Final Flashcards
1
Q
Which metabolic pathway is responsible for generating 90% of the ATP for the RBC>?
A
Glycolysis
2
Q
A unit of blood was refund to the blood bank before it was Spiked. Apparently the patients IV failed. The unit of blood was outside the blood bank for 35 minutes?
A
The unit of blood must be transfused within 4 hours or be discarded at the end of that time
3
Q
What effect does storage have on platelet?
A
Lysis
4
Q
In the normal Hb-oxygen dissociation curve. What % of oxygen is released to the tissues when PO2 averages 40 mm Hg?
A
25%
5
Q
What factors are known to influence platelet metabolism and function?
A
All of the above
6
Q
Which of the following RBC morphology may be present on the PB smear as a result of loss of RBC membrane?
A
Spherocytes
7
Q
What is the primary function of Hb?
A
Oxygen transport
8
Q
All of the following areas of RBC morphology are crucial for normal erythrocyte survival except:
A
Site of the ABO antigen attachment
9
Q
What is the correct biochemical composition of the RBC membrane>
A
52% proteins
40% lipids
8% carbohydrates
10
Q
All of the following biochemical changes are associated with loss of RBC viability upon storage except
A
Increased ATP level
11
Q
Which RBC cell preservatives has a storage time of 35 days?
A
CPDA-1
12
Q
The RBC membrane is relatively permeable to all of the following except:
A
Sodium
13
Q
RBC frozen using the high-concentration glycerol technique are usually stored at
A
-65 C
14
Q
What is the major biochemical consideration in platelet storage?
A
Regulation of pH
15
Q
What would the Hb-oxygen dissociation curve depict in a patient exhibiting clinical signs of alkalosis?
A
Shift to the left
16
Q
Name the main lipid components of RBC membrane
A
Phospholipids
17
Q
The ABO blood groups were discovered in 1901 by whom?
A
Karl Landsteiner
18
Q
A standing order of platelets was shipped to your facility by your supplier. It was inadvertently left in the corner of the department until discovered 36 hours later. What would the appropriate action be for the blood banker?
A
The platelets have fallen outside of suppliers quality assurance. The unit should be discarded because the pH has probably dropped too low and platelet activation has been compromised
19
Q
Which metabolic pathway permits the accumulation of 2,3-DPG?
A
Luebering-Rapoport Shunt
20
Q
All of the following are consistent with “shift to the right” of the Hb-oxygen dissociation curve except:
A
Decreased 2,3-DPG
21
Q
Why are platelets transfusion performed?
A
Both reasons
22
Q
What cryoprotective agent is added to RBC upon freezing
?
A
Glycerol
23
Q
If platelets are to be stored for 5 days a rotator, what is the optimal storage temperature?
A
20-24 C
24
Q
Platelets are transfused to play which role in hemostasis?
A
All of above
25
Which of the following best describes “integral” membrane proteins?
Span the entire membrane surface
26
How is stroma-free Hb solution prepared?
Outdated RBCs are lysed, and stroma is removed
27
What is the normal life span of an RBC?
120 days
28
Regarding loss of RBC membrane deformability, all of the following are true except:
Increase in ATP level
29
One of the most important control of Hb’s affinity for oxygen is
2,3-DPG
30
The normal position for oxygen dissociation curve depends on three ligands normally found within the RBC. Which one of the following is not one of these ligands?
Na+
31
Which of the following events does not occur while RBCs are stored?
2,3 DPG levels increase
32
In order to maintain ATP levels in stored blood, ______ can be added to CPD to extended the shelf-life of stored RBcs from 21-35 days. This new preservative designated as CPDA-1
Adenine and glucose
33
Which type of blood storage contained is no longer available for use in the US because it may limit the viability of RBCs
Glass bottles
34
A rare unit of blood became outdated 48 hours ago but is needed for a patient. Which of the following concepts applies to this situation?
The blood could be rejuvenated with rejuvesol, washed and given immediately to the patient
35
FDA-approved rejuvenation solution contains all of the following except
Glycerin
36
Rejuvenated RBCs may be prepared up to three days after expiration when stored in all of these except
ACD
37
When is the correct count increment (CCI) of platelets usually determined?
10-60 minutes after transfusion
38
Which of the following is not a major factor that influences platelet shape and activation while the platelet is in storage?
Volume
39
Proper agitation of platelets while they are being stored is:
Important because the pH of the stored platelets will descrease and the platelets will lose functionality
40
Which of the following is licensed additive solutions approved by for the storage for RBCs for 42 days?
All of the above
41
When 1,000 donors were tested, 75% were positive for C and 25% were negative for C; the gene frequency of C is:
0.5
42
All of the following may cause an alteration in DNA except
Enzymes
43
How s it genetically possible for a child to type Rh-negative?
Both parents are Dd
44
all of the following are included in transcription except
- mRNA terminated at the 5’ end
45
Which of the following best describes the structure of human chromosomes?
Linear strands of DNA would around histones
46
In Mendel’s law of separation, the first filial generation is
Heterozygous
47
A father carries the Xa trait and passes it on to all of his daughter but none of his son. What type of inheritance does this represent?
X-linked dominant
48
Methods to isolate intact DNA in order for it to be studied include all of the following except
Heat treatment
49
Point mutations include which of the following
Substitutions, insertions, and deletions
50
Which of the following best describes the process of mitosis?
Cell division that produces two daughter cells having the same number of chromosomes as the parent
51
All of the following process occur in replication, except
DNA polymerase acts on the 3’ and 5’ parent strand to produce anti-complementary duplicate strand
52
Which types of genetic change (mutation) on incapable of reverting back to the original phenotype?
Deletion
53
In the MN blood group system, a person who inherits an “M” allele and an “N” allele expresses both M and N antigens on the RBCs. Which of the following is true?
M and N are codominant alleles
54
A gene, such as the O gene, that produces no detectable product is called
An amorph
55
What blood group sis the best example of codominantely inherited blood group genes?
MN
56
When in individual is said to have blood group A , it refers to the individuals
Phenotype
57
The two strands of DNA are: ______ out runs in a 5’ to 3’ direction, and the other run in a 3’ to 5’ direction
Anti-parallel
58
In what stage of mitosis is DNA not actively dividing?
Interphase
59
How many chromsomes do somatic cells of humans have?
46
60
The diploid chromosome number in humans is:
46
61
Which constituent in the Hardy-Weinberg principle fail?
All of the above
62
What amino acid initiates translation by attaching to tRNA?
Methionine
63
What is meant by the term autosomal?
Trait is to carried on the sex chromosomes
64
Which of the following best describes classical genetics?
Transmission of characteristics from parents to offspring
65
How is RNA different from DNA?
All of the above
66
A triples set of nucleotides is a
Codon
67
A human gamete (egg or sperm) contains how many chromosomes?
23 chromosomes
68
How do restriction endonucleases function?
Cut DNA into small fragments
69
DNA is composed of all of the following except:
Uracil
70
A woman with blood group A marries a man with blood group O. Their firstborn child has blood group O. The mothers most probable genotype is
AO
71
A structural alteration of DNA in an organism that is caused by physical or chemical agent is called:
Mutation
72
What is a vector?
Extrachromosomal genetic element that can carry a recombinant DNA molecules into a host bacterial cell
73
Which of the following must be true when using the Hardy-Weinberg equation?
All of the above
74
Alternate forms of a gene that can occur at a single a chromome locus are referred to as:
Alleles
75
The condition in which one chromosome has a copy of the gene and the other chromosome has that gene deleted or absent is referred to as:
Hemizygous
76
Most antigens in the various blood group systems follow what kind of inheritance patterns?
Codominant
77
All of the following are consistent with Mendel’s basic rules of inheritance except:
A pair of genes is always found in the same gamete
78
Only 5% of Kell-negative individuals will develop antibodies to Kell if exposed to the Kell antigen, whereas 50-70% of Rh(D)-negative individuals would produce antibodies to D upon exposure. What is the reason for this?
Difference in the immunogenicity
79
What is the definition of of an Immunoglobin?
A protein molecule produced in response to an antigen
80
IgG-coated RBCs will be phagocystized by what effector cells?
Monocytes/macrophages
81
What class of immunoglobulin is capable of crossing the placenta
IgG
82
What is the responsible for recognition of the antibody-binding site to homologous antigen?
Variable region of light/heavy chain
83
At what temperature do IgM antibodies react?
22 C
84
What is a possible explanation for a weak reaction (1+) in a reverse ABO grouping test?
All of the above
85
How can T cells be differentiated from B cells?
All of the above
86
Which of the following statements is true concerning immunoglobulin variations?
Isotopic refers to all members of a species
87
What test is used to remove autoantibodies from test serum?
Adsorption
88
A person with the genotype MM shows a 3+ reaction when RBCs are mixed with M antisera, whereas a person with the genotype MN shows a 1+ reaction. What phenomenon is this ?
Dosage
89
Name a lymphoid organ in which cells of immune system can be found
all of the above
90
At what age do infants begin to produce their own antibodies?
2-3 weeks?
91
What is the purpose of the anithuman globulin (AHG) test in blood banking?
It detects RBCs coated with antibody by bridging the gap between RBCs
92
Extravascular hemolysis occurs when RBCs are coated with antibody; what organ sequesters these cells?
Reticuloendothelial system
93
Which IgG subclass primarily comprises antibodies to the Rh blood group system?
IgG1, IgG3
94
Which immunoglobulin exists in a pentameric configuration?
IgM
95
All of the following are monoclonal reagents except
Undetectable subgroups of A
96
All of the following are characteristics of as secondary immune response except:
Higher dose of antigen required to form antibodies
97
Which of the following antibodies is considered the most significant in blood banking because it reacts at body temperature?
IgG
98
What does a hemolysis represent in an antigen-antibody reaction?
A positive result
99
When antigen and antibody combine, they are held together by non covalent forces. With the absence of a visible lattice, this stage is called:
Sensitization
100
What Rh type does a mother have to be to produce antibodies to Rh(D) from an Rh-positive infant?
Rh-negative
101
Which immunoglobulin is found in greatest concentration in serum,?
IgG
102
Which antibodies characteristically demonstrate a decreased avidity for antigen?
HTLA
103
What are enzymes used in blood banking?
Salic acid is released from RBCs. Which helps to reduce the zeta potential
104
When there is an excess of antigen in a serological test system, What course of action should be followed?
Increase the serum-to-cell ratio
105
At what temperature do IgG antibodies react optimally?
37 C
106
What cells are responsible for mounting a secondary response when exposure to the same antigens occurs ?
Memory T/B cells
107
In an immune response, what is the time called during which no antibody is detected in the test serum?
Latency period
108
How is the classical pathway of complement activated?
By binding of antigen with antibody
109
What cells are considered polymophnuclear granulocytes?
Eosinophils
110
What is the characteristic of natural killer (NK) cells?
They bind to an lyse antibody-coated cells in ADCC
111
In an immune response, _______ antibodies are formed before _______
IgM, IgG
112
All of the following are true regarding IgM antibodies except:
IgM antibodies form against Kell
113
What does the term zeta potential mean?
The attraction of negative charges on the surface of RBCs to positive charges in an ionic cloud
114
What is the equivalent of Factor D (alternative pathway) in the classic complement pathway ?
C1s
115
Which of the following corresponds to the basic structure of immunoglobin?
Two light chains and two heavy chains held together by covalent disulfide bonds
116
Which of the following are produced after exposure to genetically different nonself antigens of the same species?
Alloantibodies?\
117
An immunogenic substance that reacts with an antibody is
Antigen
118
All of the following are functions performed by the complement systems except:
Decreased vascular permeability
119
What MHC class encodes complement components?
Class III
120
Which blood group antibodies are known to activate complement, leadinf to intravascular hemolysis?
ABO
121
Why is EDTA not conducive to complement activation?
Calcium is inactivated
122
All of the following techniques are used in the laboratory to detect blood group antigens or antibodies except:
ELISA
123
The portion of the immunoglobulin molecule that determines class is the:
Heavy chain
124
All of the following are included in the actions of cytokines except:
Decreases in the number of cell receptors when going from a resting to a reactive state
125
What substances are responsible for the activation of the alternate complement pathway?
Polysaccharides
126
A patient with multiple myeloma exhibits rouleaux formation in an immediate spin cross match. What procedure is recommended to distinguish true RBC agglutination from nonspecific agglutination?
Saline dilution
127
All of the following are characteristics of antigens that affect the type and extent of immune response except:
Genetic locus
128
What is the function of mononuclear phagocytes?
They present processed antigen to lymphocytes
129
Why is low ionic strength solution (LISS) used in blood banking?
It reduces the incubation time
130
Which of the following statements concerning the structure of immunoglobulins is false?
IgM participates in placental transfer
131
The immune response that consists of physical barriers, biochemical effectors, and immune cells is the _______ immune response
Innate
132
Opsonization is
All of the above
133
Which of the following is not true? (1)
MHC molecules are required for B cells to recognize foreign antigens
134
________ are produced by monocytes and lymphocytes to help regulate growth, mobility, and differentiation of leukocytes
Cytokines
135
HLA proteins are coded by what complex?
MHC
136
Anti Jk (Kidd) antibodies are of what class of antibody?
IgG3
137
HDN is most often associated with what class of antibody?
IgG1
138
The four unique serum proteins of the alternative pathway of complement include all but which of the following?
X factor
139
In preparing anti-IgG, how is excess antibody removed for titer adjustment?
