Blood Banking Questions

1. Which one of the following would NOT be expected to cause a positive DAT or
subsequent incompatible major crossmatch?
a. Group A fresh frozen plasma to a patient who was type O
b. Group O fresh frozen plasma to a patient who was type A
c. Group O whole blood to a patient who was type A
d. Group O platelets to a patient who was type B

2. The following results were obtained when testing a sample from a 02 year old,
healthy, first time blood donor. What is the most likely cause of this ABO
discrepancy? Forward Group: Anti-A: Neg, Anti-B: Neg, Reverse Group: A1
cells: Neg, B cells: 3+
a. loss of antigen due to disease
b. acquired B
c. phenotype Oh "Bombay"
d. weak subgroup of B
e. weak subgroup of A

3. Cold agglutinin syndrome is best associated with which of the following blood
groups?
a. Duffy
b. P
c. I/i
d. Rh

4. Mr. Gilling's history includes the fact that he has been sensitized to RBC antigens
in a previous transfusion. His antibody screen is negative today. Mr. Gilling
should;
a. Not be transfused
b. Be transfused with crossmatch compatible RBC's
c. Be transfused with antigen negative, crossmatch compatible RBC's
d. Be treated as indicated by current testing, ignoring previous test results

5. woman begins to breathe rapidly while donating blood. Choose the correct course
of action.
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
D. Tell her to sit upright and apply a cold compress
to her forehead
6. What would be the result of group A blood given to an O patient?
A. Nonimmune transfusion reaction
B. Immediate hemolytic transfusion reaction
C. Delayed hemolytic transfusion reaction
D. Febrile nonhemolytic transfusion reaction
 7. A blood donor is group B, Le (a-b-), and is known to be a secretor. His saliva
will contain the blood group substances:
a. A, B, H,
b. B and H
c. H, B, Le
d. Lea only

8. Mr. Simmons gives the following reactions: Mr.S. cells: anti-A: 2, anti-B: 2, anti-
AB: 2, anti-H: 2, Mr. S. Serum: A1 cells: 4+, A0 cells: 4+, B cells: 4+, O cells:
4+. Mr. Simmons has which of the following ABO groups?
a. A
b. B
c. AB
d. O
e. Bombay

9. What type of antibodies are most often clinically significant for blood
transfusion?
a. Cold autoantibodies, generally IgM
b. Warm alloantibodies, generally IgG
c. Both cold autoantibodies, IgM, and warm alloantibodies, IgG
d. Cold alloantibodies, generally IgM

12. Which typing result below indicates an `acquired B' antigen?

a. Anti-A: 4+, Anti-B: 3+, A1 Cells: neg, B Cells: neg
b. Anti-A: 3+, Anti-B: neg, A1 Cells: neg, B Cells: neg
c. Anti-A: 4+, Anti-B: 1+, A1 Cells: neg, B Cells: 4+
d. Anti-A: 4+, Anti-B: 4+, A1 Cells: 2+, B Cells: neg

11. What should be done if all forward and reverse ABO results and the autocontrol
are positive?
a. Wash cells with warm saline; autoabsorb the serum at 4C
b. Retype the sample using a different lot number of reagents
c. Repeat ABO grouping using polyclonal typing reagents
d. Report the sample as group AB

12. Prior to blood donation, the intended venepuncture site

must be cleaned with a scrub solution containing:
A. hypochlorite
B. isopropyl alcohol
C. 10% acetone
D. PVP iodine complex

13. The purpose of adding antibody-coated red cells to all negative AHG tubes is to:
a. ensure proper tube reading
b. ensure proper cell washing and addition of AHG reagent
c. check for hemolysis or reaction of complement
d. check for attachment of additional antibody
14. What procedure would help to distinguish between an anti-e and anti-Fya in an
antibody mixture?
a. Lower pH of test serum
b. Run an enzyme panel
c. Use a thiol reagent
d. Run a regular panel

15. What is done to prevent hemolytic disease of the newborn caused by maternal
anti-K antibody formation?
a. Give Kell immune globulin
b. Monitor mother's antibody level
c. Prevent formation of K positive cells in fetus
d. Not a problem; anti-K will not cause HDN

16. Of the following, which antibody would be eliminated through pre-warm

testing?
a. Anti-M
b. Anti-D
c. Anti-K
d. None of the above

11. Testing reveals a weak D (Du) that reacts 1+ after indirect antiglobulin testing
(IAT). How is this result classified?
a. Rh-positive
b. Rh-negative; Du-positive
c. Rh-negative
d. Rh-positive; Du-positive

11. Which component has the longest expiration date?

A. Cryoprecipitate
B. FFP
C. Frozen RBCs
D. Platelet concentrates

19. Addition of which of the following will enhance the shelf-life of Red Blood Cells?
a. heparin
b. adenine
c. hydroxyethyl starch
d. lactated Ringer's solution

