問題一覧
1
Transfusion medicine is defined as:
The procedures involved in collecting, storing, processing, and distributing blood and dispensing blood components to patients.
2
Immunohematology is defined as:
The techniques and procedures involving the study of the immunologic responses of blood (RBCs)
3
All the following are benefits and reasons for blood transfusion except:
Replace antibiotics in treatment of granulocytic patients with infections.
4
Fresh frozen plasma is characterized by all the following statement except:
A source of all coagulation factors
5
Packed red blood cells are characterized by all the following except:
Can be used exclusively in cases of massive bleeding without any other fluids.
6
Platelet concentrates are characterized by all the following except:
Never need to be crossmatched
7
Which of the following tests is required in the screening of potential blood donors for transfusion-transmitted disease?
All the above
8
8) Autologous donation is characterized as:
All the above
9
17) Other blood group systems include.
All the following
10
18) The indirect antiglobulin test is performed:
On serum suspected of containing antibodies
11
19) The direct antiglobulin test (DAT) is performed:
On RBCs suspected of being coated with antibody
12
20) When blood is to be transfused to a patient, the most important question is:
Does the patient’s serum contain an antibody against the donor’s RBCs?
13
22) Crossmatching of the donor’s RBCs with the patient’s serum could demonstrate:
Major incompatibility between patient and donor
14
23) Testing of the patient’s serum with a panel of group O cells for unexpected antibodies can demonstrate:
Patient antibodies to various no self-antigens
15
23) Compatibility testing can help to detect:
All the above
16
Which of the following are generally characterized as a transfusion reaction?
All the above
17
Crossmatching of the donor’s RBCs with the patient serum.
True
18
Crossmatching of the patient’s RBCs with the donor serum
False
19
Factor VIII
Treatment of severe von Willebrand’s disease.
20
Crystalloid solutions or plasma substitutes
Restore or maintain blood volume.
21
Fresh frozen plasma
Source of labile clotting factors
22
Packed red blood cells
Restore or maintain oxygen-carrying capacity
23
Platelet concentrates
Bleeding caused by low or dysfunctional platelets
24
Whole blood
Rarely, if ever, used in transfusion
25
how often is ABO incompatibility seen ?
1 out of 5 pregnancies; most often mild or subclinical
26
Pathogenesis
Fetomaternal Hemorrhage--> Maternal antibodies formed against paternally derived antigens--> During subsequent pregnancy, placental passage of Maternal IgG antibodies--> maternal antibody attaches to fetal RBC--> fetal RBC hemolysis
27
what subclass of IgG cause greater red cell destruction ?
IgG1 and IgG3
28
What is the most important diagnostic procedure to assess the severity of HDN in utero?
amniocentesis; the decision to perform is based on maternal AB titter and obstetric history and ultrasound examination
29
when is intrauterine transfusion used
- severe anemia when the infant is under 29 weeks gestation, or immature for gestational age and should not be delivered. - accomplished indirectly by infusing packed cells throughout the abdominal wall into the peritoneum( lining of the abdominal cavity)
30
ultra sound examination can detect symptoms of what diseases
subcutaneous edema, pericardial effusion, or fetal ascites
31
Exhange transfusion
removes bilirubin and maternal anitbodies in additon to replacing antibody coated RBC with compatible donor cells
32
phototherapy
exposure to UV light, decomposes bilirubin into non-toxic substances. used to treat low levels of bilirubin in conditions such as ABO-HDN or normal neonatal jaundice
33
what is the most important serologic test in diagnosis of HDN after childbirth
Direct antibody test - positivity: indicates that antibody is coating infants RBC's in vivo( in living organisms) - equate may be performed to identify AB
34
The number of adsorptions performed to remove the suspected autoantibody is dependent on the strength of its reactivity....
True
35
Paroxysmal Nocturnal Haemoglobinuria AIHA was not associated with syphilis but more recently is seen secondary to viral
False
36
A patient had a transfusion reaction. The technologist began the laboratory investigation of the transfusion reaction by assembling pre and post-transfusion specimens and paperwork along with computer printout. He checked the patient's records and talked with the nurse in charge of the patient. What should he do first?
