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133 Cards in this Set
- Front
- Back
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Leukocyte reduced filters can: |
-Reduce the risk of CMV infection -Prevent or reduce the risk of HLA alloimmunization -Prevent febrile, nonhemolytic transfusion reactions |
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Albumin should NOT be given for: |
nutrition |
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Which blood type is selected when a patient can't wait for ABO-matched RBCs? |
O |
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Patients who need an irradiated component: |
-Bone marrow transplant recepient -Neonate weighing less than 1200 g -Adult receiving an RBC transfusion from a blood relative |
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RBC transfusions should be given: |
within 4 hours |
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What type of transplantation requires all cellular blood components be irradiated? |
bone marrow |
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Characteristics of deglycerolized RBCs include: |
24 hour expiration date after thawing, used for rare antigen type donor blood, used for IgA-deficient recipient with history of severe reaction |
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What is the appropriate product for a bone marrow transplant patient with anemia? |
irradiated RBCs |
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What blood product should be selected for a Vitamin K deficiency? |
plasma |
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What fluid should be used to dilute RBCs? |
0.9% saline |
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Transfusion therapy is used primarily to treat two conditions: |
-inadequate oxygen carrying capacity because of anemia or blood loss -insufficient coagulation proteins or platelets to provide adequate hemolysis |
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A unit of whole blood or RBCs in an adult should increase the hematocrit level ___% or hemoglobin level ___ g/dL |
3; 1 |
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______ are indicated for increasing the RBC mass in patients who require increased oxygen carrying capacity |
RBCs |
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________ transfusions are indicated for patients who are bleeding because of thrombocytopenia. In addition, platelets are indicated prophylactically for patients who have platelet counts under 5,000 to 10,000/uL |
platelet |
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Each dose of platelets should increase the platelet count _______ to _____/uL in a 70-kg human |
20,000-40,000 |
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A plateletpheresis product is collected from one donor and must contain a minimum of _____________ platelets |
3 x 10^11 |
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___________ contains all coagulation factors and is indicated for patients with multiple coagulation deficiencies that occur in liver failure, DIC, vitamin K deficiency, warfarin overdose, and massive transfusion |
plasma |
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_______________ contains at least 80 units of factor VIII and 150 mg of fibrinogen, as well as vWF and factor XIII |
cryoprecipitate |
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Factor_____ is used in the treatment of persons with hemophilia B |
IX |
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_____________________ is used in the treatment of congenital hypogammaglobulinemia and patients exposed to hepatitis A or measles |
immunoglobulin (IG) |
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Massive transfusion is defined as the replacement of ______________ blood volumes within 24 hours or about _____ units of blood in an adult |
one or more; 10 units |
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Emergency transfusion warrants group _____ RBCs when patient type is not yet known. |
O |
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What component is most frequently involved with transfusion associated sepsis? |
platelets |
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Fatal transfusion reactions are most commonly caused by: |
clerical errors |
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Early manifstation of an acute hemolytic transfusion reaction can be confused with: |
febrile nonhemolytic reaction |
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Pain at infusion site and hypotension are observed with what type of reaction? |
acute hemolytic transfusion reaction |
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irradiation of blood is performed to prevent: |
transfusion-associated graft versus host disease |
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The only presenting sign most often accompanying a delayed hemolytic transfusion reaction is: |
unexplained decrease in hemoglobin |
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What transfusion reaction presents with fever, maculopapular rash, watery diarrhea, abnormal liver function, and pancytopenia? |
transfusion associated graft versus host disease |
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A suspected transfusion related death must be reported to: |
FDA |
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Nonimmune hemolysis can be caused during transfusion by: |
-Use of small bore size needle -Use of an infusion pump -Improper use of a blood warmer |
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Transfusion reactions are classified according to: |
-Signs or symptoms presenting during or after 24 hours -Immune or nonimmune -infectious or noninfectious |
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febrile nonhemolytic transfusion reactions: |
-are self-limited -fever resolves within 2-3 hours |
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Absolute IgA deficiency is a classic example of a severe allergic reaction. Results indicating an absolute IgA deficiency: |
