Blood Bank Final

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| By Julie Huynh
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Julie Huynh
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1. The secretor gene is 

Explanation

The correct answer is "Se" because the secretor gene, also known as FUT2 gene, is responsible for the production of certain carbohydrates on the surface of red blood cells and other body fluids. Individuals who have the "Se" allele are able to secrete these carbohydrates into their bodily fluids, while those who do not have this allele are unable to do so. The Bombay phenotype, on the other hand, is a rare blood type characterized by the absence of certain antigens on the surface of red blood cells, and is not directly related to the secretor gene.

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About This Quiz
Blood Bank Final - Quiz

The 'BLOOD BANK FINAL' quiz assesses knowledge on Autoimmune Hemolytic Anemia (AIHA), focusing on types, mechanisms, and clinical implications. It is crucial for learners in medical and laboratory sciences, enhancing their understanding of blood bank procedures and autoimmune responses.

2. Packed RBCs are transfused to treat deficiency in O2 carrying capacity

Explanation

Packed RBCs, or packed red blood cells, are transfused to treat deficiency in oxygen carrying capacity. This is because red blood cells contain hemoglobin, which binds to oxygen and carries it to the body's tissues. When a person has a deficiency in red blood cells or hemoglobin, their ability to transport oxygen is impaired. Transfusing packed RBCs can help restore the oxygen carrying capacity and improve oxygen delivery to the tissues. Therefore, the statement "Packed RBCs are transfused to treat deficiency in O2 carrying capacity" is true.

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3. Is [your statement here] true or false?

Explanation

The given statement is true.

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4. When does GVHD occur?

Explanation

GVHD (Graft-versus-host disease) occurs when the donor's immune cells recognize the recipient's tissues as foreign and attack them. This happens when the donor is homozygous for one of the recipient's HLA (human leukocyte antigen) haplotypes. HLA molecules are responsible for immune system regulation and matching between donor and recipient is important to prevent GVHD. Homozygosity increases the likelihood of a match and therefore increases the risk of GVHD.

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5. For disease testing, "RPR" is for testing 

Explanation

RPR stands for Rapid Plasma Reagin, which is a blood test used to detect antibodies produced by the body in response to the bacteria that causes syphilis. Therefore, RPR is specifically used for testing syphilis, not Hepatitis C, Hepatitis B, or Zika.

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6. Prewarm testing is done to...

Explanation

Prewarm testing is done to determine whether warm reacting antibodies are present in the serum that also contains complement binding cold antibody. This test helps in identifying the presence of antibodies that react at warmer temperatures and can cause adverse reactions in blood transfusions or organ transplants. By detecting these antibodies, healthcare professionals can take necessary precautions and select compatible blood or organs for transplantation to ensure the safety and success of the procedure.

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7. For those who are platelet donors, they must.. 

Explanation

Platelet donors must avoid taking aspirin 48 hours before donation with HCT levels of 36% because aspirin can affect platelet function and increase the risk of bleeding during the donation process. HCT levels below 36% may indicate anemia, which can also affect the ability to donate platelets. Therefore, it is important for platelet donors to abstain from aspirin and ensure their HCT levels are within the appropriate range to ensure a safe and successful donation.

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8.
  • Symptoms: mild jaundice, fever and decrease hct/hgb
  • Anamnestic response - previously sensitized 
  • Extravascular 
  • No complement activation 
  • DAT positive
  • Occurs 3 - 7 days after transfusion

Explanation

The given symptoms of mild jaundice, fever, and decrease in hct/hgb suggest a delayed hemolytic transfusion reaction. This type of reaction occurs when the recipient has been previously sensitized to the donor's red blood cell antigens, leading to destruction of the transfused red blood cells. It is an extravascular reaction, meaning it occurs outside of the bloodstream. There is no complement activation in this type of reaction, and the direct antiglobulin test (DAT) is positive. Delayed hemolytic transfusion reactions typically occur 3-7 days after transfusion.

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9. Leukocyte Reduction/filtration is done to 

Explanation

Leukocyte Reduction/filtration is done to prevent CMV infection and HLA alloimmunization. CMV (Cytomegalovirus) is a common viral infection that can be transmitted through blood transfusion, and it can cause severe complications in immunocompromised patients. HLA (Human Leukocyte Antigen) alloimmunization refers to the development of antibodies against foreign HLA antigens, which can lead to transfusion reactions and difficulty in finding compatible blood for future transfusions. Leukocyte reduction/filtration removes white blood cells from the blood product, reducing the risk of CMV transmission and the likelihood of HLA alloimmunization.

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10. Bombay phenotypes..

Explanation

The given answer states that Bombay phenotypes lack the H antigen, which is necessary for the presence of ABO antigens. As a result, they also lack ABO antigens. This means that Bombay phenotypes do not have the typical A, B, or AB blood types. However, since they lack the H antigen, they can be transfused with any other blood types, as they do not have any antibodies against the ABO antigens.

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11. Symptoms include: erythema, pruritis, hives IgEVery mild and non-life threateningTreat with benadryl

Explanation

The symptoms described in the question, such as erythema, pruritis, and hives, are characteristic of an allergic reaction. The mention of IgE suggests that this reaction is mediated by immunoglobulin E, which is commonly involved in allergic responses. Additionally, the fact that the symptoms are described as very mild and non-life threatening indicates that this is likely an allergic reaction rather than a more severe condition like febrile, TRALI, or TACO. The suggested treatment of benadryl further supports the idea that this is an allergic reaction.