Block titration
140
An advantages of polyclonal anti-IgG over monoclonal. Anti-IgG is:
Polyclonal anti-IgG will recognize IgG variants
141
Why is incubation omitted in the direct AHG test?
In vivo antigen antibody complex is already formed
142
Which of the following is consistent with HDN?
Maternal antibody coating fetal RBCs
143
What is the incubation time for the IAT when saline is used instead of LISS?
30 minutes
144
The antihuman globulin (AHG)test was discovered in 1945 by whom?
Coombs
145
A patient came in for a routine type and screen prior to surgery. The antibody screening was negative at 37 C and at the AHG phase. Check cells did not produce agglutination often. What is a possible explanation for this?
Inadequate washing
146
What effect does a low pH have on a saline AHG test?
Enhances antibody elution
147
At what temperature is the incubation phase of the AHG test?
37 C
148
Most clinically significant blood group antibodies are of which IgG subclasses?
IgG1 and IgG3
149
Polyspecific AHG contains
Anti-IgG and anti-C3d
150
“Complete” agglutinins RBCs in saline are of which immunoglobulin class?
IgM
151
What do “check cells” contain?
Rh(D)+ RBCs coated with anti-D
152
All of the following are important in evaluating a positive DAT except
Donation history
153
The indirect antiglobulin test detects which antigen-antibody reactions?
In vitro
154
What is the action of PEG?
Removes water molecules, thereby concentrating antibody
155
How many IgG molecules must be present on the RBC for a positive IAT to occur?
100
156
All of the following condition may produce a positive DAT except:
Lymphoma
157
Which IgG antibodis are contained in polyspecific AHG?
High titer, high avidity
158
All of the following complement proteins can be found on the RBC membrane except
C4a
159
A patient is discovered to have anti-Fya in the serum. The medical technologist needs to phenotype the patients cells for the corresponding antigen. What test is appropriate for phenotyping?
IAT
160
Why are check cells added to all negative reactions in the AHG test?
To ensure AHG was not neutralized by free globulin molecules
161
What type of globulin does the antiglobulin test detect?
All of the above
162
How is polyclonal antiglobulin serum made?
Human serum is injected into rabbits, and an immune response triggers the production of an antibody
163
All of the following statements regarding the AHG test true except
Incubation time with LISS should be a minimum of 30 minutes
164
What class of antibody can be present in AHG?
All of the above
165
An antibody screen is performed, and all three tubes are negative after adding AHG. Check cells are added, and the tubes are centrifuged. No agglutination occurs after the addiction of check cells. What is the next course of action?
Repeating the antibody screen
166
Conventional tube testing in AHG testing has one distinct advantage over gel testing. Identify the advantage
Cost
167
An advantage of monoclonal anti-C3 over polyclonal anti-C3 is
With monoclonal antibodies-C3, the antibody potency can be controlled
168
Anti-IgG is specific for what part of the IgG molecule?
FC fragment
169
What is the purpose of washing cells in the AHG test?
To remove all unbound protein
170
Saline used for blood banking tests should have a pH of ______
7.2-7.4
171
How would a negative IAT be demonstrated in solid phase methodology?
There is a pellet at the bottom of the well.
172
False-negatives results in antihuman globulin testing can be caused by:
All of the above
173
Which of the following antibodies is least likely to bind complement?
Kell
174
Which of the following is not a clinical application for a direct antiglobulin test?
Heterophilic detection
175
What is the optimal temperature for complement activation?
37 C
176
Anti-A from a group B is primarily what class of immunoglobulin?
IgM
177
Which of the following criteria is used to classify the B subgroups?
All of the above
178
Approximately how many antigens sites exist on a type-A individual’s RBC?
1 million
179
What substances are found in a group A secretor?
AH
180
Where are ABH substances detected in secretors?
Tears
181
Which of the following is not characteristic of antibodies within the ABO system?
ABO antibodies do not activate complement
182
A group O person with warm autoimmune hemolytic anemia may demonstrate weak reactions in the forward grouping due to:
RBCs being coated with antibody
183
What is a lectin?
seed extracts that agglutinate human cells with moderate specificity
184
What ABO groups contains the least amount of H substance?
A1B
185
What testing is available that will differentiate between a true B and an acquired C?
All of the above
186
What is the source of anti-A1 lectin?
Dolichos biflorus
187
Secretor studies were performed on a person who expressed weak reactions in forward grouping. Only B and H substance were present in the saliva. What is this persons ABO group?
B
188
Serum from a group B individual contains anti-A. When A2 cells are added to serum and centrifuged, the cells with attached anti-A are removed from serum. What is the name of this technique?
Absorption
189
All of the following may result in weak or missing antigens except
Hypogammaglobulinemia
190
What is the biochemical structure of secreted A, B, and H substances?
Glycoprotein
191
Which ABO groups reaction will be the weakest with anti-H lectin?
AB
192
When performing secretor studies, what is omitted in the control tube but present in the patient tube?
Saliva
193
Two drops of serum are added to one drop of A1 cells and two drops are added to one drop of B cells; the two tubes are centrifuged. The tubes shows reactivity when read macroscopically. This is an example of:
Reverse grouping
194
Why is reverse grouping not performed on cord blood specimens?
Antibodies are generally not present at birth
195
If a group O mother give birth to a group A baby, which of the following antibodies is usually responsible for crossing the placenta and causing HDN?
Anti-AB
196
What immunodominant sugar is responsible for H specifcity?
L-fucose
197
What % of type A population is A2?
20%
198
An elderly patient is documented as being type O. The forward group is negative with anti-A and anti-B. The reverse grouping shows no reactivity with A1 cell and B cells. What can be done to correct the discrepancy?
Incubate the patient’s serum and reagent cells for 15 minutes at room temperature
199
What is used to stimulate saliva secretion in secretor studies?
Paraffin wax
200
The ABO group antibodies are primarily:
Naturally occurring
201
What % of the white population has type-O blood?
45%
202
All of the following are technical errors that could result in ABO discrepancies except:
Failure to warm reagents
203
If a type-A person contains anti-M in his or her serum , what might the reverse grouping type as?
O
204
What is the source of anti-B lectin?
Bandeiraea simplicifolia
205
What is the cause of polyagglutination is most cases?
Exposure of T antigen caused by bacterial contamination
206
Which blood group contains the highest concentration of H antigen?
O
207
What is the only possible phenotype of an offspring produced from two group O parents?
4,000 antigenic sites on RBCs
208
Forward grouping is defined as:
Detecting antigen(s) on an individual’s RBCs via reagent antisera
209
What does the hh genotype refer to?
Bombay
210
Approximately how many antigens sites can be found on A2 cells?
260,000
211
Individuals with group B blood are more common among which populations?
Black/Asian
212
A patient was previously typed as blood group O. Forward grouping was negative with anti-A and anti-B. Reverse grouping showed reactivity with A1 and B cells. The technologist reported this patients type as
Clerical error
213
Which substance must be formed first before A or B specificity is determined?
H
214
How are ABH antigens formed?
Production of specific glycosyltransferase add sugars to precursor substances
215
What percentage of A2 individuals produce anti-A1?
5%
216
What would be a possible genotype of an A2B individual?
A2B
217
What % of individuals inherit the secretor gene?
80%
218
What immunodominant sugar is responsible for B specificity?
D-galactose
219
An AB male mates with an AB female. What could be the genotype of the offspring?
All of the above
220
The state in which an individuals RBCs are agglutinated by all sera regardless of blood type is called:
Polyagglutination
221
All of the following are tests performed in the blood bank to classify subgroups of A except:
LISS enhancement
222
All of the following may depress antigen expression except:
Coronary heart disease
223
What % of the type-A population are A1?
80%
224
All of the following may result in rouleaux formation except
Leukemia
225
Weak agglutination with anti-A typing sera is to be expected with which of the following blood groups?
A3
226
Antibody titer specific to antigens from the ABO system are typically highest
When the patient is around 10 years old
227
A1 lection agglutinates
Only A1 cells
228
What is an advantage of using chemically modified anti-D?
It provides a low protein medium
229
The Rh antibody agglutinates what % of RBCs?
85%
230
Why is determination of Rh status crucial from obsteric patients?
All Rh-negative mothers are possible candidate for Rh immune globulin
231
Which antigen represents RH3 in Rosenfield terminology?
E
232
G-antigen is present on all of which type of RBCs?
C-positive
233
What does Rh genotype refer to?
Rh gene inherited from both parents
234
Where is the Rh antigen located relative to the RBC membrane?
Integrally
235
Which of the following statements regarding anti-LW is true?
Anti-LW reacts stronger with Rh-positive cells than with Rh-negative cells
236
Of the three following categories of altered D antigens, in which variation of D antigen expression are you more likely to encounter an allo-anti-D?
Partial D
237
A cord blood sample was sent to the blood bank for a type and DAT. Cells were washed sixties with saline before testing. The forward grouping typed as an O. There was no agglutination with anti-D and washed cord cells. The DAT was 3+ with polyspecific AHG. What is the Rh type of the baby?
Rh type cannot be determined
238
Which gene combination is expressed in the greatest frequency in the black population?
Dce
239
Which of the following genotypes is consistent with f antigen expression?
Dce/DCE
240
How are the Rh antigens inherited?
Codominant alleles
241
All of the following may cause a false-negative reaction in Rh typing except:
Rouleaux
242
In the Fisher-Race nomenclature what does “d” refer to?
All of the above
243
Which of the following genotypes would demonstrate the strongest expression of D antigen?
DCe/dce
244
Most Rh antibodies are of what immunoglobin class?
IgG
245
What clinical manifestation may be associated with the Rh-null syndrome?
All of the above
246
Which IgG subclasses carry the most significance with regard to Rh antibodies?
IgG1/IgG3
247
In which population is the genetic Du usually found?
Black
248
What does hr’ refer to in the wiener nomenclature?
- c
249
All of the following may occur following an Rh-mediated hemolytic transfusion reaction except:
Intravascular hemolysis
250
All of the following are consistent with International society of blood transfusion (ISBT) terminology except:
All genes are written in bold print
251
Rh-immune globulin is effective is prevention which type of HDN?
Anti-D
252
The Rh testing on a blood donor was negative at immediate spin. The tube was incubated at 37 C for 15 minutes. The tube was centrifuged and read macroscopically. The test was negative at 37 C. The tube was washed three times with saline, and two drops of AHG were added. After centrifugation, the tube yielded a 2+ reaction. How is this Rh type reported on the donor unit?
Rh-positive
253
What does the “R” represent in Rh-Hr terminology?
Presence of D antigens
254
What is the basis of Rosenfield Rh terminology?
The positive (+) or negative (-) sign demonstrates the presence of absence of antigen on a RBC
255
In the black population, a mosaic form of which antigen may be found?
- e
256
Which of the following Rh antigens is the most immunogenic?
D
257
What protocol is put in place to validate Rh testing when high-protein reagents are used, especially when the patient types as an AB-positive?
Run a control with Rh test
258
The Del phenotype is most commonly found in individuals of which ethnicity?
Asian
259
What is the frequency of E antigen in the general population?
30%
260
The Rh gene is located on which chromosome?
1
261
What is the principle of the Rh-Hr (Weiner) terminology ?
The Rh gene produces at least three factors within an agglutination
262
What of the following reagents or methods is best for categorizing partial D types?
A combination of serological typing and molecular analysis
263
All of the following are true regarding Rh antibodies except?
Rh antibodies can bind complement on the RBC membrane
264
On which chromosome are the genes that code for RH proteins, namely, RHD and RHCE located?
Chromosome 1
265
When one or more D epitopes within the entire D protein is missing it is termed ________
Partial D
266
A male patient was seen in the emergency room with an acute bleed. The recommended from the blood supplied is to give O-positive RBCs an uncrossmatched blood. This patient has already been exposed to Rh-positive blood after a previous accident. What is a possible outcome?
The patent may have a hemolytic transfusion reaction from an allo-immunized anti-D
267
Anti-LW will react most strongly with:
Adult Rh-positive RBCs
268
Which of the following statements are false? (1)
Anti-D usually stimulates complement
269
When a patient has Rh-null syndrome, what kind of packed RBCs need to be transfused?
ABO compatible Rh-null blood
270
The antigen ceCF is known as:
Crawford antigen
271
Why do false-negative Rh testing results occur in babies with severe HDN due to anti-D?
All D sites are covered by maternal anti-D, which block the reagent
272
Which of the following Rh phenotypes invites C3 antigen testing?
C+c-
273
*Rhig prevents HDN by:
Anti-D
274
*partial D expression patient transfused with/ Rh+ blood:
Forms antibody to the portion missing
275
*Give the genotypes in FR and R forms: D+ C+ E- c- e+
- DCe/DCe : R1R1
- DCe/dCe : R1r1
276
*Weak D is labeled:
Rh positive
277
*Bowel problem in group A individual may type as AB in reverse typing due to:
Acquired B
278
*ABO
Codominant
279
*Anti-A: 4+
Anti-B: 0
Anti-AB: 4+
A1 cells: 3+
B cells: 4+
Group A2 with anti-A1
280
*Rh antigens in order of greater to least antigenicity:
D > c > E > C > e
281
* Reverse grouping
Patient serum + reagent cells
282
*Homozygous definition
Posses a pair of identical alleles (AA, BB, OO)
283
*Blood groups producing the most H to least H:
O > A2 > B > A2B > A1 > A1B
284
* d signifies:
All of the above
285
Anti-A: 4+
Anti-B: 4+
A1: 2+
B: 2+
Autocontrol: 2+
What is related to these results?
