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WorksheetsMEDL 279 Immunohematology Review
Total questions: 95
Worksheet time: 48mins
What is the maximum collection of whole blood per kilogram of body weight, including samples?
10.5mL
5mL
15mL
20mL
Platelets cannot be taken from someone who is on platelet affecting medication such as ________.
aspirin
paracetamol
ibuprofen
amoxicillin
What is the minimum age required for a blood donor?
>16 years old
<15 years old
10 years old
21 years old
What is the acceptable oral temperature range for a blood donor?
Less than 37.5°C or 99.5°F
Less than 36.0°C or 96.8°F
Less than 38.5°C or 101.3°F
Less than 35.0°C or 95.0°F
A blood donor must have a systolic blood pressure less than ______ and a diastolic blood pressure less than ______.
180 systolic, 100 diastolic
160 systolic, 90 diastolic
200 systolic, 120 diastolic
140 systolic, 80 diastolic
What is the minimum hemoglobin/hematocrit (Hgb/Hct) required for a blood donor?
Greater than 12.5%/38%
Greater than 11.0%/33%
Greater than 13.5%/40%
Greater than 10.0%/30%
What is the acceptable pulse reading range for a blood donor?
50-100 bpm
40-60 bpm
100-120 bpm
30-80 bpm
What is the minimum weight required for a blood donor?
110 lbs
90 lbs
130 lbs
150 lbs
How long is the donor deferred if there is possible exposure to hepatitis, HIV, or malaria?
1 year
3 months
6 months
2 years
How long is the donor deferred if there is possible exposure to malaria?
3 years
6 months
1 year
5 years
Which anticoagulant has a 21-day expiration?
ACD/CPD/CPD2
CPDA-1
Additive solutions
Which additive solution has a 42-day expiration?
ACD/CPD/CPD2
CPDA-1
Additive solutions
What is the minimum hemoglobin (Hgb) level required for autologous donations?
11 g/dL
10 g/dL
12.5 g/dL
13.5 g/dL
What is the hematocrit (Hct) requirement for autologous donations?
25%
33%
40%
50%
If a donor's blood is drawn using a regular blood bag and the volume drawn is standard, what is the total fill volume?
450 mL
350 mL
500 mL
400 mL
How much blood is collected in a standard donation using a 70/110x450 mL bag?
100 mL
200 mL
286 mL
400 mL
If donor weight is given in kg, how do you calculate the volume to draw?
Divide donor weight by 100
Divide donor weight by 50, then multiply by 350
Multiply donor weight by 2
Subtract 10 from donor weight
What is the formula to calculate the amount of anticoagulant to use for a 286 mL blood draw?
286 x 14% = amount of anticoagulant
286 ÷ 14% = amount of anticoagulant
286 x 10% = amount of anticoagulant
286 + 14% = amount of anticoagulant
In apheresis collection, what is the maximum number of platelet, granulocyte, or leukocyte donations allowed in any 7-day period?
2
1
3
5
A 2-unit RBC donation must not decrease the donor's Hct below 30% or Hgb below 10g/dL.
True
False
What is the purpose of using hematopoietic progenitor and stem cells in medical practice?
To reconstitute bone marrow post chemotherapy/irradiation or to replace abnormal marrow cells with normal marrow cells.
To increase red blood cell count in healthy individuals.
To treat viral infections directly.
To enhance muscle growth in athletes.
Cells for hematopoietic stem cell transplantation can be obtained from which sources?
Bone marrow, umbilical cord blood, and peripheral blood.
Liver, spleen, and pancreas.
Skin, muscle, and fat tissue.
Lung, heart, and kidney.
Allogenic marrow-HLA identical match lowers the chance for GVHD, and ABO compatibility is not required.
True
False
Which tests are included in donor blood processing?
ABO, Rh, Antibody Screens, Syphilis, Viral disease.
Blood glucose, Liver function, Renal function, Malaria, Typhoid.
Hemoglobin, Platelet count, Blood urea, Creatinine, Dengue.
Electrolytes, Lipid profile, Thyroid function, Tuberculosis, HIV.
Whole blood is given in cases of severe shock when blood loss is greater than what percentage of blood volume?
25%
10%
40%
60%
What is the main difference between packed RBCs and whole blood?
Packed RBCs have plasma removed and provide the same O2 carrying capacity as whole blood with less volume.
Packed RBCs contain more platelets than whole blood.
Packed RBCs have a higher plasma content than whole blood.
Packed RBCs are used primarily to treat dehydration.
What does washing RBCs with saline prevent?
Prevents allergic response to plasma proteins and anaphylactic shock in IgA deficient patients with anti-IgA.
Prevents hemolysis due to bacterial contamination.
Prevents clotting of blood during storage.
Prevents iron overload in transfusion-dependent patients.
Leukocyte reduced RBCs are used primarily for which type of patients?
Patients with repeated febrile nonhemolytic reactions.
Patients with sickle cell anemia.
