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Chapter 1 RBCs and Platelet Preservation: Historical Perspectives and Current Trends
x x x x x x x x x x
Multiple Choice
x
Identify the choice that best completes the statement or answers the question.
x x x x x x x x x x x
1. Which metabolic pathway is responsible for generating 90% of the ATP for the RBC?
x x x x x x x x x x x x x
a. Pentose phosphate shunt c. Glycolysis x x
b. Luebering-Rapoport shunt d. Methemoglobin reductase x x x
2. A unit of blood was returned to the blood bank before it was spiked. Apparently the patient’s IV failed. The uni
x x x x x x x x x x x x x x x x x x x x
t of blood was outside the blood bank for 35 minutes. Which of the statements below is most accurate?
x x x x x x x x x x x x x x x x x x
a. The unit of blood should be discarded immediately.
x x x x x x x
b. The unit of blood can be returned to inventory.
x x x x x x x x
c. The unit of blood must be transfused within 4 hours or be discarded at the end of that time.
x x x x x x x x x x x x x x x x x x
d. The unit of blood must be transfused with 24 hours.
x x x x x x x x x
3. What is the average diameter of a platelet?
x x x x x x x
a. 5 to 10 µm x x x c. 1 to 2 µm x x x
b. 2 to 4 µm x x x d. 4 to 6 µm
x x x x x
4. In the normal hemoglobin-
x x x
oxygen dissociation curve, what percentage of oxygen is released to the tissues when PO2 averages 40 mm
x x x x x x x x x x x x x x x x x
Hg?
a. 75% c. 100%
b. 25% d. 50% x
5. What factors are known to influence platelet metabolism and function?
x x x x x x x x x
a. Storage temperature c. Platelet count x x
b. Initial pH d. All of the above
x x x x x
6. Which of the following red blood cell morphologies may be present on the peripheral blood smear as a result of l
x x x x x x x x x x x x x x x x x x x x
oss of RBC membrane?x x x
a. Spherocytes c. Burr cells x
b. Target cells d. Schistocytes
x x
7. What does the term autologous transfusion refer to?
x x x x x x x
a. A parent donating blood for his or her child
x x x x x x x x
b. An individual donating blood for a friend
x x x x x x
c. An individual donating blood for a relative
x x x x x x
d. An individual donating blood for his or her own transfusion
x x x x x x x x x
8. What is the primary function of hemoglobin?
x x x x x x
a. Iron metabolism x c. Oxygen transport x
b. Porphyrin synthesis x d. Signal transduction
x x
9. All of the following areas of red blood cell biology are crucial for normal erythrocyte survival except:
x x x x x x x x x x x x x x x x
a. Cellular metabolism. c. Site of the ABO antigen attachment.
x x x x x x
b. RBC membrane. d. Hemoglobin structure.
x x x
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x 10. What is the correct biochemical composition of the RBC membrane?
x x x x x x x x x x
a. 52% protein, 40% lipid, 8% carbohydrate
x x x x x
b. 40% protein, 8% lipid, 52% carbohydrate
x x x x x
c. 8% protein, 52% lipid, 40% carbohydrate
x x x x x
d. 8% lipid, 40% carbohydrate, 52% protein
x x x x x
x 11. All of the following biochemical changes are associated with loss of red blood cell viability upon storage
x x x x x x x x x x x x x x x x x
except:
a. Decreased pH. c. Increased ATP level. x x x
b. Loss of red blood cell function. x d. Decreased glucose consumption.
x x x x x x x
x 12. Which red blood cell preservative has a storage time of 35 days?
x x x x x x x x x x x x
a. ACD c. AS-1
b. CPDA-1 d. CPD x x
x 13. The RBC membrane is relatively permeable to all of the following except:
x x x x x x x x x x x x
a. Chloride. c. Bicarbonate.
b. Sodium. d. Water. x
x 14. What percentage of platelets is sequestered in the spleen as functional reserve after being released from the bo
x x x x x x x x x x x x x x x x x x
ne marrow?
x
a. 30% c. 10%
b. 50% d. 25% x x
x 15. What is the major biochemical consideration in platelet storage?
x x x x x x x x x
a. Glucose metabolism c. Production of carbon dioxide
x x x x
b. Oxygen supply d. Regulation of pH
x x x x
x 16. What would the hemoglobin-
x x x x
oxygen dissociation curve depict in a patient exhibiting clinical signs of alkalosis?