20. What is/are the minimum pretransfusion testing requirement(s) for autologous
donations collected and transfused by the same facility?
a. ABO and Rh typing only
b. ABO/Rh type, antibody screen
c. ABO/Rh type, antibody screen, crossmatch
d. no pretransfusion testing is required for autologous donation
1. Which of the following donors could be accepted for blood donation?
A. 22-year female who is currently pregnant
B. 44-year-old female who lived in London from 8811 - 8882
C. 44-year-old male who has been taking aspirin every four hours for the
past two days
D. 24-year-old man who had a tooth extraction two months ago

2. After the second spin in the preparation of platelets from whole blood, the
platelet products should be:
A. Allowed to rest for 8-2 hours.
B. Agitated vigorously for 3 hours
C. Pooled immediately and microwaved
D. Frozen

3. Which is the first marker (antigen or antibody) which will become positive
after exposure to Hepatitis B:
A. HBsAg
B. Anti-HBs
C. Anti-HBe
D. Anti-HBc

4. Which one of the following blood group antigens is not expressed, or only
weakly expressed on cord blood cells?
A. K
B. Jka
C. M
D. Leb
E. ABO

5. Which of the following contains all the possible phenotypes that could be the
result of parents who are type O and type A:
 A. Type A or type O only
B. Type A only
C. Type O only
D. All possible blood types

6. An exchange transfusion has been ordered for a low birth weight infant. The
physician has ordered irradiated Red Blood Cells for this purpose. Why is it
necessary to irradiate the blood products for this patient?
A. To prevent alloimmunization of the patient
B. To prevent transfusion-associated graft-versus-host disease (TA-
GVHD)
C. To kill bacteria and viruses present in the Red Blood Cells
D. To allow the cells to have a longer half-life

7. The antibody screening test is a routine test performed in the blood bank. It is
an essential test performed in several situations, particularly prior to
crossmatching blood for a patient. Which of the following choices best
describes the antibody screening test, as it is performed in the blood bank?
A. reagent antisera is reacted against reagent red blood cells
B. reagent antisera is reacted against the patient’s red blood cells
C. reagent red blood cells are reacted against the patient’s plasma
D. reagent red blood cells are reacted against the patient’s red blood cells

8. The accepted interval between blood donations is:

A. 82 weeks
B. 1 weeks
C. 6 weeks
D. Depends on hematocrit level
9. A historically type AB patient comes into the hospital again and his physician
orders a routine Type and Rh. You perform a gel ABO/Rh test and observe the
following results. The front type suggests an AB patient but the back type
appears questionable. What do you suspect?

a. The back type is correct. The front type is incorrect and probably due
to a manufacturing defect at the gel card production facility
b. An elderly type O patient with a weak reaction in the back type due to
compromised anti-A and anti-B production
c. The front type is correct. The discrepancy in the back type can be
ignored because it is not strong
d. The front type is correct and the back type is due to cold agglutinins.
Warm patient serum and repeat the back type.

11. Rh antibodies generally:

A. React best at 4 degrees Celsius
B. React best at room temperature
C. React best in saline
D. React best at 33 degrees Celsius
 11. You perform a gel ABO/Rh test on a 84-year-old woman and this is the result.
You recognize a discrepancy between the front and back types. Which one of
the following descriptions is most likely?

A. Individual with both a weak subgroup of A and a weak subgroup of B

B. Elderly Type O POS patient whose production of ABO antibodies is
depressed
C. Individual with Bombay phenotype

Enzyme treatment of RBCs:

A. destroys RBC antibodies

B. enhances RBC antibodies

C. denatures RBC antigens such as K

D. enhances RBC antigens such as Jka and Rh

Mr. Simmons gives the following reactions: Mr.S. cells with: anti-A: 2,
anti-B: 2, anti-A,B: 2 Mr. S. Serum with: A1 cells: 4+, B cells: 4+ Mr. Simmons
has which of the following ABO groups?

A. A

B. B
 C. AB

D. O

Mr. Jenkins has the following reactions: Mr.J. cells with: anti-A: 4+, anti-
B: 2, anti-AB: 4+ Mr.J. serum with: A1 cells: 2, B cells: 4+ Mr. Jenkins' ABO
group is:

A. A

B. B

C. AB

D. O

What type of antibodies are most often clinically significant for blood
transfusion?

A. Cold autoantibodies, generally IgM

B. Warm alloantibodies, generally IgG

C. Both cold autoantibodies, IgM, and warm alloantibodies, IgG

D. Cold alloantibodies, generally IgM

Which typing result below indicates an `acquired B' antigen?

A. Anti-A: 4+, Anti-B: 3+, A1 Cells:0, B Cells: 0

B. Anti-A: 3+, Anti-B: neg, A1 Cells: 0, B Cells: 0

C. Anti-A: 4+, Anti-B: 1+, A1 Cells: 0, B Cells: 4+

D. Anti-A: 4+, Anti-B: 4+, A1 Cells: 2+, B Cells: 0

Which of the following techniques is necessary to detect weak D(Du) in

Rh testing?

A. 4 degree incubation

B. LISS + indirect antiglobulin testing (IAT)

 C. Direct antiglobulin testing (DAT)

D. indirect antiglobulin testing (IAT)

Which immunoglobulin can best cross the placenta?

