IMMUNOHEMATOLOGY AND TRANSFUSION MEDICINE

BLOOD DONATION, DONOR SCREENING, DONOR PHLEBOTOMY

1. In preoperative autologous blood, collection should not be done later than

a. 24 hrs
b. 48 hrs
c. 72 hrs
d. 5-6 weeks
2. To qualify as an autologous donor a patient’s hemoglobin should be at least
a. 8 g/dL
b. 11 g/dL
c. 13 g/dL
d. 15 g/dL
3. To qualify as an autologous donor a patient’s hematocrit should be at least
a. 30%
b. 33%
c. 36%
d. 39%
4. For apheresis donors who donate platelets more frequently than every 4 weeks, a platelet count
must be performed prior to the procedure and the count should be at least be ____ x 103 per uL
a. 150
b. 200
c. 250
d. 300
5. Autologous donation is not advisable in
a. Patients with an antibody against a high-incidence antigen
b. Patients with uncompensated anemia
c. Open heart surgery patients
d. Patients with multiple antibodies
6.

COMPONENT PREPARATION, PRESERVATION, AND STORAGE

1. Length and Time of Centrifugation for preparation of PRP

a. 3000 rpm for 3-5 minutes
b. 3,200 rpm for 2-3 mins
c. 3,600 rpm for 5 mins
d. 5000 rpm for 5 mins
2. Storage of whole blood when platelets are to be prepared
a. 1-10 degrees Celsius
b. 20 degrees Celsius
c. 37 degrees Celsius
d. A or B
3. Hematocrit of whole blood must yield at least
a. 80%
b. 40%
c. 35%
 d. 60%
4. Leukocyte reduced RBCs must have
i. Absolute WBC count < 5 x106 / L
ii. 85% original RBC mass
iii. Biological Response modifiers if performed prior to storage
iv. Less than 80% HCT for CPDA1 units
a. I, II only
b. I, II, III only
c. I, III IV only
d. I, II, III, and IV
5. Cryopoor Plasma contains
i. ADAMTS13
ii. Prothrombin Group
iii. Factor V
iv. Factor XI
a. I only
b. III and IV only
c. II only
d. I, II, III, IV
6. Cryoprecipitates contain
i. Atleast 80 mg Fibrinogen
ii. Atleast 150 IU Factor VIII
iii. vWF
iv. Factor XIII
v. Fibronectin
a. I, II only
b. III, IV, V only
c. I, II, III only
d. I, II, III, IV, V
7. True about platelet concentrates
i. Must be prepared within 4 hrs
ii. Cannot be prepared when collection time exceeded 15 mins
iii. Stored for 7 days with continuous agitation at RT
iv. Maintained at pH less than 6.2
v. SDP may be stored at 20 degrees Celsius

