TRANSFUSION CSMLS EXAM
QUESTIONS AND ANSWERS
Kleihauer Betke Test - Correct Answers -If Rosette test is positive, quantifies FMH. Acid
elution principle, fetal hemoglobin (HgbF) is resistant to acid elution, adult hemoglobin
(HgbA) is not resistant.
-Quantitative test
1. Blood smear from postpartum maternal sample exposed to acid buffer.
2. HgB from adult red cells leaches into buffer and leaves only stroma, whereas the fetal
red cells retain their Hgb
3. Smears washed, stained and examined under oil immersion.
4. Adult red cells appear as "ghosts", fetal cells appear pink
Reported as percentage of fetal red cells ( # fetal red cells / total red cell count) #fetal
cells/1000 RBC
Rosette Test - Correct Answers -Screen method , demonstrates presence of Rh
Positive Baby cells.
- Qualitative test
Suspension of maternal Red cells (contains D -negative maternal and small # of D-
positive fetal red cells) incubated with Anti-D. Anti-D binds to D-pos fetal cells.
Suspension then washed and D positive indicator red cells added which bind to anti-D
and form rosette around D positive fetal red cells, which is then examined
microscopically.
< 1 rosette per 3 lpf: 1 dose of RhIG> 1 rosette per 3pg: quantitate bleed
ACD, CPD, CP2D - Correct Answers -21 days after used (Anticoagulants)
CPDA-1 - Correct Answers -Anticoagulant
35 day expiration
Additive Solutions - Correct Answers -Preserving solutions that are added to the RBCs
after removal of the plasma with or without platelets
, 42 days
Packed Red Blood Cells (PRBCs) - Correct Answers -Red cells with plasma removed
To increase oxygen-carrying capacity in patients with anemia, in patients with
substantial hemoglobin deficits, and in patients who have lost up to 25% of their total
blood volume
Washed Red Cells - Correct Answers -- Plasma removed by successive saline washes
(automated instruments)
- Prevents allergic response to plasma proteins and anaphylactic shock in IgA deficient
patients with anti-IgA (IgA is in normal plasma)
- Expires 24 hours after seal of original unit broken
Leukocyte reduced RBCs - Correct Answers -Removal of leukocytes (WBCs) from the
RBC component resulting in <5 x 10^6 WBCs in the entire unit.
85% of RBCs retained.
- For patients with repeated febrile nonhemolytic FNH reactions.
Deglycerolized RBCs - Correct Answers -Cryoprotective agent (40% glycerol) protect
from ultra low temperatures.
- Thawed @ 37c and glycerol removed. 80% of RBCs must be recovered.
- Stored @ <-65c; 1-6c for 24hrs after deglycerolizing
- Used for storage of autologous units and rare units; expires in 10 years.
Fresh Frozen Plasma (FFP) - Correct Answers --Prepared by separating cells and
plasma by centrifugation and freezing plasma within 8 hours of collection
-Expires 1 year from date of collection when stored at ≤ 18°C or 7 years stored at ≤ -
65°C
-Once thawed (between 30-37°C), expires in 24 hours, if stored at 1-6°C
- Used for multiple coagulation deficiencies, factor XI deficiency and other congenital
deficiencies for which no concentrate is available
Cryoprecipitate - Correct Answers -FFP frozen within 8 hrs of WB collection is thawed
@ 1-6C, cold insoluble portion of plasma forms. It is refrozen within 1 hour.
- Contains >150mg fibrinogen and >80IU/bag of factor VIII, Contains vWF, factor XIII
and fibronectin
QUESTIONS AND ANSWERS
Kleihauer Betke Test - Correct Answers -If Rosette test is positive, quantifies FMH. Acid
elution principle, fetal hemoglobin (HgbF) is resistant to acid elution, adult hemoglobin
(HgbA) is not resistant.
-Quantitative test
1. Blood smear from postpartum maternal sample exposed to acid buffer.
2. HgB from adult red cells leaches into buffer and leaves only stroma, whereas the fetal
red cells retain their Hgb
3. Smears washed, stained and examined under oil immersion.
4. Adult red cells appear as "ghosts", fetal cells appear pink
Reported as percentage of fetal red cells ( # fetal red cells / total red cell count) #fetal
cells/1000 RBC
Rosette Test - Correct Answers -Screen method , demonstrates presence of Rh
Positive Baby cells.
- Qualitative test
Suspension of maternal Red cells (contains D -negative maternal and small # of D-
positive fetal red cells) incubated with Anti-D. Anti-D binds to D-pos fetal cells.
Suspension then washed and D positive indicator red cells added which bind to anti-D
and form rosette around D positive fetal red cells, which is then examined
microscopically.
< 1 rosette per 3 lpf: 1 dose of RhIG> 1 rosette per 3pg: quantitate bleed
ACD, CPD, CP2D - Correct Answers -21 days after used (Anticoagulants)
CPDA-1 - Correct Answers -Anticoagulant
35 day expiration
Additive Solutions - Correct Answers -Preserving solutions that are added to the RBCs
after removal of the plasma with or without platelets
, 42 days
Packed Red Blood Cells (PRBCs) - Correct Answers -Red cells with plasma removed
To increase oxygen-carrying capacity in patients with anemia, in patients with
substantial hemoglobin deficits, and in patients who have lost up to 25% of their total
blood volume
Washed Red Cells - Correct Answers -- Plasma removed by successive saline washes
(automated instruments)
- Prevents allergic response to plasma proteins and anaphylactic shock in IgA deficient
patients with anti-IgA (IgA is in normal plasma)
- Expires 24 hours after seal of original unit broken
Leukocyte reduced RBCs - Correct Answers -Removal of leukocytes (WBCs) from the
RBC component resulting in <5 x 10^6 WBCs in the entire unit.
85% of RBCs retained.
- For patients with repeated febrile nonhemolytic FNH reactions.
Deglycerolized RBCs - Correct Answers -Cryoprotective agent (40% glycerol) protect
from ultra low temperatures.
- Thawed @ 37c and glycerol removed. 80% of RBCs must be recovered.
- Stored @ <-65c; 1-6c for 24hrs after deglycerolizing
- Used for storage of autologous units and rare units; expires in 10 years.
Fresh Frozen Plasma (FFP) - Correct Answers --Prepared by separating cells and
plasma by centrifugation and freezing plasma within 8 hours of collection
-Expires 1 year from date of collection when stored at ≤ 18°C or 7 years stored at ≤ -
65°C
-Once thawed (between 30-37°C), expires in 24 hours, if stored at 1-6°C
- Used for multiple coagulation deficiencies, factor XI deficiency and other congenital
deficiencies for which no concentrate is available
Cryoprecipitate - Correct Answers -FFP frozen within 8 hrs of WB collection is thawed
@ 1-6C, cold insoluble portion of plasma forms. It is refrozen within 1 hour.
- Contains >150mg fibrinogen and >80IU/bag of factor VIII, Contains vWF, factor XIII
and fibronectin