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12. Occurs when a patient's cardiopulmonary system exceeds its volume capacity. 

Explanation

Transfusion associated circulatory overload (TACO) occurs when a patient's cardiopulmonary system exceeds its volume capacity due to a rapid or excessive transfusion of blood products. This can lead to fluid overload and pulmonary edema, causing symptoms such as shortness of breath, coughing, and chest pain. TACO is a serious complication of blood transfusion and requires prompt recognition and management to prevent further complications.

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13. —64 yr old M admitted for GI bleed. Hx of intestinal cancer. Samples sent for T/S and 2 RBCs STAT.What is the discrepancy? 
Anti AAnti BA1 cellsB cells 
4+1+ 04+

Explanation

The correct answer is B acquired phenotype. The term "acquired phenotype" refers to a change in the expression of certain characteristics or traits in cells due to external factors or influences. In this case, the discrepancy is likely related to the acquired phenotype of the cells observed in the samples sent for T/S and 2 RBCs STAT. This could be indicative of a change in the antigenic properties of the cells, possibly due to the patient's medical history of intestinal cancer or other factors.

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14. HDFN occurs when

Explanation

HDFN, or Hemolytic Disease of the Fetus and Newborn, occurs when maternal antibodies react with fetal antigens. This happens when the mother's immune system recognizes the antigens on the surface of the fetal red blood cells as foreign and produces antibodies against them. These antibodies can then cross the placenta and attack the fetal red blood cells, leading to hemolysis and potential complications for the fetus or newborn.

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15.
  • The transfusion of the donor's antibodies to the recipient white cells 
  • Complement is activated
  • Symptoms: chills, cough, fever, cyanosis, hypotension, increased respiratory distress
  • X-ray would show pulmonary edema
  • Give leuko reduced 

Explanation

Transfusion Related Acute Lung Injury (TRALI) is the correct answer because the symptoms mentioned, such as chills, cough, fever, cyanosis, hypotension, increased respiratory distress, and pulmonary edema on X-ray, are consistent with TRALI. TRALI occurs when transfused antibodies react with the recipient's white blood cells, leading to an inflammatory response in the lungs. This can result in fluid accumulation in the lungs, causing respiratory distress. Leuko reduction, which involves removing white blood cells from the transfusion product, is a preventive measure for TRALI.

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16. A fetal screen is done on 

Explanation

A fetal screen is done on every Rh negative women who delivers a Rh positive baby or a baby of an unknown Rh. This is because Rh negative women who carry Rh positive babies are at risk of developing Rh sensitization, where the mother's immune system may produce antibodies against the Rh factor in the baby's blood. This can lead to complications in future pregnancies if the mother becomes pregnant with another Rh positive baby. Therefore, it is important to screen these women to monitor their Rh status and provide appropriate medical interventions if necessary.

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17. Match the immunodominant sugars to their allele
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18. Adsol would give RBCs a ___ expiration

Explanation

Adsol is a solution used for the preservation of red blood cells (RBCs). It contains various components that help maintain the viability and function of RBCs. The expiration period refers to the time until which the solution can effectively preserve the RBCs without compromising their quality. Therefore, Adsol would give RBCs a 42-day expiration, meaning that the RBCs can be stored and used for transfusion purposes for up to 42 days when preserved in Adsol solution.

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19. When are crossmatches done on neonates?

Explanation

Crossmatches are done on neonates when the mother has a known Antibody. This is because the mother's antibodies can potentially cross the placenta and cause harm to the baby. By performing a crossmatch, healthcare providers can determine if there is compatibility between the mother's antibodies and the baby's blood, and take appropriate measures to prevent any adverse reactions.

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20. Shortens the life span of RBCs to 28 days 

Explanation

Irradiating red cells is the correct answer because it shortens the life span of RBCs to 28 days. This process involves exposing the red cells to radiation, which damages their DNA and prevents them from dividing and replicating. As a result, the irradiated red cells have a shorter lifespan compared to non-irradiated cells. This is important in certain medical procedures, such as blood transfusions, where it is necessary to use red cells with a limited lifespan to ensure the safety and effectiveness of the procedure.

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21. Deacetylating enzyme alters N-acetylgalactosamine(A-antigen) by removing the acetyl group, N-galactosamine resembles D-galactose (B-antigen) and cross reacts with B reagents

Explanation

In this scenario, the individual is classified as "Group A with acquired B Ag." This means that the person's blood type is A, but they have acquired the B antigen. The explanation for this is that the deacetylating enzyme has altered the N-acetylgalactosamine (A-antigen) by removing the acetyl group. As a result, N-galactosamine, which resembles D-galactose (B-antigen), is formed and cross-reacts with B reagents. This leads to the presence of the B antigen in the individual's blood, even though their blood type is A.

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22. A good Document Control Plan:

Explanation

The correct answer is "Ensures that only current versions of forms and procedures are in use". This is because a good Document Control Plan should ensure that outdated versions of forms and procedures are not being used. By ensuring that only current versions are in use, it helps to maintain accuracy and consistency in the documentation process. It also helps to prevent any potential errors or confusion that may arise from using outdated information.

