IMMUNOHEMATOLOGY 2

100問 • 2年前

問題一覧

19. Given a situation where screening cells, major crossmatch, autocontrol, and DAT (anti-IgG) are all positive, what procedure should be performed next? * 1/1 A. Adsorption using rabbit stroma B. Antigen typing of patient cells C. Elution followed by a cell panel on the eluate D. Selected cell panel

C. Elution followed by a cell panel on the eluate

20. A major crossmatch and screening cells are 2+ at the IS phase, 1+ at 37°C, and negative at the IAT phase. Identify the most likely problem. * 0/1 A. Combination of antibodies B. Cold alloantibody C. Rouleaux D. Test error

B. Cold alloantibody

21. What corrective action should be taken when rouleaux causes positive test results? * 0/1 A. Perform a saline replacement technique B. Perform an autoabsorption C. Run a panel D. Perform an elution

A. Perform a saline replacement technique

22. All of the following are reasons for performing an adsorption, except: * 0/1 A. Separation of mixtures of antibodies B. Removal of interfering substances C. Confirmation of weak antigens on RBCs D. Identification of antibodies causing a positive DAT

D. Identification of antibodies causing a positive DAT

23. How long must a recipient sample be kept in the blood bank after compatibility testing? * 1/1 A. 3 days B. 5 days C. 7 days D. 10 days

C. 7 days

24. What is the crossmatching protocol for platelets and/or plasma? * 0/1 A. Perform a reverse grouping on donor plasma B. No testing is required C. Perform a reverse grouping on recipient plasma D. Platelets must be HLA compatible

B. No testing is required

25. What are the compatibility requirements for an autologous unit? * 0/1 A. ABO and Rh typing B. Type and screen C. Major crossmatch D. All of these options

A. ABO and Rh typing

26. A patient is typed as AB positive. Two units of blood have been ordered by the physician. Currently, the inventory shows no AB units, 10 A-positive units, 1 A-negative unit, 5 B-positive units, and 20 O-positive units. Which should be set up for the major crossmatch? * 0/1 A. A-positive units B. O-positive units C. B-positive units D. Call another blood supplier for type-specific blood

A. A-positive units

27. Which of the following comprises an abbreviated crossmatch? * 1/1 A. ABO, Rh, and antibody screen B. ABO, Rh, antibody screen, IS crossmatch C. Type and screen D. ABO, Rh, IS crossmatch

B. ABO, Rh, antibody screen, IS crossmatch

28. When may IS crossmatching be performed? * 1/1 A. When a patient is being massively transfused B. When there is no history of antibodies and the current antibody screen is negative C. When blood is being emergency released D. When a patient has not been transfused in the past 3 months

B. When there is no history of antibodies and the current antibody screen is negative

1. A patient had a transfusion reaction to packed RBCs. The MLS began the laboratory investigation of the transfusion reaction by assembling pre- and post-transfusion specimens and all paperwork and computer printouts. What should the MLS do next? * 0/1 A. Perform a DAT on the post-transfusion sample B. Check for clerical error(s) C. Repeat ABO and Rh typing of patient and donor units D. Perform an antibody screen on the post-transfusion sample

B. Check for clerical error(s)

2. What is the pathophysiological cause surrounding anaphylactic and anaphylactoid reactions? * 1/1 A. Antibody in patient's serum is detected 3 to 7 days after transfusion and is attached to donor RBCs B. Donor plasma has reagins (IgE or IgA) that combine with allergens in patient's plasma C. Patient is deficient in IgE and develops IgE antibodies via sensitization as a result of transfusion or pregnancy D. Patient is deficient in IgA and develops IgA antibodies via sensitization as a result of transfusion or pregnancy

D. Patient is deficient in IgA and develops IgA antibodies via sensitization as a result of transfusion or pregnancy

3. A patient has a hemolytic reaction to blood transfused 8 days ago. What is the most likely cause? * 1/1 A. Immediate, nonimmunologic, probably as a result of volume overload B. Delayed immunologic, probably as a result of an antibody such as anti-Jka C. Delayed nonimmunologic, probably as a result of iron overload D. Immediate, immunologic, probably as a result of clerical error, ABO incompatibility

B. Delayed immunologic, probably as a result of an antibody such as anti-Jka

4. What may be found in the serum of a person who is exhibiting signs of transfusion-related acute lung injury (TRALI)? * 0/1 A. RBC alloantibody B. IgA antibody C. Antileukocyte antibody D. Allergen

C. Antileukocyte antibody

5. Which type of transfusion reaction occurs in about 1% of all transfusions, results in a temperature rise of greater than 1°C above 37°C associated with blood component transfusion, and is not related to the patient’s medical condition? * 0/1 A. Immediate hemolytic B. Delayed hemolytic C. Febrile nonhemolytic reaction D. TRALI

