AMSECT PBMS Exam UPDATED QUESTIONS AND
VERIFIED ANSWERS
Are allogenic blood transfusions 100% beneficial to the patient? - CORRECT ANSWER✅✅✅NO!
- HIgh risk of pathogen transmission, acute lung injury, allergic reaction etc.
- Associated with significant risk and there is not enough proof of adequate therapeutic outcome.
What are the 13 standard for PBM programs? - CORRECT ANSWER✅✅✅1. Leadership and Program
Structure
2. Consent Process and Patient Directives
3. Blood Administration Safety
4. Review and Evaluate of PBM Program
5. Transfusion Guidelines and Peer review of transfusions
6. preoperative anemia evaluation and readiness for surgery
7. perioperative autologous blood collection for administration
8. phlebotomy blood loss
9. minimizing blood loss during surgery
10. massive hemorrhage protocol
11. management of anemia in hospitalized patients
12. managing anemia in non-surgical outpatients
13. PBM for pediatric patients
Why are non-hemorrhaging patients typically transfused? - CORRECT ANSWER✅✅✅Failure to treat,
diagnose, and treat anemia
Which types of patients are transfusion dependent? - CORRECT ANSWER✅✅✅those with
hemoglobinopathy and myelodysplasia
What is the function of warfarin and how can it be reversed? - CORRECT ANSWER✅✅✅- An
anticoagulant ; inhibits synthesis of vitamin-K dependent clotting factors
,- A plasma transfusion can reverse warfarin
What is the purpose of the Society for the Advancement of Blood Management (SABM)? - CORRECT
ANSWER✅✅✅Educates caregivers on the clinical issues associated with blood transfusion and the
impact on patient outcomes
What is hemostasis? - CORRECT ANSWER✅✅✅blood clotting
What are the 4 guiding principles of Patient Blood Management (PBM) to improve patient outcomes? -
CORRECT ANSWER✅✅✅- Interdisciplinary Blood Conservation Modalities
- Managing Anemia
- Optimizing Coagulation
- Patient Centered Decision Making
What are the levels of leadership in the PBM program? - CORRECT ANSWER✅✅✅- physician as
medical director (clinical leadership)
- program manager (operational leadership) (nurse, MT, pharmacist, etc.)
- multispecialty steering committee (functions as medical director also if needed)
- Overall monitors patient outcomes and the use of resources (ex: prbc)
- a committee reviews and evaluates al aspects of the patient blood management program
What is the function of the physician (medical director) in the PBM program? - CORRECT
ANSWER✅✅✅- Must have knowledge of blood and therefore helps establish protocols for PBM in
order to reduce blood loss.
- consults and educates others on appropriate transfusion practices.
What is the function of the program manager in the PBM program? - CORRECT ANSWER✅✅✅- Must
have experience with transfusion medicine/PBM
- Must be able to navigate the health care system, handle day-to-day operations and assist with
educating staff
,What are alternatives to allogenic transfusions? - CORRECT ANSWER✅✅✅- autologous transfusions
- human derived growth factors
- essential cofactors
- recombinant products
- factor concentrates
- blood derivatives and fractions
What are the more than half of the adverse affects of allogenic blood transfusion attributed to? -
CORRECT ANSWER✅✅✅Human error
What is an important tool for improving patient outcomes? - CORRECT ANSWER✅✅✅evaluating the
effectiveness of the pbm program
- done via collecting data such as amount of red cells, platelets, plasma and cryo transfused; pre and
post lab results, number of patients enrolled in preoperative anemia management, use of erythropoietic
stimulating agents, anticoagulant and anti platelet medication, use of preoperative cell collection, etc.
What is a key element in a successful patient blood management program? - CORRECT
ANSWER✅✅✅effective implementation of comprehensive transfusion guidelines
How are transfusion guidelines established? - CORRECT ANSWER✅✅✅- written by multidisciplinary
group of physicians
- then evaluated by the hospitals transfusion/quality management committee
- approved by the medical staff/committee
What should the transfusion guidelines consider ? - CORRECT ANSWER✅✅✅- must promote an
evidence-based approach demonstrating the benefits and risks of transfusion.
- should consider factors such as patient age, diagnosis, clinical circumstances, lab values
What is an effective tool for supporting adherence to transfusion guidelines? - CORRECT
ANSWER✅✅✅- blood component ordering process
, - paper based or computer based ordering system
- way to require provider to indicate reason for transfusion
- prospective review and retrospective review of blood use
What is an important screening process that must occur prior to surgery? - CORRECT
ANSWER✅✅✅anemia screening
- must be assessed at least 3-4 weeks prior to surgery
- may lead to surgery rescheduled until anemia treated
What is preoperative anemia associated with? - CORRECT ANSWER✅✅✅- increased preoperative
morbidity and mortality
- it is the most reliable predictor of significant post-procedure anemia and transfusion requirements
What are some factors that increase the risk of perioperative transfusion? - CORRECT
ANSWER✅✅✅- advanced age
- small body size
- female gender
- chronic renal disease or connective tissue disease
What are common causes of anemia? - CORRECT ANSWER✅✅✅- iron deficiency
- B12 deficiency
- CKD
How to treat anemia? - CORRECT ANSWER✅✅✅- administration of oral or intravenous iron
- erythropoietic agents
- folate or vitamin B12
What should a pre-operative evaluation include? - CORRECT ANSWER✅✅✅- medical history
VERIFIED ANSWERS
Are allogenic blood transfusions 100% beneficial to the patient? - CORRECT ANSWER✅✅✅NO!
