Donors/Component Therapy
A donor who has just donated 2 units of Apheresis Red Blood Cells is deferred from further blood donation for a minimum of how many weeks?
A. 8 B. 12 C. 16 D. 24
What is C. 16 weeks
A common strategy to reduce alloimmunization in chronically transfused patients with Sickle Cell Disease (CSD) is to provide red cells matched for which of the following antigens?
A. Fya and Fyb
B. M, N and S
C. Jka and Jkb
D. C, E and K
What is D. C, E and K
Approximately 25-30% of SCD patients develop alloantibodies due to repeated red cell transfusions. A recommended strategy to reduce the number of patients who develop alloantibodies is to phenotype for C, E and K antigens and transfuse with phenotypically identical units. If patients do become alloimmunized to these antigens, additional phenotyping for red cell antigens in the Kidd and Duffy systems and Ss is recommended, followed by transfusion with phenotypically identical units.
When processing specimens for mycobacterial testing, what specific engineering control must be used?
A. horizontal laminar flow hood
B. barrier protection only
C. biological safety cabinet
D. fume hood
What is C. biological safety cabinet
A is for pharmacy and other "clean room" functions.
B does not provide adequate respiratory protection
D is used for chemical not biohazard control
A. kidney
B. spleen
C. liver
D. intestine
What is D. intestine
Increased CSF lactate is found in:
A. bacterial meningitis
B. Reye encephalopathy
C. spina bifida
D. multiple sclerosis
What is A. bacterial meningitis
Lactate is increased in the CSF in conditions that cause hypoxia. The highest lactate values (>35 mg/dL) are found in patients with bacterial meningitis. Viral, tubercular and fungal meningitis have lactate levels above normal, but not as high as bacterial meningitis.
What is the primary reason that infectious agents can be transmitted through transfusion?
A. pathogen technology reduction failure
B. donor in the window period of early infection
C. leukocyte-reduction failure
D. donor history questionnaire not completed
What is B. donor in the window period of early infection
The primary reason for transfusion transmitted infections is the donor in the window period of early infection before results become positive.
A patient serum reacts with 2 of 3 antibody screening cells at the AHG phase. Eight of the 10 units crossmatched were incompatible at the AHG phase. All reactions are markedly enhanced by enzymes. These results are most consistent with:
A. Anti-M
B. Anti-E
C. Anti-c
D. Anti-Fya
What is C. Anti-c
A chemical that causes immediate visible destruction or irreversible alterations of human tissue at the contact site is best classified as:
A. corrosive
B. carcinogenic
C. toxic
D. ignitable
What is A. corrosive
Carcinogenics and toxic chemicals are health hazards, but typically do not cause immediate tissue damage.
Ignitable = are combustible and flammable, but only cause tissue damage if accidental flame or explosion occurs.
Which of the following enzymes in heme biosynthesis is inhibited by lead?
A. aminolevulinate synthase
B. porphobilinogen synthase
C. uroporphyrinogen synthase
D. bilirubin synthetase
What is B. porphobilinogen synthase
Lead toxicity is expressed as inhibition of PBG synthase and ferrochelatase. Other enzymes in the hematopoietic pathway are not affected.
A 2-year old child had a positive urine ketone. This would most likely be caused by:
A. vomiting
B. anemia
C. hypoglycemia
D. biliary tract obstruction
What is A. vomiting
Vomiting leads to dehydration and utilization of fat for energy. Fat metabolism produces ketones.
If the seal is broken on a unit of Red Blood Cells stored at 1-6 degrees C, what is the maximum allowable storage period in hours?
A. 6 B. 24 C. 48 D. 72
What is B. 24
If a seal is broken during processing, components are considered to be prepared in an open system instead of a closed system. The expiration period for Red Blood Cells in an open system is 24 hours (stored at 1-6C).
A patient's serum sample was reactive with all cells except the auto control when tested by PEG-AHG. The patient's phenotype was confirmed as: C-E+c+e+, K-k+, Kp(a-b+), Js(a-b+), Fy(a-b+), Jk(a-b-), M+N+S+s+. Phenotypically similar cells were tested and found to be nonreactive. In what population of donors are we most likely to find a compatible donor for this patient?
A. African
B. Middle Eastern
C. South American
D. Tahitian
What is D. Tahitian
As high as 1 in 400 people of Polynesian ethnicity have a silent gene at the Jk locus, leading to the Jk(a-b-) phenotype
Diagnostic specificity is defined as the percentage of individuals:
A. with a given disease who have a positive result by a given test
B. without a given disease who have a negative result by a given test
C. with a given disease who have a negative result by a given test
D. without a given disease who have a positive result by a given test
What is B. without a given disease who have a negative result by a given test
Specificity is negativity by absence of disease (fewer false positives)
A 10 year old child was admitted to pediatrics with an initial diagnosis of skeletal muscle disease. The best confirmatory tests would be:
A. creatine kinase and isocitrate dehydrogenase
B. gamma-glutamyl transferase and alkaline phosphatase
C. aldolase and creatine kinase
D. lactate dehydrogenase and malate dehydrogenase
What is C. aldolase and creatine kinase
Increased levels of these are seen with skeletal muscle disease. The magnitude of the elevation is dependent on the type of skeletal muscle disease.