C. Febrile nonhemolytic reaction

6. What would be the result of group A blood given to a group O patient? * 0/1 A. Nonimmune transfusion reaction B. Immediate hemolytic transfusion reaction C. Delayed hemolytic transfusion reaction D. Febrile nonhemolytic transfusion reaction (FNHTR)

B. Immediate hemolytic transfusion reaction

7. Patient DB received 2 units of group A-positive RBCs 2 days ago. Two days later, he developed a fever and appeared jaundiced. His blood type was A positive. A transfusion reaction workup was ordered. There were no clerical errors detected. A posttransfusion specimen was collected and a DAT performed. The DAT result was positive with monospecific anti-IgG. The plasma was also hemolyzed. An antibody screen and panel studies revealed the presence of anti-Jkb in the post-transfusion specimen. The antibody screen on the pretransfusion specimen was negative. Which of the following explains the positive DAT? * 1/1 A. The donor cells had a positive DAT B. The donor cells were polyagglutinable C. The donor cells were likely positive for the Jkb antigen D. The recipient cells were likely positive for the Jkb antigen

C. The donor cells were likely positive for the Jkb antigen

8. All of the following are part of the preliminary evaluation of a transfusion reaction, except: * 1/1 A. Check pre- and post-transfusion samples for color of serum B. Perform ABO and Rh recheck C. Perform DAT on the post-transfusion sample D. Perform a panel on pre- and post-transfusion samples

D. Perform a panel on pre- and post-transfusion samples

9. A 68-year-old female diagnosed with neutropenia and inflammation of the left hand was typed as A positive and received 1 packed RBC unit. The antibody screen was negative, and crossmatch was compatible. During the transfusion, her pulse was 94, and blood pressure (BP) rose from 114/59 mm Hg to 132/64 mm Hg. Temperature rose from 37.1°C before transfusion to 37.8°C 60 minutes after starting transfusion and then to 38.3°C upon completion. A post transfusion specimen yielded plasma that was neither hemolyzed nor icteric, and a negative DAT. Post-transfusion urinalysis showed 1+ blood and protein with 10 RBCs/high-power field (hpf) microscopically. The clerical check result was acceptable. What type of reaction most likely occurred as a result of transfusion? * 1/1 A. Allergic B. Circulatory overload C. Febrile nonhemolytic D. Delayed hemolytic

C. Febrile nonhemolytic

10. A 92-year-old male diagnosed with anemia and episodes of frequent falling was typed as B negative and transfused with 1 unit of packed RBCs, also B negative. He had not been recently transfused, and the antibody screen was negative. During the transfusion, his temperature rose from 36.2°C to 36.4°C, his pulse from 96 to 124, respirations from 18 to 20, and BP from 127/81 mm Hg to 174/83 mm Hg. He was transfused with 205 mL before a reaction was called by the transfusionist. The post-transfusion specimen DAT result was negative, and the clerical check result was acceptable. Urinalysis showed 1+ blood with 5 RBCs microscopically. Other symptoms included tachycardia and flushing. What reaction had most likely taken place? * 0/1 A. Febrile nonhemolytic B. Acute hemolytic C. Anaphylactic D. Volume overload

D. Volume overload

11. A 76-year-old female diagnosed with urosepsis was transfused with 2 units of packed RBCs. Her type was AB positive and she had a negative result on antibody screen. The units transfused were AB positive. Upon receiving the second unit, the patient became hypoxic with tachypnea. The clerical check result was acceptable, and the DAT was negative. She received 269 mL from the second unit before a reaction was called. Her temperature fell from 38°C to 36.4°C, her pulse increased from 72 to 90, and respirations rose from 35 to 41. Her BP was 110/70 mm Hg. The patient died approximately 12 hours after the reaction was called. What type of reaction was most likely present? * 0/1 A. Febrile B. Symptoms not related to transfusion C. Allergic D. TRALI

B. Symptoms not related to transfusion

12. A 52-year-old male received 2 units of packed RBCs as an outpatient in the intravenous (IV) therapy unit. He had had a head trauma 20 years ago and was quadriplegic. He had recurrent pneumonia and hematuria as a result of removal of a Foley catheter. His blood type was A positive, with previously identified anti-Fya. There was an ABO discrepancy, in that reverse typing with reagent A1 cells was positive. The MLS attributed this reaction to Fya antigen being present on the reagent A1 cells. The patient also had a cold autoantibody. Two units of A-positive packed cells were crossmatched that were Fya negative and were compatible. One unit was transfused at 11:30 a.m. without incident. The second unit was transfused at 2:16 p.m. and stopped at 3:55 p.m. because of reddish brown–tinged urine found in his collection bag. A post-transfusion specimen yielded a positive DAT and plasma that was grossly hemolyzed. A prewarm crossmatch was incompatible in both the pre- and post-transfusion specimens. Anti-E and anti-c were present in the post-transfusion specimen. What reaction was most likely present? * 0/1 A. Acute hemolytic B. Febrile C. Allergic D. TRALI