a. I, II only
b. III, IV, V only
c. I, II, IV, V only
d. I, II, III, IV, V
8. Endpoint in preparation of cryoprecipitate
a. Swirling phenomenon
b. Slushy plasma
c. Pass through effect
d. Determine by Factor VIII assay.
9. RDP characteristics
i. Max volume 300 mL
ii. Contains 4-6 SDP
 iii. At least 5.5 x1010 / L platelet
iv. Can be stored at 20 degrees Celsius
v. Expires within 5 days
a. I and II only
b. III, IV, V only
c. I, III, IV V only
d. I, II, III, IV, V
10. Leukocyte Reduced Platelets
i. 5 days expiration
ii. If RDP, must yield < 8.3x1010 / L WBC in 95% of unit
iii. Must have < 5 x 106 / L WBC in final pool
iv. Must have < 5 x 106 / L WBC in 95% of unit of SDP
a. I, II only
b. III, IV only
c. I, II, III only
d. I, II, III, IV only
11. PF24 / FFP
i. Lifespan of 1 yr if at -18 degrees Celsius
ii. Lifespan of 7 yrs if at -65 degrees Celsius
iii. 400 mg Fibrinogen
iv. If thawed, store at 1-6 degrees until retrieved for transfusion
a. I and II
b. I, II, IV
c. I, III, IV
d. I, II, III, IV
12. A satellite bag containing 250 mL of fresh plasma is selected for quality control of cryoprecipitate
production. The Factor VIII activity was 1 IU/mL. The final product has 10 mL volume with 9 IU/mL
activity. Which of the following statements are accurate based from the situation
i. Percent yield is 36%
ii. The product meets AABB standards for cryoprecipitate production
iii. The percent yield is helpful in monitoring various stages of production when the
monthly quality control assays fall below the acceptable standard.
iv. There is no standard guidelines for percent yield.
a. I, III only
b. II only
c. I and II only
d. All are correct
13. RBC freezing must be done in CPDA1 units
a. Within 6 hrs from collection
b. Within 14 days
c. Within 6 days
d. Within 24 hrs
14. Frozen RBCs
i. Storage at -65 degrees Celsius or lower
ii. Uses liquid nitrogen in low glycerol freezing method
iii. Must have 80% recovery and 70% RBC vitality at 24 hrs post transfusion
iv. Stored up to 10 years
a. I and IV only
 b. All except II
c. All Except III
d. All are true
15. Deglycerolized RBCs
i. Thawed using decreasing osmolarity of NaCl solutions
ii. 0.2% dextrose added on the first step
iii. 24 hrs lifespan
iv. Stored at 1-6 degrees celsius
a. III and IV only
b. All except II
c. All except I
d. All are true
16. Correct Volume of Blood Units
i. Whole Blood : 450 to 509 mL
ii. Granulocytes : 200 to 600 mL
iii. Leukoreduced RBC : 250 mL to 300 mL
iv. Cryoprecipitate : 10-25 mL
v. FFP : 200 – 250 mL
a. All are correct
b. All except II
c. All except III
d. Only I and IV are Correct
17. Granulocyte unit lifespan
a. 6 hrs
b. 12 hrs
c. 8 hrs
d. 24 hrs
18. Discontinuation of agitation of platelet units for up to 24 hrs is acceptable only during
a. Anytime
b. Transportation
c. Pooling
d. Never
19. Correct Expiration
a. Pooled Platelets – 4 days
b. Granulocytes – 7 days
c. Deglycerolized RBCs – 24 hrs
d. Cryoprecipitate – 10 yrs
20. Platelet Aliquots must be used for transfusion within
a. 4 hrs
b. 8 hrs
c. 1 hr
d. 6 hrs
21. 100 mL additive solutions must be added to whole blood units within
a. 6 hrs of collection
b. 24 hrs of collection
c. 72 hrs of collection
d. Additive solutions are added on packed rbcs only
22. RBCs treated with Rejuvasol
 i. Expired RBCs prolonged for 3 more days
ii. Are that which came from CPD or CPDA1 units that have expired for no longer than
3 days
iii. Requires washing before transfusion
iv. May be cryopreserved through glycerolization and have 10 yrs lifespan
a. All are correct
b. All except I
c. III only
d. II and III only
23. Temperature limits for shipping RBC
a. 1-6 degrees Celsius
b. 2-8 degrees Celsius
c. 1-10 degrees celsius
d. 20-24 degrees Celsius
24. Correct about irradiated pRBC
i. Have higher plasma potassium
ii. Have lower ATP and 2,3-BPG levels
iii. 28 days lifespan
iv. Indicated to prevent GVHD
a. III, IV only
b. IV only
c. All except II
d. All are Correct
25. When platelets are stored on a rotator set on an open bench top, the ambient air temperature must
be recorded
a. Once a day
b. Every 3 hrs
c. Every 4 hrs
d. Every hour
26. A unit of platelet upon inspection is noted to have visible clots but otherwise appears normal. What
action must be done
a. Issue without concern
b. Filter to remove clots
c. Centrifuge and express off clot
d. Quarantine for gram stain and culture