A. IgA

B. IgG

C. IgM

D. IgD

The purpose of adding antibody-coated red cells (Coombs control cell) to

all negative AHG tubes is to:

A. ensures proper tube reading

B. ensures proper cell washing and addition of AHG reagent

C. check for hemolysis or reaction of complement

D. check for attachment of additional antibody

What procedure would help to distinguish between an anti-e and anti-Fya

in an antibody mixture?

A. Lower pH of test serum

B. Run an enzyme panel

C. Use a thiol reagent

D. Run a regular panel

What samples are required to perform compatibility testing?

A. Patient serum and donor cells

B. Donor serum and patient cells

C. Patient serum and donor serum

D. Patient cells and donor cells

 What factors influence physical attachment of antibody and RBC
antigens?

a. Concentration of antibodies and antigens

b. Temperature

c. Presence of potentiators

d. All of the above

The optimum storage temperature for Red Blood Cells is:

a. 0C

b. 4C

c. 10C

d. 25C

Detection of an antigen/antibody reaction which has occurred in the

circulating blood of the patient(in vivo) is the purpose of the:

a. Weak D test

b. Immediate spin crossmatch

c. indirect antiglobulin test

d. direct antiglobulin test

An A pos individual is bleeding profusely and is in need of an immediate

transfusion. No group A units are available. It is decided to administer an ABO
compatible, non-group specific unit. What component and blood group would be
the "safest" to administer?

a. group O pos whole blood

b. group O pos packed cells

c. group AB neg packed cells

d. group B neg packed cells

e. group AB whole blood

The phenomenon whereby blood group antibodies react more strongly

with homozygous antigens than with heterozygous antigens is known as the:

a. compatibility effect

b. dosage effect

c. immune complex effect

d. mosaic effect

e. gene interaction effect

Which of the following would be the best indicator that a serum sample
contained multiple antibodies?

a. Antibodies will exhibit dosage

b. All panel cells will be positive

c. Panel cells will react at different strengths at different phases

d. Antibodies will react at room temperature

Testing reveals a weak D (Du) that reacts 1+ after indirect antiglobulin

testing (IAT). How is this result classified if the DAT is negative?

a. Rh-positive

b. Rh-negative; Du-positive

c. Rh-negative

d. Rh-positive; Du-positive

The optimum storage temperature for platelets is:

a. 22C

b. 4C

c. -12C

d. -20C

Of the following, which antibody would not likely react at AHG?

a. Anti-M

b. Anti-D

c. Anti-K

d. Anti-Fya

Addition of which of the following will enhance the shelf-life of Red Blood
Cells?

a. heparin

b. adenine (AS-1, AS-3, AS-5)

c. hydroxyethyl starch

d. lactated Ringer's solution

A woman begins to breathe rapidly while donating blood. Choose the correct
course of action.

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

D. Tell her to sit upright and apply a cold compress to her forehead

All of the following are required tests on donor blood, except:

A. HBsAg
B. Anti-CMV

C. HIV-1

D. Anti-HTLV I/II

Which of the following is the correct interpretation of this saliva

neutralization testing?

A. group A secretor
B. group B secretor
C. group AB secretor
D. group 0 secretor

Which one of the following constitutes permanent rejection status of a

donor?
A. a tattoo 5 months previously
B. recent close contact with a patient with viral hepatitis
C. 2 units of blood transfused 4 months previou sly
D. confirmed positive test for HBsAg 10 years previously
Refer to the following panel:

Based on the results of the above panel, the most likely antibodies are:
A. anti-M and anti-K
B. anti-E, anti-Jka and anti-K
C. anti-Jka and anti-M
D. anti-E and anti-Leb
Based on RED CELL PANEL CHART 1 ,the most likely antibody(ies) in the
patient's serum is(are)
A. Anti-S and anti-E
B. Anti-E and anti-K
C. Anti-Fyb showing dosage
D. Anti-K, anti-Jsa, and anti-Lea

A white female's red blood cells gave the following reactions upon phenotyping:
D+ C+ E- c+ e+. Which of the following is the most probable Rh genotype?
A. DCe/Dce
B. DCe/dce
C. DCe/DcE
D. Dce/dCe

Convert the following gentype from Weiner nomenclature to Fisher-Race

nomenclature: R1r
A. DcE/cDe
B. DCe/dce
C. DCE/dce
D. DCe/Dce
Consider the following ABO typing results:
Patient's cells vs: Patient's serum vs:

anti-A A1 cells
4+ +1

anti-B B cells
2 4+

Additional testing was performed using patient serum:

IS RT
screening cell I 1+ 0+
screening cell II 1+ 0+
auto control 1+ 0+
What is the most likely cause of this discrepancy?
A. A2 with anti-A1
B. cold alloantibody
C. cold autoantibody
D. acquired-A phenomenon

A serum containing anti-Lub is not frequently encountered. This is

because
A. Lub is not a good immunogen

B. Lub antigen is high frequency

C. Lub antigen is low frequency

D. Lub antibody is high frequency

A patient's red blood cells are being typed for the Fya antigen. Which of
the following is the proper cell type of choice for a positive control of the
anti-Fya reagent?
A. Fy(a+b-)
B. Fy(a+b+)
C. Fy(a-b+)
D. Fy(a-b-)