Multiple myeloma
286
Anti-A: 4+
Anti-B: 0
A1: 3+
B: +/-
Autocontrol: 0
What is related to these results?
A2 patient making Anti-A1
287
Anti-A: 4+
Anti-B: 1+
A1: 0
B: 4+
Autocontrol: 0
Acquired B
288
Anti-A: 0
Anti-B: 4+
A1: 0
B: 0
Autocontrol: 0
What is related to these results?
Newborn
289
Anti-A: 0
Anti-B: 0
A1: 0
B: +/-
Autocontrol: 0
What is related to these results?
Geriatric (85 years old)
290
*Rh haplotype most prevalent in African Americans:
Dce
291
*principle of antiglobulin test
- hemoagglutination
- Anti-human globulin anti-IgG acts as a link between the antibody coating of neighboring RBCs and induces agglutination.
- uncontested RCDs will not agglutinate. Anti-human globulin anti-IgG is prepared by immunizing rabbits with human IgG.
292
*FR and W Rh D+ C+ E- c+ e+
- DCe/Dce : R1R0
- DCe/dce : R1r
- Dce/dCe : R0r’
293
*forward typing detects:
Antigens
294
*H antigen sugar:
L-fuctose
295
An individual from Bombay who has inherited the Le gene will have a phenotype of:
Le(a+b-)
296
Which of the following may be a possible cause for the lack of expression of Lewis antigens during pregnancy?
Increased ratio of plasma lipoprotein to RBC mass
297
What percentage of the white population inherits the Le gene?
90%
298
Approximately what % of the black population is [Le(a-b-)]?
22%
299
In order for an individual to express Leb antigen on their RBCs, they must have inherited which gene?
All of above
300
Pregnant women usually express which phenotype?
Le(a-b-)
301
All of the following statements are representative of Lewis antibodies except:
They are destroyed by enzymes
302
Anti-Lea, which is reactive at the Coombs phase, may cause what kind of hemolysis?
In vivo
303
What does the type 1 chain refer to?
Beta-linkage of the number 1 carbon to the number 4 carbon of N-acetylglucosamine residue of precursor structure
304
Lewis cell-bound antigens absorbed from plasma onto the RBC membranes are:
Glycolipids
305
Lewis antibodies are of what immunoglobulin class?
IgM
306
Which enzyme is responsible for Lewis specificity ?
L-fucose
307
Where are Lewis antigen found?
All of the above
308
What substances would be present in saliva of a person with the LeLe HH SeSe AA genotype ?
A, H, Lea, Leb
309
What would be the probable genotype of patient who phenotypes as ABLe(a-b-)?
- lele sese HH AB
310
What is found in the secretions of Le(a-b-) individuals?
None of the above
311
At which phase are Lewis antibodies usually detected?
Immediate spin
312
How does anti-Lea differ from anti-Leb?
Anti-Le can bind complement more efficiently
313
Why are Lewis antibodies not generally implicated in HDN?
Lewis antibodies are IgM and cannot cross the placenta
314
Which blood group system is not based on carbohydrates?
Rh
315
The true Lewis phenotype will normally be detected at what age?
Not necessarily ever
316
Which of the following statements about the Lewis system is not true?
Secretion of Lewis substance is controlled by the Se gene
317
P1 antigens:
Take up to 6-7 years to develop
318
I and i are found in plasma, serum, and what other possible source?
All of the above
319
Persons with the Kidd-null phenotype have been found in
New zealand
320
Lutheran antibodies are rarely associated with causing HDN for which of the following reasons?
All of the above
321
Which of the following is not involved in the Kell blood group system?
Jka
322
Where the Duffy antigens found?
RBCs
323
What is the most common Kidd phenotype in the black population?
Jk(a+b-)
324
Why is it relatively easy to find a compatible units for a patient with anti-K?
Kell is a low-frequency antigen
325
The Fy5 antigen has been shown to be the result of an interaction between Duffy genes and
Rh
326
What will happen to I antigen expression when ABH sugars removed from RBCs?
Increased expression
327
What is the ISBT assignment for the antigen P2?
003001
328
What is the definition of blood group system?
A group of antigens produced by alleles at a single gene locus
329
Where are the Kell blood group antigens found in?
RBCs
330
Which of the following is known to enhance K antigen expression in the AHG test?
Polyethylene glycol (PEG)
331
Anti-Lea reacts at what temperature?
Room temperature
332
At what phase of the AHG test will anti-Kell be detected?
AHG
333
What is the function of a GPB-GPA hybrid (anti-Lepore type)
GPB
334
What sample requirement is essential for ID of a Kidd antibody?
Fresh serum or plasma
335
What does the U in U antigen stand for?
Universal
336
Infection with which organism is associated with naturally occurring IgM anti-K
All of the above
337
The M and N antigens are found in the which glycoprotein?
Glycophorin A
338
Which of the following distinguishes the recessive LuLu gene from the dominant In(Lu) gene?
Normal expression of P1
339
All of the following are characteristics of Kidd antibodies except?
Naturally occurring
340
Which RBCs are resistant to lysis?
Jk(a-B-)
341
What MN phenotype is found in highest frequency in the white population?
M+N+
342
Anti-M will react strongest with which cells?
M+N-
343
The Lu gene shares chromosome 19 with other blood group gene?
All of the above
344
All of the following are grouped with the para-Kell antigens except:
K11
345
What anemia will result in an increased expression of i antigens, which exceeds that found on control cord cells?
CDA type II
346
The Kell gene is located on the long arm of which chromosome?
7
347
At what age does I antigen become detectable on the infants cells
18 months
348
What characteristic differenitiates Ss antigens from MN antigens?
Enzyme degradation
349
A person who inherits alleles Fya and Fyb will carry which antigens on their RBCs
Both Fya and Fyb antigen
350
What is the IBST designation for the Ii blood groups?
207
351
On which malaria receptor site is Duffy antigen dependent?
Junction receptor
352
The structures that carry the P antigens also carry which determinants?
All of the above
353
The genes that code for GPA and GPB are closely linked on the long arm of which chromosome?
4
354
Persons who expresses the phenotype P2 are a risk for developing anti-P1 when handling what animal species
Pigeons
355
What abnormal blood cell morphology is associated with the McLeod phenotype?
Acanthocytes
356
What is the ISBT designation for the Lutheran blood group system?
LU
357
How are lipids dissociated from the RBC membrane for biochemical studies?
Organic solvents
358
Persons who are negative for Duffy antigens are less likely to contract which of the following diseases?
malaria
359
What type of Hemolytic transfusion reactions (HTR) occurs more frequently in patients with Jk antibodie?
Delayed
360
Anti-I is found in association with what microorganism?
Mycoplasma pneumonia
361
Autoantibodies to Jka have been found in patients taking
Methyldopa
362
What adult phenotype is rich in I antigen and common to the white population?
- i1
363
Most blood group alleles are
Codominant
364
What is the most common genetic combination in the Kell blood group system?
- kKpbJsbK11
365
All of the following are characteristics of Duffy antibody except:
They are not implicated in HDN
366
What sequence of antigens coincides with strongest immunogen to weakest immunogen?
D, K, Fya, Fyb
367
Anti-N will react stronger with which phenotype?
M-N+
368
The Ii antigens are found on the membranes of which structures?
All of the above
369
Where are the Kidd antigens found?
RBCs
370
Anti-N is known to occur in ____________ patients undergoing dialysis with equipment sterilized by formaldehyde?
Renal
371
Approximately what % of the black populations are s-?
3%
372
What can be done to rule in anti-M when only M+N+ RBCs are available?
Decrease the serum to cell ratio
373
What fatal disease is associated with the McLeod phenotype?
Chronic granulomatous disease
374
What is the etiology of chronic granulomatous disease (CGD)?
Phagocytes are unable to generate hydrogen peroxide, which is used to kill invading bacteria
375
What are the antibody characteristicss of Fy3, Fy4, and Fy5?
All of the above
376
What biochemical observations signify a protein composition to the Kell antigens?
Inactivation at 56 C
377
Most Kell autoantibodies are directed agains which antigens that are usually undefined?
High-frequency
378
Black persons who genotype as Fy4Fy4 will phenotype as
Fya(a-b-)
379
What is the ISBT designation for the Kell system?
006
380
What Kell phenotype is found in highest frequency in her white population?
K-k+
381
Anti-i is found in association with what disease?
IM
382
What is the ISBT designation for the Kidd blood group system?
009
383
What portion of GPA reacts with anti-EnaFR?
Ficin resistant
384
How is the Luke (LKE) system related to the P blood group system?
Anti-LKE reacts with all P1 and P2 individuals
385
At birth, infant cells are rich in _______, and _____ is nearly undetectable
- i/I
386
All of the following are true about the Kell antigen except?
It is destroyed by ficin treamment
387
What is the biochemical structure of the P system antigens?
Glycophinogolipids
388
Which of the following are true concerning the I and i antigens?
I and I antigens have a reciprocal relationship
389
Anti-Lu3 will be compatible with donor blood from individuals with which of the following phenotypes?
Lu(-b-)
390
Where are the P antigens found?
All of the above
391
What amino acid is specific for S antigens?
Methionine
392
Why does anti-Lua go undetected in routine testing?
Most reagent cells are Lu(a-)
393
Why are the U antigen included in the MNSs blood group system?
All U-negative RBCs were also S-s
394
Duffy antigens are destroyed by
Ficin
395
A person who inherits the In(Lu) gene will not ecxpress which antigens?
Lua
396
DDT, when used alone, can destroy antigens in which blood group system?
Kell
397
The gene that codes for P1 is located on which chromsomes?
22
398
What class of immunoglobulin makes up anti-Lua?
All of the above
399
Which population has the greatest frequency of the Fy(a-b-) phenotype?
Black
400
What is the most common Lutheran phenotype in the white population ?
Lu(a-b+)
401
Anti-Lua is destroyed by what enzyme?
Trypsin
402
Which organ removes cells coated with Jk antibodies from circulation?
Liver
403
Autoantibodies to U antigen may be found in patients with?
Warm autoimmune hemolytic anemia
404
What name is attached to the ENa antigen?
Envelope
405
What is the unique about the Kpa antigens?
It suppresses the expression of k and Jsb
406
All of the following characteristics are consistent with benign anti-I except:
It does not bind complement
407
Why are the M and N antigens important for paternity testing?
Antigens are well developed at birth
408
Serologic tests determine a persons:
Phenotype
409
What effect do enzymes-treated cells have on anti-I detection
?
Enhances reactivity
410
A patient who had a viral infection suspected to be IM may develop which antibody?
Anti-i
411
Type I H antigen is secretions is a product of which of the following genes?
Se
412
A patient who recently recovered from mycoplasma pneumoniae infection may develop which antibody?
Anti-I
413
Antibodies to the blood groups below exhibit dosage except:
Kell
414
RBCs antigens are written using which of these conventions?
Genes are written in italics
415
Which of the following techniques/reagents may be useful in increasing the reactivity of anti-M?
Acidified serum techniques
416
You have a patient with anti-P1. Theoretically. How many units would be compatible if you set up 10 units of blood?
2
417
Enzymes that destroy the antigens of which of the following blood groups?
All of the above
418
Which antigen is antithetical partner to s?
MN
419
Which of the following blood groups is inherited from the parents but absent at birth?
Fya
420
Which of the following are written in the order of allele, antigen, and phenotype?
A^1, A1, and Av1
421
All of the following antigens are found on reagent screening cells except:
Jsa
422
What screening cells are used primarily for testing donor units for unexpected antibodies?
Pooled
423
When performing the elution procedure, the solution containing the recovered antibody is called:
The eluate
424
What is the purpose of Coombs control cells?
All of the above
425
What test might rouleaux cause in interference?
Reverse ABO grouping
426
What is elution?
A technique used to dissociate IgG antibodies from sensitized RBCs
427
The process of removing antibody from serum by combining a serum sample with appropriate RBCs under optimal condition is called:
Absorption
428
How does LISS enhance antibody detection in the antibody screen?
Increases the rate at which antibody binds to RBCs antigens
429
Which cells are employed to remove autoantibody from patient serum without removing any alloantibody from serum?
Patient RBCs
430
Why is it important to math the lot number on the panel sheet with the lot number on the panel cells?
Pattern of reactions will change from lot to lot
431
A person developed an antibody to the LISS reagent. What test will not be affected by this circumstance?
DAT
432
Which of the following statements is correct concerning cold antibody screens?
Patient serum is incubated with group O adult and cord RBCs at 4C
433
Routine pretransfusion testing consist odd all of the following except:
a DAT
434
A positive Autocontrol in antibody detection procedures is usually indicative of
Positive DAT
435
In interpreting an antibody screen, which of the following questions might be asked to decipher the class of antibody?
In what phase did the reaction occur?
436
Why is enzyme treatment used in antibody ID?
Enzymes aid in the separation and ID of multiple antibodies and the absorption of autoantibody from patient serum
437
Which of the following is a mechanism of an elution procedure?
Disruption of structural complementarity of antigen and antibody
438
Neutralization of antibody is applicable to all of the following blood except?
Rh
439
What determines if a RBC antibody is clinically significant?
Shortened RBC survival
440
Why are screening cells group O ?
To prevent interference with anti-A and anti-B in patient serum
441
Cold-reactive autoantibodies can be selectively removed from patient serum by adsorption with autologous RBC. What other cells can be used?
Rabbit RBCs
442
Why is rouleaux not usually found in the AHG phase of antibody screens?
Patient serum is washed away before adding AHG
443
What is the most common use of adsorption?