HEMOTHERAPY

1. Component most commonly associated with sepsis

a. PRBC
b. FFP
c. PC
d. Whole Blood
2. Platelet concentrate is usually indicated and effective in
i. Liver Disease
ii. ITP
iii. Dengue Hemorrhagic Fever
iv. DIC
 a. II, III, IV only
b. IV only
c. II and III only
d. III only
3. Washed RBC is indicated for Except :
a. IgA deficient patients requiring RBC transfusion
b. Patients with PNH
c. Avoidance of Anaphylaxis reaction
d. Preventing HLA Alloimmunization
4. To avoid complications in transfusing a blood unit obtained from a blood relative, ____ is performed
on the unit prior to transfusion
a. Pre-storage Leukoreduction
b. Post storage leukoreduction
c. Washing or Deglycerolization
d. Irradiation
5. Cytokine associated febrile non hemolytic reaction can be prevented by
a. Pre-storage leukoreduction
b. Post-storage leukoreduction
c. Washing or deglycerolization
d. Irradiation
6. Prothrombin Complex concentrate is used to treat deficiencies of
a. Factor VIII
b. Factor IX
c. Factor XI
d. vWF
7. Calculate the dose of CRYO concentrate needed for a 75 kg man with 4 units/dL FVIII activity to
increase to at least 70 units per dL
a. 12 bags
b. 15 bags
c. 20 bags
d. NOTA
8. In which of the following may an ABO incompatible unit be acceptable for transfusion
a. PF24
b. Cryoprecipitate
c. Apheresis Granulocytes
d. Apheresis Platelets
9. Blood transfusion should be completed within
a. 3 hrs
b. 4 hrs
c. 6 hrs
d. 8 hrs
10. A transfusion of a 10-15 mL/kg RBC aliquot unit with 80% hematocrit should raise the hemoglobin of
pediatric patients by
a. 1-2 g/dL
b. 2-3 g/dL
c. 3-4 g/dL
d. 4-5 g/dL
11. A transfusion of a 10-15 mL/kg RBC aliquot unit with 80% hematocrit should raise the hematocrit of
pediatric patients by
a. 3%
b. 4%
c. 5%
d. 6%
12. Units to be employed for intrauterine transfusion should be
a. Irradiated
b. Leukoreduced
c. Washed
d. Pre-warmed
13. Patient with Wiskott-Aldrich syndrome has hemoglobin of 8 g/dL and Hematocrit of 30%. His
platelet count is 50,000 per uL. Which action must be taken
a. Transfuse Leukoreduced pRBC
b. Transfuse Irradiated pRBC
c. Transfuse Platelet
d. No transfusion required
14. Hemophilia A patient with circulating anti-human factor VIII antibody must be given
a. Recombinant Factor VIII concentrate
b. Factor VIIa
c. Porcine Factor VIII
d. Cryoprecipitated FVIII
15. CCI indicative of refractoriness
a. 9000
b. 4900
c. 5500
d. 7400
16. Neonatal alloimmune thrombocytopenia
a. Washed Platelet of maternal origin
b. Washed platelet of paternal origin
c. Pooled PRP
d. Irradiated Platelet Concentrate
17. Blood selected for exchange transfusion must
a. Lack rbc antigens corresponding to maternal antibodies
b. Be less than 3 days old
c. Be of the same Rh type as the baby
d. Be ABO compatible with the father
18. When the main objective of exchange transfusion is to remove infant’s antibody sensitized rbcs and
to correct hyperbilirubinemia, the blood product of choice is an ABO compatible :
a. Fresh Whole Blood
b. Washed RBC
c. RBC suspended in FFP
d. Heparinized RBC

TRANSFUSION REACTIONS

1. Post-transfusion purpura is associated with

a. Refractoriness
 b. Swirling phenomenon
c. Anti-HPA-1a
d. HLA alloantibody

OTHER BLOOD GROUPS

1. Which of the following is associated with spontaneous abortion

a. Anti-P
b. Anti-P1
c. Anti-PP1Pk
d. None of these
2. Which of the following is also known as anti-Tja
a. Anti-P
b. Anti-P1
c. Anti-PP1Pk
d. None of these
3. All of the following describes PP1Pk antibody
i. They are both IgM and IgG
ii. They are potent hemolysins that may cause severe HTRs and HDFN.
iii. produced by p individuals early in life without RBC sensitization and reacts with
all RBCs except those of the p phenotype
iv. components of anti-PP1Pk are not separable through adsorption

