MCQs Blood Bank Scribd 3
MCQs Blood Bank Scribd 3
MCQs Blood Bank Scribd 3
Given the most probable genotypes of the parents, which of the following
statements best describes the most probable Rh genotypes of the 4 children?
The most probable reason for these findings is that the patient is group:
a. O; confusion due to faulty group O antiserum
b. O; with an anti-A1
c. Ax; with an anti-A1
d. A1; with an anti-A
85. Human blood groups were discovered around 1900 by:
a. Jules Bordet
b. Louis Pasteur
c. Karl Landsteiner
d. PL Mollison
86. Cells of the A3 subgroup will:
a. react with Dolichos biflorus
b. bE-with anti-A
c. give a mixed-field reaction with anti-A,B
d. bE-with anti-H
87. The enzyme responsible for conferring H activity on the red cell membrane is alpha-:
a. galactosyl transferase
b. N-acetylgalactosaminyl transferase
c. L-fucosyl transferase
d. N-acetylglucosaminyl transferase
88. Even in the absence of prior transfusion or pregnancy, individuals with the Bombay
phenotype (Oh) will always have naturally occurring:
a. anti-Rh
b. anti-Ko
c. anti-U
d. anti-H
89. The antibody in the Lutheran system that is best detected at lower temperature is:
a. anti-Lua
b. anti-Lub
c. anti-Lu3
d. anti-Luab
90. Which of the following antibodies is neutralizable by pooled human plasma?
a. anti-Kna
b. anti-Ch
c. anti-Yka
d. anti-Csa
91. Anti-Sda is strongly suspected if:
a. the patient has been previously transfused
b. the agglutinates are mixed-field and refractile
c. the patient is group A or B
d. only a small number of panel cells are reactive
92. HLA antibodies are:
a. naturally occurring
b. induced by multiple transfusions
c. directed against granulocyte antigens only
d. frequently cause hemolytic transfusion reactions
93. Genes of the major histocompatibility complex (MHC):
a. code for HLA-A, HLA-B, and HLA-C antigens only
b. are linked to genes in the ABO system
c. are the primary genetic sex-determinants
d. contribute to the coordination of cellular and humoral immunity
94. Isoimmunization to platelet antigen HPA-1a and the placental transfer of maternal
antibodies would be expected to cause newborn:
a. erythroblastosis
b. leukocytosis
c. leucopenia
d. thrombocytopenia
95. Saliva from which of the following individuals would neutralize an auto anti-H in the
serum of a group A, Le(a-b+) patient?
a. group A, Le (a-b-)
b. group A, Le (a+b-)
c. group O, Le (a+b-)
d. group O, Le (a-b+)
96. Inhibition testing can be used to confirm antibody specificity for which of the
following antibodies?
a. anti-Lua
b. anti-M
c. anti-Lea
d. anti-Fya
97. Which of the following Rh antigens has the highest frequency in Caucasians?
a. D
b. E
c. c
d. e
98. Anti-D and anti-C are identified in the serum of a transfused pregnant woman, gravid
2, para 1. Nine months previously she received RH immune globulin (RhIg) after
delivery. Tests of the patient, her husband, and the child revealed the following:
anti-D anti-C anti-E anti-c anti-e
patient 0 0 0 + +
father + 0 0 + +
child + 0 0 + +
The most likely explanation for the presence of anti-C is that this antibody is:
a. actually anti-Cw
b. from the RhIg dose
c. actually anti-G
d. naturally occurring
99. The phenomenon of an Rh positive person whose serum contains anti-D is best
explained by:
a. gene deletion
b. missing antigen epitopes
c. trans position effect
d. gene inhibition
100. When the red cells of an individual fail to react with anti-U, they usually fail
to react with:
a. anti-M
b. anti-Leb
c. anti-S
d. anti-P1
101. Which of the following red cell antigens are found on glycophorin-A?
a. M,N
b. Lea, Leb
c. S, s
d. P, P1, Pk
102. Paroxysmal cold hemoglobinuria (PCH) is associated with antibody
specificity toward which of the following?
