Blood Products

The minimum Hb concentration in a fingerstick from a blood donor is:

12.5

the value must not be performed on an earlobe stick.

All donors, regardless of sex, require a minimum hemoglobin of 12.5 g/dL.

Blood Products

A cause for permanent defferal for blood donation is

History of jaundice of uncertian cause.

jaundice is a sign of liver impairment, which might be due to HBV or HCV, Infection with HBV  and HCV is a cause for indefinite defferral.

Blood Products

Which of the following perspective donors whould be accepted for donation.

a thirty-two year old woman who recieved a transfusion 5 months previously.

a 19 year old sailor who has been state-side for 9 months.

a 22 year old college who has a temperture of 99.2.

a 45 year old woman who has just recovered from bladder infection and is still taking antobiotics.

a thirty-two year old woman who recieved a transfusion 5 months previously.NO, 6 MONTH DEFFERAL

a 19 year old sailor who has been stateside for 9 months.NO, travel in malaria area 12 months

a 22 year old college who has a temperture of 99.2 YES temp must be over  99.5 to reject

a 45 year old woman who has just recovered from bladder infection and is still taking antobiotics.NO could have transient bacteremia

Blood Products

Which of the following constitutes permanent rejection status of a donor.

Tatoo 5 months previously.

recent close contact with a patient with a patient with hepatitus.

2 units of blood transfused 4 months previously.

Confirmed positive test for HBsAg 10 years previously.

Confirmed positive test for HBsAg 10 years previously

A positive test for HBsAg at any time is an indefinite deferral.

Blood Products

According to AABB standards, which of the following  donors may be accepted as a blood donor.

Traveled in an area endemic for malaria 9 months previously.

Spontaneous abortion at two months of pregnancy , 3 months previoulsy.

resides with a known hepatitis patient.

recieved a blood transfusion 22 weeks previously.

Traveled in an area endemic for malaria 9 months previously.NO

Spontaneous abortion at two months of pregnancy , 3 months previoulsy.YES, ok after 6 weeks.

resides with a known hepatitis patient.No

recieved a blood transfusion 22 weeks previously. NO

Blood Products

Below are the history obtained from a prespective female donor.

Age: 16, Temp: 99.0, Hct: 36%, History: tetanus toxoid immunization 1 week.

How many results excludes the donor from giving blood.

The Hct. must be 38%. A donor may be 16 unless state law differs. Temp must not exceed 99.5. Blood pressure must be < 180 systolic and < 100 diastolic. Pulse 50-100 unless an athelete (which can be lower). Toxoids and vaccines from synthetic or killed sources have no deferral. 

Blood Products

For aphoresis donors who donate platelets more frequently than every four weeks , a platelet count must be performed prior to the proceedure , and must be more than

150 x 10³

A minimum platelet count required for frequent repeat donors is: 150 x 10 ³  /uL.

A platelet count is not required prior to the first donaton or if the interval between donations is a least 4 weeks.

Blood Products

Prior to blood donation the intended veinapuncture site must be cleaned with a scrub solution containing:

Blood Products

All blood donor testing must include:

Serological test for syphilis.

Testing for syphilis was the first mandated doror screening test for infectious disease and is still part of the donor screening.

Blood Products

During the preparation of Platelets from whole blood should be :

Cooled towards 20-24 degrees

Platelets are prepared and stored at 20-24 degrees centigrade.

Blood Products

The most common cause of post-transfusion hepatitis can be detected in donors by testing for :

HBsAg.

The most common post-transfusion hepatitis is hepatitis B. The estimated risk of transmission is 1:220,000 units transfused.

The risk of hepatitis C transmission is 1:180,000 units. Hepatitis B surface Antigen is a required donor test for detection of acute or chronic HBV infection.

Blood Products

The Western blot is a confirmatory test for the presence of:

anti-HIV

Western blot uses purified HIV proteins  to confirm reactivity in samples whose screening test for  anti- HIV is positive.

Blood Products

The test that is currently used to detect donors who are infected with the AIDS virus is

anti-HIV 1,2

The causitive agent of for AIDS is the human immunodificiency virus types 1 and 2

Blood Products

A commonly used screening method for HIV-1 detection is:

The enzyme labeled immunosorbent assay (ELISA) method is a very sensitive method employed to screen donors for markers, of transfusion transmitted viruses.

Blood Products

Rejuvenation of a unit of Red blood cells is a method used to:

Blood Products

A unit of packed cells is split into two aliquots under closed sterile conditions at 08:00AM. the expiratrion time for each unit is now:

The original date of the unsplit unit

Sterile docking devices allow entry into donor units without affecting the expiration date of the product.

Blood Products

A unit of red cells is expiring in 35 days is split into 5 small aliquots, using a sterile pediatric quad set. and a sterile connecting device, each aliquot must be labeled as expiring in :

35 days.

Sterile docking devices allow entry into donor units without affecting the expiration date of the product.

Blood Products

When platelets are stored on a rotator set on an open bench top, the ambiant air temperture must be recorded:

every four hours.

If storage devices do not have automated temperature recording, temperatures must be manually monirtered every four hours.

Blood Products

If the seal is entered on a unit of Red blood cells stored at 1-6*C What is the Maximum allowed storage period in hours?

24 hours

If the seal is broken during processing components are considered to be prepared in an open system rather than a closed system. The expiration time for Red Blood Cells in an open system is 24 hours. 

Blood Products

The optimal storage tempreature for red blood cells is

4C

Red blood cells are stored at 1-6C

Blood Products

The optimum storage temperture for Red Blood cells, frozen is:

-65*C or lower

Red Blood frozen with 40% glycerol is

 -65*C or lower.

Blood Products

Which of the following is the correct storage temperture for the component listed.

Cryoprecipatated AHF, 4*C

Fresh Frozen Plasma, -20*C

Red Blood Cells, Frozen, -40*C

Platelets, 37*C

Blood Products

A unit of red cells is issued at 09:00 AM. At 09:10 the unit is returned to the blood bank.The container has not been entered, but the unit has not been refrigerated during this time span. The best course of action for the technologist is to

Record the return and place the unit back in the inventory.

Blood may be returned to the blood bank after issue provided that

 1. The container has not been entered.

2. At least 1 sealed segment is attached to the container.

3. visual insepection of the unit is satifactory and documented.

4. The unit has been maintained at the appropriate storage and transport temperture.

Studies have shown that components retain an acceptible temperature of < 10C for up to 30 mins after removal from the refrigerator.

Blood Products

The optimum storage temperture for

Cryoprecipitated AHG is:

Cryoprecipitated AHG is stored at -18C or lower.

Blood Products 

Cryoprecipitated AHG must be transfused within what period of time following thawing and pooling?

4  hours

Cryoprecipitated AHG must be transfused within 4 hours of pooling.

Blood Products

Platelets prepared in a polyolifin type container stored at 22-24C in 50ml of plasma and gently agitated may be used up to

5 days

Whole blood derived platelets are stored at 20-24C with continuos gentle agitation. Platelets prepared by PRP method may be stored up to 5 days.  

Blood Products

The optimum storage temperature for platelets is

22C

The required temperature for platelets is 20-24C

Blood Products

According to AABB standards, Fresh Frozen Plasma must be infused within what period of time following thawing?

Blood Products

Cryoprecipitated AHF, if maintained in the frozen state at -18 C or below, has a shelf life of:

Cryoprecipitate has a shelf life of 12 months in the frozen state.

Blood Products

Once thawed, Fresh frozen Plasma must be transfused within :

Blood Products

The important determinant of platelet viability during storage is:

Plasma pH.

The pH of platelets should be maintained at 6.2 or above throughout the storage period.

Blood Products

During storage the concentration of 2,3-diphosphoglycerate decreases in a unit of:

Red Blood Cells.

2,3-DPG declines during storage in a unit of Red Blood Cells, causing a shift to the left in the oxygen dissociation curve and an impared ability to deliver oxygen to the tissues.

 this is called storage leision

Blood Products

In a Liquid (thawed) state plasma must be stored at:

Blood Products

Cryoprecipitated AHF

Is indicated for fibrinogen deficicies.

 Cryoprecipitate is used primarily for fibrinogen replacement. It is stored at room temperture(20-24C) after thawing and must be infused within 6 hours. If pooled with other cryo units, it must be infused within 4 hours.

Blood Products

Which aphoresis product should be irradiated.

Blood Products

Irridiation of  a unit of red blood cells is done to prevent the replication of donar:

lymphocytes

Irriadiation inhibits the proliferation of T lymphocytes.

Blood Products

plastic bag overwraps are recommended when thawing units of FFP in a 37C water bath because they prevent

The entry ports from becoming contaminated with water.

 FFP thawed in a water bath should be protected so that entry ports are not contaminated with water. One may use a plastic overwrap to keep ports above the water level.

Blood Products

Which of the following blood components must be perpared within 8 hours after phlebotomy

FFP

Fresh Frozen Plasma must be separated and frozen within 8 hours of whole blood collection.

Blood Products

Cryoprecipitate AHF, contains how many units of factor VIII

80

Cryoprecipitate contains at least 80 units of AHF.

Blood Products

Which of the following blood components contains the most Factor VIII concentration relative to volume.

Cryoprecipitated AHF.

Cryoprecipitated AHF contains at least 80 IU of factor VIII concentrate in about 10 ml of plasma.

Blood Products

The most effective component to treat a patient with fibrinogen deficicency is:

Cryoprecipitated AHF.

 Cryoprecipitate is indicated as a source of fibrinogen for hypofibrinogenemia, It contains a minimum of 150 mg of fibrinogen concentrated in a small volume of plasma.

