the availability of the HIV-1 grp O testing (in relation w/ the DHQ question “have you ever had sexual contact with anyone who was born or has lived in Africa?”)?

Answer 237

They may be reentered provided that it has been at least 1 yr since the last potential exposure to HIV-1 grp O and the screening test results are nonreactive

Question 238

What is the deferral time if the prospective donor has a family history of CJD (in relation w/ the DHQ question “have you ever have any of your relatives had Creutzfeldt -Jakob disease (CJD)?”)?

Answer 238

Indefinite deferral (as recommended by FDA; unless the dx of CJD was confidently excluded)

Question 239

Can the donor (who was deferred due to family history of CJD) be reentered (in relation w/ the DHQ question “have you ever have any of your relatives had Creutzfeldt -Jakob disease (CJD)?”)?

Answer 239

Yes, if the dx of CJD in the family member/s is confidently excluded or CJD in the family member/s is iatrogenic, or if appropriate lab testing such as gene sequencing shows the donor does not have a mutation found in association w/ familial CJD

Question 240

What is the deferral time if the donor received cells, tissues, / organs from a nonhuman animal source (in relation w/ the DHQ question “have you ever received a xenotransplantation?”)?

Answer 240

Permanent deferral

Question 241

What are acceptable to be received by the donor (in relation w/ the DHQ question “have you ever received a xenotransplantation?”)?

Answer 241

Nonliving biologics / materials from nonhuman animals such as:

1) Porcine heart valves
2) Porcine insulin

Question 242

What is done by the donor center representative (in terms of physical examination | or what are the parts of physical exam)?

Answer 242

He/she evaluates the prospective donor w/ regard to:

1) General appearance
2) Weight
3) Temp
4) Hgb
5) Presence of skin lesions

Question 243

True or False

A BB physician should be available to evaluate any special considerations (w/ regards to physical exam)

Answer 243

True

Question 244

What should the donor center representative do (in relation w/ physical exam, in terms of general appearance)?

Answer 244

He/she should observe the prospective donor for presence of:

1) Excessive anxiety
2) Drug or alcohol influence
3) Nervousness

Question 245

How should observance of the prospective donor in terms of his/her general appearance (in relation w/ physical exam) be done?

Answer 245

This should be done by the donor center representative in a gentle manner (so as not to deter the donor from future donations)

Question 246

What should be the weight of all donors (in connection w/ weight | in terms of physical exam)

Answer 246

At least 110 lbs

Question 247

What is the max. weight of the donor (as mandated by Standards | in connection w/ weight | in relation w/ physical exam)?

Answer 247

Max. of 10.5 mL of blood/kg of donor weight (for WB collection), inclusive of pilot tubes for testing

Question 248

What must be done if the donor weighs < 100 lbs (in connection w/ weight | in relation w/ physical exam)?

Answer 248

The amt of blood collected must be proportionately reduced as well as that of the anticoagulant

Question 249

What are the formulas that can be used to calculate the adjusted volume of blood to be collected and anticoagulant (CPD and CPDA-1) to be used (in connection w/ weight | in relation w/ physical exam)?

Answer 249

1) Volume to collect = (donor’s weight in kg/50) X 450 mL
2) Volume to collect/450 X 63 mL = reduced volume of anticoagulant
3) 63 mL - above calculated volume = amount of solution to be removed

Question 250

What must be the temp of the donor (in terms of temp | in relation w/ physical exam)?

Answer 250

It must be < or equal to 37.5 DC or 99.5 DF

Question 251

What is asked to donors (in relation w/ temp | in relation w/ physical exam)?

Answer 251

They are asked not to drink coffee or hot beverages while waiting to donate

Question 252

Why are donors asked not to drink coffee or hot beverages while waiting to donate (in connection w/ temp | in relation w/ physical exam)?

Answer 252

Because by doing so, it may sometimes affect their temp

Question 253

What is the characteristic of oral temps (/ temps collected orally | in connection w/ temp | in relation w/ physical exam)?

Answer 253

These are lower > normal

Question 254

Are oral temps a cause for deferral (in connection w/ temp | in relation w/ physical exam)?

Answer 254

No

Question 255

What should be the hgb lvl and hct lvl of female donors (/ women) in allogeneic donations (in connection w/ hgb | in relation w/ physical exam)?

