Set 19207649

Blood Bank Review Questions
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1.
A 2+ reading in gel would

resemble: (a) Pellet at top of gel
(b) agglutination spread evenly
throughout gel (c) Pellet at the
bottom with agglutination
spreading upwards slightly (d)
Pellet at the bottom of the gel
C - most cells passed

through gel, but some got
trapped . A would be a 4+
and D would be a 0.
9.
A 65 year old man whose birthday is

tomorrow wishes to donate blood for
allogenic transfusion: (a) defer
temporarily (b) defer for 1 year (c) defer
indefinitely (d) accept
D - no age
restriction on the
elderly as long as
written
permission from
MD or blood
bank attending
2.
A 12% suspension in saline is

used in the tube procedure.
Which is most likely to occur?
(a) false positive due to antigen
excess (b) false negative due to
prozone effect (c) false negative
due to antigen excess
10.
A 70 kg male with a plt count of 15,000

was given 6 units of pooled platelets,
what would you expect the posttransfusion platelet count to be? (a) 2127,000/uL (b) 25-35,000/uL (c) 4575,000/uL (d) 75-125,000/uL
3.
A 18 year old with poison ivy in

his hands and face wishes to
donate blood for allogenic
transfusion: (a) defer
temporarily (b) defer for 1 year
(c) defer indefinitely (d) accept
D - unless rash covers

venipuncture site which
could cause contamination
C - without
complications, a
unit will increase
platelet count
from 510,000/uL.
15+30,000/60,000
= 45-75,000/uL
11.
AABB standards require two unique

identifiers and what else on a blood
tube before delivery? (a) patient room #
(b) date of phlebotomy (c) phlebotomy
initials (d) attending MDs name
B - Initials are
needed on req
or tube, not
both, but date is
needed on tube.
A 25 year old man who had

jaundice right after birth
wishes to donate blood for
allogenic transfusion: (a) defer
D - HDN is not a cause for

deferral
12.
The ab normally found in the serum of

group B individuals is: (a) anti-B (b) antiA (c) anti-H (d) anti-A,B
13.
A - DCE/dCE
does not express
c or e
A 26 year old B neg female

requires a transfusion and no B
neg units are available. What
should be given ? (a) A new WB
(b) O neg RBCs (c) AB neg WB (d)
A neg RBCs
A african american patient has

phenotype: D+C+E+c+e+. Which
genotype is not possible? (a) Rz/ry (b)
R0/ry (c) Rz/r (d) R1/r"
14.
After addition of onoclonal anti-D,

agglutination occurs. This means: (a)
patient is D neg (b) D pos (c) canot
interpret (d) invalid result
A 35 year old runner with a

pulse of 46 bpm wishes to
D - general physical
requirements are: 50-100
bpm, temp < 37.7 deg, bp <
180/100, hgb >/= 12.5 g/dL.
Exceptions for pulse can be
made for athelets as long
as no irregularities are
detected
15.
After a transfusion reaction, which

would not be included a nurses workup
of the reaction? (a) Return the unit to BB
(b) draw posttransfusion EDTA (c) obtain
posttransfusion urine sample (d) obtain
a fresh unit from the BB for immediate
transfusion
D - do not issue
additional units
until reaction has
been
investigated.
16.
After donation, a donor is found to be at

high risk for HIV/AIDS, what should be
done with the unit? (a) Quarantine until
diagnosed (b) Use for research (c)
Properly dispose/destroy unit (d)
Destroy RBC's, but use plasma
C - destroy the
unit
17.
After leukocyte reduction, what

percent of RBCs and absolute leukocyte
values must be maintained? (a) 85%, 5e8
(b) 80%, 5e6 (c) 75%, 5e5 (d) 70%, 5e4
B - prevents
GvHD, CMV
transmission
4.
5.
6.
7.
8.
A 45 year old woman donated

blood 54 days ago and wishes to
A - minimum time between

donations is 8 weeks (56
days). Exceptions can be
made with autologous
donation.
A 50 year old man who had

male-male sex in 1980 wishes to
C - any male-male sex after

1977 is permanently
deferred.
18.
After receiving part of an RBC unit, a patient

experiences elevated temperature 37.5-40,
severe rigors, and goes into shock. What is
the most likely type of reaction? (a)
Hemolytic (b) anaphylactic (c) septic (d)
embolic
C - the
sudden rise
in
temperature
signifies
bacterial
sepsis.
19.
After releasing blood for emergency release

and the patient requires additional units
set up for stand-by, what should the next
step be? (a) Prepare 6 units of
uncrossmatched B pos WB (b) check
records for any previous information (c)
type and screen a patient sample (d)
prepare 6 units of uncrossmatched group O
units
B - check
previous BB
records.
Then
proceed to C
immediately
and request
a patient
sample.
20.
An ag:ab reaction alone does not cause

hemolysis. Which factor eventually leads to
RBC lysis? (a) albumin (b) complement (c)
G6PD (d) AHG
Bcomplement
cascade
21.
Agglutination characterized with many

small agglutinates in the backgrounddd of
free cells would be graded as: (a) 1+ (b) 2+ (c)
3+ (d) 4+
AHG in the DAT is used: (a) to provide

complement and mediate hemolysis of
indicator RBCs (b) precipitate antierythrocyte ab's (c) fix complement and
detect pre-existing ab's (d) detect ab's fixed
on RBCs
All cells in a cell panel using LISS reacts 3+

with AHG. The autocontrol is negative. This
pattern of reactivity is most likely due to:
(a) rouleaux (b) warm autoantibody (c)
alloantibody against a high frequency
antigen (d) antibody against LISS
C - rouleaux
would not
occur in AHG
phase b/c all
serum has
been
washed
away. The
autocontrol is
negative.
24.
An alloantibody is: (a) called an isoantibody

(b) called an isoagglutinin (c) human
antibody against another human (d)
antibody against another species
25.
Antibodies to D antigen are usually

demonstrated: (a) at birth (b) within a year
of birth (c) in pregnant women who are D
pos (d) as a result of immunization by RBCs
D - can only
develop antiD as a
alloantibody
22.
23.
26.
The antibody produced during a

secondary response to a foreign
antigen is usually: (a) IgM (b)
produced by T lymphs (c)
produced a month or more after
secondary stimulus (d) present at
a higher titer than after primary
response
27.
These antigens are primarily

found on WBCs, but can also
occur on erythrocytes and are
the RBC equivalent of HLA on
WBCs: (a) Lea, Leb (b) Bga, Bgb,
Bgc (c) Kpa, Kpb, Kpc (d) Doa,
Dob
B - Bg(a) corresponds
with HLA-B7, Bg(b)
corresponds with HLAB17, Bg(c) corresponds
with HLA-A28
28.
The antiglobin test does not

require washing of the addition
of IgG-coated cells in which of
the following methods? (a) solidphase RBC adherence assay (b) gel
test (c) affinity column
technology (d) PEG technique
B - gel test
29.
Antisera to ABO antigens is(are):

(a) 37 deg reacting (b) Saline
reacting (c) protein dependent
(d) usually IgG
30.
At he end of AHG test, if negative

reactions do not have a positive
control cell test, what does that
mean? (a) test is valid (b) AHG
reagent was working properly (c)
cells were not washer thoroughly
(d) controls cells are
contaminated
C - underwashing can
cause reagent
neutralization by free
AHG
31.
An autocontrol is positive only in

AHG phase is suggestive of? (a)
rouleaux (b) positive DAT (c)
positive alloantibody (d) ABO
grouping
B - suggests coating of
RBCs
32.
Bacterial sepsis is highest among

what type of component? (a) RBC
(b) FFP (c) cryoprecipitate (d)
platelets
D - most bacterial grow

at RT. Pooled platelets
have the highest rate.
Yersinia enterocolitica is
the most common RBCtransmitted bacterial
agent b/c it can grow in
the refrigerator.
33.
The BB procedure manual must

be revised: (a) annually (b) after
AABB Standard preparation (c)
prior to inspection (d) annually
by authorized individual
Before intrauterine
transfusion, what prep does
the unit need to go through
before transfusio? (a) Add FFP
and pool-ed plasma (b) Check
that the RBC group in
consistent with the fathers
group (c) irradiate the RBCs (d)
Test the RBCs with neonatal
eluate
C - needs to be irradiated
to prevent GvHD. A
minimum of 25 Gy
delivered to midplane and
15 Gy to all other areas.
35.
Before transfusion, what is not

included during review of
previous BB records? (a)
ABO/Rh type (b) clinical
significant antibodies (c)
serious adverse reactions (d)
hepatitis testing
36.
The best way to make a positive

ab ID that is causing a positive
DAT in a baby is to perform: (a)
titration using maternal serum
(b) panel using maternal serum
(c) panel using eluate from
maternal RBCs (d) panel using
eluate from baby's RBCs
D - babies blood is a much

better source
37.
A black patient has the

following phenotype:
D+C+E+c+e+, which is the least
likely genotype? (a) DCE/dce (b)
DCe/DcE (c) DCe/dcE (d)
DcE/dCe
C - B is the most frequent.
Calculate percent yield of

platelet reduced plasma (PRP)
when WB = 450mL, 200,000
plts/uL and PRP = 250mL,
300,000 plts/uL. (a) 33% (b) 45%
(c) 66% (d) 83%
D - percent yield =
(250300,000)/(450200,000)
= 83%
39.
Calculate the final percent

yield when PRP = 250mL,
300,000 plts/uL and final plts =
50mL, 900,000 plts/uL. (a) 30%
(b) 45% (c) 50% (d) 60%
D - percent yield =
(50900,000)/(250300,000)
= 60%
40.
Cells used to make reagent

screening cells are type: (a) O
(b) A (b) B (d) AB
CHD is associated with what

type of antibody causing
positive DAT? (a) IgM (b) IgG (c)
IgA (d) C3
D - although usually
associated with IgM, CHD
is generally caused by C3
binding to cells and IgM
binding to C3 in
extremities at lower
temperature.
34.
38.
41.
42.
Check cells are prepared by

incubating: (a) Rh neg cells with
anti-D (b) Rh pos cells with anti-D (c)
Rh neg cells with albumin (d) Rh pos
cells with albumin
B - the only positive

reaction
43.
Criteria determining RhIg eligibility

include: (a) mother is Rh pos (b)
infant is Rh neg (c) mother has not
been previously immunized to D
antigen (d) infant has a positive DAT
C - D could be any
antibody
44.
The crossmatch is performed using:

(a) donor serum, recipients cells (b)
donors cells, recipients serum (c)
donor serum, reagent RBCs (d)
recipient serum, reagent RBCs
B - can be done by
electronic
crossmatch, basic
(IS), or extended (IS,
37, AHG) for positive
antibody screens
45.
Cryoprecipitate generally treats

hypofibrinogenemia and
hemophilia A. What components are
not found in cryo? (a) Fibrinectin (b)
F13 (c) F8:vW (d) Antithrombin 3
D - AT3 is found in
FFP and commercial
sources and is used
to treat liver disease,
DIC, and
thromboembolic
disorder.
Cryoprecipitate
contains: F8:c, F8:vW,
F13, Fibrinogen,
Fibronectin, VWF,
cryoglobulin.
46.
The DAT is useful for: (a) ID unknown

alloantibodies (b) ID antigens on
RBC surfaces (c) detect RBCs
sensitized with antibody (d) type
RBCs
47.
A D negative woman received one

vial of RhIG due to postpartum
RhIG. She now requires a transfusion
and the antibody screen is positive,
but the crossmatches were both
compatible. What is likely the cause
of the positive ab screen? (a) anti-K
(b) actively acquired anti-D (c)
passively acquired anti-D (d) Rh ab
other than anti-D
C - passive anti-D is
most likely still in
maternal blood from
the RhIG
administration.
48.
A donor has taken 2 tablets of

aspirin a day for 36 hours, which
applies to his unit of blood? (a) may
not be used for pooled platelet prep
(b) should not be collected until
36hrs after last dose (c) may be used
for pooled platelet prep (d) RBC and
FFP use is okay, but platelets need to
be discarded.
C - patients cannot
donate with aspirin
ingestion </= 36 hrs.
During a reported HTR, a pretransfusion

specimen has straw-colored plasma, a
posttransfusion specimen has reddish
plasma. This indicates: (a)
uncomplicated transfusion (b)
intravascular transfusion reaction (c)
drugs infused with blood product (d)
febrile transfusion reaction
B - represents
hemolysis. Also
look for
haptoglobin
decrease and
hemoglobinuria.
50.
Failure to yield a positive antigenantibody result due to excess antibody is

known as: (a) dosage (b) prozone (c)
adsorption (d) postzone
B - excess ab
causes ration
ag:ab to be small
51.
False negative at AHG phase of antibody

screening are most likely due to: (a)
excessive RBC washing (b) inadequate
washing of RBCs (c) warm autoantibody
present in patient serum (dO failure to
allow blood to clot properly
B - failure to
wash off free
human globulin,
which can
neutralize AHG.
The following has been obtained: A0,

B4+, D0, AC4+, BC2+, Rh cont 0. What is
next? (a) draw new sample (b) test
patient serum with A2 cells and serum
with anti-A1 lectin (c) repeat ABO
grouping using 3x washed saline cells (d)
perform ab screening at IS using group O
cells
The following platelet

concentrations/volumes are measured:
pH 6.0, 45mL; 5.5, 38; 5.8, 40, and 5.7, 41.
What corrective action is needed? (a) No
corrective action (b) recalibrate pH
meter (c) increase plasma volume (d)
decrease plasma volume
C - increase
plasma volume.
Helps to
neutralize lactic
acid, a product
of anaerobic
glycolysis.
Four units FFP are requested on a group

O patient who is F5 deficient, what units
are acceptable to thaw and issue? (a)
Group O only (b) Group O or A (c) Group
O or AB (d) Any group available
D - O blood
group already
have anti-A and
anti-B.
Given a negative screening, what may

cause a false positive compatibility test?
(a) incorrect ABO typing of the donor
patient (b) alloantibody against a lowfrequency antigen on donor cells (c)
prior coating of IgG antibody on donor
cells (d) all of the above
C - positive DAT
would help
resolve
discrepancy.
56.
Group O screening cells will not detect:

(a) anti-M (b) anti-N (c) anti-A1 (D) anti-K
C - ABO
antibodies are
not generally
included
57.
How are antibodies to Rh antigens

usually characterized? (a) natural
occuring IgM (b) immune IgG (c) Immune
IgM (d) naturally occurring IgG and IgM
B - IgG that
react at LISS
and albumin
49.
52.
53.
54.
55.
58.
How do you differentiate acquired B

antigen from persons who are type
AB? (a) anti-B in serum (b) secrete
A,B,H substance (c) are always nonsecretors (d) are usually healthy
people
59.
How is CHD different from PCH? (a)

PCH s a common from of cold
autoimmune disease and CHD is
rare (b) PCH is WAIHA (c) PCH is IgG
and CHD is IgM (d) PCH is IgM and
CHD is IgG
C - PCH is rare IgG

with anti-P specificity.
Use DonathLandsteiner test to
confirm
60.
How many bags (units) should be

thawed to provide 2g of fibrinogen?
(a) 2 (b) 4 (c) 8 (d) 10
C - each unit contains

0.25g.
61.
How many genes encode the

following RH antigens: D, C, E, c, e?
(a) one (b) two (c) three (d) four
B - RHD and RHCE
62.
How many mL can an individual

donate per Kg if they are under 110
lbs? (a) 1 mL/kg (b) 9 mL/kg (c) 10.5
mL/kg (d) 20 mL/kg (e) There is no
minimum to blood donation.
C - 10.5 mL/kg. Do not

forget to convert lbs
to Kg
63.
How many platelets must one unit

of WB derived platelets contain? (a)
5.5e6 (b) 5e8 (c) 5.5e10 (d) 5e10
C - 5.5e10 plts and

pH > 6.2
64.
How many units need to be

screened to find 2 units Jk(a)- and Kblood if Jk(a)+ frequency is 77% and
K+ frequency is 10%? (a) 6 (b) 10 (c) 20
(d) 36
B - need to calculate
frequency of antigen
negative units
(.23*.9) and then
divide the units by
this number (2/.21).
65.
How many units would it take to

raise a patients hemoglobin from
8.1 g/dL to 10 g/dL? (a) 1 (b) 2 (c) 3 (d)
4
B - each unit raises

Hgb by 1 g/dL
66.
How would one demonstrate

antibody attached to patient cells
in vivo? (a) DAT (b) Complement
fixation (c) Elution (d) IAT
A - DAT
67.
If 98% of RBCs are viable during

transfusion, what percent of cells
will be viable after 28 days? (a) 10%
(b) 30% (c) 50% (d) 70%
D - 1% of RBCs are
cleared each day
68.
69.
70.
If a D neg woman had a fetomaternal

hemorrhage and her baby was D pos,
what would you expect? (a)
premature birth (b) mother requires
a transfusion (c) infant has positive
acid elution test (d) weak D test on
maternal blood shows mixed field
reaction microscopically
D - Indicates D pos
and D neg cell
populations. A FMH
(rosette) and KB
test should be done
on the mothers
blood and RhoGAM
administered if
necessary
If a donor has received blood

products within 12 months, why are
the disqualified from donation? (a)
HBV, HCV, HIV (b) two cell
populations (3) cannot tolerate
blood loss (4) Hemoglobin too low
A - Infectious
disease's
If a D-positive person makes anti-D,

this person is probably: (a) partial D
(b) D negative (c) weak D as position
effect (d) weak D due to transmissible
genes
A - partial D
individuals are
missing one or more
epitopes and will
not recognize a full
D epitope as their
own.
If a final spin yields 50mL and 900,000

plts/uL, does this product meet AABB
standards for platelet concentrate
production? (a) Yes (b) No, plt count
is too low (c) No, percent recovery is
too low (d) Data insufficient
B - platelet count
needs to 5.5e10 plts,
this count yields
4.5e10 plts (50
mL900000
plts/uL1000uL/mL)
If a patient has a positive DAT, can

you perform a weak D test? (a) No,
cells are already coated with ab (b)
No, cells are Rh null (c) Yes, Ig will not
interfere with test (d) Yes, Rh
reagents are enhanced in protein
A - could be false
negative
73.
If a patient has a rare blood type, who

would provide the most compatible
blood specimen? (a) grandparents (b)
parents (c) siblings (d) spouse
C - genetic material
provided from each
parent
74.
If a patient has a warm autoantibody

reacting at AHG, how would you
identify the antibody ? (a)
autoabsorption followed by a panel
on the absorbed serum (b) elution
followed by ab panel on eluate (c)
enzyme treated panel on serum (d)
panel on serum
B - warm auto
reacting at AHG
would have a
positive DAT and
would need to be
eluted before a
panel is run.
If a patient has no ABO antibodies

after serum testing, what ABO
antigens are present on RBC's? (a) A
(b) B (c) A, B (d) neither A or B
71.
72.
75.
76.
If a patient is group A, what

cryoprecipitate units could she receive?
(a) Group A only (B) Group AB only (c)
Group A and group O (d) Group A and
group AB
D - plasma
components,
group AB is
universal donor
77.
If a person has genetic makeup of Hh,