x x x x x x x x x x x
a. Normal c. Shift to the right x x x
b. Shift to the left x d. None of the above
x x x x x x
x 17. Name the main lipid components of a red blood cell membrane.
x x x x x x x x x x x
a. Phospholipid c. Glycolipid
b. Sphingomyelin d. Glycophorin A x x
x 18. The ABO blood groups were discovered in 1901 by whom?
x x x x x x x x x x
a. Charles Drew c. Loutit and Mollison
x x x
b. Karl Landsteiner x d. Edward Lindeman x x
x 19. A standing order of platelets was shipped to your facility by your supplier. It was inadvertently left in the corner
x x x x x x x x x x x x x x x x x x x x
of the department until discovered 36 hours later. What would the appropriate action be for the blood banker?
x x x x x x x x x x x x x x x x x x
a. If the temperature in the box was 22 +/-
x x x x x x x x
2°C and the platelet swirl seemed OK, it would be OK to accept the unit into inventory.
x x x x x x x x x x x x x x x x x
b. The platelets have fallen outside the supplier’s quality assurance. The unit should be disc
x x x x x x x x x x x x x
arded because the pH has probably dropped too low and platelet activation has been compr
x x x x x x x x x x x x x x
omised.
c. If the temperature was 1°C to 6°C and the platelet swirl seemed OK, it would be OK to
x x x x x x x x x x x x x x x x x
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accept the unit into inventory. x x x x
d. If the platelets appeared OK and passed the platelet swirl test after being placed on the ag
x x x x x x x x x x x x x x x x
itator, they could be accepted into the inventory.
x x x x x x x
x 20. Which metabolic pathway permits the accumulation of 2,3 diphosphoglycerate (2,3-DPG)?
x x x x x x x x x x
a. Glycolysis c. Pentose phosphate shunt x x
b. Luebering-Rapoport shunt d. Methemoglobin reductase x x x
x 21. All of the following are consistent with a "shift to the right" of the hemoglobin-oxygen dissociation curve
x x x x x x x x x x x x x x x x x
except:
a. Increased 2,3-DPG. x
b. 50% O2 saturation to tissues. x x x x
c. Decreased 2,3-DPG. x
d. Decreased hemoglobin affinity for O2. x x x x
x 22. What is the normal platelet count range per cubic millimeter?
x x x x x x x x x x
a. 100 to 350 x x c. 50,000 to 200,000 x x
b. 150,000 to 350,000 d. 350,000 to 500,000
x x x x x
x 23. What cryoprotective agent is added to red blood cells upon freezing?
x x x x x x x x x x x
a. Dextrose c. Glycerol
b. Adsol d. All of the above x x x x
x 24. If platelets are to be stored for 5 days on a rotator, what is the optimal storage temperature?
x x x x x x x x x x x x x x x x x x
a. 1°C to 6°C x x c. 35°C to 37°C x x
b. 20°C to 24°C x d. 1°C to 10°C
x x x x
x 25. What role do platelets play in hemostasis?
x x x x x x x
a. Maintenance of vascular integrity x x x
b. Initial arrest of bleeding by platelet plug formation
x x x x x x x
c. Stabilization of the hemostatic plug x x x x
d. All of the above x x x
x 26. Which of the following best describes "integral" membrane proteins?
x x x x x x x x x
a. Reside at the cytoplasmic surface of membrane x x x x x x
b. Span the entire membrane surface x x x x
c. Form the red blood cell cytoskeleton x x x x x
d. None of the above x x x
x 27. How is stroma-free hemoglobin solution prepared?
x x x x x x
a. Outdated red blood cells are concentrated, and stroma is removed.
x x x x x x x x x
b. Outdated red blood cells are diluted with saline, and stroma is removed.
x x x x x x x x x x x
c. Outdated red blood cells are lysed, and stroma is removed. x x x x x x x x x
d. None of the above x x x
x 28. What is the normal life span of an RBC?
x x x x x x x x x
a. 100 days x c. 120 hours x
b. 120 days x d. 2 days
x x
x 29. Regarding loss of RBC membrane deformability, all of the following are true except:
x x x x x x x x x x x x x
a. Increase in ATP level. x x x
b. Decrease in ATP level. x x x
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Chapter 1 RBCs and Platelet Preservation: Historical Perspectives and Current Trends
x x x x x x x x x x
Multiple Choice
x
Identify the choice that best completes the statement or answers the question.