a. Kell system antigens
b. Duffy system antigens
c. P antigen
d. I antigen
103. Which of the following is a characteristic of anti-i?
a. associated with warm autoimmune hemolytic anemia
b. found in the serum of patients with infectious mononucleosis
c. detected at lower temperatures in the serum of normal individuals
d. found only in the serum of group O individuals
104. In case of cold autoimmune hemolytic anemia, the patient's serum would
most likely react 4+ at immediate spin with:
a. group A cells, B cells and O cells, but not his own cells
b. cord cells but not his own or other adult cells
c. all cells of a group O cell panel and his own cells
d. only penicillin-treated panel cells, not his own cells
105. Cold agglutinin syndrome is associated with an antibody-specificity toward
which of the following?
a. Fy:3
b. P
c. I
d. Rh:1
106. Which of the following is a characteristic of anti-i?
a. often associated with hemolytic disease of the newborn
b. reacts best at room temperature or 4oC
c. reacts best at 37oC
d. is usually IgG
107. The Kell (K1) antigen is:
a. absent from the red cells of neonates
b. strongly immunogenic
c. destroyed by enzymes
d. has a frequency of 50% in the random population
108. In chronic granulomatous disease (CGD), granulocyte function is impaired.
An association exists between this clinical condition and a depression of which of the
following antigens?
a. Rh
b. P
c. Kell
d. Duffy
109. The antibodies of the Kidd blood group system:
a. react best by the indirect antiglobulin test
b. are predominantly IgM
c. often cause allergic transfusion reactions
d. do not generally react with antigen positive enzyme-treated RBCs
110. Proteolytic enzyme treatment of red cells usually destroys which antigen?
a. Jka
b. E
c. Fya
d. k
111. Anti-Fya is:
a. usually a cold-reactive agglutinin
b. more reactive when tested with enzyme-treated red blood cells
c. capable of causing hemolytic transfusion reactions
d. often an autoagglutinin
112. Resistance to malaria is best associated with which of the following blood
groups?
a. Rh
b. I/i
c. P
d. Duffy
113. What percent of group O donors would be compatible with a serum sample
that contained anti-X and anti-Y if X antigen is present on red cells of 5 to 20 donors,
and Y antigen is present on red cells of 1 of 10 donors?
a. 2.5
b. 6.8
c. 25.0
d. 68.0
114. How many Caucasians is an population of 100,000 will have the following
combination of phenotypes?
System Phenotype frequency(%)
ABO O 45
Gm Fb 48
PGM1 2-1 37
EsD 2-1 18
a. 1
b. 14
c. 144
d. 1,438
115. What is the approximate probability of finding compatible blood among
random Rh-positive units for a patient who has anti-c and anti-K? (Consider that 20%
of Rh-positive donors lack c and 90% lack K)
a. 1%
b. 10%
c. 18%
d. 45%
116. A 25-year-old Caucasian woman, gravid 3, para 2, required 2 units of Red
Blood Cells. The antibody screen was positive and the results of antibody panel are
shown below:
EM
Cell D C c E e K Jka Lea Leb M N P1 37oC AHG
1 + + 0 0 + + + 0 + + + + 0 0
2 + + 0 0 + 0 + 0 + + 0 0 0 0
3 + 0 + + 0 0 + 0 + + + + 0 1+
4 + + + 0 + 0 0 0 + + 0 + 0 1+
5 0 0 + 0 + 0 + 0 + + 0 0 0 1+
6 0 0 + + + 0 + + 0 + + 0 0 1+
7 0 0 + 0 + + + + 0 + + + 0 1+
8 0 0 + 0 + 0 0 0 + 0 + + 0 1+
auto 0 0
Which of the following is the most probable explanation for these results?