AO, LeLe, sese. What substance is ion
secretions? (a) A (b) B (c) Le(a) (d) Le(b)
C - A,B,H only
produced by
secretors (Se).
Le(b) only
produced by Le,
Se patients
78.
If check cells are negative in IAT phase,

what should be done? (a) repeat with
new AHG reagent (b) add more check
cells (c) add more AHG (d) record results
as negative
79.
If father is weak D positive and mother

is D negative, what is the probability
that their kids will be D-negative? (a) 0%
(b) 25% (c) 50% (d) 75%
80.
If father is weak D positive, mother is D

negative, and infant is D pos, what can
be said: (a) father is not the really the
father (b) father is definitely the father
(c) father may or may not be the father
(d) Infant D typing is a false positive
81.
If father is weak D positive, mother is D

negative, and infant is D pos, which
could make anti-D? (a) father (b) father
and mother (c) mother (d) none
82.
If insufficient yield is recorded while

preparing platelets and the second spin
produced drastically less percent yield
(60%), the best course of action would
be to modify centrifugation by (a)
increase time and/or rpm for first spin
(b) increase time and/or rpm for second
spin (c) decrease time and/or rpm for
first spin (d) decrease time and/or rpm
for second spin
B - increase time
and/or RPM
when percent
yield is low
83.
If test and control tubes exhibit

hemolysis in the Donath Landsteiner
test, what does this mean? (a) positive
(b) negative (c) invalid (d) false negative
C - in PCH, cold
anti-P antibodies
bind cells at 4
deg and lyse cells
at 37 due to
complement
activation.
control cells or
cells in a patient
with CHD should
not lyse at 37
deg.
84.
In a case of a multiple transfusionlinked hepatitis, what action

should be taken? (a) all donors
deferred permanently (b) repeat
hepatitis testing on fresh samples
from all donors (c) notify donor
center that collected units (d)
interview all implicated donors
C - best answer, allow

donor center to deal
with patients.
85.
In a panel where all cells react

positive except one cell that is K+k(the only cell k-), what would the
best next step be? (a) treat panel
cells with enzyme and repeat (b)
treat panel cells with DTT and
repeat (c) Treat serum with DTT and
repeat (d) treat patients serum with
enzyme abd repeat
B - treating panel cells

with DTT destroys Kell
system antigens. Is no
reactions are positive
with DTT treated cells,
than more rule/out
can be made. Enzyme
has no effect on Kell
antigens and treating
serum with DTT
would only effect IgM
in serum, cellano is
IgG.
An individual is dce/dce genotype

and is given dCe/dce blood.
Antibody response appears to be
anti-C and anti-D. What is the most
likely explaination? (a) anti-G (b)
anti-partial D (c) anti-Cw (d)
incorrectly read
An infant has a positive DAT of 4+, a

bilirubin of 20 mg/dL, and requires
a transfusion. A maternal specimen
is unavailable. What would be the
best approach to the situation? (a)
ID antibody in serum and
crossmatch for antigen negative
units (b) issue O neg units (c) refuse
to issue units without a maternal
specimen (d) ID antibody in serum
and eluate and crossmatch for
antigen negative units
D - antibody coating
cells may be maternal
and not found in
serum. Eluate, in lieu
of maternal blood,
would offer the
availability of both
antibody sources.
In the gel test, a positive reaction is

represented by: (a) button of cells
in the center of the column (b) RBCs
attached to the sides of the wells (c)
button at the bottom of the gel (d)
RBCs trapped in the microtube gel
column
D - rarely get
suspended in button
form
86.
87.
88.
89.
In the last phase of crossmatch, agglutination

appeared in both screening tubes and there
was no agglutination in the crossmatch tube.
What is the patients problem? (a) patient has
a cold antibody reacting with screening cells
(b) donor has a positive DAT (c) patient has an
alloantibody to donor cells lacking
corresponding antigen (d) patient has a
positive DAT
D - would
react at
coombs
phase
90.
In which of the following may ABO

backtyping be invalid? (a)
hypogammaglobulinemia (b) IgM
alloantibodies (c) Cold autoantibodies (d) all
of the above
91.
Is a QC'd cryoprecipitate product acceptable

if the satellite bag contained 250mL FP, final
product has 10mL, F8 assays before and after
prep are 1 IU/mL and 9 IU/mL, respectively?
(a) Yes (b) No, % recovery is too low (c) No,
final F8 level is too low (d) data is insufficient
A - Yes.
Total IU F8
needs to be
above 80
IU. Final IU
= 9 IU/mL *
10 mL = 90
IU
92.
Is the following mother a candidate for RhIG?

Female D neg, miscarriage at 11 weeks (a) yes,
50ug dose (b) yes, 300 ug dose (c) yes
additional testing for dose (d) RhIG not
indicated
A - 50ug for
early
termination
93.

Mother D neg, infant D pos with rosette test
pos = 1-2 rosette per field(a) yes, 50ug dose (b)
yes, 300 ug dose (c) yes additional testing for
dose (d) RhIG not indicated
C - need to
perform KB
test for
dosage.
94.

Mother D -neg, infant weak D (a) yes, 50ug
dose (b) yes, 300 ug dose (c) yes additional
testing for dose (d) RhIG not indicated
B - full dose
for postpartum
weak D
infant
95.

Mother D neg, twin 1 D neg, twin 2 D pos (a)
yes, 50ug dose (b) yes, 300 ug dose (c) yes
indicated
B - full postpartum
dose for D
pos twin
96.

Mother D neg with anti-D titer 2 (RhIG
injection at 30 weeks), infant D pos (a) yes,
indicated
B - passive
anti-D from
previous
RhIG
97.

Mother D neg with anti-Fy(a), infant D pos (a)
yes, 50ug dose (b) yes, 300 ug dose (c) yes
indicated
B - full postpartum
dose for D
pos infant
98.
Is the following mother a candidate for

RhIG? Mother O neg, infant group A, DAT
2+, D neg at IS w/o weak D (a) yes, 50ug
dose (b) yes, 300 ug dose (c) yes additional
testing for dose (d) RhIG not indicated
B - always
administer
RhIG if
infant Rh is
in question.
99.
Is the following mother a candidate for

RhIG? Mother weak D, infant D pos (a) yes,
indicated
It is necessary to use a heterozygous cell as

a positive control because: (a) weakest
example of ab (b) strongest example of ag
(c) weakest example of ag (d) strongest
example of ab
101.
A KB acid elution for FMH is reported as

1.3%. What is the total volume of FMH? (a)
6.5mL (b) 13mL (c) 26mL (d) 65mL
D - KB%50 =
milliliters
bleed.
1.3%50 =
65mL
102.
A KB acid elution test is reported as 1.3%,

how many bottles of RhIG should be
administered within 72 hours of childbirth
is infant is D pos? (a) 1 (b) 2 (c) 3 (d) 4
C - 65mL/30
= 2.2, round
up to 3
bottles
103.
The last unit of autologous blood should

be collected at least how many hours
before surgery? (a) 24 (b) 36 (c) 48 (d) 72
B - Allows for
BV
replacement.
104.
A letin is: (a) an auto RBC antigen (b) an

alloantibody (c) a product of plant seeds
(d) produced from antigen stimulation
105.
Lymphotoxicity can be used to detect

antibodies to: (a) Wr(a), Wr(b) (b) HLA
antigens (c) Bg(a), Bg(b), Bg(c) (d) JMH
antigen
A male patient is O neg but was transfused

with O pos blood years ago. Could he be
given O pos blood now? (a) Yes, if ABS is neg
(b) Yes, b/c O pos blood was previously
given (c) Yes, b/c males have no risk of HDN
(d) Yes, it is always safe to give O pos blood
to an O neg patient
A - needs to
be
compatible.
Only a small
percentage
of the
population
will produce
antibody
A male trauma victim is type AB, Dnegative, antibody screen neg, and will
need a large amount of blood, what should
be given next taking inventory into
account? (a) 30 units, group O, D pos (b) 26
units, group A, D pos (c) 10 units, group O,
D neg (d) 5 units, group A, D neg
B - because
male,
antibody
screen in
negative, risk
anti-D to not
deplete Dneg units
100.
106.
107.
108.
An MD delivers an unlabelled
specimen to the lab, one should: (a)
discard the specimen (b) label
specimen with MD provided
instructions (c) label specimen with
data from transfusion record (d)
request the specimen be returned to
nursing station for labelling
109.
Most blood group antibodies are of

what class? (a) IgA, IgD (b) IgA, IgM (c)
IgE, IgD (d) IgG, IgM
D - IgG 80%, IgM

6%, IgA 13%
110.
The most serious transfusion reaction

are due to incompatibility in which
blood group system? (a) ABO (b) Rh (c)
MN (d) Duffy
A - major
incompatibility
111.
A mother has a high anti-D titer and

the infant appears to be weak D, but
has a 4+ DAT and weak D cannot be
confirmed. What is the cause of
patients positive DAT? (a) Wharton's
jelly contaminating sample (b) ABO
HDN (c) "blocked D antigen" (d) A
different antibody causing positive
DAT
C - All sites on
neonatal RBCs
are being blocked
by maternal antiD. A gentle heat
elution or
cloroquine
diphosphate
could resolve
discrepancy.
112.
Mother has DCe with anti-c, father has

DCce, baby is Rh negative and does not
have HDN. What is one possible
phenotype? (a) dCe (b) dCce (c) Dce (d)
Dcce
A - all the others

are either Rh pos
or have c.
113.
Mother is CDe/cde, baby is CDe/CDe.