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23. When whole blood is collected using CPDA-1, what is the expiration 

Explanation

CPDA-1 is an anticoagulant solution used to preserve whole blood for transfusion purposes. It contains citrate, phosphate, dextrose, and adenine. The expiration period of whole blood collected using CPDA-1 is 35 days. This is because CPDA-1 helps to prevent clotting and maintain the viability of red blood cells, but it does not provide long-term preservation like other solutions. After 35 days, the quality and safety of the blood may start to deteriorate, making it unsuitable for transfusion. Therefore, whole blood collected using CPDA-1 should be used within this timeframe to ensure its effectiveness.

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24. In preparing platelets from a unit of whole blood, the correct order of centrifugation is 

Explanation

The correct order of centrifugation for preparing platelets from a unit of whole blood is first performing a light spin followed by a hard spin. This order ensures that the platelets are separated from the other components of the blood in an efficient manner. The light spin helps to separate the red and white blood cells from the plasma, while the hard spin further concentrates the platelets at the bottom of the tube. This sequential centrifugation process allows for the isolation of a higher concentration of platelets for further use.

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25. Transfusion of donor IgA to a patient with IgA antibodies, can be characterized with NO FEVER & abdominal cramps. Symptoms also includes coughing, dyspnea, nausea, flushing, chest pain.  

Explanation

The symptoms described in the question, including coughing, dyspnea, nausea, flushing, and chest pain, are consistent with an anaphylactic reaction. Anaphylaxis is a severe allergic reaction that can occur when a person is exposed to an allergen, in this case, donor IgA. This reaction can cause a range of symptoms, including respiratory distress, gastrointestinal symptoms, and cardiovascular symptoms. The absence of fever and abdominal cramps suggests that the reaction is not due to bacterial contamination or TRALI (transfusion-related acute lung injury). TACO (transfusion-associated circulatory overload) is also unlikely as it typically presents with symptoms such as fluid overload and pulmonary edema, which are not mentioned in the question.

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26. A single vial of RhIG can suppress how mL of fetal hemorrhage?

Explanation

A single vial of RhIG can suppress 30 mL of fetal hemorrhage.

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27. After the "best" solution has been implemented in a Process Improvement undertaking, you should:

Explanation

After implementing the "best" solution in a Process Improvement undertaking, it is important to collect data to assess the impact. This allows for the evaluation of whether the implemented solution has achieved the desired results and improvements. Collecting data helps in measuring the effectiveness and efficiency of the solution, identifying any potential issues or areas for further improvement, and providing evidence-based feedback for future decision-making. It is a crucial step in the continuous improvement process to ensure that the implemented solution is truly effective and beneficial.

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28. Hydatid cyst fluid is a neutralizing substance for 

Explanation

Hydatid cyst fluid is a neutralizing substance for P1 antigen.

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29. FFP is prepared within how many hours of collection?

Explanation

FFP, or Fresh Frozen Plasma, is prepared within 8 hours of collection. This means that after the plasma is collected, it is processed and frozen within a time frame of 8 hours. This is important to maintain the quality and effectiveness of the plasma, as it needs to be frozen at a specific temperature to preserve its clotting factors and other important components. If the plasma is not frozen within this time frame, it may lose its efficacy and become unsuitable for transfusion purposes.

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30. RBCs that have been frozen are stored at which minimum temperature and maximum storage of time?

Explanation

RBCs (red blood cells) that have been frozen are stored at a minimum temperature of -65°C for a maximum storage time of 10 years. This temperature and duration ensures the preservation of the RBCs and maintains their viability for future use. Freezing RBCs helps to extend their shelf life and allows for their storage in blood banks or medical facilities for an extended period, ensuring a steady supply of blood for transfusions when needed.

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31.
  • Caused by antibodies in the host to the donors WCs
  • Give leuko reduced or washed, deglyced cells 
  • Can be pretreated with anti-pyretics
  • Increase in 1C without any causes

Explanation

Febrile reactions are caused by antibodies in the host to the donor's leuko reduced or washed, deglyced cells. These reactions can be pretreated with anti-pyretics. Febrile reactions are characterized by an increase in body temperature (1C) without any identifiable causes.

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32. Which antibodies are not a risk of HDFN

Explanation

Anti-Lea antibodies are not a risk of Hemolytic Disease of the Fetus and Newborn (HDFN). HDFN occurs when the mother's antibodies cross the placenta and attack the red blood cells of the fetus. However, anti-Lea antibodies do not typically cause severe hemolytic reactions and are not commonly associated with HDFN. Therefore, they do not pose a risk in this context.

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33. Rz

Explanation

The given answer "CDE" is the correct answer because it includes all the letters that are present in the given options. The letters "C", "D", and "E" are present in the options "CDE", "CDe", "ce", and "CE", while the letter "R" is not present in any of the options. Therefore, "CDE" is the only option that includes all the required letters.

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34. RhIG should be administered within how many hours of delivery?

Explanation

RhIG (Rh immune globulin) should be administered within 72 hours of delivery. This is because RhIG is given to Rh-negative mothers who have given birth to Rh-positive infants in order to prevent the mother's immune system from producing antibodies that could harm future pregnancies. Administering RhIG within 72 hours helps to ensure that the mother's immune system does not have enough time to develop an immune response and produce antibodies against Rh-positive blood.

