Blood bank ASCP MLT medialab exams |\ |\ |\ |\ |\ |\
QUESTIONS WITH 100% CORRECT |\ |\ |\ |\
ANSWERS
When performing an antibody screen, both the screen cells are
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
4+ at immediate spin and W+ at AHG. The antibody panel shows
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
4+ reactions at immediate spin and W+ reactions at AHG and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
there is no specific match to the reaction pattern. The auto
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
control is negative. What would be a logical next step?
|\ |\ |\ |\ |\ |\ |\ |\ |\
- Have patient redrawn
|\ |\ |\
- Repeat testing using warmed patient sample/reagent and just
|\ |\ |\ |\ |\ |\ |\ |\ |\
do AHG reading
|\ |\
- Run an enzyme panel
|\ |\ |\ |\
- Use acidified reagents - CORRECT ANSWERS ✔✔- Repeat testing
|\ |\ |\ |\ |\ |\ |\ |\ |\
using warmed patient sample/reagent and just do AHG reading
|\ |\ |\ |\ |\ |\ |\ |\ |\
Phase of reactivity is primarily at immediate spin (4+) and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reactions get weaker at AHG (w+). There is no specific pattern of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reactivity and the auto control is negative which rules out an
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
autoantibody. This is a strong cold antibody which is still slightly |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
present after incubation and washing. Activation and binding of
|\ |\ |\ |\ |\ |\ |\ |\ |\
the antibody takes place at room temperature or colder. Warming
|\ |\ |\ |\ |\ |\ |\ |\ |\
the sample/reagents and eliminating this phase will prevent the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
antibody from binding. Cold antibodies usually are more of a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
nuisance to blood bankers and are not clinically significant.
|\ |\ |\ |\ |\ |\ |\ |\
There does not seem to a problem with the sample so the patient
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
does not need to be redrawn.
|\ |\ |\ |\ |\ |\
,Enzymes can be used to enhance reactions of certain antibodies
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
but in this case the antibody present appears to be one that may
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
not be clinically significant so enhancement is not needed.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Acidified reagents can be used as a way to enhance certain
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
antibodies as well. |\ |\
Donor and recipient blood samples must be kept for at least how
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
long after transfusion? |\ |\
- 10 days
|\ |\
- 7 days
|\ |\
- 3 days
|\ |\
- 24 hours - CORRECT ANSWERS ✔✔- 7 days
|\ |\ |\ |\ |\ |\ |\ |\
The correct answer is 7 days.
|\ |\ |\ |\ |\
Donor and recipient samples must be available to investigate a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
transfusion reaction, if necessary. |\ |\ |\
Samples used for antibody screening and serological |\ |\ |\ |\ |\ |\ |\
crossmatches must be less than 72 hours (3 days) old, but the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
sample must be kept the full 7 days. |\ |\ |\ |\ |\ |\ |\
5 days is not long enough to retain a sample in case of a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
transfusion reaction workup. |\ |\
10 days is in excess of the required retention time of 7 days.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Which of the following consequences of severe hemolytic disease
|\ |\ |\ |\ |\ |\ |\ |\
of the fetus and newborn (HDFN) is most associated with
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
neonatal death before or shortly after birth? |\ |\ |\ |\ |\ |\
- Enlarged liver
|\ |\
,- Enlarged spleen
|\ |\
- Cardiac failure
|\ |\
- Hyperbilirubinemia - CORRECT ANSWERS ✔✔- Cardiac failure
|\ |\ |\ |\ |\ |\ |\
While the other consequences of HDFN can be severe in and of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
themselves, cardiac failure is the greatest threat to the fetus. |\ |\ |\ |\ |\ |\ |\ |\ |\
In HDFN, the antibodies bind to the fetal antigens, which ends in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
red cell destruction by macrophages in the fetal liver and spleen.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
As red cell destruction continues, the fetus becomes increasingly
|\ |\ |\ |\ |\ |\ |\ |\ |\
anemic. The fetal liver and spleen enlarge as erythropoiesis
|\ |\ |\ |\ |\ |\ |\ |\ |\
increases to compensate for the red cell destruction. Hemoglobin
|\ |\ |\ |\ |\ |\ |\ |\
is liberated from the damaged cells, metabolized to indirect
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
bilirubin and is transported across the placenta where it is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
conjugated by the maternal liver and excreted. As the red cell |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
destruction continues, cardiac failure resulting from |\ |\ |\ |\ |\ |\
uncompensated anemia will occur. |\ |\ |\
Which of the following best describes a transfusion reaction:
|\ |\ |\ |\ |\ |\ |\ |\
- Any adverse event associated with the transfusion of blood
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
components
- A fever associated with a transfusion
|\ |\ |\ |\ |\ |\
- The destruction of transfused red cells
|\ |\ |\ |\ |\ |\
- The development of a rash after transfusion - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔- Any adverse event associated with the transfusion |\ |\ |\ |\ |\ |\ |\ |\
of blood components
|\ |\ |\
A transfusion reaction can be defined as any adverse event
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
occurring during or after the transfusion of blood components.