What is father's most likely genotype?
(a) R1/r (b) R2/R2 (c) R/r (d) R2/r
A - could not have

E (r/o B and D)
114.
Mother is K+k+, father is K-k+. Children

are K+k- and K-k+. How is this
possible? (a) dominant inhibitor gene
is passed to child 1 (b) father is K(0)k (c)
Father is MacLeod phenotype (d)
mother has cis-Kk gene
B - Child 1 is
K(0)K, child 2 is
K(0)k. MacLeod
expresses weak
Kk, no cis-Kk
exists.
115.
Mother is type A, Rh ce, and HLA A2,

A29, B12, B17. Alleged father is type A,
Rh DCce, and HLA A2, A3, B9, B27.
Infant is type O, Rh ce, HLA A2, A3, B12,
B15. What rules out paternity? (a) ABO
system (b) Rh system (c) HLA system (d)
Paternity cannot be ruled out
C - B15 does not

match either
maternal of
paternal HLA
types.
116.
A multiple transfused patient has units

requested and the check samples are
badly hemolytic. What is one possible
explanation? (a) AIHA (b) anti-Fya (c)
anti-Jka (d) Paroxysmal nocturnal
hemoglobinuria
C - Jka often
declines to low
levels in serum
and may be
undetectable in
an antibody
screen.
Intravascular
delayed
hemolytic
transfusion
reaction is
characteristic of
Kidd antibodies.
A negative antibody screen indicates:

(a) no clinically significant antibodies
are present (b) no clinically significant
ab's are detected (c) the crossmatch
will be compatible (d) no reaction will
occur if patient is transfused
118.
Neonate is O pos with a 3+ positive

DAT. Maternal antibody screen is
negative. HDN could be due to: (a) Fyb
antigen (b) K antigen (c) low-incidence
antigen (d) A or B antigen
C - A and B are
r/o by negative
maternal ab
screen. D is r/o
because baby is
O and does not
have A or B
antigen sites.
119.
A patient comes to the hospital with a

card that reads group B, D-pos in his
wallet and requires 6 units of blood
immediately and is not able to wait for
crossmatch, what units should be
released immediately? (a) 6 units
uncrosmatched B pos (b) check
records before releasing 6 units B pos
(c) withhold until crossmatch is
complete (d) 6 units uncrossmatched
group O.
D - emergency
release
procedure
A patient had anti-E five years ago and

is now anti-E negative,what is the best
thing to do? (a) Type the patient for E
antigen during crossmatch (b) Use E
negative units and crossmatch E
negative units (c) crossmatch units and
release compatible products (d)
Crossmatch donor units with enzyme treated RBCs -
B - could cause
severe DTR.
Need compatible
units.
A patient has a 2+mf DAT with anti-IgG.

He was transfused 2 weeks ago with 2
units. His eluate would likely contain:
(a) no antibody (b) autoantibody (c)
alloantibody (d) drug-related antibody
C - most likely
DHTR due to
surgery.
117.
120.
121.
122.
A patient has a history of antiJk(a) and anti-e in her

autoabsorbed eluate, but is only
showing anti-e today. What
blood would be selected for
crossmatch? (a) Jk(a)- (b) e- (c)
Jk(a) -and e- (d) no screening is
necessary
A - the autoantibody
anti-e would be hard to
find units for (80% of
pop is e+). Anti-Jk(a) can
evade titers and Jk(a)blood takes priority.
The autoantibody will
destroy donor cells at
the same rate as
current patient cells,
but the allo cold cause
HTR.
123.
A patient has anti-E, what

crossmatch should performed?
(a) no crossmatch required (b)
computer crossmatch (c) IS
crossmatch (d) 37 deg AHG
crossmatch
D - anti-E reacts at 37
deg
124.
A patient has a positive DAT due

to cephalosporin treatment.
How should you crossmatch this
specimen? (a) use eluate from
patients RBCs and donor cells (b)
autoabsorbed patients serum
and untreated donor cells (c)
untreated patient cells and
untreated donor cells (d)
cephalopsporin treated donor
cells and untreated patient cells
C - cephalosporin
antibodies will
generally not react with
RBCs unless the RBCs
have been treated with
cephalosporin. Eluate
should cause the same
result as untreated
crossmatch. Only
perform eluate if
patient has also been
recently transfused
also.
125.
Patient is A0,B0, AB0, AC4+, BC4+.

What describes cells? (a) group
AB (b) cannot be determined (c)
group O (d) group B
126.
A patient is A pos with a history

of anti-K, which unit could
potentially be compatible? (a) A
pos, K+k+ (b) A neg, K-k+ (c) O pos
K+k- (d) O neg, K+k-
C - the only unit with K-
127.
A patient is DCe/DCe and receives

a unit of blood that is DCe/dce.
What antibody could they
develop? (a) anti-C (b) anti-c (c)
anti-D (d) anti-E
128.
129.
130.
131.
132.
A patient is on methyldopa
therapy and has an 3+ DAT
positive and anti-e has been ID'd.
Patient has not been recently
transfused. How would you
determine whether it is an auto
and an alloantibody? (a) type
patients cells with low-protein
anti-e reagent (b) perform
autoabsorption (c) absorb the
eluate with R2R2 RBCs (d) absord
the eluate with rr RBCs
A - autoantibodies
target the patients own
RBCs. A low-protein
anti-e should be
negative.
A patient is O pos and has not

been transfused for 5 years. She
is seen ion the ED with a Hgb
value of 8.9 g/dL. Her antibody
screening was negative at IS and
37 deg LISS. There were 4+
reactions at AHG and a 4+
autocontrol. What is the likely
cause for these results? (a)
polyagglutination (b) rouleaux
(c) transfusion reaction (d) warm
autoantibody
D - positive AHG means

that all her cells were
likely coated with
antibody, which is why
they did not react at
LISS (not enough ab in
serum). Rouleaux gets
washed away at AHG.
Polyagglutination will
not react in the
autocontrol b/c they
lack the antigen causing
agglutination.
A patient is suspected to have

acquired B antigen with
reactions in forward typing and
reverse B cells, which would
confirm this suspicion? (a)
positive autocontrol (b) secretor
studies show nonsecretor (c)
leukemia diagnosis (d) negative
result with monoclonal anti-B
reagent lacking ES-4 clone
D - ES-4 clone cells are

specific for acquired B
cells, but will not react
with human acquired
anti-B
A patients DAT is positive due to

penicillin antibody: (a) the
serum will react only if penicillin
is added to the test system (b)
the serum will react with all cells
(c) the eluate will react with
penicillin coated RBCs (d) the
eluate will react with all RBCs
C - will only react with

penicillin coated cells,
but since the DAT is
positive, eluate testing
will indicate antibody
bound to cells
Patients who have a clinically

significant antibody should: (a)
receive blood negative for the
corresponding antigen (b)
receive IS crossmatched
compatible blood (c) must
receive Rh negative blood (d)
none of the above
A - crossmatch should
go to coombs
133.
A patient treated with methyldopa has a

4+ DAT. An eluate of his RBCs would be
most likely react with: (a) untreated panel
cells (b) untreated D positive cells (c) panel
cells treated with methyldopa (d) panel
cells when methyldopa is added to eluate
A - induced
WAIHA that
reacts with all
panel cells.
134.
A patient with last transfusion 9 months

ago has a negative ab screen, positive
autocontrol, a positive DAT of 2+, and
negative drug history. Which of the
following is most likely present on his
eluate? (a) no antibody (b) alloantibody (c)
alloantibody, autoantibody (d)
autoantibody
D - in vivo
positive DAT
represents
autoantibody
and negative
screen r/o
allo's.
135.
A patient with no history of transfusions

and 3 months pregnant with her first child
has 4+ reactions in backtyping and on all
screening cells at IS, 37 deg, and AHG. If her
RBCs were tested against anti-H lectin and
did not react, she would be identified as a:
(a) acquired B (b) Oh phenotype (c)
Secretor (d) Subgroup of A
B - patient is
most likely
bombay
phenotype
136.
A patient with no history of transfusions

and 3 months pregnant with her first child
has 4+ reactions in backtyping and on all
screening cells at IS, 37 deg, and AHG, this
could be because: (a) cold autoantibody
(b) inherited sese gene (c) inherited hh
gene (d) rouleaux
C - patient is
bombay
phenotype
b/c of positive
AHG (no
serum left).
137.
A phenomenon when an antibody reacts

more strongly on a red cell carrying a
homozygous inheritance than a
heterozygous inheritance is called: (a)
codominance (b) dosage (c)
hemagglutination (d) affinity
138.
Pilot tubes for a donor unit break in the

centrifuge, what is next? (a) Use previous
records (b) Discard the unit (c) Discard the
cells and salvage plasma (d) Remove
sufficient segments to complete donor
processing.
D - Sufficient
volume can
be
withdrawn
from
segments.
139.
Pooled sera tests positive for HCV by NAT,

what is the next action? (a) exclude all
donors (b) test each donor individually (c)
label all donors as HCV pos (d) Confirm the
test via RIBA
B - Identify
the infected
donor and
exclude all
units from
distribution.
A potential donor weighs 9lbs, how

many mL's of blood can she donate
in one event? (a) 367mL (b) 378mL (c)
454mL (d) 473mL
C - 454 mL. she can

donate 10.5 mL/Kg if
she weighs less than
110 lbs. (95/2.2)*10.5
= 454mL
141.
Previous patients ABO and Rh must

be immediately available for: (a) 6
month (b) 12 month (c) 10 years (d)
indefinitely
B - keep records for