Blood Products

A blood component prepared by thawing fresh frozen plasma at refrigerator temperture and removing the fluid portion is :

Cryoprecipitated AHF.

Cryoprecipitate is the fraction of plasma proteins that precipitate when FFP is slowly thawed at 1-6C

Blood Products

Upon inspection a unit of platelets is noted to have visable clots, but other wise appears normal. The technologist should:

Quarentine and gram stain the culture.

Clots in a unit may indicate contamination.

Blood Products

According to AABB standards, 90% of all aphoresis platelet units  tested shall contain a minimum number of how many platelets.

3.0 x 10¹¹

Per AABB standards, at least 90% of the platelet phoresis units  sampled must contain at least 3.0 x 10 ¹¹  platelets

Blood Products

According to AABB standards, platelets prepared from whole blood should have at least

5.5 x 10¹⁰

Per AABB standards at least 90% of the platelets prepared from whole blood that are sampled must contain at least

5.5 x 10¹⁰  platelets

Blood Products

Which of the following is the proper procedure for the preperation of platelets from whole blood.

light spin followed by a hard spin.

Whole blood derived platelets are prepared by a light spin to separate the red blood cells from the platelet rich plasma (PRP), followed by a heavy spin of the PRP to concentrate the platelets.

Blood Products

According to AABB standards What is the minimum Ph required for platelets at the end of the storage period.

6.2

Per AABB standards, at least  90% of platelet units sampled must have a Ph of a least 6.2 at the end of the allowable storage.

Blood Products

According to AABB platelets must be:

gently agitated if stored at room temperture.

 Per AABB standards store platelets at 20-24C  with constant agitation. Platelets must be separated from whole blood units and maintained at a temperture  of a least 20C. The Ph must be at least 6.2 at the end of the storage period. 

Blood Products

A unit of whole blood derived (random donor) Plateltes should contain at least

5.5 x 10 ¹⁰  Platelets

Whole blood derived (random donor)Platelets should contain at least 5.5 x 10¹⁰  Platelets, be stored with continous agitation at 20-24C and have a Ph of 6.2 or higher when tested at the end of the storage period.

Blood Products

Platelets prepared by Aphoresis should contain at least:

Blood Products

Leukocyte reduced red blood cells are ordered for a newly diagnosed bone marrow candidate . Which way is the best way to prepare this product.

Transfuse through a log³ leukocyte removing filter

 Newly diagnosed bone marrow candidates  are at great risk for severe sequelae of CMV infection. Infection can best be reduced by using leukocyte reduction filters.  CMV sero-negative units are rarely used since leukocyte reducing via filtration is so effective. Washing does not remove as many leukocytes as filtering.

Blood Products

Of the following blood components which should be used to prevent HLA alloimmunization of the recipient.

Leukocyte reduced red blood cells.

 Luekoreduction of blood products reduces donor leukocytes to less than 5 x 10⁶ and decreases the risk of HLA alloimmunization

Blood Products

A father donating patelets for his son is connected to a continous flow machine, which uses the principle of centrufugation to separate platelets from whole blood. As the platelets are harvested, all other remaining elements are returned to the donor. This method for platelet collection is known as:

Aphoresis

The Aphoresis process is to remove whole blood, the desired component removed, and the remaining portion of blood returned to the donor /patient.

Blood Products

To qualify as a donor for autologous transfusion a patients Hgb should be at least:

11g/dL

Autologous donors have less stringent criteria than allogenic donors. Donations must be collected at least 72 hours prior to surgery.

Blood Products

What is the maximun pretransfusion testing requirement for autologous donations

ABO and Rh type only,

Only ABO and Rh is required with the patients sample.. Each autologous unit must be confirmed for ABO and Rh from an integrally attached segment.

Blood Products

In a quality assurance program, Cryoprecipitayed AHF must contain a minimum of how many international Units of factor VIII

80IU

FDA requires that 4 representative units be tested each month for factor VIII levels of 80 IU or higher. If the average value is less than 80IU of factor VIII, corrective action must be taken.

Blood Products

An assay of plasma from a bag of cryoprecipitate AHF yealds a concentration of 9 International Units of factor VIII per mL of cryoprecipitated AHF. If the volume is 9 mLs What is the factor VIII

81

To determine the total IU of factor VIII per bag of cryoprecipitate , multiply the assayed value /mL in the container.

Blood Group Systems

Mother is R1r, Father is R1R1 Which of the  statement best describes the most probable genotypes of the 4 children

R1=DCe

r-dce

Blood Group Systems

The linked HLA genes on each chromosome constitute an

HAPLOTYPE

The entire set of HLA antigens located on one chromosome is a haplotype.

Blood Group Systems

An individuals red blood cells give the following reactions with Rh antisera:

Anti-D 4+

anti-C 3+

anti-E 0

anti-c 3+

anti-e 3+

Rh control 0

Most probable genotype is

DCe/dce

R1r

Thr RHD gene is more likely inherited with Ce than with ce.This genotype is found in 31% of white and 15% of the black population

Blood Group Systems

A blood donor has the genotype hh,AB. What is his red cell phenotype.

You GOTTA HAVE H TO EXPRESS AorB

O

The A and B structures can not be developed since there is no H precursor.

Blood Group Systems

An individual has been sensitized to the k antigen. and has produced anti-k. what is her most probable Kell system phenotype.

KK

This individual cannot have any K antigen on their cells, K_O K_O is rare and no kell system antigens are detected on the red blood cells. Those individuals usually produce antigens that are reactive with all normal cells. KK is the most probable geneotype.

Blood Group Systems

Given the following typing results what is the donors ethnicity?

Fy^a (a-b-)

African American,

(a-b-) individuals are very rare with all populations other than the individuals of african decent. 68% of African americans are Fya(a-b-)

Blood Group Systems

In an emergency situation, Rh negative red cells are transfused into an Rh positive person of the genotype CDe/CDe. The first antibody most likely to develop is:

anti-c

The most common genotype in Rh negative individuals is rr. An anti-e would not form because the recipiants red cells contains the e antigen. the first antibody likely to develop would be anti-c.

Blood Group Systems

Most blood group systems are inherited as:

autosomal dominant

Blood group genes are autosomal. They are not carried on the sex gene. Whenever the gene is inherited the antigen is expressed on the red blood cells. which is known as co-dominant.

Blood Group Systems

The Mating of an Xg(a+) man and an Xg (a-) woman will only produce

Xg(a-) sons and Xg(a+) daughters.

The Xg blood group is unique in that the gene encodes on the X chromosome. A negative mother would not have Xg to pass on, A positive father however would transmit the Xg gene to all of his daughters,

Blood Group Systems

Refer to the following Data

Anti-C+,Anti-D+,Anti-E+,Anti-c+,Anti-e+

given the reactions above which is the most possible genotype.

DCe/DcE

All common antigens are present on the red blood cells R1(DCe) and R2(DcE) are the most frequent genotypes.

Blood Group Systems

A patients red cell types as follows

anti-D 4+,anti-C-,anti-E-

R_O R_O is the only correct choice here.

 R_O= D+ C- E- c+ e+

R_o  = Dce

Blood Group Systems

The red cells of the non-secretor will most likely type as

Le(a+b-)

you gotta be b+ to be a secretor

The Lewis antigens are developed by gene interaction. both the lewis and secretor gene are required for red cells to type as Le(a-b+) if a person has a Lewis gene and not a secretor gene then the cells type as Le(a+b-). The Le (a-b-) phenotype is derived when the Lewis gene is absent may or may not be present. The Le (a+b-) phenotype occurs in 22% of the population  and the Le (a-b-) occuts in 6% so the most likely phenotype of a non-secretor (se/se) is Le(a+b-)

Blood Group Systems

Which of the following phenotypes will react with anti-f

rr

anti-f will will react with cells that carry c and e on the same Rh polypeptide. No other listed genotypes produce an Rh polypeptide that carries both c and e

A patients red blood cells give the following reactions:

anti-D+

anti-C+

anti-E+

anti-c+

anti-e+

anti-f 0

SO c+ AND e+ ARENT ON THE SAME RH POLY PEPTIDE IT HAS TO BE

R₁R₂

Non reactivity with anti-f indicates the cells do not have an Rh polypeptide that posseses both c and e, which is necessary to type as f+. R₁R₂ is the most likely genotype.

Blood Group Systems

Anti-N is identified in a patients serum if random crossmatches are performed on 10 donor units how many would be expected to be compatible.

3

The N antigen is lacking in 30% of the caucasian population.

Blood Group Systems

A woman types as Rh positive. She has an anti-c titer of 32 at AHG. Her baby has a negative DAT and is not affected by hemolytic disease of the newborn What is the fathers most likely phenotype.

R₁ r

The baby appears to lack c since no HDFN is evident. The Mom is most likely R₁R₁ so she had to pass R₁ onto the baby. The father must has passed on an Rh gene that also did not produce c. Given the choices the father has to be R₁r

Blood Group Systems

Which of the following red cell typings are most commonly found in the African American donor population.

Lu(a-b-)

Jk(a-b-)

Fy(a-b-)

K-k-

Fy(a-b-)

The Fy(a-b-) phenotype occurs in 68% of the population of African American decent but is extremly rare in other ethnic backgrounds. Lu(a-b-), Jk(a-b-), and K-k- are very rare in all ethnic backgrounds.

Four units of blood are needed for elective surgery. The patients serum contains

anti-C

anti-e

anti-Fya

anti-Jkb

rare donor file

The frequency of compatible donors for the patient can be calculated by multiplying the percentage of the population that is e-C-x Fya-x Jkb-

the blood suppliers immunohemotology reference laboratory may have units in stock or can request blood from other IRLs through the american rare donor w.

