,Chapter 1 RBCs and Platelet Preservation: Historical Perspectives and Current Trends
jj jj jj jj jj jj jj jj jj jj
Multiple Choice
jj
Identify the choice that best completes the statement or answers the question.
j j j j j j j j j j j j jj j j j j j j j j
1. Which metabolic pathway is responsible for generating 90% of the ATP for the RBC?
jj j j jj j j j j j j j j j j j j jj jj j j j j
a. Pentose phosphate shunt c. Glycolysis j j j j
b. Luebering-Rapoport shunt d. Methemoglobin reductase jj j j
2. A unit of blood was returned to the blood bank before it was spiked. Apparently the
jj j j j j j j j j j j j j j j j j j j j j j j j j jj jj
patient’s IV failed. The unit of blood was outside the blood bank for 35 minutes.
j j j j jj j j j j j j j j j j j j j j j j j j j j j j j j
Which of the statements below is most accurate?
j j j j j j j j jj j j j j j j
a. The unit of blood should be discarded immediately. jj j j j j j j j j j j jj
b. The unit of blood can be returned to inventory. j j j j j j j j j j j j j j j j
c. The unit of blood must be transfused within 4 hours or be discarded at the end of that
jj j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j
time. j j
d. The unit of blood must be transfused with 24 hours. j j j j j j j j j j j j j j j j j j
3. What is the average diameter of a platelet?
j j j j j j j j j j j j j j
a. 5 to 10 µm c. 1 to 2 µm
j j j j j j j j j j j j
b. 2 to 4 µm d.j j4 to 6 µm j j j j j j j j j j
4. In the normal hemoglobin-oxygen dissociation curve, what percentage of oxygen is
j j j j j j j j j j j j j j j j j j mm
released to the tissues when PO2
j j averages 40 mm Hg? j j j j jj j j j j j j j j j j
a. 75% c. 100%
b. 25% d. 50%
5. What factors are known to influence platelet metabolism and function?
jj j j j j j j j j j j j j jj j j
a. Storage temperature c. Platelet count j j jj
b. Initial pH d. All of the above j j j j j j mm
6. Which of the following red blood cell morphologies may be present on the peripheral
j j j j j j j j j j j j j j j j j j mm j j j j j j
blood smear as a result of loss of RBC membrane?
j j j j jj j j j j j j j j j j j j j j
a. Spherocytes c. Burr cells mm
b. Target cells d. Schistocytes jj
7. What does the term autologous transfusion refer to?
j j j j j j j j j j mm j j
a. A parent donating blood for his or her child
jj j j mm j j j j j j j j j j
b. An individual donating blood for a friend j j j j j j j j mm j j
c. An individual donating blood for a relative j j mm j j mm j j j j
d. An individual donating blood for his or her own transfusion
j j mm j j j j mm j j j j j j j j
8. What is the primary function of hemoglobin?
mm mm j j jj mm mm
a. Iron metabolism c. Oxygen transport
j j jj
b. Porphyrin synthesis d. Signal transduction j j j j
9. All of the following areas of red blood cell biology are crucial for normal erythrocyte survival
j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j
except: j j
a. Cellular metabolism. c. Site of the ABO antigen attachment. jj jj j j jj jj j j
b. RBC membrane. d. Hemoglobin structure.
j j j j
, 10. What is the correct biochemical composition of the RBC membrane?
j j j j j j j j j j j j j j j j j j
a. 52% protein, 40% lipid, 8% carbohydrate
j j j j j j j j j j
b. 40% protein, 8% lipid, 52% carbohydrate
j j j j j j j j j j
c. 8% protein, 52% lipid, 40% carbohydrate
j j j j j j j j j j
d. 8% lipid, 40% carbohydrate, 52% protein
j j j j j j j j j j
11. All of the following biochemical changes are associated with loss of red blood cell viability
j j j j j j j j j j j j j j j j j j j j j j j j j j j j
storage upon
jj
except:
a. Decreased pH. j j c. Increased ATP level. jj jj
b. Loss of red blood cell function. j j j j j j j j j j d. Decreased glucose consumption. j j j j
12. Which red blood cell preservative has a storage time of 35 days?
j j j j j j j j j j j j j j j j j j j j j j
a. ACD c. AS-1
b. CPDA-1 d. CPD
13. The RBC membrane is relatively permeable to all of the following except:
j j j j j j j j j j j j j j j j j j j j j j
a. Chloride. c. Bicarbonate.
b. Sodium. d. Water.
