Why can the Rh-hr control be eliminated from donor processing?

Rh Negative blood typed as Rh Positive will only be given to Rh-Pos pt

In the United States, fatalities associated with transfusion are required to be reported to which organization?

U.S. Food and Drug Administration

A benign cold autoagglutinin may cause interference in antibody screening procedures when:

Polyspecific AHG is used in the test procedure

Why would an Rh type be ordered on a cord blood sample?

To determine mother's candidacy for RhIg if she is Rh-negative

What is the most common prevent. error occurring among the nursing and medical staff that results in a transfusion death

Improper patient identification

Which of the following describes the etiology of graft-versus-host disease?

T lymphs from donor blood react with major and minor histocompatibility Ag

Why is a febrile nonhemolytic transfusion reaction (FNHTR) said to be a diagnosis of exclusion?

Fever can be the result of many other underlying maladies

Why is the Rh-positive firstborn of an Rh-negative mother unaffected by Rh hemolytic disease of the fetus and newborn?

The mother has not been immunized against D until placental separation

What measure can be taken to prevent transfusion-associated hypothermia?

Transfusion of product using a blood warmer

Immediate spin resulting in agglutination may be caused by:

Cold reacting alloantibodies or autoantibodies

Electronic crossmatching:

Must confirm current with historical ABO group

The label on the recipient’s pretransfusion specimen:

Must duplicate patient wristband information

A STAT type and screen is received from the OR, the nurse who drew the sample did not label it with the BBID# action?

Reject the specimen and have it re-collected

Why do clotted specimens yield positive DAT with anti-C3 in the presence of a benign cold autoagglutinin?

Complement can be activated in vitro

Which of the following urinalysis results represents hemolysis?

Strip positive for blood in absence of intact RBC

Which of the following statements is false?

RBCs are phago by macrophages in the spleen and liver in INTRAvascular RXN

Which of the following is consistent with bacterial contamination reactions?

The organism thrives in cold temperatures

WAIHA patient, Anti-K was identified in absorbed serum. Patient phenotyped for K using IAT what would the tech find?