ABO/Rh for 10 years
and immediately
available to 12
months
142.
The racial origin of a screening cell

that is Fy(a-b-) is most likely: (a)
black (b) eskimo (c) oriental (d)
white
143.
140.
144.
145.
146.
147.
148.
149.
150.
The temperatre required for RBC and

WB transport is: (a) 0-4 (b) 1-6 (c) 1-10
(d) 5-15
C - 1-10 deg
celcius
151.
Testing requires use of an inti-serum

that is rarely used. How can one verify
the antiserum is working correctly? (a)
perform cell panel (b) perform cell
screening (c) duplicate test (d) test one
cell that is antigen negative and
another that is heterozygous
D - provides
control check and
a check that weak
expression will be
positive
152.
This is a laboratory test to determine if

a transfusion reaction is febrile or
hemolytic (a) DAT (b) IAT (c) Elution
test (d) KB test
A - looks for
coated cells in
vivo
A recently transfused patient has a

3+ reaction at IS and a 1+ reaction at
AHG on all cells but the ii cell.
Autocontrol is similar. What is the
next step in the crossmatch? (a)
autoabsorb serum (b) prewarm
technique (c) ID antibody and
obtain rare donor blood (d) Use LISS
additive
A - most likely due to

cold autoagglutinin
anti-I. Use prewarmed technique
to eliminate
interference with
cold agglutinins.
Cannot autoabsorb
due to recent
transfusion.
153.
To determine patient RBC antigen

group, what antibody source is
needed? (a) commercial RBCs (b)
commercial antisera (c) patient serum
(d) patient plasma
154.
A recently transfused patient has a

positive antibody screen at IS, LISS,
37, and AHG. You have ID'd anti-Fya
and anti-C. What should you do
next? (a) elution (b) absorption (c)
antigen typing (d) enzyme panel
D - Duffy is
destroyed by
enzyme, as is MNS,
Xg.
Two units are requested for emergency

release on the following young female
patient: A+,B+,D+,Rhcont+,AC+,BC+.
What should be done: (a) perform DAT
on patients RBCs (b) perform full
workup before releasing units (c) begin
antibody screening test (d) Release 2 O
neg units
D - Both forward
and reverse
testing is in
question. Release
O neg to a female
of childbearing
age following
emergency
release protocol.
155.
Rh antibodies react at which of the

following temperatures? (a) 4 (b) 18
(c) 22 (d) 37
D - IgG reacting at
LISS and albumin
Type O cells contain the following

antigens on RBCs: (a) A (b) B (c) A, B (d)
neither A or B
156.
The Rh genotype is written as

CDE/cDE, what is the Weiner
notation? (a) R0/R1 (b) Ry/R2 (c)
R2/R1 (d) Rz/R2
D - rewrite as
DCE/DcE
Using patient serum and RBCs that

have a known antigen is called: (a)
forward grouping (b) reverse grouping
(c) antigen testing (d) screening test
157.
Select the term that desribes the

bond between a single antigenic
determinant and an individual
combining site: (a) affinity (b)
avidity (c) clone (d) immunogen
The weak D test involves: (a) IAT (b)

DAT (c) anti-Du typing sera (d) anti-D
antisera with LISS potentiator
A - need to
induce weak
binding
158.
The specificity of antibody in WAIHA

is most often associated with which
blood group system? (a) ABO (b) Kell
(c) Kidd (d) Rh
D - Usually broad
Rh specificity, but
most often
associated with antie. Rh(null) may be
less likely to develop
WAIHA
What ABo antibody is expected in a

patients serum with the following
reaction: A0, B4+ (a) anti-B (b) anti-A (c)
anti-A and anti-B (c) neither anti-A or
anti-B
159.
What ab's are present in polyspecific

AHG reagent? (a) anti-IgG (b) IgG and C3
(c) anti-IgG, andti-C3 (d) anti-C3
160.
What ab's could an R(1)R(1) individual

make if exposed to R(2)R(2) blood? (a)
anti-e, anti-C (b) anti-E, anti-c (c) antiE, anti-C (d) anti-e, anti-c
B - RCe/RCe
exposed to
RcE/RcE
The strength of that a multivalent

antibody binds to a multivalent
antigen is called: (a) cross reactivity
(b) affinity (c) avidity (d) specificity
What antigen source is used to

determine the presence of RBC
antibody in a patient sample? (a)
commercial RBCs (b) commercial
antisera (c) patient serum (d)
patient RBCs
What are the most serious

immediate (within a few hours of
birth) consequences of HDN? (a)
anemia and positive DAT (b)
hyperbilirubinemia and anemia
(c) hyperbilirubinemia and
jaundice (d) hyperbilirubinemia
and kernicterus
B - heart failure
caused by severe
anemia can occur
within the first few
hours of life.
What are two serological

procedures that would help
investigate a patient with
multiple antibodies? (a)
phenotyping (b) DAT (c) Antibody
panel (d) Rh tying
A and C
What class of antibody is

generally associated with an
anaphylactic reaction? (a) IgA (b)
IgD (c) IgE (d) IgG
A - Certain individuals
are genetically
deficient in IgA and will
have anti-IgA in their
plasma. Must receive
washed or frozenthawed RBCs from IgA
deficient donors.
What correction should be taken

for rouleaux causing positive test
results? (a) wash cells and dilute
serum (b) perform
autoabsorption (c) run a panel (d)
perform an elution
A - saline replacement
166.
What drug would cause the

following hemolytic anemia
reactions; poly AHG 3+, IgG AHG
3+, anti-C3d 0? (a) phenacetin (b)
quinidine (c) penicillin (d)
tolmetin
167.
168.
161.
162.
163.
164.
165.
169.
170.
What is component of choice for

Factor 5 deficiency? (a) platelet
concentrate (b) RBCs (c)
Cryoprecipitate (d) FFP
D - FFP contains
F2,5,7,9,10
171.

hemorrhagic episode during
intensice chemotherapy? (a)
platelet concentrate (b) RBCs (c)
A - platelets are
generally needed
during hemorrhagic
episode.
172.

Hypofibrinogenemia? (a) platelet
C - Cryo contains
vWF, fibrinogen,
fibrinectin, F8, and
F13.
173.

Liver Disease? (a) platelet
D - Liver disease can

have deficiencies in
F2,7,9,10 - all found
in FFP.
174.

von Willibrand disease? (a) platelet
C - Cryo contains
vWF (F8:C, F8:vW),
fibrinogen,
fibrinectin, F8, and
F13.
175.
What is not a cause for apositive

hemagglutination reaction during
crossmatch? (a) incorrect ABO of
donor (b) unexoected ab's in
recipient serum (c) Positive DAT on
recipient RBCs (d) Positive DAT on
donor RBCs
C - Crossmatch is
performed by using
donor RBCs and
recipient plasma.
176.
What is not avoidable in a

autologous blood transfusion? (a)
transmission of disease (b) clerical
error (c) allergic reactions (d) GvHD
C - penicillin causes the

profile observed w/o
complement activity.
177.
What is occuring during a 2+

reaction in gel? (a) antibody-coated
cells are trapped in suspension (b)
too heavy cell suspension (c)
hemolysis (d) mixed field
A - unbound cells go
right through
suspension while
bound cells get
trapped in
suspension
What grouping is most most

commonly associated with
fetomaternal incompatibility and
a positive neonatal DAT is: (a) ABO
(b) Rh (c) Kell (d) Kidd
A - Most common, but

rarely caused HDN
and there is no
treatment to prevent.
178.
What is one result of storage lesion?

(a) increased pH (b) increased
plasma K+ (c) increased plasma Na+
(d) decreased plasma Hgb
What Ig class is primarily

associated with ABO antibodies?
(a) IgA (b) IgG (c) IgE (d) IgM
B - results from
decrease in RBC
viability. K, Hgb, and
ammonia increase.
Na, pH, and 2,3-BPG
decrease. Due to
decrease in ATP.
179.
What is a characteristic of Xg(a)

blood group system? (a) higher in
women than men (b) higher in
men than women (c) enhanced by
enzyme (d) saline reacting
What is patients type: A2+, B4+,

AC2+, BC0? (a) A (b) B (c) AB (d)
further testing needed
D - front/back
discrepancy. Patient
could be A2B, r/o
with lectin testing
180.
What is the allowable shelf life

for AS-1 preserved blood
products? (a) 21 days (b) 35 days
(c) 42 days (d) not approved
anticoagulant
181.

for CPDA-1 preserved blood
anticoagulant
B - adenine helps ATP

regeneration

for CPD or ACD preserved blood
anticoagulant
183.

for EDTA preserved blood
anticoagulant
184.
What is the best explanation for

the following discrepancy:
A4+,B0,AC2+, BC4+? (a) elderly
patient (b) A subgroup (c) reagent
deterioration (d)
hypogammaglobinemia
B - anti-A reacts with all

A cells, patient also has
antibody to A1 cells.
What is the best specimen to

restore or maintain oxygencarrying capacity? (a) albumin (b)
cryoprecipitate (c) WB (d) RBCs
D - RBCs
What is the best treatment for