Removal of autoantibody from patient serum
444
What is a positive DAT
In vivo sensitization of RBC with antibody
445
Which is the second phase of a hemagglutination reaction?
Agglutination
446
What test is used to confirm the efficacy of chloroquine treatment?
DAT
447
What antibody is associated with a mixed-field reaction?
Sda
448
What is tested is an antibody screen?
Patient serum is tested against group O reagent screening cells
449
What effect does ZZAP reagent have on sensitized RBCs?
All of the above
450
What is a possible explanation for nonreactive eluate?
Positive DAT due to drugs
451
What might a positive antibody screen and a negative auto control indicate?
All alloantibody has been detected
452
When might you suspect multiple antibodies in a patents serum?
All of the above
453
In what circumstance would an alloadsorption be performed?
Multiple antibodies in serum
454
When are antibody titration studies warranted?
During pregnancy
455
What test must be performed on a patient with a warm autoantibody in their serum before transfusing
Warm autoadsorption
456
What is the first step in reading hemagglutination reactions?
Checking supernatant for hemolysis
457
What is the purpose of saline washing in the antibody screen procedure?
Removal of unbound IgG that would neutralize the AHG reagent
458
All of the following antigens are interacted by proteolytic enzymes except
C
459
When should multiple antibodies be suspected in a positive antibody screen?
Cells react at different phases and strengths
460
Tests with which AHG reagents can determine if IgG, complement, or both are coating RBCs?
Polyspecific
461
Which of the following is known as the “sensitization phase” in the antibody screen?
37 C incubation
462
What is an antigen profile sheet?
An insert listing the antigenic makeup of each vial of screening cells
463
What makes up autologous control?
Patient serum and patient cells
464
What is the final step in antibody ID?
Phenotype patients RBCs for corresponding antigen
465
Cells that have antibody attached to them but are still separated from one another are:
Sensitized
466
What is the advantage of having a 3-cells panel screen versus a 2-cell panel screen?
All of the above
467
Name a disease in which your positive D control might be positive
Mulitple myeloma
468
The electrical force that exists between RBCs is
All of the above
469
Pseudoagglutination:
All of the above
470
Of the antibodies listed below, which down not fir with the others in terms of optimal temperature of reactivity?
Anti-E
471
Antibodies formed as the result of RBC stimulation of the patient are known as:
Immune
472
Antibodies resulting from exposure to pollen, fungus, or bacteria are known as:
Naturally occurring
473
The AABB’s standards for blood bands and transfusion services requires antibody screen of all populations listed below except
Prenatal patients
474
In which section of the blood bank laboratory would blood be issued for transfusion?
Main laboratory
475
Electronic cross matching?
Must confirm current with historical recipients ABO group
476
What tests are involved when a physician orders a 4-unit cross match on a patient?
ABO, Rh, antibody screen, IS crossmatch
477
Which of the following might be used to investigate a cold autoantibody?
Rabbit erythrocyte stroma
478
A positive DAT may be seen in:
All of the above
479
Why are monoclonal anti-D reagents preferred over the slide test reagents?
They contain a low protein concentration and are not prone to false-positive reactions
480
If an intrauterine transfusion is indicated, which of the following is acceptable?
Only type O RBC
481
Immediate spin resulting in agglutination may be caused by
Cold reacting the allo- or autoantibodies
482
Which cells are used for donors antibody screen?
Pooled screening cells (2 donors)
483
Which of the following would prolong labeling of the packed RBC unit?
None of the above
484
What one forward-typing reagent can be used to confirm O units collected from another facility?
Anti-A, B
485
All of the following procedures might be done in an investigation of an ABO discrepancy’s except:
Neutralization studies with urine
486
The label on the recipients pretransfusion specimen
Must duplicate patient wristband information
487
Where can an ID band be placed on a double arm amputee?
All of these
488
How are 8 units of cryoprecipitate usually issued?
As one pooled unit
489
A three-cell antibody screening set provides _____ antigen expression in all major blood group systems except Kell
Homozygous
490
All of the following viral test are required for donor processing except
CMV
491
What is the main concern for obsteric patients in prenatal testing?
Antibody that causes HDN
492
In which department of the blood bank laboratory would an ABO discrepancy be resolved?
Reference laboratory
493
A proper blood bank specimen is good for how many days after it is drawn from a patient that has a had a prior transfusion within 90 days?
3 days
494
Which of the following options are suitable requirements for product labeling?
All of the above
495
Why would an Rh type be ordered on a cord blood sample?
To determine mothers candidacy for RhIG if she is Rh-negative
496
The advantages of electronic crossmatching compared to serologic cross match include
All of these
497
Why can the Rh-hr control eliminated from donor processing?
An Rh-negative unit of blood typed as an Rh-positive would only be transfused to an Rh positive patient
498
Patient blood management programs
Are based on patient evidence
499
Personalized medicine involves
All of these
500
Which patient is most likely to require irradiated products?
Patient undergoing a bone marrow transplant
501
Possible reasons for incompatibilities after initial spin during a crossmatch include
All of these reasons
502
After completing an antibody screen using the gel testing method, results after centrifugation yield a pellet of unagglutinated cells at the bottom of the micro tube and a thin layer of cells at the top by gel column. This situation commonly indicates
That fibrin from serum that has not clotted completely
503
The indicator cells used to detect antibodies in a solid phase technology are:
AHG-coated RBCs
504
Which of the following factors are likely to cause false-positive results while using gel technology
All of the above
505
The FDA has approved the _______ for application of gel technology
ABO, Rh, DAT, antibody screen and ID, as well as cross matching
506
When performing an antibody screen by gel technology, the following steps are eliminated
The saline wash and control check cells
507
The gel system has all of the following advantages over the traditional tube procedure except
Different grading system
508
Which of the following test is not available for both the gel testing method and solid phase technology?
DAT
509
If you had a lipemic and icteric sample that needed to have an antibody screen done, which of the following would obtain the dest results ?
SPRCA
510
In a gel-based technology the solid band at the top of the gel indicates a ________, whereas formation of a pellet at the bottom of the micro tubes indicates_______
4+ reaction/ a negative reaction
511
Using the affinity column technique, a serologic reaction that forms a fine RBC band at the top of the gel column and a RBC button at the bottom of the gel column in interpreted as:
Mixed-field
512
Low ionic strength saline (LISS) is added to antibody screening methods for which of the following test systems>?
SPRCA
513
The washing procedure is applicable to which of the following serologic methods?
Solid phase and tube system
514
A layer of RBCs agglutinates at the tip of the gel media, and a pellet of unagglutinated RBCs forms at the bottom. These finings are comparable to which of the following reactions in the test tube’?
Mixed-field
515
Which of the following is a factor in possible false-negative and false-positive results when using the gel systems to screen for antibodies
All of the above
516
Which of the following statements is most accurate? A mixed- field in the gel system
Needs to have further testing performed
517
Which of the following substances may interfere with gel technology but not SPRCA technology?
All of the above
518
SPRCA testing requires the use of all these specialized microplate equipment except:
Thermal cycler
519
Special pipette are required for this method
Column agglutination technology
520
True or False: An anti-M detected by using gel AHG antibody screening cards is considered clinically insignificant
False
521
If a prospective blood donor has participated in aphersis donation , at least how much time must pass before he or she can donate whole blood?
48 hours
522
A whole blood donor who has taken Tegison should be:
Permanently deferred
523
What is the deferral period for a donor who has received a live attenuated Vaccine for rubella?
4 weeks
524
A woman received a transfusion of packed RBCs while delivering her baby. Six months later she wanted to donate a unit of blood back to the American Red Cross. If the woman meet all other criteria for donation, is she allowed to donate at this time?
No. She needs to wait 6 more months
525
A patient who recently stopped taking clopidogrel (Plavix) needs to donate platelets. How long must te patient defer donation after completing the medication?
14 days
526
What is the minimum hemoglobin level for a potential autologous donor?
11 g/dL
527
What is the minimum hemoglobin level for a potential allogeneic donor?
12.5 g/dL
528
Which of the following is the only pheresis procedure that require administration of a growth factor to the donor?
Leukopheresis
529
A blood donor with a history of hepatitis B should be excluded
Permanently
530
An autologous unit should be donated what time period prior to the patients surgery/need?
72 hours
531
The following blood donors regularly give blood. Which donor may donate on September 11th?
A 28 year old man who had plateletpheresis on August 24th
532
How many times can a person meeting all the optimal criteria donate an apheresis unit of platelets per year?
24 times
533
Autologous blood donations may occur as
All of these
534
What is the last time a patient can donate for an autologous unit before surgery?
3 days before the scheduled surgery
535
Which of the following tests is optimal for the collecting facility for an autologous donation ?
Antibody screen
536
Which of the following tests is not optional for the transfusing facility for an autologous donation?
Group & type
537
There is a decreased risk of each of these when using autologous donations except;
Bacterial contamination
538
Blood product collections and component manufacturing but not donor selection, is regulated by the:
CBER
539
Which of the following accredits blood banks?
CAP
540
A blood transfusion service is scheduled for an inspection. What of the following agencies may be conducting the inspection?
Any of these
541
Which of the following statement is true regarding directed donations?
Directed donations may need irradiation to precent GVHD
542
Which of the following serologic tests is required for directed donations?
All of these
543
When should mixing of the blood bag be performd>?
Periodically during collection
544
Nausea, twitching and muscle spasms during blood donations are categorized as:
Mild reactions
545
A donor has fainted during blood collection. Which of the following is NOT an appropriate action?
Place wam compresses on the donor’s forehead
546
In addition to signs experienced during a mild reaction to blood donation, a moderate reaction includes which of the following?
Loss of consciousness
547
Convulsions may occur during blood donation as a result of
Any of these
548
Ensuring the presence of an adequate airway is most important in which type of blood donation reaction?
Severe reactions
549
Which statement concerning a hematoma is true?
A hematoma is a localized collection of blood under the skin
550
Treating occurrence the hematoma development during blood donation involves?
Removing the tourniquet and needle from donors arm
551
A 4-week deferral is required of donors exposed to which of these organisms?
Zika
552
A 8-week deferral is required of donors exposed to which of these organisms?
Ebola
553
A donor exposed to which of these organisms may be able to donate in as soon as as 2 weeks?
Babesia
554
In order for a donor to be infected with West Nile Virus he/she must be bitten by a mosquito that has first bitten which reservoir hosts?
Birds
555
Which is the most economical way to test for West Nile virus?
MP-NAT with follow-up by ID-NAT on positives
556
A donor who was repeatedly reactive with anti-HBc may be considered for re-entry if agates 8 weeks if which of these tests are negative?
All of these must be negative
557
Prions are
Spongiform organism that resist deactivation
558
Donors must be screened for which virus that causes a neurological disorder of myelopathy?
HTLV
559
How long is the donation deferral for persons who visit malaria-endemic countries?
3 years
560
Which of theses countries is NOT a malaria-endemic country?
Austria
561
A U.S. military officer was deployed to Belgium from 1982 to 1985. How long is his deferment from blood donations once returning to the U.S.?
Indefinitely
562
A 25 year old patient who had travelled to Ireland in the last year has been experiencing neurological abnormalities since returning to the US several months ago. Which of the following is most likely?
Creutfeldt-Jakob disease with no accumulation of prion proteins
563
A person infected with HIV-1 is diagnosed with AIDS-related condition (ARC). What antibodies will be present in the patients serum at this stage?
Anti-p24 and anti-gp41
564
The cytomegalovirus and EBV belong to which family of viruses?
Herpesvirdae
565
The hepatitis C virus is thought to be included in which family?
Flaviviridae
566
HIV belongs to which family ?
Retroviridae
567
Why is transmission of CMV through blood components not a significant risk to most recipients?
Most recipients are CMV-positive
568
How is the hepatitis A virus usually spread?
Oral-fecal route
569
This disease can be transmitted through blood transfusion and is characterized by sponge-like lesions of the brain
Cretzfeldt-Jakob disease
570
According to the CDC, an HIV-positive person is considered to have AIDS according to what criterion?
Fewer than 200 CD4+ T cells per uL
571
Which two infectious agents share the same vector?
Babesia and borrelia
572
All of the following viruses have been associated with TAH except
Hepatitis E
573
HBsAG is what part of the hepatitis B virus?
Coat protein
574
Which of the following parasites has not been associated with transmission via blood transfusion?
None of the above
575
In the HIV-1 virus ______ is a core protein
P24
576
What is the causative agent for Rocky Mountain spotted fever?
Rickettsia Rickettsii
577
The hepatitis B virus belongs to which family?
Hepadviridae
578
Which test can reveal a symptomatic patient with TAH?
ALT
579
What treatment is recommended for chronic liver disease due to hepatitis C virus infection?
Alpha interferon
580
Which test for HIV infection depends on amplification of HIV integrated in the DNA of infected cells?
PCR
581
What is the incubation period hepatitis A virus in transfusion-associated hepatitis?
40-60 days
582
The hepatitis A virus belongs to which family of viruses?
Picornarviridae
583
Persons infected with the Hepatitis C virus may develop what disease?
All of the above
584
The most sensitive test for the detection of HIV infection is the
PCR
585
Why are donors deferred for 6 months following receipt of blood products?
To permit adequate screening for transfusion-acquired viral infections
586
What marker usually is not detected when the hepatitis-B infected patient enters the convalescent phase?
HBeAg
587
Which of the following is indicated when a recipient of blood or blood components develops a viral disease?
Donor look-back
588
Which of the following patients would be at a greater risk for CMV infection?