Check for clerical error
37
A patient has a haemolytic reaction to blood transfusion 8 days age. What is the most likely cause?
Delaved immunologic; probably due to an antibody such as anti-JKª.
38
When hematuria is observed in a recently transfused patient what is the possible Implication?
Hematuria is indicative of a severe haemolytic reaction
39
A patient with severe anemia became cyanotic and develop tachycardia, hypertension and difficulty breathing after receiving 3 units of blood. No fever or other symptoms were evident. This is most likely what type of reaction?
Transfusion-associated circulatory overload (TACO)
40
Autoantibodies are all of the following except:
Non immune and naturally occurring
41
Evidence of Autoimmune Hemolytic Anemia include:
Continuous elevation of unconjugated bilirubin levels.
42
A trauma patient had a severe hemolytic reaction just minutes after receiving a blood transfusion. What is the most likely cause?
Immediate, immunologic; probably due to clerical error, ABO incompatibility.
43
All of the following are reasons for performing an adsorption except
Identification of antibodies causing a positive DAT
44
What is needed for detection of some drug-induced antibodies?
Drug-coated cells
45
After receiving a unit of packed red cells the patient immediately experience flushing, nervousness and a fever spike 102 degrees, shaking, chills and back pain. the plasma hemoglobin was elevated and there was hemoglobinuria. Laboratory investigation of the adverse reaction would likely show:
an error in ABO grouping
46
A patient has become refractory to platelet transfusion. which of the following are the probable cause?
Development of antibodies to HLA antigens
47
A poor increment in platelet count 1 hour following platelet transfusion is most commonly caused by?
Alloimmunization to HLA antigens
48
Symptoms of dyspnea, coughing, hypoxemia and pulmonary edema within 6 hours of transfusion is most likely which type of reaction?
TRALI
49
A 65 year old woman experience fever 102 degrees, chills and shaking approximately 40 minutes after receiving a second unit of packed red cells. The most likely explanation for the patients condition is?
Transfusion of bacterially contaminated blood
50
Which of the following transfusion reaction is characterized by high fever, shock, hemoglobinuria, DIC and renal failure?
Bacterial Contamination
51
When evaluating a suspected transfusion reaction, which is the ideal sample collection time for bilirubin determination.
6 hours post transfusion
52
During initial investigation of a suspected hemolytic transfusion reaction, it was observed that the post transfusion serum sample was yellow in color and the direct antiglobulin test was negative. repeated ABO typing on the post transfusion sample confirmed the pretransfusion results. What is the next step you should take in this investigation?
No further serological test is necessary
53
Which of the following antibodies is classified as "biphasic" and an autoantibody?
Anti-P
54
A patient receiving ceftriaxone develops haemolytic anaemia. The DAT is positive (IgG + C3). The patient's serum reacts with all test RBC's (no drug added) by the indirect Antiglobulin test, but an eluate prepared from the patient's BC is non-reactive. Which is the most likely explanation for these results?
Elution
55
A warn non-specific autoantibody was causing a positive DAT. How can these antibodies can be removed from red cells?
ZZAP
56
A patient had a transfusion reaction. His red cells revealed a positive DAT; however, his antibody screen was negative. what procedure would remove the antibody from his red cells to allow for the identification of the probable cause of the transfusion reaction?
EElution
57
Post transfusion Purpura is usually caused by white cell antibodies.
False
58
Sever intravascular hemolysis is primarily caused by antibodies to the Rh system?
False
59
Hives and itching are symptoms of which transfusion reaction.
Allergic
60
Clinical findings include renal failure occurs in about 50% of the patients suffering from Drug Induced Autoimmune Hemolytic Anemia.
True
61
Fresh Frozen Plasma from a group A, Rh-positive donor may be safely transfused to a patient who is group.
A, Rh-negative
62
Alternatives to allogenic and autologous blood transfusions include the following ___________ and ________.
ESA and PAD
63
To Prevent recurrent or severe allergic reactions, IgA deficient patients is best transfused with
Washed RBCs