Exam D Flashcards
A unit of fresh frozen plasma was thawed between 1 and 6 C for the purpose of precipitating the cold-insoluble portion of the plasma. What is the minimum amount of fibrinogen in this newly harvested component?
150 mg/dL
160 mg/dL
170 mg/dL
180 mg/dL
150 mg/dL
The antibody screen on a unit of blood included which of the following phases of testing?
Only the 37 C to the AHG is required to detect IgG antibodies
Immediate spin, room temperature phases only are required to detect IgM antibodies
All phases of testing are required to detect every possible antibody present
Only the 37 C phase is required since this is body temperature
All phases of testing are required to detect every possible antibody present
A tech noticed that the cell button in a tube has been centrifuged in an old serological centrifuge wasn’t not clearly delineated on the bottom. Also, the button seemed to dislodge after only one or two shakes. What does this mean?
The tech probably shook the tube as he removed it from the centrifuge
The tech is shaking too hard that the bottom button breaks up in one or two shakes
The centrifuge needs to be recalibrated to determine the optimal spin time
The revolutions per minute are probably too fast for the time of centrifugation
The centrifuge needs to be recalibrated to determine the optimal spin time
Four units of blood Group O, Rh negative packed cells were signed out to the emergency room at 0300. At 0800 a custodian discovered two of the units on the crash cart. He told the charge nurse, who returned them to the blood bank. What can be done with them?
Place them in the refrigerator to cool and use as needed
The units must be destroyed, they were out of the refrigerator too long
Wash prior to using to remove any hemolysis created by old, dying cells
Freeze the unit to preserve whatever cells are still viable
The units must be destroyed, they were out of the refrigerator too long
Nucleic acid testing (NAT) is used to detect viral markers for HIV and HCV. Select the correct answer below.
This test can be used by pooling sera to decrease the cost
Although this is a very expensive test, it reduces the exposure window by detecting very low numbers of viral copies after they appear in the blood stream
The advantage of using this test is the relative lack of false-positive results as long as sample and laboratory cross-contamination are controlled
All of the above are correct
All of the above are correct
This product is indicated in the treatment of classic hemophilia (Hemophilia A). The doctor ordered ten bags of this product be thawed and pooled prior to its being infused. What is the storage temperature for this thawed, pooled product?
Six hours from the start of the pooling; stored at 1 to 6 C
24 hours from the completion of the pooling; stored at 1 to 4 C
Four hours from the start of the pooling; stored at 20 to 24 C
24 hours from the start of pooling; stored at 20 to 24 C
Four hours from the start of the pooling; stored at 20 to 24 C
A patient had anti-vel and was in critical need of transfusion. After many phone calls by the rare donor center, a liquid unit was found in another state. The blood bank shipped it, and it arrived within six hours. When the box was unpacked and dry ice removed, the tech noticed that the blood was almost pure hemolysate. What could have happened?
The blood was packed beneath the bag of dry ice, and it reached temperatures colder than 10 degrees centigrade
The ice was dry ice rather than wet ice and it reached temperatures less than one degree centigrade
There was no protectant such as newspaper between the bag of blood and the ice
The blood was packed above the ice, and it reached temperature above ten degrees centigrade
The blood was packed beneath the bag of dry ice, and it reached temperatures colder than 10 degrees centigrade
The lab had just purchased a new serological centrifuge. Before it could be placed into service, what validation testing had to be done on it?
Optimum spin times for all mediums used in the lab, the revolutions per minute (rpm) and the timer check must be done on the new centrifuge
Only the rpm and the timer check need to be tested. Optimum spin times as used on other centrifuges
On most centrifuges the rpms are not adjustable; so rpms do not have to be measured. The timer and optimum spin time for each medium must be done
Only the rpm and the timer check need to be tested. Optimum spin times as used on other centrifuges
A unit of fresh frozen plasma was thawed between 1 and 6 C for the purpose of precipitating the cold-insoluble portion of the plasma. What is the storage time and temperature for this new harvested component?
Twelve months from the date of preparation at minus 18 C or colder
Five years from the date drawn at minus 65 C or colder
Twelve months from the date drawn at minus 18C or colder
Two years from the date prepared at minus 18 or colder
Twelve months from the date drawn at minus 18C or colder
A very excited eighteen-year-old came to the donor center to donate for the first time. He had about 100 mls left before the bag was full and the needle could be pulled when he started to show symptoms of nausea, pallor, and perspiration. Despite efforts to calm him, he went into vasovagal syncope (he fainted). What should be done?