|\ |\ |\ |\ |\ |\ |\ |\ |\
, This event may or may not include a fever, the destruction of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
transfused red cells, or the development of a rash. |\ |\ |\ |\ |\ |\ |\ |\
Which situation will cause a positive DAT (direct antiglobulin test)
|\ |\ |\ |\ |\ |\ |\ |\ |\
in the newborn?
|\ |\ |\
- Hemolytic disease of the fetus and newborn
|\ |\ |\ |\ |\ |\ |\
- Mother is group AB and newborn is group O
|\ |\ |\ |\ |\ |\ |\ |\ |\
- Mother is Rh positive and newborn is Rh positive
|\ |\ |\ |\ |\ |\ |\ |\ |\
- Mother is Rh positive and newborn in Rh negative - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔- Hemolytic disease of the fetus and newborn|\ |\ |\ |\ |\ |\ |\ |\
The DAT is ordered to detect IgG or complement proteins bound
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to patient cells. This can be from autoimmune hemolytic anemia,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
hemolytic disease of the fetus and newborn (HDFN), a drug-
|\ |\ |\ |\ |\ |\ |\ |\ |\
related mechanism, or an antibody reaction to transfused red
|\ |\ |\ |\ |\ |\ |\ |\ |\
cells.
In HDFN, the fetal cells are coated with IgG that has crossed the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
placenta from the mother's circulation. |\ |\ |\ |\
With the mother being AB, there would not be any ABO
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
antibodies present to cross the placenta. |\ |\ |\ |\ |\
With the mother being Rh positive, there would not be any
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
antibodies formed from exposure of the fetal red cells, whether
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the fetus is Rh positive or Rh negative.
|\ |\ |\ |\ |\ |\ |\
In an extreme emergency, if the ABO and Rh type are unknown,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
which of the following should be given to the patient?
|\ |\ |\ |\ |\ |\ |\ |\ |\
- Group O, Rh positive blood
|\ |\ |\ |\ |\
- Group AB, Rh negative blood
|\ |\ |\ |\ |\
QUESTIONS WITH 100% CORRECT |\ |\ |\ |\
ANSWERS
When performing an antibody screen, both the screen cells are
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
4+ at immediate spin and W+ at AHG. The antibody panel shows
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
4+ reactions at immediate spin and W+ reactions at AHG and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
there is no specific match to the reaction pattern. The auto
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
control is negative. What would be a logical next step?
|\ |\ |\ |\ |\ |\ |\ |\ |\
- Have patient redrawn
|\ |\ |\
- Repeat testing using warmed patient sample/reagent and just
|\ |\ |\ |\ |\ |\ |\ |\ |\
do AHG reading
|\ |\
- Run an enzyme panel
|\ |\ |\ |\
- Use acidified reagents - CORRECT ANSWERS ✔✔- Repeat testing
|\ |\ |\ |\ |\ |\ |\ |\ |\
using warmed patient sample/reagent and just do AHG reading
|\ |\ |\ |\ |\ |\ |\ |\ |\
Phase of reactivity is primarily at immediate spin (4+) and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reactions get weaker at AHG (w+). There is no specific pattern of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reactivity and the auto control is negative which rules out an
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
autoantibody. This is a strong cold antibody which is still slightly |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
present after incubation and washing. Activation and binding of
|\ |\ |\ |\ |\ |\ |\ |\ |\
the antibody takes place at room temperature or colder. Warming
|\ |\ |\ |\ |\ |\ |\ |\ |\
the sample/reagents and eliminating this phase will prevent the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
antibody from binding. Cold antibodies usually are more of a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
nuisance to blood bankers and are not clinically significant.
|\ |\ |\ |\ |\ |\ |\ |\
There does not seem to a problem with the sample so the patient
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
does not need to be redrawn.
|\ |\ |\ |\ |\ |\
,Enzymes can be used to enhance reactions of certain antibodies
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
but in this case the antibody present appears to be one that may
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
not be clinically significant so enhancement is not needed.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Acidified reagents can be used as a way to enhance certain
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
antibodies as well. |\ |\
Donor and recipient blood samples must be kept for at least how
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
long after transfusion? |\ |\
- 10 days
|\ |\
- 7 days
|\ |\
- 3 days
|\ |\
- 24 hours - CORRECT ANSWERS ✔✔- 7 days
|\ |\ |\ |\ |\ |\ |\ |\
The correct answer is 7 days.