A. Acute hemolytic

13. An 82-year-old male was admitted for renal failure. His type was B positive, and his antibody screen was negative. Two units of RBCs were ordered. The first unit was transfused at 1:00 p.m. without incident. The second was started at 4:15 p.m. and stopped at 5:12 p.m. after the nurse observed that the patient had died. Vital signs had been taken at 4:30 p.m. with no abnormalities. A transfusion reaction was called and the blood unit, tubing, and paperwork sent to the blood bank. There were no clinical manifestations noted on the paperwork, and no post-transfusion specimen was sent to the blood bank. What type of reaction most likely occurred? * 1/1 A. Cause not related to transfusion B. Acute hemolytic reaction C. Anaphylactic reaction D. Volume overload

A. Cause not related to transfusion

1. A male patient with cancer was admitted to the hospital with acute abdominal pain and a hemoglobin level of 6 g/dL. Small bowel resection was indicated, but the attending physician wanted to raise the patient’s hemoglobin level to 12 g/dL before surgery. How many units of RBCs would most likely be required to accomplish this? * 0/1 A. 2 B. 3 C. 6 D. 8

C. 6

2. Which of the following is not a viable method for removing leukocytes from RBCs? * 1/1 A. Prestorage filtration B. Bedside filtration C. Poststorage filtration D. Buffy coat removal

D. Buffy coat removal

3. Four units of packed RBCs were brought to the nurses’ station at 10:20 a.m. Two units were transfused immediately, and 1 unit was transfused at 10:40 a.m. The remaining unit was returned to the blood bank at 11:00 a.m. The units were not refrigerated after leaving the blood bank. What problem(s) is (are) present in this situation? * 0/1 A. The only problem is with the returned unit; the 30-minute limit has expired and the unit cannot be used. B. The unit should not have been transfused at 10:40 a.m. because the time limit had expired; this unit and the remaining unit should have been returned to the blood bank C. The returned unit may be held for this patient for 48 hours but cannot be used for another patient D. No problems; all actions were performed within the allowable time limit

A. The only problem is with the returned unit; the 30-minute limit has expired and the unit cannot be used.

4. A unit of whole blood is collected at 10:00 a.m. and stored at 20°C to 24°C. What is the last hour at which platelet concentrates may be made from this unit? * 1/1 A. 4:00 p.m. B. 6:00 p.m. C. 7:00 p.m. D. 8:00 p.m.

B. 6:00 p.m.

5. Which of the following is acceptable according to the AABB standards? * 0/1 A. Rejuvenated RBCs may be made within 3 days of outdated and transfused or frozen within 24 hours of rejuvenation B. Frozen RBCs must be prepared within 30 minutes of collection and may be used within 10 years C. Irradiated RBCs must be treated within 8 hours of collection and transfused within 6 hours D. Leukocyte-reduced RBCs must be prepared within 6 hours of collection and transfused within 6 hours of preparation

A. Rejuvenated RBCs may be made within 3 days of outdated and transfused or frozen within 24 hours of rejuvenation

6. Which of the following is true regarding apheresis platelets? * 0/1 A. The minimum platelet count must be 3.0 × 10^11, pH must be 6.0 or greater B. The minimum platelet count must be 3.0 × 10^10, pH must be 6.2 or less C. The minimum platelet count must be 3.0 × 10^11, pH must be 6.2 or greater D. The minimum platelet count must be 5.5 × 10^10, pH must be 6.0 or less

C. The minimum platelet count must be 3.0 × 10^11, pH must be 6.2 or greater

7. What is the component of choice for a patient with chronic granulomatous disease (CGD)? * 1/1 A. Fresh frozen plasma (FFP) B. Granulocytes C. Cryoprecipitate D. RBCs

B. Granulocytes

8. What method can be employed to detect bacteria in random donor platelets? * 1/1 A. pH B. Glucose C. Pan-genera detection (PGD) assay D. Gram stain

C. Pan-genera detection (PGD) assay

9. All of the following statements regarding FFP are true, except: * 1/1 A. FFP must be prepared within 24 hours of collection B. After thawing, FFP must be transfused within 24 hours C. Storage temperature for FFP with a 1-year shelf life is –18°C or less D. When thawed, FFP must be stored between 1°C to 6°C

