MLT ASCP BOC Blood Bank Questions with Answers

A blood donor has totype: hh, AB. ing anti-A and anti-B antisera., the donor's red cells will type as group US? - Answer- O which of the following is proper procedure for preparation of platelets from Whole blood? - Answer- light spin followed by a hard spin The minimum hemoglobin concentration in a finger-stick from a male blood donor is: - Answer- 13.0 g/dL A cause for indefinite deferral of blood donation is: - Answer- Positive test for Trypanosoma cruzi What of the following prospective donors would be accepted for donation? - Answer- 22-year-old college student who has a temperature of 99.2 degrees F (37.7 C) and states that he feels well, but is nervous about donating Which of the following constitutes permanent deferral status of a donor? - Answer- Confirmed positive test for HBsAg 10 years previously According to AABB standards, which of the following donors may be accepted as a blood donor? - Answer- Spontaneous abortion at 2 months of pregnancy, 3 months previously In order to be a plateletpheresis donor, the platelet count must be at least: - Answer- 150,000/ul Prior to blood donation, the intended venipuncture site must be cleaned with a scrub solution containing: - Answer- Providone iodine A donor who has just donated 2 units of Apheresis Red Blood Cells will be deferred from further blood donation for a minimum of how many weeks? - Answer- 16 Which of the following infectious agents relies solely on donor questioning to avoid transmission from transfused blood products? - Answer- Plasmodium falciparum Which of the following practices at the time of blood cell collection helps minimize bacterial contamination of platelet products? - Answer- Diversion pouch According to AABB standards, what is the minimum hemoglobin level for an autologous donor? - Answer- 11.0 g/dL What is/are the minimum pretransfusion testing requirement(s) for autologous donations collected and transfused by the same facility? - Answer- ABO and Rh typing only Which of the following must be included on the label of a unit of Red Blood Cells Leukocytes Reduced? - Answer- Unique collection facility identifier All donor blood testing must include: - Answer- serological test for syphilis The test that is currently used to detect donors who are infected with the AIDS virus is: - Answer- Anti-HIV-1/2 Which of the following practices has been useful in reducing the incidence of Transfusion Related Acute Lung Injury (TRALI)? - Answer- Use of Fresh Frozen Plasma from male donors Which of the following infectious agents must be tested for using a nucleic acid testing (NAT) assay? - Answer- HBV What is the primary reason that infectious agents can be transmitted following blood transfusion? - Answer- Donor in the window period of early infection The transport temperature of Red Blood Cells Leukocytes Reduced is: - Answer- 1-10 degrees C The transport temperature for Apheresis Platelets is: - Answer- 20-24 degrees C A unit of RBC's expiring in 35 days is split into 5 small aliquots using a sterile pediatric quad set and a sterile connecting device. Each aliquot must be labeled as expiring in: - Answer- 35 days When platelets are stored on a rotator set on an open bench top, the ambient air temperature must be recorded: - Answer- Every 4 hours Which of the following is the correct storage temperature for the component listed? - Answer- Fresh Frozen Plasma -20 C Six units of RBC's are issued to the OR at 9am in a cooler, validated to maintain a temperature of 1-10 degrees C for 2 hours. 40 minutes later, the cooler containing the units of blood is returned to the blood bank as surgery was cancelled. What should be done with these units? - Answer- Inspect units and established that appropriate temperature has been maintained An acceptable storage temperature for RBC's, frozen is: - Answer- 80 degrees C RBC's leukocytes reduced must be stored at: - Answer- 1-6 degrees C If the seal is entered on a unit of RBC's stored at 1- 6Cwhat is the maximum allowable storage period in hours? - Answer- 24 hours Cryoprecipitated AHF must be stored at: - Answer- or equal to -18 C Plasma, frozen within 24 hours after phlebotomy (PF24) and thawed for transfusions has an expiration of: - Answer- 24 hours Apheresis platelets must be stored at: - Answer- 20-24 degrees C Cryoprecipitated AHF, if maintained in the frozen state at -18*C or below, has a shelf life of: - Answer- 12 months Thawed plasma must be stored at: - Answer- 1-6*C Upon inspection, a unit of Apheresis Platelets is noted to have visible clots, but otherwise appears normal. The technologist should: - Answer- Quarantine for Gram stain and culture Upon expiration, a unit of thawed plasma frozen within 24 hours (PF24) is converted to thawed plasma. This thawed