Unit 3 Review Flashcards

1
Q

If a prospective blood donor has participated in a pheresis donation (platelets, plasma, granulocytes), atleast how much time must pass before he or she can donate whole blood?

A

48 hours

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2
Q

A whole blood donor who has taken Tegison should be:

A

Permanently deferred

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3
Q

What is the deferral period for a donor who has received a live attenuated vaccine for rubella?

A

4 weeks

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4
Q

A women 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 meets all the other criteria for donation, is she allowed to donate at this time?

A

No, she needs to wait 6 more months

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5
Q

A patient who recently stopped taking clopidogrel (plavix) needs to donate platelets. How long must the patient defer donation after completing the medication?

A

14 days

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6
Q

What is the minimum hemoglobin level for a potential allogeneic donor?

A

12.5 g/dL

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7
Q

What is the minimum hemoglobin level for a potential autologous donor?

A

11 g/dL

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8
Q

Which of the following is the only pheresis procedure that requires administration of a growth factor to the donor?

A

Leukopheresis

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9
Q

A blood donor with a history of hepatitis B should be excluded:

A

Permanently

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10
Q

An autologous unit should be donated what time period prior to the patients surgery/need?

A

72 hours

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11
Q

The following blood donors regularly give blood. Which donor may donate on September 11th?

A

A 28 year old man who had plateletphersis on August 24th

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12
Q

How many times can a person meeting all the optimal criteria donate an apheresis unit of platelets per year?

A

24 times

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13
Q

A world traveler came in to do a directed donation for his sister when he found out she needed surgery for her hip? After spending 5 weeks in Europe, he traveled extensively throughout Africa. How should his case be handled?

A

He would not be able to donate, because all directed donors must meet the same criteria as allogenic donors

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14
Q

Autologous blood donations may occur as:

A
  • all of the above
  • preoperative collection
  • intraoperative collection
  • postoperative collection
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15
Q

Who is NOT included in the documentation process in the decision to use preoperative analogous blood?

A

Blood bank staff

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16
Q

What is the last time a patient can donate for an autologous unit before surgery?

A

3 days before the scheduled surgery

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17
Q

Which of the following tests is optional for the collection facility for an autologous donation?

A

Antibody screen

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18
Q

Which of the following tests is not optimal for the transfusing facility for an autologous donation?

A

Group and type

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19
Q

There is a decreased risk of each these when using autologous donations except:

A

Bacterial contamination

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20
Q

For which of the following cases would intraoperative autologous collection NOT be contraindicated?

A

Cardiac surgery where there is no risk of contamination with clotting agents

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21
Q

Blood product collections and component manufacturing, but not donor selection, is regulated by the:

A

CBER

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22
Q

Which of the following accredits blood banks?

A

CAP

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23
Q

A blood transfusion service is scheduled for an inspection. Which of the following agencies may be conducting the inspection?

A
  • Any of these
  • AABB
  • CAP
  • FDA
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24
Q

Which of the following statement is true regarding directed donations?

A

Directed donations may need irradiation to prevent GVHD

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25
Q

Which of the following serologic tests is required for directed donations?

A
  • All of these
  • HepB
  • HIV
  • FTA
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26
Q

Donor arm preparation must be repeated if which of the following occurs?

A
  • All of these occurrences
  • the donor bends the arm
  • the prepared site is touched with the fingers
  • a nonsterile object comes in contact with the prepared site
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27
Q

When should mixing of the blood bag be performed?

A

Periodically during collection

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28
Q

How are pilot tubes for donor serologic testing collected?

A
  • blood is collected from tubing connected to a needle in the donor’s arm
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29
Q

Nausea, twitching, and muscle spasm during blood donations are categorized as:

A

Mild reactions

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30
Q

Which of the following may be a sign of a potential fainting event?

A

*All of these
- sweating
- dizziness
- Pallor

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31
Q

A donor has fainted during blood collection. Which of the following is not an appropriate action?

A

Place warm compresses on the donors forehead

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32
Q

In addition to signs during a mild reaction to blood donation, a moderate reaction includes which of the following?

A

Loss of consciousness

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33
Q

Convulsions may occur during blood donation as a result of:

A

*Any of these
- cerebral ischemia
- epilepsy
- marked hyperventilation

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34
Q

Ensuring the presence of an adequate airway is most important in which type of blood donation reaction?

