Blood Bank Purple Book, BOC Blood Bank FINAL,
Blood Banking, Lecture 9 (Donor Processing and
Component Prep), BB - ASCP Study Set -
antibodies, BB - ASCP Study - Misc. questions, BB
For ASCP Exam - Blood Temps and Storage, Blood
Bank Temperatures.
Comprehensive Exam Study Guide Latest Updated
2025/2026
List several blood group antigens of low incidence. - ansKp(a)
Js(a)
Lu(a)
C(w)
These antigens are found in less than 1% of the population
List several high incidence blood group antigens - ansKp(b)
k
Js(b)
Lu(b)
I
U
These antigens are found in 99% of the population
What 4 RBC antigens are not fully expressed at birth - ansA
B
I
P(1)
Lewis
Lutheran
What is sensitization? - ansAttachment of antibodies to antigen on a red cell
Why should serum separator tubes not be used for blood bank testing? - ansThe gel can
contaminate the red blood cells during sampling and can cause false-positive test results.
What is the terminal sugar on the B antigen? - ansD-galactose
What is the terminal sugar on the A antigen? - ansN-acetylgalactosamine.
Which races have the higher percentage of group B? - ansBlacks and Chinese.
When might anti-A,B be used? - ansAnti-A,B is no longer used for routine typing but some
labs use it for confirmatory typing of Group 0 red cell units.
What might cause the naturally-occurring isoagglutinins to be decreased in titer or missing? -
ansHypo- or agammaglobulinemia, leukemia, or the age of the patient.
Babies do not have detectable levels of naturally-occurring isoagglutinins in their
plasma/serum until 3-6 months of age and titers decrease in the elderly.
What are lectins? - ansExtracts from plant seeds or animals that have antibody-like activity.
For example, Dolichos biflorus agglutinates A1 cells and Ulex europeus reacts with the H
determinant.
Why is anti-A1 not detected in an antibody screen? - ansAntibody screening cells are group
0. Anti-A1 only reacts with A1 cells.
How is anti-A1 usually discovered? - ansBy an ABO discrepancy in which there is
unexpected agglutination of Ai cells in the reverse grouping of a group A.
,Blood Bank Purple Book, BOC Blood Bank FINAL,
Blood Banking, Lecture 9 (Donor Processing and
Component Prep), BB - ASCP Study Set -
antibodies, BB - ASCP Study - Misc. questions, BB
For ASCP Exam - Blood Temps and Storage, Blood
Bank Temperatures.
Comprehensive Exam Study Guide Latest Updated
2025/2026
What group of blood should be transfused to a patient with anti-A1? - ansIf the antibody is
reactive at 37°C, cells lacking the A1 antigen (subgroup of A or group 0) should be
transfused.
Anti-A1 that only reacts below 30°C is not considered clinically significant. In actual
practice, some blood banks would provide subgroup of A or group 0 blood without testing the
thermal range of the Anti-A1. The laboratory's
standard operating procedures (SOP) should be followed.
How can rouleaux interfere with blood bank tests? - ansRouleaux cause false-positive
reactions with all cells mixed witth the serum. Rouleaux are due to a serum protein
abnormality and are usually seen in patients with multiple myeloma.
While retyping a group B trauma patient, the technologist observes mixed field agglutination
with anti-B. Typing at the lime of admission showed 4+ agglutination with anti-B. What
might have caused this change in
reactivity? - ansThe patient might have been transfused with a large volume of group 0
ABCs. The transfusion history should be
checked.
How does the acquired B antigen usually react? - ansIt typically agglutinates strongly with
anti-A and weakly with anti-B, and the serum contains strong anti-B.
How might transfusion of non-group specific blood affect subsequent blood grouping result?
- ansDonor cells are detectable in the recipient for up to 4 months, the life span of the RBC.
Front grouping reactions may be weak or mixed-field if group 0 cells have been transfused to
a patient of another group. Passive anti-A
and/or anti-B might be detected in the reverse grouping if large volumes of group 0 RBCs or
platelets have been transfused to a patient of another group. These products contain some
plasma and naturally-occurring isoagglutinins
How might agammaglobulinemia or leukemia affect a patient's blood grouping? - ansThe
naturally-occurring isoagglutinins might be weak or missing. With leukemia, certain antigens
may also be
weak or missing.
Which blood groups are most likely to have anti-H? - ansAl and AIR (Bombays also have
very string anti-H.)
What type of antibody is anti-H? - ansA naturally-occurring cold antibody
Which Rh antigen determines Rh type? - ansD (Rho). The presence of the D antigen denotes
Rh-positive blood.
Why is an Rh control included when using high-protein Rh typing sera? - ansTo detect false-
positive reactions. If the Rh typing and the Rh control are both positive, the test is invalid.
Which Rh typing sera do not require use of an Rh control? - ansSaline anti-D,
,Blood Bank Purple Book, BOC Blood Bank FINAL,
Blood Banking, Lecture 9 (Donor Processing and
Component Prep), BB - ASCP Study Set -
antibodies, BB - ASCP Study - Misc. questions, BB
For ASCP Exam - Blood Temps and Storage, Blood
Bank Temperatures.
Comprehensive Exam Study Guide Latest Updated
2025/2026
chemically modified anti-D,
or anti-D monoclonal/polyclonal blend.
These reagents have a low
protein content. Manufacturers frequently recommend the ABO front type as a suitable
control. For group AB patients, a 6-8% albumin control or a saline control should be run. The
manufacturer's instructions should always
be followed.
How is testing for weak D performed and when is it required? - ansThe Rh typing is carried
through an indirect antiglobulin phase. Weak D testing is required on blood donors who
type Rh negative.
A unit of Rh-positive blood is erroneously typed as Rh negative. Will this mistake be caught
in the
crossmatch? - ansNot unless the Rh-negative recipient has anti-D and a complete crossmatch
is performed.
A donor's RBCs fail to react with anti-D typing serum during routine testing. When the tubes
are carried through the indirect antiglobulin phase, agglutination is observed with anti-D, but
not with the control. How should this blood be classified for transfusion purposes? - ansThe
donor is a weak D, therefore, the unit is labeled Rh positive.
What Rh type should a weak D patient receive? - ansA weak D recipient may be transfused
with either Rh positive or Rh negative.
Since the test for weak D is not routinely performed on recipients, Rh-negative blood is
usually provided.
What are the consequences of infusing D positive RBCs into an Rh-negative recipient with a
negative antibody screen? - ansThere would not be a transfusion reaction, but the recipient
might develop anti-D.
Which Rh gene complexes are most common in Caucasians? - ansRI, R2, and r. (The
frequencies are 42%, 14%, and 26% respectively.)
Which Rh gene complex is common in Blacks and uncommon in Caucasians? - ansR°. (The
frequency is 44% for Blacks and 4% for Caucasians.)
Which Rh gene complexes are present in only 2% or less of Caucasians
What is the most common genotype for Rh negatives? - ansrr
What is the most common genotype for Rh positives? - ansR1r
What is the most common Rh antigen in Caucasians? - ans98% of Caucasians are positive for
e.
, Blood Bank Purple Book, BOC Blood Bank FINAL,
Blood Banking, Lecture 9 (Donor Processing and
Component Prep), BB - ASCP Study Set -
antibodies, BB - ASCP Study - Misc. questions, BB
For ASCP Exam - Blood Temps and Storage, Blood
Bank Temperatures.
Comprehensive Exam Study Guide Latest Updated
2025/2026
What percentage of Rh-negative children would be expected from an R'R' mother and an R1r
father? - ansNone. All offspring would be Rh positive
A patient's RBCs react with anti-D, anti-C, anti-c, and anti-e. They do not react with anti-E.
Which of the
following might be the patient's Rh genotype: R1r, RIR2, rr, r'r? - ansR1r
Which of the following Rh genotypes could develop anti-C: RIr, R'R', r'r, rr? - ansrr
Which antibody could an RIRI individual make if exposed to R2R2 blood? - ansanti-E
If a patient has anti-e, which of the following units could he receive: R2R2, R1R1, RIR2,
R2R2, R1r? - ansR2R2 (DcE/DcE). All of the others have the e antigen.
b (All donors, regardless of sex, require a minimum hemoglobin of 12.5 g/dL [125 g/L]. The
value must not be performed on an earlobe stick.) - ans1) The minimum Hgb concentration in
a fingerstick from a male blood donor is:
a. 12.0 g/dL (120 g/L)
b. 12.5 g/dL (125 g/L)
c. 13.5 g/dL (135 g/L)
d. 15.0 g/dL (150 g/L)
d (A positive test for HbsAg at any time is an indefinite deferral.) - ans4) Which of the
following constitutes permanent rejection status of a donor?
a. a tattoo 5 months ago
b. recent close contact with a patient with viral hepatitis
c. 2 units of blood transfused 4 months previously
d. confirmed positive test for HbsAg 10 yrs. earlier
b (The Hct must be >38%. A donor may be 16 unless state law differs. Temperature must not
exceed 99.5F/37.5C, blood pressure must be <180 mmHg systolic and <100 mmHg diastolic,
pulse 50-100 unless an athlete [which can be lower]. Toxoids and vaccines from synthetic or
killed sources have no deferral.) - ans6) Below are the results of the history obtained from a
prospective female blood donor:
- age: 16
- temperature: 99.0F (37.2C)
- Hct: 36%
- history: tetanus toxoid immunization 1 week previously
How many of the above results excludes this donor from giving blood for a routine
transfusion?
a. none
b. 1
c. 2
d. 3
Blood Banking, Lecture 9 (Donor Processing and
Component Prep), BB - ASCP Study Set -
antibodies, BB - ASCP Study - Misc. questions, BB
For ASCP Exam - Blood Temps and Storage, Blood
Bank Temperatures.
Comprehensive Exam Study Guide Latest Updated
2025/2026
List several blood group antigens of low incidence. - ansKp(a)
Js(a)
Lu(a)
C(w)
These antigens are found in less than 1% of the population
List several high incidence blood group antigens - ansKp(b)
k
Js(b)
Lu(b)
I
U
These antigens are found in 99% of the population
What 4 RBC antigens are not fully expressed at birth - ansA
B
I
P(1)
Lewis
Lutheran
What is sensitization? - ansAttachment of antibodies to antigen on a red cell
Why should serum separator tubes not be used for blood bank testing? - ansThe gel can
contaminate the red blood cells during sampling and can cause false-positive test results.
What is the terminal sugar on the B antigen? - ansD-galactose
What is the terminal sugar on the A antigen? - ansN-acetylgalactosamine.
Which races have the higher percentage of group B? - ansBlacks and Chinese.
When might anti-A,B be used? - ansAnti-A,B is no longer used for routine typing but some
labs use it for confirmatory typing of Group 0 red cell units.
What might cause the naturally-occurring isoagglutinins to be decreased in titer or missing? -
ansHypo- or agammaglobulinemia, leukemia, or the age of the patient.
Babies do not have detectable levels of naturally-occurring isoagglutinins in their
plasma/serum until 3-6 months of age and titers decrease in the elderly.
What are lectins? - ansExtracts from plant seeds or animals that have antibody-like activity.
For example, Dolichos biflorus agglutinates A1 cells and Ulex europeus reacts with the H
determinant.
Why is anti-A1 not detected in an antibody screen? - ansAntibody screening cells are group
0. Anti-A1 only reacts with A1 cells.
How is anti-A1 usually discovered? - ansBy an ABO discrepancy in which there is
unexpected agglutination of Ai cells in the reverse grouping of a group A.
,Blood Bank Purple Book, BOC Blood Bank FINAL,
Blood Banking, Lecture 9 (Donor Processing and
Component Prep), BB - ASCP Study Set -
antibodies, BB - ASCP Study - Misc. questions, BB
For ASCP Exam - Blood Temps and Storage, Blood
Bank Temperatures.
Comprehensive Exam Study Guide Latest Updated
2025/2026
What group of blood should be transfused to a patient with anti-A1? - ansIf the antibody is
reactive at 37°C, cells lacking the A1 antigen (subgroup of A or group 0) should be
transfused.
Anti-A1 that only reacts below 30°C is not considered clinically significant. In actual
practice, some blood banks would provide subgroup of A or group 0 blood without testing the
thermal range of the Anti-A1. The laboratory's
standard operating procedures (SOP) should be followed.
How can rouleaux interfere with blood bank tests? - ansRouleaux cause false-positive
reactions with all cells mixed witth the serum. Rouleaux are due to a serum protein
abnormality and are usually seen in patients with multiple myeloma.
While retyping a group B trauma patient, the technologist observes mixed field agglutination
with anti-B. Typing at the lime of admission showed 4+ agglutination with anti-B. What
might have caused this change in
reactivity? - ansThe patient might have been transfused with a large volume of group 0
ABCs. The transfusion history should be
checked.
How does the acquired B antigen usually react? - ansIt typically agglutinates strongly with
anti-A and weakly with anti-B, and the serum contains strong anti-B.
How might transfusion of non-group specific blood affect subsequent blood grouping result?
- ansDonor cells are detectable in the recipient for up to 4 months, the life span of the RBC.
Front grouping reactions may be weak or mixed-field if group 0 cells have been transfused to
a patient of another group. Passive anti-A
and/or anti-B might be detected in the reverse grouping if large volumes of group 0 RBCs or
platelets have been transfused to a patient of another group. These products contain some
plasma and naturally-occurring isoagglutinins
How might agammaglobulinemia or leukemia affect a patient's blood grouping? - ansThe
naturally-occurring isoagglutinins might be weak or missing. With leukemia, certain antigens
may also be
weak or missing.
Which blood groups are most likely to have anti-H? - ansAl and AIR (Bombays also have
very string anti-H.)
What type of antibody is anti-H? - ansA naturally-occurring cold antibody
Which Rh antigen determines Rh type? - ansD (Rho). The presence of the D antigen denotes
Rh-positive blood.
Why is an Rh control included when using high-protein Rh typing sera? - ansTo detect false-
positive reactions. If the Rh typing and the Rh control are both positive, the test is invalid.