plasma can be stored for an additional: - Answer- 4 days The transfusion service is preparing aliquots from a unit of RBC's leukocytes reduced with the aid of a sterile connecting device for a pediatric patient. When checking the weld for one of these aliquots, it is noted that the weld is incomplete and leaking. This unit is then released with an acceptable weld. What will the expiration date of this unit be? - Answer- 24 hours During the preparation of platelets from whole blood, the blood should be: - Answer- cooled towards 20-24 C Red blood cells leukocytes must be prepared by a method known to reduce the leukocyte count to: - Answer- 5.0x106 A unit of RBC's that expires in 32 days has just been irradiated. The expiration date of this unit will: - Answer- be reduced by 4 days Cryoprecipitated AHF must be transfused within what period of time following thawing and pooling? - Answer- 4 hours According to AABB standards, Fresh Frozen Plasma must be infused within what period of time following thawing? - Answer- 24 hours CryoprecipitateD AHF - Answer- is indicated for fibrinogen deficiencies Which apheresis platelets product should be irradiated? - Answer- a directed donation given by a mother for her son. irradiation of a unit of red blood cells is done to prevent the replication of donor - Answer- lymphocytes Plastic bag overwrap are recommended when thawing units of FFP in 37 degree C water baths because they prevent: - Answer- c) the entry ports from becoming contaminated with water Which of the following blood components must be prepared within 8 hours after phlebotomy? - Answer- b) fresh frozen plasma an important determinant of platelet viability during storage is: - Answer- plasma pH According to AABB standards, at least 90% of all Apheresis platelets units tested shall contain a minimum of how many platelets? - Answer- 3 x 10^11 platelets According to AABB standards, platelets prepared from whole blood shall at least: - Answer- 5.5 x 10 *10 platelets per unit in at least 90% of the unit tested According to AABB standards, what minimum pH required for Apheresis platelet at the end of the storage period? - Answer- 6.2 what percentage of red blood cells must be retained when preparing red blood cells leukocytes reduced? - Answer- 85 % in a quality assurance program, cryoprecipitated AHF must contain a minimum of how many international units of Factor VIII? - Answer- 80 IU or higher The linked HLA genes on each chromosome constitute a(n): - Answer- haplotype Most blood group systems are inherited as - Answer- autosomal codominant The mating of an Xg(a+) man and an Xg(a-) woman will only produce: - Answer- Xg(a-) sons and Xg(a+) daughters which phenotype could not result from the mating of a Jk(a+b+) female and a Jk(a-b+) male? - Answer- Jk(a-b-) which of the following phenotypes is the result of homozygous inheritance of the corresponding genes? - Answer- Fy(a-b+) which of the following antibodies is usually clinically insignificant? - Answer- anti-P1 an individual red blood cells give the following reactions with Rh anti-sera? Anti-D=4+ Anti-C=3+ Anti-E=0 Anti-c=3+ Anti-e=3+ Rh control=0 the individual's most probable genotype is: - Answer- DCe/dce an individual has been sensitized to the k antigen and has produced anti-k. what is the most probable Kell system genotype? - Answer- KK a mother has the red cell phenotype D+C+E-c-e+ with anti-c (titer of 32 at AHG) in her serum. The father has the phenotype D+C+E-c+e+. The baby is Rh-negative and not affected with hemolytic diseases of the newborn. What is the baby's most probably Rh genotype? - Answer- r'r' in an emergency situation, Rh-negative red cells are transfused into an Rh-positive person of the genotype CDe/CDe. The first antibody most likely to develop is: - Answer- anti-c data: anti-C (+) anti-D (+) anti-E (+) anti-c (+) anti-e (+) - Answer- R1R2 a patient's red cells type as follows:anti-D (4+) anti-C (0) anti-E (0) - Answer- R0R0 The red cells of a nonsecretor (se/se) will most likely type as: - Answer- Le(a+b-) which of the following phenotypes will react with anti-f? - Answer- rr a patient's RBC gave the following reactions:anti-D (+) anti-C (+) anti-E (+) anti-c (+) anti-e (+) anti-f (0) the most probable genotype of this patient is: - Answer- R1R2 A woman types as Rh-positive. She has an anti-c titer of 32 at AHG. Her baby has a negative DAT and is not affected by hemolytic disease of the newborn. What is the father's most likely Rh phenotype? - Answer- R1r which of the following red cell typings are most commonly found in the African American donor population? - Answer- Fy(a-b-) A donor is tested with Rh antisera, with the following results :Anti-D + Anti-C+ Anti-E+ anti-c+ anti-e +Rh control 0 What is the probable Rh genotype? - Answer- R1r