Question 1

What is the most common preventable error occurring among the nursing and medical staff that results in a transfusion-related death?

Accepted Answer

A)  Alloantibody misidentified 
B)  Improper patient identification 
C)  Specimen mislabeled 
D)  Incorrect crossmatch procedure 
A)  Alloantibody misidentified 
B)  Improper patient identification 
C)  Specimen mislabeled 
D)  Incorrect crossmatch procedure

Question 2

Which of the following urinalysis results represents hemolysis?

Accepted Answer

A)  Reagent strip is negative for blood in presence of intact red blood cells (RBCs) (microscopic) 
B)  Reagent strip is positive for blood in presence of intact RBCs (microscopic) 
C)  Reagent strip is positive for blood in absence of intact RBCs (microscopic) 
D)  Reagent strip is negative for blood and positive for urobilinogen 
A)  Reagent strip is negative for blood in presence of intact red blood cells (RBCs) (microscopic) 
B)  Reagent strip is positive for blood in presence of intact RBCs (microscopic) 
C)  Reagent strip is positive for blood in absence of intact RBCs (microscopic) 
D)  Reagent strip is negative for blood and positive for urobilinogen

Question 3

The myeloid line of hematopoietic progenitor cells (HPC) includes all but which of the following?

Accepted Answer

A)  Erythrocytes 
B)  Monocytes 
C)  Dendritic cells 
D)  Basophils 
A)  Erythrocytes 
B)  Monocytes 
C)  Dendritic cells 
D)  Basophils

Question 4

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

Accepted Answer

A)  Prudent use of platelet concentrates 
B)  Close monitoring of patient vital signs 
C)  Transfusion of product using a blood warmer 
D)  Premedication with calcium gluconate 
A)  Prudent use of platelet concentrates 
B)  Close monitoring of patient vital signs 
C)  Transfusion of product using a blood warmer 
D)  Premedication with calcium gluconate

Question 5

The most important initial step in evaluating a suspected hemolytic transfusion reaction is to:

Accepted Answer

A)  perform a CBC and urinalysis. 
B)  perform a DAT. 
C)  recheck the compatibility testing, using a pre- and post-sample. 
D)  reconfirm the patient's identity and reexamine all pre-transfusion testing. 
A)  perform a CBC and urinalysis. 
B)  perform a DAT. 
C)  recheck the compatibility testing, using a pre- and post-sample. 
D)  reconfirm the patient's identity and reexamine all pre-transfusion testing.

Question 6

What is the primary mediator of an allergic response?

Accepted Answer

A)  Melatonin 
B)  Lysozyme 
C)  Histamine 
D)  Pyrimidine 
A)  Melatonin 
B)  Lysozyme 
C)  Histamine 
D)  Pyrimidine

Question 7

A patient transfused with 2 units of packed red blood cells demonstrated signs of a transfusion reaction just before the second unit was completely infused. Hypotension, fever, and back pain are the immediate symptoms. Blood work reveals a 3% drop in hematocrit and prolonged PT. What therapy is given to correct the PT?

Accepted Answer

A)  FFP 
B)  Dopamine 
C)  Platelet concentrates 
D)  Mannitol 
A)  FFP 
B)  Dopamine 
C)  Platelet concentrates 
D)  Mannitol

Question 8

What is the most frequent cause of circulatory overload?

Accepted Answer

A)  Transfusion of a unit at too slow a rate 
B)  Massive transfusion of blood components 
C)  Transfusion of a unit at too fast a rate 
D)  Transfusion of a partially deglycerolized unit 
A)  Transfusion of a unit at too slow a rate 
B)  Massive transfusion of blood components 
C)  Transfusion of a unit at too fast a rate 
D)  Transfusion of a partially deglycerolized unit

Question 9

Hypothermia as a result of cold fluid replacement can result in all of the following except:

Accepted Answer

A)  hemolysis. 
B)  abnormal electrocardiogram. 
C)  coagulopathy. 
D)  citrate toxicity. 
A)  hemolysis. 
B)  abnormal electrocardiogram. 
C)  coagulopathy. 
D)  citrate toxicity.

Question 10

A delayed hemolytic transfusion reaction is most often the result of:

Accepted Answer

A)  bacterial-contaminated red blood cells. 
B)  a unit of packed cells infected with hepatitis B virus. 
C)  an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy. 
D)  hemosiderosis in a massively transfused patient. 
A)  bacterial-contaminated red blood cells. 
B)  a unit of packed cells infected with hepatitis B virus. 
C)  an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy. 
D)  hemosiderosis in a massively transfused patient.

Question 11

Prior to the recipient receiving the transplant of hematopoietic progenitor cells, the cells must be conditioned with:

Accepted Answer

A)  gamma radiation. 
B)  high-dose chemotherapy. 
C)  cytokines. 
D)  gamma radiation, high-dose chemotherapy, or both. 
A)  gamma radiation. 
B)  high-dose chemotherapy. 
C)  cytokines. 
D)  gamma radiation, high-dose chemotherapy, or both.

Question 12

Which of the following results when large excesses of free hemoglobin are released into the blood?

Accepted Answer

A)  Hemosiderinuria 
B)  Hematuria 
C)  Hemoglobinuria 
D)  Hemoglobinemia 
A)  Hemosiderinuria 
B)  Hematuria 
C)  Hemoglobinuria 
D)  Hemoglobinemia

Question 13

Which of the following is not characteristic of an anaphylactic reaction?