x x x x x x x x x x x
1. Which metabolic pathway is responsible for generating 90% of the ATP for the RBC?
x x x x x x x x x x x x x
a. Pentose phosphate shunt c. Glycolysis x x
b. Luebering-Rapoport shunt d. Methemoglobin reductase x x x
2. A unit of blood was returned to the blood bank before it was spiked. Apparently the patient’s IV failed. The uni
x x x x x x x x x x x x x x x x x x x x
t of blood was outside the blood bank for 35 minutes. Which of the statements below is most accurate?
x x x x x x x x x x x x x x x x x x
a. The unit of blood should be discarded immediately.
x x x x x x x
b. The unit of blood can be returned to inventory.
x x x x x x x x
c. The unit of blood must be transfused within 4 hours or be discarded at the end of that time.
x x x x x x x x x x x x x x x x x x
d. The unit of blood must be transfused with 24 hours.
x x x x x x x x x
3. What is the average diameter of a platelet?
x x x x x x x
a. 5 to 10 µm x x x c. 1 to 2 µm x x x
b. 2 to 4 µm x x x d. 4 to 6 µm
x x x x x
4. In the normal hemoglobin-
x x x
oxygen dissociation curve, what percentage of oxygen is released to the tissues when PO2 averages 40 mm
x x x x x x x x x x x x x x x x x
Hg?
a. 75% c. 100%
b. 25% d. 50% x
5. What factors are known to influence platelet metabolism and function?
x x x x x x x x x
a. Storage temperature c. Platelet count x x
b. Initial pH d. All of the above
x x x x x
6. Which of the following red blood cell morphologies may be present on the peripheral blood smear as a result of l
x x x x x x x x x x x x x x x x x x x x
oss of RBC membrane?x x x
a. Spherocytes c. Burr cells x
b. Target cells d. Schistocytes
x x
7. What does the term autologous transfusion refer to?
x x x x x x x
a. A parent donating blood for his or her child
x x x x x x x x
b. An individual donating blood for a friend
x x x x x x
c. An individual donating blood for a relative
x x x x x x
d. An individual donating blood for his or her own transfusion
x x x x x x x x x
8. What is the primary function of hemoglobin?
x x x x x x
a. Iron metabolism x c. Oxygen transport x
b. Porphyrin synthesis x d. Signal transduction
x x
9. All of the following areas of red blood cell biology are crucial for normal erythrocyte survival except:
x x x x x x x x x x x x x x x x
a. Cellular metabolism. c. Site of the ABO antigen attachment.
x x x x x x
b. RBC membrane. d. Hemoglobin structure.
x x x
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x 10. What is the correct biochemical composition of the RBC membrane?
x x x x x x x x x x
a. 52% protein, 40% lipid, 8% carbohydrate
x x x x x
b. 40% protein, 8% lipid, 52% carbohydrate
x x x x x
c. 8% protein, 52% lipid, 40% carbohydrate
x x x x x
d. 8% lipid, 40% carbohydrate, 52% protein
x x x x x
x 11. All of the following biochemical changes are associated with loss of red blood cell viability upon storage
x x x x x x x x x x x x x x x x x
except:
a. Decreased pH. c. Increased ATP level. x x x
b. Loss of red blood cell function. x d. Decreased glucose consumption.
x x x x x x x
x 12. Which red blood cell preservative has a storage time of 35 days?
x x x x x x x x x x x x
a. ACD c. AS-1
b. CPDA-1 d. CPD x x
x 13. The RBC membrane is relatively permeable to all of the following except:
x x x x x x x x x x x x
a. Chloride. c. Bicarbonate.
b. Sodium. d. Water. x
x 14. What percentage of platelets is sequestered in the spleen as functional reserve after being released from the bo
x x x x x x x x x x x x x x x x x x
ne marrow?
x
a. 30% c. 10%
b. 50% d. 25% x x
x 15. What is the major biochemical consideration in platelet storage?
x x x x x x x x x
a. Glucose metabolism c. Production of carbon dioxide
x x x x
b. Oxygen supply d. Regulation of pH
x x x x
x 16. What would the hemoglobin-
x x x x
oxygen dissociation curve depict in a patient exhibiting clinical signs of alkalosis?