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35. Calibration is an important part of cGMPs because it: 

Explanation

Calibration is an important part of cGMPs because it provides information regarding the accuracy of our measuring devices. It ensures that the measurements taken with these devices are reliable and trustworthy. By calibrating the devices, we can determine if they are functioning correctly and if any adjustments or corrections are needed. This helps to maintain the quality and integrity of the data collected and ensures that the products or processes being measured are within acceptable limits. Calibration also helps to identify any potential issues or errors in the measuring devices, allowing for timely maintenance or replacement to prevent any negative impact on the quality of the final product.

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36. The principle of the Kleihauer Betke test is that 

Explanation

The principle of the Kleihauer Betke test is based on the fact that fetal hemoglobin (hgb) resists acid elution. Acid elution is a technique used to differentiate between fetal and adult red blood cells. In this test, a maternal blood sample is treated with acid to remove adult red blood cells, leaving behind fetal red blood cells. These fetal red blood cells are then stained and counted to determine the amount of fetal blood that has mixed with maternal blood, which is important in cases of fetomaternal hemorrhage.

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37. Intact red cell is removed from circulation by RE system; coated with IgG

Explanation

The correct answer is "Extravascular." This means that intact red cells, which are coated with IgG, are removed from circulation by the reticuloendothelial (RE) system outside of the blood vessels. This process occurs outside of the bloodstream, suggesting that the removal of these cells happens in tissues or organs rather than within the blood vessels themselves.

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38. Which cells have the least amount of H antigens?

Explanation

A1B blood type has the least amount of H antigens. The presence of H antigens determines the blood type, and A1B has a weaker expression of these antigens compared to the other options. This means that A1B blood type has a lower concentration of H antigens on the surface of its red blood cells.

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39. Eight units of platelets were pooled without a sterile connecting device. The new expiration is 

Explanation

When platelets are pooled without a sterile connecting device, there is an increased risk of bacterial contamination. Bacteria can multiply rapidly in the pooled platelets, leading to a higher chance of infection when transfused to a patient. To minimize this risk, the pooled platelets should be used within a shorter timeframe. In this case, the new expiration is set at 4 hours, which allows for a safer transfusion and reduces the risk of bacterial contamination.

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40. Which one of these are naturally occuring Abs?

Explanation

Anti-M is a naturally occurring antibody. The term "naturally occurring" refers to antibodies that are present in an individual's blood without any prior exposure to foreign antigens. Anti-M is commonly found in the serum of individuals who lack the M antigen on their red blood cells. This antibody can cause hemolytic transfusion reactions or hemolytic disease of the newborn if a person with M-positive blood receives blood from an M-negative donor or if an M-negative mother carries an M-positive fetus.

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41. Rouleaux can.. 

Explanation

Rouleaux refers to the stacking of red blood cells in a column-like formation, resembling stacked coins when viewed under a microscope. This phenomenon can be related to an increase in serum protein levels, as high levels of certain proteins can cause the red blood cells to stick together. In some cases, rouleaux formation can be resolved by replacing the saline solution surrounding the cells with a different solution.

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42. Complications that can occur with transfusing sickle cell patients include 

Explanation

Transfusing sickle cell patients can lead to complications such as iron overload. This is because these patients require regular blood transfusions, which can cause an accumulation of iron in the body over time. Iron overload can lead to organ damage and other health problems. Sensitization of RBCs refers to the development of antibodies against red blood cells, which can cause transfusion reactions. Rejection of the RBCs is not a common complication in sickle cell patients.

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43. What blood group antibody is associated with paroxysmal cold hemoglobinuria?

Explanation

Paroxysmal cold hemoglobinuria (PCH) is a rare autoimmune hemolytic anemia that is associated with the presence of anti-P antibodies. These antibodies bind to the P antigen on red blood cells, causing them to be destroyed. The P antigen is a complex carbohydrate found on the surface of red blood cells, and the presence of anti-P antibodies can lead to complement-mediated destruction of red blood cells, especially in cold temperatures. Therefore, the correct answer is Anti-P.

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44. How does the indicator cells work in Fetal screens?

Explanation

The indicator cells in Fetal screens are positive D cells that bind to the antibodies (abs) that are already coating the positive fetal cells. This binding allows for the detection and identification of the antibodies present in the maternal blood that may be harmful to the fetus. By observing the interaction between the indicator cells and the antibodies, healthcare professionals can determine the risk of hemolytic disease of the newborn and take appropriate measures to ensure the health of the fetus.

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45. Washed red cells would most likely be given to patients who 

Explanation

Washed red cells would most likely be given to patients who are IgA deficient and have made anti-IgA. This is because washing the red cells removes any remaining plasma, including IgA antibodies. IgA deficiency is a condition where the body does not produce enough IgA antibodies, and in some cases, the patient may develop antibodies against IgA. Giving washed red cells helps prevent a transfusion reaction in these patients by removing any IgA antibodies that may be present in the transfused blood.

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46.
  • Screening tests for unexpected antibodies are negative
  • High titer IgG - anti penicillin antibody is always present in the serum
  • DAT is strong due to IgG coating

Explanation

The correct answer is drug adsorption. Drug adsorption refers to the binding of drugs to proteins in the blood, which can result in the formation of immune complexes. In this case, the high titer IgG anti-penicillin antibody is present in the serum due to the drug adsorption phenomenon. The screening tests for unexpected antibodies are negative because the antibodies are bound to the drug and not freely circulating in the blood. This can also explain the strong direct antiglobulin test (DAT) due to the IgG coating on the drug-protein complexes.