Accepted Answer

A)  Hypotension 
B)  Abdominal cramps 
C)  Electrophoretic levels of IgA 
D)  Loss of consciousness 
A)  Hypotension 
B)  Abdominal cramps 
C)  Electrophoretic levels of IgA 
D)  Loss of consciousness

Question 14

The plasma level of unconjugated bilirubin is elevated in:

Accepted Answer

A)  intravascular hemolysis. 
B)  extravascular hemolysis. 
C)  intravascular and extravascular hemolysis. 
D)  none of the above. 
A)  intravascular hemolysis. 
B)  extravascular hemolysis. 
C)  intravascular and extravascular hemolysis. 
D)  none of the above.

Question 15

A patient transfused with 2 units of packed cells spiked a fever of 99.5°F and complained of chills 3 days after transfusion. The DAT was positive with polyspecific antisera and anti-IgG, but negative with anti-C3d. Compatibility testing was performed on the pre- and post-transfusion specimens. The latter was incompatible with one of the donor units transfused. An antibody screen was done on both the pre- and post-transfusion specimens. An antibody was detected in the post-transfusion specimen only and identified by panel studies as anti-Jka. This transfusion reaction is most likely caused by:

Accepted Answer

A)  an anaphylactic response. 
B)  delayed hemolytic transfusion reaction (DHTR) caused by anamnestic response. 
C)  DHTR caused by primary alloimmunization. 
D)  post-transfusion purpura. 
A)  an anaphylactic response. 
B)  delayed hemolytic transfusion reaction (DHTR) caused by anamnestic response. 
C)  DHTR caused by primary alloimmunization. 
D)  post-transfusion purpura.

Question 16

What test is indicated for the detection of HLA antibodies?

Accepted Answer

A)  Direct Coombs' 
B)  Antibody screen 
C)  Lymphocyte panels 
D)  Cold antibody panel 
A)  Direct Coombs' 
B)  Antibody screen 
C)  Lymphocyte panels 
D)  Cold antibody panel

Question 17

All of the following signs are consistent with circulatory overload except:

Accepted Answer

A)  orthopnea. 
B)  fever. 
C)  dyspnea. 
D)  tachycardia. 
A)  orthopnea. 
B)  fever. 
C)  dyspnea. 
D)  tachycardia.

Question 18

What is meant by the term iatrogenic?

Accepted Answer

A)  Generic treatment 
B)  Underlying disease 
C)  Physician-caused 
D)  Hospital-contracted 
A)  Generic treatment 
B)  Underlying disease 
C)  Physician-caused 
D)  Hospital-contracted

Question 19

How is an febrile nonhemolytic transfusion reaction FNHTR best defined?

Accepted Answer

A)  A 1°C temperature rise associated with transfusion that has no medical explanation other than blood component transfusion 
B)  A 1°C temperature rise associated with transfusion and inflammation of the colon 
C)  A 2°C temperature rise associated with transfusion that has no medical explanation other than component transfusion 
D)  A 2°C temperature rise associated with transfusion and pneumonia 
A)  A 1°C temperature rise associated with transfusion that has no medical explanation other than blood component transfusion 
B)  A 1°C temperature rise associated with transfusion and inflammation of the colon 
C)  A 2°C temperature rise associated with transfusion that has no medical explanation other than component transfusion 
D)  A 2°C temperature rise associated with transfusion and pneumonia

Exam 17: Cellular Therapy

What is the most common preventable error occurring among the nursing and medical staff that results in a transfusion-related death?

Which of the following urinalysis results represents hemolysis?

The myeloid line of hematopoietic progenitor cells (HPC) includes all but which of the following?

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

The most important initial step in evaluating a suspected hemolytic transfusion reaction is to:

What is the primary mediator of an allergic response?

What is the most frequent cause of circulatory overload?

Hypothermia as a result of cold fluid replacement can result in all of the following except:

A delayed hemolytic transfusion reaction is most often the result of:

Prior to the recipient receiving the transplant of hematopoietic progenitor cells, the cells must be conditioned with:

Which of the following results when large excesses of free hemoglobin are released into the blood?

Which of the following is not characteristic of an anaphylactic reaction?

The plasma level of unconjugated bilirubin is elevated in:

What test is indicated for the detection of HLA antibodies?

All of the following signs are consistent with circulatory overload except:

What is meant by the term iatrogenic?

How is an febrile nonhemolytic transfusion reaction FNHTR best defined?

Red Blood Cells and Platelet Preservation: Historical Perspectives and Current Trends

Basic Genetics

Fundamentals of Immunology

Concepts in Molecular Biology

The Antiglobulin Test

The Abo Blood Group System

The RH Blood Group System

Blood Group Terminology and the Other Blood Groups

Detection and Identification of Antibodies

Pre-Transfusion Testing

Overview of the Routine Blood Bank Laboratory

Other Technologies and Automation

Donor Screening and Component Preparation

Apheresis

Transfusion Therapy

Transfusion-Transmitted Diseases

Hemolytic Disease of the Fetus and Newborn

Autoimmune Hemolytic Anemias

The Hla System

Relationship Testing

Quality Management

Transfusion Safety and Federal Regulatory Requirements

Utilization Management

Laboratory Information Systems

Medicolegal and Ethical Aspects of Providing Blood Collection and Transfusion Services

Tissue Banking: A New Role for the Transfusion Service

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