An allogenic bone marrow transplant recipient
589
How can hepatitis A infection poses a severe threat to chronically transfused individuals who carry the hepatitis B virus ?
Superinfection by hepatitis D virus
590
Which cell is invaded by the HIV viruses?
Lymphocyte
591
What is the source of hepatitis B immune globin (HBIG)?
Persons with a high titer of anti-HBs
592
The “look back” process includes notifying donors of abnormally with
All of these
593
Which of the following is not included in the signs and symptoms of TAH?
Splenomegaly
594
In an individual infected with Hepatitis B virus, which of the following is detected first?
HBsAg
595
Pathogen inactivation intervention includes all of these except
Millipore filtration
596
Which test is now used in the processing of all source plasmas for pathogen inactivation verification?
NAT
597
Lipid-enveloped viruses are inactivated by used of:
Detergent
598
The current risk of enveloped virus transmission is very low because of
A combination of all of these
599
Pathogen inactivation using psoralen activated by ultraviolet light is most effective in:
Platelet concentrates
600
Pathogen reduction systems may not be effective against which agents?
Prions
601
True or False: a person with acute hepatitis B is immune to infection from other hepatitis viruses
False
602
A whole blood donation contains a volume of 350 mL. Which of the following is true regarding this unit
?
FFP cannot be made from this unit
603
A unit of RBCs has man expiration date of 11/15/12. A patient currently on a fludarabine regimen requires irradiated packed RBCs. The unit is irradiated for this patient on 11/02/12. What is the correct expiration date post-irradiation?
11/15/12
604
Packed RBCs must have a final Hct of less than or equal to :
80%
605
Leukoreduced packed RBCs must have an absolute WBC of less than and contain at least what % of original RBC mass?
5 X 10^6/85
606
What is the minimal pH required for platelets?
6.2
607
Cryoprecipitate is indicate for all of the following disorders except
Hemophilia B
608
A patient has a baseline platelet count of 30,000/uL. Upon receiving a platelet pool of 4 random platelets, what would you expect the post-transfusion platelet count to be?
50,000/uL
609
What is the expiration time for platelet concentrates that have been pooled?
4 hours
610
Which of the following of platelet concentrates from single units of whole blood must procedure a product that yields a minimum of
5.5 x 10^10 platelets per unit in 75% of units tested
611
Normally, what % of 35 day old RBCs should be circulating 24 hours after transfusion?
70%
612
What is the ratio of anticoagulant to whole blood in a unit of whole blood?
14 mL of anticoagulant-preservative for every 100 mL of whole blood collected
613
A unit of whole blood must be stored at what temperature??
1-6 C
614
What is the shelf life for acid-citrate dextrose? (ACD)
21 days
615
What is the shelf life for whole blood collected in citrate-phosphate-double dextrose? (CP2D)
21 days
616
What is the shelf life of whole blood collected in citrate-phosphate-dextrose-adenine?
35 days
617
How are RBCs separated from whole blood?
All of these
618
Within what time after collection of whole blood must RBCs be separated from whole blood in order for platelet and plasma components to be prepared?
8-24 hours
619
A unit of packed RBCs must be stored at what temperature?
1-6C
620
What are platelets obtains from apheresis donations called?
Single donor platelets (SDPs)
621
Manufacturing RDPs is accomplished by using all fo the following methods except
Apheresis collection
622
A unit of packed platelets must be stored at what temperature?
20-24 C
623
Units of platelets are stored under which of these conditions
Constant agitation
624
What is the shelf-life of platelets if the unit is tested for bacterial contamination just prior to issuing?
7 days
625
What is the shelf-life of frozen RBCs?
10 years
626
A unit of cryopreserved RBs must be stored below what temperature?
-65C
627
What is the expiration date of deglycerolized unit of RBCs
24 hours
628
Which statement about frozen platelet plasma is correct?
The expiration of frozen plasma stored at-65 C is 7 years
629
Frozen plasma is thawed at what temperature
30-37C
630
Which statement about liquid plasma is correct?
All of these are correct
631
Liquid plasma is prepared from a unit whole blood collected in CPDA-1 on July 28th, what is the expiration date of this plasma?
September 7th
632
A unit of granulocyte would contain at least what concentration of granulocytes?
1 x 10^10
633
A unit of granulocytes prepared on April 13 at 10:00 AM and is irradiated at 2:00 pm the same day. What is the expiration date?
April. 14th, 10 AM
634
Plasma factor concentrates are separated into various proteins by manipulating which variable?
All of these
635
Viruses are inactivated in units of plasma concentrate by all of these methods except
Freezing
636
Which factor concentrate has almost completely replaced cryoprecipitate as the product of choice to treat patients with hemophilia A?
FVIII
637
Xenographic forms of factor VIII are made from which source of plasma?
Porcine plasma
638
What is the half life of immune serum globulin?
18-32 days
639
How is the preparation of PPF different than that of NSA?
PPF contains less albumin and more globulins than NSA
640
What is the storage temperature for normal serum albumin?
2-10C
641
What is the shelf-life for normal serum albumin?
5 years
642
What is the storage temperature for plasma protein fraction?
2-10 C
643
What is the shelf life for plasma protein fractions?
5 years
644
Which of the following does NOT describe the preparation of antithrombin?
Apheresis of a single donor sensitized donor
645
In which animal has transgenic methods produced rAT in the milk?
Goats
646
Which of the following best describes the principle of the Kleihaur-Betke test?
D-positive indicator cells form rosettes around fetal Rh-positive RBCs
647
What tests are indicated for cord blood specimens if the mother has made anti-K
ABO, Rh, antibody screen
648
Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?
Bilirubinemia
649
All of the following are goals of an exchange transfusion except:
Correct anemia
650
Why is suppression of erythropoiesis an advantage of exchange transfusion ?
Decreases the risk of iron overload
651
Why is revere grouping omitted in neonate ABO grouping?
Maternal antibodies mask the ABO antibodies of the neonate
652
A cord blood specimen from a Jaundice infant should be tested for which of the following?
All of the above
653
Why is the immediate spin eliminated in the prenatal antibody screen?
To reduce the detection of IgM antibodies
654
Which of the following reagents can be used to determine the immunoglobin class of anti-M?
Chloroquine
655
All of the following are characteristics of ABO hemolytic disease of the fetus and newborn (HDFN) except:
The antibody is IgM
656
What is physiological mechanism of Rh-immune globulin?
Attachment of fetal Rh-negative RBC in maternal circulation, inhibiting production of anti-D
657
Which of the following treatments uses ultraviolet light to treat hyperbilirubinemia after the infant is delivered?
Amniocentesis
658
In HDFN, the IgG antibodies are directed against which antigen on the fetal RBCs?
Viral
659
Which RBC morphology is most characteristic in ABO HDFN and absent in Rh HDFN?
Micro spherocytes
660
How is intrauterine transfusion performed?
RBCs are injected into the fetal peritoneal cavity
661
Immunization of the mother can be caused by as little as________ D-positive fetal cells
1 mL
662
Active immunization induced by Rh(D) antigen can be prevented by the concurrent administration of:
Alpha-1 protease inhibitor
663
Due to a short supply of O-negative packed cells, an Rh-negative patient was transfused with 1 unit of Rh-positive RBCs. Calculate the number of Rh-immune globulin wails needed to protect against 250 mL of Rh-positive packed cells
23
664
In order for the mother to be considered for Rh-immune globulin, her Rh type must be _______, and her newborn must be_______
Du-negative/Du-negative
665
What is the most clinical manifestation of ABO HDFN?
Hyperkalemia
666
Which of the following RBCs is appropriate for neonatal transfusions?
Group AB, CMV-negative
667
The laboratory is presented with a case of HDFN due to ABO incompatibility. The mother is group O and the infant is Group B. The most appropriate type of blood to use for an exchange transfusion for this infant is:
B
668
The most important serologic test for diagnosis of HDFN is the _____ with anti-IgG reagents
Elution
669
Which of the following antbodies have not been known to cause HDFN?
Anti-D
670
What is the physiological path of indirect bilirubin produced as a result of red blood cell destruction in HDFN?
Indirect bilirubin is transported across the placenta and excreted via maternal kidneys
671
All of the following are true regarding antibody titration o maternal IgG antibodies except:
RBCs should consist of the same genotype for each titration
672
The D-positive fetal cell sin Rh-HDN are_____
Amorphic
673
Why is the Rh-positive firstborn of an Rh-negative mother unaffected by Rh HDFN?
The plasma volume of the other is the mother is tripled during the first pregnancy which dilutes anti-D
674
Besides the Rh antibodies what other RBC antibody ins common to cause severe HDFN/
Anti-Lea
675
The results of a Kleihauer-Bette stain indicate a Fe to maternal need of 40 mL of whole blood. How many vials of Rh-immune globulin would be required?
2
676
What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen?
The chance of maternal sensitization to Rh antigen is decreased
677
Which of the following assays is used to calculate the amount of fetomaternal hemorrhage in a postpartum specimen?
Rosette test
678
On the event of clinically significant antibody found in the mother’s serum, which of the following must be performed to determine its concentration?
Elution
679
What is the cause of of HDFN?
Destruction of the fetus’s RBCs by antibody produced by the mother
680
What life-threatening disorder is characterized by a severe anemia, effusions and ascites from hepatomegaly and splenomegaly?
Hydros fetalis
681
What physiological phenomenon associated erythroblastosis fetalis with HDFN?
Release of nucleated RBCs into circulation of neonate inflicted with HDFN
682
In which type of HDFN is the firstborn affected?
ABO
683
Cannulation of the umbilical vein under ultrasound guidance is known as
Cordocentesis
684
Why are premature newborns more likely to require exchange transfusion than full-term infants?
Premature newborn livers are too underdeveloped to conjugate bilirubin
685
Blood transfusions tot he fetus and premature infants should be_____ to prevent graft-versus-host disease
Gamma irradiated
686
Which IgG subclass carries more potecncy in RBC hemolysis?
IgG3
687
Which of the following mother/infant blood types would be considered at risk for ABO HDFN?
Mother is group O; baby is group B
688
When is the antenatal dose of Rh-immune globulin given?
28 weeks
689
Rh-immune globulin should be given within how many hours after delivery?
72 hours
690
Which prenatal serological tests are recommended during the first trimester?
All of the above
691
Anti-D in the serum of third trimester pregnant woman with a titer of 16 is indicative of:
Active immunization
692
How are units for exchange transfusion prepared?
Group O RBCs and group AB
693
Why does the rate of RBC destruction after brith decrease in an infant diagnosed with HDFN?
Maternal antibody is no longer entering infant circulation via the placenta
694
What is done to prevent HDFN caused by maternal anti-Jka antibody formation?
Monitor the mothers antibody level
695
What is the role of the technologist in the diagnosis and clinical management of HDFN?
Serological diagnosis of maternal alloimmunization
696
True or false: Rh-immune globulin is of no benefit after a person has been actively immunized and formed anti-D
True
697
True or Faalse: the antibody titer of maternal antibody is directly proportional to severity of HDFN
False
698
All Rh-negative recipients who are transfused with as little as 1 mL of Rh-positive cells will develop anti-D
False
699
Which of the following can be found in warm autoimmune hemolytic anemia in the presence of hypoplastic marrow?
Reticulocytopenia
700
Most cases of warm autoimmune hemolytic anemia will be DAT-positive with which of the following?
Both Anti-IgG and Anti-C3d
701
Cold autoanti-H is more prevelant in which blood group?
A1B
702
RBCs sensitized in which drug-induced hemolytic anemia mechanism act as “innocent bystanders”?
Immune complex
703
Which drug can cause production of autoantibody?
Methyldopa
704
In warm autoimmune hemolytic anemia, the autoantibody will frequently demonstrate______-like specificity?
Rh
705
All of the following are clinical manifestations of cold hemagglutination disease (CHD) except:
Hepatosplenomegaly
706
A patient with a positive DAT needs to be phenotyped for Jka. What reagent can be used on RBCs to ensure accurate typing?
Chloroquine diphosphate
707
In which of the following is the DAT reactive with anti-C3 only?
Cold hemagglutination disease
708
Which of the following characterizes an alloimmune response in immune hemolytic anemia?
The patient produces anti-K to transfused RBCs
709
How can persons with CHD avoid hemolytic episodes?
Move to a warm climate
710
The onset of warm autoimmune hemolytic anemia (WAIHA) may be precipitated by:
All of the above
711
If a false-positive reaction was suspected with anti-D in the forward grouping due to the presence of a cold autoantibody, which of the following would show reactivity?
All of the above
712
Which of the following factors distinguishes a cold autoantibody produced in a patient with IM from the produced in a patient with pneumonia?
Anti-i specificity
713
Cold hemagglutination disease represents what % of autoimmune hemolytic anemia (AIHA) cases?
18
714
In the case of an AB-positive individual, which test must be performed to ensure that warm-reacting autoantibody is not causing false-positive reactions?
Rh control
715
Which of the following procedures can be used to resolve interference due to anti-I?
Cold autoadsoprtion and pre warm technique
716
How might a technologyish detect a patient with drug-induced hemolytic anemia?
Positive DAT
717
In a patient who has been recently transfused, a positive DAT may be due to
Alloantibody coating transfused donor cells.
718
How is RCBC destruction characterized in drug-induced immune hemolytic anemia via immune complex mechanism?
Intravascular hemolysis precipitated by complement activation
719
What technique can be used to identify an alloantibody in the presence of a cold auto agglutinin
Prewarming
720
Which of the following describes the drug adsorption (hapten) mechanism?
