BLOOD BANK UNIT
PRETEST
Hemoglobinometer
Blood Donation Bed
Blood Bag
Plasmapheresis machine
-Used for screening the donor’s hemoglobin and hematocrit
levels
-Uses photometric azide methemoglobin method
-We collect blood by pricking the skin with the lancet, then we
fill up the cuvette (see fig.2), then after waiting for 25 seconds,
we will have our result (fig.3).
-Criteria for acceptance
Male: At least 13.0 g/dl Hgb, ≥39% Hct
Female: At least 12.5 g/dl Hemoglobin, ≥36% HCT
-This is where the donor lies down while blood
collection/plasmapheresis is ongoing
-Has arm rests for easier vein access during phlebotomy.
-The back rest can be adjusted accordingly.
-In cases of donor hypotension, the back rest’s incline is
changed, it is changed to a decline position, and the donor is
put into the Trendelenburg position (head declined below the
feet, this helps reverse hypotension due to blood loss)
-Plasticized PVC bags that contains CPDA-1 (Citrate
Phosphate Dextrose Adenine, basically a mixture of
anticoagulant solution that preserves blood for up to 35 days)
-Has tubing with an attached 16-gauge needle (encircled) for
blood collection.
-In our blood bank, we have:
Single bags – no “satellite” bag
Double/triple bags – has satellite bags; used when
preparing plasma components
-Apheresis is a medical procedure that involves removing
whole blood from a donor or patient and separating the blood
into individual components so that one particular component
can be removed.
-Currently only used when apheresis platelets are needed
(Note: 1 Unit of apheresed platelets = 6 bags of platelet
concentrate, making it extremely useful in patients with very
low platelet counts)
-Plasmapheresis is more complex than regular blood
collection. Donor requirements are also more stringent.
-Rarely used. Requires special training to use properly.

Blood Processing Area
TTI Screening Machines
Refrigerated Blood Bag Centrifuge
Platelet Agitator
Blood Bag
Tube Sealer
Blood Typing and Crossmatching Area
(Interns are not allowed to operate this due to complexity)
This is one-half of the main blood bank area
This is where the collected blood bags are screened for TTIs
(Transfusion Transmissible Infections) and also the area
where FFPs and Platelet Concentrates are prepared by
centrifugation of the blood bags.
-These machines are used for the screening of TTIs
-Used for the centrifugation (and subsequent component
separation) of blood bags
-Has pre-set programs for light spin and hard spin
-Used in conjunction with plasma separation stand to squeeze
out the required components onto the satellite bags (review my
“Blood Donation, TTI and components” for more info)
-Designed to provide continuous gentle horizontal motion on
the platelet concentrates
-“For platelets to maintain their in vitro quality and in vivo
effectiveness, they need to be stored at room temperature with
gentle agitation in gas-permeable containers. The mode of
agitation affects the quality of the platelets, and a gentle
method of agitation, either a circular or a flat bed movement,
provides the best results.”
(van der Meer PF, de Korte D. Platelet preservation: agitation
and containers. Transfus Apher Sci. 2011 Jun;44(3):297-304.
doi: 10.1016/j.transci.2011.03.005. Epub 2011 Apr 21. PMID:
21514232.)
-Seals the tubing of blood bags without causing hemolysis and
leakage of blood
-Used to create “segments” – blood bag tubes which contains
the donor samples. These samples can be easily torn off the
main bag (without causing damage to the main bag), these
“segments” are used for blood typing and crossmatching.
The other half of the main blood bank area
This is where the actual immunohematological procedures are
performed – blood typing, crossmatching, resolution of
incompatibilities etc.
This is also the area where results are interpreted and
released by the medical technologist on duty
Blood Bag Refrigerator -Designed to keep the optimum 4-6 degrees Celsius
temperature for blood bags

-Has “shelves” for easier organization of blood bags according

to their blood type

-Has a built in thermometer that displays the current

temperature and has an alarm system to notify for any
variations in temperature
Ultra Low Freezer -Designed to house FFPs and Cryoprecipitates