Blood Group Systems

A donor is tested with Rh anti-sera with the following results.

anti-D+

anti-C+

anti-E-

anti-c+

anti-e+

Rh control-

Blood Group Systems

A family has been typed for HLA because one of the children needs a stem cell donor. Typing results are listed below.

Father A1, 3: B8, 35

Mother A2, 23:B12,18

Child 1 A1, 2:B8,12

Child2 A1, 23:B8, 18

Child 3 A3, 23:B18,?

B35

From the first 3 children it can be determined that MOM has the haplotype A2B12 and A2 3F. The Dad has the haplotype A1B3 and A3B35 The expected B antigen in child 3 is B35

Blood Group Systems

Which of the following is the best source of HLA-compatible platelets,

Blood Group Systems

A patient is group O, Rh negative with anti-D and anti-K in her serum. What percentage of the general Caucasian population would be compatible with this patient.

6.0%

Determination of compatibility can be determined by multiplying the percentage of compatibility of each antigen. 46% of the population is group O, 15% are D negative, and 91% are K negative.

0.46X0.15X0.91=0.06

Blood Group Systems

The observed phenotype in a particular population are:

Phenotype        Number of persons

Jk(a+b-)                                122

Jk(a+b+)                               194

Jk(a-b+)                                 84

What is the gene frequency of Jk^a in this population?

Use the Hardy Weinberg equation: p²+2pq+q²=1.0

In this example p² is the homozygous population, Jk(a+b-)The square root of p² =p, which is the gene frequency of Jk^a in this population, out of the 400 people, 122 or 30% are homozygous.the square root of 0.30 is 0.55

Blood Group Systems

In a random population. 16% of the people are Rh negative (rr). What percentage of the Rh positive population is heterozygous for r.

48%

 16+84=100

16²+2x16X84+84²

The Hardy Weinberg equation states p+q=1.0. When the equation is expanded it is p² + 2pq +q² =1.0

Blood Group Systems

In relationship testing a direct exclusion is established when a genetic marker is:

Present in the child but absent in the mother and Father.

When a marker is in a child that the mother and alledged father do not have, the alledged father cannot be the biological father of the child. 

Relationship testing produces the following red cell phenotyping results.

_____________________________________________

         ABO                                         Rh                         

alledged father B            D+C-c+E+e-

Mother  O                       D+C+E-c-e+

Child O                            D+C+E-c-e+

_______________________________________________

What conclusions may be made?

Paternity may be excluded on the basis of Rh typing

The childs genotype does not include big E

The alledged father is homozygous for E

Blood Group Systems

In a relationship testing case the child has a genetic marker that is absent in the mother and cannot be demonstrated in the alledged father. What type of paternity exclusion is this known as.

Direct

Direct exclusion of paternity is established when a genetic marker is present in the child but is absent from the mother  and the alledged father.

Blood Group Systems

A patient is typed with the following results:

Patients cells with          Patients serum with

 anti-A  0                        A₁ red cells 2+

anti-B  0                         B red cells 4+

anti-A,B 2+                     Ab screen  0

The most probable reason for these findings is that the patient is group.

A_x with an anti-A₁

A_x cells are more strongly reactive with anti-A,B than with anti-A and the plasma frequently has anti-A₁ present.

Blood Group Systems

Human blood groups were discovered around 1900 by:

Blood Group Systems

Cells of the A₃ subgroup will

give a mixed-field reaction with anti-A,B

Mixed field reactivity with anti -A and anti- A,B is a typical finding for A₃ subgroups

Blood Group Systems

The enzyme responsible for conferring H activity on the red cell membrane is alpha-??

alpha-L-fucosyl transferase.

fucosyl, the immunodominant sugar for H                                                 

Blood Group Systems

Even in the absence of prior transfusion or pregnancy, individuals with the Bombay phenotype (O_h) will always have naturally occuring

anti-H

Bombay phenotypes (O_h) lack H antigen on their red cells, and produce naturally occuring anti-H in their serum

Blood Group Systems

The antibody in the Lutherin system  that is best detected at lower tempertures is: 

anti-Lu_a

Most examples of anti Lu_a agglutinate saline suspended cells. Most examples of anti-Lu_b are IgG  and react at 37C, anti-Lu₃ usually reacts at the AHG phase as does anti-Lu_ab

Blood Group Systems

Which of the following antibodies is nutralized by pooled human plasma

anti-Ch

Anti-Ch and anti-Rg react at IAT with trace amounts of C4 (a component of complement) present on normal RBCs .The Ch and Rg substances is found soluable in plasma. Nutralization studies with pooled plasma can help confirm the antibody reactivity in a patients sample.. If test procedures are used to coat cells with C4, a patient with anti-Ch and anti-Rg may agglutinate the cells directly 

Blood Group Systems

Anti-Sd^a is strongly suspected if

The agglutinates are mixed field and refractile.

Anti-Sd^a is an antibody to a high prevalence antigen, which varies in strength from person to person. Most examples of anti-Sd^a characteristically present as small mixed field , refractile agglutinares that may have a shiny apperance when observed microscopically after the antiglobulin test.

Blood Group Systems

HLA antibodies are:

induced by multiple transfusions.

HLA antibodies are formed in response to pregnancy, transfusion or transplantation and are therefore not naturally occuring They  are associated with fibrile non-hemolytic transfusion recations and TRALI, They are directed aginst antigens found on granulocytes and other cells such as platelets.

Blood Group Systems 

Genes of the major histocompatibility complex (MHC): 

Contribute to the condition of cellular and humoral immunity.

MHC consists of both class I and class II HLA antigens. Discrimination of self from nonself is the primary function of the HLA system and it involves many immune responses.

Blood Group Systems

Iso immunozation to platelet antigen HPA-1a and the placental transfer of maternal antibodies would be expected to cause newborn.

thrombocytopenia

HPA-1a is a platelet specific antigen, which is the most common cause of neonatal alloimmune thrombocytopenia.Treatment consist of IV-Ig

Group O Le(a-b+)

Group O have the most H substance in their saliva. The person must be a secretor of ABH substances. Due to the gene interaction between the secretor gene and Lewis gene, people who are Le(a-b+) assures H in their saliva.

Blood Group Systems

Inhibition testing can be used to confirm  antibody specificity for which of the following antibodies.

anti-Le^a

Lewis antigens are found soluable in saliva . If saliva containing Lewis substance is added to a sample of anti Le^a then nutralization occurs. Le(a+) indicator cells added to the test system would be nonreactive. A proper control system is required. whenever nutralization studies are performed.

Blood Group Systems

Which of the following Rh antigens has the higest frequency in caucasions.

e

The overall of the e antigen is 98%.The overall exsistance of c is 80%, D is 85%, and E is 30%.

if you get an anti -e, go to the rare donor file

Blood Group Systems

Anti-D and anti-C are identified in the serum of a transfused pregnant woman, gravida 2, para 1. Nine months previously she recieved Rh immune globulin (RhIg) after delivery. Test of the patient, her husband, and the child reveled the following:

_____________________________________________  

      anti-D       Anti-C     Anti-E     anti-c    anti-e

father    +             0               0              +           +

    child      +             0               0              b +           +

The most likely explanation for the presence of anti-C is that this antibody is:

actually anti-G

The G antigen is normally present on red cells possessing  either C or D. Anti-G reacts with panel cells that are D+ or C+ and the antibodies appear to be anti-C and anti-D. The G antigen is expressed on the childs D+ red blood cells

Blood Group Systems

The phenomenon of an Rh positive person whose serum contains anti-D is best explained by:

missing antigen epitopes

 individuals who are partial D are missing epitopes of the D antigen and can develop antibodies toward the epitopes they lack. Since all normal D antigens have all epitopes, the specificity of the persons antibody is anti-D

Blood Group Systems

When the red cells of an individual fail to react with anti-U, they usually fail to react with:

anti-S

The U antigen is a high incidence antigen found on the RBCs of all individuals except 1% of African Americans , who lack glycoprotein B and usually type as

 S-s-U-

Blood Group Systems

Which of the following red cell antigens are found on glycophorin-A?

M,N

The M and N antigens are found on glycophorin-A

Blood Group Systems

Paroxysmal cold hemoglobinuria (PCH) is associated with antibody specificity toward which of the following?

P antigen

 Autoanti-P, a cold reacting IgG autoantibody described as biphasic hemoysin, is associated with paroxsysmal cold hemoglobinuria.

This is a cold antibody that is IgG

Blood Group Systems

Which of the following is characteristic of anti-I

all cells of group O cell panel and his own cells

4+ is a very strong reaction!

Blood Group Systems

Which of the following is characteristic of anti-i?

Reacts best at room temperature or 4*C.

Anti i is an IgM antibody that reacts with cord cells and i adult cells.

It is not associated with hemolytic disease of the newborn, since IgM antibodies do not cross the placenta.

Blood Group Systems

The Kell (K1) antigen is

strongly immunogenic

It is present on the red cells of up to 9% of adults and neonates, and is not affected by enzymes.

Blood Group Systems

In chronic granulomatous disease (CGD) granulocyte function is impaired. An association exists between this clinical condition and a depression of which of the following antigens?

Kell

Red blood cells of individuals with the McLeod phenotype lack Kx and Km and have significant depression of other Kell antigens. The McLeod phenotype has been found in patients with chronic granulomatosis disease.

