Midterm Practice Quiz Flashcards by Stacy Silver

What component is given to a TTP patient undergoing therapeutic apheresis?

CSP

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What component is given to a patient with fibrinogen deficiency?

CRYO/Fibryga

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What component is given to a patient with thrombocytopenia?

Platelets

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What component is given to a patient who is a neonate requiring a transfusion?

O Rh negative, irradiated units

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What component is given to a patient with hemophilia A?

Factor VIII Concentrate

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What component is given to a patient with sickle cell disease?

Rh and Kell Compatible RBCs

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What component is given to a patient who is IgA deficient with anti-IgA?

Washed red cells

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What component is given to a patient who is an Rh negative mother with an Rh-positive baby?

RhIg

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What component is given to a patient with octaplex/PCC?

Reversal of warfarin and apixaban

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What component is given to a patient with hemophilia B?

Factor IX

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What component is given for a paracentesis on a patient with liver disease?

Albumin

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What component is given to a patient with primary immune deficiency?

IVIG

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What component is given to a patient who needs volume replacement?

Crystalloids such as saline

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What component is given to a patient with needle stick injury?

Hepatitis B immunoglobulin

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What is the maximum allowable time used by the blood supplier to separate plasma from whole blood when preparing frozen plasma?

Within 24 hours

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Which of the following components is a source of fibrinogen?
a) Cryoprecipitate
b) Factor VII
c) Factor X
d) Intravenous immune globulin

a) Cryoprecipitate

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25% Albumin is indicated for:
a) Patients who would not tolerate a rapid increase of circulating blood volume
b) Patient with a history of allergic reaction to egg products
c) Large volume paracentesis
d) Hyper-albuminemia

c) Large volume paracentesis

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Intravenous immunoglobulin is produced by:
a) PCR amplification
b) Recombinant technology
c) Fractionation of pooled human plasma
d) Genetically purified bovine immunoglobulins

c) Fractionation of pooled human plasma

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What is the shelf life of thawed frozen plasma is stored at 1-6 degrees?

48 hours

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An example of a crystalloid solution used to treat hypovolemia is:
a) PPF
b) Albumin
c) Ringer’s lactate
d) HES solution

c) Ringer’s lactate

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Problems in routine testing caused by cold reactive autoantibodies can usually be resolved by all of the following except:
a) Prewarming
b) Washing with warm saline
c) Using anti-IgG antiglobulin serum
d) Testing clotted blood specimens

d) Testing clotted blood specimens

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Pathological cold auto-agglutinins differ from common cold agglutinins in:
a) Immunoglobulin class
b) Thermal amplitude
c) Antibody specificity
d) DAT results on EDTA specimens

b) Thermal amplitude

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Immune hemolytic anemias may be classified in which of the following categories?
a) Alloimmune
b) Autoimmune
c) Drug-induced
d) All of the above

d) All of the above

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Auto-adsorption procedures to remove either warm or cold autoantibodies should not be used with a recently transfused patient. Recently means:
a) 3 days
b) 3 weeks
c) 6 weeks
d) 3 months

d) 3 months

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With cold reactive autoantibodies, the protein coating the patient's cells and detected in the DAT is: a) C3 b) IgG c) C8 d) IgE

a) C3

The blood group involved in the autoantibody specificity in PCH is: a) ABO b) Lewis c) P d) MNS

c) P

What is the thermal range for normal cold autoantibodies?

Reactive ≤ 20° - 24° C

What is the thermal range for pathological cold autoantibodies?

Reactive ≥ 30° C

What is the titre at 4° C for normal cold autoantibodies?

≤ 64

What is the titre at 4° C for pathological cold autoantibodies?

≥ 1000

How is reactivity enhanced for normal cold autoantibodies?

Marginally enhanced with Albumin

How is reactivity enhanced for pathological cold autoantibodies?

Strongly enhanced with Albumin

What is the common specificity for normal cold autoantibodies?

Anti-I or Anti-IH

What is the common specificity for pathological cold autoantibodies?

Anti-I

Can normal cold autoantibodies bind complement?

Yes

Can pathological cold autoantibodies bind complement?

Yes

What is the DAT result for normal cold autoantibodies due to C3?

0-1+

What is the DAT result for pathological cold autoantibodies due to C3?

2-4+

Are normal cold autoantibodies clinically significant?

Are pathological cold autoantibodies clinically significant?

