BB CIULLA (W/ RATIO) EXAM QUESTIONS WITH CORRECT ANSWERS |LATEST UPDATE 100%
SOLVED| GRADED A+
A patient experiences severe rigors and goes into shock after receiving part of a unit of RBC.
The patient's temperature, which was 37.5°C pretransfusion, is now 40.0°C. Which of the
following is the most likely type of reaction?
A. Hemolytic
B. Anaphylactic
C. Septic
D. Embolic C. Septic
C. Although rigors and shock may be caused by hemolytic or anaphylactic reactions, bacterial
sepsis is the most likely cause in this case. The sudden rise of the patient's temperature from
normal to 40°C or above is typical of such an infection. Bacterial sepsis is an important cause of
transfusion reactions, with about one-fourth of these reactions resulting in death.
A patient experiences severe rigors and goes into shock after receiving part of a unit of RBC.
The patient's temperature, which was 37.5°C pretransfusion, is now 40.0°C
Referring to the reaction described in question 171, the incidence of this type of reaction is
highest with which of the following components?
A. RBC
B. FFP
C. Cryoprecipitate
,D. Platelets D. Platelets
D. The incidence of bacterial sepsis is highest with platelet components. It is higher with pooled
platelets than platelets collected by apheresis.
Pooled platelets usually involve 6 or more donations from different donors, multiplying the
chance of contamination. Most bacteria grow better at room temperature (the normal storage
temperature for platelets) than refrigerator temperature. Sepsis from RBCs is usually due to
Yersinia enterocolitica, which grows well at refrigerator temperature
The serum of a patient transfused 2 weeks ago reacts 3+ on immediate spin and 1 + at the
antiglobulin phase of testing with all reagent red cells except for the ii cell. The autocontrol
reacts similarly to the panel cells. In order to crossmatch this patient, one should
A. Use autoadsorbed serum
B. Use the prewarmed technique
C. Identify the antibody and obtain blood from the rare donor file
D. Use a LISS additive B. Use the prewarmed technique
B. The reactions are most likely all caused by the cold autoagglutinin anti-I. The I antigen is not
present on ii cells. Autoadsorption of the patient's serum with his/her own cells should not be
performed following recent transfusion. Alloantibody may be adsorbed onto circulating donor
red cells, resulting in false negative reactions with repeat testing of the autoadsorbed serum
and reagent red cells. The weak reactions at the AHG phase of testing are most likely due to
complement being bound at room temperature by the cold autoantibody reacting with the
anti-C3d in polyspecific AHG reagent. A prewarmed technique, in which the donor's cells and
,patient's serum are wanned separately to 37°C before combining, is commonly used to
eliminate interference from cold agglutinins. Many transfusion services use an anti-IgG
monospecific AHG reagent, instead of a polyspecific reagent that contains anti-IgG and anti-
C3d, in order to avoid such problems, but the prewarmed crossmatch should eliminate
complement from being bound. Because the patient was recently transfused, there is a slight
possibility that the reactions at AHG could be caused by a high-incidence alloantibody causing
delayed hemolysis. Such an antibody would still react by prewarmed technique
Six units of blood from volunteer donors are tested for ABO group, Rh type, and unexpected
antibodies. For each set of test results (questions 174-179), indicate the final disposition of the
donated unit. Assume additional FDA required testing is nonreactive, unless noted
Cell Typing Results / Serum Typing Results
Anti - A, Anti - B, Anti-D / A1 cells, A2 cells, B cells
0, 0, 3 + / 4 + , 3 + , 4 +
Weak D test = 3 +, DAT = 0
A. Label group O, D-positive
B. Label group O, D-negative
C. Label the RBC group O, D-positive; do not use the plasma
D. Perform additional testing
E. Discard the unit A. Label group O, D-positive
The ABO group and Rh type must be determined by the blood-collecting facility with every
donation.
, Six units of blood from volunteer donors are tested for ABO group, Rh type, and unexpected
antibodies. For each set of test results (questions 174-179), indicate the final disposition of the
donated unit. Assume additional FDA required testing is nonreactive, unless noted
Cell Typing Results / Serum Typing Results
Anti - A, Anti - B, Anti-D / A1 cells, A2 cells, B cells
0,0,0/4+,4+,4+
Weak D test = 3 +, DAT = 0
A. Label group O, D-positive
B. Label group O, D-negative
C. Label the RBC group O, D-positive; do not use the plasma
D. Perform additional testing
E. Discard the unit A. Label group O, D-positive
The unit must be labeled using the interpretation of current testing, not with previous donor
records from repeat donors. When the immediate-spin (IS) reaction of the donor red cells is
positive with anti-D (with a negative Rh control), the unit may be labeled D-positive. If the red
cells fail to agglutinate anti-D directly, the test must be incubated and converted to the
antiglobulin test to detect weak D phenotype. All units tested with anti-D that are IS negative
but are found to be weak D-positive must be labeled D-positive to avoid sensitizing an intended
D-negative recipient to the D antigen.