Drugs bind firmly to proteins of the RBC membrane
721
What is the most common drug associated with the drug-adsorption mechanism?
Penicillin
722
What % of AIHA cases are abuses by warm reacting autoantibodies?
70%
723
Why do clotted specimens yield positive DAT results with anti-C3 in the presence of a benign cold autoagglutinin?
Complement can be activated in vitro
724
Approximately what % of AIHA cases are due to paroxysmal cold hemoglobinuria (PCH)?
1-2%
725
All of the following are classification of immune hemolytic anemia except:
Hyper immune
726
What is one indication a positive DAT might be due to alloantibody coating donor RBCs?
Microscopic mixed-field appearance
727
What is the primary goal for treatment in patients with autoimmune hemolytic anemia?
Treat the underlying disease
728
A cold antibody titer greater than_______at 4C is characteristic of pathological CHD
1,000
729
Persons diagnosed with pneumonia caused by Mycoplasma pneumonia may produce a cold autoantibody with_______ specifcity
Anti-I
730
Which alloantibody is frequently present in the serum of i adults ?
Anti-I
731
A benign cold autoagglutination may cause inteference in antibody screening procedures when:
Polyspecific AHG reagents are used in the test procedure
732
Which of the following is a characteristic RBC morphology seen on a PB smear from a patient with warm autoimmune hemolytic anemia?
Spherocytes
733
How is the serology work up for an autoantibody produced by a drug-induced hemolytic anemia different from other autoantibody workups?
The antibody will only be reactive with RBCs in the presence of the drug
734
What treatment for warm autoimmune hemolytic anemia aids in the reduction of antibody and removes a potent site of RBC damage and destruction?
Hemoglobinuria
735
In which case might you see an anti-i?
Mononucleosis
736
Which of the following forward typing reagents may generate false-positive results in a patient with a warm-reacting autoantibody?
Anti-D
737
What is the recommended treatment for drug-induced hemolytic anemia caused by the immune complex mechanism?
Cessation of drug administration
738
Immune hemolytic anemia is defined as:
A shortened RBC survival mediated through humoral antibody production
739
What reagent cell type is used in the immune complex formation test to detect drug-anti drug interaction?
Group O
740
What is the most frequent antibody specificity in CHD?
Anti-I
741
Which of the following is a characteristic of of autoantibodies?
Antibody reacts with high-incidence antigens
742
All of the following are characteristics of benign cold autoagglutinins except
Antibodies gave a title greater than 64 at 4C
743
Which cells contain the most i antigen?
Cord blood
744
Which theory supports production of autoantibodies?
Loss of T-cell suppressor activity upon self-antigens leads to production of autoantibody
745
How can cold autoantibody interference with ABO grouping be avoided?
Washing cells with normal saline warmed to 37 C
746
In cases of warm autoimmune hemolytic anemia, what subclass of IgG is most efficient in binding complement?
IgG3
747
Which of the following regarding the immune complex mechanism in serologic testing is true
The DAT will be positive with monospecific C3 but negative with IgG
748
Which drug-induced mechanism does not result in a hemolytic episode?
Membrane modification
749
A 28 year old female with cold hemagglutinin diseases has a positive DAT. When the DAT is repeated using mono specifc reagent, which of the following is most likely to be detected?
IgM
750
The antigen I is often
The EDTA prevents compliments binding in-vitro
751
A DTAT was performed on a patient suspected of having autoimmune hemolytic anemia. The following results were obtained:PS AHG 3+, Anti-IgG 2+, anti-C3d negative. These results mean:
The patients cells are coated with IgG
752
Cold panel results obtained are:
A1 cells: 4+
A2 cells: 4+
O cells: 4+
O cord cells: 0
These results suggest which antibody?
I
753
Approximately what % of warm autoimmune hemolytic anemia will produce a positive DAT with not IgG and C3d antibodies?
67%
754
*RhIg is given when:
Mother is Rh negative and baby is Rh positive
755
*besides. Rh what causes HDFN
Anti-k
756
What are the 4 type of autologous donation?
Pre-operative
Intra-operative
Post-operative
Acute normovolemic hemodilution
757
What temperature are leukoreduced RBCs:
1-6C
758
What temperature is cryoprecipitate thawed at?
20-24C
759
What temperature is RhIg stored at?
1-6C
760
What is the purpose of dialysis in uremic patients?
Removal by-products of protein metabolism that renders vWF and platelets nonfunctional
761
Which of the following is not indication for fresh frozen plasma (FFP) transfusion?
Factor VIII deficiency
762
The rejection of the transplantation of platelets from one individual to another is termed or defined as:
Platelet refractoriness
763
Which of the following may be serious manifestation of FFP transfusion in congenital factor deficiencies?
Pulmonary edema
764
All coagulation factors are produced in the liver expect
-vWF
765
What is the advantage of performing a type and screen for patients schedule for surgery instead of crossmatching units for possible transfusion?
Increases the availability of of donor units in the inventory
766
How are RBC aliquoted prepared for a neonate transfusion?
Blood is transferred from collection bag to satellite bag and withdrawn using a syringe
767
Which of the following is an indication for immunglobulin administration?
Hepatitis A
768
Deglycerolized RBCs can be sued interchangeably with washed RBCs, because both procedures
All of the above
769
Oncology patients usually receive repeated RBC and platelet transfusions because of
All of the above
770
Which of the following is not a function of the hospital transfusion committee?
FDA certification
771
Liquid plasma is not indicated from factor_______ deficiency
V
772
Why are fresh blood units (less than 7 days old) preferred for a neonate transfusion?
They reduce the risks of Hyperkalemia
773
All of the following are consistent with graft-versus-host disease (GVHD) except
Transplantation of “immunologically naive” T lymphocytes
774
The pathological cause of a decreased RBC mass includes
All of the above q
775
Bleeding disorders may be caused by
Dysfunction of platelets
776
Which of the following are not at risk for developing cytomegalovirus (CMV) via CMV-positive blood products?
CMV-positive heart transplantation recipients
777
Which platelet pheresis product should be irradiated?
A directed donation given by a mother to her son
778
Why is whole blood contraindicated for patients with severe chronic anemia?
The plasma volume of these patients is increased
779
How is donor platelet survival determined in the recipient?
Platelet count increment (1 hour after transfusion)
780
Immunoglobulin prepared from pooled plasma is primarily
IgG
781
A blood component should be transfused within
4 hours
782
Cryoprecipitated AHF can be used in the treatment of
- vWD
783
Why is it recommended that factor VIII concentrates be used in patient with vWD?
Because of variability in vWF content
784
What whole blood component contained in pheresis granulocyte concentrate warrants crossmatching of this product?
RBCs
785
How is the whole blood component contained in pheresed granulocyte concentrate warrants crossmatching of this product?
The anticoagulant in donor blood prevents activation of the coagulation system
786
In addition to nonhemolytic febrile transfusion reactions, what other indication exists for washed RBCs?
IgA-deficient patient with anti-IgA
787
Whip of the following is an indication for plasma transfusion in a patient who has been massively transfused?
PTT greater than 60 seconds
788
In what disease state is acquired antithrombin III deficiency manifested?
DIC
789
Who is a risk for transfusion-associated graft-versus-host disease (TAGVHD)?
All of the above
790
Which class of vWD provides the lest amount of vWF?
Type III
791
Which of the following methods provides the purest factor VIII concentrates?
DNA technology
792
What is the expiration on washed RBCs?
24 hours
793
What is used to anti-coagulate the shed blood obtained from intraoperative salvage?
Citrate and heparin
794
Why is essential that irradiated blood components be used in bone marrow transplant recipients?
Bone marrow recipients are on immunosuppressive therapy
795
Persons making pre deposit donations for planned surgery will take iron supplements to replenish iron and stimulate
Erythropoiesis
796
Platelets prepared from______ are referred to as random donor platelets
Whole blood units
797
Hemophilia A is clinically apparent when the factor VII level is less than than:
10%
798
Which of the following is not an indication for transfusing platelets?
Massive transfusion, platelet count 250,000/uL
799
Which type of filter is used in routine blood administration sets to remove gross clots from all blood products?
170 um
800
Which type of autologous transfusion, successful in liver transplants, involves collecting 1 to 3 units from the patient before surgery, using crystalloid to replace blood volume and reinfusing blood at the end of surgery?
Intraoperative hemodilution
801
Factor VIII is treated by which of the following to ensure sterility for HIV and hepatitis B and C?
All of the above
802
Which of the following should be done when selecting units for a hypoxia neonate?
Hgb S testing
803
What is the source of hyper immune globulins used in the prevention of hepatitis B?
Plasma donors whose sera demonstrate a high titer of hepatitis B antibody
804
Why is the increase in hemoglobin and hematocrit evident more quickly in RBC transfusion than in whole blood transfusions?
Blood volume adjustment is less when RBCs are transfused
805
Factor IX concentrates constrain which factors (otherwise known as “prothrombin complex”
II, VII, IX, X
806
What is suspected when the hematocrit has decreased by 4% and the total bilirubin level is increased 5 days after transfusion?
Delayed hemolytic transfusion reaction
807
The rejection of platelets in multiply transfused patients is called
Refractoriness
808
What is the immunologic principle of RhIG administration?
Anti-D attaches to Rh-positive cells of the infant in maternal circulation and are subsequently removed by cells of the reticuloendothelial system, preventing sensitization
809
Vitamin K is essential for the carboxylation of which coagulation factors?
II, VII, IX, X
810
Leukoreduction filters are in the transfusion of RBCs and platelets to prevent
FNHTR
811
Which of the following factors are found in therapeutic levels in FFP?
All of the above
812
A patient with severe hemolytic anemia had a pulse of 120 beats per minute and respiratory rate of 37 breaths per minute. What blood component is indicated for this patients?
RBCs
813
Which of the following Rh-negative patients may be transfused with Rh-positive units when few O-negative units are available in an emergency?
Middle-aged male
814
What is the recommended treatment for mild vWD?
DDAVP
815
Neonatal exchange transfusion is performed using which blood preservatives?
Both B and C can be safely used
816
Why is thrombocytopenia a manifestation of a massive transfusion?
Platelet are diluted by resuscitation fluids and stored blood
817
Which blood products is used in the treatment of DIC?
All of the above
818
All of the following are characteristics of protien C except
It enhances factors V and VIII
819
Cryoprecipitate is not used to treat which condition?
Hemophilia B
820
What is the only blood component that provides concentrates of vWF?
Cryoprecipitated AHF
821
Antithrombin III concentrates are used in the treatment of:
Hereditary antithrombin III deficiency caused by venous thrombosis
822
Which IV solution is not recommended for dilution of blood components because of RBC damage?
Dextrose
823
How can GVHD be prevented in transplant recipients?
Irradiation of cellular component
824
A patient with paroxysmal cold hemoglobinuria (PCH) would require _____ in the event of a blood transfusion
A blood warmer
825
What disease state may require exogenous fibrinogen replacaement?
All of the above
826
All blood components should be transfused within what time period to avoid bacterial cotamination issues?
4 hours
827
Cryoprecipitate AHF contains how much fibrinogen?
150-250 mg
828
Which of the following criteria warrants a granulocyte concentrate transfusion?
A septic patient unresponsive to antibiotics
829
Each Cryoprecipitate unit contains at least how much factor VIII/
80 units
830
What is the most efficient way to remove leukocytes from RBCs units?
Leukreduction filters
831
What blood component is responsible for most allergic reactions?
Plasma
832
What plasma product is used to replace fluid in patients undergoing plasmapheresis procedures?
Albumin
833
What is the best-tolerated form of transplantation in humans?
RBCs
834
What transfusion therapy is indicated for a patient who is found to be refractory to random platelets?
Apheresis platelets from an HLA-compatible donor
835
What Hb level is considered critical and may warrant a RBC transfusion?
7 g/dL
836
How is a coagulation factor unit defined?
Activity in 1 mL of pooled plasma
837
Cryoprecipitate AHF contains factor VIII. What other coagulation factor is present?
I
838
What component is indicated for patients who have had moderate to severe allergic transfusion reactions and have anti-IgA antibodies became of IgA deficiency?
Washed RBCs
839
Which components provides a concentrated source of fibrinogen?
Cryoprecipitate
840
Poor increment in the platelet count 1 hour following platelet transfusion is most commonly cause by:
Splenomegaly
841
Granulocytes for transfusion should
Be ABO and Rh-compatible with the recipient;s serum
842
In anemia uncomplicated by low plasma proteins or shock, the transfusion of
Packed RBCs is most desirable
843
For which of the following transfusion candidates would CMV-negative blood be most likely indicated?
Pregnant women
844
What are the requirements for a transfusion to be classified as a massive in an adult?
10 units within 24 hours
845
What does the first transfusion in a massive transfusion protocol consists of?
2 units uncrossmathed group O whole blood
846
Treatment of post-transfusion purpura (PTP) with_______ is not advocated in medical practice
Platelet transfusions
847
A transfusion reaction investigation should include all of the following except
Neocyte transfusion
848
What should be done in the transfusion process when the patient temperature spikes from 37.5C to 38.5 C within in 30 minutes of transfusion?
Stop the transfusion and keep the IV line open
849
What groups are at risk for graft-versus hose disease (GVHD) as a result of transfusion?
Option B and C
850
A patient with two or more documented febrile nonhemolytic transfusion (FNHTRs) should receive ________ blood components
Leukopoor
851
Which of the following questions should be asked when investigating a transfusion reaction?