A positive result due to IgG coating cells

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Unit IV Review

80 termsStudBud Administration68 plays

HDN, RhIg, Compatibility, Polyagglutination, Transfusion Reactions, AIHA

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Questions 80

Answers

1
Cold autoanti-H is more prevalent in which blood group?
O
A1B
B
A2
2
A negative direct antiglobulin test is found in all of the following transfusion reactions except:
Febrile nonhemolytic
Sepsis
Acute nonimmune hemolytic transfusion reaction
Acute immune hemolytic
3
A trauma pt rec'd 5 units of PLTs, the PLT count remained <50. She rec'd more PLT with no increase, Anti-PLA1 ident. RXN
Post-transfusion purpora
Circulatory overload
GVHD
Alloimmunization
4
Which of the following might be used to investigate a cold autoantibody?
Rabbit Erythrocyte Stroma
Elution
Titration
A2 cells
5
Why can the Rh-hr control be eliminated from donor processing?
Rh Negative blood typed as Rh Positive will only be given to Rh-Pos pt
Rh Negative blood typed as Rh Positive will only be given to Rh-Neg pt
Rh Positive blood typed as Rh Negative will only be given to Rh-Pos pt
None of the above
6
5 year old boy with measles, back pain, chills, stomach pain. Dr. reveals blood in urine, Donath-Landsteiner test done
PCH
Secondary Cold AIHA
CAD
WAIHA
7
Besides the Rh antibodies, what other red blood cell antibody is common to cause severe HDFN?
M
K
Lea
Fyb
8
The results of a Kleihauer-Betke stain indicate a fetomaternal bleed of 30 mL of whole blood. How many vials of RhIg?
1
3
4
2
9
In which of the following is the direct antiglobulin test reactive with anti-C3d only?
Membrane modification
Cold Agglutinin disease
WAIHA
Drug adsorption
10
Which type of hemolysis accompanies an anaphylactic reaction?
Extravascular
None of the above
Intravascular
Acute
11
In the United States, fatalities associated with transfusion are required to be reported to which organization?
U.S. Food and Drug Administration
American Medical Association
Centers for Disease Control
National Healthcare Safety Network
12
All of the following signs are consistent with circulatory overload except:
Tachycardia
Orthopnea
Fever
Dyspnea
13
A benign cold autoagglutinin may cause interference in antibody screening procedures when:
Anti-IgG AHG is used in the test procedure
LISS is used as a potentiator for 37 incubation
The IS phase is omitted
Polyspecific AHG is used in the test procedure
14
Why would an Rh type be ordered on a cord blood sample?
None of the above
To determine mother's candidacy for RhIg if she is Rh-negative
To determine mother's candidacy for RhIg if she is Rh-positive
Because the mother had a spontaneous abortion
15
A 300-µg dose of Rh-immune globulin contains sufficient anti-D to protect against how much whole blood?
100 mL
30 mL
15 mL
50 mL
16
Which drug can cause production of autoantibody?
Tetracycline
Isoniazid
Ibuprofen
Methyldopa
17
What is the most common prevent. error occurring among the nursing and medical staff that results in a transfusion death
Alloantibody misidentified
Specimen mislabeled
Incorrect crossmatch procedure
Improper patient identification
18
Which test(s) are involved when a physician orders a 4-unit crossmatch on a patient with no history?
IS XM
ABO,Rh,DAT,IS XM
ABO,Rh,ABSC,IS XM
AHG XM
19
If an intrauterine transfusion is indicated, which of the following is acceptable?
Only type O Red Blood Cells
Red blood cells typing the same as the mother
Units with concentrated white blood cells
Nonirradiated units of blood are preferred
20
Rh-immune globulin should be given within how many hours after delivery?
48
36
72
24
21
Which of the following describes the etiology of graft-versus-host disease?
B lymphs from donor blood react with major and minor histocompatibility Ag
Alloantibody in patient serum reacts with donor red blood cells
Anti-PLA1 attaches to platelet surface, permitting extravascular destruc
T lymphs from donor blood react with major and minor histocompatibility Ag
22
What is the most common drug associated with the drug-adsorption mechanism?
Methyldopa
Erythromycin
Penicillin
Insulin
23
Most cases of warm autoimmune hemolytic anemia will be direct antiglobulin test-positive with which of the following?
IgG and C3d
Negative DAT
IgG only
C3d only
24
Why is a febrile nonhemolytic transfusion reaction (FNHTR) said to be a diagnosis of exclusion?
None of the above
FNHTR should not be suspected when fever is the sole symptom
A spiked fever can only be the result of a blood transfusion
Fever can be the result of many other underlying maladies
25
Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?
Bilirubinuria
Bilirubinemia
Kernicterus
Hydrops fetalis
26
Why is the Rh-positive firstborn of an Rh-negative mother unaffected by Rh hemolytic disease of the fetus and newborn?
Mother's plasma volume is too high and dilutes anti-D
None of the above
Anti-D titer is too low to cause destruction
The mother has not been immunized against D until placental separation
27
What measure can be taken to prevent transfusion-associated hypothermia?
Transfusion of product using a blood warmer
Close monitoring of patient vital signs