A

Severe reactions

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35
Q

Which statement concerning a hematoma is true?

A

A hemotoma is a localized collection of blood under the skin

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36
Q

Treating an occurrence of hematoma development during blood donation involves:

A

Removing the tourniquet and needle from donors arm

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37
Q

A 4-week deferral is required of donors exposed to which of these organisms?

A

Zika

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38
Q

An 8-week deferral is required of donors exposed to which of these organisms?

A

Ebola

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39
Q

A donor exposed to which of these organisms may be able to donate in as soon as 2 weeks?

A

Babesia

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40
Q

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 host?

A

Birds

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41
Q

Which is the most economical way to test for West Nile Virus?

A

MP-NAT with follow up by ID-NAT on positives

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42
Q

A donor who was repeatedly reactive with anti-HBc may be considered for re-entry if after 8 weeks if which of these tests are negative?

A
  • All of these
  • HBsAg
  • anti-HBc
  • HBV NAT
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43
Q

Prions are:

A

Spongiform organisms that resist deactivation

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44
Q

Donors must be screened for which virus that causes a neurological disorder for myelopathy?

A

HTLV

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45
Q

Donors must be screened for which virus that causes a neurological disorder of myelopathy?

A

HTLV

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46
Q

How long is the donation deferral for persons who visit malaria-endemic countries?

A

3 years

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47
Q

Which of these countries is NOT a malaria-endemic country?

A

Austria

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48
Q

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?

A

Indefinitely

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49
Q

A 25 year old patient who had travelled to Ireland in the last year has been experiencing neurological abnormalties since returning to the U.S. several months ago. Which of the following is most likely?

A
  • variant Creutzfeldt-Jakob disease with an accumulation of prion proteins
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50
Q

A 75 year old patient who had recently undergone a cornea transplant 6 months ago is suddenly experiencing neurological abnormalities. Which of the following is most likely?

A

Creutzfeldt-Jakob disease with no accumulation of prion proteins

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51
Q

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?

A

Anti-p24 and anti-gp41

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52
Q

The cytomegalovirus and Epstein-Barr virus belong to which family viruses?

A

Herpesviridae

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53
Q

American Association of Blood Bank (AABB) Standards mandate the donor of blood or a component given to a recipient who develops clinical or laboratory evidence of transfusion-associated hepatitis (TAH), HIV infection, or HTLV-I/II infection must be permanently deferred if the unit was:

A

The only unit transfused

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54
Q

The hepatitis C virus is thought to be included in which family?

A

Flaviviridae

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55
Q

HIV belongs to which family

A

Retroviridae

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56
Q

Why is transmission of cytomegalovirus (CMV) through blood components not a significant risk to most recipients?

A

most recipients are CMV-positive

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57
Q

How is the hepatitis A virus usually spread?

A

Oral-fecal route

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58
Q

A blood donors serological tests were reactive for HIV-1/2 antibodies. The test was repeated, and both were reactive. A Western blot confirmatory test was done and was negative. What is the protocol for this donor?

A

Unit is discarded

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59
Q

This disease can be transmitted through blood transfusion and is characterized by sponge-like lesions of the brain:

A

Creutzfeldt-Jakob disease

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60
Q

According to the Centers for Disease (CDC), and HIV-position person is considered to have AIDS according to what criterion?

A

Fewer than 200 CD4+ T cells per uL

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61
Q

Which two infections agents share the same vector?

A

Babesia and Borrelia

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62
Q

HBsAg is what part of the hepatitis B virus?

A

Coat protein

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63
Q

Which of the following parasites has not been associated with transmission via blood transfusion?

A

None of the above

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64
Q

In the HIV-I virus _______ is a core protein

A

P24

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65
Q

What is the causative agent for Rocky Mountain spotted fever?

A

Rickettsia Rickettsii

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66
Q

The hepatitis B virus belongs to which family?

A

Hepadnaviridae

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67
Q

Which test can reveal an asymptomatic patient with TAH?

A

ALT

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68
Q

What is treatment is recommended for chronic liver disease due to hepatitis C virus infection?

A

Alpha interferon

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69
Q

Which test for HIV infection depends on amplification of HIV integrated in the DNA of infected cells?