-Can go as low as -86 degrees Celsius

-Also has a built-in thermometer with temperature display and

also has an alarm system to notify for any variation in the
required temperature

-Temperature is so cold you could actually get ice burns lol

Table top centrifuge -For centrifugation of test tubes – be it blood samples
(separation of cellular components from plasma/serum) or test
tubes for blood typing/crossmatching (centrifugation is done to
enhance agglutination reactions)

-We have 2 table top centrifuge machines. Figure 1 is the one

usually used for blood samples stored in plastic tubes. It is
more heavy duty than the one on the right (Figure 2), which is
exclusively used for test tubes for blood typing/crossmatching

Pipettes -Air displacement pipettes are used for accurate and precise
dispensing of liquids in blood bank.

-Uses filtered tips to minimize cross contamination.

-Has different volume ranges that can be adjusted accordingly.

Blood Typing and Crossmatching Reagents A – Known A Cells. Used in reverse ABO typing.

B – Known B Cells. Used in reverse ABO typing.

C – Known O Cells. Used in Direct Coomb’s test.

D – Anti-A typing sera. Used in forward ABO typing.

E – Anti-B typing sera. Used in forward ABO typing.

F- Anti-AB plasma. Used in forward ABO typing.

G – Anti-D typing sera. Used in Rh typing.

H – LISS. Potentiator that accelerates Ag-Ab reaction from 45

minutes to 15 minutes

I – AHG – Anti-human globulin that serves to connect

sensitized IgG antibodies if present
Dry Block -Serves as an incubator for crossmatching

-Maintains a 37 degrees Celsius environment for the tubes

-Has a built in thermometer with temperature display function,

and an alarm can be set to notify the end of the incubation
period
Light -Used to confirm for the presence of microagglutinates in the
Microscope tube method of blood typing and crossmatching

-The tube is 1. Placed on the stage, 2. The lamp is turned on,

and the tube is checked under LPO

-Presence of unwanted agglutination may indicate a legit Ag-

Ab reaction, or cross-contamination.

INTRODUCTION
Ang dugo ay buhay, ito ay isang kayamanan. At tulad ng isang kayamanan, ito ay inilalagak at pinangangalagaan
sa isang bangko. Ang blood bank and nagsasagawa ng programa ukol sa “voluntary blood donation”. Ito rin ang
siyang nangangalaga sa mga dugong isinasalin sa mga pasyente. Sinisuguro nito na ligtas sa anumang
nakakahawang sakit ang transfusion and transmitted disease at compatible o tugma ang dugon a posibleng i-
transfuse o isalin sa nangangailangang pasyente
It separtes serum from It screns donor’s blood
red blood cells from transfusion
transmissible infection

Department of Pathology Blood Bank Unit Services • Donor

Offered • Syphilis Test
• VMMC Blood Program • Available Blood Components:
• Voluntary Blood Donation • Whole Blood
• Compatibility Testing (Gel Technology) • Packed Red Blood Cell
• Blood Typing (Gel Technology) • Washed RBC
• Coombs • Leukonduced PRBC
Test • Platelet Concentrate
• Direct • Conventional
• Indirect • Phereais
• Antibody Screening • Cryoprecipitate
• Patient • Fresh Frozen Platte

Donor Selection, Screening and Phlebotomy, Transfusion

Transmissible Infections and Component Preparation and Therapy
Prepared by: Ralph Joseph Pangilinan Cayetano, RMT
Intern's Monitor (online lol), Blood Bank section
In a nutshell, prospective  healthy
blood donors must be:  have a valid ID
 16 to 65 years old (16 years olds should have a consent)
 should atleast have a weight of 50kg
 Blood pressure of 90-160 systolic, 60-100 diastolic
 Pulse rate of 60-100 beats per minute, with regular rhythm (atheletes have
 lower pulse rate)
 Hgb level of atleast 13.5g/L for male donors and
 12.5g/L for female doriors
Hgb values are different from textbooks because these are subjective in
instituitions.
Interview form The prospective donor must answer a questionnaire that
aims to assess their medical and travel history and other
potentially hazardous endeavors (eg:driving heavy
vehicles, high risk sexual behaviors)

