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Blood banking > Part 3 > Flashcards

Part 3 Flashcards

1
Q

What is the pathophysiological cause surrounding anaphylactic and anaphylactoid reactions?

A. Antibody in patient serum is detected 3-7 days after transfusion, and is attached to donor red blood cells

B. Donor plasma has reagins (IgE or IgA) that combine with allergens in patient plasma

C. Patient is deficient in IgE and develops IgE antibodies via sensitization from transfusion or pregnancy

D. Patient is deficient in IgA and develops IgA antibodies via sensitization from transfusion or pregnancy

A

D. Patient is deficient in IgA and develops IgA antibodies via sensitization from transfusion or pregnancy

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2
Q

A patient has a hemolytic reaction to blood transfused 8 days ago. What is the most likely cause?

A. Immediate, nonimmunologic probably due to volume overload

B. Delayed immunologic, probably due to an antibody such as anti-Jka

C. Delayed nonimmunologic, probably due to iron overload

D. Immediate, immunologic, probably due to clerical error, ABO incompatibility

A

B. Delayed immunologic, probably due to an antibody such as anti-Jka

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3
Q

What may be found in the serum of a person who is exhibiting signs of TRALI (transfusion-related acute lung injury)?

A. Red blood cell alloantibody

B. IgA antibody

C. Antileukocyte antibody

D. Allergen

A

C. Antileukocyte antibody

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4
Q

Which type of transfusion reaction occurs in about 1% of all transfusions, results in a temperature rise of 1°C or higher, is associated with blood component transfusion, and is not related to the patient’s medical condition?

A. Immediate hemolytic

B. Delayed hemolytic

C. Febrile nonhemolytic reaction

D. Transfusion-related acute lung injury

A

C. Febrile nonhemolytic reaction

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5
Q

What would be the result of group A blood given to an O patient?

A. Nonimmune transfusion reaction

B. Immediate hemolytic transfusion reaction

C. Delayed hemolytic transfusion reaction

D. Febrile nonhemolytic transfusion reaction

A

B. Immediate hemolytic transfusion reaction

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6
Q

Patient DB received 2 units of group A-positive red cells 2 days ago. Two days later, he developed a fever and appeared jaundiced. His blood type was A positive. A transfusion reaction workup was ordered. There were no clerical errors detected. A post-transfusion specimen was collected and a DAT performed. The DAT was positive with monospecific anti-IgG. The plasma was also hemolyzed. An antibody screen and panel studies revealed the presence of anti-Jkb (postspecimen). The antibody screen on the pretransfusion specimen was negative. Which of the following explain the positive DAT?

A. The donor cells had a positive DAT

B. The donor cells were polyagglutinable

C. The donor cells were likely positive for the Jkb antigen

D. The recipient cells were likely positive for the Jkb antigen

A

C. The donor cells were likely positive for the Jkb antigen

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7
Q

All of the following are part of the preliminary evaluation of a transfusion reaction, except:

A. Check pre- and post-transfusion samples for color of serum

B. Perform ABO and Rh recheck

C. DAT on the post-transfusion sample

D. Panel on pre- and post-transfusion samples

A

D. Panel on pre- and post-transfusion samples

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8
Q

A 68-year-old female diagnosed with neutropenia and inflammation of the left hand was typed as A positive, and received 1 packed red blood cell unit. The antibody screen was negative and crossmatch was compatible. During the transfusion, her pulse was 94, and blood pressure rose from 114\59 to 132\64. Her temperature rose from 37.1°C pretransfusion to 37.8°C 60 minutes after starting transfusion, then to 38.1°C upon completion. A post-transfusion specimen yielded plasma that was neither hemolyzed nor icteric, and a negative DAT. Post-transfusion urinalysis gave a 1+ blood and protein with 10 RBCs\hpf microscopically. The clerical check was acceptable. What type of reaction most likely occurred as a result of transfusion?