<0.5 mg/dL |
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How are mild allergic transfusion reactions with isolated symptoms or hives and urticaria treated? |
Transfusion is stopped and antihistamines administrated; when symptoms improve, transfusion is restarted. |
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TRALI presents with what symptoms: |
respiratory distress, severe hypoxia and hypotension, fever |
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What is a characteristic of iron overload? |
delayed nonimmune complication, chelating agents are used, multiorgan damage may occur |
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Transfusion reactions are classified according to symptom time interval. Less than 24 hours: _______ transfusion reactions. Greater than 24 hours: ________ transfusion reactions. |
acute; delayed |
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The transfusion reaction workup is designed to rule in or rule out _____________. |
hemolysis |
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Acute transfusion reaction evaluation or testing includes: |
-clerical check -examination for visual hemolysis -DAT -patient ABO group confirmation |
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Acute transfusion reactions include: |
-Acute hemolytic reactions -Transfusion-associated sepsis -febrile nonhemolytic reactions -allergic reactions -TRALI -TACO |
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___________ hemolysis occurs when previously formed IgM (ABO) or IgG (non-ABO) antibodies in the recipient recognize the corresponding donor RBC antigen and result in complement-mediated intravascular hemolysis. Evidence of immune hemolysis in the postreaction sample from the acute transfusion reaction evaluation or test will need to be followed with comparison to the pretransfusion testing results. If necessary, additional testing in duplicate could include repeat basic immunohematology testing, eluate and antigen typing to identify the cause of the immune hemolysis. |
immune hemolysis |
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___________hemolysis occurs when the RBC suffers mechanical or chemical damage and is manifested as an asymptomatic hemoglobinuria |
non-immune |
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________________ occurs when bacteria are introduced to the patient via a contaminated blood product, manifested by an increase in body temp or more than 2C rigors and hypotension. Additional testing includes gram staining and cultures of blood component and the patient. Isolation of the same organism is key for diagnosis |
transfusion associated sepsis |
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_________________ occur when the recipient is exposed to the donor cytokines present in the WBC plasma and is manifested by an increase in body temp of more than 1C with or without chills. Workup must excluded hemolytic and septic reactions. |
febrile nonhemolytic reactions |
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Allergic reactions can be mild (hives or itching) or severe (anaphylaxis) and are mainly caused by the release of histamine from the interaction between the allergen present in the donor plasma and the recipient preformed IgE antibodies. A classic example is the one seen due to the presence of anti-IgA antibodies in a patient with absolute IgA deficiency. |
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_____________ occurs most frequently when donor leukocyte antibodies react with the WBCs in the recipient's lung vasculature, damaging the endothelium and causing noncardiogenic pulmonary edema. High plasma volume blood components from female donors are the most commonly associated blood components. |
TRALI
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_______ occurs when the patient's cardiovascular system is unable to handle the transfused volume resulting in congestive heart failure |
TACO |
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Delayed transfusion reactions include: |
-delayed serologic/hemolytic reactions, transfusion associated GVHD, post transfusion purpura, iron overload |
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____________________________ occurs when the transfusion derived donor lymphocytes attack and destroy the recipient immune system, causing pancytopenia and death. It is prevented by the gamma irradiation of blood components for transfusion to patient population at risk. |
transfusion associated GVHD |
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___________________________ is an acquired profound thrombocytopenia that occurs when a patient with preformed platelet antibodies is transfused with a blood component containing the platelet antigen and sharing specificity with the preformed antibodies, leading to the destruction of the donor and recipient platelets. |
post-transfusion purpura |
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_____________________ occurs due to long term accumulation of iron in the body from multiple RBC transfusions and causes organ damage |
iron overload |
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The fecal oral route is common in transmitting which hepatitis virus? |
HAV |
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What is the component of choice for a low birth weight infant with a hemoglobin of 8 g/dL is the mother is anti-CMV negative? |
RBCs from a donor who is anti-CMV negative |
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What test is useful to confirm that a patient or donor is infected with HCV? |
RIBA |
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What does the AABB consider to be the most significant infectious threat from transfusion? |
bacterial contamination |
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What is the most frequently transmitted virus from mother to fetus? |
CMV |
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jaundice due to HAV is seen most often in: |