Which Rh typing sera do not require use of an Rh control? - ansSaline anti-D,
,Blood Bank Purple Book, BOC Blood Bank FINAL,
Blood Banking, Lecture 9 (Donor Processing and
Component Prep), BB - ASCP Study Set -
antibodies, BB - ASCP Study - Misc. questions, BB
For ASCP Exam - Blood Temps and Storage, Blood
Bank Temperatures.
Comprehensive Exam Study Guide Latest Updated
2025/2026
chemically modified anti-D,
or anti-D monoclonal/polyclonal blend.
These reagents have a low
protein content. Manufacturers frequently recommend the ABO front type as a suitable
control. For group AB patients, a 6-8% albumin control or a saline control should be run. The
manufacturer's instructions should always
be followed.
How is testing for weak D performed and when is it required? - ansThe Rh typing is carried
through an indirect antiglobulin phase. Weak D testing is required on blood donors who
type Rh negative.
A unit of Rh-positive blood is erroneously typed as Rh negative. Will this mistake be caught
in the
crossmatch? - ansNot unless the Rh-negative recipient has anti-D and a complete crossmatch
is performed.
A donor's RBCs fail to react with anti-D typing serum during routine testing. When the tubes
are carried through the indirect antiglobulin phase, agglutination is observed with anti-D, but
not with the control. How should this blood be classified for transfusion purposes? - ansThe
donor is a weak D, therefore, the unit is labeled Rh positive.
What Rh type should a weak D patient receive? - ansA weak D recipient may be transfused
with either Rh positive or Rh negative.
Since the test for weak D is not routinely performed on recipients, Rh-negative blood is
usually provided.
What are the consequences of infusing D positive RBCs into an Rh-negative recipient with a
negative antibody screen? - ansThere would not be a transfusion reaction, but the recipient
might develop anti-D.
Which Rh gene complexes are most common in Caucasians? - ansRI, R2, and r. (The
frequencies are 42%, 14%, and 26% respectively.)
Which Rh gene complex is common in Blacks and uncommon in Caucasians? - ansR°. (The
frequency is 44% for Blacks and 4% for Caucasians.)
Which Rh gene complexes are present in only 2% or less of Caucasians
What is the most common genotype for Rh negatives? - ansrr
What is the most common genotype for Rh positives? - ansR1r
What is the most common Rh antigen in Caucasians? - ans98% of Caucasians are positive for
e.
, Blood Bank Purple Book, BOC Blood Bank FINAL,
Blood Banking, Lecture 9 (Donor Processing and
Component Prep), BB - ASCP Study Set -
antibodies, BB - ASCP Study - Misc. questions, BB
For ASCP Exam - Blood Temps and Storage, Blood
Bank Temperatures.
Comprehensive Exam Study Guide Latest Updated
2025/2026
What percentage of Rh-negative children would be expected from an R'R' mother and an R1r
father? - ansNone. All offspring would be Rh positive
A patient's RBCs react with anti-D, anti-C, anti-c, and anti-e. They do not react with anti-E.
Which of the
following might be the patient's Rh genotype: R1r, RIR2, rr, r'r? - ansR1r
Which of the following Rh genotypes could develop anti-C: RIr, R'R', r'r, rr? - ansrr
Which antibody could an RIRI individual make if exposed to R2R2 blood? - ansanti-E
If a patient has anti-e, which of the following units could he receive: R2R2, R1R1, RIR2,
R2R2, R1r? - ansR2R2 (DcE/DcE). All of the others have the e antigen.
b (All donors, regardless of sex, require a minimum hemoglobin of 12.5 g/dL [125 g/L]. The
value must not be performed on an earlobe stick.) - ans1) The minimum Hgb concentration in
a fingerstick from a male blood donor is:
a. 12.0 g/dL (120 g/L)
b. 12.5 g/dL (125 g/L)
c. 13.5 g/dL (135 g/L)
d. 15.0 g/dL (150 g/L)
d (A positive test for HbsAg at any time is an indefinite deferral.) - ans4) Which of the
following constitutes permanent rejection status of a donor?
a. a tattoo 5 months ago
b. recent close contact with a patient with viral hepatitis
c. 2 units of blood transfused 4 months previously
d. confirmed positive test for HbsAg 10 yrs. earlier
b (The Hct must be >38%. A donor may be 16 unless state law differs. Temperature must not
exceed 99.5F/37.5C, blood pressure must be <180 mmHg systolic and <100 mmHg diastolic,
pulse 50-100 unless an athlete [which can be lower]. Toxoids and vaccines from synthetic or
killed sources have no deferral.) - ans6) Below are the results of the history obtained from a
prospective female blood donor:
- age: 16
- temperature: 99.0F (37.2C)
- Hct: 36%
- history: tetanus toxoid immunization 1 week previously
How many of the above results excludes this donor from giving blood for a routine
transfusion?
a. none
b. 1
c. 2
d. 3