WAIHA? (a) transfuse packed
RBCs (b) infusion of FFP (c)
steroid exchange (d) plasma
exchange
C - steroids decrease
autoantibody
production.
Transfusion generally
increases autoantibody
production and RBC
destructio happens as
quickly to donor cells as
it does to patient cells.
187.
What is the blood banking

technique that removes
antibody from RBCs? (a) elution
(b) absorption (c) neutralization
(d) screening
188.
What is the component of choice

for someone who needs a RBC
transfusion when there is a
history of febrile transfusion
reactions? (a) RBCs less than 5
days old (b) Leuko-reduced RBCs
(c) RBCs 30-35 days old (d) frozen
RBCs that will be deglycerized
B - febrile transfusions
are usually brought on
by HLA and
granulocyte-specific
antigens.
182.
185.
186.
189.
What is the first action a nurse

should take when a patient
reports chills, fever, and back
pain after transfusion? (a) collect
post-transfusion specimen (b)
monitor pulse and BP (c)
discontinue the unit, keep line
open (d) page MD for instructions
C - discontinue and
keep the IV open so
medication may be
given to counter
transfusion reaction.
190.
What is the most common cause

of DTR? (a) blood typing (b)
antibody ID (c) Clerical (d)
Crossmatching
C - generally occur in
high-stress/highvolume areas
191.
What is the most important

factor to consider in WAIHA
patients suffering life-threatening
anemia? (a) Determine specificity
of autoantibody (b) determine Ig
class (c) exclude presence of
alloantibody (d) avoid
transfusion
C - transfusion may be
necessary, although
not advised. Auto's can
mask allo's easily and
could cause
transfusion reaction
and decrease oxygen
carrying capacity of
transfused cells.
192.
What is the most likely

cell/serum reaction for an A2
individual making anti-A1? (a) A+,
B+, AC+, BC+, OC+ (b) A+, B-, AC+,
BC+ OC- (c) A+, B+, AC-, BC+, OC(d) A-, B+, AC-, BC-, OC-
B - Type A person with

anti-A reacting
193.

cell/serum reaction for a
newborn? (a) A+, B+, AC+, BC+,
OC+ (b) A+, B-, AC+, BC+ OC- (c) A+,
B+, AC-, BC+, OC- (d) A-, B+, AC-,
BC-, OC-
D - no antibody
production. All
antibodies would be
maternal
194.

cell/serum reaction for a patient
who is immunodeficient? (a) A+,
B+, AC+, BC+, OC+ (b) A+, B-, AC+,
BC+ OC- (c) A+, B+, AC-, BC+, OC(d) A-, B+, AC-, BC-, OC-
D - no antibody
production leaves
negative backtyping.
195.

with an acquired infection due to
gram neg bacteria? (a) A+, B+,
AC+, BC+, OC+ (b) A+, B-, AC+, BC+
OC- (c) A+, B+, AC-, BC+, OC- (d) A-,
B+, AC-, BC-, OC-
C - patient is type A
with acquired B
antigen
196.

with antibodies to acriflavin
(yellow dye)? (a) A+, B+, AC+, BC+,
OC+ (b) A+, B-, AC+, BC+ OC- (c) A+,
B+, AC-, BC+, OC- (d) A-, B+, AC-,
BC-, OC-
C - false reaction in B
forward
197.

patient with an unexpected
IgM antibody in serum? (a) A+,
B+, AC+, BC+, OC+ (b) A+, B-,
AC+, BC+ OC- (c) A+, B+, AC-,
BC+, OC- (d) A-, B+, AC-, BC-,
OC-
A - positive backtyping
due to IgM
198.

patient with cold
hemagglutinin disease (CHD)?
(a) A+, B+, AC+, BC+, OC+ (b)
A+, B-, AC+, BC+ OC- (c) A+, B+,
AC-, BC+, OC- (d) A-, B+, AC-,
BC-, OC-
A - Cold agglutinin causes

false positives in
backtyping
199.

patient with MM? (a) A+, B+,
AC+, BC+, OC+ (b) A+, B-, AC+,
BC+ OC- (c) A+, B+, AC-, BC+,
OC- (d) A-, B+, AC-, BC-, OC-
A - agglutination in all
backtyping due to plasma
protein presence
200.
What is the most probable

reason for a Rh control
positive using washed RBCs
and low-protein monoclonal
anti-D? (a) Positive DAT with
anti-IgG (b) a cold
autoantibody (c) leukemia (d)
MM
B - low-protein reagents
exclude the change of
results being caused by a
positive DAT. Washed cells
eliminate the change of
MM. Wash with warm
saline and then use DTT
(destroys IgM).
201.
What is the next step for the

following unit:
A0,B0,D0,AC4+,A2C4+,BC4+,
weak D 1+, DAT 1+? (a) Label O
pos (b) Label O neg (c) Label O
pos, do not use plasma (d)
perform additional tests (e)
Discard unit
E - unable to tell is weak D

is accurate. Discard all DAT
positive blood.
202.

following unit: A0,B0, D0,
AC4+,A2C4+,BC4+, weak D 3+,
DAT neg? (a) Label O pos (b)
Label O neg (c) Label O pos, do
not use plasma (d) perform
additional tests (e) Discard
unit
A - weak D pos, treat as D

pos
203.

following unit:
A0,B0,D3+,AC0,A2C0,BC4+? (a)
Label O pos (b) Label O neg (c)
Label O pos, do not use
plasma (d) perform additional
tests (e) Discard unit
D - Perform tests to
identify discrepancy.
204.

following unit:
A0,B0,D3+,AC2+,A2C0,BC4+? (a)
Label O pos (b) Label O neg (c)
Label O pos, do not use plasma
(d) perform additional tests (e)
Discard unit
D - Perform lectin tests to

identify subgroup. Could
also use adsorption,
elution, titration, secretor
studies can also be done
if grouping is still
inconclusive.
205.

following unit:
A0,B0,D3+,AC4+,A2C3+, BC4+?
(a) Label O pos (b) Label O neg
(c) Label O pos, do not use
206.

following unit:
A0,B0,D3+,AC4+,A2C4+,BC4+,
Ab screen pos, Ab panel antiFy(a)? (a) Label O pos (b) Label O
neg (c) Label O pos, do not use
C - Unexpected ab's
should be separated
from RBC and label with
antibody ID'd.
Transfusing plasma can
cause decreased RBC
survival. Plasma may be
used for reagent usage,
but not for transfusion.
207.
What is the optimal

concentration of cell
suspension used in the tube
method? (a) 1-2% (b) 2-5% (c) 810% (d) 10-15%
208.
What is the origin of lectins? (a)

early form of monoclonal ab
priduced in nonvertibrates (b)
a plant substance that
chemically reacts with certain
RBCs (c) naturally occuring ab's
in plants (d) The ability of
plants to respond to RBC
antigens
209.
What is the percent yield of F8

if the satellite bag contained
250mL FP, final product has
10mL, F8 assays before and after
prep are 1 IU/mL and 9 IU/mL,
respectively? (a) 11% (b) 25% (c)
36% (d) 80%
C - F8 yield (F8 recovery)

= post (F8 volume) / pre
(F8volume). (9 IU/mL10
mL)/(1 IU/mL250mL) =
90/250 = 36% F8 recovery
What is the principle of the KB

test? (a) HbF is more resistant to
alk buffer than adult hemoglobin
(b) adult hemoglobin is more
resistant to alk buffer than HbF (c)
HbF is more resistant to erythrosin
and hematoxylin staining than
adult Hemoglobin (d) Adult
Hemoglobin is more soluble in
acid buffer that HbF
D - HbF is resistant to
acid elution. Stain
with erythrosin and
hematoxylin and fetal
cells appear bright
pink. count the
amount of fetal cells
per 2000 maternal
cells and multiply by
maternal BV to get
fetal bleed.
219.
What is the shelf life of platelet

concentrate in PL-732 with
agitation? (a) 24hrs (b) 5 days (c)
35 days (d) 1 yr
220.
What is the shelf life of RBCs in

CPDA-1? (a) 24hrs (b) 5 days (c) 35
days (d) 1 yr
221.
What is the shelf life of thawed

FFP? (a) 24hrs (b) 5 days (c) 35
days (d) 1 yr
What is the probable genotype of

this patient: D3+, C3+, E0, c3+, e3+,
Rh cont 0? (a) R1/R1 (b) R1/r (c) R2/r
(d) Rr
B need heterozygous
Cc and homozygous
ee. D genotyope
unknown
222.
What is the storage temp of

Cryoprecipitate? (a) 1-6 deg (b)
20-24 (c) < -18 (d) < -65
223.
What is the process of removing an

antibody from the RBC
membrane? (a) absorption (b)
adsorption (c) elution (d)
immunization
C - by temperature,
chemical, or pH
changes
What is the storage temp of FFP?

(a) 1-6 deg (b) 20-24 (c) < -18 (d) < 65
224.

frozen RBCs? (a) 1-6 deg (b) 20-24
(c) < -18 (d) < -65
What is the purpose of 37 deg

incubaction for IAT? (a) allow time
for IgM ab's to attach (b) allow
time for IgG's to attach (c) allow
time for AHG to react with RBCs (d)
allow time for AHG neutralization
225.

platelet concentrate? (a) 1-6 deg
(b) 20-24 (c) < -18 (d) < -65
B - and aggitated
226.
What is the purpose of adding

adenine as a anticoagulantpreservative? (a) Maintain ATP for
RBC viability (b) Maintain platelet
function in storage (c) Reduce
plasma K+ during storage (d)
Maintain 2,3-DPG levels for
oxygemn release to tissues
A - adenine improves
in vitro viability
during storage by
allowing continual
generation of ATP.

