MLT boards - Blood Bank (BOR) Flashcards

Terms Definitions
Isoimmunization to platelet antigen (P1^A1) and the placental transfer of maternal antibodies would be expected to cause newborn
thrombocytopenia
Following plasmapheresis, how long must a person wait before being eligible to donate a unit of Whole Blood ?
48 hours
Each unit of Whole Blood will yield approximately how many units of cryoprecipitated AHF?
80
Addition of what will enhance the shelf-life of whole blood?
adenine
Pretransfusion compatibility testing must include:
antibody screening by antiglobulin test
Severe intravascular hemolysis is most likely caused by antibodies of which blood group system?
ABO
Under extreme emergency conditions when there is no time to determine ABO group for transfusion, the technologist should:
release O, Rh-negative red blood cells
An obstetrical patient has had 3 previous pregnancies. Her 1st baby was healthy, the 2nd was jaundiced at birth and required an exchange transfusion, while the 3rd was stillborn. Which os the following is the most likely cause?
Rh incompatibility
Whith regard to inheritance, most blood group systems are:
autosomal codominant
The optimum storage temperature for Cryoprecipitated AHF is:
-20 degrees C
The optimum storage temperature for Platelets is:
22 degrees C
The oprimum storage temperature for Red Blood Cells, Frozen is:
-80 degrees C
The optimum storae temperature for Whole Blood is:
4 degrees C
Quality control tests must be performed daily on:
reagent red blood cells
Criteria determining Rh immune globulin eligibility include:
mother has not been previously immunized to the D antigen
Which of the following constitutes permanent rejection status of a donor?
a)tattoo 5 months previous
b)recent close contact w/ patient w/ viral hepatitis c.)2 units of blood transfused 4 month previous
d) confirmed positive test for HBsAg 10 yrs pre
d) confirmed positive test for HBsAg 10 yrs previous
The major crossmatch will detect a(n):
reciepient antibody directed against antigens on the donor red cells
Cells of the A3 subgroup will:
give a mixed field reaction with anti-A,B
Mixed field reactions with anti-A and antiA,B and negative reactions with anti-B and anti-A1 lectin(Dolichos biflorus) are observed. Without further testing, the most likely conclusion is that the patient is group:
A3
Anti-Fya is:
capable of causing hemolytic transfusion reactions
A patient received 2 units of RBCs & had a delayed hemolytic Tx rxn. Pre-Tx records show a neg antibody screen. Repeat testing of the pre-Tx specimen detected an antibody at the antiglobulin phase. What is the most likely explanation for original resuts?
patient's serum was omitted from the original testing
What is an indicator of polyagglutination?
agglutination with normal adult ABO-compatibility sera
Anti-Sda is strongly suspected if:
the agglutinates are mixed-field and refractile
Mixed-field sgglutination athe the anti-human globulin phase of a crossmatch may be attributed to:
an antibody such as antiSda
In suspected cases of hemolytic disease of the newborn, what signigicant information can be obtained from the baby's blood smear?
determination of teh presence of spherocytes ans elevated numbers of nucleated red blood cells
As a preventive measure against graft-versus-host disease, red blood cells prepared for infants who have received intrauterine transfusions should be:
irradiated
Which of tha following is the preferred specimen for the initial compatibility testing in exchange transfusion therapy?
maternal serum
When the main objective is an exchange transfusion is to remove the infant's antibody-sensitized RBCs and to control hyperbilirubinemia, the blood product of choice is ABO compatible:
Fresh Whole Blood
Which of the following histories represents an acceptable donor? [Hct, BP, temp, pulse, age, sex] a) 39, 100/70, 99.8, 75, 71, F b) 37, 135/84, 98.6, 80, 35, M c) 41, 90/50, 99.4, 65, 65, M d) 45, 115/80, 98.6, 102, 17, M
c) 41, 90/50, 99.4, 65, 65, M
According to AABB standards, 75% of all Platelet, Pheresis units tested shall contain how many platelets per uL?