A

PCR
Polymerase chain reaction

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70
Q

What is the incubation period of hepatitis A virus in transfusion-associated hepatitis?

A

40-60 days

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71
Q

The hepatitis A virus belongs to which family of viruses?

A

Picornarviridae

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72
Q

Persons infected with the hepatitis C may develop what disease?

A

*All of the above
- chronic liver disease
- cirrhosis
- Hepatocellular carcinoma

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73
Q

Which of the following findings is not part of the typical pattern of hepatitis A infection?

A

Elevated ALT

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74
Q

The most sensitive test for the detection of HIV infection is the:

A

Polymerase chain reaction (PCR)

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75
Q

Which of the following findings is not part of the typical pattern of hepatitis A infection?

A

Elevated ALT

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76
Q

The most sensitive test for the detection of HIV infection is the:

A

Polymerase chain reaction (PCR)

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77
Q

Why are donors deferred for 6 months following receipt of blood products?

A

To permit adequate screening for transfusion-acquired viral infections

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78
Q

Which of the following statements regarding the Western Blot confirmation test for HIV infection is false?

A

Interpretation of test depends on upon degree of immunofluorescence

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79
Q

What marker usually is not detected when the hepatitis B-infected patient enters the convalescent phase?

A

HBeAg

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80
Q

Which of the following is indicated when a recipient of blood or blood components develops a viral disease?

A

Donor look back

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81
Q

Which of the following patients would at a greater risk for CMV infection?

A

An allogenic bone marrow transplant recipient

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82
Q

How can hepatitis A infection be prevented?

A

Superinfection by hepatitis D virus (HDV)

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83
Q

Which cell is invaded by the HIV viruses?

A

Lymphocyte

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84
Q

What is the course of hepatitis B immune globulin (HBIG)?

A

Persons with a high titer of anti-HBs

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85
Q

The “look-back” process includes notifying donors of abnormality with:

A

*All of the above
- predonation evaluation
- laboratory testing
- recipient follow-up

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86
Q

Which of the following in not included in the signs of symptoms of TAH?

A

Splenomegaly

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87
Q

In an individual infected with hepatitis B virus, which of the following is detected first?

A

HBsAg

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88
Q

Which statement regarding HDV is true?

A

HDV can occur simultaneously with hepatitis B virus

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89
Q

Pathogen inactivation intervention includes all of the except:

A

Millipore filtration

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90
Q

A single donor tested positive for HIV-1 via enzyme immunoassay screening techniques. The blood was retested and found to be nonreactive. What is the status of the donor whole blood unit?

A

Blood and components are okay for use

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91
Q

Which test is now used in the processing of all source plasmas for pathogen inactivation verification?

A

NAT

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92
Q

Lipid-enveloped viruses are inactivated by use of:

A

Detergents

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93
Q

The current risk of enveloped virus transmission is very low because of:

A
  • A combination of all of the above
  • heat treatment
  • detergent treatment
  • nanofiltration methods
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94
Q

Pathogen inactivation using psoralen activated by ultraviolet light is most effective in:

A

Platelet concentrates

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95
Q

Pathogen reduction systems may not be effective against which agents?

A

Prions

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96
Q

True or false? A person with acute hepatitis B infection is immune to infection from other hepatitis viruses

A

False

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97
Q

A whole blood donation contains a volume of 350 mL Which of the following is true regarding this unit?

A

FFP cannot be made from this unit

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98
Q

A unit of RBCs has an 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 postirradiation?

A

11/15/12

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99
Q

Packed RBCs must have a final hematocrit of less than or equal to:

A

80%

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100
Q

Leukoreduced packed RBCs must have an absolute WBC count of less than and contain at least what percent of original RBC mass?

A

5 x 10^8/80

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101
Q

All of the following statements are characteristic of a penetration cryoprotective agent except:

A

Osmotic fever prevents migration of water outside of the cell, preventing dehydration

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102
Q

What is the minimal pH required for platelets?

A

6.2

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103
Q

Cryoprecipitate is indicated for all of the following disorders except:

A

Hemophilia B

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104
Q

What does of RhIG would be appropriate for a D-negative woman who has had a miscarriage at 11 weeks gestation?

A

50 ug

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105
Q

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?

A

50,000/uL

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106
Q

What is the expiration time for platelet concentrates that have been pooled?