a. ABO hemolytic disease of the fetus and newborn
b. Rh hemolytic disease of the fetus and newborn; infant has received
intrauterine transfusions
c. Rh hemolytic disease of the fetus and newborn, infant has a false-negative
Rh typing
d. large fetomaternal hemorrhage
130. A group A, Rh-positive infant of a group O, Rh-positive mother has a weak
positive direct antiglobulin test and a moderately elevated bilirubin 12 hours after
birth. The most likely cause is:
a. ABO incompatibility
b. Rh incompatibility
c. blood group incompatibility due to antibody to a low frequency antigen
d. neonatal jaundice not associated with blood group
131. In suspected cases of hemolytic disease of the newborn, what significant
information can be obtained from the baby's blood smear?
a. estimation of WBC, RBC, and platelet counts
b. marked increase in immature neutrophils (shift to the left)
c. a differential to estimate the absolute number of lymphocytes present
d. determination of the presence of spherocytes
132. The Liley method of predicting the severity of hemolytic disease of the
newborn is based on the amniotic fluid:
a. bilirubin concentration by standard methods
b. change in optical density measured at 450nm
c. Rh determination
d. ratio of lecithin to sphingomyelin
133. These laboratory results were obtained on maternal and cord blood
samples:
mother: A-
baby: AB+, DAT: 3+, cord hemoglobin: 10 g/dL (100g/L)
Given the data above, the centrifuge time for this machine should be:
a. 15 seconds
b. 20 seconds
c. 25 seconds
d. 30 seconds
165. Which of the following represents an acceptably identified patient for
sample collection and transfusion?
a. a handwritten band with patient's name and hospital identification number
is affixed to the patient's leg
b. the addressographed hospital band is taped to the patient's bed
c. an unbanded patient responds positively when his name is called
d. the chart transported with the patient contains his armband not yet
attached
166. Samples from the same patient were received on 2 consecutive days.
Test results are summarized below:
Day 1 Day 2
anti-A 4+ 0
anti-B 0 4+
anti-D 3+ 3+
A1 cells 0 4+
B cells 4+ 0
Ab screen 0 0
Antigens
1 2 3 4 5 Test results
Panel cells I + 0 0 + + +
Panel cells II 0 0 + 0 + 0
Panel cells III 0 + + + 0 0
Panel cells IV 0 + + 0 + +
Panel cells V + + + 0 0 +
auto 0
An antibody against which of the following antigens could not be excluded?
a. 1
b. 2
c. 3
d. 4
208. A 25-year-old Caucasian
209.
210. In the process of identifying an antibody, the technologist observed 2+
reactions with 3 of the 10 cells in a panel after the immediate spin phase. There was
no reactivity after incubation at 370C and after the anti-human globulin test phase.
The antibody most likely is:
a. anti-F
b. anti-Lea
c. anti-C
d. anti-Fya
211. Transfusion of Ch+ (chido-positive) red cells to a patient with anti-Ch has
been reported to cause:
a. no clinically significant red cell destruction
b. clinically significant immune red cell destruction
c. decreased 51Cr red cell survivals
d. febrile transfusion reactions
212. Result of a serum sample tested against a panel of reagent red cells gives
presumptive evidence of an alloantibody directed against a high incidence antigen.
Further investigation to confirm the specificity should include which of the
following?
a. serum testing against red cells from random donors
b. serum testing against red cells known to lack high incidence antigens
c. serum testing against enzyme-treated autologous red cells
d. testing of an eluate prepared from the patient's red cells
213. Refer to the following data:
Forward group: Reverse group:
anti-A anti-B anti-A1lectin A1cells A2cells B cells
4+ 0 4+ 0 2+ 4+
The ABO discrepancy seen above is most likely due to:
a. anti-A1
b. rouleaux
c. anti-H
d. unexpected IgG antibody present
214. Refer to the following panel:
215. Which characteristics are true of all 3 of the following antibodies: anti-Fy a,
a
anti-Jk , and anti-K?