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47. Objectives for performing an exchange transfusion include all of the following except to: 

Explanation

The objective of performing an exchange transfusion is to decrease the level of maternal antibody, reduce the level of indirect bilirubin, and provide compatible RBCs to correct anemia. However, it does not involve providing platelets to prevent disseminated intravascular coagulation.

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48.
  • Most common @ 4C
  • Low titer @ 4C
    • <64 
    • Negative DAT 
    • Can interfere with ABO typing, Rh and DAT

Explanation

The correct answer is "Benign Cold Auto" because it is the most common type of cold autoantibody. It is characterized by a low titer at 4C (

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49. Although ABO compatibility is preferred, ABO incompatibility is acceptable for which of the following components?

Explanation

ABO compatibility is preferred for all blood components, but ABO incompatibility can be acceptable for Cryoprecipitated AHF. Cryoprecipitated AHF is a blood product that contains high levels of clotting factors, including fibrinogen, von Willebrand factor, and factor VIII. It is primarily used in the treatment of bleeding disorders, such as hemophilia. ABO incompatibility in this case refers to the fact that the donor's blood type may not match the recipient's blood type. However, because Cryoprecipitated AHF is a concentrated product, the small amount of ABO antibodies present in the donor's plasma is unlikely to cause a significant reaction in the recipient.

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50. An often fatal condition characterized by general edema that results from anemia is 

Explanation

Hydrops fetalis is a condition characterized by excessive fluid accumulation in the fetus, leading to generalized edema. This condition can be caused by severe anemia, which results in a lack of oxygen-carrying capacity in the blood. Without enough red blood cells to transport oxygen, the body compensates by retaining fluid, leading to edema. Kernicterus is a neurological condition caused by severe jaundice, DIC is a disorder characterized by abnormal blood clotting, and erythroblastosis fetalis is a condition where the mother's antibodies attack the fetus's red blood cells. These conditions do not directly cause general edema as seen in hydrops fetalis.

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51. All of these components are stored at 20 - 24 C! Match them to their expirations
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52. Match the antibody specificities to the type of AIHA
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53. Which type of hemolysis is destroyed in the bloodstream releasing hemoglobin into plasma?_____

Explanation

Intravascular hemolysis refers to the destruction of red blood cells within the bloodstream, leading to the release of hemoglobin into the plasma. This can occur due to various factors such as autoimmune disorders, infections, or certain medications. The released hemoglobin can then be filtered by the kidneys, resulting in the presence of hemoglobin in the urine. Intravascular hemolysis can lead to anemia and other complications if not properly managed.

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54. FFP can be stored and kept for how long at its maximum?

Explanation

FFP (Fresh Frozen Plasma) can be stored and kept at a temperature of -65 degrees Celsius for a maximum of 7 years. This means that if FFP is stored at this temperature, it can be used for transfusion purposes for up to 7 years. It is important to store FFP at the correct temperature to maintain its effectiveness and safety for patients in need of plasma transfusion.

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55. What is associated with Mycoplasma pneumoniae

Explanation

Mycoplasma pneumoniae is associated with Pathologic cold auto. Mycoplasma pneumoniae is a bacteria that causes respiratory infections, including pneumonia. Pathologic cold auto refers to the presence of cold agglutinins in the blood, which are antibodies that can cause the red blood cells to clump together at low temperatures. This can lead to complications such as anemia and circulation problems.

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56. Platelet transfusions are indicated for 

Explanation

Platelet transfusions are indicated when platelet counts are below 20,000 and when bleeding is due to thrombocytopenia. Platelets are responsible for blood clotting, and when the platelet count is very low, it can lead to excessive bleeding and difficulty in clotting. Transfusing platelets can help increase the platelet count and improve clotting ability, reducing the risk of bleeding. Febrile reactions, on the other hand, are not directly related to platelet transfusions and do not indicate the need for transfusion.

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57. Which antibodies are not effected by proteolytic enzymes?

Explanation

Kell antibodies are not affected by proteolytic enzymes. This means that the activity and effectiveness of Kell antibodies remain unchanged even in the presence of proteolytic enzymes. On the other hand, Duffys, Lewis, and Kidd antibodies can be affected and their activity may be altered or reduced when exposed to proteolytic enzymes.

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58. What is the normal range of Hgb levels for newborns?

Explanation

The normal range of Hgb (hemoglobin) levels for newborns is 14 - 20 g/dl. Hemoglobin is a protein in red blood cells that carries oxygen throughout the body. This range is considered normal for newborns and helps ensure that they have enough oxygen in their blood. Levels below or above this range may indicate anemia or other health conditions.

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59. Symptoms: dyspnea, coughing, cyanosis, headache, restlessnessSystolic hypertension (>50)

Explanation

TACO stands for Transfusion-Associated Circulatory Overload. This condition occurs when a person receives a blood transfusion too quickly or receives too much blood, causing fluid to accumulate in the lungs and leading to symptoms such as dyspnea, coughing, cyanosis, headache, and restlessness. Systolic hypertension, which is mentioned in the symptoms, can also be a sign of TACO. Therefore, TACO is the most likely explanation for the given symptoms and systolic hypertension.

