Transfusion Medicine (HEME-301) | 100 Exam Questions on Blood Products, Coombs Testing & Transfusion Reactions

This document includes 100 A+ verified exam questions and answers on transfusion medicine, forming part of the Hematology (HEME-301) course at the University of Health Sciences for the 2025/2026 academic year. It provides a high-yield, structured review of blood product indications, compatibility testing, transfusion reactions, and transfusion-related infections—essential knowledge for both clinical and board exams. Key topics include: Blood Product Indications: RBCs: given if Hb <7.0 g/dL or Hct <21%, or in acute blood loss Plasma (FFP): indicated for bleeding with INR >1.6 or PTT >45 sec, TTP, HUS, or anticoagulant deficiencies Platelets: transfused if <20,000/uL Cryoprecipitate: indicated for fibrinogen <100 mg/dL or diffuse bleeding Compatibility Testing & Typing: Forward typing: detects patient RBC antigens using reagent antibodies Backward typing: detects patient serum antibodies using reagent RBCs Direct Coombs test: identifies IgG-coated RBCs in vivo (autoimmune hemolysis) Indirect Coombs test: screens for serum IgG against donor RBCs (pre-transfusion compatibility) Transfusion Reactions: Acute Hemolytic (ABO incompatibility): intravascular hemolysis, renal failure, DIC—requires immediate transfusion stop, IV fluids, dopamine, diuretics Delayed Hemolytic (non-ABO): extravascular hemolysis, jaundice, fever/chills Febrile Non-Hemolytic: due to WBC breakdown; symptoms include fever, chills, nausea TRALI vs. TACO: • TRALI: fever, hypotension, leukopenia, pulmonary edema • TACO: hypertension, increased BNP, volume overload Microbial Contamination & Risk of Infection: Platelets: Staph, Bacillus (room temperature contamination) RBCs: Yersinia, Pseudomonas (cold storage contamination) Each RBC unit increases infection risk by 10% Gram-negative rod-related septic shock includes Acinetobacter, Campylobacter This resource is designed for: Medical students studying hematology, internal medicine, or preparing for systems-based exams Candidates preparing for USMLE Step 1 & 2, PLAB, COMLEX, AMC, or clinical rotations Nursing, pharmacy, and clinical laboratory science students needing transfusion medicine knowledge Its Q&A structure reinforces key decision-making criteria and helps build clinical reasoning around transfusion safety and adverse event recognition. Keywords: RBC transfusion, platelet transfusion, plasma, cryoprecipitate, Coombs test, blood typing, ABO incompatibility, hemolytic reaction, TRALI, TACO, transfusion complications, febrile reaction, IgG antibodies, INR, fibrinogen, yersinia, pseudomonas, sepsis, transfusion guidelines, hematology