Advanced Test: Pre-transfusion Testing And Adverse Reactions

79 Questions

Settings
Please wait...
Advanced Test: Pre-transfusion Testing And Adverse Reactions

Welcome to the advanced test on Pre-transfusion Testing and adverse reactions. In order to perform thorough pre-transfusion testing, all components of testing must come together to give a complete and accurate set of results to render it ready for transfer to a patient. Do take this quiz and see how knowledgeable you are when it comes to the testing procedures.


Questions and Answers
  • 1. 
    What is/are tests involved in routine pre-transfusion testing?
    • A. 

      ABO/Rh

    • B. 

      Antibody Screen

    • C. 

      Crossmatch

    • D. 

      All of above

  • 2. 
    The _________ testing will determine what blood type the recipient is and what type the donor unit needs to be to be "compatible" with the recipient.
    • A. 

      ABO/Rh

    • B. 

      Antibody Screen

    • C. 

      Crossmatch

    • D. 

      All of the above

  • 3. 
    Which phase of pre-transfusion testing is the antibody screen?
    • A. 

      First phase

    • B. 

      Second phase

    • C. 

      Third phase

    • D. 

      None of the above

  • 4. 
    Which test of pre-transfusion testing is used to detect unexpected antibody (ies)?
    • A. 

      ABO/Rh

    • B. 

      Antibody Screen

    • C. 

      Crossmatch

    • D. 

      None of the above

  • 5. 
    The second phase is the crossmatch.
    • A. 

      True

    • B. 

      False

  • 6. 
    When preforming a crossmatch we use the ________ serum and the _________ red blood cells.
    • A. 

      Donor, recipient

    • B. 

      Frozen, packed

    • C. 

      Recipient, donor

    • D. 

      Packed, frozen

  • 7. 
    If the first two tests are grouped together it is called a(n) ___________.
    • A. 

      Type and Screen

    • B. 

      Crossmatch

    • C. 

      Type and Crossmatch

    • D. 

      Crossmatch Screening

    • E. 

      None of the above

  • 8. 
    If all three tests are performed at the same time it is called a(n)________.
    • A. 

      Type and Screen

    • B. 

      Crossmatch

    • C. 

      Type and Crossmatch

    • D. 

      Crossmatch Screening

    • E. 

      None of the above

  • 9. 
    There are also many pre-analytical as well as post-analytical factors essential in blood banking as well.
    • A. 

      True

    • B. 

      False

  • 10. 
    When identifying a patient what do we check? (CHECK ALL THAT APPLY)
    • A. 

      Comparing requisition to patient ID band

    • B. 

      Comparing sample label to patient ID band

    • C. 

      Asking patient for their name is enough

    • D. 

      If patient is sleeping just use ID band

    • E. 

      Compare requisition to sample label

  • 11. 
    • A. 

      First & last name

    • B. 

      Last name only

    • C. 

      Unique ID

    • D. 

      Date of collection

    • E. 

      Initials of phlebotomist

    • F. 

      Must be legible

    • G. 

      Put what we want as long at patient name matches

  • 12. 
    Tubes with the red top have what anticoagulant?
    • A. 

      Acid citrate dextrose (ACD), formula B

    • B. 

      EDTA

    • C. 

      Citrate

    • D. 

      Is blood bank sample

    • E. 

      No anticoagulant

  • 13. 
    Tubes with the yellow top have what anticoagulant?
    • A. 

      Acid citrate dextrose (ACD), formula B

    • B. 

      EDTA

    • C. 

      Citrate

    • D. 

      Is blood bank sample

    • E. 

      No anticoagulant

  • 14. 
    Tubes with Purple or pink top have what anticoagulant?
    • A. 

      Acid citrate dextrose (ACD), formula B

    • B. 

      EDTA

    • C. 

      Citrate

    • D. 

      No anticoagulant

  • 15. 
    The pink top tube is the blood bank sample.
    • A. 

      True

    • B. 

      False

  • 16. 
    With the date of the draw being 0, how many days are samples able to be used?
    • A. 

      1

    • B. 

      2

    • C. 

      3

    • D. 

      4

    • E. 

      None of the above

  • 17. 
    The antibody screen:
    • A. 

      Detects most clinically significant antibodies

    • B. 

      Detects all low-frequency antibodies

    • C. 

      Helps to distinguish between an alloantibody and autoantibody

    • D. 

      Can be omitted if the patient has no history of antibodies

  • 18. 
    HTLA antibodies:
    • A. 

      Typically react at room temperature

    • B. 

      Can be enhanced with PEG

    • C. 

      Are usually clinically insignificant

    • D. 

      Are associated with HDFN

  • 19. 
    Which of the following statements is associated with anti-I?
    • A. 