|\ |\ |\ |\ |\
Donor and recipient samples must be available to investigate a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
transfusion reaction, if necessary. |\ |\ |\
Samples used for antibody screening and serological |\ |\ |\ |\ |\ |\ |\
crossmatches must be less than 72 hours (3 days) old, but the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
sample must be kept the full 7 days. |\ |\ |\ |\ |\ |\ |\
5 days is not long enough to retain a sample in case of a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
transfusion reaction workup. |\ |\
10 days is in excess of the required retention time of 7 days.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Which of the following consequences of severe hemolytic disease
|\ |\ |\ |\ |\ |\ |\ |\
of the fetus and newborn (HDFN) is most associated with
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
neonatal death before or shortly after birth? |\ |\ |\ |\ |\ |\
- Enlarged liver
|\ |\
,- Enlarged spleen
|\ |\
- Cardiac failure
|\ |\
- Hyperbilirubinemia - CORRECT ANSWERS ✔✔- Cardiac failure
|\ |\ |\ |\ |\ |\ |\
While the other consequences of HDFN can be severe in and of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
themselves, cardiac failure is the greatest threat to the fetus. |\ |\ |\ |\ |\ |\ |\ |\ |\
In HDFN, the antibodies bind to the fetal antigens, which ends in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
red cell destruction by macrophages in the fetal liver and spleen.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
As red cell destruction continues, the fetus becomes increasingly
|\ |\ |\ |\ |\ |\ |\ |\ |\
anemic. The fetal liver and spleen enlarge as erythropoiesis
|\ |\ |\ |\ |\ |\ |\ |\ |\
increases to compensate for the red cell destruction. Hemoglobin
|\ |\ |\ |\ |\ |\ |\ |\
is liberated from the damaged cells, metabolized to indirect
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
bilirubin and is transported across the placenta where it is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
conjugated by the maternal liver and excreted. As the red cell |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
destruction continues, cardiac failure resulting from |\ |\ |\ |\ |\ |\
uncompensated anemia will occur. |\ |\ |\
Which of the following best describes a transfusion reaction:
|\ |\ |\ |\ |\ |\ |\ |\
- Any adverse event associated with the transfusion of blood
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
components
- A fever associated with a transfusion
|\ |\ |\ |\ |\ |\
- The destruction of transfused red cells
|\ |\ |\ |\ |\ |\
- The development of a rash after transfusion - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔- Any adverse event associated with the transfusion |\ |\ |\ |\ |\ |\ |\ |\
of blood components
|\ |\ |\
A transfusion reaction can be defined as any adverse event
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
occurring during or after the transfusion of blood components.
|\ |\ |\ |\ |\ |\ |\ |\ |\
, This event may or may not include a fever, the destruction of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
transfused red cells, or the development of a rash. |\ |\ |\ |\ |\ |\ |\ |\
Which situation will cause a positive DAT (direct antiglobulin test)
|\ |\ |\ |\ |\ |\ |\ |\ |\
in the newborn?
|\ |\ |\
- Hemolytic disease of the fetus and newborn
|\ |\ |\ |\ |\ |\ |\
- Mother is group AB and newborn is group O
|\ |\ |\ |\ |\ |\ |\ |\ |\
- Mother is Rh positive and newborn is Rh positive
|\ |\ |\ |\ |\ |\ |\ |\ |\
- Mother is Rh positive and newborn in Rh negative - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔- Hemolytic disease of the fetus and newborn|\ |\ |\ |\ |\ |\ |\ |\
The DAT is ordered to detect IgG or complement proteins bound
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to patient cells. This can be from autoimmune hemolytic anemia,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
hemolytic disease of the fetus and newborn (HDFN), a drug-
|\ |\ |\ |\ |\ |\ |\ |\ |\
related mechanism, or an antibody reaction to transfused red
|\ |\ |\ |\ |\ |\ |\ |\ |\
cells.
In HDFN, the fetal cells are coated with IgG that has crossed the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
placenta from the mother's circulation. |\ |\ |\ |\
With the mother being AB, there would not be any ABO
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
antibodies present to cross the placenta. |\ |\ |\ |\ |\
With the mother being Rh positive, there would not be any
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
antibodies formed from exposure of the fetal red cells, whether
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the fetus is Rh positive or Rh negative.
|\ |\ |\ |\ |\ |\ |\
In an extreme emergency, if the ABO and Rh type are unknown,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
which of the following should be given to the patient?
|\ |\ |\ |\ |\ |\ |\ |\ |\
- Group O, Rh positive blood
|\ |\ |\ |\ |\
- Group AB, Rh negative blood
|\ |\ |\ |\ |\