A. FFP must be prepared within 24 hours of collection

10. What may be done to RBCs before transfusion to a patient with cold agglutinin disease to reduce the possibility of a transfusion reaction? * 0/1 A. Irradiate to prevent graft-versus-host-disease (GVHD) B. Wash with 0.9% saline C. Warm to 37°C with a blood warmer D. Transport so that temperature is maintained at 20°C to 24°C

C. Warm to 37°C with a blood warmer

11. A unit of packed RBCs is split using the open system. One of the half units is used. What may be done with the second half unit? * 1/1 A. Must be issued within 24 hours B. Must be issued within 48 hours C. Must be irradiated D. Must retain the original expiration date

A. Must be issued within 24 hours

12. What should be done if a noticeable clot is found in an RBC unit? * 1/1 A. Issue the unit; the blood will be filtered B. Issue the unit; note the presence of a clot on the release form C. Filter the unit in the blood bank before issue D. Do not issue the unit

D. Do not issue the unit

13. Cryoprecipitate may be used to treat all of the following, except: * 0/1 A. von Willebrand disease B. Hypofibrinogenemia C. Idiopathic thrombocytopenic purpura (ITP) D. Factor XIII deficiency

C. Idiopathic thrombocytopenic purpura (ITP)

14. SITUATION: A transplant patient may receive only type A or AB platelets. Only type O apheresis platelets are available. What devices may be used to deplete the incompatible plasma and replace with sterile saline? * 1/1 A. Cytospin/irradiator B. Water bath/centrifuge C. Centrifuge/sterile connecting device D. Cell washer/heat sealer

C. Centrifuge/sterile connecting device

15. What component(s) is (are) indicated for patients who have anti-IgA antibodies? * 1/1 A. Whole blood B. Packed RBCs C. Washed or deglycerolized RBCs D. Granulocytes

C. Washed or deglycerolized RBCs

16. What is the expiration date for pooled cryoprecipitate (pooled before freezing)? * 0/1 A. 12 months from latest date of collection of product in pool B. 12 months from earliest date of collection of product in pool C. 4 hours D. 6 hours

B. 12 months from earliest date of collection of product in pool

17. All of the following are true regarding washed RBCs, except: * 0/1 A. RBCs are washed with 1 to 2 L of normal saline B. Volume is 180 mL C. Shelf life is extended D. Leukocytes are removed

C. Shelf life is extended

18. What is a special condition for the storage of platelets? * 1/1 A. Room temperature, 20°C to 24°C B. No other components may be stored with platelets C. Platelets must be stored upright in separate containers D. Platelets require constant agitation at 20°C to 24°C

D. Platelets require constant agitation at 20°C to 24°C

19. Transfusion of an irradiated product is indicated in all of the following conditions except: * 0/1 A. Exchange transfusion B. Bone marrow transplantation C. Severe combined immunodeficiency syndrome (SCIDS) D. Warm autoimmune hemolytic anemia

D. Warm autoimmune hemolytic anemia

20. What percentage of RBCs must be retained in leukocyte-reduced RBCs? * 0/1 A. 75% B. 80% C. 85% D. 100%

C. 85%

21. Which of the following is true regarding granulocyte concentrates? * 0/1 A. The product must contain a maximum of 1.0 × 1010 granulocytes B. pH must be 6.0 C. The product must be crossmatched D. The product must be irradiated

C. The product must be crossmatched

22. What course of action should be taken if an MLS inadvertently irradiates a unit of RBCs twice? * 0/1 A. Issue the unit B. Discard the unit C. Change the expiration date; then issue the unit D. Note on the irradiation sticker that the unit was irradiated twice, and then issue the unit

B. Discard the unit

23. What components(s) may be shipped together with FFP? * 1/1 A. Frozen RBCs and cryoprecipitate B. Platelets C. Packed RBCs and granulocytes D. Double RBC units

A. Frozen RBCs and cryoprecipitate

24. A blood supplier ships 3 units of pooled cryoprecipitate. Each pool consists of 5 units of cryoprecipitate. If one unit is thawed at 5:00 p.m., when must it be dispensed from the blood bank? * 1/1 A. Before 9:00 p.m. B. Before 11:00 p.m. C. Before 12:00 a.m. D. Before 5:00 p.m. the next day

A. Before 9:00 p.m.

25. How does irradiation prevent transfusion-associated graft-versus-host disease (TA-GVHD)? * 0/1 A. Gamma rays and x-rays destroy the lymphocytes’ ability to divide B. X-rays cause lysis of the lymphocytes C. Gamma rays enhance lymphocyte reactivity D. Ultraviolet radiation induces apoptosis of lymphocytes

A. Gamma rays and x-rays destroy the lymphocytes’ ability to divide

26. Which component has the longest expiration date? * 0/1 A. Cryoprecipitate B. FFP C. Frozen RBCs D. Platelet concentrates