Answer 255

Hgb lvl: should be > or equal to 12.5 g/dL

Hct lvl: should be > or equal to 38%

Question 256

What should be the hgb lvl and hct lvl of male donors (/ men) in allogeneic donations (in connection w/ hgb | in relation w/ physical exam)?

Answer 256

Hgb lvl: should be > or equal to 13.0 g/dL

Hct lvl: should be > or equal to 39%

Question 257

What should be the hgb and hct lvl of the donor (in / for autologous donation | in relation w/ hgb | in relation w/ physical exam)?

Answer 257

Hgb lvl: should be > or equal to 11.0 g/dL

Hct lvl: should be > or equal to 33%

Question 258

What are the methods used for measuring hgb (in connection w/ hgb | in connection w/ physical exam)?

Answer 258

1) Copper sulfate

2) Point-of-care instruments (using spectrophotometric methodology)

Question 259

How can hct or packed cell volume (PCV) be determined (in relation w/ hgb | in relation w/ physical exam)?

Answer 259

It can be determined manually (via or by centrifugation)

Question 260

Can the earlobe be used for hgb / hct determination (in relation w/ hgb | in relation w/ physical exam)?

Answer 260

No

Question 261

What should be done to the donor’s arms prior to donation (in connection w/ skin lesions | in connection w/ physical exam)?

Answer 261

The donor’s arms should be inspected for skin lesions

Question 262

Are evidence of skin lesions (such as multiple puncture marks) a cause for deferral (in connection w/ skin lesions | in connection w/ physical exam)?

Answer 262

Yes

Question 263

What is the deferral time if the donor has evidence of skin lesions (such as multiple puncture marks | in connection w/ skin lesions | in connection w/ physical exam)?

Answer 263

Indefinite deferral

Question 264

Are skin disorders (such as poison ivy and other rashes) a cause for deferral (in connection w/ skin lesions | in connection w/ physical exam)?

Answer 264

No

Question 265

Since skin disorders (such as poison ivy and other rashes) are not a cause for deferral, is it okay for these to be present in the area of venipuncture site (in connection w/ skin lesions | in connection w/ physical exam)?

Answer 265

No

Question 266

What should be done if skin disorders (such as poison ivy and other rashes) are present in the area of venipuncture (in connection w/ skin lesions | in connection w/ physical exam)?

Answer 266

These may be needed to be evaluated by a BB physician

Question 267

What is mandated by the AABB Standards (in terms of informed consent)?

Answer 267

It mandates that informed consent of allogeneic, autologous, and apheresis donors be obtained before donation

Question 268

What must be done to the donor (in terms of informed consent)?

Answer 268

The donor must be informed of the risks of the procedure and of the tests that are performed

Question 269

Why must the donor be informed of the risks of the procedure and of the tests performed (in connection w/ informed consent)?

Answer 269

To reduce the risk of infectious disease transmission to the recipient

Question 270

What must be done (/ what must be the capability) of the donor (in connection w/ informed consent)?

Answer 270

He/she must be able to ask questions concerning any element of the collection or testing process

Question 271

True or False

If the donor is a minor / is unable to comprehend the informed consent protocol, applicable state law provisions will intercede

Answer 271

True

Question 272

What is an autologous donor?

Answer 272

He/she is the one who donates blood for his/her own use, thus, he/she is referred to as the donor-patient

Question 273

What is the use of most autologous blood?

Answer 273

It is used to treat surgical blood (in very sp. situations where there is a reasonable opportunity to avoid homologous transfusions / when compatible allogeneic blood is not available)

Question 274

What is the potential advantage of using autologous blood over allogeneic blood?

Answer 274

There is a decreased risk of:

 1) Disease transmission
 2) Transfusion rxns 
 3) Alloimmunization

Question 275

Even if there is a potential advantage of using autologous blood over allogeneic blood, what can still be present?

Answer 275

There is still a risk of:

 1) Bacterial contamination
 2) Circulatory overload
 3) Cytokine-mediated rxns
 4) Misidentification of the product / pt

Question 276

Who are the pts whom autologous donation / transfusion holds the greatest advantage?

Answer 276

1) Those pts who have very rare blood types

2) Those pts w/ multiple Abs for w/c compatible units in the general blood supply may be difficult / impossible to find

Question 277

What are the disadvantages of autologous donation / transfusion?