which of the following is the immunodominant sugar responsible for the A antigen? - Answer- N-acetylglucosamine which of the following is considered to be a high prevalence antigen? - Answer- Vel the reason that group O individuals have the most amount of H antigen on their red cells compared to other ABO phenotypes is: - Answer- H antigen is left unchanged by the absence of A and/or B transferase enzymes given the following serologic reactions, what is the most likely A subgroup? anti-A = 2+ mfanti-B = 0 anti-A,B = 2+mf A1 cells = 1+ B cells = 4+ O cells = 0 - Answer- A3 the enzyme responsible for conferring H activity on the red cell membrane is alpha-: - Answer- L-fucosyl transferase even in the absence of prior transfusion or pregnancy, individuals with the Bombay phenotype (Oh) will always have naturally occurring: - Answer- anti-H which of the following antibodies in the Lutheran system is most likely to be IgM and detected as a direct agglutinin? - Answer- anti-Lu^a antibodies from which of the following blood group systems are notorious for causing delayed hemolytic transfusion reactions? - Answer- Kidd isoimmunization to platelet antigen HPA-1a and the placental transfer of maternal antibodies would be expected to cause newborn: - Answer- thrombocytopenia what antigens would be found in the saliva of an individual with the genotype Sese Lele AO HH? - Answer- Le^a, Le^b, A, H which of the following genes is not in the MHC class I region? - Answer- HLA-DR The phenomenon of an Rh-positive person whose serum contains anti-D is best explained by: - Answer- missing antigen epitopes when the red cells of an individual fial to react with anti-U, they usually fail to react with: - Answer- anti-S which of the following red cell antigens are found on glycophorin-A? - Answer- M, N Paroxysmal cold hemoglobinuria (PCH) is associated with antibody specificity toward which of the following? - Answer- P antigen which of the following is a characteristic of anti-i? - Answer- found in the serum of patients with infectious mononucleosis cold agglutinin disease is associated with an antibody specificity toward which of the following? - Answer- I which of the following is a characteristic of anti-i? - Answer- temperature or 4 C in chronic granulomatous disease (CGD), granulocyte function is impaired. An association exists between this clinical condition and a depression of which of the following antigens? - Answer- Kell the antibodies of the Kidd blood group system: - Answer- react best by the indirect antiglobulin test Proteolytic enzyme treatment of red cells usually destroys which antigen? - Answer- Fy^a Anti-Fy^a is: - Answer- capable of causing hemolytic transfusion reactions Resistance to malaria is best associated with which of the following blood groups? - Answer- Duffy anti-K is identified in a patient's serum. If random crossmatches are performed on 10 donor units, approximately how many would be expected to be compatible? - Answer- 9 Four units of blood are needed for elective surgery. The patients serum contains anti-C, anti-e, anti-FYa, and anti-JKb. Which of the following would be the best source of donor blood? - Answer- rare donor registry a patient is group O, Rh-negative with anti-D and anti-K in her serum. What percentage of the general Caucasian donor population would be compatible with this patient? - Answer- 6.0 which of the following Rh antigens has the highest frequency in Caucasians? - Answer- e the Kell (K1) antigen is: - Answer- strongly immunogenic what is the approximate probability of finding compatible blood among random Rh-positive units for a patient who has anti-c and anti-K? (consider that 20% of Rh-positive donors lack c and 90% lack K) - Answer- 18% which of the following is responsible for the production of blood group antibodies? - Answer- B cells in a primary immune response, which immunoglobulin class appears first? - Answer- IgM what is the most common clinical incident that results in alloantibody production? - Answer- red cell transfusion macrophages and monocytes have Fc receptors for which of the following immunoglobulins? - Answer- IgG which of the following blood group antigens is the most immunogenic, or has the greatest ability to initiate antibody production in an individual who lacks the antigen? - Answer- D IgG antibody and/or C3b sensitized RBC can be phagocytized by cells in the reticuloendothelial system (RES). This phenomenon is clinically recognized as: - Answer- extravascular hemolysis which immunoglobulin class can cross the placenta? - Answer- IgG which of the following immunoglobulins is most efficient at activating complement via the classical pathway? - Answer- IgM which of the following immunoglobulins is most efficient at causing direct hemagglutination? - Answer- IgM