a. detected at IAT phase and may cause hemolytic disease of the fetus and
newborn(HDFN) and transfusion reactions
b. not deteted with enzyme treated cells; may cause delayed transfusion
reactions
c. requires the IAT technique for detection; usually not responsible for causing
HDFN
d. may show dosage effect; may cause severe hemolytic transfusion reactions
216. Refer to the following cell panel
217. A pregnant woman has a positive antibody screen and the panel results are
given below:
218. Which of the following tests is most commonly used to detect antibodies
attached to a patient's red blood cells in vivo?
a. direct antiglobulin
b. complement fixation
c. indirect antiglobulin
d. immunofluorescence
219. Anti-I may cause a positive direct antiglobulin test(DAT) because of:
a. anti-I agglutinating the cells
b. C3d bound to the red cells
c. T-activation
d. C3c remaining on the red cells after cleavage of C3b
220. Which direct antiglobulin test results are associated with an anamnestic
antibody response in a recently transfused patient?
Test result Polyspecific IgG C3 Control
mf mf
result A + + 0 0
result B 1+ 0 1+ 0
result C 2+ 2+ 0 0
result D 4+ 4+ 4+ 0
mf = mixed field
a. result A
b. result B
c. result C
d. result D
221. In the direct(DAT) and indirect (IAT) antiglobulin tests, false negative
reactions may result if the:
222. Polyspecific reagents used in the direct antiglobulin test should have
specificity for:
a. IgG and IgA
b. IgG and C3d
c. IgM and IgA
d. IgM and C3d
223. In the direct antiglobulin test, the antiglobulin reagent is used to:
a. mediate hemolysis of indicator red blood cells by providing complement
b. precipitate anti-erythrocyte antibodies
c. measure antibodies in a test serum by fixing complement
d. detect preexisting antibodies on erythrocytes
224. AHG (Coombs) control cells:
a. can be used as a positive control for anti-C3 reagents
b. can be used only for the indirect antiglobulin test
c. are coated only with IgG antibody
d. must be used to confirm all positive antiglobulin reactions
225. A 56-year-old female with cold agglutinin disease has a positive direct
antiglobulin test (DAT). When the DAT id repeated using monospecific antiglobulin
sera, which of the following is most likely to be detected?
a. IgM
b. IgG
c. C3d
d. C4a
226. The mechanism that best explains hemolytic anemia due to penicillin is:
a. drug-dependent antibodies reacting with drug-treated cells
b. drug-dependent antibodies reacting in the presence of drug
c. drug-independent with autoantibody production
d. nonimmunologic protein adsorption with positive DAT
227. Use of EDTA plasma prevents activation of the classical complement
pathway by:
a. causing rapid decay of complement components
b. chelating Mg++ ions, which prevents the assembly of C6
c. chelating Ca++ ions, which prevents assembly of C1
d. preventing chemotaxis
228. Which of the following medications is most likely to cause production of
autoantibodies?
a. penicillin
b. cephalothin
c. methyldopa
d. tetracycline
229. Serological results on an untransfused patient were:
antibody screen: negative at AHG
direct antiglobulin test: 3+ with anti-C3d
eluate: negative
These results are most likely due to:
a. warm autoimmune hemolytic anemia
b. cold agglutinin syndrome
c. paroxysmal cold hemoglobinuria
d. drug induced hemolytic anemia
230. The drug cephalosporin can cause a positive direct antiglobulin test with
hemolysis by which of the following mechanisms?
a. drug-dependent antibodies reacting with drug-treated cells
b. drug-dependent antibodies reacting in the presence of a drug
c. drug-independent with autoantibody production
d. nonimmunologic protein adsorption with positive DAT
231. Crossmatch results at the antiglobulin phase were negative. When 1 drop of
check cells was added, no agglutination was seen. The most likely explanation is
that the:
a. red cells were overwashed
b. centrifuge speed was set too high
c. residual patient serum inactivated the AHG reagent
d. laboratorian did not add enough check cells
232. Which of the following might cause a false-negative indirect antiglobulin
test(IAT)?