adults |
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A step taken to reduce transfusion transmitted CMV is: |
leukoreduction |
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HBV remains infectious on environmental surfaces for: |
a week |
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HBV is transmitted most frequently by: |
sexual activity |
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What is the most common cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma in the US? |
HCV |
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The first retrovirus to be associated with human disease is: |
HTLV-1 |
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WNV: |
-1 in 50 infections result in severe neurologic disease -severe disease occurs most frequently in the over 50 age group -deaths occur more often in those over 65 years who present with encephalitis |
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The primary host for WNV: |
birds |
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Tests for WNV include: |
ELISA, NAT, plaque reduction neutralization test |
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Individuals exposed to EBV maintain an asymptomatic latent infection in: |
B cells |
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Fifth disease is caused by: |
Parvovirus B19 |
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Transient aplastic crisis can occur with |
Parvovirus B19 |
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Reasons why syphilis is so rare in the US blood supply include: |
-4C storage -donor questionnaire -short spirochetemia |
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Nucleic acid amplification testing for HIV was instituted in donor testing protocols to: |
reduce the window period by detecting the virus earlier than other tests available |
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Screening for HIV is performed using the following technique: |
NAT |
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The first form of pathogen inactivation was |
heat |
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What is the most common parasitic complication of transfusion? |
Plasmodium species |
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Which organism has a characteristic C or U shape on stained blood smears |
Trypanosoma cruzi |
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Which transfusion associated parasite may have asymptomatic carriers? |
-Babesia microti -Trypanosoma cruzi -Plasmodium species |
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Which disease is naturally caused by the deer tick? |
Babesiosis |
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HDFN is characterized by: |
Different RBC antigens between mother and father |
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The main difference between the fetus and the newborn is: |
bilirubin metabolism |
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Kernicterus is caused by the effects of: |
unconjugated bilirubin |
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The advantages of cordocentesis: |
-Allows measurement of fetal hemoglobin and hematocrit -Allows antigen typing of fetal blood -Allows direct transfusion of fetal circulation |
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Middle cerebral artery-peak systolic velocity is used to |
assess for anemia |
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Blood for intrauterine transfusion should be: |
-Screened for CMV -gamma irradiated -compatible with maternal serum |
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RhIG is indicated for |
mothers who are Rh negative |
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RhIG is given without regard for fetal Rh type in which conditions? |
-ectopic pregnancy rupture -amniocentesis -induced abortion |
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A Kleihauer-Betke test or flow cytometry indicates 10 fetal cells per 1,000 adult cells. For a woman with 5,000 mL blood volume, the proper dose of RhIG is: |
[(# fetal cells x maternal blood volume)/(# maternal cells)] / 30 + 1 3 vials |
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RhIG is indicated in which circumstance? |
Mother D negative, infant D positive |
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ABO HDFN is usually mild because |
ABO antigens are poorly developed at birth |
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A woman without prenatal care delivers a healthy term infant. A cord blood sample shows that the infant is A+ with a + DAT. The workup of the unexpected findings should include: |
DAT of the mother's specimen |
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_____________________ describes the presence of immature RBCs or erythroblasts in the fetal circulation because the splenic removal of the IgG coated RBCs causes anemia |
erythroblastosis fetalis |
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___________ is the most clinically significant of the non-Rh-system antibodies in the ability to cause HDFN |
anti-Kell |
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A cord blood workup includes: |
-tests for ABO and Rh -DAT |
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The most important serological test for diagnosis of HDFN is |
DAT with anti-IgG reagent |
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A QMS is |
active and continuous |
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QSEs are applied to |
the blood bank's path of workflow |
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cGMP refers to |
manufacturing blood components |
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Internal and external failure costs are: |
controlled through prevention and appraisal |
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A process: |
describes how to perform a task |
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A procedure: |
simply states what the facility will do |