RBCs, liquid? (a) 1-6 deg (b) 20-24
(c) < -18 (d) < -65
227.
What is true of the gel test? (a)

indicator cells are needed (b)
AHG control cells are required
(c) microtubes are not required
(d) saline washes are not
required
D - only suspension
prep is needed
228.
215.
What is the purpose of LISS

addition to IAT at 37 deg? (a)
increase the ab uptake rate (b)
decrease the ab uptake rate (c)
neutralize proteins (d) maintain
neutral pH
What labile antibody is a

frequent cause of DTRs? (a) antiA (b) anti-D (c) anti-Jka (d) anti-K
216.
What is the result of a decrease in

2,3-BPG levels in stored blood? (a)
RBC K+ increase (b) RBC ability to
release O2 decreases (c) Plasma hgb
is stabilized (d) ATP synthesis
increases
B - low 2,3-BPG
increases RBC affinity
for O2. plasma K+
increases, not RBC K+.
C - anti-Jk(a) is weak,
labile, and often goes
undetected in
pretransfusion testing.
Kidd antibodies are
often IgG, warm
reacting, and
complement
dependent.
229.
What permanently disqualifies a

donor? (a) syphilis (b) gonorrhea
(c) accutane treatment (d) GH
treatment/recipient
D - GH recipient. Due to
possible CJD
transmission.
217.
What is the shelf life of

Cryoprecipitate? (a) 24hrs (b) 5
days (c) 35 days (d) 1 yr
230.
A - for major crossmatch
218.
What is the shelf life of FFP? (a)

24hrs (b) 5 days (c) 35 days (d) 1 yr
What samples are required to

perform compatibility testing?
(a) patient serum and donor
cells (b) donor serum and
patient cells (c) patient serum
and donor serum (d) patient
cells and donor cells
210.
211.
212.
213.
214.
What should happen to

RBCs if the hermetic seal is
broken during
preparation? (a) discarded
(b) if CPD, label with 21-day
expiration (c) labeled with
24hr expiration (d) May be
glycerolized within 6 days
and stored frozen
C - keep at 1-6 deg after

broken and use immediately
to avoid bacteremia. Can also
be glycerolized and frozen
with in the 24hr period.
232.
What type of cells are

acceptable to transfuse to a
A neg 25 year old woman?
(a) A neg or A pos (b) A neg
only (c) AB neg (d) A neg or
O neg
233.
What type of RBCs are

acceptable to tranfuse to
an O neg patient? (a) A neg,
AB neg, B neg (b) O neg (c)
AB neg (d) AB neg, A neg, B
neg
234.
What type of transfusion

reaction is often diagnosed
by a positive DAT and a
gradual drop in patients
Hgb levels? (a) anaphylactic
(b) febrile (c) Delayed
hemolytic (d) acute
hemolytic
C - Usually occurs within 3-14

days after transfusion.
Causes extravascular
hemolysis, hence positive
DAT. Marks secondary
exposure to antigen. Acute
hemolytic reaction is due to
complement activation and
will result in intravascular
hemolysis.
231.
235.
236.
237.
What unit should be used

for a patient undergoing
intrauterine transfusion?
(a) Group A, D-neg RBC (b)
Group A, D-neg WB (c)
Group O, D-neg RBC (d)
Group O, D-neg WB
What unit type is least

likely to transmit HIV, HCV,
or HBV? (a) pooled plasma,
solvent/detergent treated
(b) cryoprecipitate (c)
Leuko-reduced RBCs (d)
Platelets
A - treating pooled plasma is

very effective at reducing
transmission risk.
What unit would be

transfused if a patient had
normovolemic anemia? (a)
platelet (b) RBC (c) RBC
leuko-reduced (d)
transfusion not indicated
B - general RBC. smallest

volume necessary to avoid
hypervolumemia
238.
What unit would be transfused if

a patient is thrombocytopenic
secondary to treating acute
leukemia? (a) platelet (b) RBC (c)
RBC leuko-reduced (d)
transfusion not indicated
A - leuko-reduced
platelets are the best for
leukemic patients with
plts < 20,000 uL.
239.

a patient requires transfusion
RBC that will not transmit CMV?
(a) platelet (b) RBC (c) RBC leukoreduced (d) transfusion not
indicated
C - leuko-reduced RBCs
are needed to be </=
5e6 to avoid febrile
episodes, CMV
transmission, GvHD, or
patient
alloimmunization by
leuks.
240.

a patient with WAIHA due to
methyldopa with hgb > 8.5 g/dL?
(a) platelet (b) RBC (c) RBC leukoreduced (d) transfusion not
indicated
D - WAIHA from
methyldopa will rapidly
correct after cessation of
drug.
241.
What virus is associated with a

high asymptomatic carrier rate,
10% of which develop cirrhosis
or hepatocellular carcinoma? (a)
HAV (b) HBV (c) HCV (d) HEV
C - HCV is the only virus

associated with
hepatocellular
carcinoma. Acute
infection is generally
asymptomatic but
carrier state shows
carcinoma, cirrhosis
dev't.
242.
What would be an inappropriate

reason to conduct compatibility
testing? (a) prevent
alloimmunization (b) ABO/Rh
verification (c) ensure proper
issue of blood products (d)
detect recipient antibodies
D - should have already

ID's clinically significant
antibodies
243.
Whay are patient RBCs washed

before addition of AHG reagents
in DAT? (a) remove bacterial
proteins (b) remove traces of
hemoglobin (c) expose
additional antigen sites(d)
remove unbound serum
proteins
244.
When is autologous donation

not advisable? (a) Patient with
antibody against high-incidence
antigen (b) uncompensated
anemia (c) open heart surgery (d)
multiple antibodies
B - cannot alter patient

RBC volume
245.
When will a mixed-field be observed?

(a) DAT of patient undergoing a DTR
(b) IAT of a patient who has anti-Le(a)
(c) DAT result of a patient on high
doses of methyldopa (d) Typing result
of anti-A in a patient who is A2
A - Donor cells will

be coated and
patient cells will be
uncoated, resulting
in mixed-field.
255.
Which f the following will be

incompatible in the crossmatch? (a) D
= A, D neg; Pt = A, D pos (b) D = O, D
pos; Pt = A, D pos (c) D = AB, D pos; Pt
= A, D pos (d) D = A, D pos; Pt = A, D
neg
C - major
incompatibility
246.
Which antibodies can be neutralized

with pooled human plasma? (a) Hy,
Ge:1 (b) Ch(a), Rg(a) (c) Co(a), Co(b) (d)
Do(a), Js(b)
B - Chido and
Rodgers are pieces
of complement C4
256.
Which Ig class is generally associated

with HDN? (a) IgG (b) IgD (c) IgE (d) IgG
D - Only
transplacental Ig
257.
247.
Which antibody carries no rick of

HDFN? (a) anti-Lea (b) anti-C (c) anti-K
(d) anti-Lea
D - Lewis is IgM
Which is acceptible to be given

intravenously with a transfusion? (a)
5% dextrose in water (b) physiological
saline (c) ringer's solution (d)
potassium chloride in saline
248.
Which antibody has been clearly

implicated in transfusion reactions
and HDN? (a) anti-I (b) anti-K (c) antiLe(a) (d) anti-N
B - Kell in the most

immunogenic
antigen aside from
Rh and ABO. IgG
detected at AHG.
B - saline is the
only acceptible
product. Ringer's
causes small clots.
5% dextrose
causes RBC lysis.
258.
D - Along with Rh,

Kell, and Duffy
Which antibody is most likely to

cause HDN? (a) anti-Lea (b) anti-c (c)
anti-P1 (d) anti-K
B - could be c or K,
but c antigen is
much higher
frequency (80% vs
10%)
Which is characteristic of Kidd

antibodies? (a) usually IgM (b)
Destroyed by enzyme (c) strong and
stable during storage (d) often
implicated in DTR
259.
Which is heterozygous for C antigen?