Answer 277

1) It has a higher cost (due to added administrative processes and special labeling requirements to ensure that units get transfused to the proper pt)
2) There is a high percentage of wasted units (30 - 50% | because pts end up not requiring any / all of the units donated)
3) The AABB Standards does not permit “crossing over” of unused autologous units into the general inventory (except in exceptional circumstances | the decision must be approved by the medical director on a case-by-case basis)

Question 278

True or False

Although the use of autologous blood has decreased in the past several yrs, it is still viable and common alternative therapy for select pts

Answer 278

True

Question 279

What are the various methods and techniques for obtaining autologous blood?

Answer 279

1) Preoperative collection
2) Acute normovolemic hemodilution
3) Intraoperative collection
4) Postoperative collection

Question 280

Preoperative collection occurs when?

Answer 280

During 5 - 6 wks (immediately preceding a scheduled, elective surgical procedure unless the RBCs and plasma are scheduled to be frozen)

Question 281

What are the procedures that typically might use preoperative autologous blood?

Answer 281

1) Orthopedic procedures
2) Vascular surgery
3) Cardiac or thoracic surgery
4) Radical prostatectomy

Question 282

Although some women do participate in an autologous collection program during pregnancy for unforeseen complications, when is blood needed?

Answer 282

It is seldom needed except in cases in w/c the mother has multiple Abs to high-frequency Ags or risk for placenta previa or intrapartum hemorrhage

Question 283

The decision to use preoperative autologous blood requires what?

Answer 283

It requires both:

1) An order (from the pt’s physician)
2) An approval (from the BB medical director)

Question 284

What is the meaning of MSBOS?

Answer 284

Maximal surgical blood order schedule

Question 285

What is the action of MSBOS?

Answer 285

It can provide guidance for surgical procedures to estimate the # of units needed for transfusion

Question 286

When should the last blood collection (for preoperative collection) occur?

Answer 286

No later than 72 hrs (3 days) before the scheduled surgery

Question 287

Why should the last blood collection (for preoperative collection) occur no later than 72 hrs / 3 days before the scheduled surgery?

Answer 287

To allow volume replacement

Question 288

What are the characteristics of the medical history and physical exam requirements for autologous donation in comparison than those for allogeneic donations?

Answer 288

These are less stringent than those for allogeneic donations

Question 289

In / for preoperative collection, is there a min. or max. age requirement for donors?

Answer 289

None

Question 290

Even if in / for preoperative collection, there is no min. or max. age requirement, what must be the characteristic that the donor must have for the said procedure?

Answer 290

The donor must be able to tolerate the donation

Question 291

Even if in / for preoperative collection, there is no min. or max. age requirement, what must be the characteristics that the donor must have for the said procedure (for younger donors)?

Answer 291

Most centers limit the age to children:

1) Whose veins can accommodate the phlebotomy needle
2) Who can understand the procedure

Question 292

What is the min hgb lvl for preoperative collection?

Answer 292

11.0 g/dL

Question 293

What is the min. hct level for preoperative collection?

Answer 293

33%

Question 294

What should be the characteristic of the donor-pt’s temp (for preoperative collection)?

Answer 294

It should not be elevated / indicate any sign of possible infection

Question 295

What should be the characteristic of the medical history questions for the donor (for preoperative collection)?

Answer 295

These can be limited to those needed to ensure the safety of the donor

Question 296

What are the medical history questions that can be asked to the donor (for preoperative collection)?

Answer 296

1) Cardiac history
2) Bleeding disorders
3) Major illness
4) Previous donor rxns
5) Fainting problems

Question 297

True or False

Questions to rule out the possibility of bacteremia in the donor-pt should be present (for preoperative collection)

Answer 297

True

Question 298

What are the information included in the questions to rule out the possibility of bacteremia in the donor-pt (for preoperative collection)?

Answer 298

Info on:

1) Current medications
2) Antibiotics
3) Recent infections
4) Fever
5) Recent minor procedures
a. Dental procedures
6) GI problems
7) Diarrhea

Question 299

What is the std for most autologous donor units (for preoperative collection)?

Answer 299

A std of 450 / 500 mL (+)(-) 10%

Question 300

What must be done if the donor weighs < 50 kg (110 lbs) (for preoperative collection)?

Answer 300

The total amt of blood must be reduced proportionately

Question 301

What must be done if the amt of blood to be collected is determined to be 300 - 405 mL for a 450 mL bag or 333 - 449 in a 500 mL bag (for preoperative collection)?

Answer 301

The unit must be labeled as low volume

Question 302

Is there a requirement to reduce the volume of anticoagulant-preservative solution (for preoperative collection)?