Some examples of common defferals are:

1 week 1 month 12 mos. Permanent Miscellaneous
 Common colds  Infectious  Blood Tx  Filariasis  Smoking (after 1
 Upper diarrhea  Body piercings  Cancers/Malignancies hour = OK)
respiratory tract  Gastroenteritis  Tattoos  Hepatitis B  Menstruation
infections  Certain  Hepatitis C (if asymptomatic =
 Hepa B vaccine  Surgeries  HIV accept.
(upon (appendectomy,  Syphilis If with blood flow=
completion) cholecystectomy,  Autoimmune diseases temporarily defer)
hysterectomy, etc.) (eg: SLE)
 Incarceration
 Former residence
in a Malaria
endemic area
 Pregnancy
Donor Phlebotomy  Properly identify donor (DOUBLE CHECK IF THE DONOR IS ELIGIBLE TO
DONATE)

 Site of choice: Antecubital Fossa; Vein of choice: Median vein

 Ideally, donor should lie down with their feet elevated (helps ease light
headedness)

 Aseptic technique should always be observed

o 70% isopropyl alcohol → povidone iodine → 70% isopropyl alcohol
o Each solution should stay in contact with the skin for at least 30 seconds
o When cleaning the intended puncture site, use an outward spiral (inner to
outer) so as to minimize carryover of skin flora in the selected vein

 Once the site is cleaned, perform the actual phlebotomy

o You should have your equipments and consumables near you (Micropore
tape, tourniquet, cottons, stress balls
o Firmly and decisively penetrate the vein (pierce slightly below the site so as
to better anchor the needle)
o As much as possible, avoid "fishing" the vein
o Tape the pilot tube to the donor's forearm in order to stabilize the collection.

 Once the unit reaches 450ml (check with the spring balance or the blood
mixer), stop the collection by using a clip to prevent blood flow into the bag.
Remove the tourniquet, and quickly pull-out the needle. Advise the donor to apply
pressure to the punctured site for a couple of minutes so as to minimize bleeding.
Post-collection  Advise the donor to lie down with his/her feet elevated for atleast 15 minutes.
procedures: Donor Replenish fluids by giving refreshments.
management o Monitor the donor for possible post-donation nausea

 Immediately inform the Nurse or Doctor on duty for any post-collection

complications.
Post-collection procedure:  Should the collection last longer than 15 minutes, that unit can no longer be
Handling of Blood Product processed into FFP and Cryoppt. (Cryoprecipitate)

 Ensure that you have collected representative samples (red and lavender tube)
of the unit. (These would be used for TTI screening and Blood Typing)

 "Segment" the blood bag tubing (aka Pilot tube)

Post-collection procedure:
Handling of Blood Product
 Component Preparation
Donor Screening:
Transfusion Transmissible
Infections
o The first part that you should segment is
the needle. It is to be discarded into a proper sharps container (aka Puncture proof
container) immediately.
 If the blood bag used is a single bag, immediately store inside the Blood Bank
refrigerator
 If the blood bag used is a double bag or a triple bag, the unit is to be subjected
to component preparation in which the platelet concentrate and FFP (or sometimes,
Cryoppt.) are prepared.
 It is mandatory to test blood products for TTI's (Transfusion Transmissible
Infections) before issuance.
 The 5 TTI's that we test here are: Human

 Immunodeficiency Virus (HIV I&II), Hepatitis B Virus (HBV), Hepatitis C Virus

(HCV), Treponema pallidum (TP) and Plasmodium spp.

 For Plasmodium, we perform the screening via the peripheral blood smear.