14. What percentage of platelets is sequestered in the spleen as functional reserve after
j j j j j j j j j j j j j j j j j j j j j j j j
being released from the bone marrow?
j j j j jj j j j j j j
a. 30% c. 10%
b. 50% d. 25%
15. What is the major biochemical consideration in platelet storage?
j j j j j j j j j j mm j j j j
a. Glucose metabolism c. Production of carbon dioxide
j j j j j j mm
b. Oxygen supply d. Regulation of pH
j j jjm j j m j j mm mm
16. What would the hemoglobin-oxygen dissociation curve depict in a patient exhibiting
j j j j j j j j j j j j j j j j j j j j
clinical signs of alkalosis?
j j jj j j j j
a. Normal c. Shift to the right j j j j j j
b. Shift to the left d. j jNone of the above j j j j j j j j j j
17. Name the main lipid components of a red blood cell membrane.
j j j j j j mm j j j j mm j j j j j j
a. Phospholipid c. Glycolipid
b. Sphingomyelin d. Glycophorin A jj
18. The ABO blood groups were discovered in 1901 by whom?
jj j j mm j j mm j j j j j j j j
a. Charles Drew c. Loutit and Mollison
mm j j j j
b. Karl Landsteiner mm d. Edward Lindeman j j
19. A standing order of platelets was shipped to your facility by your supplier. It was
j j j j j j j j j j j j j j j j j j j j j j j j j j j j
inadvertently left in the corner of the department until discovered 36 hours later. What
j j jj j j j j j j mm mm j j j j j j j j j j j j j j
would the appropriate action be for the blood banker?
j j j j j j jj j j jj j j mm j j
a. If the temperature in the box was 22 +/- 2°C and the platelet swirl
j j j j j j j j j j j j j j j j jj j j j j j j j j
seemed OK, it would be OK to accept the unit into inventory.
j j j j j j jj j j j j j j j j j j j j j j j j
b. The platelets have fallen outside the supplier’s quality assurance. The
j j j j j j j j j j j j j j j j j j
unit should be discarded because the pH has probably dropped too low
j j jj j j j j j j j j j j j j j j j j j j j j
and platelet activation has been compromised.
j j j j jj j j j j j j
c. If the temperature was 1°C to 6°C and the platelet swirl seemed OK, it would be OK to
j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j
, accept the unit into inventory. j j j j j j j j
d. If the platelets appeared OK and passed the platelet swirl test after
j j j j j j j j j j j j j j j j j j j j j j
being placed on the agitator, they could be accepted into the
j j j j jj j j j j j j j j j j j j j j j j
inventory.
j j
20. Which metabolic pathway permits the accumulation of 2,3 diphosphoglycerate (2,3-DPG)?
j j j j jj j j j j j j j j j j j j
a. Glycolysis c. Pentose phosphate shunt j j j j
b. Luebering-Rapoport shunt d. Methemoglobin reductase jj j j
curve 21. All of the following are consistent with a "shift to the right" of the hemoglobin-oxygen
j j j j j j j j j j j j j j j j j j j j j j j j j j j j
dissociation
j j
except:
a. Increased 2,3-DPG. jj
b. 50% O2 saturation to tissues.