A

4 hours

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107
Q

Which of the following are approved preservative solutions for blood storage at 1-6C for 21 days?

A

*All of the above
- ACD
- CPD
- CP2D

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108
Q

Methods of preparations of platelet concentrates from single units of whole blood must produce a product that yields a minimum of:

A

5.5 x 10^10 platelets per unit in 75% of units tested

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109
Q

Normally what percentage of 35 days old RBCs should be circulating 24 hours after transfusion?

A

70%

110
Q

Which of the following statements explains why bacterial contamination of blood is rarely a problem?

A
  • All of the above
111
Q

What is the ratio of anticoagulant to whole blood in a unit of whole blood?

A

14 mL of anticoagulant-preservative for every 100 mL of whole blood collected

112
Q

A unit of whole blood must be stored at what temperature?

A

1-6C

113
Q

What is the shelf life of whole blood collected in acid-citrate-dextrose?

A

21 days

114
Q

What is the shelf life of whole blood collected in citrate-phosphate-double dextrose?

A

21 days

115
Q

What is shelf life of whole blood collected in citrate-phosphate-dextrose-adenine?

A

35 days

116
Q

How are RBCs separated from whole blood?

A
  • All of these
  • apheresis
  • centrifugation
  • sedimentation
117
Q

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?

A

8-24 hours

118
Q

A unit of packed RBCs must be stored at what temperature?

A

1-6C

119
Q

What is the shelf life of packed RBCs collected in acid-citrate-dextrose?

A

21 days

120
Q

What are platelets obtained from apheresis donations called?s

A

Single-donor-platelets (SDPs)

121
Q

Manufacturing RDPs is accomplished by using all of the following methods except:

A

Apheresis collection

122
Q

A unit of packed platelets must be stored at what temperature?

A

20-24C

123
Q

Units of platelets are stored under which of these conditions?

A

Constant agitation

124
Q

What is the shelf-life of platelets if the unit is tested for bacterial contamination just prior to issuing?

A

7 days

125
Q

What is the shelf-life of frozen RBCs?

A

10 years

126
Q

Which of the following is/are an example of a penetrating cryoprotective agent?

A

Dimethylsulfoxide

127
Q

A unit of cryopreserved RBCs must be stored below what temperature?

A

-65C

128
Q

What is the expiration date of a deglycerolized unit of RBCs?

A

24 hours

129
Q

Which statement about frozen plasma is correct?

A

The expiration of frozen plasma stored at -65C is 7 years

130
Q

Frozen plasma is thawed at what temperature?

A

30-37C

131
Q

Which statement about liquid plasma is correct?

A

*all of these are correct
- liquid plasma is a product from whole blood donations
- the expiration of liquid plasma 5 days after its whole blood shelf-life
- liquid plasma is stored at 1-6C

132
Q

Liquid plasma is prepared from a unit of whole blood collected in CPDA-1 on July 28th. Water is the expiration date of this plasma?

A
  • September 7th
133
Q

A unit of granulocyte should contain at least what concentration of granulocytes?

A

1 x 10^10

134
Q

A unit of granulocytes prepared on April 13th at 10:00 am and is irradiated at 2 PM the same day. What is the expiration date?

A

April 14th - 10:00 AM

135
Q

Plasma factor concentrates are separated into various proteins by manipulating which variable?

A
  • all of the above
  • pH
  • alcohol content
  • temperature
136
Q

Viruses are inactivated in units of plasma factor concentrate by all of these methods except:

A

Freezing

137
Q

Which factor concentrate has almost completely replaced on cryotoprecipitate as the product of choice to treat patients with hemophilia A?

A

FVIII

138
Q

Xenograhic forms of factor VIII are made from which source of plasma?

A

Porcine plasma

139
Q

Which of the following is NOT considered in the preparation of Rho immunoglobulin?

A

Donors are Rh-(D) positive

140
Q

Which of the following does NOT describe the preparation of NSA?

A

Plasma is fractioned using a warm alcohol process

141
Q

Which of the following does NOT describe the preparation of immune serum globulin?

A

The solution of immune serum globulin is dehydrated state and must be reconstituted with saline

142
Q

What is the half-life of immune serum globulin?

A

18-32 days

143
Q

How is preparation of PPF different than that of NSA?