a. over-reading
b. IgG-coated screening cells
c. addition of an extra drop of serum
d. too heavy a cell suspension
233. The purpose of testing with anti-A,B is to detect:
a. anti-A1
b. anti-A2
c. subgroups of A
d. subgroups of B
234. What is the most appropriate diluents for preparing a solution of 8% bovine
albumin for a red cell control reagent?
a. deionized water
b. distilled water
c. normal saline
d. Alserver solution
235. Which of the following antigens gives enhanced reactions with its
corresponding antibody following treatment of the red cells with proteolytic
enzymes?
a. Fya
b. E
c. S
d. M
236. In a prenatal workup, the following results were obtained:
Forward group: Reverse Group:
anti-A anti-B anti-D Rh Control A1 cells B cells
4+ 2+ 4+ 0 0 3+
DAT: negative
antibody screen: negative
ABO discrepancy was thought to be due to an antibody directed against a
component of the typing sera. Which test would resolve this discrepancy?
a. A1 lectin
b. wash patient's RBCs and repeat testing
c. anti-A,B and extend incubation of the reverse group
d. repeat reverse group using A2 cells
237. Refer to the following panel:
238. Of the following, the most useful technique(s) in the identification and
classification of high-titer, low-avidity (HTLA) antibodies is/are:
a. reagent red cell panels
b. adsorption and elution
c. titration and inhibition
d. cold autoadsorption
239. To confirm a serum antibody specificity identified as anti-P1, a neutralization
study was performed and the following results obtained:
P1 + RBCs
serum + P1 substance: negative
serum + saline: negative
What conclusion can be made from these results?
a. anti-P1 is confirmed
b. anti-P1 is ruled out
c. a second antibody is suspected due to the results of the negative control
d. anti-P1 cannot be confirmed due to the results of the negative control
240. What happens to an antibody in neutralization study when a soluble antigen
is added to the test?
a. inhibition
b. dilution
c. complement fixation
d. hemolysis
241. To confirm the specificity of anti-Leb, an inhibition study using Lewis
substance was performed with the following results:
Le(b+) cells
tubes with patient serum + Lewis substance: 0
tubes with patient serum + saline control: +
What conclusion can be made from these results?
a. a second antibody is suspected due to the positive control
b. anti-Leb is confirmed because the tubes with Lewis substance are negative
c. anti-Leb is not confirmed because the tubes with Lewis substance are
negative
d. anti-Leb cannot be confirmed because the saline control is positive
242. Which of the following is the correct interpretation of this saliva
neutralization testing?
Indicator cells
Sample A B O
saliva plus anti-A: + O O
saliva plus anti-B: O + O
saliva plus anti-H: O O O
a. group A secretor
b. group B secretor
c. group AB secretor
d. group O secretor
243. A person's saliva incubated with the following antibodies and tested with
appropriate A2, O, and B indicator cells, gives the following test results:
Antibody specificity Test results
anti-A reactive
anti-B inhibited
anti-H inhibited
The person's red cells ABO phenotype is:
a. A
b. AB
c. B
d. O
244. An antibody screen performed using solid phase technology revealed a
diffuse layer of red blood cells on the bottom of the well. These results indicate:
a. a positive reaction
b. a negative reaction
c. serum was not added
d. red cells have a positive direct antiglobulin test
245. On Monday, a patient's K antigen typing result was positive. Two days later,
the patient's K typing was negative. The patient was transfused with 2 units of Fresh
Frozen Plasma. The tech might conclude that the:
a. transfusion of FFP affected the K typing
b. wrong patient was drawn
c. results are normal
d. anti-K reagent was omitted on Monday
246. Which one of the following is an indicator of polyagglutination?
a. RBCs typing as weak D+
b. presence of red cell autoantibody
c. decreased serum bilirubin
d. agglutination with normal adult ABO compatible sera
247. While performing an antibody screen, a test reaction is suspected to be
rouleaux. A saline replacement test is performed and the reaction remains. What is
the best interpretation?