 For HIV, HBV, HCV and TP, we run the donor's serum via CMIA
(Chemiluminescent Microparticle Immunoassay).
CMIA: Donor serology testing principle
CMIA is a variation of the enzyme immunoassay (EIA) principle. Basically, it uses light-generating molecules (such
as acridinium conjugates) that produce chemiluminescent signals whenever the target analyte is present in the
sample. The said signal is then compared to the machine's cut-off value(COV): If the value produced is greater than
that of the COV, then the sample is considered reactive.
 HIV(Human Immunodeficiency Virus)-detection of p24 antigen and antibodies to HIV 1/ HIV 2

 HBV (Hepatitis B Virus)-detection of Australia Ag/HbSAg (Hepatitis B surface Ag)

 HCV (Hepatitis C Virus)- detection of Anti-HCV Abs

 TP (Treponema pallidum)-detection of Anti-Treponema Abs

Reactive vs Non-reactive  Non-reactive samples that are free from damages may be used for
crossmatching and future transfusions.

 Reactive samples are retested. If they remain reactive after retesting, they are
sent to RITM

 (Research Institute for Tropical Medicine) and are subjected to confirmatory

testing. (We only perform screening. RITM is still the one responsible for confirming
reactive samples.)
Component Preparation and Therapy In a nutshell
 Blood component preparation involves refrigerated centrifugation of the blood bag.
o A primary "soft/light" spin which separates the platelet rich plasma from the WBC's and RBC's
o A secondary "hard" spin which separates the platelet concentrate from the platelet poor plasma (FFP).
 After every centrifugation, the blood bag is hung and pressed on by a Plasma Extractor/ Blood separation
stand.
Soft/Light Spin  The initial spin which separates the plasma from the cellular components

 * Lower centrifugal force, shorter centrifugation time (1500rpm x 10 mins)

 The blood bag will be divided into

o Top: Platelet rich plasma
o Bottom: Packed red cells

 Blood bag is then subjected to plasma extraction-the platelet rich plasma is

transferred to a satellite bag (a tinier bag that is attached to the main bag) and the
packed red cells are left in the original bag.

 The bags are then subjected to hard/heavy spin.
Hard/Heavy spin  The final centrifugation which separates the platelet concentrate from the
plasma

 Higher centrifugal force, longer centrifugation time (5000rpm for 20mins)

 After centrifugation, the satellite bag containing the plasma is hung on the
Plasma extractor
o The platelet poor plasma is expressed into another satellite bag and is
frozen in an ultralow freezer @>-16 deg. Celsius, becoming Fresh Frozen
Plasma
o The platelet rich portion is left on the original satellite bag, becoming a
Platelet Concentrate and is loaded onto a platelet agitator for continuous
mixing
Blood and Blood components here in VMMC A summary
*see BB4.png/last page. Watch Video!

ABO/Rh Blood Typing

Prepared by: Ralph Joseph Pangilinan Cayetano, RMT
Intern's Monitor (online lol), Blood Bank section
 Here in Bloodbank, one of our main objectives is the issuance of safe, and properly blood typed and compatible
blood/blood products. N

 To do so, we have to properly identify the patient's blood type and we must be able to demonstrate compatibility
between donor and patient.

 Failure to properly type or crossmatch the blood units can lead to possible transfusion reactions, some of which
can be severe enough to cause life threatening illness or death.
Antigen-Antibody reaction  Our major goal in ABO/Rh typing and Crossmatching is to demonstrate Ag-Ab
principles in Blood Bank reactions in vitro
 Agglutination = most common demonstrable Ag-Ab reaction here in Blood Bank
Antigen-Antibody reaction 1. Sensitization, in which Ab attaches to Ag
principles in Blood Bank -
2 stages of agglutination 2. Actual agglutination/Lattice formation of sensitized RBC's with the
antibodies from serum/Anti-sera (valid only for IgM; IgG cannot directly
agglutinate, only attach)
Antigen-Antibody reaction  ↑ Ab= ↑ sensitization, thus we observe the 2:1 ratio of serum to 2%-5% red cell
principles in Blood Bank - suspension (RCS)
Factors that may affect o Prozone (excess Ab than the recommended 2:1, inhibits direct
agglutination agglutination, false negative)
o Postzone (Excess Ag, limits agglutination, false negative)