- HIgh risk of pathogen transmission, acute lung injury, allergic reaction etc.
- Associated with significant risk and there is not enough proof of adequate therapeutic outcome.
What are the 13 standard for PBM programs? - CORRECT ANSWER✅✅✅1. Leadership and Program
Structure
2. Consent Process and Patient Directives
3. Blood Administration Safety
4. Review and Evaluate of PBM Program
5. Transfusion Guidelines and Peer review of transfusions
6. preoperative anemia evaluation and readiness for surgery
7. perioperative autologous blood collection for administration
8. phlebotomy blood loss
9. minimizing blood loss during surgery
10. massive hemorrhage protocol
11. management of anemia in hospitalized patients
12. managing anemia in non-surgical outpatients
13. PBM for pediatric patients
Why are non-hemorrhaging patients typically transfused? - CORRECT ANSWER✅✅✅Failure to treat,
diagnose, and treat anemia
Which types of patients are transfusion dependent? - CORRECT ANSWER✅✅✅those with
hemoglobinopathy and myelodysplasia
What is the function of warfarin and how can it be reversed? - CORRECT ANSWER✅✅✅- An
anticoagulant ; inhibits synthesis of vitamin-K dependent clotting factors
,- A plasma transfusion can reverse warfarin
What is the purpose of the Society for the Advancement of Blood Management (SABM)? - CORRECT
ANSWER✅✅✅Educates caregivers on the clinical issues associated with blood transfusion and the
impact on patient outcomes
What is hemostasis? - CORRECT ANSWER✅✅✅blood clotting
What are the 4 guiding principles of Patient Blood Management (PBM) to improve patient outcomes? -
CORRECT ANSWER✅✅✅- Interdisciplinary Blood Conservation Modalities
- Managing Anemia
- Optimizing Coagulation
- Patient Centered Decision Making
What are the levels of leadership in the PBM program? - CORRECT ANSWER✅✅✅- physician as
medical director (clinical leadership)
- program manager (operational leadership) (nurse, MT, pharmacist, etc.)
- multispecialty steering committee (functions as medical director also if needed)
- Overall monitors patient outcomes and the use of resources (ex: prbc)
- a committee reviews and evaluates al aspects of the patient blood management program
What is the function of the physician (medical director) in the PBM program? - CORRECT
ANSWER✅✅✅- Must have knowledge of blood and therefore helps establish protocols for PBM in
order to reduce blood loss.
- consults and educates others on appropriate transfusion practices.
What is the function of the program manager in the PBM program? - CORRECT ANSWER✅✅✅- Must
have experience with transfusion medicine/PBM
- Must be able to navigate the health care system, handle day-to-day operations and assist with
educating staff
,What are alternatives to allogenic transfusions? - CORRECT ANSWER✅✅✅- autologous transfusions
- human derived growth factors
- essential cofactors
- recombinant products
- factor concentrates
- blood derivatives and fractions
What are the more than half of the adverse affects of allogenic blood transfusion attributed to? -
CORRECT ANSWER✅✅✅Human error
What is an important tool for improving patient outcomes? - CORRECT ANSWER✅✅✅evaluating the
effectiveness of the pbm program
- done via collecting data such as amount of red cells, platelets, plasma and cryo transfused; pre and
post lab results, number of patients enrolled in preoperative anemia management, use of erythropoietic
stimulating agents, anticoagulant and anti platelet medication, use of preoperative cell collection, etc.
What is a key element in a successful patient blood management program? - CORRECT
ANSWER✅✅✅effective implementation of comprehensive transfusion guidelines
How are transfusion guidelines established? - CORRECT ANSWER✅✅✅- written by multidisciplinary
group of physicians
- then evaluated by the hospitals transfusion/quality management committee
- approved by the medical staff/committee
What should the transfusion guidelines consider ? - CORRECT ANSWER✅✅✅- must promote an
evidence-based approach demonstrating the benefits and risks of transfusion.
- should consider factors such as patient age, diagnosis, clinical circumstances, lab values
What is an effective tool for supporting adherence to transfusion guidelines? - CORRECT
ANSWER✅✅✅- blood component ordering process
, - paper based or computer based ordering system
- way to require provider to indicate reason for transfusion
- prospective review and retrospective review of blood use
What is an important screening process that must occur prior to surgery? - CORRECT
ANSWER✅✅✅anemia screening
- must be assessed at least 3-4 weeks prior to surgery
- may lead to surgery rescheduled until anemia treated
What is preoperative anemia associated with? - CORRECT ANSWER✅✅✅- increased preoperative
morbidity and mortality
- it is the most reliable predictor of significant post-procedure anemia and transfusion requirements
What are some factors that increase the risk of perioperative transfusion? - CORRECT
ANSWER✅✅✅- advanced age
- small body size
- female gender
- chronic renal disease or connective tissue disease
What are common causes of anemia? - CORRECT ANSWER✅✅✅- iron deficiency
- B12 deficiency
- CKD
How to treat anemia? - CORRECT ANSWER✅✅✅- administration of oral or intravenous iron
- erythropoietic agents
- folate or vitamin B12
What should a pre-operative evaluation include? - CORRECT ANSWER✅✅✅- medical history