Answer 302

None

Question 303

Is plasma suitable for transfusion (for preoperative collection)?

Answer 303

No

Question 304

What must be done if the unit must be < 300 mL (for preoperative collection)?

Answer 304

The anticoagulant-preservative solution must be adjusted and approval by the BB medical director is required

Question 305

What is the characteristic of testing requirements for autologous donor units than w/ allogeneic units (for preoperative collection)?

Answer 305

These are somewhat less stringent than w/ allogeneic units

Question 306

What must be done by the collecting facility (for preoperative collection)?

Answer 306

It must determine the ABO and Rh of the blood

Question 307

Is Ab screen required to be done by the collecting facility (for preoperative collection)?

Answer 307

No, it is optional

Question 308

Is viral marker testing required to be done (for preoperative collection)?

Answer 308

No, if the collecting and the transfusing facilities are the same

Question 309

What must be done by the collecting facility if the collecting and transfusing facilities are different (for preoperative collection)?

Answer 309

The collecting facility must test for:

1) HBV DNA
2) HBsAg
3) Anti-HBc
4) Anti-HCV
5) HCV RNA
6) Anti-HIV-1/2
7) HIV-1 RNA
8) Anti-HTLV-I/II
9) WNV RNA
10) STS

Question 310

In what unit should the tests be conducted by the collecting facility (if the collecting and transfusing facilities are different | for preoperative collection)?

Answer 310

On at least the 1st unit collected from the donor in every 30-day period

Question 311

What must be done if any of the markers (whereas the tests are conducted by the collecting facility | w/c are conducted because the collecting and transfusing facilities are different | for preoperative collection) yield a (+) / reactive result?

Answer 311

The pt’s physician and transfusing facility must be notified of the result

Question 312

What must be done by the transfusing facility (for preoperative collection)?

Answer 312

It must reconfirm the ABO and Rh of the unit, but a crossmatch is optional

Question 313

What can be done as a good safety check for confirming that the selected unit is identified properly (in connection w/ the transfusing facility reconfirming the ABO and Rh of the unit | for preoperative collection)?

Answer 313

Immediate spin crossmatch

Question 314

What must be done to units collected for autologous use (for preoperative collection)?

Answer 314

These must be labeled appropriately

Question 315

What should be the cmpts of the label (for units collected for autologous use | for preoperative collection)?

Answer 315

1) Pt’s full name
2) Pt’s unique identifying number (UIN)
3) Expiration date of the unit
4) Name of the facility (where the donor-pt will be transfused)

Question 316

What must the label (for units collected for autologous use) clearly state (for preoperative collection)?

Answer 316

“For Autologous Use Only”

Question 317

True or False

Autologous units also generally have a distinct green label and tag (for preoperative collection)

Answer 317

True

Question 318

Why is a distinct green label and tag generally present in autologous units (for preoperative collection)?

Answer 318

This is done both to ensure the unit is linked correctly w/ the donor-pt and to make the BB technologists aware that certain pts have autologous units on the shelf that must be transfused before allogeneic units (more specifically, the oldest units should be transfused 1st)

Question 319

True or False

BBs should have a system in place to ensure autologous units are selected 1st (for preoperative collection)?

Answer 319

True

Question 320

What is the meaning of ANH?

Answer 320

Acute normovolemic hemodilution

Question 321

ANH results in what?

Answer 321

Collection of WB w/ the concurrent infusion of crystalloid / colloid solutions, thus maintaining a normal blood volume but decreasing the pt’s hct

Question 322

What is the ratio of replacement for crystalloids (for ANH)?

Answer 322

3:1

Question 323

What is the ratio of replacement for colloids (for ANH)?

Answer 323

1:1

Question 324

The # of units collected (for ANH) depends on what?

Answer 324

The pts’s ability to tolerate the decrease in hgb / hct

Question 325

What is the effect of a limited hemodilution (for ANH)?

Answer 325

It will reduce the hct to 28%

Question 326

What is the effect of severe dilution (for ANH)?

Answer 326

It will reach 21% or less (hct)

Question 327

What is recommended to be done for / by the pt (for ANH)?

Answer 327

It is recommended that the pt start w/ a hgb of at least 12.0 g/dL

Question 328

When is ANH performed?

Answer 328

It is performed in surgery immediately prior to beginning the surgical procedure

Question 329

Who manages the ANH procedure?

Answer 329

The anesthesiology