(a) R1/r (b) R2/R2 (c) R1/R1 (d) r'/r'
260.
Which is not considered a useful

predictor of HDN during gestation?
(a) anti-A (b) anti-D (c) anti-Fya (d)
anti-U
A - all others are

unexpected
antibodies.
261.
Which is not included in routine,

early prenatal testing? (a) ABO/Rh (b)
antibody screening (c) amniocentesis
(d) weak D on Rh mothers
C - amniocentesis
is only peformed
when clinically
indicated. As early
as 14 weeks.
262.
Which is NOT necessary when testing

cord blood samples? (a) ABO (b) Rh (c)
DAT (d) antibody screen
D - only necessary
after positive DAT
warrants antibody
work up
263.
Which is not true of an exchange

transfusion from HDN? (a) remove
unconjugated bilirubin (b) reduces
incompatible antibody in the babies
circulation (c) remove antibody
coated RBCs (d) provide RBCs for the
baby's type
D - unnecessary,
need to provide O
neg cells b/c of the
maternal antibody
source. Do not
really care about
babies type.
264.
Which is not true of anti-Fy(a) and

anti-Fy(b)? (a) clinically significant (b)
enhanced by enzyme (c) Cause HTR's
(d) Cause mild HDN
B - Kidd, I, Lewis,
Rh, ABO, P1 are
enhanced by
enzyme
265.
Which may produce ABO

discrepancies in serum testing? (a)
Newborn (b) hypogammaglobinemia
(c) cold alloantibody (d)
hypergammaglobinemia
D - hypo may
cause no
backtyping also
249.
250.
251.
Which blood group may change

during pregnancy? (a) P (b) MNS (c)
Lewis (d) Duffy
C - lewis is
absorbed onto
RBC membranes.
Pregnant women
have increase RBC
mass and can
appear to be Le(ab-) .
Which blood type requires an

additional Rh control tube when
using a monoclonal anti-D reagent?
(a) O pos (b) A pos (c) D pos (d) AB pos
D - Need to have a
negative control.
Patient cells +
albumin (or patient
serum autocontrol).
252.
Which cell is the correct cell to use

for anti-Fy(a) reagent? (a) Fy(a+b-) (b)
Fy(a+b+) (c) Fy(a-b+) (d) Fy(a-b-)
B - Need cell with

weakest Fy(a)
expression
253.
Which criteria disqualifies this

person from blood donation? (a) 110
lbs (b) pulse = 73 bpm (c) BP = 125/75
mmHg (d) Hct = 35%
D - hematocrit
needs to be >/=
38%
Which does FFP not provide? (a) F5

(b) F8 (c) F9 (d) Platelets
D - FFP contains
clotting factors
only. Platelets are a
cellular element
and need to be
stored at 20-24 deg
Celcius.
254.
266.
Which of the following antibodies

does not match the others as far as
optimal temperature is concerned?
(a) anti-Fya (b) anti-Jka (c) anti-N (d)
anti-U
C - reacts at RT
saline. The others
go to AHG.
278.
Which of the following specimens

could be used as a crossmatch
specimen for RBCs ordered? (a) 1
day old (b) 4 days old (c) 1 week
old (d) 1 month old
A - 3 days max. A is the

only specimen that fits
that description.
267.
Which of the following antibodies is

neutralizable? (a) anti-D (b) anti-Jka
(c) anti-Lea (d) anti-M
C - ant-Le(a) is not
a cell membrane
and can be
absorbed in the
serum
279.
268.
Which of the following blood group

systems are generally IgM? (a) duffy (b)
Rh (c) Kell (d) Lewis
Which of the following sugars

must be present on a precursor
substance for A and B antigenic
activity to be expressed? (a) Dgalactose (b) NAcetylgalactosamine (c) Glucose
(d) L-fucose
D - fucose is a
precursor to all A,B
antigens. Galactose
will lead to A antigen.
N-acetylgalactosamine
will lead to B antigens
280.
269.
Which of the following is associated

with a rare allele of M and N? (a)
MacLeod phenotype (b) M(g) (c) Kp(a)
(d) Ss
A - Only D-negative
units need to be
confirmed
270.
Which of the following is associated

with weak Kell expression? (a)
(d) Ss
A - all Kell
associated
substances are
expressed weakly
Which of the following tests must

be repeated on donor units if they
were not collected at the
transfusion facility? (a) ABO/Rh
confirmation on D negative units
(b) ABO/Rh confirmation on all
units (c) Weak D on all D negative
units (d) antibody screening
281.
D - all of the above
271.
Which of the following is

assocociated with chronic
granulomas disease? (a) MacLeod
phenotype (b) M(g) (c) Kp(a) (d) Ss
Which of the following units

should be labelled weak D
positive? (a) weak D due to
transmitted disease (b) weak D as
position effect (c) weak partial D
(d) all of the above
272.
Which of the following is destroyed

during enzyme treatment? (a) anti c
(b) anti K (c) anti-Jka (d) anti Fya
D - remember
DMX (Duffy, MNSs,
Xg)
282.
D - cannot predict the

in vivo response to
transfuse RBCs.
273.
Which of the following is generally

detected at AHG phase? (a) anti-Jka (b)
anti-M (c) anti-P1 (d) anti-I
Which of the following will the

crossmatch do? (a) prevent
immunization (b) prevent DTR (c)
guarantee normal survival of RBCs
(d) frequently verify donor ABO
compatibility
274.
Which of the following is least likely

to transmit hepatitis? (a)
Cryoprecipitate (b) RBCs (c) Plasma
protein fraction, PPF (d) platelets
C - PPF is pooled
and heated at 60
deg Celcius for
10hrs. Virtually no
chance of viral
transmission.
283.
Which of the following would

react least strongly to anti-H? (a) O
(b) A2B (c) A2 (d) A1
DO>B>A2>A2B>A1>A1B
284.
Which of the following is linked with

MN? (a) MacLeod phenotype (b) M(g)
(c) Kp(a) (d) Ss
Which set of antibodies could you

possibly find in a patient with no
history of transfusion or
pregnancy? (a) anti-I, s, P1 (b) Lea,
A1, D (c) M, c, B (d) P1, Lea, I
D - these three
antibodies are often
non-RBC stimulated
antibodies.
285.
276.
Which of the following is not true

about anti-U? (a) clinically significant
(b) is only found in black individuals
(c) only occurs in S-s- individuals (d)
Only occurs in Fy(a-b-) individuals
D - No relation to
Fy(a-b-). 99% of
black people are
U+. 100% of whites
are U+.
Which situation would be

inappropriate for IAT testing? (a)
Weak D for Rh neg donor (b) major
crossmatch (c) antibody screening
(d) cord blood testing for
antibody fixed in vivo
D - DAT and elution

more appropriate for
antibody ID
277.
Which of the following is

predominantly found in whites? (a)
(d) Ss
C - Kp(a) is only
reported in whites
286.
Which test(s) is/are not performed

during routine donor processing?
(a) ABO/Rh (b) HBAg (c) HIV ab (d)
HBAb
D - Hepatitis immunity
would not tell you
anything
287.
Which virus resides exclusively in

leukocytes? (a) CMV (b) HIV (c) HBV
(d) HCV
A - CMV is exclusively
found inleukocytes
275.
288.
Which will cause an incompatible major crossmatch? (a) Pt A pos, Donor A neg (b)
Pt A pos, Donor O pos (c) Pt A pos, Donor AB pos (d) Pt A neg, Donor A pos (e) Pt A
neg, Donor O pos
C - all the other's are either compatible or

present minor incompatibility (Rh)
289.
Which would not indicate antibody presence? (a) positive crossmatch (b) positive
ab screening (c) rouleaux (d) forward/reverse typing discrepancy
C - D could also be to unwanted plasma

protein or weak antigen expression due to
leukemia
290.
A white female's RBC's have phenotype: D+C+E-c+e+, which genotype is most likely?
(a) DCe/Dce (b) DCe/dce (c) DCe/DcE (d) Dce/dCe
B - DCe/dce are very common in white

individuals , approximately 31% of the
white population
291.
Why is serum containing anti-k very rare? (a) most people are k+ (b) most people are
k- (c) k antigen is not a good immunogen (d) Kell(null) people are rare
A - k antigen (public antigen) is high

frequency, > 99% of population.
292.
Why might a patient not be able to perform autologous donation? (a) 100 lbs (b) 14
yrs old (c) Hgb 12 g/dL (d) Mild bacteremia
D - Mild bacteremia (bacteria proliferates

in storage)
293.
Why should patients RBCs be washed after DAT? (a) prevent hemolysis (b) prevent
neutralization (c) prevent pseudoagglutination (d) to remove RBCs
294.
A woman who had a baby 2 months ago wishes to donate blood for allogenic
transfusion: (a) defer temporarily (b) defer for 1 year (c) defer indefinitely (d) accept
D - deferral for childbirth is 6 weeks unless

mothers blood is needed for her infant.

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Blood Bank Review Questions

Study online at quizlet.com/_bfopt

A 2+ reading in gel would

C - most cells passed

A 65 year old man whose birthday is

A 12% suspension in saline is

A 70 kg male with a plt count of 15,000

A 18 year old with poison ivy in

D - unless rash covers

AABB standards require two unique

A 25 year old man who had

D - HDN is not a cause for

The ab normally found in the serum of

A 26 year old B neg female

A african american patient has

After addition of onoclonal anti-D,

A 35 year old runner with a

After a transfusion reaction, which

After donation, a donor is found to be at

After leukocyte reduction, what

A 45 year old woman donated

A - minimum time between

A 50 year old man who had

C - any male-male sex after

After receiving part of an RBC unit, a patient

After releasing blood for emergency release

An ag:ab reaction alone does not cause

Agglutination characterized with many

AHG in the DAT is used: (a) to provide

All cells in a cell panel using LISS reacts 3+

An alloantibody is: (a) called an isoantibody

Antibodies to D antigen are usually

The antibody produced during a

These antigens are primarily

The antiglobin test does not

Antisera to ABO antigens is(are):

At he end of AHG test, if negative

An autocontrol is positive only in

Bacterial sepsis is highest among

D - most bacterial grow

The BB procedure manual must

Before transfusion, what is not

The best way to make a positive

D - babies blood is a much

A black patient has the

C - B is the most frequent.

Calculate percent yield of

Calculate the final percent

Cells used to make reagent

CHD is associated with what

Check cells are prepared by

B - the only positive

Criteria determining RhIg eligibility

The crossmatch is performed using:

Cryoprecipitate generally treats

The DAT is useful for: (a) ID unknown

A D negative woman received one

A donor has taken 2 tablets of

During a reported HTR, a pretransfusion

Failure to yield a positive antigenantibody result due to excess antibody is

False negative at AHG phase of antibody

The following has been obtained: A0,

The following platelet