3.0 x 10^11
Following the 2nd spin in the preparation of Platelets, the platelets should be:
allowed to sit undisturbed for 1 hour
What is the proper procedure for preparation of Platelets from Whole Blood?
light spin followed by a hard spin
the purpose of a low-dose irradiation of blood components is to:
prevent graft-vs-host (GVH) disease
Platelets prepared in a polyolefin type container, stored at 22-24 degrees C in a 50 mL a plasma, and gently agitated can be used for up to:
5 days
The enzyme responsible for conferring H activity on the red cell membrane is alpha-:
glucosyl transferase
{refer to data on page 43} The ABO discrepancy seen above is most likely due to:
anti-H
A 25 yr old caucasian women, gravida 3, para 2, required 2 units of blood. The antibody screen was POS & the results of the antibody panel refer to chart pg. 44 . Which 2 antibodies may be the cause of the POS antibody screen?
anti-c & anti-E
A 25 yr old caucasian women, gravida 3, para 2, required 2 units of blood.The antibody screen was POS & the results of the antibody panel refer to chart pg. 44. What is the most probable genotype of the patient?
R1R1
A 25 yr old caucasian women, gravida 3, para 2, required 2 units of blood.The antibody screen was POS & the results of the antibody panel refer to chart pg. 44. Which common antibody has NOT been ruled out by the panel?
anti-K
A patient's serum reacted weakly POS w/ 16 of 16 group O panel cells at the AHG test phase. Tha autocontrol was NEG. Tests w/ ficin-treated panel cells demonstrated no reactivity at AHG phase. Which antibody is most likely responsible for these results?
anti-Ch
Useof EDTA plasma prevents activation of the classical complement pathway by:
chelating C++ ions, which prevents assembly of C1
A Kleihauer-Betke stain of a postpartum blood film reveales 0.3% fetal cells. What is the estimated volume (mL) of the fetomaternal hemorrhage expressed as whole blood?
15
The most effective component to treat a patient w/ fibrinoen deficiency is:
Cryoprecipitated AHF
An assay of plasma from a bag of cryoprecipitated AHF yields a concentration of 9 international units (IU) of Factor VIII per mL of cryoprecipitated AHF. If the volume is 9 mL, what is the Factor VIII content of the bag of IU?
81
The approximate percentage of the original plasma content of Factor VIII recovered in cryoprecipitated AHF is:
40-80%
A newborn demonstrates petechiae, ecchymosis, and mucosal bleeding. The preferred blood component for theis infant would be:
platelets
A 65-yr-old woman experienced shaking, chills, & fever of 103 degrees F approximately 40 min following the transfusion of a second unit of RBCs. The most likely explanation for the patient's symptoms is:
severe febrile transfusion reaction
An acid elution stain of a 1hr post delivery maternal blood, 2,000 cells were counted & 30 seemed to contain fetal hemoglobin. The medical center adds 1 vial of Rhogam to the dose when the est. volume of hemmorrhage exceeds 20 mL. Calculate the # of vials
4
The Liley method of predicting the severity of hemolytic disease of the newborn is based on the amniotic fluid:
change in optical density measured at 450 nm
A unit of FFP was inadvertently thawed and then immediately refrigerated at 4 degrees C on Monday morning. On Tuesday evening this unit may still be transfused as a replacement for:
Factor IX
According to AABB standards, which of the following donors may be accepted as a blood donor? a. hip replacement 5 months ago b. spontaneous abortion at 2 months, 3 months ago c. resides w/ known hepatitis pt d.received a blood tx 22 weeks ago
b. spontaneous abortion at 2 months, 3 months ago
What is correct storage temperature for Fresh Frozen Plasma?
-20 degrees C
Whatis the possible genotype for an individual whose red cells give the reactions shown on page 47?
R1R2
What blood component contains the nost Factor VIII concentration relative to volume?
cryoprecipitated AHF
What blood component must be prepared w/i 8 hours after phlebotomy?
Fresh Frozen Plasma
Although ABO compatibility is prefered, ABO incompatible product may be administered when transfusing:
cryoprecipitated AHF
What blood component is the best source of Factor IX?
Prothronbin complex
Coughing, cyanosis, and difficult breathing are symptoms of which transfusion reaction?
cirulatory overload
Hypotemsion, nausea, flushing, fever, and chills are symptoms of what transfusion reaction?
hemolytic
Hives and itching are symptoms of which transfusion reaction?
allergic
Hemoglobinuria, hypotemsion, ans generalized bleeding are symptoms of what transfusion reaction?
hemolytic
Fever and chills are symptoms fo what transfusion reaction?
febrile
cold agglutinin syndrome is best associated with what blood group?