SOLVED| GRADED A+
A patient experiences severe rigors and goes into shock after receiving part of a unit of RBC.
The patient's temperature, which was 37.5°C pretransfusion, is now 40.0°C. Which of the
following is the most likely type of reaction?
A. Hemolytic
B. Anaphylactic
C. Septic
D. Embolic C. Septic
C. Although rigors and shock may be caused by hemolytic or anaphylactic reactions, bacterial
sepsis is the most likely cause in this case. The sudden rise of the patient's temperature from
normal to 40°C or above is typical of such an infection. Bacterial sepsis is an important cause of
transfusion reactions, with about one-fourth of these reactions resulting in death.
A patient experiences severe rigors and goes into shock after receiving part of a unit of RBC.
The patient's temperature, which was 37.5°C pretransfusion, is now 40.0°C
Referring to the reaction described in question 171, the incidence of this type of reaction is
highest with which of the following components?
A. RBC
B. FFP
C. Cryoprecipitate
,D. Platelets D. Platelets
D. The incidence of bacterial sepsis is highest with platelet components. It is higher with pooled
platelets than platelets collected by apheresis.
Pooled platelets usually involve 6 or more donations from different donors, multiplying the
chance of contamination. Most bacteria grow better at room temperature (the normal storage
temperature for platelets) than refrigerator temperature. Sepsis from RBCs is usually due to
Yersinia enterocolitica, which grows well at refrigerator temperature
The serum of a patient transfused 2 weeks ago reacts 3+ on immediate spin and 1 + at the
antiglobulin phase of testing with all reagent red cells except for the ii cell. The autocontrol
reacts similarly to the panel cells. In order to crossmatch this patient, one should
A. Use autoadsorbed serum
B. Use the prewarmed technique
C. Identify the antibody and obtain blood from the rare donor file
D. Use a LISS additive B. Use the prewarmed technique
B. The reactions are most likely all caused by the cold autoagglutinin anti-I. The I antigen is not
present on ii cells. Autoadsorption of the patient's serum with his/her own cells should not be
performed following recent transfusion. Alloantibody may be adsorbed onto circulating donor
red cells, resulting in false negative reactions with repeat testing of the autoadsorbed serum
and reagent red cells. The weak reactions at the AHG phase of testing are most likely due to
complement being bound at room temperature by the cold autoantibody reacting with the
anti-C3d in polyspecific AHG reagent. A prewarmed technique, in which the donor's cells and
,patient's serum are wanned separately to 37°C before combining, is commonly used to
eliminate interference from cold agglutinins. Many transfusion services use an anti-IgG
monospecific AHG reagent, instead of a polyspecific reagent that contains anti-IgG and anti-
C3d, in order to avoid such problems, but the prewarmed crossmatch should eliminate
complement from being bound. Because the patient was recently transfused, there is a slight
possibility that the reactions at AHG could be caused by a high-incidence alloantibody causing
delayed hemolysis. Such an antibody would still react by prewarmed technique
Six units of blood from volunteer donors are tested for ABO group, Rh type, and unexpected
antibodies. For each set of test results (questions 174-179), indicate the final disposition of the
donated unit. Assume additional FDA required testing is nonreactive, unless noted
Cell Typing Results / Serum Typing Results
Anti - A, Anti - B, Anti-D / A1 cells, A2 cells, B cells
0, 0, 3 + / 4 + , 3 + , 4 +
Weak D test = 3 +, DAT = 0
A. Label group O, D-positive
B. Label group O, D-negative
C. Label the RBC group O, D-positive; do not use the plasma
D. Perform additional testing
E. Discard the unit A. Label group O, D-positive
The ABO group and Rh type must be determined by the blood-collecting facility with every
donation.
, Six units of blood from volunteer donors are tested for ABO group, Rh type, and unexpected
antibodies. For each set of test results (questions 174-179), indicate the final disposition of the
donated unit. Assume additional FDA required testing is nonreactive, unless noted
Cell Typing Results / Serum Typing Results
Anti - A, Anti - B, Anti-D / A1 cells, A2 cells, B cells
0,0,0/4+,4+,4+
Weak D test = 3 +, DAT = 0
A. Label group O, D-positive
B. Label group O, D-negative
C. Label the RBC group O, D-positive; do not use the plasma
D. Perform additional testing
E. Discard the unit A. Label group O, D-positive
The unit must be labeled using the interpretation of current testing, not with previous donor
records from repeat donors. When the immediate-spin (IS) reaction of the donor red cells is
positive with anti-D (with a negative Rh control), the unit may be labeled D-positive. If the red
cells fail to agglutinate anti-D directly, the test must be incubated and converted to the
antiglobulin test to detect weak D phenotype. All units tested with anti-D that are IS negative
but are found to be weak D-positive must be labeled D-positive to avoid sensitizing an intended
D-negative recipient to the D antigen.