A

PPF contains less albumin and more globulins than NSA

144
Q

What is the storage temperature for normal serum albumin ?

A

2-10C

145
Q

What is the shelf-life for normal serum albumin?

A

5 years

146
Q

what is the storage temperature for plasma protein fraction?

A

2-10C

147
Q

What is the shelf-life for plasma protein fraction?

A

5 years

148
Q

Which of the following does NOT describe the preparation of anti thrombin?

A

Apheresis of a single donor sensitized donor

149
Q

In which animal has transgenic methods produced rAT in the milk?

A

Goats

150
Q

Which of the following best describes the principle of the Kleihauer-Betke test??

A

D-positive indicator cells form rosettes around fetal Rh-positive RBCs

151
Q

What tests are indicated for cord blood specimens if the mother has made anti-K?

A

ABO, Rh, antibody screen

152
Q

Which of severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?

A

Bilirubinemia

153
Q

All of the following are goals of an exchange transfusions except:

A

To correct anemia

154
Q

Why is suppression of erythropoiesis an an advantage of exchange transfusions?

A

Decreases the risk of iron overload

155
Q

Why is reverse grouping omitted in neonate ABO grouping?

A

Maternal antibodies mask the ABO antibodies of the neonate

156
Q

A cord blood specimen from a jaundiced infant should be tested for which of the following?

A

*All of the above
- ABO
- DAT
- Rh

157
Q

Why is the immediate spin eliminated in the prenatal antibody screen?

A

To reduce the detection of IgM antibodies

158
Q

Which of the following reagents can be used to determine the immunoglobulin class of anti-M?

A

Chloroquine

159
Q

All of the following are characteristics of ABO hemolytic disease of the fetus and newborn (HDFN)except;

A

The antibody is IgM

160
Q

What is the physiological mechanism of Rh-immune globulin?

A

Attachment of fetal Rh-negative RBCs in maternal circulation, inhibiting production of anti0D

161
Q

Which of the following treatments uses ultraviolet light to treat hyperbilirubinemia after the infant is delivered?

A

Aminocentesis

162
Q

A 300 ug- dose of Rh-immune globulin contains sufficient anti-D to protect against how much whole blood?

A

100 mL

163
Q

In HDFN, the IgG antibodies are direct against which antigen on the fetal RBC?

A

Viral

164
Q

An O-positive mother gave birth to an A-negative baby. After 24 hours the newborns bilirubin level rose to 18 mg/dL. A DAT performed on the cord blood specimen was positive with polyspecific AHG and anti-IgG reagents. It is probable that ________ from maternal circulation is coating the newborns RBCs

A

Anti-B

165
Q

Which RBC morphology is most characteristic in ABO HDFN and absent in Rh HDFN?

A

Microspherocytes

166
Q

How is intrauterine transfusion performed?

A

RBCs are injected into the fetal peritoneal cavity

167
Q

Immunization of the mother can be caused by a little as________ D-positive cavity

A

1 mL

168
Q

Active immunization induced by Rh(D) antigen can be prevented by the concurrent administration of:

A

Alpha-1 protease inhibitor

169
Q

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 vials needed to protect against 250 mL of Rh-positive packed cells

A

23

170
Q

In order for the mother to be considered for Rh-immune globulin, her Rh type must be _______, and her newborn must be ________

A

Du-negative/Du-negative

171
Q

What is the common clinical manifestation of ABO HDFN?

A

Hyperkalemia

172
Q

Which of the following RBCs is appropriate for neonatal transfusion?

A

Group AB, CMV-negative

173
Q

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 use for an exchange transfusion for this infant is:

A

B

174
Q

The most important serologic test for the diagnosis of HDFN is the _____ with anti-IgG reagents

A

Elution

175
Q

Which of the following antibodies path of indirect bilirubin produced as a result of RBC destruction in HDFN?

A

Anti-D

176
Q

What is the physiological path of indirect bilirubin produced as a result of RBC destruction in HDFN?

A

Indirect bilirubin is transported across the placenta and excreted via maternal kidneys

177
Q

All of the following are true regarding antibody titration of maternal IgG antibodies except:

A

RBCs should consist of the same genotype for each titration

178
Q

The D-positive fetal cells in Rh-HDN are ________

A

Amorphic

179
Q

Why is the Rh-positive firstborn of an Rh-negative mother unaffected by Rh hemolytic disease of the fetus and newborn (Rh HDFN)?