Pull the needle and administer CPR
Pull the needle when the bag is full and fan the donor
Pull the needle when the bag is full and raise his legs above the level of his head
Pull the needle and apply cold compress to the donor’s forehead
Pull the needle and apply cold compress to the donor’s forehead
Plasma from a unit of whole blood must be frozen within 8 hours of collection. If it is frozen after the 8 hours, what is the problem?
It only contains coagulation factors I, VIII, an XIII
The albumin becomes too concentrated
The stable coagulation factors have deteriorated
The labile coagulation factors have deteriorated
The labile coagulation factors have deteriorated
Aspirin containing products affect which of the following components
Red blood cells
Platelets
Fresh frozen plasma
cryoprecipitate
Platelets
Plasma cryoprecipitate reduced (also called “cryo free frozen plasma”) is indicated for which of the following?
Liver cancer
Hypofibrinogenemia
Hemophilia A
TTP
TTP
During a plateletpheresis procedure the hermetic seal on the bag broke. What should be done with the bag of platelets?
The bag must be destroyed because it won’t be processed prior to the 24 hour expiration
The bag can be stored for 7 hours in the refrigerator to kill any bacteria that may have entered during the breakage. Then it can be transfused within the following 48 hours
The bag can be stored for five days with continuous shaking. It can be transfused during that time period
The bag will expire within 72 hours because of the breakage, it can be transfused when needed during that time period
The bag must be destroyed because it won’t be processed prior to the 24 hour expiration
A unit of blood tested positive for hepaitis B surface antigen. Two more samples on the same unit were also positive. The confirmation test, a neutralization procedure was positive. How long must the donor wait until he can donate allogenic blood sample?
He can donate in 56 days
He can donate in 120 days
He can donate in 12 months
He is indefinitely deferred
He is indefinitely deferred
An immunocompromised patient needed leukoreduced red blood cells that were negative for the cytomegalovirus. No CMV negative blood was available. What is an acceptable alternative?
Leukoreduced red blood cells filtered prior to storage
Washed red blood cells less than five days old
Irradiated red blood cells
There is no alternative
Leukoreduced red blood cells filtered prior to storage
How frequently should the temperature be read and recorded on a freezer or refrigerator that contains blood products for transfusion?
Every 4 hours
Every 6 hours
Every 12 hours
Every 24 hours
Every 4 hours
A person was in the military and desired to donate blood at the local blood drive. He had never left the US since he enlisted; however, he was not about to be deployed overseas. He last donated blood six weeks age. His hemoglobin was 13.6 gm/dL, his blood pressure was 110/70, his temperature was 98.3 F, his pulse was 60 beats per minute. He was deferred from donating. Why?
His hemoglobin was too high
His blood pressure was too low
He was about to be deployed overseas
There should be eight weeks between donations
There should be eight weeks between donations
A phlebotomist was scrubbing a donor’s arms with iodine when a red rash began to appear. Immediately the iodine was washed off. In the future, what should be used to scrub the patient’s arm prior to phlebotomy.
Green soap
Chlorhexidine and 70% alcohol
An across the counter product containing an antimicrobial substance
Povidone iodine
Povidone iodine
A unit of blood was drawn on Jul 1 of this year. Within six hours of being drawn, fresh frozen plasma was made. If properly stored, when does the FFP expire?
One year from the date that the unit of blood expires
One year from the date that the unit of blood was drawn
Thirsty days from the date that the unit of blood was drawn
Five years from the date that the fresh frozen plasma was made
One year from the date that the unit of blood was drawn
Both the Fy(a) and P1 antigen deteriorate in storage before any of the other antigens deteriorate; however, of the two, the Fy(a) is monitored rather than the P1. Why?
The antibody to the Fy(a) antigen is IgG and we are more interested in checking that a clinically significant antigen is present rather than a clinically significant antigen
The antibody to the P1 antigen is IgG and we are more interested in checking that a clinically significant antigen is present rather than a clinically insignificant antigen.