which of the following structures of an immunoglobulin molecule is involved in the activation of complement via the classical pathway? - Answer- Fc region immunoglobulin classes are differentiated according to the molecular structure of: - Answer- heavy chains which of the following pairs of immunoglobulins is most efficient at activating complement via the classical pathway? - Answer- IgG1 and IgG3 the immune response to red cell antigens with numerous epitopes results in a heterogenous population of antibodies referred to as: - Answer- polyclonal the following ABO results are noted on a sample from a 90 yo male admitted to the ER for possible GI bleeding:cells tested with anti-A = 0 anti-B = 0 serum tested with A1 cells = 0 B cells = 1+ what might be a likely explanation for these results? - Answer- patient's age appropriate antigen-antibody ratios are important to avoid an excess of unbound antibody known as: - Answer- prozone effect blood group antigen and antibody hemagglutination reactions are influenced by which of the following? - Answer- temperature which of the following blood group antibodies will no longer react with its respective antigens once those antigens are treated with proteolytic enzymes? - Answer- anti-Fy^a some blood group antibodies may react stronger with the red cells of individuals who have inherited 2 identical alleles for the antigen to which the antibody is directed. This is known as: - Answer- dosage effect which of the following reagents is used to facilitate hem-agglutination following the sensitization of red cells with an IgG alloantibody? - Answer- anti-human globulin serum the addition of antibody-sensitized red cells (check cells) to all negative anti-human globulin (AHG) tests ensures that:the test was interpreted correctly - Answer- AHG reagent was added to each test in which of the following clinical situations will the direct antiglobulin test be positive? - Answer- hemolytic disease of the fetus and newborn in which of the following is the indirect antiglobulin test utilized? - Answer- antibody detection (screening) test polyspecific AHG reagents - Answer- anti-IgG and anti-C3d a false negative direct antiglobulin test can be the result of: - Answer- insufficient saline washing of red cells a false positive indirect antiglobulin test can be the result of: - Answer- overcentrifugation a negative result using solid phase adherence assays will demonstrate indicator red cells as: - Answer- a RBC pellet in the bottom of the well a 4+ positive reactions using gel technology will appear as RBCs: - Answer- in a layer at the top of the gel media one of the advantages of performing antibody screening (detection) studies using gel technology is: - Answer- saline washing is not required monoclonal blood banking reagents have which of the following as a disadvantage? - Answer- overspecificity the direct antiglobulin test in a suspected case of warm autoimmune hemolytic anemia is positive. Which of the following monospecific reagents would be used in further direct antiglobulin testing? - Answer- anti-C3d low ionic strength saline (LISS) acts as an enhancement medium and facilitates antibody uptake by: - Answer- reducing zeta potential the membrane attack complex (MAC) formed during the activation of complement via the classical pathway consists of: - Answer- C5b through C9 in ABO hemolytic transfusion reactions, complement is activated via which of the following pathways? - Answer- classical IgG-sensitized red cells that activate complement may not complete complement activation to cell lysis. In addition to IgG on the surface of these red cells, what complement component is present? - Answer- C3b In a normal adult, the spleen acts as a site for: - Answer- removal of aging red blood cells which of the following cells transport O2 and CO2? - Answer- erythrocytes which of the following cells is the largest cell in the bone marrow? - Answer- megakaryocyte in patients who present with bleeding due to a low platelet count, the most common type of bleeding is: - Answer- mucosal bleeding Transfusion of which of the following is needed to help correct hypofibrinogenemia due to DIC? - Answer- cryoprecipitated AHF a blood component used in the treatment of hemophilia A is: - Answer- factor VIII a unit of Fresh Frozen Plasma was inadvertently thawed and then immediately refrigerated at 4 oC on Monday morning. On Tuesday evening this unit may still be transfused as a replacement for: - Answer- Factor IX a newborn demonstrates petechiae, ecchymosis and mucosal bleeding. the preferred blood component for this infant would be: - Answer- Platelets which of the following would be the best source of platelets for transfusion in the case of alloimmune neonatal thrombocytopenia? - Answer- mother