a. original reaction of rouleaux is confirmed
b. replacement test is invalid and should be repeated
c. original reaction was due to true agglutination
d. antibody screen is negative
248. A 10-year old girl was hospitalized because her urine had a distinct red color.
The patient had recently recovered from an upper respiratory infection and
appeared very pale and lethargic. Tests were performed with the following results:
hemoglobin: 5g/dL
reticulocyte count: 15%
DAT: weak reactivity with poly-specific and anti-C3d, anti-IgG
was negative
antibody screen: negative
Donath-Lansteiner test: positive; P cells showed no hemolysis
The patient probably has:
a. paroxysmal cold hemoglobinuria (PCH)
b. paroxysmal nocturnal hemoglobinuria (PNH)
c. warm autoimmune hemolytic anemia
d. hereditary erythroblastic multinuclearity with a positive acidified serum test
(HEMPAS)
249. Which of the following is useful for removing IgG from red blood cells with
positive DAT to perform a phenotype?
a. bromelin
b. chloroquine
c. LISS
d. DTT
250. A patient's serum contains a mixture of antibodies. One of the antibodies is
identified as anti-D. Anti-Jka, anti-Fya and possibly another antibody are present.
What technique(s) may be helpful to identify the other antibody(ies)?
a. enzyme panel; select cell panel
b. thiol reagents
c. lowering the pH and increasing the incubation time
d. using albumin as an enhancement media in combination with selective
absorption
251. A sample gives the following results:
Cells with: Serum with:
anti-A 3+ A1 cells 2+
anti-B 4+ B cells 0
Which lectin should be used first to resolve this discrepancy?
a. Ulex europaeus
b. Arachis hypogaea
c. Dolichos biflorus
d. Vicia graminea
252. The serum of group O, Cde/Cde donot contains anti-D. In order to prepare a
suitable anti-D reagent from this donor's serum, which of the following cells would
be suitable for the adsorption?
a. group O, cde/cde cells
b. group O, Cde/cde cells
c. group A2B, CDe/cde cells
d. group A1B, cde/cde cells
253. A 26-year-old female is admitted with anemia of undetermined origin.
Blood samples are received with a crossmatch request for 6 units of Red Blood Cells.
The patient is group A, Rh-negative and has no history of transfusion or pregnancy.
The following results were obtained in pretransfusion testing:
IS 370C IAT
screening cell I 0 0 3+
screening cell II 0 0 3+
autocontrol 0 0 3+
all 6 donors 0 0 3+
The best way to find compatible blood is to:
a. do an antibody identification panel
b. use the saline replacement technique
c. use the pre-warm technique
d. perform a warm autoadsorption
254. A patient's serum was reactive 2+ in the antiglobulin phase of testing with all
cells on a routine panel including their own. Transfusion was performed 6 months
previously. The optimal adsorption method to remove the autoantibody is:
a. autoadsorption using the patient's ZZAP-treated red cells
b. autoadsorption using the patient's LISS-treated red cells
c. adsorption using enzyme-treated red cells from a normal donor
d. adsorption using methyldopa-treated red cells
255. In a cold autoadsorption procedure, pretreatment of the patient's red cells
with which of the following reagents is helpful?
a. ficin
b. phosphate-buffered saline at pH 9.0
c. low ionic strength solution (LISS)
d. albumin
256. The process of separation of antibody from its antigen is known as:
a. diffusion
b. adsorption
c. neutralization
d. elution
257. Which of the following is most helpful to confirm a weak ABO subgroup?
a. adsorption-elution
b. neutralization
c. testing with A1 lectin
d. use of anti-A,B
258. One of the most effective methods for the elution of warm autoantibodies
from RBCs utilizes:
a. 10% sucrose
b. LISS
c. change in pH
d. distilled water
259. How would the hematocrit of a patient with chronic anemia be affected by
the transfusion of a unit of Whole Blood containing 475 mL of blood, vs 2 units of
Red Blood Cells each with a total volume of 250 mL?