A. Allergic

B. Circulatory overload

C. Febrile nonhemolytic

D. Delayed hemolytic

A

C. Febrile nonhemolytic

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9
Q

A 92-year-old male diagnosed with anemia and episodes of frequent falling was typed as B negative and transfused 1 unit of packed red blood cells, also B negative. He was not recently transfused, and the antibody screen was negative. During the transfusion, his temperature rose from 36.2°C to 36.4°C, his pulse rose from 96 to 124, respirations from 18 to 20, and BP from 127\81 to 174\83. He was transfused with 205 mL before a reaction was called by the transfusionist. The postspecimen DAT was negative and clerical check acceptable. Urinalysis yielded 1+ blood with 5 RBCs microscopically. Other symptoms included tachycardia and flushing. What reaction had most likely taken place?

A. Febrile nonhemolytic

B. Acute hemolytic

C. Anaphylactic

D. Volume overload

A

D. Volume overload

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10
Q

A 76-year-old female diagnosed with urosepsis was transfused 2 units of packed red blood cells. Her type was AB positive with a negative antibody screen. The units transfused were AB positive. Upon receiving the second unit, the patient became hypoxic with tachypnea. The clerical check was acceptable and DAT negative. She received 269 mL from the second unit before a reaction was called. Her temperature fell from 38°C to 36.4°C, her pulse increased from 72 to 90, and respirations rose from 35 to 41. Her BP was 110\70. The patient expired approximately 12 hours from the time the reaction was called. What type of reaction was most likely present?

A. Febrile

B. Symptoms not related to transfusion

C. Allergic

D. TRALI

A

B. Symptoms not related to transfusion

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11
Q

A 52-year-old male received 2 units of packed red blood cells as an outpatient in the IV therapy unit. He had a 20-year history of head trauma and was quadriplegic. He had recurrent pneumonia and hematuria due to removal of a Foley catheter. His blood type was A positive with a previously identified anti-Fya. There was an ABO discrepancy in that the A1 cells were positive. The technologist attributed the reaction to the Fya antigen being present on the A1 cells. The patient also had a cold autoantibody. Two units of A-positive packed cells were crossmatched that were Fya negative, and were compatible. One unit was transfused at 11:30 a.m. without incident. The second unit was transfused at 2:16 p.m., and stopped at 3:55 p.m. due to reddish brown-tinged urine discovered in his collection bag. A post-transfusion specimen yielded a positive DAT, and plasma that was grossly hemolyzed. A prewarm crossmatch was incompatible in both the pre- and postspecimen. Anti-E and c were present in the postspecimen. What reaction was most likely present?

A. Acute hemolytic
B. Febrile
C. Allergic
D. TRALI

A

A. Acute hemolytic

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12
Q

A male cancer patient with a hemoglobin of 6 g\dL was admitted to the hospital with acute abdominal pain. Small bowel resection was indicated, but the attending physician wanted to raise the patient’s hemoglobin to 12 g\dL before surgery. How many units of RBCs would most likely be required to accomplish this?

A. 2

B. 3

C. 6

D. 8

A

C. 6

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13
Q

Which of the following is not a viable method for removing leukocytes from red blood cells?

A. Prestorage filtration

B. Bedside filtration

C. Poststorage filtration

D. Buffy coat removal

A

D. Buffy coat removal

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14
Q

Four units of packed RBCs were brought to the nurses’ station at 10:20 a.m. Two units were transfused immediately, and 1 unit was transfused at 10:40 a.m. The remaining unit was returned to the blood bank at 11:00 a.m. The units were not refrigerated after leaving the blood bank. What problem(s) is (are) present in this situation?

A. The only problem is with the returned unit; the 30-minute limit has expired and the unit cannot be used

B. The unit should not have been transfused at 10:40 a.m. because the time limit had expired; this unit and the remaining unit should have been returned to the blood bank

C. The returned unit may be held for this patient for 48 hours but cannot be used for another patient

D. No problems; all actions were performed within the allowable time limits

A

A. The only problem is with the returned unit; the 30-minute limit has expired and the unit cannot be used

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15
Q

A unit of whole blood is collected at 10:00 a.m. and stored at 20°C-24°C. What is the last hour platelet concentrates may be made from this unit?

A. 4:00 p.m.

B. 6:00 p.m.

C. 7:00 p.m.

D. 8:00 p.m.

A

B. 6:00 p.m.

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16
Q

Which of the following is acceptable according to AABB standards?