Anti-Fy(a) is more readily available than anti-P1
Anti-P1 has a longer incubation period than anti-Fy(a) and we elect to test by the most efficient method possible
The antibody to the Fy(a) antigen is IgG and we are more interested in checking that a clinically significant antigen is present rather than a clinically significant antigen
A unit of blood was found to be Jk(a-b-); therefore, the lab director requested that it be frozen. The tech quickly added the glycerol to the unit before it warmed above six degrees Centigrade. Promptly the unit was placed at minus sixty-five degrees centigrade for storage. Two years later the unit was needed. The unit was thawed at 37 degrees C and solutions of saline in decreasing concentration were used to wash the cells. To everyone’s dismay, the unit was grossly hemolyzed. Why?
The unit should have been allowed to thaw at room temperature rather than 37 degrees C
The deglycerolization procedure should have used increasing concentrations of saline rather than decreasing concentrations
The Jk(a-b-) phenotype withstand freezing
Two years ago the glycerol should have been added slowly with continuous shaking after the bag has warmed to room temperature
The deglycerolization procedure should have used increasing concentrations of saline rather than decreasing concentrations
An adult average sized patient received one bag of platelets obtained by apheresis. What is the expected rise in his platelet count?
5000 to 10,000/uL
15,000 to 25,000/uL
30,000 to 60,000/uL
80,000 to 100,000/uL
30,000 to 60,000/uL
Viruses can invade host defenses by:
Maintaining a stable genetic identity
Inducing increased expression of MHC class I
Inducing increased expression of MCH class II
Hiding from the immune system in a latent state
Hiding from the immune system in a latent state
In the western blot test for HIV antibody, a positive test result is indicated by the bands p24 and p55
False
A complement fixation test for histoplasma antibodies shows a 1:32 titer. This means the patient is negative for histoplasma infection
False
Serology is performed on a patient with a rash and fever. Results are rubella IgM = positive; rubella IgG = positive; measles IgM = negative; measles IgG = positive; varicella-zoster IgM = negative; varicella-zoster IgG= negative. What is the interpretation of these results?
Acute infection with rubella virus
Which of the following serologic test results indicate that a patient is a chronic carrier of hepatitis B?
HbsAb negative; HBsAg positive for 12 months
Pt has liver cancer and the result of PT and APTT was abnormally long. Which components should he receive
Recovered plasma, thaw
Cryo
Fresh WB
Thaw FFP
Thaw FFP
A unit of leukoreduced red blood cells was drawn on December 1 in CPD and frozen by the high glycerol method on December 21. At what temperature is the unit stored and when does it expire?
Store at –18 C for ten years from the date frozen
Store at –65 C for ten years from the date drawn
Store at –65 C for ten years from the date frozen
Store at –65 C for ten years from the CPD expiration date
Store at –65 C for ten years from the date drawn
A unit of red blood cells was washed prior to its being transfused with documented urticarial transfusion reactions. At what temperature and for what period of time can the washed cells be stored?
1 C to 6C for 24 hours
1 C to 10 C for 6 hours
20 C to 24 C for 24 hours
20 C to 24 C for 4 hours
1 C to 6C for 24 hours
A child received a bone marrow transplant and soon had a fungal infection and required a granulocyte transfusion. After the granulocytes were obtained by apheresis, what manipulation and testing were done before the child could receive them?
Sickle cell negative and irradiated
HLA matched and leukoreduced
ABO and Rh matched and washed
Irradiated and crossmatched, unless collected by a method known to result in a component with less than 2 mL of red cells
Irradiated and crossmatched, unless collected by a method known to result in a component with less than 2 mL of red cells
What is the disadvantage of choosing FFP over plasma protein fraction (PPF) for fluid replacement in persons?
FFP can transmit hepatitis and HIV, whereas PPP has been treated and there Is no documentation of its transmitting the aforementioned diseases
FFP lacks the labile coagulation factors; whereas, PPF has all coagulation factors
FFP is more likely to cause potassium toxicity than PPF
FFP contains only stable coagulation factors; whereas, PPF has the labile coagulation
FFP is more likely to cause potassium toxicity than PPF
The doctor desired to raise the hemoglobin of his patient by 4 gm/dL. How many compatible units of red blood cells must be transfused to obtain this?
2 units
4 units
6 units
8 units
4 units
The antibody screen on a unit of blood included which of the following phases of testing?
Only the 37 C to the AHG is required to detect IgG antibodies
Immediate spin, room temperature phases only are required to detect IgM antibodies
All phases of testing are required to detect every possible antibody present
Only the 37 C phase is required since this is body temperature
All phases of testing are required to detect every possible antibody present
Thawed FFP Expiration
24 hours
Thawed PF24 expiration
24 hours