A

The plasma volume of the mother is tripled during the first pregnancy which dilutes anti-D

180
Q

Besides the Rh antibodies, what other RBC antibody is common to cause severe HDFN?

A

Anti-Lea

181
Q

The results of a Kleihauer-Betke stain indicate a fetomaternal bleed of 40 mL of whole blood. How many vials of Rh-immune globulin would be required?

A

2

182
Q

What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen?

A

The chance of maternal sensitization to Rh antigen is decreased

183
Q

Which of the following assays is used to calculate the amount of fetomaternal hemorrhage in a postpartum specimen?

A

Rosette test

184
Q

In the event of a clinically significant antibody found in the mother’s serum, which of the following must be preformed to determine its concentration?

A

Elution

185
Q

What is the cause of HDFN???

A

Destruction of the fetus’s RBCs by antibody by the mother

186
Q

What immunoglobulin is capable of crossing the placenta?

A

IgG

187
Q

What life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepatomegaly and splenomegaly?

A

Hydrosphere fetalis

188
Q

What physiological phenomenon associates erytrhoblastosis fetalis with HDFN?

A

Release of nucleated RBCs into circulation of neonate inflicted with HDFN

189
Q

In which type of HDFN is the firstborn affected?

A

ABO

190
Q

Cannulation of the umbilical vein under ultrasound guidance is known as:

A

Cordocentesis

191
Q

Why are premature newborns more likely to require exchange transfusions than full-term infants?

A

Premature newborn livers are loo underdeveloped to conjugate bilirubin

192
Q

Blood transfusions to the fetus and premature infants should be _______ to prevent graft-versus-host disease

A

Gamma irradiated

193
Q

Which IgG subclass carries more potency in RBCs hemolysis?

A

IgG3

194
Q

Which of the following mother/infant blood types would be considered at risk for ABO hemolytic disease of fetus and newborn?

A

Mother is group O; baby is group B

195
Q

When in the antenatal dose of Rh-immune globulin given?

A

28 weeks

196
Q

Rh-immune globulin should be given within how many hours after delivery?

A

72

197
Q

Which prenatal serologic tests are recommended during the first trimester?

A

*all of the above
- ABO
- Rh
- antibody screen

198
Q

Anti-D in the serum of a third trimester pregnant woman with titer of 16 is indicative of:

A

Active immunization

199
Q

How are units for exchange transfusion prepared?

A

Group O RBC and group AB plasma

200
Q

Why does the rate of RBC destruction after birth decrease in an infant diagnosed with HDFN?

A

Maternal antibody is no longer entering infant circulation via the placenta

201
Q

What is done to prevent HDFN caused by maternal anti-Jka antibody formation?

A

Monitor the mothers antibody level

202
Q

What is the role of the technologist in the diagnosis and clinical management of HDFN?

A

Serological diagnosis of maternal alloimmunization

203
Q

True or false? Rh-immune globulin is of no benefit after a person has been actively immunized and formed anti-D

A

True

204
Q

True or False? The antibody titer of maternal antibody is directly proportional to severity of HDFN

A

False

205
Q

All Rh-negative recipients who are transfused with as little as 1 mL of Rh-positive cells will develop ant-D

A

False

206
Q

Which of the following can be found in warm autoimmune hemolytic anemia in the presence of hypoplastic marrow?

A

Reticulocytopenia

207
Q

Most cases of warm autoimmune hemolytic anemia will be DAT-positive with which of the following ?

A

Both anti- IgG and Anti-C3d

208
Q

Cold autoanti-H is more prevalent in which blood group?

A

A1B

209
Q

RBCs sensitized in which drug-induced hemolytic anemia mechanism act as “innocent bystanders?”

A

Immune complex

210
Q

Which drug can cause production of autoantibody?

A

Methyldopa

211
Q

Which of the following is a proposed theory for methyldropa-induced mechanism of immune hemolytic anemia?