Blood Group Systems

The antibodies of the Kidd blood group system:

react best by the indirect antiglobulin test

Antibodies in the kidd blood group system are IgG and react best at antiglobulin phase. These antibodies are associated with delayed hemolytic transfusion reactions.

Blood Group Systems

Proteolytic enzyme treatment of red cells usually destroys which antigen?

Fy^a

The Fy^a and Fy^b antigens are sensitive to denaturation  by proteolytic enzymes. Serum containing anti-Fy^a reacts with untreated FY^(a) cells but not with enzyme treated FY^a cells

Blood Group Systems

anti-Fy^a is:

capable of causing hemolytic transfusion reactions

Anti-FYa is an IgG antibody that reacts best at the AHG phase, does not react with enzyme treated cells, is capable of causing hemolytic disease of the newborn, ans is not known to be an auto-agglutinin.

Blood Group Systems

Resistance to malaria is best associated with which of the following blood groups?

Duffy

The duffy glycoprotein on red cells is a receptor for the malarial parasite, Plasmodium Vivax. Red cells with the phenotype FY(a-,b-) are resistant to invasion by P vivax.

Blood Group Systems

What percent  of group O donors  would be compatible with a serum sample that contained anti-X and anti-Y if X antigen is present on red cells of 5 fo 20 donors, and Y antigen is present on cells of 1 of 10 donors?

68%

75% of donors would be compatible with anti-X and 90% with anti-Y. the frequency of compatibility for both antigens is determined by multiplying the 2 compatibility percentages together.

0.75 X 0.90 = 0.675

Blood Group Systems

How many caucasians in a population of 100,000 will have the following combinations of phenotypes?

System               Phenotype                 Frequency

ABO                    0                              45 

Gm                     Fb                             48 

PGM1                  2-1                           37

EsD                     2-1                           18  

45X48X37X18=1,438

you multiply the frequencys

Blood Group Systems

What is the approximate probability of finding compatible blood amoung random Rh-positive units for a patient who has anti-c and anti-K? (Consider that 20% of Rh-positive donors lack c and 90% lack K.)

.20X .90=18%

you multiply the frequencies

Blood Group Systems

if you lack c in you phenotype what is your most probable genotype

R1R1

DCe/DCe

Physiology and Pathophysiology

A man suffering from gastrointestinal bleeding has recieved 20 units of red blood cells in the last 24 hours and is still oozing post-operatively. The following results were obtained.

PT:                            20 seconds (control 12 seconds)

APTT:                        43 seconds (control 31 seconds)

PLT count:                 160            ( 160                    )

Hgb:                         10 g/L        (100g/L                 )

Factor VIII              86%

What blood product should be administered?

FFP

Massive transfusion patients (2 or more X blood volume)

usually reqire platelets and FFP but since his platelet count is adequite, only FFP sholud be given at this time.

Physiology and Pathophysiology

Transfusion of which of the following is needed to help correct hypofibrinoginemia due to DIC?

Cryoprecipitated AHF

Cryo is used for fibrinogen replacement fibrinigon is decreased in patients with DIC due to uncontroled thrombin generation.

Physiology and Pathophysiology

A blood component used in the treatment of hemophilia A is:

Factor VIII concentrate

Patients with severe hemophilia A may have spontaneous hemorrhages that are treated with factor VIII concentration.

Physiology and Pathophysiology

Which of the following blood components is most appropriate to transfuse to an 8 year old male hemophiliac who is about to under go minor surgery?

Factor VIII concetrate

Physiology and Pathophysiology

A unit of fresh frozen plasma was inadvertently thawed and the immediately refrigerated at 4*C on monday morning. On tuesday evening this unit may still be transfused as a replacement for

Factor IX

Factors V and VIII (labile factors) would be decreased but IX would not be decreased.

this has an outdate of 24 hours????

Physiology and Pathophysiology

A newborn demonstrates petechiae, ecchymosis and mucosal bleeding. The preferred blood component for this infant would be

Platelets

These are symptoms of a low platelet count.If the mothers platelet count is normal, the newborn likely has neonatal alloimmune thrombocytoenia (NAIT) caused by maternal antibody to the infants platelet antigens.

Physiology and Pathophysiology

Which of the following would be the best source of Platelets for transfusion in the case of alloimmune neonatal thrombocytopenia?

Mother................after washing to remove antibody

When platelets are needed, maternal platelets are often prepared for use at cordocentesis or delivery. Platelets should be washed to remove maternal antibody.

Physiology and Pathophysiology

An obstetrical patient had three previous pregnancies, Her first baby was healthy, the second was jaundiced at birth and required an exchange transfusion, while the third was still born, Which of the follwing was the most likely cause?

Rh incompatibility

HDFN is caused by maternal antibody crossing the placenta and destroyong fetal antigen positive red cells. Unlike ABO antibodies, which are naturally occuring and can affect the first pregnancy, Rh antibodies are not produced until the mother has been exposed to Rh positive red cells, usually during delivery of the first Rh positive child. Once immunized subsequent pregnancies with Rh positive infants are affected, usually with increasing severity.

Physiology and Pathophysiology

A specimen of cord blood was submitted to the transfusion service for routine testing. The following results were obtained:

anti-A          anti-B            anti-D        Rh cont      DAT

4+                  =                   3+                 =              2+

It is known that the father is group B , with a genotype of cde/cde. Of the following 4 antibodies, which 1 is the most likely cause of the positive DAT? 

anti-c

HDFN is caused by maternal antibodies aginst antigens on fetal red cells inherited from the father.Since the father is homozygous for c, the babys red cells have to be c+, and could react with maternal anti-c if present. The father is A-,

D- and C- and cannot pass these antigens to the child

Physiology and Pathophysiology

ABO hemolytic disease of the newborn

is usually seen only in the newborns of group O mothers

ABO HDFN is a mild disease , not usually requiring transfusion. It may occur in any pregnancy in which there is ABO incompatibility. High-titered IgG anti bodies are more frequently seen in group O mothers than in A or B mothers.

Physiology and Pathophysiology

Which of the following antigens is most likely to be involved in hemolytic disease of the newborn?

Le^_a, P₁, M, Kell

Kell

HDFN is caused by maternal IgG antobodies outside the Rh system, the most clinically significant antibody for HDFN is anti-K. IgM antibodies do not cross the placenta.

Physiology and Pathophysiology

ABO hemolytic disease of the fetus and newborn (HDFN) differs from Rh HDFN in that:

Physiology and Pathophysiology

The following results were obtained:

         anti-A       anti-B    anti-D   weakD   DAT    Ab screen

infant    0              0             0          NT       4+        NT

mother  4+             0             0          0         NT      anti-D

Which of the following is the most probable explanation for these results:

Rh hemolytic disease of the fetus and newborn , infant has a false negative Rh typing.

Remember a strong DAT (4+) can mask the infants Rh typing

The mother has anti-D; the baby has a positive DAT (4+); the baby appears to be Rh negative. If the baby has a stronglu positive DAT, the babys red cells may be so heavly coated with maternal antibody that the D antigen sites are blocked and cannot react with anti D reagents, causing a false negative Rh type.

Physiology and Pathophysiology

A group A, Rh positive infant of a group O Rh-positive mother has a weakly positive direct antiglobulin test and a moderately elevated bilirubin 12 hours after birth. The most likely cause is

ABO incompatibility

ABO HDFN occurs most commonly in group A babies born to group O mothers, and usually has a mild course, The DAT is typically weak or negative and jaundice develops 12 to 48 hours after birth.

Physiology and Pathophysiology

In suspected cases of hemolytic disease of the newborn, what significant information can be obtained from the babys blood smear?

determination of the presence of spherocytes

spherocytes have antibodys on them

Spherocytosis is characteristic of ABO HDFN but not Rh HDFN

Physiology and Pathophysiology

The Liley method of predicting the severity of hemolytic disease of the newborn is based on the amniotic fluid

change in optical density measured at 450nm

The Liley graph is divided into three zones that pedict the severity of thr HDFN and the need for intravention and treatment

Physiology and Pathophysiology

These labroatory results

were obtain on maternal and cord blood samples

Mother  A-

baby     AB+     DAT 3+      cord Hgb  10 g/dL (100 gL) 

Does the baby have HDFN?

Yes the cord Hgb and DAT both support HDFN

A positive DAT on cord blood demonstrates the presence of maternal antibody coating the babies red cells and indicates hemolytic disease of the newborn. Normal cord hemoglobin in newborns ranges from 14-20 g/L. A cord hemoglobin value of 10 g/L indicates anemia and supports the diagnosis of HDFN.

Physiology and Pathophysiology

The main purpose of performing antibody titers on serum from prenatal imminized women is to:

Identify candidates for amniocentesis or percutaneous umbilical blood sampling

Titers above a critical level, usually 16-32 identify candidates for amniocentesis or PUBS to monitor the fetus and determine the course of treatment.

Physiology and Pathophysiology

Which unit should be selected for exchange transfusion if the newborn is group A, Rh positive and the mother is group A Rh positive with anti-c?

A CDe/CDe

Blood for an exchange transfusion should lack the antigen to any maternal antibodies that have entered the infants circulation and are reactive at 37*C or AHG

Physiology and Pathophysiology

A mother is group A-, with anti-D in her serum. What would be the preferred blood product if an interuterine transfusion is indicated?

O Rh-negative red blood cells

 irradiated

less than 5 days old

Laboratory studies of maternal and cord blood yield the following results

Maternal blood                Cord blood

O, Rh-negative                 B, Rh-positive

anti-E in serum                 DAT 2+

                                      anti-E in eluate

If an exchange transfusionis necessary, the best choice of blood is:

O, Rh-negative, E-

Blood selected for exchange transfusion is usually crossmatched with the mothers blood and should be ABO compatible. It should be negative for the antigen that she has made antibody against.