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60. —57 yr old F was admitted for transfusion of 2 units to treat chronic anemia. Pt is multiply transfused (another facility). Samples were drawn and sent for T/S, 2 units of RBCs to be transfused tomorrow.What is most likely the cause of this discrepancy if the auto control is also positive?
Anti AAnti BA1 CellB cells
4+4+1+1+ 

Explanation

The most likely cause of this discrepancy is Cold Auto. This is suggested by the positive auto control and the fact that the patient is multiply transfused, indicating a history of cold autoantibodies. Cold autoantibodies can cause agglutination of red blood cells at lower temperatures, leading to a positive result in the auto control.

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61. The greatest danger to the fetus (before delivery) affected by HDFN is 

Explanation

The greatest danger to the fetus affected by HDFN (Hemolytic Disease of the Fetus and Newborn) before delivery is anemia. HDFN occurs when the mother's antibodies attack the red blood cells of the fetus, leading to their destruction. This can result in a decrease in the number of red blood cells, causing anemia in the fetus. Anemia can lead to inadequate oxygen supply to the tissues and organs, potentially causing serious complications and even death in severe cases. Therefore, anemia is the greatest danger to the fetus affected by HDFN before delivery.

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62. When the B gene transfers trace amounts of N-acetylgalactosamine and D-galactose to the H-Ag acceptor molecules 
  • The trace amounts react with Anti-A

Explanation

When the B gene transfers trace amounts of N-acetylgalactosamine and D-galactose to the H-Ag acceptor molecules, the trace amounts react with Anti-A. This reaction leads to the formation of the B(A) phenotype, where individuals with blood group A acquire the B antigen. This phenomenon is observed in subgroup A individuals who have the B gene and can produce both A and B antigens on their red blood cells. In cases where individuals with blood group B are transfused with Group O red blood cells, the trace amounts of B antigen can react with the Anti-A antibodies present in the recipient's plasma, causing a transfusion reaction.

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63. A cord blood workup consists of 

Explanation

A cord blood workup typically includes testing for Weak D, ABO/Rh - Forward, and DAT. Weak D refers to a variant of the D antigen in the Rh blood group system. ABO/Rh - Forward testing determines the ABO blood type and Rh factor of the cord blood. DAT stands for Direct Antiglobulin Test, which is used to detect antibodies that may be coating the red blood cells in the cord blood. These tests are commonly performed to assess the compatibility and overall health of the cord blood for potential transfusions or other medical purposes.

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64. What's the hct/hgb ratio that is required of eligible donors?

Explanation

The hct/hgb ratio that is required of eligible donors is 36%/12.5 g. This means that the hematocrit (hct) level should be 36% and the hemoglobin (hgb) level should be 12.5 g. This ratio is used to determine if a person's blood is suitable for donation.

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65. Which of the following is not a characteristic of ABO HDFN

Explanation

ABO HDFN (hemolytic disease of the fetus and newborn) is a condition where the mother's antibodies attack the red blood cells of the fetus or newborn. A strongly positive DAT (direct antiglobulin test) indicates the presence of antibodies on the surface of the baby's red blood cells. However, this is not a characteristic of ABO HDFN. In ABO HDFN, the mother's antibodies are usually of the IgM type, which does not cross the placenta and therefore does not cause a positive DAT. Instead, ABO HDFN is typically milder and may not require treatment or phototherapy. Additionally, ABO HDFN is most frequent in babies born to group A or B mothers, not group O mothers.

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66. Which types of AIHA's show AHG reactivity

Explanation

The types of AIHA's that show AHG reactivity are WARM and MIXED. WARM AIHA is characterized by the presence of warm-reacting autoantibodies that bind to red blood cells at body temperature. MIXED AIHA, on the other hand, is a combination of warm and cold-reacting autoantibodies. It is important to note that COLD AIHA and PCH (Paroxysmal Cold Hemoglobinuria) do not show AHG reactivity.

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67. R1

Explanation

The correct answer is "CDe" because it follows a pattern of alternating capital and lowercase letters, starting with a capital "C". Each letter in the answer corresponds to the same position in each line of the given options.

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68.
  • Reactivity up to 32 C
  • Idiopathic
  • Spontaneous agglutination that disperses at 37
  • C3 only 
  • Only a problem with heart surgery - when temp is decreased 

Explanation

The given answer "Pathologic" is the correct answer because it is the opposite of "Benign" which means that the condition described is not harmless or normal, but rather indicative of a disease or abnormality. The information provided in the question suggests that there is a problem with spontaneous agglutination that disperses at 37C, which is not a normal physiological response. Therefore, it can be concluded that the condition described is pathologic.

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69. Cryo contains

Explanation

Cryo, short for cryoprecipitate, is a blood component that contains several important proteins. These proteins include Factor VIII (FVIII), Von Willebrand Factor (VWF), Factor XIII (FXIII), and Fibrinogen. FVIII is essential for blood clotting, while VWF helps with platelet adhesion and clot formation. FXIII is involved in stabilizing the clot, and fibrinogen is a precursor to fibrin, the main component of a blood clot. Therefore, cryo is a valuable resource for patients with deficiencies in these proteins or those experiencing bleeding disorders.

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70. A patient is found to have anti-Kell. Four units of RBC's are requested for surgery tomorrow. How many units should you screen in order to fill this order?

Explanation

To fill the order for four units of RBCs, you should screen five units. This is because the patient has anti-Kell antibodies, which means they have antibodies against the Kell antigen on red blood cells. Screening involves testing the compatibility of the donor blood with the patient's antibodies. By screening five units, you ensure that at least four units are compatible and can be safely transfused to the patient during surgery.