C. Frozen RBCs

27. All of the following are advantages of using single-donor platelets as opposed to random donor platelets, except: * 1/1 A. Less preparation time B. Less antigen exposure for patients C. May be HLA matched D. No pooling is required

A. Less preparation time

28. What is the expiration of cryoprecipitate once pooled without the use of a sterile connecting device? * 0/1 A. 4 hours B. 6 hours C. 8 hours D. 24 hours

A. 4 hours

29. What is the number of WBCs permitted in a unit of leukocyte-reduced RBCs? * 0/1 A. Less than 5 × 10^10 B. Less than 5 × 10^6 C. Less than 8.3 × 10^5 D. Less than 8.3 × 10^6

B. Less than 5 × 10^6

30. SITUATION: A patient with cancer recently developed a severe infection. The patient’s hemoglobin level is 8 g/dL as a result of chemotherapy with a drug known to cause bone marrow depression and immunodeficiency. Which blood products are indicated for this patient? * 1/1 A. Liquid plasma and cryoprecipitate B. Crossmatched platelets and washed RBCs C. Factor IX concentrates and FFP D. Irradiated RBCs, platelets, and granulocytes

D. Irradiated RBCs, platelets, and granulocytes

1. Which of the following individuals is acceptable as a blood donor? * 1/1 A. A 29-year-old man who received the hepatitis B vaccine last week B. A 21-year-old woman who had her nose pierced last week C. A 30-year-old man who lived in Zambia for 3 years and returned last month D. A 54-year-old man who tested positive for hepatitis C last year but has no active symptoms of disease

A. A 29-year-old man who received the hepatitis B vaccine last week

2. SITUATION: A 53-year-old woman donates blood at her place of employment. She weighs 150 lb and has a hemoglobin level of 13 g/dL. She is currently on warfarin and vitamin B12. Is she an acceptable donor? * 0/1 A. Yes B. No, she is on warfarin C. Yes, for RBCs only D. No, her hemoglobin is too low

C. Yes, for RBCs only

3. Which immunization has the longest deferral period? * 1/1 A. Hepatitis B immune globulin (HBIG) B. Rubella vaccine C. Influenza vaccine D. Yellow fever vaccine

A. Hepatitis B immune globulin (HBIG)

4. The following whole blood donors regularly give blood. Which donor may donate on September 10? * 0/1 A. A 40-year-old woman who last donated on July 23 B. A 28-year-old man who had plateletpheresis on August 24 C. A 52-year-old man who made an autologous donation on September 9 D. A 23-year-old woman who donated blood for her aunt on August 14

B. A 28-year-old man who had plateletpheresis on August 24

5. Which of the following precludes acceptance of a plateletpheresis donor? * 0/1 A. Platelet count of 75 × 10^9/L in a donor who is a frequent platelet donor B. Plasma loss of 800 mL from plasmapheresis 1 week ago C. Plateletpheresis performed 4 days ago D. Aspirin ingested 7 days ago

A. Platelet count of 75 × 10^9/L in a donor who is a frequent platelet donor

6. Which of the following donors could be accepted for whole blood donation? * 1/1 A. A construction worker who was incarcerated for opiate abuse B. A triathlete with a pulse of 45 C. A man who is currently taking finasteride (Propecia) D. A woman in her 14th week of pregnancy

B. A triathlete with a pulse of 45

7. Which physical examination result is cause for rejecting a whole blood donor? * 1/1 A. Weight of 105 lb B. Pulse of 75 C. Temperature of 37.4°C (99.3°F) D. Diastolic pressure of 110 mm Hg

D. Diastolic pressure of 110 mm Hg

8. Which situation is not a cause for indefinite deferral of a donor? * 1/1 A. Male donor whose father has been diagnosed with Creutzfeldt-Jakob disease (CJD) B. Donation of a unit of blood that transmitted hepatitis B virus (HBV) to a recipient C. Donor tested reactive for HBV by nucleic acid testing (NAT) D. Accidental needlestick 1 year ago; negative for infectious disease

D. Accidental needlestick 1 year ago; negative for infectious disease

9. A whole blood donor currently on clopidogrel (Plavix) is precluded from donating which product? * 0/1 A. Platelets B. RBCs C. FFP D. Cryoprecipitate

A. Platelets

10. How much anticoagulant would have to be removed from the collection bag given a donor who weighs 90 lb? * 0/1 A. 12 mL B. 15 mL C. 20 mL D. 23 mL

A. 12 mL

11. A woman begins to breathe rapidly while donating blood. Choose the correct course of action. * 0/1 A. Continue the donation; rapid breathing is not a reason to discontinue a donation B. Withdraw the needle, raise her feet, and administer ammonia C. Discontinue the donation, and provide a paper bag for donor to breathe slowly into D. Tell her to sit upright, and apply a cold compress to her forehead