A. Rejuvenated RBCs may be made within 3 days of outdate and transfused or frozen within 24 hours of rejuvenation

B. Frozen RBCs must be prepared within 30 minutes of collection and may be used within 10 years

C. Irradiated RBCs must be treated within 8 hours of collection and transfused within 6 hours

D. Leukocyte-reduced RBCs must be prepared within 6 hours of collection and transfused within 6 hours of preparation

A

A. Rejuvenated RBCs may be made within 3 days of outdate and transfused or frozen within 24 hours of rejuvenation

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17
Q

Which of the following is true regarding apheresis platelets?

A. The minimum platelet count must be 3.0 × 1011, pH must be ≥6.0

B. The minimum platelet count must be 3.0 × 1010, pH must be ≤6.2

C. The minimum platelet count must be 3.0 × 1011, pH must be ≥6.2

D. The minimum platelet count must be 5.5 × 1010, pH must be ≤6.0

A

C. The minimum platelet count must be 3.0 × 1011, pH must be ≥6.2

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18
Q

What is the component of choice for a patient with chronic granulomatous disease (CGD)?

A. FFP

B. Granulocytes

C. Cryoprecipitate

D. RBCs

A

B. Granulocytes

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19
Q

What method can be employed to detect bacteria in random donor platelets?

A. pH

B. Glucose

C. Pan genera detection (PGD) assay

D. Gram stain

A

C. Pan genera detection (PGD) assay

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20
Q

All of the following statements regarding FFP are true, except:

A. FFP must be prepared within 24 hours of collection

B. After thawing, FFP must be transfused within 24 hours

C. Storage temperature for FFP with a 1-year shelf life is ≤−18°C

D. When thawed, FFP must be stored between 1°C-6°C

A

A. FFP must be prepared within 24 hours of collection

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21
Q

What may be done to RBCs before transfusion to a patient with cold agglutinin disease in order to reduce the possibility of a transfusion reaction?

A. Irradiate to prevent graft-versus-host-disease (GVHD)

B. Wash with 0.9% percent saline

C. Warm to 37°C with a blood warmer

D. Transport so that temperature is maintained at 20°C-24°C

A

C. Warm to 37°C with a blood warmer

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22
Q

A unit of packed RBCs is split using the open system. One of the half units is used. What may be done with the second half unit?

A. Must be issued within 24 hours

B. Must be issued within 48 hours

C. Must be irradiated

D. Must retain the original expiration date

A

A. Must be issued within 24 hours

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23
Q

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

A. Issue the unit; the blood will be filtered

B. Issue the unit; note the presence of a clot on the release form

C. Filter the unit in the blood bank before issue

D. Do not issue the unit

A

D. Do not issue the unit

24
Q

Cryoprecipitate may be used to treat all of the following, except:

A. von Willebrand’s disease

B. Hypofibrinogenemia

C. Idiopathic thrombocytopenic purpura (ITP)

D. Factor XIII deficiency

A

C. Idiopathic thrombocytopenic purpura (ITP)

25
Q

SITUATION: A transplant patient may receive only type A or AB platelets. There are only type O apheresis platelets available. What devices may be used to deplete the incompatible plasma and replace with sterile saline?

A. Cytospin\irradiator

B. Water bath\centrifuge

C. Centrifuge\sterile connecting device

D. Cell washer\heat sealer

A

C. Centrifuge\sterile connecting device

26
Q

What component(s) is (are) indicated for patients who have anti-IgA antibodies?

A. Whole blood

B. Packed RBCs

C. Washed or deglycerolized RBCs

D. Granulocytes

A

C. Washed or deglycerolized RBCs

27
Q

FFP can be transfused without regard for:

A. ABO type

B. Rh type

C. Antibody in product

D. All of these options

A

B. Rh type

28
Q

All of the following are true regarding washed RBCs, except:

A. RBCs are washed with 1-2 L of normal saline

B. Volume is 180 mL

C. Shelf life is extended

D. Leukocytes are removed

A

C. Shelf life is extended

29
Q

What is a special condition for the storage of platelets?