I/i
What is th most probable explanation for the results listed on pg 49?
large fetomaternal hemorrhage
Antibodies involved in a warm autoimmune hymolytic anemis are often associated with which blood group system?
Rh
What is the most probable explanation for the results of tests listed on page 50?
Rh hemolytic disease of the newborn, infant has a false-negative Rh typing
The use of Red Blood Cells, Deglycerolized would ve most beneficial when transfusing a patient:
who is sensitized to platelet antigens
A method currently in routine use for freezing Red Blood Cells is:
high concentration of glycerol (40%w/v)
rejuvenation of a unit of Red Blood Cells is a methos used to:
restore 2,3-DPG and ATP to normal levels
A unit of RBCs is issued at 0900. At 0910 the unit is returned to the blood bank. The container has NOT been entered, but the unit has NOT been refrigerated during this time span. The best course of action for the tech is to:
record the return and place the unit back into inventory
Cryoprecipitated AHF, if maintained in the frozen state at -18 degrees C or below, has a shelf life of:
12 months
The quality assurance program for RBCs, Deglycerolized should include regularly scheduled monitoring to determine:
acceptable glycerol removal
What is a characteristic of polyagglutinable red cells?
are agglutinated by most adult sera
What situation could result in an ABO discrepancy that is caused by problems with the patient's red cells?
Tn activation
What is characteristic of Tn polyagglutinable red cells?
If group O, they may appear to have acquired a group A antigen
Mixed field agglutination encountered in ABO grouping would most likely be due to:
A3 red cells
The use of leukocyte-depleted RBCs and Platelet Concentrates is indicated for what patient group?
patients with history of febrile transfusion reactions
Blood selected for exchange transfusion must:
lack red blood cell antigens corresponding to maternal antibodies
ABO-hemolytic disease of the newborn is usually seen:
only in the newborns of group O mothers
While performing routine postpartum testing for an Rh innune globulin(RhIg) candidate, a weekly POS antibody screening test was found. Anti-D was identified. This antibody is most likely the result of:
antenatal administration of RhIg at 28 weeks' gestation
A blood component used in the trreatment of hemophilia A is:
Factor VIII concentrate
A 24-year-old mans with hemophilia is involved in an auto accident and is actively bleeding. Factor VIII assay results are 8%. The blood product of choice is:
Cryoprecipitated AHF
An adult patient who is activly bleeding has test results listed on pg 53. 6 units of RBC' are ordered STAT. The Blood Bank has the RBC units listed on pg 53. Which of the units should be crossmatched for this patient while more blood is being ordered?
4 A, Rh-negative and 2 A, Rh-positive
What blood component is most appropriate to transfuse to an 8-year-old male hemophiliac who is about to undergo minor surgery
heat-treated Factor VIII concentrate
According to AABB standards, platelets prepared from whols blood shall have at least:
5.5 x 10^10 platelets per unit in at least 75% of the units tested
Based upon Kleinhauer-Betke test results. what formula is used to determine the volume of fetomaternal hemorrhage in mL of Whole Blood?
% of fetal cells x 50
According to the AABB standards, what is the minimum pH required for platelets?
6
During the preparation of platelet concentrates from Whole Blood, the blood should be:
kept at room temperature
A temperature rise of 1 degree C or more occuring in association with a transfusion is usually indicative of what transfusion reaction?
febrile
What transfusion reaction is characterized by high fever, shock, hemoglobinuria, DIC, and renal failure?
bacterial contamination
What transfusion reaction occurs after infusion of only a few milliliters of blood and gives no history of fever?
anaphylactic
During initial investigation of a suspected hemolytic Tx rxn, it was observed the the posttransfusion serum was yellow in color and the direct antiglobulin test was negative. What is the next step in this investigation?
No further serologic testing is necessary
A granulocyte transfusion is indicated if the patient has:
an absolute granulocyte count of 350/uL or less
Transfusion of what is needed to help correct hypofibrinogenemia due to DIC?