How many millimeters of RBCS were transfused
852
What measure can be taken to prevent transfusion-associated hypothermia?
Transfusion of product using a blood warmer
853
Which of the following products may lead to sepsis in a patient when contaminated with E. Coli?
All of the above
854
All of the following are disease that can mimic a transfusion reaction except?
AML
855
Persons with a documented history anaphylactic reactions should be transfused with _________blood products
Washed
856
What would be the result of group B blood given to a group O patient?
Immediate hemolytic transfusion reaction
857
For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment goal should be to:
Reverse hypotension and minimize renal damage
858
The plasma level of unconjugated bilirubin is elevated in
Intravascular and Extravascular hemolysis
859
Which of the following is an indicator of acute immune hemolytic transfusion reaction?
increased bilirubin
860
A negative direct antiglobulin test (DAT) is found in al of the following transfusion reactions exceptL
Acute immune hemolytic transfusion reaction
861
Which of the following is false? (2)
RBCs are phagocytized by macrophages in the spleen and liver in intravascular reactions
862
A 35 year old woman was transfused with 1 unit of packed RBCs. The nurse monitoring the transfusion noticed hives on the patients arm and an increase in body temperature. What is the choice of treatment for this patient?
Antihistamines
863
Why is an FNHTR should not be suspected when fever is the sole symptom exhibited by the patient
Fever can be the result of many other underlying maladies
864
Which of the following results when large excesses of free Hb are released into the blood?
Hemoglobinemia
865
What is a cause of death in GVHD?
Infection
866
The principle clinical signs of extravasular hemolysis include
positive DAT
867
All of the following are symptoms of an allergic reaction except
Anemia
868
What treatment is recommended following a bacterial contamination reaction
Broad-spectrum antibodies
869
In the US, fatalities associated with transfusion are required to be reported to which organization?
CDC
870
Which of the following is not a finding associated with intravascular hemolytic reaction?
Methemalbumin decreases
871
Which of the following is the most common transfusion reaction reported to blood banks
Febrile reaction
872
Treatment in the event of an anaphylactic or anaphylactoid reaction should include all of the following except
Immediately administering PPF
873
Hypothermia as a result of cold fluid replacement can result in all of the following except
Citrate toxicity
874
Which of the following organisms have been implicated in bacterial contamination reaction?
Yersinia enterocolitica
875
What is the team of medical officers who investigate all reported cases of transfusion related fatalities?
CBER
876
What is the physiological mechanism of histamine?
Histamine is released when the allergen-reagin complex attachés to the surface of tissue mast cells, increasing vascular dilation and permeability
877
How can depletion and dilution of coagulation factors be avoided in a massively transfused patient ?
Prudent use of platelets and FFP
878
A delayed hemolytic transfusion reaction is most often the result of
An anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy
879
Who developed the imputability criteria for reporting cases of transfusion fatalities?
NHSN
880
Which of the following is consistent with bacterial contamination reactions?
The organism thrives in cold temperatures
881
What is the most common preventable error occurring among the nursing and medical staff that results in a transfusion-related death?
Improper patient ID
882
Which mechanism may play a role in fever development in an FNHTR?
Release of pyrogen from transfused WBCs
883
how could a potential alloimmunization due to anti-K be prevented?
Matching of donor and recipient RBC phenotype
884
Which of these is/are involved in hemovigilance?
All of these
885
What is the most frequent cause of circulatory overload?
Transfusion of a unit at too fast a rate
886
What is meant by the term iatrogenic
?
Physican-caused
887
What is the purpose of performing serial Hb and Hct after a blood transfusion?
To mother the therapeutic or nontherapeutic response
888
Upon investigation of a DHTR, what should be included in the medical history ?
All of the above
889
Which of the following clinical manifestation is not included in the physically or chemically induced transfusion reactions?
Hemosidrosis
890
All of the following are immediate nonhemolytic transfusion reactions, except
PTP
891
Which of the following is indicative of GVHD?
Pancytopenia
892
A patient transfused with 2 units of packe RBCs demonstrated signs of a transfusion reaction just before the second unit was completely infused. Hypotension, fever and back pain are the immediate symptoms. Blood work reaveals a 3% drop in Hct and prolong PT. What therapy is given to correct the PT?
FFP
893
Which of the following is not a symptom of non cardiogenic pulmonary edema?
Hypervolemia
894
Which of the following may be a factor in a non immune transfusion reaction?
Circulatory overload
895
Which of the following urinalysis results represents hemolysis?
Reagent strip is positive for blood in absence of intact RBC’s microscopic
896
Physical or chemical damage of the transfused RBCs can result in
Intravascular hemolysis
897
A O-positive patient transfused with A-positive RBCs would experience which of the following
Acute hemolysis
898
What is the primary mediator of an allergic response?
Histamine
899
The presence of intact RBCs in microscopic urinalysis examination indicates
Bleeding
900
Immediate transfusion reaction procedures consist of all of the following except:
Serum haptoglobin
901
What symptom would not usually by found in a bacterial contamination reaction?
Tachycardia
902
What test is indicated for the detection of HLA antibodies?
Lymphocyte panels
903
What may be found in the serum of a person who is exhibiting signs of a noncardiogenic pulmonary edema reaction?
Anti-leukocyte antibody
904
Which of the following describe the etiology of GVHD?
T lymphocytes from donor blood reacts with major and minor histocompatibility antigens in the patient
905
A severe manifestation of alloimmunization might include
Platelet refractoriness
906
Which patient are not at risk for circulatory overload>?
Patients with iron-deficiency anemia
907
What type of hemolysis accompanies an anaphylactic reaction?
None of the above
908
Which of the following therapies is not advocated in circulatory overload?
Whole blood units
909
Which of the following should be collected immediately from a patent exhibiting signs of a septic reaction to blood products?
Blood cultures
910
Changes that occur to RBC’s upon storage include an increase in
Calcium
911
Which of the following indicates a hemolytic process?
Pre-transfusion plasma is yellow, post-transfusion plasma is red
912
What is a common finding in a DHTR?
Jaundice
913
Persons with PTP exhibit thrombocytopenia with platelet counts as low as 10,000 per uL. What other complications might be present?
Hematuria
914
Which of the following is not characteristic of an anaphylactic reaction?
Electrophoretic levels of IgA
915
What type of hemolysis is implicated in a DHTR caused by primary alloimmunization?
Extravascular
916
Which of the following dest describes a transfusion reaction?
Any unfavorable transfusion-related event occurring in a patient during or after transfusion of blood components
917
In a NHTR, patient antibody attaches to the specific foreign donors RBC antigen, causing sensitization of RBCs, which are removed by the
Reticuloendothelial system
918
Which of the following is characterized by a rapid onset of thrombocytopenia due to anamestic production of platelet antibody?
PTP
919
What is the length of time required from production of antibody in a DHTR caused by an anamnestic immune response?
3-7 days
920
All of the following signs are consistent with circulatory overload except
Fever
921
The most important initial step in evaluating a suspected hemolytic transfusion reaction is to
Reconfirm the patients identity and reexamine all pre-transfusion that has no medical explanation other than blood component transfusion
922
Besides Hb, what other protein can cause a pink discoloration of serum or plasma in association with muscle trauma?
Myoglobin
923
Alloimmunization may result from which of the following
Prior exposure to donor blood components
924
Circulatory overload is cause by which of the following?
All of these
925
Alloimmunization is categorized as what type of transfusion reaction?
Delayed nonhemolytic
926
Which of the following should be collected 5-7 hours after transfusion for unconjugated bilirubin determination?
Clotted blood specimen
927
What is the pathophysiological cause surrounding anaphylactic and anaphylactoid reactions?
A patient who is deficient in IgA develops IgA antibodies via sensitization from transfusion or pregnancy
928
The specific cell product used for treating sepsis is the
Granulocyte
929
Photopheresis is effective against what malignant disorder?
Cutaneous T cell lymphoma
930
Plasma exchange is most effective when ______ is considered the pathological substance
IgM
931
What is an example of a continuous flow centrifugation (CFC) instrument?
COBE spectra
932
What effect does aspirin have on platelets?
Prevents platelet aggregation
933
Which of the following incorporates membrane filtration technology with intermittent flow centrifugation (IFC) apheresis?
Fenway autospheresis-C
934
What is the definition of apheresis?
Separation or removal of blood component from whole blood
935
Which cell type is densest in the WBC layer when anticoagulated blood is centrifuged?
Granulocyte
936
When a sample of whole blood is spun, distinct layers form. What cell line or lines make up the Buffy coat?
WBC and platelets
937
A child undergoing apheresis may require CFC to minimize
Extracorporeal volume
938
A normal healthy donor undergoes a procedure to obtain platelets that will be transfused to a patient is representative of
Components apheresis collection
939
In what circumstances is a plasmpheresis donor rejected from donation?
Serum protien = 5.0 g/dL
940
What other technique is available for neonates with sepsis when apheresis is unavailable
A Buffy coat prepared from a whole blood unit less than 12 hours old
941
Which of the following is an indication for therapeutic apheresis?
B and C
942
Which of the following factors influenced the need for apheresis technology ?
The blood component need of patients on chemotherapy
943
All of the following statements are consistent with photopheresis except
The patient is given an oral dose of piroxicam, which binds to the RNC of all nucleated cells
944
Which of the following statements best describes the apheresis concept?
Blood is removed from an individual, anticoagulated, and separated, the desired component is retained and the remaining portions are returned to the donor/patients
945
What is the physicological cause of citrate toxicity in cytapheresis procedures?
The anticoagulant in plasma contains citrate, which binds calcium, lowering the body ionized calcium
946
FFP is not the optimal product for replacement fluids for a therapeutic plasma exchange procedure. For which patient is FFP the optimal product of choice?
All of the above
947
What possible risk exists when hydroxyethyl starch (HES) concentration has exceeded the renal threshold and excretion is retarded? q
Blockage of the reticuloendothelial system
948
All of the following statements are consist with CFC except?
Reinfusions to the patient completes one cycle
949
Currently, the immuno affinity column has FDA licensure for treating what disease state?
Idiopathic thrombocytopenia purpura (ITP)
950
What is the disadvantage of choosing FFP for fluid replacement in persons under going therapeutic plasmapheresis ?
All of the above
951
The platelet count ________ of plateletpheresis donor must be_______ prior to the procedure
>150 x 10^9 per L
952
A donors estimated total blood volume was determined to be 4,500 mL before a plasmapheresis procedure. The extracorporeal blood volume should not exceed:
675 mL
953
In plateletpheresism, which blood component in returned to the donor
A and C
954
Antiplatelet medications have differing deferral time periods. Which of the following doses not match?
Feldene- 7 days
955
_______ testing is performed on platelet apheresis products to make sure that HIV, WNV, and hepatitis c are not present
Nucleic acid
956
Plasmapheresis is synonymous with what term?
Plasmas exhange
957
Erythrocytapheresis is successful in which of the following conditions?
Malaria
958
What is the primary anticoagulant used in pheresis procedures
Citrate
959
What variables are necessary to calculate the donors total blood volume ?
All of the above
960
Fatalities that result from therapeutic aphersis have primarily been caused by
Cardiac arrest and arrhythmia
961
Leukopheresis may be indicated when the WBC count exceeds
100,000 per uL
962
Which apheresis method carries the additional risk of retuning RBCs to the worn individual and yielding the smallest volume of selected blood component/?
Manual aphersis
963
Which immunoadsorbent has an affinity for IgG classes 1, 2 and 4 and their immune complexes?
Staphylococcal protein A
964
What can be done to prevent the development of HLA alloimmunization and platelet refractoriness?
Ruched the number of leukocytes in the platelet product
965
Which of the following is not indication for plasmapheresis ?
To decrease iron deposition in tissues in chronically transfused patients
966
All of the following constitute variables of apheresis procedures except
Blood type
967
What is therapeutic plasmapheresis?
The removal of large volumes of patient plasma
968
The hematopoietic progenitor cells that eventually repopulate the bone marrow and also circulate in the blood are called
Peripheral blood stem cells
969
A person participating in a serial aphersis program would not
Lose more than 25 ml of RBCs per week
970
How is HES used in apheresis production
As a sedimenting against to separate WBCs from RBCs
971
While undergoing plasmapheresis, the donor experienced numbness around his mouth which is indicative of citrate toxicity. How can this be treated?
Administrating exogenous calcium
972
The concentrate obtained from plateletpheresis via a closed system is store for 5 days at room temperature. What must the pH be at the end of storage?
> = 6.0
973
When is isolation of PBSCs via apheresis equipment indicated?
All of the above
974
The method in which a specific ligand is bound to an insoluble matrix in a column and plasma is perfused over the column with select removal pathogenic substance and return of patients plasma is known as
Immunoadsorption
975
Which of the following conditions would necessitate a plasmapheresis procedure
Barbiturate poisoning
976
During a plasmapheresis procedure, the RBCs must be returned within how many hours of phlebotomy?
2 hours
977
Citrate used as an anticoagulant in aphersis procedures is removed from the body by:
Being metabolized in the liver
978
What effect do steroids have on Leukopheresis?
Increase the vascular pool of granulocytes
979
Which patients are at the most risk for platelet refactoriness where they come alloimmunized to HLA antigens on platelets?
Leukemic patients
980
One unit of apheresed platelets should increase the platelet count ______
20,000-60,000 per uL
981
Compatibility testing is required for granulocyte concentration if the RBC contamination is greater than
5 mL
982
What does the Hct need to be (regardless of gender) for a double RBC collection?