 Chemical bonds-Hydrogen bonds, hydrophobic bonds and Van der Waals

forces

 Reaction temperature
o IgG - Clinically significant; reacts at 37 deg. Celsius aka body temperature
o IgM = Clinically insignificant. Reacts at 4-24 deg Celsius aka room temp
 pH = 7.0

 Use of potentiators like LISS (Low lonic Strength Saline, decreases Zeta
potential between RBC's, thus increasing Ag/Ab binding)
ABO system in a nutshell  The foundation of pretransfusion testing due to the dire consequences
associated with Incompatibilities (They are VERY immunogenic)

 A, B, AB and O

 A noteworthy characteristic of this system is the presence of naturally occurring

Abs directed against missing A & B Ags (Reciprocal relationship)
Rh system in a nutshell  RhD antigen is most immunogenic of the Rh antigens

 Second only to ABO in clinical significance; Notorious cause of HDN

 Most complex of the blood group system (Don't worry we won't tackle this in
depth lol)
Pre-analytic considerations: ABO/Rh testing
 Properly-filled up request forms

 Blood Samples - in general, samples should be properly labeled and must not be > 3 days old (just a general
precaution just in case the patient has formed antibodies)
Red top (Serum; Clotted) Source of Antibody; Red is preferred over gold due to possible
interference of thixotropic gel, leading to a false positive/incompatible;
Another source of error when using red top is that if incompletely
clotted samples are centrifuged, it leads to the formation of fibrin clots
(False positive/incompatible again)
Lavander top (Whole Blood; Anti- Source of Antigen; Samples must not be hemolyzed for it may mask
coagulated) complement induced hemolysis (false negative)

ABO/Rh Bloodtyping: Forward typing

 We use commercially prepared anti-sera
Anti-A1 Agglutinates A1 red cells, color blue
Anti-B Agglutinates B red cells, color yellow
Anti-AB Agglutinates both A and B red cells, we use the serum of type O
individuals
Anti-D Agglutinates RhD positive cells

ABO/Rh Bloodtyping: Reverse typing

 We use known cells (red cell suspension from known type A, B and O individuals)
Known A cells Agglutinated by serum of type B individuals
Known B cells Agglutinated by serum of type A individuals
 The results of forward and reverse typing should always agree for they are checks of each other. Any
discrepancies between the two should be investigated and resolved.

Common errors in Blood typing

False negative False positive
  Failure to add anti-sera/known cells lol  Contaminated reagents and equipments
 Prozone and Postzone  Overcentrifugation
 Failure to recognize hemolysis as a positive result  Dirty glasswares
 Expired reagents  Fibrin clots in reverse typing
 Wrong incubation temperature

Special cases/ Problematic scenarios

 Patients who have cold agglutinins (false positive in all tubes)
 Patients who have Leukemia (ex: AML) in which cell Ags are suppressed during leukemic phase
 Use of incompletely clotted serum for reverse typing (fibrin clots).
 Immunodeficient patients very weak to no reaction at reverse typing
 Infants 4-6 mos. Old (serum contains momsie's Antibody)
Watch video!!!