A. Room temperature, 20°C-24°C

B. No other components may be stored with platelets

C. Platelets must be stored upright in separate containers

D. Platelets require constant agitation at 20°C-24°C

A

D. Platelets require constant agitation at 20°C-24°C

30
Q

Transfusion of an irradiated product is indicated in all of the following conditions except:

A. Exchange transfusion

B. Bone marrow transplant

C. Severe combined immunodeficiency syndrome (SCIDS)

D. Warm autoimmune hemolytic anemia (WAIHA)

A

D. Warm autoimmune hemolytic anemia (WAIHA)

31
Q

What percentage of red cells must be retained in leukocyte-reduced red cells?

A. 75%

B. 80%

C. 85%

D. 100%

A

C. 85%

32
Q

Which of the following is true regarding granulocyte concentrates?

A. The product must contain a maximum of 1.0 × 1010 granulocytes

B. The pH must be 6.0

C. The product must be crossmatched

D. The product must be irradiated

A

C. The product must be crossmatched

33
Q

What course of action should be taken if a medical laboratory scientist inadvertently irradiates a unit of red cells twice?

A. Issue the unit

B. Discard the unit

C. Change the expiration date; then issue the unit

D. Note on the irradiation sticker that the unit was irradiated twice and issue

A

B. Discard the unit

34
Q

What components(s) may be shipped together with FFP?

A. Frozen RBCs and cryoprecipitate

B. Platelets

C. Packed RBCs and granulocytes

D. Double red cell

A

A. Frozen RBCs and cryoprecipitate

35
Q

A blood supplier ships 3 units of pooled cryoprecipitate. Each pool consists of 5 units of cryoprecipitate. If one unit is thawed at 5:00 p.m., when must it be dispensed from the blood bank?

A. Before 9:00 p.m.

B. Before 11:00 p.m.

C. Before 12:00 a.m.

D. Before 5:00 p.m. the next day

A

A. Before 9:00 p.m.

36
Q

How does irradiation prevent transfusion associated graft-versus-host disease (TA-GVHD)?

A. Gamma rays and x-rays destroy the lymphocytes’ ability to divide

B. X-rays cause lysis of the lymphocytes

C. Gamma rays enhance lymphocyte reactivity

D. Ultraviolet radiation induces apoptosis of lymphocytes

A

A. Gamma rays and x-rays destroy the lymphocytes’ ability to divide

37
Q

Which component has the longest expiration date?

A. Cryoprecipitate

B. FFP

C. Frozen RBCs

D. Platelet concentrates

A

C. Frozen RBCs

38
Q

All of the following are advantages of using single-donor platelets as opposed to random donorplatelets, except:

A. Less preparation time

B. Less antigen exposure for patients

C. May be HLA matched

D. No pooling is required

A

A. Less preparation time

39
Q

What is the expiration of cryoprecipitate once pooled?

A. 4 hours

B. 6 hours

C. 8 hours

D. 24 hours

A

A. 4 hours

40
Q

What is the number of white blood cells permitted in a unit of leukoreduced red cells?

A. <5 × 1010

B. <5 × 106

C. <8.3 × 105

D. <8.3 × 106

A

B. <5 × 106

41
Q

SITUATION: A cancer patient recently developed a severe infection. The patient’s hemoglobin is 8 g\dL owing to chemotherapy with a drug known to cause bone marrow depression and immunodeficiency. Which blood products are indicated for this patient?

A. Liquid plasma and cryoprecipitate

B. Crossmatched platelets and washed RBCs

C. Factor IX concentrates and FFP

D. Irradiated RBCs, platelets, and granulocytes

A

D. Irradiated RBCs, platelets, and granulocytes

42
Q

Which of the following individuals is acceptable as a blood donor?

A. A 29-year-old man who received the hepatitis B vaccine last week

B. A 21-year-old woman who had her nose pierced last week

C. A 30-year-old man who lived in Zambia for 3 years and returned last month

D. A 54-year-old man who tested positive for hepatitis C last year, but has no active symptoms of disease

A

A. A 29-year-old man who received the hepatitis B vaccine last week

43
Q

SITUATION: A 53-year-old woman donates blood at her place of employment. She weighs 150 lb and has a hemoglobin of 13 g\dL. She is currently on warfarin and vitamin B12. Is she an acceptable donor?

A. Yes

B. No, she is on warfarin

C. Yes, for red cells only

D. No, her hemoglobin is too low

A

C. Yes, for red cells only

44
Q

Which immunization has the longest deferral period?