40%
983
The removal of bile acids from patient plasma can be assisted through the use of the which adsorbent during plasmapheresis procedures?
Charcoal
984
The removal of endotoxins from patient plasma can be assisted through the use of which adsorbent during plasmapheresis procdures?
Polymyxin B
985
The removal of granulocytic cells from patient plasma can be assisted through the use of which adsorbent during plasmapheresis procdures?
Cellulose acetate
986
What is the purpose of washing the cells after the initial cell-serum incubation in the Amos-modified antibody screen procedure?
To remove aggregated immunoglobin in the serum
987
How is induction of tolerance achieved in kidney transplantation ?
Blood transfusion before transplant
988
How are the heavy chains of major histocompatibilty complex (MHC) classes I and II molecules transported into the cell membrane?
Heavy chains are inserted through the membrane via hydrophobic residues
989
Which of the following is a phenomenon in which an antiserum directed against one HLA determinant reacts with other HLA antigenic determinants?
Cross reactivity
990
HLA-DR typing requires a ______ suspension
B-lymphocyte
991
HLA testing is useful in what other area of study?
All of the above
992
All of the following disease have been associated with a significant HLA correlation except:
Fanconi’s anemia
993
Why is histocompatibility testing negated in both lung and heart transplants?
The cold ischemic time is too short
994
What is the most important step for increasing the number of bone marrow transplants performed?
Expand the donor pool to include both related and unrelated individuals
995
What is meant be the term public as applied to HLA antibodies?
Binding to epitopes shard by more than one HLA gene product
996
What is the definition of total ischemic time in heart transplantation?
The amount of time there is nit blood flow through the organ
997
The MHC class I region encodes for all of the following gene except:
HLA-DR
998
Which of the following is an example of linkage disequilibrium?
The actually occurrence of haplotype HLA-A1 and HLA-B8 is 8%; the expected occurrence based on gene frequencies is 2%
999
What does HLA stand for
Human leukocyte antigen
1000
Why are monoclonal antibodies able to detect a broad range of epitopes?
They are derived through xenoimmunization
1001
How is complement detected in HLA testing?
Uptake of trypan blue dye
1002
The majority of HLA alloantibodies are ________ immunoglobulins
IgG
1003
How is histocompatibility testing different from RBC testing?
None of the above
1004
The surface marker, or antigen, detected in histocompatibility testing of a single individual is referred to as HLA
Phenotype
1005
Which of the following is acceptable for cytotoxicity techniques
ACD
1006
What is the main purpose of crossmatching before transplantion ?
To identify antibody in the serum of the potential recipient to antigens present on donor tissues
1007
Recipient lymphocytotoxic HLA-antibody to donor antigens is associated with:
Haplotype
1008
The genetic region that contains surface antigens or receptors responsible for the recognition and elimination of foreign tissues is referred to as:
MHC
1009
How many targets are required for HLA antibody screening?
30
1010
How might platelet survival be improved in a patient receiving platelets despite a near perfect HLA match between recipient and donor?
Remove leukocytes from the donor unit
1011
In HLA testing, what is the purpose of mineral oil contained in the testing well?
To prevent evaporation of antisera during incubation
1012
Kidney transplant are used to treat which disease?
End-stage renal disease
1013
Which MHC region encodes for complement proteins?
Class III
1014
Between which two loci are recombination (crossing over) most likely to occur?
HLA-A and HLA-DP
1015
What does the R signify in the HLA-DR locus?
Subregion of D
1016
MHC class II molecules are expressed on all of the following except
Platelets
1017
A common technique used for HLA class II typing that involves amplification of specific DNA sequences for hybridization is called
PCR
1018
In testing for HLA-D antigens ______ typing cells of each phenotype are set up in an MLR as______ against the test cells.
Homozygous/stimulators
1019
What is most important pretransplant test performed on the recipient in a heart transplantion?
HLA-antibody screen
1020
How are monoclonal HLA antibodies (MoAbs) produced?
The fusion of HLA antibody, producing B cells with plasmacytoma lines
1021
Why are the T cells unacceptable for cytotoxicity testing using fluorescent labeling?
T cells lack immunoglobulin on their surface
1022
What kidney transplant strategy is satisfied through matching of the donor and recipient antigens?
Reduction of graft “foreigness
1023
A double lung transplant is indicated in which of the following disorders?
Cystic fibrosis
1024
A patient who has been presensitized to foreign HLA antigens will demonstrate _______if the donor tissue expresses the same antigens
Graft rejection
1025
The primary indication for pancreas transplantation is
Diabetes
1026
The HLA-A locus antigens A2, A23, A24, and A28 make up the
A2-CREG
1027
Which of the following specificities designates the HLA-C gene?
Cw
1028
Which of the following is NOT a rule for HLA nomenclature?
The allele group is designated by the fourth numeric field
1029
What is placed between the gene name and the numerical identified for the allele to differentiate between the gene nomenclature and HLA serologic reactivity?
Asterisk
1030
Which of these is NOT the purpose of the virtual crossmatch?
Eliminating the serologic testing process
1031
Which of these is not a concern in the virtual crossmatch?
The type of organ that is being transplanted
1032
True or false: patients who have presensitized to HLA antigens have a much higher graft Survival rate in liver transplantation than non sensitized patients
False
1033
True or false: the majority of cross-reactive alloantibodies detect HLA specificities of allelic molecules coded by the same locus
True
1034
How do internal assessments differ from compliance inspections?
Internal assessments are more frequent than compliance inspections
1035
Why might a laboratory adopt in individualized quality control plan (IQCP)?
To do all of these
1036
Employee training takes place
After hiring and after implementing new procedures
1037
What is the function of the quality committee or quality council?
To set priorities for quality improvements
1038
What is the main purpose of linking Current Good Manufacturing Practices (CGMPs) to process control?
To build quality into the manufacturing process from the beginning to the end
1039
A physician complains that she has not received, what measure is taken to determine equivalency?
Lot-to-lot testing of new and old numbers of reagent
1040
Which of the following is not regarded as an instrument?
Cuvette
1041
Which of the following might lead to unacceptable quality control results?
All of the above
1042
Which of the following is an example of an external customer?
A blood donor
1043
Which statement concerning compliance programs is false?
Programs are designed to evaluate effectiveness of blood bank laboratories
1044
A standard operating procdure (SOP) is:
A set of directions for how to perform a particular task
1045
What phase is synonymous with “quality management”?
Organization-wide quality assurance
1046
All of the following are transfusion service quality assurance indicators used to monitor patient care except
Number of therapeutic units drawn
1047
Which of the following statements concerning equipment is true?
Frequency of testing is determined by manufacturer recommendations
1048
Which continuous improvement cycle component ensures the finished product has met required specifications?
Assess
1049
As part of postemployment departmental training, a medical technologist was given 10 known blood samples to analyze for ABO specificity. This is referred to as
A competence assessment
1050
Process improvement teams address all of the following issues except
Filing a grievance
1051
Calibrating equipment prior to use is considered which function of quality?
Quality control
1052
Daily testing the reactivity of blood typing reagents is considered which function of quality?
Quality control
1053
Which of the following is not part of an individualized quality control plan (IQCP)?
New instrument validation
1054
Which of these need NOT be evaluated during a risk assessment?
Patient opinion survey
1055
Which of these should be evaluated during risk assessment?
All of these
1056
Quality assessment monitors include reviews of all of these except
Vendor management system
1057
A quality framework in the blood bank ensues all of the following except
Blood bank operation are customized to individual staff preferences
1058
Which of the following relationships is NOT considered a quality essential of an organization?
Blood ban, personnel links to their families
1059
Which of the following is NOT an internal customer for the transfusion service?
Patient receiving blood products
1060
Laboratory safety training must include which of these for blood bank personnel?
All of these
1061
Competency assessment for blood bank personnel includes all of these except
Cross-training into other areas of the laboratory
1062
Which of these records may reviewed during competency assessment for blood bank personnel?
All of these
1063
What is a flowchart?
A tool that displays all the elements involved in a process
1064
What is the purpose of a flowchart?
All of these
1065
Which of these does NOT describe a flowchart?
Is useless in obtaining better control of a process
1066
Testing all activities in a new process to ensure that the process will work in the live environment is a function of
Validation studies
1067
The use of different colored sera for blood bank reagents is an example of
Process control
1068
Which of these is part of process control ?
All of these
1069
An outcomes of performing procedures and testing is called a
Result
1070
Copies of regulations and accreditation requirements are examples of
Documents
1071
Examples of documents include
All of the above
1072
Examples of forms include
All of the above
1073
A good document control process does all of these except
Eliminates the need to document all changes or corrections to procedures
1074
Which of the following statements is true?
Remedial action does not uncover the real cause of the nonconformance
1075
An action taken to identify and eliminate the cause of nonconformance is what type of action?
Corrective
1076
An action taken to reduce or eliminate the potential for a nonconformance is what type of action?
Preventive
1077
The process of define, measure. Analyze, improve and control is known as which process?
Six sigma
1078
A Pareto chart is used at what stage of the DMAIC process
Define
1079
Using a SIPOC diagram occurs at what stage of DMAIC process?
Define
1080
Understanding the cause of and effect relationships occurs at what stage of the DMAIC process?
Analyze
1081
Using the DOE tool occurs as what stage of the DMAIC process?
Improve
1082
Ensuring that the implemented changes are sustained occurs at what stage of the DMAIC process?
Control
1083
The cost of good quality (COGQ) does NOT include which of these?
Nonconformance costs
1084
Conformance costs may include
All of these
1085
The cost incurred for calibration materials and reagents is an example of what type of cost?
Internal evaluation costs
1086
The cost incurred for proficiency testing and periodic licensure or accreditation inspections is what type of cost?
External evaluation costs
1087
Which of these costs is a cost of poor quality (COPQ)
Nonconformance costs
1088
The cost incurred when discarding donated blood units is an example of what type of cost?
Internal failure costs
1089
The cost incurred with customer product recalls is an example of what type of cost?
External failure cost
1090
Both the blood bank and the entire medical laboratory use which of the following?
All of these
1091
Many transfusion-transmitted acquired immunodeficiency syndrome (TTAIDS) lawsuits have been dismissed because of
Inability to prove negligence
1092
What is the meaning of tort reform?
Protecting of specialty practices from punitive or excessive awards by state legislatures
1093
What kind of cases stimulated state legislatures to enact protection for blood banks through so-called bood shield statues?
TTH
1094
What body of government is authorized to pass laws?
All of the above
1095
Why are physicians selected as the “respondent superior” in negligent cases?
Physicians give the order to transfuse
1096
Which of the following situations is grounds for a plaintiff claim under invasion of privacy?
All of the above
1097
What is the rationale surrounding the Doctrine of Charitable immunity??
Courts provide immunity from excess liability for nonprofit organizations
1098
Liability for negligence includes all of the following except`
Failure to meet the duty was indirectly responsible for harm suffered by injured party
1099
How does the doctrine of informed consent protect the donor?
By requiring that information be provided to the donor in a manner that he or she can understand and ask questions about, if so desired
1100
What would be the effect of redefining blood banking outside the realm of medical practice in litigation cases??
Expert medical testimony would not be needed to establish standard of care
1101
How is battery conceptualized in transfusion medicine ?
A donor claim never to have agreed to be stuck by a needle
1102
In regard to donor histories, the federal government has put an emphasis on______ in the hope of acquiring more descriptive information from persons who may be injected with HIV
Face-to-face oral questions
1103
What would be the plaintiffs claim for a case involving a donor or defendant who intentionally donated HIV-positive blood for transfusion purposes?
Wrongful death
1104
All of the following are emerging concerns of transfusion medicine except
Antibody testing procedures
1105
Blood banks are federally regulated which of the following?
FDA
1106
In transfusion services, who is liable for the actions of employees as determined by federal law?
Physician
1107
The _______ is an example of a voluntary standard, as related to transfusion Medicine
AABB standards
1108
Who determines the professional standard of care in a negligence lawsuits ?
Expert witnesses
1109
Plaintiffs have prevailed in TTAID multimillion-dollar medical malpractice suits against physicians for which of the following arguments?
The patient did not needs a transfusion based on clinical data
1110
Which of the following best describes strict liability?
Manufacturers are legally liable for all harm that occurs through use of a product
1111
Which of the following species of organisms are known to infect RBCs in storage?
All of the above
1112
What is the legal basis for lawsuits filed against as a result of transfusion?
Civil actions for tort and tort liability
1113
All of the following injuries from component collection maybe grounds for a civil suit except
A hematoma
1114
Vivian cases involving TTAIDS in the 1980s, when plaintiffs argued infected patients were insufficiently warned of the hazards of transfusion, were unsuccessful in their litigation efforts because
Scientific knowledge was limited, as stated by experts
1115
Lawsuits against blood collection agencies from improper donor screening can be ruled in favor of blood center if which of the following occurs?
Scientific knowledge was limited, as stated by experts
1116
Lawsuits against blood collection agencies for improper donor screening can be ruled in favor of the blood center if which of the following occurs?
All of these
1117
Lawsuits against blood collection agencies for improper donor screening can be ruled in favor of the plaintiff if which of the following occurs?
Any of these
1118
How must a standard operating procedure (SOP) be written in order to stand up against legal scrutiny?
All of these
1119
In the absence of federal law, what justification can provide precedence for future decisions
State
1120
Donors who were protected in the past from subpoena in cases of transfusion-transmitted diseases now may be questioned by the court. How might the donors identity be handled?
Any of these