4. Anti-P specificity is associated with

a. hydatid cyst fluid
b. cold-reactive IgG autoantibody in patients with paroxysmal cold hemoglobinuria (PCH)
c. spontaneous abortion
d. bovine liver fluke disease
e. all of the above
5. Anti-P1 specificity is associated with
a. Echinococcus granulosus tapeworm infections
b. Fascioliasis
c. Bird handlers
d. All of the above
6. Globoside Blood Group System

i. P
ii. P1
iii. Pk
a. I only
b. I and II only
c. I and III only
d. II and III only
e. I, II, III
7. True regarding PP1PK blood antigens Except
a. Globoside Blood Group is assigned with ISBT number 028, while the Globoside collection
with ISBT number 209
b. P antigen locus : Chromosome 3 ; P1PK locus : Chromosome 22
c. 4-α-galactosyltransferase is responsible for P1 synthesis
d. gene (B3GALNT1) encoding the 3-β-Nacetylgalactosaminyltransferase (Gb4 synthase) is
responsible for converting Pk to P
e. P1PK gene and the P gene are inherited independently.
8. Which of the following is accurate regarding P2k phenotype
a. Antigen Present is P and Pk
b. One of the antibodies found in individuals with P2k phenotype is anti-P1
c. Common among whites
d. All are True regarding P2k
e. None of these
9. Phenotype when globoside, P1, and Pk antigens are found on RBCs
a. P1
b. P2
c. p
d. P1k
e. P2k
10. The phenotype that describes RBCs that do not react with anti-P1 but do react with anti-P
a. P1
b. P2
c. p
d. P1k
e. P2k
11. All are true except
a. P1, P, or Pk may be found on RBCs, lymphocytes, gr
 b. anulocytes, and monocytes
c. the precursor substance for Pk is also a precursor for type 2H chains that carry ABH
antigens
d. P can be found on platelets, epithelial cells, and fibroblasts.
e. P and Pk have also been found in plasma as glycosphingolipids and as glycoproteins in
hydatid cyst fluid.
f. The P blood group antigens are resistant to treatment with ficin and papain, DTT,
chloroquine, and glycine-acid EDTA.
12. Serve as receptors for P-fimbriated uropathogenic E. coli—a cause of urinary tract infections.
a. Globoside Collection
b. P1
c. Pk
d. P
13. Receptor for shiga toxins, which cause shigella dysentery and E. coli associated hemolytic
uremic syndrome.
a. Globoside Collection
b. P1
c. Pk
d. P
14. receptor of human parvovirus B19.
a. Globoside Collection
b. P1
c. Pk
d. P
k
15. P antigen precursor
a. Lactosylceramide
b. Paragloboside
c. Globoside
d. Lactotriaosylyceramide
16. True regarding the I Blood System Except
a. I and i are antithetical antigens
b. ISBT number 027
c. Locus : Chromosome 6
d. Also found on the membranes of leukocytes and platelets
e. None of these
17. cold agglutinin syndrome
a. anti-I
b. anti-i
c. anti-IT
d. None of These
18. Found in patients with warm autoimmune hemolytic anemia, with a special association with
Hodgkin’s disease
a. anti-I
b. anti-i
c. anti-IT
d. None of These
19. True regarding MN blood antigens
a. M and N are not antithetical antigens
b. M is defined by serine at position 1 and glycine at position 5; N has leucine and
glutamic acid at these positions, respectively.
c. they are resistant to enzyme treatment be it ficin, papain, and bromelin
d. assigned the ISBT number 005
e. All of the above
20. All are true regarding S and s Except
a. S and s are differentiated by the amino acid at position 29 on GPB.
b. Threonine defines S while Methionine defines s.
c. Trypsin does not destroy the S and s antigens, and neither does DTT, AET, chloroquine,
or glycine-acid EDTA treatment.
d. S and s antigens are less easily degraded by enzymes because the antigens are located
farther down the glycoprotein, and enzyme-sensitive sites are less accessible
e. None of these
21. Which of the following is inaccurate regarding U antigen or antibody
a. U antigen is resistant to enzyme treatment
b. ISBT MNS5

IMMUNOHEMATOLOGY AND TRANSFUSION MEDICINE 10

c. high-prevalence antigen is found on RBCs of all individuals except about 1% of African
Americans (and 1% to 35% of Africans) who lack GPA because of a partial or complete
deletion of GYPA.
d. All of these
e. None of these

IMMUNOHEMATOLOGY AND TRANSFUSION MEDICINE 11