Physiology and Pathophysiology

Blood selected for exchange transfusion must:

Lack red cell antigens cooresponding to maternal antibodies

Blood selected for exchange transfusion should be antigen negative and ABO compatible with the mother and baby. Red blood cells usually less than 7 days old, CMV-, Hemoglobin S-, and irradiated.

Physiology and Pathophysiology

When the main objective of an exchange transfusion is to remove the infants antibody -sensitized red blood cells and to control hyperbilirubinemia, the blood product of choice is ABO compatible:

RBC suspended in fresh frozen plasma

FFP to get rid of the bilirubin

Physiology and Pathophysiology

To prevent graft vs host disease. Red blood cells prepared for infants who have recieved intrauterine transfusons should be:

Physiology and Pathophysiology

Which of the following is the perferred specimen for the initial compatibility testing in exchange transfusion therapy?

Maternal serum

If the initial antibody screen, using either the mothers or babies serum is positive, either antigen negative or AHG crossmatch-compatible units are selected until antibody is no longer demonstrable in babies serum.

Physiology and Pathophysiology

Rh-immune globulin is requested for an Rh-negative mother who has the following results

                             D   Dcont    weakD      weakD cont

mothers pp samp   0      0           1+               0

what is the most likely explanation?

Physiology and Pathophysiology

The following results are seen on a postpartum sample:

                             D      Dcont      weakD      weakD cont

mothers pp samp   0         0             1+              0

The most appropriate corse of action is to:

Physiology and Pathophysiology

What is the most appropriate interpretation for the laboratory data given below when an Rh-negative woman has an Rh-positive child?

Rosette fetal screen using enzyme treated D+cells

mothers sample:             1 rosette/3 fields

positive control:             5 rosettes/3 fields

negative control:            no rosettes observed   

mother is not a candidate for RhIg

mother should recieve 1 vial of RhIg for a normal bleed

Physiology and Pathophysiology

Refer to the following information:

Postpartum  anti-D   Rh control   Weak D    Wk D cont rosette

mother          0          0            +micro         0           20/ 5fields

newborn            4+              0              NT            NT            NT

What is the best interpretation for the laboratory data given above?  

Physiology and Pathophysiology

A weakly reactive anti-D is detected in a postpartum specimen from an Rh-negative woman. During her prenatal period, all antibody screening test were negative. These findings indicate:

2

one dose of RhIg will protect a mother form a bleed of 30 mL. The bleed was 35 mL. 2 vials of RhIg will be needed.

Physiology and Pathophysiology

A fetomaternal hemorrage of 35 mL of fetal Rh positive packed RBCs has been detected in an Rh-negative woman. How many vials of Rh immune globulin should be given?

3,

 One vial of Rh immune globulin protects against a fetomaternal hemorrage of 15mL of red cells, or 30 mL of whole blood. Divide the volume of fetomaternal hemorrage (35) by 15 ;round down to 2 the add 1 extra vial =3 vials total

Physiology and Pathophysiology

Criteria determinnig Rh immune volume eligibility include

Physiology and Pathophysiology

While performing routine postpartum testing for an Rh immune globulin candidate, a weakly positive antibody screening test was found . Anti-D was identified. This antibody is most likely the result of:  

Physiology and Pathophysiology

Rh immune globulin administered would not be indicated in an Rh-negative woman who has an

Physiology and Pathophysiology

A Klehauer betke stain of a postpartum blood film revealed 0.3% fetal cells. What is the estimated volume (mL) of the fetal hemorrage expressed as whole blood?

Physiology and Pathophysiology

An acid elution stain was made using 1 hour post-delivery maternal blood sample. Out of 2,000 cells that were counted , 30 of them appeared to contain fetal hemoglobin. It is the policy of the medical center to add 1 vial of Rh immune globulin to the calculated dose when the estimated volume exceeds 20 mL of whole blood. Calculate the number of vials of Rh immune globulin that would be indicated under these circumstances.

30/2000 X 5000 =75 mLs RhIg protetcs aginst 30 mLs so 2.5 vials are needed round up to 3 full vials and  add 1 vial per hospital policy

4 vials are needed 

Physiology and Pathophysiology

The rosette test will detect a fetomaternal hemorrage (FMH) as small as:

Physiology and Pathophysiology

A 10 mL fetal maternal hemorrage in an Rh-negative woman who delivered an Rh-positive baby means that the:

Physiology and Pathophysiology

Mixed leukocyte culture (MLC) is a biological assay for detecting which of the following?

HLA-D antigens

The mixed lymphocyte culture (MLC) is used to detect genetic differences in the HLA D regions antigens.

Physiology and Pathophysiology

A 40 year old man with autoimmune hemolytic anemia due to anti-E has a hemoglobin level of 10.8 g/dL. This patient will most  be treated with

No transfusion

Transfusion should generally be avoided except in life threatening anemia. A hemoglobin of 10.8 g/dL is not life threatening, especially if the patient is not actively bleeding.

Physiology and Pathophysiology

A patient in the immediate post bone marrow transplant period has a hemotocrit of 21%. The red cell prduct of choice for this patient would be:

irradiated

Bone marrow transplant patients are at a risk for transfusion assiociated graft vs host disease  (TA-GVHD) and therefore should recieve irrdiated blood product.

Physiology and Pathophysiology

HLA antigen typing is important in screening for:

a kidney donor

HLA antigen typing is important to consider before organ transplantation.

Physiology and Pathophysiology

DR antigens in the HLA system are:

significant in organ transplantation

Dr antigens, also known as Class II antigens, are significant in organ transplantation. These antigens are expressed on B lymphocytes , macrophages, monocytes, and endothelial cells and are detected in the lymphocytology test.

Physiology and Pathophysiology

Anti-E is identified in a panel at the antiglobulin phase. When check cells are added to the tubes, no agglutination is seen. The most appropriate course of action would be to:

Quality control the AHG reagent and check cells and repeat the panel

Results are invalid

SEROLOGY

A serological centrafuge is recalibrated for ABO testing after major repairs.

TIME IN SECONDS             15        20        25          30

is button delineated             yes       yes       yes         yes

is supernatent clear             no         yes       yes         yes

button easy to resuspend     yes       yes       yes          no

strength of reaction            +m         1+         1+           1+

given the data above, the centrafuge time for this machine should be: 

20 seconds

The listed criteria are typical for serological calibration of a centrafuge. Optimum spin time is the least amount of time when all criteria are satified.

SEROLOGY

Which of the following represents an acceptibly identified patient for sample collection and transfusion?

A handwritten band with patients name and hospital identification number affixed to the patients leg.

Samples must be labeled with two independent  patient identifiers and the date of colletion. This information should be identical to that on the patients identification band and request.

SEROLOGY

Samples from the same patient were recieved on 2 consecutive days, test results are summerized below:

                                DAY 1                     DAY 2

anti-A                         4+                           0

anti-B                          0                            4+

anti-D                         3+                           3+

A1 cells                       0                            4+

B cells                         4+                           0

Ab screen                   0                             0  

How should the request for crossmatch be handled?

Collect a new sample and repeat the test

SEROLOGY

The following test results are noted for a unit of blood labeled group A Rh-negative

           Cells tested with:

  Anti-A                 Anti-B                  anti-D

      4+                       0                         3+                      

What should be done next?

SEROLOGY

What information is essential on patient blood sample labels drawn for compatibility testing?

SEROLOGY

Granulocytes for transfusion should:

Be ABO compatible with the recipiants serum

Granulocytes must be compatible with the recipients plasma . Granulocyte products have an expiration date of 24 hours.

SEROLOGY

A neonate will be transfused for the first time with group O red blood cells, Which of the following is appropriate compatibility testing?

No crossmatch is necessary if initial plasma screening is negative

Because neonates are immunologically immature, alloimmunization to the red antigens is very rare during the neonatal period. No crossmatching is required if the initial antibody screen performed with either the babys or mothers plasma is negative.

SEROLOGY

A group B Rh-negative patient has a positive DAT. Which of the following situations would occur?

The weak D test and control would be positive

 A positive DAT wil interfere with a weak D testing causing both the patient and control to demonstrate positive results. Any positive result in the control tube invalidates any results.

SEROLOGY

The following reactions were obtained:

Cells tested with                serum tested with   

anti-A  anti-B  anti-AB               A1 cells     B cells

 4+       3+      4+                  2+         4+

  The  technologist washed the patients cells with saline, and repeated the forward typing. The following results were obtained: 

cells tested with                        serum tested with

anti-A anti-B  anti-AB                  A₁cells  B cells

   4     0       4+                         0        4+

the results are consistant with:

Multiple Myeloma

rouleaux

looks like agglutionation

do a saline replacement and retype

SEROLOGY

What is the most likely cause of the following ABO discrepancy?

Patients cells vs:                      Patients serum vs:

anti-A       anti-B                          A1 cells   B cells

   0              0                                    0           0

obtained from a heel stick of a two month old baby

no antibodies yet

SEROLOGY

Which of the following patient data best reflects the discrepancy seen when a persons red cells demonstrate the aquired B phenotype

            FORWARD GROUPING     REVERSE GROUPING

patient A         B                                      0

patient B         AB                                    B

patient C          O                                     B

patient D          B                                     AB

patient B

Aquired B occurs in group A individuals and is due to deacetylation of the A antigen by bacterial enzymes. Detection of aquired B is dependant upon the source of the anti B used

SEROLOGY

Which of the following is characteristic of Tn polyagglutinable red cells?

if group O they may appear to have aquired a group A antigen

Tn is caused from a somatic mutation and the phenomenon is persistant.  Resolution of the red cell typing can be preformed with enzyme treated patient cells, since Tn is denatured by enzymes. although the reactivity with anti-A may be weak, testing with A1 lectin gives strong reactivity, unlike subgroups of A, which are weakly reacting with anti-A and nonreactive with A1 lectin.