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71. Storage lesion leads to _____ in pH_____ in lactic acid_____ of glucose concentration _____ in hemoglobin oxygen affinity _____ of ATP levels_____ of 2,3 DPG levels 

Explanation

Storage lesion refers to the changes that occur in blood components during storage. These changes can lead to a decrease in pH, an increase in lactic acid levels, a decrease in glucose concentration, an increase in hemoglobin oxygen affinity, and a decrease in ATP levels and 2,3 DPG levels. These changes can affect the quality and function of stored blood components, making them less effective when transfused into patients.

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72. Select the antibodies that are enhanced by proteolytic enzymes

Explanation

Proteolytic enzymes are known to enhance the reactivity of certain antibodies. Rh, Kidds, Lewis, and P are all blood group systems that have been shown to exhibit enhanced reactivity in the presence of proteolytic enzymes. MNS and Duffy, on the other hand, do not show this enhanced reactivity. Therefore, the correct answer is Rh, Kidds, Lewis, and P.

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73.
  • Causes a positive DAT 3 - 6 months after tx 
  • Red cells are coated with IgG
  • DAT diminishes after therapy is discontinued but can take 1 month to 2 years to clear
  • immune hemolysis antibodies are formed that reacts with intrinsic red cells antigens

Explanation

The correct answer is "Induction of autoimmunity." This is because the statement mentions that the DAT (Direct Antiglobulin Test) becomes positive 3-6 months after therapy, indicating the presence of antibodies that react with intrinsic red cell antigens. This suggests that the therapy has induced an autoimmune response, where the body's immune system mistakenly targets its own red blood cells.

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74. Match the following
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75. Which major types of AIHA has a non reactive eluate?

Explanation

The major types of AIHA that have a non-reactive eluate are COLD and PCH. In COLD (cold agglutinin disease), the antibodies are activated by cold temperatures, causing red blood cells to clump together. However, the eluate, which is the fluid obtained from washed red blood cells, does not react with the antibodies. In PCH (paroxysmal cold hemoglobinuria), the antibodies are also activated by cold temperatures, leading to the destruction of red blood cells. Again, the eluate does not show reactivity with the antibodies.

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76. Select the benefits of an exchange transfusion

Explanation

An exchange transfusion is a medical procedure that involves removing a patient's blood and replacing it with donor blood. This procedure can be beneficial in several ways. Firstly, it can help remove elevated levels of bilirubin, which is a waste product of red blood cell breakdown and can be toxic in high amounts. Secondly, it can eliminate maternal circulating antibodies, which can cause complications in the fetus. Thirdly, it can remove sensitized antibodies, which can lead to immune reactions. Lastly, it can replace incompatible red blood cells with compatible ones, preventing further complications.

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77. Select those that are associated with GVHD

Explanation

The correct answer options are all associated with graft-versus-host disease (GVHD). GVHD is a condition that can occur after a bone marrow or stem cell transplant, where the donor's immune cells attack the recipient's tissues. Bone marrow failure or aplasia can occur as a result of GVHD. Increased bilirubin and liver enzymes are indicative of liver damage, which can occur in GVHD. Skin rash is a common symptom of GVHD, often presenting as a red, itchy rash. High fever is another common symptom, as the immune system is activated and fighting against the recipient's tissues. Gastrointestinal disturbances, such as diarrhea and abdominal pain, are also associated with GVHD.

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78. Match the following
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79. PCH can be associated with...

Explanation

PCH, or Paroxysmal Cold Hemoglobinuria, is a rare autoimmune disorder that is commonly associated with children. It is often triggered by viral infections, leading to the destruction of red blood cells and subsequent hemolysis. Rapid intravascular hemolysis, where red blood cells are destroyed within blood vessels, is also a characteristic feature of PCH. Age and gender may play a role in the susceptibility to PCH, but they are not exclusive factors associated with the condition.

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80. After transfusion of a unit of RBCs or WB there should be a _____  % increase in hematocrit or _____  g increase in hemoglobin

Explanation

After transfusion of a unit of RBCs or WB, there should be a 3% increase in hematocrit or 1g increase in hemoglobin. This means that the transfusion should result in a small but measurable increase in the concentration of red blood cells or hemoglobin in the recipient's blood. This increase is important for improving oxygen-carrying capacity and overall blood volume.

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81. PCH reacts at less than _____ C

Explanation

The given statement suggests that PCH (possibly referring to a chemical compound or a physical process) undergoes a reaction at a temperature lower than 20 degrees Celsius.

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82. When the drug alters the red cell membrane cause the membrane to absorb proteins including IgG and complement components. 
  • Causes a + DAT

Explanation

The correct answer is "Nonimmune adsorption of proteins." This is because when the drug alters the red cell membrane, it causes the membrane to absorb proteins, including IgG and complement components. This process is referred to as nonimmune adsorption of proteins.

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83. What can aid in the detection of warm autoantibodies

Explanation

DAT (Direct Antiglobulin Test) is a laboratory test that aids in the detection of warm autoantibodies. Warm autoantibodies are antibodies that react with red blood cells at body temperature. Panels are also used for detecting warm autoantibodies, as they contain a variety of red blood cell samples to test for antibody reactions. Eluates are obtained by washing red blood cells and collecting the antibodies that are bound to them, which can be useful for identifying the specific warm autoantibodies. Adsorptions involve removing unwanted antibodies from the patient's serum, allowing for more accurate detection of warm autoantibodies.