      It has weaker reactions with stored blood

    • B. 

      It can be neutralized with commercially prepared substance

    • C. 

      It reacts best at 37 degree C

    • D. 

      It does not react with cord blood cells

  • 20. 
    A multiple antibody problem was resolved using enzymes. One of the antibody reactions was eliminated after treatment. Which of the following antibodies was probably present?
    • A. 

      Anti-c

    • B. 

      Anti-I

    • C. 

      Anti-Jk a

    • D. 

      Anti-Fy a

  • 21. 
    An antibody demonstrating the dosage would mean that:
    • A. 

      Homozygous cells were stronger

    • B. 

      Heterozygous cells were stronger

    • C. 

      Cells reacted best with PEG

    • D. 

      Cells reacted best at 4 degrees C

  • 22. 
    A DAT performed on a clotted sample stored at 4 degrees C may demonstrate:
    • A. 

      In vivo complement attachment

    • B. 

      In vivo IgG attachment

    • C. 

      In vitro complement attachment

    • D. 

      In vitro IgM attachment

  • 23. 
    The prewarm technique may weaken IgG reactions because:
    • A. 

      Samples are not read at the immediate spin phase

    • B. 

      Warm saline washes may detach IgG antibodies

    • C. 

      The 37 degree C readings are omitted

    • D. 

      Polyspecific IgG is not recommended

  • 24. 
    The procedure that removes intact antibodies from the red cell membranes is:
    • A. 

      Autoadsorption

    • B. 

      Neutralization

    • C. 

      Enzyme pretreatment

    • D. 

      Elution

  • 25. 
    An antibody was detected in the screen at 37 degrees C and did not react at the AHG phase. Which of the following should be suspected?
    • A. 

      Anti-S

    • B. 

      Anti-E

    • C. 

      Anti-N

    • D. 

      Anti-Jk a

  • 26. 
    Antigen typing on red cells should not be performed if the patient has been transfused within the following:
    • A. 

      30 days

    • B. 

      2 months

    • C. 

      3 months

    • D. 

      6 months

  • 27. 
    DTT is useful in evaluating a sample when which antibody is suspected?
    • A. 

      Anti-Js b

    • B. 

      Anti-Kp b

    • C. 

      Anti-k

    • D. 

      All of the above

  • 28. 
    The purpose of additional procedures when working up a warm autoantibody is to:
    • A. 

      Identify the warm autoantibody specificity in the serum

    • B. 

      Locate RBC units that are compatible with autoantibody

    • C. 

      Identify potential underlying allantibodies

    • D. 

      Identify the antibodies coating the red cells

  • 29. 
    Detection of serologic incompatibility between donor RBC's and recipient serum is performed in the:
    • A. 

      Antibody screen

    • B. 

      Crossmatch

    • C. 

      DAT

    • D. 

      Autologous control

  • 30. 
    • A. 

      IgM alloantibodies in recipients serum

    • B. 

      ABO incompatibilities

    • C. 

      IgG alloantibodies in recipients serum

    • D. 

      Room temperature incompatibilities

  • 31. 
    Which of the following statements is true regarding compatibility testing for infants younger than 4 months of age?
    • A. 

      A DAT is required

    • B. 

      A crossmatch is needed when the antibody screen is negative

    • C. 

      Maternal serum can be used for the crossmatch

    • D. 

      Testing for ABO antibodies is required for the infant

  • 32. 
    What test(s) are included in compatibility testing?
    • A. 

      Blood typing of the recipient

    • B. 

      Antibody screening of recipient

    • C. 

      Crossmatch

    • D. 

      All of the above

  • 33. 
    One group B, D-positive unit of RBC's is received in the transfusion service. What repeat testing is required on this donor unit?
    • A. 

      ABO typing only

    • B. 

      ABO and D typing

    • C. 

      ABO, D, and weak D typing

    • D. 

      ABO and D typing; antibody screen

  • 34. 
    • A. 

      Group O, D-positive

    • B. 

      Group O, D-negative

    • C. 

      Group A, D-positive

    • D. 

      Group AB, D-negative

  • 35. 
    What antibodies are detected in the immediate spin crossmatch?
    • A. 

      Rh antibodies

    • B. 

      High-titer, low-avidity antibodies

    • C. 

      ABO antibodies

    • D. 

      Kell antibodies

  • 36. 
    Current pretransfusion testing on John Smith reveals a negative antibody screen with a previous history of anti-K. He is group A, D-positive.......... Which of the following crossmatch procedures is performed to identify compatible units?
    • A. 

      Immediate spin crossmatch

    • B. 

      Electronic crossmatch

    • C. 