a. patient's hematocrit would be equally affected by the Whole Blood or the
Red Blood Cells
b. Red Blood Cells would provide twice the increment in hematocrit as the
Whole Blood
c. Whole Blood would provide twice the increment in hematocrit as the Red
Blood Cells
d. Whole Blood would provide a change in hematocrit slightly less than the Red
Blood Cells
260. After checking the inventory, it was noted that there were no units on the
shelf marked "May Issue as Uncrossmatched: For Emergency Only." Which of the
following should be placed on this shelf?
a. 1 unit of each of the ABO blood groups
b. units of group O, Rh-positive Whole Blood
c. units of group O, Rh-negative Red Blood Cells
d. any units that are expiring at midnight
261. The primary indication for granulocyte transfusion is:
a. prophylactic treatment for infection
b. additional supportive therapy in those patients who are responsive to
antibiotic therapy
c. clinical situations where bone marrow recovery is not anticipated
d. severe neutropenia with an infection that is nonresponsive to antibiotic
therapy
262. A 42-year-old male of average body mass has a history of chronic anemia
requiring transfusion support. Two units of Red Blood Cells are transfused. If the
pretransfusion hemoglobin was 7.0g/dL (70g/L), the expected posttransfusion
hemoglobin concentration should be:
a. 8.0g/dL (80g/L)
b. 9.0 g/dL (90g/L)
c. 10.0 g/dL (100g/L)
d. 11.0 g/dL (110g/L)
263. How many units of Red Blood Cells are required to raise the hematocrit of a
70kg nonbleeding man from 24% to 30%?
a. 1
b. 2
c. 3
d. 4
264. For which of the following transfusion candidates would CMV-seronegative
blood be most likely indicated?
a. renal dialysis patients
b. sickle cell patient
c. bone marrow and hematopoietic cell transplant recipients
d. CMV-seropositive patients
265. Although ABO compatibility is preferred, ABO incompatibility product may
be administered when transfusing:
a. Single-Donor plasma
b. Cryoprecipitated AHF
c. Fresh Frozen Plasma
d. Granulocytes
266. Transfusion of plateletpheresis products from HLA-compatible donors is the
preferred treatment for:
a. recently diagnosed cases of TTP with severe thrombocytopenia
b. acute leukemia in relapse with neutroppenia and sepsis
c. immune thrombocytopenic purpura
d. severely thrombocytopenic patients, known to be refractory to random
donor platelets
267. Washed Red Blood Cells are indicated in which of the following situations:
a. an IgA-deficient patient with a history of transfusion-associated anaphylaxis
b. a pregnant woman with a history of hemolytic disease of the newborn
c. a patient with a positive DAT and red cell autoantibody
d. a newborn with a hematocrit of <30%
268. Which of the following is consistent with standard blood bank procedure
governing the infusion of fresh frozen plasma?
a. only blood group-specific plasma may be administered
b. group O may be administered to recipients of all blood groups
c. group AB may be administered to AB recipients only
d. group A may be administered to both A and O recipients
269. A patient who is group AB, Rh-negative needs 2 units of Fresh Frozen
Plasma. Which of the following units of plasma would be most acceptable for
transfusion?
a. group O, Rh-negative
b. group A, Rh-negative
c. group B, Rh-positive
d. group AB, Rh-positive
270. What increment of platelets/uL (platelets/L), in the typical 70-kg human, is
expected to result from each single unit of Platelets transfused to a non-HLA-
sensitized recipient?
a. 3,000-5,000
b. 5,000-10,000
c. 20,000-25,000
d. 25,000-30,000
271. Platelet transfusions are of most value in treating:
a. hemolytic transfusion reaction
b. post-transfusion purpura
c. functional platelet abnormalities
d. immune thrombocytopenic purpura
272. Washed Red Blood Cells would be the product of choice for patient with:
a. multiple red cell alloantibodies
b. an increased risk of hepatitis infection
c. warm autoimmune hemolytic anemia
d. anti-IgA antibodies
273. A patient received about 15mL of compatible blood and developed severe
shock, but no fever. If the patient needs another transfusion, what kind of red blood
cell component should be given?
a. Red Blood Cells
b. Red Blood Cells, washed
c. Red Blood Cells, Irradiated
d. Red Blood Cells, Leukocyte-Reduced
274. Fresh Frozen Plasma from a group A, Rh-positive donor may be safely
transfused to a patient who is group:
a. A, Rh-negative
b. B, Rh-negative
c. AB, Rh-positive
d. AB, Rh-negative
275. A patient admitted to the trauma unit requires emergency release of Fresh
Frozen Plasma (FFP). His blood donot card states that he is group AB, Rh-positive.