Patients with iron deficiency anemia.
Patients with acute blood loss.
Cells protected from ultra-low temps by cryoprotective agent, ____ glycerol.
40%
5%
10%
25%
What temperature must be achieved and glycerol removed prior to transfusion of cryopreserved RBCs?
37°C
4°C
25°C
0°C
What percentage of original RBCs must be recovered in cryopreserved RBCs?
80%
60%
90%
50%
Cryopreserved RBCs are used for storage or autologous units and rare units, and expire in ____ years.
10 years
2 years
5 years
20 years
FFP is prepared by separating cells & plasma by centrifugation & freezing plasma within ____ hours of collection.
8 hours
12 hours
24 hours
2 hours
FFP expires 1 year from date of collection when stored at < -18°C or ____ years when stored at < -65°C.
7 years
3 years
5 years
10 years
Once thawed (between 30-37°C), FFP expires in ____ hours if stored at 1-6°C.
24 hours
12 hours
48 hours
6 hours
FFP must be ABO compatible with recipient cells.
True
False
Cryoprecipitate must contain more than ____ mg of fibrinogen and more than ____ IU/bag of Factor VIII.
150 mg of fibrinogen, 80 IU/bag of Factor VIII
100 mg of fibrinogen, 60 IU/bag of Factor VIII
200 mg of fibrinogen, 50 IU/bag of Factor VIII
120 mg of fibrinogen, 100 IU/bag of Factor VIII
Cryoprecipitate is used for all of the following except:
Fibrinogen & Factor XIII deficiencies
Severe von Willebrand disease
Topical fibrin sealant
Hemophilia B
Platelets are prepared from whole blood stored at what temperature prior to processing?
20-24°C
2-6°C
37-40°C
0-4°C
Which of the following is NOT a condition for platelet transfusion?
Severe thrombocytopenia
Platelet dysfunction
Contraindicated in TTP & heparin-induced thrombocytopenia
Prophylactic use when platelet count is high
Platelets from donors who are within 48 hours of taking drugs that impair platelet function should not be used as a single source of donation.
True
False
Platelet refractoriness can be caused by antibodies to HLA class I antigens.
True
False
How much should 1 unit of platelets raise the platelet count in an average sized adult?
5,000-10,000
1,000-2,000
15,000-20,000
20,000-30,000
Only one ABO type/pool of platelets expires how many hours after pooling in an open system?
4 hours
8 hours
12 hours
24 hours
What is the minimum pH required at the end of storage for platelets?
>6.2
5.5
7.0
<6.5
Granulocytes are usually obtained by which method?
Apheresis
Centrifugation
Dialysis
Filtration
Granulocyte transfusions are mainly used for neutropenic patients with documented gram-negative sepsis who have not responded to antibiotic treatment.
True
False
Which of the following is a risk if blood is not irradiated before transfusion?
Can transmit CMV
Induce HLA immunization
Cause GVHD
All of the above
What is the recommended storage temperature for blood without agitation before transfusion?
1-6°C
20-24°C
10-15°C
0-4°C
Blood for transfusion should be _______ with the recipient.
ABO-compatible
Rh-incompatible
non-matching
unrelated
What is the minimum dose of irradiation (in Gy) required for blood components to prevent GVHD?
25 Gy
10 Gy
15 Gy
40 Gy
After irradiation, RBCs expire on the original outdate or how many days after irradiation, whichever comes first?
7 days
14 days
21 days
28 days
How much anticoagulant is present in each bag of blood?
63 mL
50 mL
100 mL
75 mL
At what temperature should RBCs be transported?
1-10°C
20-24°C
-20°C
37°C
If red cells are visible in pooled product, patient plasma antibodies should be compatible with those red cells.
True
False
ABO antigens are defined by _______ on the cell surface.
immunodominant sugar
membrane protein
lipid anchor
nucleic acid sequence
Which of the following is a principal subgroup of A?
A) A1 and A2
B) B1 and B2
C) O1 and O2
D) AB1 and AB2
A1 cells are agglutinated based on reactivity with which antibody?
Anti-B
Anti-A1
Anti-H
Anti-Le
Fill in the blank: Lack of H is genetically ___ (Bombay phenotype).
hh
HH
Hh
hH
Which gene allows expression of A, B, H, Leb in body fluids?
Se (secretor) gene
Le gene
H gene
A gene
In cell typing (forward typing), if Anti-A is + and Anti-B is 0, what is the interpretation?
Group O cells
Group AB cells
Group A cells
Group B cells
In cell typing (forward typing), if Anti-A is 0 and Anti-B is +, what is the interpretation?
Group O cells
Group AB cells
Group A cells
Group B cells
In serum typing (reverse typing), what does it mean if unknown serum + reagent red cells = No agglutination?
Serum lacks antibody to antigen on red cell.
Serum contains antibody to antigen on red cell.
Reagent red cells are hemolyzed.
Agglutination is always expected in this test.
