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