Premedication with calcium gluconate
Prudent use of platelet concentrates
28
When is the antenatal dose of Rh-immune globulin given?
20 weeks
28 weeks
36 weeks
13 weeks
29
Immediate spin resulting in agglutination may be caused by:
Too much saline in the reagents used
Cold reacting alloantibodies or autoantibodies
Matching ABO groups between donor and patient
Prewarming the specimens
30
Electronic crossmatching:
Disregards discrepancies between recipient and donor unit
Allows the antibody screening to be eliminated
Does not eliminate the need for serologic crossmatch
Must confirm current with historical ABO group
31
HDN Case - ABO incompatibility - Mother is Group O, baby is Group B. Most appropriate unit for exchange transfusion?
AB
O
A
B
32
The label on the recipient’s pretransfusion specimen:
Cannot be a barcode
Must be affixed prior to collection
Need not include phlebotomist ID
Must duplicate patient wristband information
33
A STAT type and screen is received from the OR, the nurse who drew the sample did not label it with the BBID# action?
Reject the specimen and have it re-collected
Call OR and have the nurse come down to label the specimen
Accept it, there's nothing wrong
Label the specimen yourself and continue
34
Autoanti-I was identified in a patient transfused 1 month ago. Which technique is advocated to detect alloAb in the pt?
Cold autoabsorption
Enzyme Treatment
Prewarming
Warm autoabsorption
35
Why do clotted specimens yield positive DAT with anti-C3 in the presence of a benign cold autoagglutinin?
Complement can be activated in vitro
Complement is inhibited due to calcium chelation
Complement is activated in the absence of fibrinogen
Complement can be activated in vivo
36
Which of the following urinalysis results represents hemolysis?
Strip is negative blood and positive for urobilinogen
Strip positive for blood in presence of intact RBC
Strip positive for blood in absence of intact RBC
Strip negative for blood in presence of intact RBC
37
Which of the following statements is false?
Intravascular transfusion reactions require complete complement activation
Intravascular reactions usually involve IgM antibodies.
RBCs are phago by macrophages in the spleen and liver in INTRAvascular RXN
Intravascular transfusion reactions can have immediate clinical signs.
38
All of the following are diseases that can mimic a transfusion reaction except:
PNH
Hemoglobin C disease
Acute Myelogenous Leukemia
G6PD deficiency
39
In which type of hemolytic disease of the fetus and newborn is the firstborn affected?
Rh
P
ABO
Lewis
40
Specimen collected Saturday in ED, patient goes home, comes in Wednesday for transfusion is the specimen still good?
Yes
No
41
A 40 year old male stabbing patient is bleeding, type discrepancy is present, which blood should be used for EMR TX?
Type-specific uncrossmatched
Electronic crossmatched Blood
O Negative uncrossmatched
O Negative crossmatched
42
What is the most frequent cause of circulatory overload?
Transfusion of a partially deglycerolized unit
Transfusion of a unit too fast
Transfusion too slow
MTP patient
43
Which severe outcome can be caused by indirect bilirubin levels greater than 18 mg/dL in the newborn?
Hydrops fetalis
Bilirubinemia
Kernicterus
Bilirubinuria
44
Why is reviewing a potential recipient’s historical data important?
Previous antibodies may decrease to undetectable levels
all of the above
Current medications may produce unusual results
Donor units must be negative to previous antibodies even if none are showin
45
Red blood cells sensitized in which drug-induced hemolytic anemia mechanism act as “innocent bystanders”?
Membrane modification
Autoantibody formation
Immune complex
Drug absorption
46
A patient with two or more documented febrile nonhemolytic transfusion reactions should receive __________ blood
Leukopoor
Sickle Negative
Irradiated
CMV negative
47
In warm autoimmune hemolytic anemia, the autoantibody will frequently demonstrate _________ -like specificity.
Fya
K
Jkb
Rh
48
A three-cell antibody screening set provides _________ antigen expression in all major blood group systems except Kell.
Heterozygous
Homozygous
Heterogenous
Homogenous
49
Patient has WAIHA. A weak D was performed and was pos, a FCS was done and showed no rosettes. What is Rh type of pt?
Negative
Unknown
Positive
Weak D positive
50
Which of the following is consistent with bacterial contamination reactions?
The organism thrives in cold temperatures
The organism thrives in warm temperatures
The organism exhibits motility
The organism is a fastidious anaerobe
51
WAIHA patient, Anti-K was identified in absorbed serum. Patient phenotyped for K using IAT what would the tech find?
A negative result after cells were treated with ficin
A positive result due to IgM coating cells
A positive result due to IgG coating cells
Patient would type negative for K antigen
52
All of the following viral tests are required for donor processing except:
Anti-HTLV-1
Anti-HIV
CMV
HBsAg
53
How could a potential alloimmunizaton due to Anti-K be prevented?
Apheresis Platelets
Leukoreduction
Phenotypically matched blood
Washed red blood cells
54
In a patient who has been recently transfused, a positive direct antiglobulin test may be due to:
Alloantibody coating patient cells
None of the above
Antibodies to a drug coating donor cells
Alloantibody coating transfused donor cells
55
What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen?
The chance of maternal sensitization to Rh antigen is decreased.
No effect
The chance of maternal sensitization to Rh antigen is increased.
None of the above
56
What should be done in the transfusion process when the patient’s temperature spikes from 37.5°C to 38.5°C within 30 min
Continue with tranfusion after giving patient tylenol
Give the patient Benadryl
Stop the transfusion, keep the IV line open
Leukoreduce the rest of the unit
57
Which of the following organisms have been implicated in bacterial contamination reactions?
Corynebacterium flavescens
Enterobacter aerogenes
Clostridium perfringens
Yersinia enterocolitica
58
What would be the result of group B blood given to a group O patient?
Nonimmune hemolytic transfusion reaction
Delayed hemolytic transfusion reaction
Immune acute hemolytic transfusion reaction
No reaction, units are compatible
59
For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment goal should be to:
Prevent hemoglobinemia
Diminish chill and fever and make the patient comfortable
Reverse hypotension and minimize renal damage
Prevent alloimmunization
60
All of the following are goals of an exchange transfusion except:
To remove high levels of unconjugated bilirubin
To remove high levels of conjugated bilirubin
To remove high levels of maternal antibody
To correct anemia
61
Blood transfusions to the fetus and premature infants should be ________ to prevent graft-versus-host disease.
Negative for CMV
Less than 7 days old
Negative for sickle cells
Irradiated
62
In the case of an AB-positive individual, what test must be performed to ensure that a warm-reacting Ab is not false +
DAT
IAT
Rh control
Rosette Test
63
What is the main concern for obstetric patients in prenatal testing?
Drug-induced antibody
Antibody that causes HTR
Autoantibodies
Antibody that causes HDN
64
A positive direct antiglobulin test may be seen in:
All of the above
CAIHA
Hemolytic Transfusion Reactions
WAIHA
65
Which of the following antibodies have not been known to cause hemolytic disease of the fetus and newborn?
C
D
S
Lea
66
Which patient is most likely to suffer from GVHD is blood is not irradiated?
Patient undergoing open heart surgery
Patient undergoing a BMT
Geriatric Patient
Newborn
67
Which life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepato and splenomegaly
Hydrops fetalis
Thalassemia
Hereditary persistence of fetal hemoglobin
Sickle-cell anemia
68
Which of the following is indicative of graft-versus-host disease?
Anemia
Thrombocytopenia
Hematuria
Pancytopenia
69
1. Which of the following best describes the principle of the Kleihauer-Betke test?
Fetal hgb is resistant to acid, appearing pink, whereas Mom appear as ghost
D-positive indicator cells form rosettes around maternal Rh-positive RBCs
D-positive indicator cells form rosettes around fetal Rh-positive RBCs
Mom hgb is resistant to acid, appearing pink, whereas fetal appear as ghost
70
In a DHTR, pt Ab attaches to the specific foreign donor red blood cell Ag, sensitizing RBC, which are removed by:
Kidneys
Complement
Reticuloendothelial system
Major histocompatibility complex
71
Which of the following should be collected immediately from a patient exhibiting signs of a septic reaction?
DAT
CBC
Blood Cultures
Urine
72
Persons with a documented history of anaphylactic reactions should be transfused with _________ blood products.
IgE-deficient
Washed
Irradiated
Leukoreduced
73
O Neg pt. received Rh Positive blood, 250mL unit, how much Rhogam must be given to protect against anti-D formation?
23
17
10
5
74
30 minutes into RBC transfusion, pt complains of itching and hives, clerical check ok, DAT neg, hemolysis neg, what RXN?
Urticarial
Anaphylactic
Alloimmunization
Post-transfusion purpura
75
O Pos mom had an A-Negative baby after 24 hours, baby's bili is now 18mg/dL. DAT 3+ IgG. Which antibody is coating baby?
Anti-A,B
Anti-D
Anti-B
Anti-A
76
Anti-D in the serum of a third trimester pregnant woman with a titer of 16 is indicative of:
Active immunization
Passive immunization
Rh-immune globulin
None of the above
77
What is done to prevent hemolytic disease of the fetus and newborn caused by maternal anti-Jk^a antibody formation?
Monitor the mom's antibody level
Give Jka-immune globulin
No action is necessary, anti-Jka will not cause HDFN
Prevent formation of Jka positive cells in the fetus
78
3 days POST-TXN, Pt. has fever 99.5, chills, DAT-Pos IgG, units XM again w/ pre and post and incomp with post what RXN?
DHTR cause by anamnestic response
DHTR caused by primary alloimmunization
Post-transfusion purpura
Anaphylactic
79
Which of the following is not a symptom of noncardiogenic pulmonary edema? (TRALI)
Hypotension
Coughing
Fever
Hypervolemia
80
Which of the following factors distinguishes a cold auto produced in a patient with infectious mono from pneumonia?
Anti-i specificity
Titer greater than 64
An IgM class of antibody
A wide thermal range

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