A. HBIG

B. Rubella vaccine

C. Influenza vaccine

D. Yellow fever vaccine

A

A. HBIG

45
Q

The following whole blood donors regularly give blood. Which donor may donate on September 10th?

A. A 40-year-old woman who last donated on July 23rd

B. A 28-year-old man who had plateletpheresis on August 24th

C. A 52-year-old man who made an autologous donation 2 days ago

D. A 23-year-old woman who donated blood for her aunt on August 14th

A

B. A 28-year-old man who had plateletpheresis on August 24th

46
Q

Which of the following precludes acceptance of a plateletpheresis donor?

A. Platelet count of 75 × 109\L in a donor who is a frequent platelet donor

B. Plasma loss of 800 mL from plasmapheresis 1 week ago

C. Plateletpheresis performed 4 days ago

D. Aspirin ingested 7 days ago

A

A. Platelet count of 75 × 109\L in a donor who is a frequent platelet donor

47
Q

Which of the following donors could be accepted for whole-blood donation?

A. A construction worker who was incarcerated for opiate abuse

B. A triathlete with a pulse of 45

C. A man who is currently taking finasteride (Propecia)

D. A woman in her 14th week of pregnancy

A

B. A triathlete with a pulse of 45

48
Q

Which physical examination result is cause for rejecting a whole-blood donor?

A. Weight of 105 lb

B. Pulse of 75

C. Temperature of 99.3° F

D. Diastolic pressure of 110 mm Hg

A

D. Diastolic pressure of 110 mm Hg

49
Q

Which situation is not a cause for indefinite deferral of a donor?

A. Male currently on dutasteride (Avodart)

B. Donation of a unit of blood that transmitted hepatitis B virus to a recipient

C. History of Creutzfeldt-Jacob disease

D. Accidental needle stick 1 year ago; negative for infectious disease

A

D. Accidental needle stick 1 year ago; negative for infectious disease

50
Q

A whole-blood donor currently on clopidogrel (Plavix) is precluded from donating which

product?

A. Platelets

B. Red blood cells

C. FFP

D. Cryoprecipitate

A

A. Platelets

51
Q

How much anticoagulant would have to be removed from the collection bag given a donor who weighs 90 lb?

A. 12 mL

B. 15 mL

C. 20 mL

D. 23 mL

A

A. 12 mL

52
Q

A woman begins to breathe rapidly while donating blood. Choose the correct course of action.

A. Continue the donation; rapid breathing is not a reason to discontinue a donation

B. Withdraw the needle, raise her feet, and administer ammonia

C. Discontinue the donation and provide a paper bag

D. Tell her to sit upright and apply a cold compress to her forehead

A

C. Discontinue the donation and provide a paper bag

53
Q

A donor bag is half filled during donation when the blood flow stops. Select the correct course of action.

A. Closely observe the bag for at least 3 minutes; if blood flow does not resume, withdraw the needle

B. Remove the needle immediately and discontinue the donation

C. Check and reposition the needle if necessary; if blood flow does not resume, withdraw the needle

D. Withdraw the needle and perform a second venipuncture in the other arm

A

C. Check and reposition the needle if necessary; if blood flow does not resume, withdraw the needle

54
Q

Who is the best candidate for a predeposit autologous donation?

A. A 45-year-old man who is having elective surgery in 2 weeks; he has alloanti-k

B. A 23-year-old female leukemia patient with a hemoglobin of 10 g\dL

C. A 12-year-old boy who has hemophilia

D. A 53-year-old woman who has septicemia

A

A. A 45-year-old man who is having elective surgery in 2 weeks; he has alloanti-k

55
Q

Can an autologous donor donate blood on Monday, if he is having surgery on Friday?

A. Yes, he or she can donate up to 72 hours before surgery

B. No, he or she cannot donate within 7 days of surgery

C. Yes, he or she can donate, but only a half a unit

D. No, he or she cannot donate within 5 days of surgery

A

A. Yes, he or she can donate up to 72 hours before surgery

56
Q

Which of the following is an acceptable time in which a unit of whole blood is collected?

A. 33 minutes

B. 25 minutes

C. 20 minutes

D. 13 minutes

A

D. 13 minutes

Blood banking (4 decks)

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