SEROLOGY

Mixed field agglutination encountered in ABO grouping with no history of transfusion would most likely be due to:

SEROLOGY

Which of the following is characteristic of polyagglutinable red cells?

SEROLOGY

Consider the following ABO typing results:

Patients cells Vs:                              Patients serum Vs: 

anti-A    anti-B                                   A1 cells     B cells

4+            O                                             1+            4+

 additional testing was performed using patient serum:

                                         IS             RT

screening cell I                 1+              2+

screening cell II               1+               2+

auto control                      1+               2+

What is the most likely cause of this descrepancy    

cold auto antibody

The key is

It got stronger at room temperature

SEROLOGY

Consider the following ABO typing results:

  Patients cells Vs:                            Patients serum Vs: 

    anti-A  anti-B                                 A1 cells    B cells

     4+          O                                         1+            4+

Additional testing was done:

                                     IS                        RT

screening cell I             1+                         2+

screening cell II           1+                         2+

auto control                  1+                         2+

What sholud be done next?       

Perform serum type at 37*C

to rule out cold auto

it got stronger at room temperature

SEROLOGY

The following results were obtained on a patients blood sample during routine ABO and Rh testing

   Cell testing                               serum testing

 anti-A       O                                A1 cells       4+

 anti-B        4+                               B cells        2+

anti-D         O                                      

auto cont    O  

 Select the course of action to resolve this problem  

Perform antibody screening  procedure at immediate spin using group O cells

an unexpected antibody is reacting with the B cells

SEROLOGY

Which of the following explains an ABO descrepancy coused by problems with the patients red blood cells

SEROLOGY

The test for weak D is performed by incubating patients red cells with

anti D  serum followed by washing and antiglogulin serum

take it out to AHG phase

SEROLOGY

Refer to the following data

Forward group                               Reverse group

anti-A   anti-B  anti-A1 lectin     A1 cells A2 cells  B cells 

   4+          O             4+                   O           2+        4+

Which of the following antibody screen results would you expect with this ABO discrepancy 

Positive with all screen cells  at the RT phase; auto control is negative.                                       

The ABO discrepancy is most likely due to anti H in an A1 individual, Anti-H reacts most strongly at room temperature

with group O screening cells and weaker or negative at room temperture with autologous or donor group A1 cells. as the branched H structures are converted to A, some group A1 individuals may delvelp a clinically significant anti-H, recognizing H structures on group O  and A2 blood groups. 

The following results were obtained when testing a sample from a 20 year old, first time blood donor:

Forward group                                       Reverse group

anti-A    anti-B                                       A1 cells   B cells 

   O           O                                                O           3+

what is the most likely cause of this ABO discrepancy?

SEROLOGY

A mother is Rh-negative and the father is Rh-positive, Their baby is Rh-negative. It may be concluded that:

SEROLOGY

Some blood group  antibodies characteristically hemolyze appropriate red cells in the persence of

SEROLOGY

Review the following schematic diagram:

PATIENT SERUM + REAGENT GROUP O CELLS

INCUBATE----- READ FOR AGGLUTINATION

WASH-----ADD AHG -----AGGLUTINATION OBSERVED

The next step would be  

SEROLOGY

The following results were obtained in pretransfusion testing

                                    37*            IAT

screening cell I             0                3+

screening cell II           0                3+

autocontrol                   0                3+     

The most probable cause of these 

results is?                                                                             

warm auto antibody

the auto-control is POSITIVE

SEROLOGY

A patient is typed as group O, Rh-positive and crossmatched with 6 units of blood. At the indirect antiglobulin phase of testing, both antibody screening cells and 2 crossmatched units are uncompatible. What is the most likely cause of the incompatibility?

SEROLOGY

Refer to the following data:

Hemoglobin                         7.4

reticulocyte count              22%

Direct antiglobulin test     Ab screen = IAT

polyspecific  3+                   SCI:    3+

IgG:              3+                   SCII:  3+

C3:                0                    auto:  3+

Which clinical condition is consistant with the lab results shown above?

SEROLOGY

A patient recieved 2 units of red blood cells and had a delayed transfusion reaction. Pretransfusion antibody screening  records indicate no agglutination except after the addition of IgG sensitized cells. Repeat testing of the pretransfusion specimen detected an antibody at the antiglobulin phase. What is the most likely explanation for the original results?

SEROLOGY

At the indirect antiglobulin phase of testing, there is no agglutination between patient serum and screening cells. One of the 3 donors was incompatible.

The most prabable explanation for these findings is that the:

SEROLOGY

A major crossmstch will detect a

                                                                  SEROLOGY

A 42 year old female is undergoing surgery tomorrow and her physician request that 4 units of red blood cells be crossmatched. The following results were obtained:

                                 IS             37*                 IAT

sceening cell I           0               0                     0

screening cell II        0               0                     0

screening  cell III     0                0                     0

CROSSMATCH        IS             37*                 IAT

donor I                      2+              1+                   1+

donor 2,3,4                0               0                     0   

What is the most likely cause of the incompatibility of donor I?

SEROLOGY

Which of the following would most likely be responsible for an incompatible antiglobulin  crossmatch?

SEROLOGY

A reason why a patients crossmatch may be incompatible while the antibody screen is negative is?

SEROLOGY

A blood specimen types as A, Rh-positive with a negative antibody screen, 6 units of group A Rh-positive units were crossmatched and one unit was incompatible in the antiglobulin phase. The same result was obtained when the test was repeated .

Which should be done first?

SEROLOGY

During emergency situations when there is no time to determine  ABO group and Rh type on a current sample for transfusion, The patient is known to be A, Rh-negative. The technologist should:

SEROLOGY

A 29 year old male is hemorrhaging severly. He is AB, Rh-negative. 6 units of blood are required STAT. Of the following types availabel in the blood bank, which would be most preferable?

AB Rh positive, A Rh negative, A Rh positive,O Rh positive

SEROLOGY

A patient is group A₂B, Rh-positive and has an antiglobulin reacting anti-A₁ in his serum. He is in the operating room bleeding profusely and group A₂B Red cells are NOT available. Which of the following blood types is first choice for crossmatching?

B Rh-positive

The patient has an anti-A₁, Which eliminates A₁B cells immediately. Rh negative units should be conserved for Rh negative patients when Rh positive units are available. Selecton of group B units provides compatible units quickly.

SEROLOGY

A 10% red cell suspension in saline is used in a compatibility test. Which of the following would most likely occur?

SEROLOGY

A patient serum reacts with 2 of the three antibody screening cells at the AHG Phase. 8 of the 10 units crossmatched were incompatible at the AHG phase. All reactions are markedly enhanced by enzymes. results are most compatible with:

(choices)

Anti-M, Anti-E, Anti-c, anti-Fy^a

anti-c

Rh antibodies show enhanced activity with enzyme pretreated cells. The M and FY^a antigens are cleaved from enzyme pretreated cells and therefore there would be no reaction between enzyme pretreated cells and serum containing anti-M or anti-FY^a.

The incidence of the antigen is is 80% in whites and 96% in blacks.

SEROLOGY

A patient recieved 4 units of blood 2 years previously and now has multiple antibodies. He has not been transfused since that time. It would be most helpful to:

SEROLOGY

Autoantibodies demonstrating blood group specificity in warm autoimmune hemolytic anemia are associated most often with which blood group system.

Rh

Warm autoantibodies often exhibit Rh specificity

SEROLOGY

An antibody that causes in vitro hemolysis and reacts with red blood cells of 3 out of 10 crossmatched donor units is most likely:

anti-Le^a

22%

Lewis blood group binds complement

I did not know that

SEROLOGY

A patients serum reacted weakly positive (1+^w) with 16 of 16 group O panel cells at the AHG test phase. The auto control was negative. Test with fican-treated panel cells demonstrated no reactivity at the AHG phase. Which antibody is most likely responsible for these results?

anti-Ch, anti-k, anti-e, anti-Js^b

anti-Ch

Chido antigens are sensitive to treatment with enzymes.

Chido is a high incidence antigen

SEROLOGY

An antibody identification  is performed with a 5 cell panel.

look at panel on page 32

SEROLOGY

In the process of identifying an antibody the technologist observed 2+ reactions with 3 of the 10 cells in a panel after the immediate spin phase.There was no reactivity after incubaton at 37* C or after AHG test phase. The antibody most likely is:

Lewis a

22% of the population is Lewis a

2-2 (louie-louie)

Lewis antibodies are usually IGM and agglutinatate saline suspended cells. Approximately 22% of the population is: Le(a+), which would account for 3 out of 10 donor units being incompatible.

and Lewis blood group binds complement

SEROLOGY

Transfusion of Ch+ (chido positive) red cells to a patient with anti h has been reported to cause:

No clinically significant red cell destruction.

Chido antibodies are insignificant

SEROLOGY

Results of a serum sample tested aginst a panel of reagent red cells gives presumptive evidence of an alloantibody directed aginst a high incidence antigen . Further investigation to confirm the specificity should include which of the following?