Which of the following blood groups of FFP should be issued?
a. A
b. B
c. AB
d. O
276. Fresh Frozen Plasma:
a. contains all labile coagulative factors except cryoprecipitated AHF
b. has a higher risk of transmitting hepatitis than does Whole blood
c. should be transfused within 24 hours of thawing
d. need not be ABO-compatible
277. Ten units of group A platelets were transfused to a group AB patient. The
pretransfusion platelet count was 12 x 103/uL (12 x 109/L) and the posttransfusion
count was 18 x 103/uL (18 x 109/L). From this information, the laboratorian would
most likely conclude that the patient:
a. needs group AB platelets to be effective
b. clinical data does not suggest a need for platelets
c. has developed antibodies to the transfused platelets
d. should receive irradiated platelets
278. Hypotension, nausea, flushing, fever and chills are symptoms of which of the
following transfusion reactions?
a. allergic
b. circulatory overload
c. hemolytic
d. anaphylactic
279. A patient has become refractory to platelet transfusion. Which of the
following are probably causes?
a. transfusion of Rh-incompatible platelets
b. decreased pH of the platelets
c. development of an alloantibody with anti-D specificity
d. development of antibodies to HLA antigen
280. A poor increment in the platelet count 1 hour following platelet transfusion
is most commonly caused by:
a. splenomegaly
b. alloimmunization to HLA antigens
c. disseminated intravascular coagulation
d. defective platelets
281. Posttransfusion purpura is ually caused by:
a. anti-A
b. white cell antibodies
c. anti-HPA-1a (P1A1)
d. platelet wash-out
282. An unexplained fall in hemoglobin and mild jaundice in a patient transfused
with Red Blood Cells 1 week previously would most likely indicate:
a. paroxysmal nocturnal hemoglobinuria
b. posttransfusion hepatitis infection
c. presence of HLA antibodies
d. delayed hemolytic transfusion reaction
283. In a delayed transfusion reaction, the causative antibody is generally too
weak to be detected in routine compatibility testing and antibody screening tests,
but is typically detectable at what point after transfusion?
a. 3-6 hours
b. 3-7 days
c. 60-90 days
d. after 120 days
284. The most serious hemolytic transfusion reactions are due to incompatibility
in which of the following blood group systems?
a. ABO
b. Rh
c. MN
d. Duffy
285. Severe intravascular hemolysis is most likely caused by antibodies of which
blood group system?
a. ABO
b. Rh
c. Kell
d. Duffy
286. Which of the following blood group systems is most commonly associated
with delayed hemolytic transfusion reactions?
a. Lewis
b. Kidd
c. MNS
d. I
287. After receiving a unit of Red Blood Cells, a patient immediately developed
flushing, nervousness, fever spike of 102 0F (38.90C), shaking, chills and back pain.
The plasma hemoglobin was elevated and there was hemoglobinuria. Laboratory
investigation of this adverse reaction would most likely show:
a. an error in ABO grouping
b. an error in Rh typing
c. presence of anti-Fya antibody in patient's serum
d. presence of gram-negative bacteria in blood bag
288. A trauma patient who has just received ten units of blood may develop:
a. anemia
b. polycythemia
c. leukocytosis
d. thrombocytopenia
289. Five days after transfusion, a patient becomes mildly jaundiced and
experiences a drop in hemoglobin and hematocrit with no apparent hemorrhage.
Below are the results of the transfusion reaction workup: