Overview of Modern Blood Bank Laboratory

Question 1

What facility is involved in the collection, storage, processing, and distribution of human blood and blood products for transfusion?

Answer 1

Blood Bank Laboratory

Question 2

Blood Bank laboratory regulating agency?

Answer 2

FDA (Food and Drug Administration)

Question 3

Blood bank laboratory accrediting organization?

Answer 3

AABB (American Association of Blood Banks)

Question 4

Whole blood allowed to cooled to room temperature can be used to prepare what component other than PRBCs?

Answer 4

random platelets

Question 5

Whole blood allowed to cool to 1-6 degreed C can be used to prepare what component other than PRBCs?

Answer 5

frozen plasma

Question 6

What is the most common method for collecting platelets?

Answer 6

apheresis

Question 7

Fresh frozen plasma must be prepared within how many hours of collection of a whole blood unit?

Answer 7

8 hours

Question 8

What blood component can be further manipulated to prepare cryoprecipitate?

Answer 8

fresh frozen plasma

Question 9

TRUE OR FALSE: Tests only need to be performed on a donor unit the first time a donor donates.

Answer 9

FALSE. Testing is done after every donation, even if the individual has donated before.

Question 10

When are blood component products officially labeled?

Answer 10

After all testing is complete and carefully reviewed

Question 11

What testing is done on a donor unit?

Answer 11

ABO/Rh
Ab Screen (on plasma products)
Viral Marker tests
Syphilis Test

Question 12

TRUE OR FALSE: When donor units are received from an outside source, testing is performed at the new facility to ensure that the results match the results on the donor unit label.

Answer 12

TRUE

Question 13

What testing needs to be reconfirmed when a donor unit is shipped to a new facility?

Answer 13

ABO/Rh

Question 14

Confirmatory testing is performed in which laboratory?

Answer 14

Main laboratory

Question 15

A minimum of how many identifiers is required for patient samples to be used for blood bank testing?

Answer 15

two identifiers

Question 16

Which two identifiers are required for blood bank sample testing?

Answer 16

Patient’s full name and date of birth (and/or medical record number)

Question 17

What is the purpose of cord blood studies?

Answer 17

If a Rh negative mother gives birth to a Rh positive baby, fetal-maternal hemorrhage testing is performed to determine how much of the baby’s blood the mother was exposed to.

Question 18

Name 5 types of routine testing a physician may order on a patient’s blood bank sample?

Answer 18

1. Type and Screen
2. Type and Crossmatch
3. Prenatal Evaluation
4. Postpartum evaluation
5. Cord blood studies

Question 19

What tests are performed when a physician orders a type and screen?

Answer 19

ABO/Rh typing and Antibody Screen

Question 20

What tests are performed when a physician orders a type and crossmatch?

Answer 20

ABO/Rh typing, Ab screen, and major crossmatch

Question 21

If a clinically significant antibody is found in a patient, what type of units must be administered to the patient?

Answer 21

corresponding antigen-negative units

Question 22

What tests are performed when a physician orders a prenatal evaluation?

Answer 22

ABO/Rh type the mother and Ab screen the mother for potential antibodies that may be implicated in HDFN

Question 23

Why are postpartum evaluations done?

Answer 23

Determine the Rh type of the mother.

If the mother is Rh negative and delivers and Rh positive baby, fetal-maternal hemorrhage testing is done.

Question 24

A fetal-maternal hemorrhage of what volume is considered significant?

Answer 24

> 30 mL whole blood

Question 25

What study is performed to determine a mother’s candidacy for RhIg?

Answer 25

Cord Blood Studies

Question 26

Women who have clinically significant antibodies and deliver a baby need to have what tests performed on the infant’s cord blood?

Answer 26

ABO/Rh typing and DAT

Question 27

Which laboratory is considered the problem solving section of the transfusion service?

Answer 27

Reference laboratory

Question 28

What information is beneficial when resolving discrepancies detected in routine testing?

Answer 28

Patient’s diagnosis, age, pregnancy, drug, and transfusion history

Question 29

The following testing methods can be used to resolve which type of discrepancies?

• Testing with A2 cells or anti-A2 lectin
• Room temperature antibody ID
• Adsorption, elution, and autoadsorption studies
• removal of RBC-bound cold autoantibodies
• Secretor studies

Answer 29

Inconsistencies between forward and reverse ABO group typing

Question 30

Which discrepancies can be resolved using the following:

• Rh phenotyping
• Adsorption and elution using Rh antisera
• isolation of cell populations
• Use of rare antisera and RBCs

Answer 30

Rh discrepancies

Question 31

A positive antibody screen with a negative DAT or autocontrol indicates possible…

Answer 31

alloantibody immunization

Question 32

What may be the result of an immune reaction to a drug, a disease state, or a delayed HTR?

Answer 32

Positive DAT

Question 33

Warm antibodies may mask the presence of what?

Answer 33

clinically significant antibodies

Question 34

What may cause ABO discrepancies, a positive DAT, and may mask clinically significant alloantibodies?

Answer 34

Cold autoantibodies

Question 35

Transfusion reactions must be investigated to determine if the reaction is…

Answer 35

antibody-mediated

Question 36

Initial studies for transfusion reactions include…

Answer 36

ABO/Rh, DAT, and visual inspection for hemolysis

Question 37

What regulation established personnel qualifications for laboratories performing certain types of testing?

Answer 37

CLIA ‘88, Subpart M

Question 38

What is the name of the manuals that outline the operations of the laboratory?

Answer 38

Standard Operating Procedures (SOPs)

Question 39

Details on how, when, and why particular procedures are done can be found where?

Answer 39

Standard operating Procedure (SOPs)