A

The drug affects the synthesis of IgG, exerting a direct effect on T lymphocytes, which results in a loss of suppressor function and subsequent proliferation of autoantibodies by B lymphocytes

212
Q

In warm autoimmune hemolytic anemia, the autoantibody will frequently demonstrate__________ -like specificity

A

Rh

213
Q

All of the following are clinical manifestations of cold hemoagglutinin disease (CHD) except:

A

Hepatosplenomegaly

214
Q

A patient with a positive DAT needs go be phenotypes for Jka. what reagent can be used on RBCs to ensure accurate typing?

A

Chloroquine diphosphate

215
Q

In which of the following is the DAT reactive with anti-C3d only?

A

Cold hemagglutiinin disease

216
Q

Which of the following characterizes an alloimmune response in immune hemolytic anemia?

A

The patient produces anti-K to transfused RBCs

217
Q

How can persons with CHD avoid hemolytic episodes?

A

Move to a warm climate

218
Q

The onset of warm autoimmune hemolytic anemia (WAIHA) may be precipitated by:

A
  • all of the above
  • pregnancy
  • bacterial infection
  • trauma
219
Q

In the digitonin-acid elution procedure, what is the purpose of adding phosphate buffer to the eluate solution?

A

To restore neutrality to the eluate

220
Q

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?

A
  • All of above
  • Du test
  • DAT
  • Rh control
221
Q

Which of the following factors distinguishes a cold autoantibody produced in a patient with IM from that produced in a patient with pneumonia?

A

Anti-i specificity

222
Q

Cold hemagglutinin disease represents what % of autoimmune hemolytic anemia (AIHA) cases?

A

18

223
Q

In the case of an AB-positive individual, what test must be performed to ensure that a warm-reacting autoantibody is not causing false-positive reactions?

A

Rh control

224
Q

Which of the following procedures can be used to resolve interference due to anti-I?

A

Cold autoabsorption and prewarm technique

225
Q

How might a technologist detect a patient with drug-induced hemolytic anemia?

A

Positive DAT

226
Q

In a patient who has been recently transfused, a positive DAT may be due to:

A

Alloantibody coating transfused donor cells

227
Q

How is RBC destruction characterized in drug-induced immune HA via immune complex mechanism?

A

Intravascular hemolysis precipitated by complement activation

228
Q

Anti-K was identified in absorbed serum of a patient with warm autoimmune hemolytic anemia. If a RBC phenotype was performed using an indirect antiglobulin test to ensure the patient was negative for antigen, what would the technologists find?

A

A positive result due to IgG coating cells

229
Q

What technique can be used to ID an alloantibody in the presence of a cold autoagglutinin?

A

Prewarming

230
Q

A patient with a warm reacting 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 RBC phenotype: R2R2, ss, Fy(a-b+), Jk(a+b-), kk. What alloantibody would remain in the serum after absorption?

A

Anti-S

231
Q

Which of the following describes the drug-absorption (hapten) mechanism?

A

Drugs bind firmly to proteins of the RBC membrane

232
Q

What is the most common drug associated with the drug-absorption mechanism?

A

Penicillin

233
Q

What percentage of AIHA cases are caused by warm reacting autoantibodies?

A

70%

234
Q

Why do clotted specimens yield positive DAT results with anti-C3 is the presence of a benign cold auto agglutinin?

A

Complement can be activated in Vitro

235
Q

Approximately what percentage of AIHA cases are due to paroxysmal cold hemoglobinuria (PCH)?

A

1-2%

236
Q

All of the following are classification of immune HA except:

A

Hyperimmune

237
Q

What is one indication a positive DAT might be due to alloantibody coating donor RBCs?

A

Microscopic mixed-field appearance

238
Q

What is the primary goal for treatment in patients with warm autoimmune HA?

A

Treat the underlying disease

239
Q

Autoanti-I was identified in a patient transfused 1 month ago. Which technique is advocated to detect alloantibodies in this patient?

A

Prewarming

240
Q

A cold antibody titer greater than______ at 4C is characteristic of pathological CHD

A

1,000

241
Q

Persons diagnosed with pneumonia caused by Mycoplasma pneumonia may produce a cold autoantibody with _______ specificity

A

Anti-I

242
Q

Which alloantibody is frequently present in the serum of i adults?

A

Anti-I

243
Q

A benign cold autoagglutinin may cause interference in antibody screening procedures when:

A

Polyspecific AHG reagents are used in the test procedure

244
Q

Which of the following is a characteristic RBC morphology seen on a peripheral blood smear from a patient with warm autoimmune HA?

A

Spherocytes

245
Q

How is the serology workup for an autoantibody produced by a drug-induced hemolytic anemia different from other autoantibody workups?

A

The antibody will only be reactive with RBCs in the presence of the drug

246
Q

Which of the following describes a cold autologous absorption procedure?

A

An aliquot of patient cells is incubated with an equal aliquot of patient serum at 4C autoantibody is removed while alloantibody remains in the serum

247
Q

What treatment for warm autoimmune hemolytic anemia aids in the reduction of antibody and removes a potent site of RBC damage and destruction?

A

Splenectomy

248
Q

Which of the following signifies intravascular hemolysis in AIHA?

A

Hemoglobinuria

249
Q

A 5-year old boy suffering from the measles complained of back pain, chills, and stomach pain. A visit to the doctor revealed hemoglobinuria, bilirubinemia, and hemoglobinemia. The child’s Hb level had fallen to 6 g/dL. A Donath-Landsteiner test was performed and showed the following: control sample = no hemolysis; test sample = hemolysis. The results are consistent with what disorder?

A

Paroxysmal cold hemoglobinuria

250
Q

In which case might you see an anti-i?

A

Mononucleosis

251
Q

Which of the following forward-typing reagents may generate false-positive results in a patient with a warm-reacting autoantibody?

A

Anti-D

252
Q

What is the recommended treatment for drug-induced hemolytic anemia caused by the immune complex mechanism?

A

Cessation of drug administration

253
Q

Immune hemolytic anemia is defined as:

A

A shortened RBC survival mediated through humoral antibody production

254
Q

What reagent cell type is used in the immune complex formation test to detect drug-anti drug interaction?

A

Group O

255
Q

What is the most frequent antibody specificity in CHD?

A

Anti-I

256
Q

Chemically modified anti-D reacted negatively in a patient with a warm-reacting autoantibody. A Du test was performed using monospecific IgG, which was positive in Coombs phase. A fetal screen (rosette test) was also performed on this patient and showed no rosettes when viewed microscopically. based on these results, what is the correct Rh type of this patient?

A

Rh-negative

257
Q

Which of the following is a characteristic of autoantibodies?

A

Antibody reacts with high-incidence antigens

258
Q

All of the following are characteristics of benign cold autoagglutinin except:

A

Antibodies have a titer greater than 64 at 4 C

259
Q

Which cells contain the most i antigen?

A

Cord blood

260
Q

Which theory supports production of autoantibodies?

A

Loss of T-cell suppressor activity upon self-antigens leads to production of autoantibody

261
Q

How can cold autoantibody interference with ABO grouping be avoided?

A

Washing cells with normal saline warmed to 37C

262
Q

In cases of warm autoimmune hemolytic anemia, what subclass of IgG is most efficient in binding complement?

A

IgG3

263
Q

Which of the following regarding the immune complex mechanism is serologic testing is true?

A

The DAT will be positive with monospecific C3 but negative with IgG

264
Q

Which drug-induced mechanism does not result in a hemolytic episode?

A

Membrane modification

265
Q

What is the mechanism by which thiol reagents, such as DTT, disperse agglutination caused by cold-reactive autoantibody?

A

Cleavage of the intersubunit disulfide bonds of pentameric IgM molecules

266
Q

A 28 year old female with cold hemagglutinin disease has a positive DAT. When the DAT is repeated using monospecific reagent, which of the following is most likely to be detected?

A

IgM

267
Q

The antigen I is often:

A

Absent on all cord cells

268
Q

An EDTA sample is preferred over a clotted sample for performing DAT testing because:

A

The EDTA prevents complement binding in-vitro

269
Q

A DAT was performed on a patient suspected of having autoimmune HA. The following results were obtained. PS AHG 3+, Anti-IgG 2+, Anti-C3d-negative. These results mean:

A

The patients cells are coated with IgG

270
Q

Cold panel results obtained are:
A1 cells: 4+
A2 cells: 4+
O cells: 4+
O cord cells: 0
These results suggest which antibody?

A

I

271
Q

Approximately what percentage of warm autoimmune HA will produce a positive DAT with both IgG and C3d antibodies?

A

67%