      Antiglobulin crossmatch

    • D. 

      None of the above

  • 37. 
    • A. 

      Group A, D-positive, K+k+

    • B. 

      Group A, D-negative, K-k+

    • C. 

      Group O, D-positive, K+k-

    • D. 

      Group O, D-negative, K+k-

  • 38. 
    • A. 

      Name, unique identification number

    • B. 

      Name, unique identification number, date of collection

    • C. 

      Name, unique identification number, date of collection, physicians name

    • D. 

      None of the above

  • 39. 
    The computer crossmatch is easily implemented in the blood bank and does not require validation.
    • A. 

      True

    • B. 

      False

  • 40. 
    A crossmatch detects most errors in the identification of antigens on patients red cells.
    • A. 

      True

    • B. 

      False

  • 41. 
    A crossmatch demonstrating a 2+ agglutination is interpreted as compatible.
    • A. 

      True

    • B. 

      False

  • 42. 
    An immediate spin crossmatch of a D-positive recipient with a D-negative donor unit is incompatible.
    • A. 

      True

    • B. 

      False

  • 43. 
    The computer crossmatch requires two ABO and D phenotypes on the recipient.
    • A. 

      True

    • B. 

      False

  • 44. 
    A crossmatch prevents the immunization of the recipient to blood group antigens.
    • A. 

      True

    • B. 

      False

  • 45. 
    A type and screen protocol provides a mechanism to increase the number of uncrossing matched donor units in inventory.
    • A. 

      True

    • B. 

      False

  • 46. 
    The only component that requires crossmatching is a unit of RBC's.
    • A. 

      True

    • B. 

      False

  • 47. 
    Group O plasma is considered the universal donor of plasma products.
    • A. 

      True

    • B. 

      False

  • 48. 
    The recipient sample must be labeled with full name, unique identifying number, date, and some means of identifying the phlebotomist.
    • A. 

      True

    • B. 

      False

  • 49. 
    A patient experiences chills and fever, nausea, flushing, and lower back pain following the infusion of 350 mL of blood. To rule out a transfusion reaction because of acute hemolysis, one should immediately:
    • A. 

      Perform a DAT and observe serum on posttransfusion sample

    • B. 

      Measure serum haptoglobin on prereaction and postreaction samples

    • C. 

      Repeat crossmatches on prereaction and postreaction samples

    • D. 

      Gram stain and culture the unit

  • 50. 
    Dyspnea, severe headache, and peripheral edema occurring soon after transfusion is indicative of which type of transfusion reaction?
    • A. 

      Hemolytic

    • B. 

      Febrile

    • C. 

      Circulatory overload

    • D. 

      Anaphylactic

  • 51. 
    • A. 

      Recipient is allergic to the donor's plasma proteins

    • B. 

      Donor unit is cold

    • C. 

      Donor unit has a positive DAT

    • D. 

      Recipient has antibodies to the donors HLA antigens

  • 52. 
    • A. 

      Albumin

    • B. 

      Haptoglobin

    • C. 

      Transferrin

    • D. 

      C-reactive protein

  • 53. 
    Which of the following adverse complications of transfusion is prevented by the irradiation of blood components.
    • A. 

      Circulatory overload

    • B. 

      Hyperkalemia

    • C. 

      Iron overload

    • D. 

      TA-GVHD

  • 54. 
    Which of the following characteristics is associated with a delayed HTR?
    • A. 

      Hives and wheals

    • B. 

      Hemosiderosis

    • C. 

      Positive antibody screen in the postreaction sample

    • D. 

      ABO incompatibility between donor unit and recipient

  • 55. 
    • A. 

      High titer, low avidity

    • B. 

      ABO

    • C. 

      MNS

    • D. 

      Kidd

  • 56. 
    A patient has expierenced two febrile reactions following transfusion.  What is the preferred blood component if future transfusions are necessary?
    • A. 

      Leukocyte-reduced RBCs

    • B. 

      Irradiated RBCs

    • C. 

      Cytomegalovirus - negative RBCs

    • D. 

      Group O D-negative RBCs

  • 57. 
    Which of the following patient histories might suggest future transfusions with saline-washed RBCs?
    • A. 

      History of multiple red cell alloantibodies

    • B. 

      History of previous DIC

    • C. 

      History of multiple urticarial reactions

    • D. 

      History of transfusion-associated sepsis

  • 58. 
    • A. 

      Excess citrate

    • B. 

      Pl A1 antigen

    • C. 

      Iron overload

    • D. 

      Circulatory overload

  • 59. 
    • A. 

      ABO and Rh typing

    • B. 

      Antibody screen

    • C. 

      Crossmatch

    • D. 

      DAT

  • 60. 
    • A. 