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84. What are common to cause bacterial contamination in TRs?

Explanation

The common causes of bacterial contamination in TRs include Serratia species, Campylobacterm pseudomona, and Yersinia enterocolitica. These bacteria can contaminate TRs and cause infections or illnesses in individuals who come into contact with them. It is important to prevent and control bacterial contamination in TRs to ensure the safety and well-being of the people using them.

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85. List the three antigens that are not present on cord cells 

Explanation

The three antigens that are not present on cord cells are I, Lewis Ags, and P1.

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86. Match the following
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87. DAT positive + Eluate negative can be due to 

Explanation

The presence of DAT positive (Direct Antiglobulin Test) indicates the presence of antibodies or complement proteins on the surface of red blood cells. However, a negative eluate suggests that these antibodies or complement proteins are not specifically bound to any particular antigen. Therefore, the possible explanations for this combination could include complement coating cells, nonspecific binding of proteins, cold antibodies, and antibodies to drugs.

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88. Match the following
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89. Match the following
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The secretor gene is 
Packed RBCs are transfused to treat deficiency in O2 carrying capacity
Is [your statement here] true or false?
When does GVHD occur?
For disease testing, "RPR" is for testing 
Prewarm testing is done to...
For those who are platelet donors, they must.. 
Symptoms: mild jaundice, fever and decrease hct/hgbAnamnestic response...
Leukocyte Reduction/filtration is done to 
Bombay phenotypes..
Symptoms include: erythema, pruritis, hives IgEVery mild and...
Occurs when a patient's cardiopulmonary system exceeds its volume...
—64 yr old M admitted for GI bleed. Hx of intestinal cancer. Samples...
HDFN occurs when
The transfusion of the donor's antibodies to the recipient white...
A fetal screen is done on 
Match the immunodominant sugars to their allele
Adsol would give RBCs a ___ expiration
When are crossmatches done on neonates?
Shortens the life span of RBCs to 28 days 
Deacetylating enzyme alters N-acetylgalactosamine(A-antigen) by...
A good Document Control Plan:
When whole blood is collected using CPDA-1, what is the...
In preparing platelets from a unit of whole blood, the correct order...
Transfusion of donor IgA to a patient with IgA antibodies, can be...
A single vial of RhIG can suppress how mL of fetal hemorrhage?
After the "best" solution has been implemented in a Process...
Hydatid cyst fluid is a neutralizing substance for 
FFP is prepared within how many hours of collection?
RBCs that have been frozen are stored at which minimum temperature and...
Caused by antibodies in the host to the donors WCsGive leuko reduced...
Which antibodies are not a risk of HDFN
Rz
RhIG should be administered within how many hours of delivery?
Calibration is an important part of cGMPs because it: 
The principle of the Kleihauer Betke test is that 
Intact red cell is removed from circulation by RE system; coated with...
Which cells have the least amount of H antigens?
Eight units of platelets were pooled without a sterile connecting...
Which one of these are naturally occuring Abs?
Rouleaux can.. 
Complications that can occur with transfusing sickle cell patients...
What blood group antibody is associated with paroxysmal cold...
How does the indicator cells work in Fetal screens?
Washed red cells would most likely be given to patients who 
Screening tests for unexpected antibodies are negativeHigh titer IgG -...
Objectives for performing an exchange transfusion include all of the...
Most common @ 4CLow titer @ 4C<64 Negative DAT Can...
Although ABO compatibility is preferred, ABO incompatibility is...
An often fatal condition characterized by general edema that results...
All of these components are stored at 20 - 24 C! Match them to their...
Match the antibody specificities to the type of AIHA
Which type of hemolysis is destroyed in the bloodstream releasing...
FFP can be stored and kept for how long at its maximum?
What is associated with Mycoplasma pneumoniae
Platelet transfusions are indicated for 
Which antibodies are not effected by proteolytic enzymes?
What is the normal range of Hgb levels for newborns?
Symptoms: dyspnea, coughing, cyanosis, headache, restlessnessSystolic...
—57 yr old F was admitted for transfusion of 2 units to treat chronic...
The greatest danger to the fetus (before delivery) affected by HDFN...
When the B gene transfers trace amounts of N-acetylgalactosamine and...
A cord blood workup consists of 
What's the hct/hgb ratio that is required of eligible donors?
Which of the following is not a characteristic of ABO HDFN
Which types of AIHA's show AHG reactivity
R1
Reactivity up to 32 CIdiopathicSpontaneous agglutination that...
Cryo contains
A patient is found to have anti-Kell. Four units of RBC's are...
Storage lesion leads to _____ in pH_____ in lactic acid_____ of...
Select the antibodies that are enhanced by proteolytic enzymes
Causes a positive DAT 3 - 6 months after tx Red cells are coated...
Match the following
Which major types of AIHA has a non reactive eluate?
Select the benefits of an exchange transfusion
Select those that are associated with GVHD
Match the following
PCH can be associated with...
After transfusion of a unit of RBCs or WB there should be a...
PCH reacts at less than _____ C
When the drug alters the red cell membrane cause the membrane to...
What can aid in the detection of warm autoantibodies
What are common to cause bacterial contamination in TRs?
List the three antigens that are not present on cord cells 
Match the following
DAT positive + Eluate negative can be due to 
Match the following
Match the following
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