SEROLOGY

Refer to the following data:

Forward group                                 Reverse group

anti-A    anti-B   anti-A₁ lectin       A₁cells A₂cells  Bcells

4+           O         4+                         O           2+        4+

The ABO descrepancy is most likely due to anti-H

An ABO descrepancy in an A₁ individual manifested by agglutination in the serum grouping A₂ cells , is most likely due to anti-H.

The greatest concentration of H substance is found on O cells, followed by  A₂ cells, The least amount of H substance is found on A₁ and A₁B cells.

SEROLOGY

What characteristics are true of all three of the following antibodies: anti-Fy^a, anti-JK^a. and anti-K?

1.Detected at IAT phase 

2.may cause hemolytic disease of the fetus and newborn (HDFN)

3. may cause transfusion reactions.

SEROLOGY

Which of the following test is most commonly used to detect antibodies attached to a patients red blood cells ?

SEROLOGY

anti I may cause a positive direct antiglobulin test because of:

C3d bound to the red cells.

if you used polyspecific IgG you would catch this

SEROLOGY

Which direct antiglobulin test  results are associated with an anamnestic response in a recently transfused patient?

Test Result     polyspecific      IgG       C3      Coombs

result A             +^mf                                  +^mf                0               0

result B              1+                         0             1+             0

result C              2+                         2+            1+             0

result D              4+                         2+            4+            0

Result A

(mf only the donor cells are sensitized)

The anamnestic response is a secondary response from memory cells. There will be an increasing antibody titer upon exposure.

SEROLOGY 

In the direct (DAT) and indirect (IAT) antiglobulin test , false negative reactions may result if the:

SEROLOGY

Polyspecific reagents  used in the direct antiglobulin test should have specificity for

SEROLOGY

In the direct antiglobulin test , the antiglobulin reagent is used to :

SEROLOGY

AHG coombs control cells :

are coated with IgG antobody

(check cells)

SEROLOGY

A 56 year old female with cold agglutinin disease has a positive direct antiglubulin test. (DAT)

When the DAT is repeated  using monospecific antiglobulin sera, which of the following is most likely to be detected

C3d

Cold agglutinin = IgM

Cold agglutinin disease is associated with cold reactive antibodies that typically activete complement. Cells that do not undergo lysis due to complement activation have C3d attached to the red blood cells.

SEROLOGY

The mechanism that best explains hemolytic anemia due to penicillin is:

SEROLOGY

Use of EDTA plasma prevents activation of the classical complement pathway by

SEROLOGY

Which of the following medications is most likely to cause production of autoantibodies?

SEROLOGY

Serological results on an un-transfused patient were :

antibody screen           negative at AHG

direct antiglobulin test   3+ with anti-C3d

eluate                      negative

These results are most likely due to:

cold agglutinin syndrome

The eluate is negative as C3d cannot be eluted from cells.

SEROLOGY

The drug cephalosporin can cause a positive direct antiglobulin test with hemolysis by which of the following mechanisms 

drug dependant antibodies acting in the presence of the drug

second and third generation cephalosporins react when serum, the drug and red cells are present, direct or indirect agglutination or lysis may be observed.

SEROLOGY

Crossmatch results at the antiglobulin phase were negative. When 1 drop of check cells was added, no agglutination was seen. The most likely explanation is:

residual patient serum inactivated the AHG

Inadequate washing of red cells may leave residual patient serum behind.

SEROLOGY

Which of the following might cause a false negative indirect antiglobulin test (IAT)?

Too heavy a cell suspension

Weak antibodies may be missed if there are excess RBC antigens as there may be too few antibodies to bind to red cell antigens

SEROLOGY

The purpose of testing with anti-A,B is to detect.

subgroups of A

A_x cells react more strongly with anti-A,B than with anti-A.

SEROLOGY

What is the most appropriate diluant for preparing a solution of 8% bovine albumin for a red cell control reagent?

normal saline

(volume2 x concentration2)

A solution of 6-8% albumin is used with some anti-D reagents as a control for spontaneous agglutination.

SEROLOGY

Which of the following antigens gives enhanced reactions with its cooresponding antibody following treatment of the red cells with proteolytic enzymes?

E

Rh and kidd are enhanced

MNS and duffy are weakened

SEROLOGY

In a prenatal work-up the following results were obtained:

Forward group:                                   Reverse group;

anti-A   anti-B   anti-D   Rh cont         A₁ cells B cells

4+          2+           4+          O                  O           3+

DAT                       neg

antibody screen      neg

ABO descrepancy was thought to be due to an antibody directed aginst a component of the typing sera. Which test would resolve this descrepancy?

Wash Patients red cells and repeat testing.

Patients may have antibodies to components of reagents. Washing the patients cells prior to testing to remove their plasma from the cell suspension will resolve the reactivity with anti-B

SEROLOGY

How to resolve an antibody screen with FY^a and Jk^a blocking each others rule outs?

Use proteolytic enzyme treatment

FY^a is destroyed and JK^a is not

duffy and MNS are destroyed by enzymes.

SEROLOGY

Of the following the most useful techniques  in the identification and classification of high-titer low-avidity (HTLA) antibodies is:

titration and inhibition

Soluable forms of some blood group antigens can be prepared from other sources and used to inhibit reactivity of the corresponding antibody, such as the HTLA antibodies anti-ch and anti-rg. Most HTLA antibodies, although wealky reactive in undiluted serum, will continue to react weakly at higher dilutions.

                                                                     SEROLOGY

To confirm a serum antibody specificity identified as anti-P₁, a neutrilization study was performed and the following results obtained:

                                    P₁ + RBCs

serum + P₁ substance    negative

serum + saline               negative

what conclusion can be made from these results?

anti-P₁ cannot be confirmed due to the results of the negative control.

For nutrilization studies to be valid, the saline dilutional control must be reactive. Since neutrilization studies involve adding a substance to the patients plasma, nonreactivity in test tubes may be due to simple dilution. The saline control acts as a dilutional control and must be reactive. When the saline control is reactive, then if the tube with the substance is nonreactive, the interpretation that nutrlization has occured is made. if it is reactive, neutralization did not occur. 

                                                         SEROLOGY

What happens to an antibody in neutralization study when a soulable antigen is added to the test?

inhibition

The soulable antigen acts as a blocking antigen

                                                                SEROLOGY
To confirm the specificity of anti-Le^b, an inhibition study using Lewis substance was performed

                                               Le^(b) cells

tubes with patient serum + Lewis substance     O

tubes with patient serum and saline                  +

anti-Le^b is confirmed because the tubes with Lewis substance are negative.

The "substance" neutralizes the Lewis antibody

                                                            SEROLOGY

Which of the following is the correct interpretation of this saliva neutralization testing?

                                                                  indicator cells

Sample                           A                      B                    O

saliva plus anti-A             +                      O                   O

saliva plus anti-B             O                      +                   O

saliva plus anti-H             O                     O                   O

Group O secretor

group O cells should agglutinate with anti-H, but the "substance" in the saliva has neutrilized the anti-H

SEROLOGY

A persons saliva incubated with the following antibodies and tested with appropriate A₂, O and B indicator cells, Give the following test results:

Antibody specificity                                Test results 

anti-A                                                         reactive

anti-B                                                         inhibited

anti-H                                                         inhibited

The persons red cells ABO phenotype is:

B

In nutralization, a known source of blood group soluable substance (for example saliva, urine, or plasma) is incubated with a plasma antibody. During the incubation, the antibody combinds with the soluble substance. The antibody is neutrilized and inhibited form combining with the same blood group substance found on red blood cells when the blood cells are added to the system.

SEROLOGY

An antibody screen performed using solid phase technology revealed a diffuse layer of red blood cells on the bottom of the well. These results indicate:

a positive reaction

The antibody screening cells are bound to the surface of the well.

SEROLOGY

On monday, a patient's K antigen result was positive . Two days later, the patients K type was negative. The patient was transfused 2 units Fresh Frozen Plasma. The tech might conclude that the:

wrong patient was drawn

The K antigen is part of the red cell and would not change.

SEROLOGY

Which one of the following is an indicator of polyagglutination?

agglutination with normal adult ABO compatible sera

Polyagglutination is a property of the red blood cells. Structures on the red cells are altered due to bacterial enzymes or a somatic mutation, so crypt antigens not normally espressed on cells are now present. Antibodies to the exposed structures are naturally occuring in adult plasma.

SEROLOGY

While performing an antibody screen, a test reaction is suspected to be rouleaux. A saline replacement test is performed and the reaction remains. What is the best interpretation?

Original reaction was due to true agglutination

Rouleaux will redily disperse in saline.

True agglutination will remain.

A 10 year old girl was hospitilized because her urine had a distinct red color. The patient had recently recovered from an upper respiratory infection and appeared very pale and lethargic. Test were performed with the folllowing results.

Hemoglobin           5g/dL

reticulocyte count 15% 

DAT   weak reaction with polyspecific  and anti-C3d; anti-IgG was neg

antibody screen               negative

Donath-landsteiner test:        Positive: P- cells showed no hemolysis

The patient probably has:

Paroxsmal cold hemoglobinuria (PCH)

The patients cells are coated with complement

SEROLOGY

Which of the following is useful for removing IgG from red blood cells with a positive DAT to preform a phenotype?

SEROLOGY

A patients serum contains a mixture of antibodies. One of the antibodies is identified as anti-D, anti-JKa, anti-Fya and possibly another antibody present, What techniques may be helpful to identify the other  antibody(s)

enzyme panel and select cell panel 

JK^a and D is enhanced by enzymes and FY^a is destroyed

SEROLOGY

A sample gives the following results:

cells with:                            serum with:

anti-A  3+                             A1 cells  2+

anti-B  4+                              B  cells   0

Which lectin should be used first to resolve this descrepancy?  