x x x x x x x x x x x
a. Normal c. Shift to the right x x x
b. Shift to the left x d. None of the above
x x x x x x
x 17. Name the main lipid components of a red blood cell membrane.
x x x x x x x x x x x
a. Phospholipid c. Glycolipid
b. Sphingomyelin d. Glycophorin A x x
x 18. The ABO blood groups were discovered in 1901 by whom?
x x x x x x x x x x
a. Charles Drew c. Loutit and Mollison
x x x
b. Karl Landsteiner x d. Edward Lindeman x x
x 19. A standing order of platelets was shipped to your facility by your supplier. It was inadvertently left in the corner
x x x x x x x x x x x x x x x x x x x x
of the department until discovered 36 hours later. What would the appropriate action be for the blood banker?
x x x x x x x x x x x x x x x x x x
a. If the temperature in the box was 22 +/-
x x x x x x x x
2°C and the platelet swirl seemed OK, it would be OK to accept the unit into inventory.
x x x x x x x x x x x x x x x x x
b. The platelets have fallen outside the supplier’s quality assurance. The unit should be disc
x x x x x x x x x x x x x
arded because the pH has probably dropped too low and platelet activation has been compr
x x x x x x x x x x x x x x
omised.
c. If the temperature was 1°C to 6°C and the platelet swirl seemed OK, it would be OK to
x x x x x x x x x x x x x x x x x
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accept the unit into inventory. x x x x
d. If the platelets appeared OK and passed the platelet swirl test after being placed on the ag
x x x x x x x x x x x x x x x x
itator, they could be accepted into the inventory.
x x x x x x x
x 20. Which metabolic pathway permits the accumulation of 2,3 diphosphoglycerate (2,3-DPG)?
x x x x x x x x x x
a. Glycolysis c. Pentose phosphate shunt x x
b. Luebering-Rapoport shunt d. Methemoglobin reductase x x x
x 21. All of the following are consistent with a "shift to the right" of the hemoglobin-oxygen dissociation curve
x x x x x x x x x x x x x x x x x
except:
a. Increased 2,3-DPG. x
b. 50% O2 saturation to tissues. x x x x
c. Decreased 2,3-DPG. x
d. Decreased hemoglobin affinity for O2. x x x x
x 22. What is the normal platelet count range per cubic millimeter?
x x x x x x x x x x
a. 100 to 350 x x c. 50,000 to 200,000 x x
b. 150,000 to 350,000 d. 350,000 to 500,000
x x x x x
x 23. What cryoprotective agent is added to red blood cells upon freezing?
x x x x x x x x x x x
a. Dextrose c. Glycerol
b. Adsol d. All of the above x x x x
x 24. If platelets are to be stored for 5 days on a rotator, what is the optimal storage temperature?
x x x x x x x x x x x x x x x x x x
a. 1°C to 6°C x x c. 35°C to 37°C x x
b. 20°C to 24°C x d. 1°C to 10°C
x x x x
x 25. What role do platelets play in hemostasis?
x x x x x x x
a. Maintenance of vascular integrity x x x
b. Initial arrest of bleeding by platelet plug formation
x x x x x x x
c. Stabilization of the hemostatic plug x x x x
d. All of the above x x x
x 26. Which of the following best describes "integral" membrane proteins?
x x x x x x x x x
a. Reside at the cytoplasmic surface of membrane x x x x x x
b. Span the entire membrane surface x x x x
c. Form the red blood cell cytoskeleton x x x x x
d. None of the above x x x
x 27. How is stroma-free hemoglobin solution prepared?
x x x x x x
a. Outdated red blood cells are concentrated, and stroma is removed.
x x x x x x x x x
b. Outdated red blood cells are diluted with saline, and stroma is removed.
x x x x x x x x x x x
c. Outdated red blood cells are lysed, and stroma is removed. x x x x x x x x x
d. None of the above x x x
x 28. What is the normal life span of an RBC?
x x x x x x x x x
a. 100 days x c. 120 hours x
b. 120 days x d. 2 days
x x
x 29. Regarding loss of RBC membrane deformability, all of the following are true except:
x x x x x x x x x x x x x
a. Increase in ATP level. x x x
b. Decrease in ATP level. x x x
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