C. Discontinue the donation, and provide a paper bag for donor to breathe slowly into

12. A donor bag is half filled during donation when the blood flow stops. Select the correct course of action. * 1/1 A. Closely observe the bag for at least 3 minutes; if blood flow does not resume, withdraw the needle B. Remove the needle immediately, and discontinue the donation C. Check and reposition the needle, if necessary, if blood flow does not resume, withdraw the needle D. Withdraw the needle, and perform a second venipuncture in the other arm

C. Check and reposition the needle, if necessary, if blood flow does not resume, withdraw the needle

13. Who is the best candidate for a predeposit autologous donation? * 0/1 A. A 45-year-old man who is having elective surgery in 2 weeks; he has alloanti-k B. A 23-year-old female patient with leukemia and a hemoglobin level of 10 g/dL C. A 12-year-old boy who has hemophilia D. A 53-year-old woman who has septicemia

A. A 45-year-old man who is having elective surgery in 2 weeks; he has alloanti-k

14. Can an autologous donor donate blood on Monday if he or she is having surgery on Friday? * 1/1 A. Yes, he or she can donate up to 72 hours before surgery B. No, he or she cannot donate within 7 days of surgery C. Yes, he or she can donate, but only a half a unit D. No, he or she cannot donate within 5 days of surgery

A. Yes, he or she can donate up to 72 hours before surgery

15. Which of the following is an acceptable time in which a unit of whole blood is collected? * 0/1 A. 33 minutes B. 25 minutes C. 20 minutes D. 13 minutes

D. 13 minutes

16. Which of the following is true regarding acute normovolemic hemodilution? * 0/1 A. One or more units of blood are withdrawn from the patient and replaced with FFP B. Units removed may be stored in the operating room at room temperature for 8 hours C. Units removed may be stored in the operating room at room temperature for 24 hours D. Unused units can be added to the general donor blood inventory

B. Units removed may be stored in the operating room at room temperature for 8 hours

17. All of the following apply to a double RBC unit apheresis collection except: * 0/1 A. The hematocrit must be at least 38% B. The weight for a female is at least 150 lb C. The height for a male is at least 5 ft 1 in D. The deferral period following collection is 16 weeks

A. The hematocrit must be at least 38%

18. An autologous unit of whole blood was collected on a 33-year-old woman in preparation for a knee replacement procedure in 3 weeks. The whole blood unit had her hyphenated last name, first name, and last four digits of her social security number for identification. The laboratory computer system, however, only had her married name and first name, medical record number, and social security number. What should be done with this blood product? * 1/1 A. Discard the unit B. Make the unit available for transfusion C. Confirm the name with the donor, have admissions make the correction in the computer system, and then make the unit available for transfusion D. Ensure that social security number match, confirm the name with the donor and have admissions make the correction in the computer system with the medical director's approval, and then make the unit available for transfusion

D. Ensure that social security number match, confirm the name with the donor and have admissions make the correction in the computer system with the medical director's approval, and then make the unit available for transfusion

19. What is the youngest age a person can make allogeneic whole blood donation? * 1/1 A. 14 years B. 15 years C. 16 years D. 17 years

C. 16 years

20. Which of the following donors are acceptable for whole blood donation? * 1/1 A. A man who had sex with another man 2 weeks ago B. A male construction worker who tested positive for hepatitis B surface antigen (HBsAg) C. A man who had sex with another man 2 years ago D. A female who had sex with a male who had sex with another male (MSM) 1 month ago

C. A man who had sex with another man 2 years ago

1. All of the following are reasons for a positive DAT on cord blood cells of a newborn except: * 1/1 A. High concentrations of Wharton jelly on cord blood cells B. Immune anti-A from an O mother on the cells of an A baby C. Immune anti-D from an Rh negative mother on the cells of an Rh-positive baby D. Immune anti-K from a K-negative mother on the cells of a K-negative baby

D. Immune anti-K from a K-negative mother on the cells of a K-negative baby

2. A fetal screen yielded negative results on a mother who is O negative and infant who is O positive. What course of action should be taken? * 1/1 A. Perform a Kleihauer-Betke test B. Issue one full dose of RhIg C. Perform a DAT on the infant D. Perform an antibody screen on the mother

B. Issue one full dose of RhIg

3. What should be done when a woman who is 24 weeks pregnant has a positive antibody screen? * 0/1 A. Perform an antibody identification panel; titer, if necessary B. No need to do anything until 30 weeks’ gestation C. Administer RhIg D. Adsorb the antibody onto antigen-positive cells