Cryoprecipitated AHF
According to AABB standards, Fresh Frozen Plasma must be infused within what period of time following thawing?
24 hours
In a quality assurance program, at least 75 of the bags of Cryoprecipitated AHF must contain a minimun of how many international units of Factor VIII?
80
In the liquid state, plasma must be stored at:
1-6 degrees C
Cryoprecipitated AHF must be transfused within what period of time following thawing and pooling?
4 hours
In the autoadsorption procedure for the removal of cold agglutinins from serum, pretreatment of the patient's red cells with what reagent is helpful?
ficin
In an emergency situation, Rh-negative red cells are transfused into ans Rh-positive person of the genotype CDe/CDe. The first antibody MOST likely to develope is:
anti-c
A 10% red cell suspension in saline is used in a compatibility test. What would most likely occur?
a false-negative result due to antigen excess
the most serious transfusion reactions are due to incompatibility in which of the following blood group systems?
ABO
a 29-year-old male is hemorrhaging severly. He is AB NEG. 6 units of blood are required STAT. The blood bank has units of AB POS, A NEG, A POS, O NEG, which would be most preferable for crossmatch?
A NEG
The results listed on page 57 were obtained on a patient's blood group and type during routine ABO and Rh testing: What is the course of action to resolve this problem?
perform antibody screening procedure at immediate spin using group O cells
An antibody that causes in vitro hemolysis ans reacts with the red cells of three of ten crossmatched donor units is most likely:
anti-Lea
In a delayed transfusion reaction, the causative antibody is generally too weak to e dected in routine compatibility testing and antibody screening tests but becomes detectable at what point after transfusion?
1 to 5 days
The most frequent transfusion-associated disease complication of blood transfusions is:
hepatitis
A 22-yer-old man is admitted to the ER in shock following massive hemorrhage from knife wounds to his chest and abdomen. An emergency transfusion is required. What is the product of choice?
O, Rh-negative Red Blood Cells
The compatibility results on page 58 were obtained. The most probable explanation for these findings is that the:
patient has a positive direct antiglobulin test
An antibody identification study is performed with the five-cell panel shown on page 58: An antibody against which of the antigens could NOT be excluded?
1
A pt rec'd 2 units of RBC's & had a delayed Tx rxn. Ab screen records indicate that there was no agglutination except after the addition of IgG-sensitized cells. Repeat testing of the pre Tx specimen detected an antibody at the antiglobulin phase. explain
patient's serum was omitted from the original testing
a Pt is group A2B POS & has an antiglobulin-reacting anti-A1 in his serum. He is bleeding profusely in the OR & group A2B RBC's are NOT available. What type of blood should be given as a 1st choice?
B, Rh-positive
What might cause a false-negative indirect antiglobulin test (IAT)?
Too heavy a cell suspension
How many units of RBC's are required to raise the hematocrit of a 70-kg non-bleeding man from 24 to30%?
2
After rec'vg a unit of Whole Blood, a Pt immediately developed flushing, nervousness, fever spike of 102 F, shaking, chills, & back pain. The plasma hemoglobin was elevated & there was hemoglobinuria. Lab investigation of this rxn would most likely show:
an error in ABO grouping
A patient whose saline and albumin crossmatches were compatible had a severe hemolytic reaction. The one antibody most likely present is anti-:
K
In the direct (DAT) and indirect (IAT) antiglobulin techniques. false-negative reactions may result if the:
addition of AHG is delayed for 40 minutes or more after washing the serum/cell mixture
Which of the following antigens gives enhanced reactions with its corresponding antibody following treatment of the red cells with proteolytic enzymes?
E
A request is received to crossmatch 5 units of RBCs on a man who is group AB, Rh-positive. The blood inventory is listed on page 60. Assuming all the blood crossmatched is compatible, the desirable sequence of blood units that can be issued for Tx is:
2 units of group AB, Rh-positive: 3 units of group A, Rh-positive
The results of a Kleihauer-Betke stain indicate a fetomaternal hemmorrhage of 35 mL of Whole Blood. How many vials of Rh innune globulin would be required?
2
What is the component of choice for treatment of von Willebrand's disease?
Cryoprecipitated AHF
What component id the best source of fibrinogen for transfusion to a patient with hypofibrinogenemia?
Cryoprecipitated AHF
What is consistant with standard blood bank procedure governing the infusion of Fresh Frozen Plasma?
Group A may be administered to both A and O reciepients
What is an immediate non immunologic adverse effect of a transfusion?
congestive heart failure
A 40-year-old man with autoimmune hemolytic anemia dude to anti-E has a hemoglobin level of 10.8gm/dL. This patient will most likely be treated with:
no transfusion
On pg 62 are results of the history obtained from a prospective female blood donor. How many of the results will exclude this donor from giving blood for a routine transfusion?
1
A group A, Fh-positive infant of a group O, Rh-positive mother has a weakly positive direct antiglobulin test and a moderately elevated bilirubin at birth. The most likely cause is:
ABO incompatibility
Prior to blood donation, the intended venipuncture site must be cleaned with a scrub solution containing:
PVP iodine complex
When removed fron the refrigertor, a unit of donor blood was observed to have an accumulation of cream-colored material at the toe of the plasma. The most probable cause of the accumulation is:
ingestion of fatty meal shortly before blood donation
A blood specimen fron a pregnant woman is found to be group B, Rh-ne & the serum contains anti-D with a titer of 512. What would be the most appropriate type of blood to have available for a possible exchange transfusion for her infant?
O, Rh-negative
A patient who is group AB, Rh-negative needs 2 units of Fresh Frozen Plasma. Which units of pf plasma would be MOST acceptable for transfusion?
group AB, Rh-positive
Washed RBCs would be the product of choice for a patient with:
anti-IgA antibodies
When evaluating a suspected transfusion reaction, what is the ideal sample collection time for a bilirubin determination?
6 hours posttransfusion
The test for weak D is performed by incubating a patient's red cells with:
anti-D serum followed by washing and antiglobulin serum
Refer to the data on page 64. These parents would most likely have a child with the genotype:
rr
A 35-year-old man w/ von Willebrand's disease has an acute mosebleed & a hemoglobin level of 9.9gm/mL. What blood component is the MOST appropriate choice for transfusion to this patient.
Cryoprecipitated AHF
Refer to dato on page 64. What genotypes would correspond to these results?
R0R0
Whole Blood for exchange transfusion of a newborn with hemolytic disease due to ABO incompatibility should be:
group O with no hemolytic anti-A or Anti-B
4 units of blood are needed for elective surgery. The patient's serum contains anti-C, anti-e, anti-Fya, and anti-Jkb. Which would be the best source of donor blood?
autologous donations
Refer to the diagram on page 65. Given the most probable genotypes of the parents, What statement best describes the most probable Rh genotypes of the 4 children?
2 are R1r, 2 are R1R1
What unit should be selected for exchange transfusion if the newborn is group A, Rh-positive and the mother is group A, Rh-positive with anti-c?
A, CDe/CDe
polyspecific reagents used in the direct antiglobulin test should have specificity for:
IgG and C3d
In the direct antiglobulin test, the antiglobulin reagent is used to:
detect preexisting antibodies on erythrocytes
Human blood groups were discovered around 1900 by:
Karl Landsteiner
What increment of platelets/uL, per m^2 body surface area, is expected to result from each single unit of Platelets transfused into a non-HLA-sensitized recipient?
10,000
If the seal is entered on a unit of Whole Blood stored at 1-6 degrees C, What is the maximum allowable storage period, in hours?
24 hours
A Whole Blood unit from a donor that contains a clinically significant red cell alloantibody should be:
processed into components containing minimal plasma
Which of the following Rh antigens has the highest frequency in Caucasians? D, E, c, or e
e
Which of the following blood group systems is most commonly associated with delayed hemolytic transfusion reactions? Lewis, Kidd, MNS, or I
Kidd
Which of the following immunoglobulins is present in the highest concentration in normal human serum? IgM, IgG, IgA or IgE
IgG
A mother is Group A, with anti-D in her serum. What is the preferred blood product if an intrauterine transfusion is indicated?
O, Rh-negative Red Blood Cells, irradiated
the most appropriate laboratory test for early detection of acute hemolysis is:
a visual inspection for free plasma hemoglobin
Even in the absence of prior transfusion or, individuals with the Bombay pheno-type (Oh) will always have naturally occurring:
anti-H
HLA antibodies are:
induced by multiple transfusions
Genes of the major histocompatibility complex (MCH) contribute to:
the coordination of cellular and humoral immunity
During storage, the concentration of 2,3-diphosphoglycerate (2,3-DPG) decreases in a unit of:
Red Blood Cells
Which of the following antigens in MOST likey to be involved in hemolytic disease of the newborn? Lea, P1, M or Kell
Kell
Fresh frozen Plasma should be transfused within:
24 hours of thawing
Cryoprecipitated AHF is indicated for:
fibrinogen deficiencies
An important determinant of platelet viability following storage is:
plasma pH
According to AABB standards, Platelets must be__________________if stored at room temperature.
gently agitated
Platelet transfusions are of most value in treating:
functional platelet abnormalities
An unexplained fall in hemoglobin and mild jaundice is a patient transfused with RBCs 1 week ago would most likely indicate:
delayed hemolytic transfusion reaction
Fresh Frozen Plasma from a group A, Rh-positive donor may be safely transfused toa a patient who is group:
A, Rh-negative
the drug cephalosporin can cause a positive direct antiglobulin test by what mechanism?
membrane modification
Which would most likely be responsible for an incompatible major crossmatch? recipient's RBCs posses a low-frequency antigen, anti-K antibody in donor serum, recipient's RBCs are polyagglutinable, donor RBCs have a positive DAT
Donor red calls have a positive direct antiglobulin test (DAT)
Rh immune globulin administration would NOT be indicated in a Rh-negative woman who has a: 1st trimester abortion, husband who is Rh-positive, anti-D titer of 1:4096, or positive direct Coomb's test
anti-D titer of 1:4096
A fetomaternal hemprrhage of 35 mL of fetal Rh-positive packed RBC's has been dected in an Rh-negative woman. How many vials of Rh immune globulin should be given?
3
what information is essential on the label of recipient blood samples drawn for compatibility testing?
patient's hospital identification number
Which of the following red cell antigens are found on glycophorin-A? M and N, Lea ad Leb, S and s, P and P1 and Pk
M and N
current testing on all donor blood must include serological test for:
syphilis
irradiation of a unit of red Blood Cells is done to prevent the replication of donor:
lymphocytes
AHG (coombs) control cells are coated only with:
IgG antibody
During the issue of an autologous unit of Whole Blood, the supernatant plasma is observed to be dark red in color. what would be the best course of action?
Quarantine the unit until further testing determines disposition.
An Rh-positive patient's serum is known to contain anti-LW. Red Blood Cells selected for crossmatch should be from what genotype?
rr
A first-time blood donor is noticed to experience rapid breathing and involuntary twitching of his fingers shortly after starting phlebotomy. The phlebotomist should:
have him rebreathe air from a paper bag
The most important step in the safe administration of blood is to:
accurately identify the donor unit and intended reciepient
what is the most probable recial origin of this donor with the following typing results? Le(a-b-);Fy(a-b-);js(a+b+)
Black
the Kell (K1) antigen is strongly:
immunogenic
the antibody in the Lutheran system that is best detected at lower temeratures is:
anti-Lua
which of the following HTLA antibodies is considered to be most clinically significant? anti-Yta, anti-Ch, anti-Yk, or anti-Cs
anti-Yta
A donor is tested with Rh antisera, with the following results:
anti-D +
anti-C +
anti-E 0
anti-c +
anti-e +
Rh control 0
What is the most probable Rh genotype?
R1r
while performing an antibody screen, a test reaction is observed that is suspected to be rouleaux. a saline replacement test is done and the reaction remains. What is the best interpretation?
'The original reaction was due to true agglutination.
What is a frequent characteristic of anti-i?
frequently a cold agglutinin
the test currently used to detect donors who are infected with the AIDS virus is:
anti-HIV 1,2
What is/are the minimum pretransfusion testing requirement(s) for autologous donations collected and transfused by the dame facility?
ABO and Rh typing only
for plateletpheresis donors, the pretransfusion platelet count must be at least:
150 x 10^3/uL
a patient admitted to the trauma unit requires emergency release of Fresh Frozen Plasma (FFP). His blood donor card states that he is group AB, Rh-positive. What blood group of FFP should be issued?
AB
Refer to the data on page 74. Which clinical condition is consistant with the lab results shown?
warm autoinnune hemolytic anemia
the mechanism that best explains hemolytic anemia due to penicillin is;
drug adsorption
Laboratory studies of maternal and cord blood yield the results listed on page 74. If exchange transfusion is necessary, the best choice of blood is:
O,Rh-positive, E negative
the blood sample of choice for the pretransfusion testing of neonates with HDN is:
maternal serum
refer to page 75 for data. what is the most likely caude of the following ABO discrepancy?
hypogammaglobulinemia due to advanced patient age
A patient is typed as group O,Rh-pos & crossmatched w/ 6 units fo blood. At the indirect antiglobulin (IAT) phase of testing, both antibody screening cells & 2 crossmatched units are incompatible. What is the most likely cause of the incompatibility?
recipient alloantibody
Refer to the data on page 75. Consider the following ABO typing results: Additional testing was performed using serum: What should be done next?
cold autoadsorption
For what transfusion canidates would CMV-seronegative blood be MOST likely indicated?
transplant candidates
Posttransfusion purpura is caused by:
anti-P1a1
Posttransfusion anaphylactic reactions occur most often in patients with:
IgA deficiency
the antibodies of the kidd blood group system react best by:
the indirect antiglobulin test
Refer to the data on page 76. Which of the following prospective donors would be accepted for donation?
c. 22-year-old college student who has a temperature of 99.2 degrees F and states that he feels well but is nervous about donating
transfusion of plateletpheresis products from HLA-compatible donors is the preferred treatment for:
severely thrombocytopenic patients, known to be refractory to random donor platelets
Why are donors deferred for 6 months following receipt of blood products?
to permit adequate screening for transfusion-acquired viral infectiona
A 37-year-old female w/ SLE is admitted w/ anemia. Blood samples are received w/ a crosmatch request for 4 units or RBCs. the patient is group B, Rh-negative. Using the testing results on page 77, what is the most likely cause of the results?
a warm autoantibody
A 42-year-old female is undergoing surgery tomorrow 7 her physician requests that 4 units of RBCs be crossmatched. See page 77 for results. What is the most likely cause of the incompatibility of donor 1?
single alloantibody
Examine the results on page 78 of ABO typing tests and state the most probable cause of the discrepancy.
weak subgroup of A with anti-A1
A 14-year-old male trauma victim is in need of 3 units of RBDs. Refer to page 78 for the results obtained during pretransfusion testing. What is the FIRST step in resolving this problem?
perform a DAT on donor 2
the western Blot is a confirmatory test for the prescence of:
anti-HIV-1
A commonly used screening method for anti-HIV-1 detection is:
enzyme-linked immunosorbent assay (ELISA)
What red cell typings would most commonly be found in the black donor population?
Fy(a-b-)
An individual's RBCs give the reactions listed on page 79 with Rh antisera. The most probable genotype of this individual is:
CDe/cde
A patient is typed with the results listed on page 79. the most probable reason for these findings is that the patient is group;
Ax- with an anti-A1 antibody
the primary indication for granulocyte transfusion is:
severe neutropenia with an infection nonresponsive to antibody therapy
A patient in the immediate post-bone marrow transplant period has a hematocrit of 21%. The red cell product of choice for this patient would be:
irradiated
A sample gives the results listed on page 80. Which lectin should be used first to resolve this discrepancy?
Dolichos biflorus
a man suffering fron gastrointestinal bleeding has received 20 units of RBCs in the past 24 hours and is still oozing postoperatively. The results on page 80 were obtained. What blood product should be administered?
Fresh Frozen Plasma
Anti-I usually results in a positive direct antiglobulin test (DAT) because of:
C3d bound to the red cells
B lymphocytes are associated with:
synthesis of antibody
Plastic bog overwraps are recommended when thawing units of FFP in 37 degree C water baths because they prevent:
The entry ports from becoming contaminated with water
A unit of RBCs expiring in 35 days is split into five small aliquots using a sterile pediatris quad set and a sterile connecting devise. Each aliquot must be labeled as expiring in:
35 days
Refer to the chart on page 81. What is the best interpretation for the laboratory data given in the chart?
mother has had a fetal-maternal hemorrhage
A woman who was requested to be a sdirected donor has a mastectomy w/ radiotherapy for breast carcinoma 5 years ago. Currently, she is well and has a hemoglobin of 14 g/dL and a hematocrit of 41%. The blood bank should:
defer the donor permanently
A cause for permanent referral of blood donation is a history of ______________ of uncertain cause
jaundice
The reactions on page 82 were obtained. Then the technologist washed the patient's cells with saline, and added 2 drops of saline to the reverse grouping. Upon repeat testing, the results on page 82 were obtained. The results are concictant with:
multiple myeloma
Upon inspection, a unit of Platelets is noted to have visable clots, but otherwise appears normal. The technologist should:
quarantine for Gram Stain and culture
Which plateletpheresis priduct should be irradiated?
a directed donation given by a mother for her son
The results listed on page 83 are moted for a unit of blood labeles group A, Rh-negative. What should be done next?
notify the collecting facility
A thchnologist typed 10 units for c antigen. All 10 units test c-negative after a 37 degree C incubation. The Technologist should:
recheck the antisera with positive and negative controls
Leukocyte-reduced Red Blood Cells are ordered for a newly diagnosed bone marrow candidate. What is the best way to prepare this product?
transfuse through a 3 Log leukocyte-removing filter
When Plateletsare stored on a rotator set on an open top, the ambient air temperature must be recorded:
every 4 hours
What test is most commonly used to demonstrate antibodies that have become attached to a patient's red cells in vivo?
direct antiglobulin
Some bolld group antibodies characteristically hemolyze appropriate red cells in the presence of:
complement
The minimum hemoglobin concentration in g/dL in a fingerstick from a male blood donor is:
12.5
The purpose of testing with anti-A,B is to detect:
subgroups of A
A mother is Rh-negative and the father Rh-positive. Their baby is Rh-negative. It may be concluded that:
the father is heterozygous Rh-positive
In performing an antibody screening test and/or compatibility test, the use of a patient's specimen collected in an EDTA tube will:
prevent the setection of compliment-dependent antibodies
What represents an acceptably identified patient for sample collection and transfusion?
A handwritten band with patient's mane and hospital identification number is affixed to tha patient's leg.
Rh-immune globulin is requested for an Rh-negative mother who has the following results: Mothers postpartum sample D=0, D control=0, Du=1+mixed field, Du control =0. What is the most likely explanation?
Mother has a fetomaternal hemorrhage of D+ cells.
Samples from the patient on page 85 were received on 2 consecutive days. Test results are listed on page 85. How should the request for crossmatch be handled?
collect a new sample and repeat the tests
The following results are seen on a maternal postpartum sample: Aother's cells Rh=0, Rh control=0, Du =+mixed field, Du control=0. The most appropriate course of actionis to:
investigate for a fetomaternal hemorrhage
The test results on page 86 were obtained on a patient sample. Tha anti-D used was a chemically modified reagent. The best interpretation is that:
the sample is Rh-positive
Review the schematic diagram on page 86. The next step would be:
identify the cause of the agglutination
the most common cause of posttransfusion hepatitis can be detected in donors by testing for:
anti-HCV
A unit os packed cells is split into 2 aliquots under closed sterile conditions at 8 AM. The expitation time for each aliquot is now:
the original date of the unsplit unit
A group-B, Rh-negative patient has a positive DAT. What situation would occur?
the Du test and control would be positive
Which blood monponent is most effective in treating a patient with von Willebrand's disease?
cryoprecipitated AHF
A group B, Rh-negative patient is shock from acute blood loss would benefit most from a transfusion:
group B, Rh-negative Whole Blood
To qualify as a donor for autologous transfusion, a patient's hemoglobin should be at least:
11 g/dL
After checking the inventory, it was noted that there were no units on the shelf marked "May issue as uncrossmatched: For Emergency Only." What should the tech now place on this shelf?
units of group O, Rh-negative Red Blood Cells
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