Dolochos biflorus

Dolochos biflorus plant seed extract forms complexes with N-acetygalactosamine.  It can distinguish between A₁ donor cells and all other subgroups of A

it agglutinates A₁ but not A₂

so you can tell its an A₂ with anti A₁

SEROLOGY

The serum of a group O, Cde/Cde donor contains anti-D. On order to prepare a suitable anti-D reagent from this donors serum, which of the following cells would be suitable for the absorption?

group A₁B cde/cde

the serum of a group O individual contains anti A and anti-B you can remove these antibodies by incubating with A₁B cells

To prepare a suitable reagent, the ABO antibodies must be removed and anti-D left in the serum.The serum would need to be absorbed with cells of the A₁B cde/cde phenotype.

SEROLOGY

A 26 year old female is admitted with anemia of undetermined origin. Blood samples are recieved with a crossmatch request for 6 units of red blood cells. The patient is group A, Rh-negative and has no history of transfusion or pregnancy. The following results were obtained in pretransfusion testing.

                   Is               37                  IAT 

screening cell I      0                0                    3+

screening cells II   0                0                    3+

auto-control           0                 0                   3+

all six donors          0                 0                   3+

the best way to find blood is to:

perform a warm auto-adsorption

An Adsorption with autologous cells to remove the antibody, to use the adsorbed plasma for alloantibody detection is the next step.

SEROLOGY

A patients serum was reactive 2+ in the antiglobulin phase of testing with all cells on a routine panel including their own. Transfusion  was performed 6 months previously. The optimal adsorption procedure, pretreatment of the patients cells  with which of the following  reagents is helpful.

autoadsorption using the patients ZZAP treated cells.

ZZAP removes IgG

removes autoantibodies

SEROLOGY

In a cold autoadsorption procedure, pretreatment of the patients red cells with which of the following reagents is helpful

SEROLOGY

The process of separation of antibody from its antigen is known as

SEROLOGY

Which of the following is most helpful to confirm a weak ABO subgroup?

adsorption - elution

looking for anti-A or anti-B

Transfusion Practice

How would the hematocrit of a patient with chronic anemia be affected by the transmission of a unit of whole blood containing 475 mL of blood, vs 2 units of red blood cells each with a total volume of 250 mL?

Transfusion Practice

After checking the inventory, it was noted that there were no units on the shelf marked : "May issue as uncrossmatched: For emergency only" Which of the following should be placed on this shelf?

Transfusion Practice

The primary indication for granulocyte transfusion is:

Transfusion Practice

A 42 year old male of average body mass has a history of chronic anemia requiring transfusion support. Two units of red blood cells are transfused. If the pretransfusion hemoglobin was 7.0 g/dL the expected post-transfusion  hemoglobin concentration should be:

9.0 g/dL

you should get a bump of 1- 1 ¹/₂

Transfusion Practice

How many units of red blood cells are required to raise the hematocrit of a 70 kg non-bleeding man from 24% to 30%

Transfusion Practice

For which of the following transfusion candidates would CMV sero-negative blood be most likely indicated?

Transfusion Practice

Although ABO compatibility is preferred, ABO incompatible product may be administered when transfusing:

 Transfusion Practice

Transfusion of plateletphoresis products from HLA-compatible donors is the preferred treatment for:

severly thrombocytopenic patients, known to be refractory to random donor platelet

you would never go to the trouble of HLA matching unless the patient was refractile

Transfusion Practice

Washed red cells are indicated in which of the following situations?

An IgA deficient  patient with a history of transfusion associated anaphylaxis

washed red cells less than 5 days old for neonates

Transfusion Practice

Which of the following is consistant with standard blood bank procedure governing the infusion of fresh frozen plasma?

group A may be administered to both A and O recipients.

A has anti B in it, so does 'O'

ABO compatible does not mean blood group specific

Transfusion Practice

A patient who is group AB Rh-negative needs 2 units of fresh frozen plasma. Which of the following units of plasma would be most acceptible for the transfuson?

Transfusion Practice

What increment of platelets in the typical 70kg human, is expected to result from a single unit of platelets transfused to a non-HLA sensitized recipient?

Transfusion Practice

Platelet transfusions are of most value in treating

Transfusion Practice

Washed red blood cells  would be the product of choice for a patient with

Transfusion Practice

A patient recieved about 15 mLs of compatible blood  and developed  severe shock, but no fever. the patient needs another transfusion, what kind of red cell component should be given:

Red blood cells washed

severe shock, no fever is an IgA reaction

Transfusion Practice

Fresh frozen plasma from Group A , Rh-positive donor may be safely transfused to a patient who is group?

Transfusion Practice

A patient admitted to the trauma unit requires emergency release of fresh frozen plasma. His blood donor card states that he is group AB Rh-positive. Which of the following blood group of FFP should be issued?

AB

only.

Transfusion Practice

Fresh frozen plasma:

Transfusion Practice

Ten units of group A platelets were transfused to a group AB patient. The petransfusion platelet count was 12x10³ and the postransfusion count was 18x10³. From this information, the labratorian would most likely conclude that the patient:

Has developed antibodies to the transfused platelets

he should have gotton a bump of 10,00 per unit 

Transfusion Practice

Hypotension, nausea flushing, fever and chills are symptoms of which kind of transfusion reaction?

hemolytic.

fever!!!

Transfusion Practice

A patient has become refractory to platelet transfusion. Which of the following are probable causes

Transfusion Practice

A poor increment in the platelet count 1 hour following platelet transfusion is most commonly caused by:

Transfusion Practice

Posttransfusion purpura is usually caused by:

anti-HPA-1a

Transfusion Practice

An unexplained fall in hemoglobin and mild jaundice in a patient transfused with red blood cells 1 week previously would most likely indicate:

Transfusion Practice

In a delayed transfusion reaction, the causitive antibody is generallly too weak to be detected in routine compatibility testing and antibody screening tests, but is typically detectible at what point after transfusion?

Transfusion Practice

The most serious hemolytic reactions are due to incompatibility in which of the following blood groups?

Transfusion Practice

Severe intravascular hemolysis is most likely caused by antibodies if which blood group system?

Transfusion Practice

Which of the following blood group systems is most commonly associated with delayed hemolytic transfusion reactions?

Transfusion Practice

After recieving a unit of red blood cells, a patient immediatly developed flushing, nervousness, fever spike of 102*F , shaking , chills, and back pain. The plasma hemoglobin was elevated and there was hemogobinuria. Laboratory investigation of this adverse reaction would most likely show:

Transfusion Practice

A trauma patient who had just recieved 10 units of blood may develop:

Thrombocytopenia.

patients recieving > 1 x volume of blood may develop thrombocytopenia

Transfusion Practice

Five days after transfusion, a patient becomes mildly jaundiced and experiances a drop in hemoglobin and hematocrit with no apparent hemorrage. Below are the results of the transfusion reacton workup:

                         anti-a  anti-B    anti-D   A1 cells  B cells   AB sc    DAT

pre- transfusion   =         4+           3+        4+           =           =           =

posttransfusion    =          4+           3+       4+            =          1+          1+

donor 1                  =          =             3+       4+           4+         =  

donor 2                  =          4+           3+        4+           =          =

in order to reach a conclusion the techician should first:

Transfusion Practice

The most appropriate laboratory test for early detection of acute posttransfusion hemolysis is:

Transfusion Practice

During the initial investigation of a suspected hemolytic transfusion reaction, it was observed that the posttransfusion sample was yellow in color and the direct antiglobulin test was negative. Repeat ABO typing on the posttransfusion sample confirmed the pretransfuson results. What is the next step in this investigation?

Transfusion Practice

Which of the following transfusion reactions is characterized by high fever, shock, hemoglobinuria, DIC and renal failure?

Transfusion Practice

Hemoglobinuria, hyopotension, and generalized bleeding are symptoms of which of the following transfusion reactions?

Transfusion Practice

When evaluating a suspected transfusion reaction, which of the following is the ideal sample collection time for a bilirubin determination?

Transfusion Practice

a patients record shows a previous anti-Jk^a, but the current antibody screen is negative. What further testing should be done before transfusion?

Transfusion Practice

A posttransfusion blood sample from a patient experiancing chills, and fever show distinct hemolysis. The direct antiglobulin test is positive (mixed field). What would be most helpful to determine the cause of the reaction?

Transfusion Practice

a patient is readmitted to the hospital with a hemoglobin level of 7 g/dL 3 weeks after recieving 2 units of red cells. The initial serological test are:

ABO/Rh                 A+

antibody screen      negative

DAT                        1+ mixed field

Which test should be performed next? 

Perform an elution and identify the antibody in the eluate.

Lack of expected rise in hemoglobin may be  a sign of a delayed hemolytic transfusion reaction.

Transfusion Practice

In a delayed hemolytic transfusion reacton, the direct antiglobulin test is typically:

Transfusion Practice

A patient has a massive trauma involving replacement of 1 blood volume with red blood cells and crystalloid. She is currently experiancing oozng from mucus membranes and surgical incisions. Laboratory values are as follows:

PT:                        normal

PTT:                      normal

Bleeding time:       prolonged

Platelet count       20 X 10³

hemoglobin            11.4 g/dL 

What is the blood component of choice for this patient?

platelets

In massive transfusions, platelets are indicated if the platelet count is less than 50,000

patients recieving > 1 x volume of blood often develop thrombocytopenia

Transfusion Practice

For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment should be:

Transfusion Practice