Cholesterol crystals will most likely be observed in urine that contains:
A. 3+ glucose
B. 4+ protein
C. WBC casts
D. triple phosphate crystals
What is B. 4+ protein
Increased lipids in the urine is a characteristic of the nephrotic syndrome. Massive amounts of protein also are associated with the nephrotic syndrome. The crystals form more readily in urine that has been refrigerated.
Platelet transfusions are of most value in treating:
A. Hemolytic transfusion reactions
B. Post-transfusion purpura
C. Immune thrombocytopenia
D. Functional platelet abnormalities
What is D. Functional platelet abnormalities
Functional abnormalities are found in several platelet disorders. Decreased platelets is not an outcome of HTRs. PTP is usually self-limiting and due to an antibody to a specific platelet antigen. ITP patients have low platelet counts, but rarely have hemorrhage.
Which of the following blood bank chemicals produce Kell null cells?
A. DTT
B. ficin
C. formaldehyde
D. chloroquine diphosphate
What is A. DTT
Sulfhydral reagents (DTT, AET, or 2-ME) may be used to eliminate certain blood group system antigens. Thes antigens include those in the Kell, Dombrock, Cartwright, LW, and Knops systems. The use of DTT would eliminate Kell blood group system antigens from red cells, thus creating Kell null cells.
Which of the following is the formula for calculating unknown concentration by Beer's Law? (A = absorbance, C = concentration)
A. (A unknown/A standard) x C standard
B. C standard x A unknown
C. A standard x A unknown
D. (C standard/A standard) x 100
What is A. (A unknown/A standard) x C standard
A of unknown / C of unknown = A of standard / C of standard
A fasting serum sample from an asymptomatic 43-year-old female patient is examined visually and chemically with the following results:
initial appearance of serum = milky
appearance of serum after overnight refrigeration = cream layer over turbid serum
triglyceride level = 2,000 mg/dL (22.6 mmol/L)
cholesterol level = 550 mg/dL (14.25 mmol/L)
The sample contains predominantly:
A. chylomicrons, alone
B. Chylomicrons and very low-density lipoproteins (VLDL)
C. very low-density lipoproteins (VLDL) and low-density lipoproteins (LDL)
D. high-density lipoproteins (HDL)
What is B
Mixed hyperlipoproteinemia or type V Hyperlipoproteinemia occurs primarily in adulthood and is characterized by markedly elevated triglycerides, elevated very low-density lipoproteins(VLDL) and chylomicrons. Because of the markedly increased triglyceride level, the specimen integrity is milky, and overnight refrigeration shows a creamy layer over turbid serum due to the chylomicrons and triglycerides.
Plasma for cortisol determinations were collected at 7am after waking the patient, and at 10 pm that evening. The cortisol level of the morning sample was higher than the evening sample. This is consistent with:
A. A normal finding
B. Cushing syndrome
C. Addison disease
D. hypopituitarism
What is A. The normal variation of serum cortisol is higher at 8 am than 4 pm, which are often the standard times used to measure cortisol. This assumes sleep patterns at night. These may be altered in disorders such as Cushing syndrome or Addison disease as well as hypopituitarism.
Which of the following is consistent with standard blood bank procedure governing the infusion of fresh frozen plasma?
A. only blood group-specific plasma may be administered
B. Group A may be administered to both A and O recipients
C. Group O may be administered to recipients of all blood groups
D. Group AB may be administered to AB recipients only
What is B. Group A may be administered to both A and O recipients
Using the antigen typing results below, what is the patient's likely phenotype?
D C E c e f G
+ 0 + + + + +
A. R1R1
B. R2R2
C. R2r
D. R1R2
What is C. R2r
To prepare 40 mL of a 3% working solution, an MLS would use what volume of a stock solution?
A. 0.9 mL
B. 1.2 mL
C. 1.5 mL
D. 3.0 mL
What is B. 1.2 mL
C1 x V1 = C2 x V2
40 (3) = 100 (V2)
120/100 = V2
Decreased serum iron associated with increased TIBC is compatible with which of the following disease states?
A. anemia of chronic infection
B. iron deficiency anemia
C. chronic liver disease
D. nephrosis
What is B - features of iron deficiency anemia
Which of the following factors is not relevant to therapeutic drug monitoring (TDM) of the aminoglycosides, antibiotics, and vancomycin?
A. intestinal absorption
B. nephrotoxicity
C. ototoxicity
D. renal function
What is A. intestinal absorption
Due to poor GI absorption, these drugs are not administered orally so changes in intestinal absorption is not a factor. Toxicity due to high tissue levels of these antibiotics are associated with ototoxicity, nephrotoxicity, and declining renal function which makes elimination of the drug slower and less efficient.