Refer to the following table and answer: A1 Cell: 0, B Cell: +, Antibody in Serum: Anti-B. What is the Interpretation?
A
B
AB
O
Refer to the following table and answer: A1 Cell: +, B Cell: 0, Antibody in Serum: Anti-A. What is the Interpretation?
A
B
AB
O
Agglutination shown in the "A" well and the "B" well of a gel card would be interpreted as what blood type?
AB
O
A
B
There was no agglutination seen in the A & B wells, however there was agglutination seen in the both wells when the reverse side. What would the interpretation be?
O
A
B
C
Which antigens are part of the Rh system?
D, C, E, c, e
A, B, H, K, F
M, N, S, s, U
P, L, I, K, Fy
What is the most immunogenic of all blood group antigens?
D
A
B
K
Presence of D is the only antigen routinely tested in the Rh system.
True
False
What is the most common cause of a positive D control?
A positive DAT
Improper centrifugation
Expired reagents
Low temperature during testing
Fill in the blank: The Lewis blood group system is an example of ________ blood group system.
Other
ABO
Rh
MNS
Fill in the blank: The I and i antigens are part of the ________ blood group system.
Other
ABO
Rh
Kell
Fill in the blank: The P antigen is part of the ________ blood group system.
Other
ABO
Rh
Kell
MNSs is:
a blood group system
a type of enzyme
a genetic disorder
a hormone
KELL is:
a blood group antigen
a type of enzyme
a hormone
a vitamin
KIDD is:
a type of blood group system
a medical device
a genetic disorder
a pharmaceutical drug
DUFFY is:
a blood group antigen
a type of virus
a hormone
a vitamin
In direct exclusion for relationship testing, if a marker is present in the child but absent from both the father and mother, what does this indicate?
Direct exclusion (the alleged father is not the biological father).
The marker is inherited from a distant relative.
The test result is inconclusive and needs to be repeated.
The marker is a result of a laboratory error.
A infant suffering from HDFN from ABO causes would show what test results below?
Increase spherocytes, Negative DAT
Positive DAT, Increase Retics
Increase Retics, Negative DAT
Positive IAT, Increase Spherocytes
This test is used to quantitate fetal maternal bleeds, in order to calculate RhIg dosage.
Kleihauer-Betke
DAT
LAP
Alkaline-Elution
Which of the following statements is TRUE about indirect exclusion in relationship testing?
The child has a marker that the alleged father must transmit
The child lacks a marker that the alleged father must transmit
The child has all markers from the mother
The child has no markers from either parent
What is assumed in relationship testing for parentage using RBC blood groups?
Maternity is assumed.
Paternity is assumed.
Both parents are unrelated.
Blood type is irrelevant.
In antibody screening, what is the purpose of adding patient serum to screening cells?
To test for the presence of antibodies against specific blood group antigens.
To determine the patient's blood type.
To increase the sensitivity of the test.
To neutralize any antigens present in the serum.
What does a positive reaction in the IAT (Indirect Antiglobulin Test) indicate?
A positive reaction is indicated by agglutination or decrease in size of button due to hemolysis at 37°C.
A positive reaction is indicated by a clear solution with no visible changes.
A positive reaction is indicated by the formation of a precipitate at room temperature only.
A positive reaction is indicated by a color change from red to blue.
Which of the following enhancement media decreases negative surface charge and only increases antibody uptake under low ionic conditions?
LISS
Albumin (bovine)
Enzymes (bromelin, ficin, papain, trypsin)
PEG
Which enhancement media increases antibody uptake which allows decrease in incubation time?
Albumin (bovine)
LISS
Enzymes (bromelin, ficin, papain, trypsin)
PEG
Enzymes such as bromelin, ficin, papain, and trypsin remove sialic acid which decreases negative surface charge and promotes cell agglutination. They also decrease reactivity of which antibodies?
Rh, Kidd, and Lewis antibodies
ABO and HLA antibodies
IgM and IgA antibodies
Duffy, Kell, and MNS antibodies
PEG increases uptake, removes water which increases antibody concentration which promotes _________.
antibody uptake
antibody degradation
antibody loss
antibody precipitation
Rh antibodies may show at 37°C when using Albumin (bovine) as the enhancement media.
True
False
What is added to 3-4 times washed cells in the DAT procedure?
Antiglobulin
Normal saline
Albumin
Coombs control cells
Which sample is optimum for preventing complement activation by plasma antibody in DAT testing?
EDTA sample
Heparin sample
Citrate sample
Serum sample
What should be added to all negative antiglobulin tests in antibody detection and compatibility testing?
Check cells
Saline
Albumin
Distilled water
Polyspecific AHG reagent contains antibodies to both human IgG and C3d component of complement.
True
False
What is the principle behind elution in the context of DAT?
Breaking antigen-antibody bond, removing antibody from cell surface
Enhancing antigen-antibody binding on the cell surface
Stabilizing the antibody on the cell membrane
Promoting cell lysis by complement activation