A. Perform an antibody identification panel; titer, if necessary

4. All of the following are interventions for fetal distress caused by maternal antibodies attacking fetal cells except: * 0/1 A. Intrauterine transfusion B. Plasmapheresis on the mother C. Transfusion of antigen-positive cells to the mother D. Middle cerebral artery peak systolic velocity (MCA-PSV)

C. Transfusion of antigen-positive cells to the mother

5. Cord blood cells are washed six times with saline, and the DAT result and negative control are still positive. What should be done next? * 0/1 A. Obtain a heelstick sample B. Record the DAT result as positive C. Obtain another cord blood sample D. Perform elution on the cord blood cells

A. Obtain a heelstick sample

6. What can be done if HDFN is caused by maternal anti-K? * 0/1 A. Give Kell immune globulin B. Monitor the mother’s antibody level C. Prevent formation of K-positive cells in the fetus D. Not a problem; anti-K is not known to cause HDFN

B. Monitor the mother’s antibody level

7. Should an O-negative mother receive RhIg if a positive DAT on the newborn is caused by immune anti-A? * 1/1 A. No, the mother is not a candidate for RhIg because of the positive DAT result B. Yes, if the baby’s type is Rh negative C. Yes, if the baby’s type is Rh positive D. No, the baby’s problem is unrelated to Rh blood group antibodies

C. Yes, if the baby’s type is Rh positive

8. Should an A-negative woman who has just had a miscarriage receive RhIg? * 0/1 A. Yes, but only if she does not have evidence of active anti-D B. No, the type of the baby is unknown C. Yes, but only a minidose regardless of trimester D. No, RhIg is given to women at full-term pregnancies only

A. Yes, but only if she does not have evidence of active anti-D

9. SITUATION:. The automated blood bank analyzer reports a type of O negative on a woman who is 6 weeks pregnant with vaginal bleeding. The woman tells the emergency department physician she is O positive and presents a blood donor card. The MLS performs a test for weak D and observes a 1+ reaction in the AHG phase. The Kleihauer-Betke test result is negative. Is this woman a candidate for RhIg? * 0/1 A. Molecular testing is indicated to ascertain the type of weak D B. Yes, she is Rh positive C. No, there is no evidence of a fetal bleed D. Yes, based on the automated typing results

A. Molecular testing is indicated to ascertain the type of weak D

10. Which of the following patients would be a candidate for RhIg? * 1/1 A. B-positive mother; B-negative baby; first pregnancy; no anti-D in mother B. O-negative mother; A-positive baby; second pregnancy; no anti-D in mother C. A-negative mother; O-negative baby; fourth pregnancy; anti-D in mother D. AB-negative mother; B-positive baby; second pregnancy; anti-D in mother

B. O-negative mother; A-positive baby; second pregnancy; no anti-D in mother

11. The Kleihauer-Betke acid elution test identifies 40 fetal cells in 2,000 maternal RBCs. How many full doses of RhIg are indicated? * 0/1 A. 1 B. 2 C. 3 D. 4

D. 4

12. Kernicterus is caused by the effects of: * 1/1 A. Anemia B. Unconjugated bilirubin C. Antibody specificity D. Antibody titer

B. Unconjugated bilirubin

13. Anti-E is detected in the serum of a woman in the first trimester of pregnancy. The first titer for anti-E is 32. Two weeks later, the antibody titer is 64 and then 128 after another 2 weeks. Clinically, there are beginning signs of fetal distress. What may be done? * 0/1 A. Induce labor for early delivery B. Perform plasmapheresis to remove anti-E from the mother C. Administer RhIg to the mother D. Perform an intrauterine transfusion using E-negative cells

B. Perform plasmapheresis to remove anti-E from the mother

14. What testing is done for exchange transfusion when the mother’s serum contains an alloantibody? * 1/1 A. Crossmatching and antibody screen B. ABO, Rh, antibody screen, and crossmatching C. ABO, Rh, antibody screen D. ABO and Rh only

B. ABO, Rh, antibody screen, and crossmatching

15. Which blood type may be transfused to an AB-positive baby who has HDFN caused by anti-D? * 0/1 A. AB negative, CMV negative, Hgb S negative; irradiated or O negative, CMV negative, Hgb S negative B. AB positive, CMV negative; irradiated or O positive, CMV negative C. AB negative only D. O negative only

A. AB negative, CMV negative, Hgb S negative; irradiated or O negative, CMV negative, Hgb S negative

16. All of the following are routinely performed on a cord blood sample except: * 0/1 A. Forward ABO typing B. Antibody screen C. Rh typing D. DAT

B. Antibody screen

17. Why do Rh-negative women tend to have a positive antibody screen compared with Rh-positive women of childbearing age? * 0/1 A. They have formed active anti-D B. They have received RhIg C. They have formed anti-K D. They have a higher rate of transfusion