Yes

What is the optimal reaction temperature of cold AIHA?

<30 degrees

What is the optimal reaction temperature of warm AIHA?

>32 degrees

What is the immunoglobulin classification in cold AIHA?

IgM

What is the immunoglobulin classification in warm AIHA?

IgG

Is there complement activation in cold AIHA?

Yes

Is there complement activation in warm AIHA?

Not in all cases

What is the site of hemolysis in cold AIHA?

Extra or intravascular

What is the site of hemolysis in warm AIHA?

Usually extravascular

What is the frequency of cold AIHA and PCH?

It's 16% of AIHA cases, with PCH being 1-2%

What is the frequency of warm AIHA?

70-75% of AIHA cases

What is the specificity in cold AIHA?

The Li system and in PCH it's autoanti-P

What is the specificity in warm AIHA?

Frequent Rh specificity

Most cases of warm AIHA will be DAT positive with which of the following? a) Anti-IgG only b) Anti-C3d only c) Both anti-IgG and anti-C3d d) None of the above

a) Anti-IgG only

Which drug can cause the production of an autoantibody? a) Ibuprofen b) Isoniazid c) Methyldopa d) Tetracycline

c) Methyldopa

In warm AIHA, the autoantibody will frequently demonstrate _______-like specificity a) Fya b) K c) Rh d) Jkb

c) Rh

Which of the following characterizes an alloimmune response in immune hemolytic anemia? a) The patient produces an antibody reactive with her own RBCs b) The patient produces an antibody to a prescribed antibiotic c) The patient produces anti-K to transfused RBCs d) None of the above

c) The patient produces anti-K to transfused RBCs

In a patient who has been recently transfused, a positive DAT may be due to: a) Alloantibody coating patient cells b) Alloantibody coating transfused donor cells c) Antibodies to a drug coating donor cells d) None of the above

b) Alloantibody coating transfused donor cells

A patient with a warm reaction autoantibody needs 2 units of compatible, packed cells. Medical history reveals a blood transfusion 2 months ago. A homologous absorption is performed using the following red blood cell phenotype: R2R2, ss, Fy(a-b+), Jk(a+b-), kk. What alloantibody would remain in the serum after absorption? a) Anti-Jka b) Anti-E c) Anti-S d) Anti-Fyb

c) Anti-S

What is the indication and storage for divided (satellite packs)?

For neonates Store at 1-6 degrees for 42 days unless specified

What is the indication and storage for washed red blood cells?

For a patient with a history of severe reactions to components Store at 1-6 degrees and transfuse within 7 days or store at 20-24 degrees and transfuse within 4 hours

What is the indication and storage for extra washed RBCs?

For an IgA deficient recipient with anti-IgA Store at 1-6 degrees and transfuse within 7 days or store at 20-24 degrees and transfuse within 4 hours

What is the indication and storage for phenotypically matched RBCs for Rh and Kell?

For Sickle cell, thalassemia, and aplastic anemia patients Store at 1-6 degrees for 42 days unless specified

What is the indication and storage for leukocyte reduced RBCs?

No specific indication, this is the standard unit Store at 1-6 degrees for 42 days unless specified

What is the indication and storage for irradiated blood components?

For immunocompromised patients Store at 1-6 degrees for 14 days post irradiation or 28 days post collection

What is the indication and storage for deglycerolized (frozen/thaw) RBCs?

For rare or specific recipients Can be frozen for up to 10 years

Which of the following blood components should be used to prevent HLA alloimmunization of the recipient? a) RBCs b) Granulocytes c) Irradiated RBCs d) LR RBCs

c) Irradiated RBCs

During storage, the concentration of 2,3-DPG decreases in a unit of: a) Platelets b) Fresh Frozen Plasma c) RBCs d) Cryoprecipitate AHF

c) RBCs

If the seal is entered on a unit of RBCs stored at 1-6 degrees, what is the maximum allowable storage period in hours?

24 hours

Irradiation of a unit of RBCs is done to prevent the replication of donor: a) Plasma proteins b) Platelets c) Fibrinogen d) Lymphocytes

d) Lymphocytes

What should be done if a noticeable clot is found in an RBC unit?

Do not issue the unit

What component(s) is (are) indicated for patients who have anti-IgA antibodies? a) Whole Blood b) Packed Red Cells c) Washed Red Cells d) Granulocytes

c) Washed Red Cells