      Staphylococcus aureus

    • B. 

      Yersinia enterocolitica

    • C. 

      Staphylococcus epidermidis

    • D. 

      Bacillus cereus

  • 61. 
    • A. 

      Increase of 0.5%

    • B. 

      Increase of 1%

    • C. 

      Increase of 2%

    • D. 

      Increase of 3%

  • 62. 
    Anaphylactic reactions to transfusion are usually caused by:
    • A. 

      Anti-IgA in IgA-deficient recipient

    • B. 

      Anti-IgG in IgA-deficient recipient

    • C. 

      IgA deficiency

    • D. 

      IgG deficiency

  • 63. 
    A precipitous fall in a recipients platelet count following a transfusion is associated with:
    • A. 

      Circulatory overload

    • B. 

      PTP

    • C. 

      Citrate toxicity

    • D. 

      Factor VIII deficiency

  • 64. 
    Any cold IgM antibody group can interfere with patient blood typing.
    • A. 

      True

    • B. 

      False

  • 65. 
    It is the job of the packed cell components to ______________ the RBC mass to ______________ oxygen carrying capacity.
    • A. 

      Decrease, decrease

    • B. 

      Increase, increase

    • C. 

      Decrease, increase

    • D. 

      Increase, decrease

  • 66. 
    Why do we transfuse platelets?
    • A. 

      Low pH count

    • B. 

      Can give as prophylaxis (preventative transfusion)

    • C. 

      PH malfunction

    • D. 

      All of the above

  • 67. 
    What coag factors are in FFP (fresh frozen plasma)?
    • A. 

      Factor V

    • B. 

      Factor VIII

    • C. 

      Factor X

    • D. 

      All Coagulation Factors

  • 68. 
    • A. 

      Platelets

    • B. 

      FFP (Fresh frozen plasma)

    • C. 

      Cryoprecipitate

    • D. 

      None of the above

  • 69. 
    • A. 

      Platelets

    • B. 

      FFP

    • C. 

      Cryoprecipitate

    • D. 

      None of the above

  • 70. 
    What disorder has a deficiency of factor VIII?
    • A. 

      Hemophilia A

    • B. 

      Hemophilia B

    • C. 

      Vitamin K Deficiency

    • D. 

      None of the above

  • 71. 
    Which factor is involved in Cryoprecipitate component? 
    • A. 

      Factor I

    • B. 

      Factor II

    • C. 

      Factor IX

    • D. 

      None of the above

  • 72. 
    Hemolytic Transfusion Reactions are known as HTR's and are broken down by:
    • A. 

      Immediate reactions

    • B. 

      Delayed reactions

    • C. 

      Both A & B

    • D. 

      None of the above

  • 73. 
    Immediate HTR's occur at the time of the transfusion of incompatible donor RBC's. Signs and symptoms occur:
    • A. 

      Immediately

    • B. 

      Within first few mins

    • C. 

      Within the first few hours

    • D. 

      None of the above

  • 74. 
    Which of the following are the four (4) most commonly identified antibodies associated with causing HTR?
    • A. 

      Anti-S

    • B. 

      Anti-s

    • C. 

      Anti-A

    • D. 

      Anti-Le a

    • E. 

      Anti-K

    • F. 

      Anti-Jk a

    • G. 

      Anti-D

    • H. 

      Anti-Fy a

    • I. 

      Anti-C

  • 75. 
    ________________ occurs due to the binding of complement, and the lysis releases free hemoglobin.
    • A. 

      Intravascular hemolysis

    • B. 

      Extravascular hemolysis

    • C. 

      In vitro hemolysis

    • D. 

      None of the above

  • 76. 
    ________________ occurs outside of the vessels by removal of the Ag:Ab complexes by the liver, spleen and other RES sites.
    • A. 

      Intravascular hemolysis

    • B. 

      Extravascular hemolysis

    • C. 

      In vivo hemolysis

    • D. 

      None of the above

  • 77. 
    __________________is the mechanism of lysis and is most often linked to antibodies such as anti-Jk a, anti-E, -D, -C, anti-K, anti-Fy a, and anti-M.
    • A. 

      Intravascular hemolysis

    • B. 

      Extravascular hemolysis

    • C. 

      In vivo hemolysis

    • D. 

      None of the above

  • 78. 
    The most common nonhemolytic reactions are the ____________ and allergic reactions.
    • A. 

      Anamnestic

    • B. 

      Sensitized

    • C. 

      Febrile

    • D. 

      None of the above

  • 79. 
    Febrile reactions are caused by ______________ antibodies.
    • A. 

      Kell

    • B. 

      Leukopoor

    • C. 

      Leukocyte

    • D. 

      None of the above