j j j j j j j j j j
c. Decreased 2,3-DPG. jj
d. Decreased hemoglobin affinity for O2. jj jj jj jj
22. What is the normal platelet count range per cubic millimeter?
j j j j j j j j j j j j j j j j j j
a. 100 to 350 j j c. 50,000 to 200,000
j j j j j j
b. 150,000 to 350,000 d. 350,000 to 500,000
j j j j j j j j
23. What cryoprotective agent is added to red blood cells upon freezing?
j j j j j j j j j j j j j j j j j j j j
a. Dextrose c. Glycerol
b. Adsol d. All of the above j j j j mm
24. If platelets are to be stored for 5 days on a rotator, what is the optimal storage
j j j j j j j j j j j j j j j j j j j j j j j j mm j j j j mm
temperature?
j j
a. 1°C to 6°C j j c. 35°C to 37°C
j j mm j j
b. 20°C to 24°C j j d. 1°C to 10°C j j mm j j
25. What role do platelets play in hemostasis?
j j j j j j j j j j j j
a. Maintenance of vascular integrity j j j j j j
b. Initial arrest of bleeding by platelet plug formation
j j j j j j jj j j j j j j
c. Stabilization of the hemostatic plug j j j j j j jj
d. All of the above j j j j j j
26. Which of j j j j the following best describes "integral" membrane proteins?
j j j j j j j j j j j j
a. Reside at j j j j the cytoplasmic surface of membrane
j j mm j j j j
b. Span the jj j j entire membrane surface j j mm
c. Form the j j j j red blood cell cytoskeletonj j mm mm
d. None of j j j j the above j j
27. How is stroma-free hemoglobin solution prepared?
j j j j j j j j j j
a. Outdated red blood cells are concentrated, and stroma is removed.
j j j j j j j j mm j j jj j j j j
b. Outdated red blood cells are diluted with saline, and stroma is removed.
jj j j j j mm mm j j j j j j j j j j j j
c. Outdated red blood cells are lysed, and stroma is removed.
j j j j j j j j j j j j j j j j j j
d. None of the above j j j j j j
28. What is the normal life span of an RBC?
j j j j j j j j j j j j j j j j
a. 100 days j j c. 120 hours j j
b. 120 days j j d. 2 days j j
29. Regarding loss of RBC membrane deformability, all of the following are true except:
j j j j j j j j j j j j j j j j j j j j j j j j
a. Increase in ATP level. j j jj jj
jj jj jj jj jj jj jj jj jj jj
Multiple Choice
jj
Identify the choice that best completes the statement or answers the question.
j j j j j j j j j j j j jj j j j j j j j j
1. Which metabolic pathway is responsible for generating 90% of the ATP for the RBC?
jj j j jj j j j j j j j j j j j j jj jj j j j j
a. Pentose phosphate shunt c. Glycolysis j j j j
b. Luebering-Rapoport shunt d. Methemoglobin reductase jj j j
2. A unit of blood was returned to the blood bank before it was spiked. Apparently the
jj j j j j j j j j j j j j j j j j j j j j j j j j jj jj
patient’s IV failed. The unit of blood was outside the blood bank for 35 minutes.
j j j j jj j j j j j j j j j j j j j j j j j j j j j j j j
Which of the statements below is most accurate?
j j j j j j j j jj j j j j j j
a. The unit of blood should be discarded immediately. jj j j j j j j j j j j jj
b. The unit of blood can be returned to inventory. j j j j j j j j j j j j j j j j
c. The unit of blood must be transfused within 4 hours or be discarded at the end of that
jj j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j
time. j j
d. The unit of blood must be transfused with 24 hours. j j j j j j j j j j j j j j j j j j
3. What is the average diameter of a platelet?
j j j j j j j j j j j j j j
a. 5 to 10 µm c. 1 to 2 µm
j j j j j j j j j j j j
b. 2 to 4 µm d.j j4 to 6 µm j j j j j j j j j j
4. In the normal hemoglobin-oxygen dissociation curve, what percentage of oxygen is
j j j j j j j j j j j j j j j j j j mm
released to the tissues when PO2
j j averages 40 mm Hg? j j j j jj j j j j j j j j j j
a. 75% c. 100%
b. 25% d. 50%
5. What factors are known to influence platelet metabolism and function?
jj j j j j j j j j j j j j jj j j
a. Storage temperature c. Platelet count j j jj
b. Initial pH d. All of the above j j j j j j mm
6. Which of the following red blood cell morphologies may be present on the peripheral
j j j j j j j j j j j j j j j j j j mm j j j j j j
blood smear as a result of loss of RBC membrane?
j j j j jj j j j j j j j j j j j j j j
a. Spherocytes c. Burr cells mm
b. Target cells d. Schistocytes jj
7. What does the term autologous transfusion refer to?
j j j j j j j j j j mm j j
a. A parent donating blood for his or her child
jj j j mm j j j j j j j j j j
b. An individual donating blood for a friend j j j j j j j j mm j j
c. An individual donating blood for a relative j j mm j j mm j j j j
d. An individual donating blood for his or her own transfusion
j j mm j j j j mm j j j j j j j j
8. What is the primary function of hemoglobin?
mm mm j j jj mm mm
a. Iron metabolism c. Oxygen transport
j j jj
b. Porphyrin synthesis d. Signal transduction j j j j
9. All of the following areas of red blood cell biology are crucial for normal erythrocyte survival
j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j
except: j j
a. Cellular metabolism. c. Site of the ABO antigen attachment. jj jj j j jj jj j j
b. RBC membrane. d. Hemoglobin structure.
j j j j
, 10. What is the correct biochemical composition of the RBC membrane?
j j j j j j j j j j j j j j j j j j
a. 52% protein, 40% lipid, 8% carbohydrate
j j j j j j j j j j
b. 40% protein, 8% lipid, 52% carbohydrate
j j j j j j j j j j
c. 8% protein, 52% lipid, 40% carbohydrate
j j j j j j j j j j
d. 8% lipid, 40% carbohydrate, 52% protein
j j j j j j j j j j
11. All of the following biochemical changes are associated with loss of red blood cell viability
j j j j j j j j j j j j j j j j j j j j j j j j j j j j
storage upon
jj
except:
a. Decreased pH. j j c. Increased ATP level. jj jj
b. Loss of red blood cell function. j j j j j j j j j j d. Decreased glucose consumption. j j j j
12. Which red blood cell preservative has a storage time of 35 days?
j j j j j j j j j j j j j j j j j j j j j j
a. ACD c. AS-1
b. CPDA-1 d. CPD
13. The RBC membrane is relatively permeable to all of the following except:
j j j j j j j j j j j j j j j j j j j j j j
a. Chloride. c. Bicarbonate.
b. Sodium. d. Water.
14. What percentage of platelets is sequestered in the spleen as functional reserve after
j j j j j j j j j j j j j j j j j j j j j j j j
being released from the bone marrow?
j j j j jj j j j j j j
a. 30% c. 10%
b. 50% d. 25%
15. What is the major biochemical consideration in platelet storage?
j j j j j j j j j j mm j j j j
a. Glucose metabolism c. Production of carbon dioxide
j j j j j j mm
b. Oxygen supply d. Regulation of pH
j j jjm j j m j j mm mm
16. What would the hemoglobin-oxygen dissociation curve depict in a patient exhibiting
j j j j j j j j j j j j j j j j j j j j
clinical signs of alkalosis?
j j jj j j j j
a. Normal c. Shift to the right j j j j j j
b. Shift to the left d. j jNone of the above j j j j j j j j j j
17. Name the main lipid components of a red blood cell membrane.
j j j j j j mm j j j j mm j j j j j j
a. Phospholipid c. Glycolipid
b. Sphingomyelin d. Glycophorin A jj
18. The ABO blood groups were discovered in 1901 by whom?
jj j j mm j j mm j j j j j j j j
a. Charles Drew c. Loutit and Mollison
mm j j j j
b. Karl Landsteiner mm d. Edward Lindeman j j
19. A standing order of platelets was shipped to your facility by your supplier. It was
j j j j j j j j j j j j j j j j j j j j j j j j j j j j
inadvertently left in the corner of the department until discovered 36 hours later. What
j j jj j j j j j j mm mm j j j j j j j j j j j j j j
would the appropriate action be for the blood banker?
j j j j j j jj j j jj j j mm j j
a. If the temperature in the box was 22 +/- 2°C and the platelet swirl
j j j j j j j j j j j j j j j j jj j j j j j j j j
seemed OK, it would be OK to accept the unit into inventory.
j j j j j j jj j j j j j j j j j j j j j j j j
b. The platelets have fallen outside the supplier’s quality assurance. The
j j j j j j j j j j j j j j j j j j
unit should be discarded because the pH has probably dropped too low
j j jj j j j j j j j j j j j j j j j j j j j j
and platelet activation has been compromised.
j j j j jj j j j j j j
c. If the temperature was 1°C to 6°C and the platelet swirl seemed OK, it would be OK to
j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j j
, accept the unit into inventory. j j j j j j j j
d. If the platelets appeared OK and passed the platelet swirl test after
j j j j j j j j j j j j j j j j j j j j j j
being placed on the agitator, they could be accepted into the
j j j j jj j j j j j j j j j j j j j j j j
inventory.
j j
20. Which metabolic pathway permits the accumulation of 2,3 diphosphoglycerate (2,3-DPG)?
j j j j jj j j j j j j j j j j j j
a. Glycolysis c. Pentose phosphate shunt j j j j
b. Luebering-Rapoport shunt d. Methemoglobin reductase jj j j
curve 21. All of the following are consistent with a "shift to the right" of the hemoglobin-oxygen
j j j j j j j j j j j j j j j j j j j j j j j j j j j j
dissociation
j j
except:
a. Increased 2,3-DPG. jj
b. 50% O2 saturation to tissues.
j j j j j j j j j j
c. Decreased 2,3-DPG. jj
d. Decreased hemoglobin affinity for O2. jj jj jj jj
22. What is the normal platelet count range per cubic millimeter?
j j j j j j j j j j j j j j j j j j
a. 100 to 350 j j c. 50,000 to 200,000
j j j j j j
b. 150,000 to 350,000 d. 350,000 to 500,000
j j j j j j j j
23. What cryoprotective agent is added to red blood cells upon freezing?
j j j j j j j j j j j j j j j j j j j j
a. Dextrose c. Glycerol
b. Adsol d. All of the above j j j j mm
24. If platelets are to be stored for 5 days on a rotator, what is the optimal storage
j j j j j j j j j j j j j j j j j j j j j j j j mm j j j j mm
temperature?
j j
a. 1°C to 6°C j j c. 35°C to 37°C
j j mm j j
b. 20°C to 24°C j j d. 1°C to 10°C j j mm j j
25. What role do platelets play in hemostasis?
j j j j j j j j j j j j
a. Maintenance of vascular integrity j j j j j j
b. Initial arrest of bleeding by platelet plug formation
j j j j j j jj j j j j j j
c. Stabilization of the hemostatic plug j j j j j j jj
d. All of the above j j j j j j
26. Which of j j j j the following best describes "integral" membrane proteins?
j j j j j j j j j j j j
a. Reside at j j j j the cytoplasmic surface of membrane
j j mm j j j j
b. Span the jj j j entire membrane surface j j mm
c. Form the j j j j red blood cell cytoskeletonj j mm mm
d. None of j j j j the above j j
27. How is stroma-free hemoglobin solution prepared?
j j j j j j j j j j
a. Outdated red blood cells are concentrated, and stroma is removed.
j j j j j j j j mm j j jj j j j j
b. Outdated red blood cells are diluted with saline, and stroma is removed.
jj j j j j mm mm j j j j j j j j j j j j
c. Outdated red blood cells are lysed, and stroma is removed.
j j j j j j j j j j j j j j j j j j
d. None of the above j j j j j j
28. What is the normal life span of an RBC?
j j j j j j j j j j j j j j j j
a. 100 days j j c. 120 hours j j
b. 120 days j j d. 2 days j j
29. Regarding loss of RBC membrane deformability, all of the following are true except:
j j j j j j j j j j j j j j j j j j j j j j j j
a. Increase in ATP level. j j jj jj