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A policy: |
can be flowcharted |
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A blank form is a |
document |
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An example of a remedial action is: |
resolving the immediate problem |
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The PDCA cycle is used for |
problem resolution |
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The difference between the blood bank and laboratory QMSs is that |
The laboratory has a different path of workflow |
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The QSEs for the blood bank QMS can be used for the laboratory because |
the QSEs are universal |
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What screening cells are used for testing donor units for unexpected antibodies? |
Pooled |
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Process of removing antibodies from serum by combining a serum sample with appropriate red blood cells under optimal conditions: |
Absorption |
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Routine pre transfusion testing consists of: |
ABO typing, Rh typing, antibody screen |
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What determines if a red blood cell antibody is clinically significant? |
Shortened red blood cell survival |
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Why are screening cells group O? |
To prevent interferences with anti-A and anti-B in patient serum |
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What test is used to confirm the efficacy of chloroquine treatment? |
DAT |
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When might you suspect multiple antibodies in a patient's serum? |
Pattern of reactivity not fitting a single antibody, variation in phase of reactivity, variation in antibody reactivity strength |
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What is the simplest way of reducing the interferences from benign cold autoantibodies in antibody screening procedures? |
Use monospecific IgG |
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What is the purpose of saline washing in the antibody screen procedure? |
Removal of unbound IgG that would neutralize the AHG reagent |
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Why can't autoadsorption be performed on a patient who was transfused 1 month before? |
Donor cells might adsorb out alloantibody in serum |
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What makes up an autologous control |
Patient serum and patient cells |
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What makes up an autologous control |
Patient serum and patient cells |
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If you suspected anti-C is present in a patient's serum and anti-Fya still has to be ruled out using other reagent cells, what would the phenotype of the rule out cell have to be? |
Fy(a+), C+, Fy(b-) |
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After completing an antibody screen using the gel testing method, results after centrifugation yield a pellet of unagglutinated cells at the bottom of the microtube and a thin layer of cells at the top gel column. This situation indicates: |
That fibrin from serum that has not clotted completely |
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The FDA has approved the __________ for application of gel technology |
ABO, antibody screen, DAT |
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Which tests are available for both the gel testing method and solid phase technology? |
AHG, ABO, DAT |
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The washing procedure is applicable to what serological methods? |
Solid phase and tube system |
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What may be added to samples from patients taking heparin to induce clotting |
Protamine sulfate |
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A phlebotomist enters a patient room to draw blood for a 2-unit cross match. The patient is not wearing a wristband. How can the patient be identified? |
Ask patient to state their full name, address, and social security number and match response to information on requisition form. |
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What type of blood must be given in an intrauterine transfusion if the blood type of the fetus is unknown? |
O-negative |
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What criterion governs the use of the electronic crossmatch? |
Patient's ABO group must have Ben determined on two separate occasions |
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What is an electronic cross match? |
Comparison of donor and patient ABO groups and serologic data from a computer file |
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What is an electronic cross match? |
Comparison of donor and patient ABO groups and serologic data from a computer file |
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Why is it acceptable to transfuse an AB person with A packed red blood cells but unacceptable to transfuse type A whole blood |
The anti-B in donor whole blood would sensitize recipient cells |
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What tests are required on autologous units transfused within the collecting facility? |
ABO, Rh, antibody screen |
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Recipient serum that reacted with one out of five donor units in the AHG phase and where the antibody screen was negative is probably due to: |
An alloantibody directed against a low frequency antigen |
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Recipient serum that reacted with one out of five donor units in the AHG phase and where the antibody screen was negative is probably due to: |
An alloantibody directed against a low frequency antigen |
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What may be used as potentiators in the antiglobulin crossmatch? |
Albumin, LISS, PEG |