B. They have received RhIg

18. SITUATION: An O-negative mother gave birth to a B-positive infant. The mother had no history of antibodies or transfusion. This was her first child. The baby was mildly jaundiced, and the DAT result was weakly positive with polyspecific antisera. What could have caused the positive DAT result? * 0/1 A. Anti-D from the mother coating the infant RBCs B. An alloantibody, such as anti-K, coating the infant RBCs C. Maternal anti-B coating the infant RBCs D. Maternal anti-A, B coating the infant RBCs

D. Maternal anti-A, B coating the infant RBCs

19. SITUATION: RhIg is requested on a 28-year-old woman with suspected abortion. When the nurse arrives in the blood bank to pick up the RhIg, she asks the MLS if it is a minidose. The MLS replies that it is a full dose, not a minidose. The nurse then requests to take 50 μg from the 300 μg syringe to satisfy the physician’s orders. What course of action should the MLS take? * 1/1 A. Let the nurse take the syringe of RhIg, so that she may withdraw 50 μg B. Call a supervisor or pathologist C. Instruct the nurse that the blood bank does not stock minidoses of RhIg and manipulating the full dose will compromise the purity of the product D. Instruct the nurse that the blood bank does not stock minidoses of RhIg, and relay this information to the patient’s physician

D. Instruct the nurse that the blood bank does not stock minidoses of RhIg, and relay this information to the patient’s physician

1. What protocol is followed when screening whole blood donors for HIV-1 RNA? * 0/1 A. Pools of 10 are tested; if the pool is nonreactive, donors are accepted B. Pools of 20 are tested; if the pool is reactive, samples are tested individually C. Pools of up to 16 donors are tested; if pool is reactive, individual samples are screened D. All donors are screened individually; if samples are reactive, blood is discarded

C. Pools of up to 16 donors are tested; if pool is reactive, individual samples are screened

2. Currently, nucleic acid testing (NAT) testing is performed to detect which viruses? * 0/1 A. HIV and Human T-cell lymphotropic virus (HTLV-1) B. HTLV I/II C. HIV, HCV, HBV, Zika, and West Nile virus (WNV) D. HIV, HBV, and WNV

C. HIV, HCV, HBV, Zika, and West Nile virus (WNV)

3. John comes in to donate a unit of whole blood at the collection center of the community blood supplier. The enzyme immunoassay assay (EIA) screen for anti-HIV-1,2 is nonreactive; however, the NAT HIV is reactive. After 8 weeks John is tested again and found to be NAT nonreactive and EIA anti-HIV-1,2 nonreactive: * 0/1 A. This renders him eligible for donation B. Donation is deferred for 6 months C. Status is dependent on further confirmatory testing D. Donation is deferred for 12 months

A. This renders him eligible for donation

4. What marker is the first to appear in HBV infection? * 1/1 A. Hepatitis B core antibody (anti-HBc) IgM B. HbsAg C. Hepatitis B surface antibody (anti-HBs) D. Anti-HBc IgG

B. HbsAg

5. What marker indicates immunity to hepatitis B infection? * 1/1 A. Anti-HBc IgM B. HBsAg C. Anti-HBs D. Anti-HBc IgG

C. Anti-HBs

6. A patient with multiple myeloma is placed on daratumumab (Darzalex). What tests are affected by this drug, and what are typical recommendations for transfusion? * 0/1 A. Antibody screen/least incompatible RBCs B. ABO/washed RBCs C. Rh/leukocyte-poor RBCs D. All of the above

A. Antibody screen/least incompatible RBCs

7. A unit tests positive for syphilis with use of the rapid plasma reagin (RPR) test. The Treponema pallidum particle agglutination (TP-PA) test on the same unit is negative. What is the disposition of the unit? * 0/1 A. The unit may be used to prepare components B. The donor must be contacted and questioned further; if the RPR test result is most likely a false positive, then the unit may be used C. The unit must be discarded D. Cellular components may be prepared but must be irradiated before issue

A. The unit may be used to prepare components

100

8. SITUATION: John Smith donated a unit of whole blood in May. RBCs made from whole blood were transfused to a recipient at a community hospital in June, with no apparent complications. The blood supplier notified the medical director of the hospital that the donor had reported engaging in high-risk behavior with another male in April, although viral tests remain negative and the donor is healthy. What course of action should be taken? * 0/1 A. No action should be taken B. The recipient’s physician should be notified C. The recipient’s physician and the recipient should be notified D. The recipient should be notified

B. The recipient’s physician should be notified

other names parasitology

Yves Laure Pimentel · 70問 · 2年前

other names parasitology