Crossmatching
 It is important that all blood units be properly typed (ABO/Rh minimum), screened (TTI's) and crossmatched
prior to issuance of blood unit.
 Thus, we perform crossmatching.
o Pre-transfusion test which demonstrates compatibility/incompatibility between donor's blood and recipient's
serum/plasma.
Tube method  The samples we need are the patient's serum (red top), patient's washed red
cell and a sample of the donor bag (blood and plasma from pilot tube)

 Components of the crossmatch include

Errors in Crossmatching
 If the crossmatch is compatible, the unit may be transfused to the patient. If the crossmatch is incompatible, we
repeat the crossmatch using a different blood bag.
o Repeat blood typing of donor unit (A & B)
o Minor crossmatch (Patient's cells (PC) Donor's serum (DS): to assess
survivability of transfused RBC's
o Auto-control (Patient's serum Patient's cells); to check for presence of auto
antibodies
 Major crossmatch (Patient's serum (PS)+ Donor's cells (DC)
o We use LISS to speed up the reaction by 3x (usual incubation without LISS
is 45 mins here in VMMC)
o We incubate this inside the dry block/ water bath to promote IgG
sensitization
o We wash 3x afterwards so as to eliminate any possible interfering proteins
trapped between the red cells
o We add AHG reagent so as to induce the agglutination of possible IgG
coated RBC's
False negative/ False compatible
 Delay in washing major crossmatch(elution)
 Failure to add LISS (under incubation)
 Prozone and Postzone
False positive/ False incompatible
 Cold antibodies
 "Rouleaux"
 Contaminated equipments, reagents and glasswares

 After crossmatching, we prepare the procurement forms-these forms are basically the ward's "claim stub" for
their crossmatched blood.

 Ensure that the bags are free from damages prior to releasing to the ward.
Watch Video!!!
 ACTIVITY 1
You observed that all of your ABO reactions are always Prepare a fresh batch of known cells
negative on reverse typing regardless of their forward
ABO type. Upon checking the known A and B red cells, Hemolyzed known red cells = false negative. Prepare
you noticed that said reagents are hemolyzed. Do you: a new batch.
a) Prepare a written apology to your staff, clinical
instructor and co-interns
b) Purchase a fresh batch of known cells via Shopee
c) Carry on as usual
d) Prepare a fresh batch of known cells
You were assigned to perform ABO bloodtyping and Inform the staff that the unit might be
crossmatching on a unit of pRBC. While inspecting the contaminated and must be replaced
bag of pRBC, you noticed that the unit is near expiry,
discolored and there is a mass of clotted material inside
the bag. Do you: Presence of clots & discoloration could possibly be
a) Inform the staff that the unit might be caused by contamination of normal skin flora (Gram
contaminated and must be replaced positive bacteria), most likely caused by improper
b) Inform the staff that the unit might be aseptic collection techniques or prolonged blood
contaminated but transfusion could still be collection.
performed if the blood is transfused along with
ethanol
c) Panic and incinerate the bag
d) Proceed with the blood typing and crossmatching
as usual
While collecting blood from a donor, your donor suddenly Immediately stop the procedure and inform the
felt nauseous and lightheaded. What should you do? staff on duty

a) Beg for the donor to endure the process for you
will accumulate a demerit if the collection stops
b) Immediately stop the procedure and inform the
staff on duty
c) Give the donor lots of TLC and moral support \
(^o^)/
d) Return the blood to the donor by using multiple
10ml syringes – administered via intramuscular
route
While performing temperature monitoring on the various
blood bank refrigerators, you noticed that the temperature
of the blood bag refrigerator is at 20 degrees Celsius. Do
you:
a) Just write it down as usual
b) Let the next shift interns handle it ╮( ˘ ､ ˘ )╭
c) Inform the staff that the temperature is lower than
usual and it might lead to the crystallization of the
blood products
d) Inform the staff that the temperature is higher than
usual and it might lead to faster deterioration of
the whole blood and PRBC products
The temporary lowering of blood pressure leads to
nausea, somewhat putting the donor’s health (and
other people’s health especially if said person is
driving) at risk. Donor’s health and safety takes top
priority over the blood unit to be collected (Donor’s
safety > Donor’s blood)
Inform the staff that the temperature is higher than
usual and it might lead to faster deterioration of
the whole blood and PRBC products
The refrigerator for pRBCs and whole blood products
should have a temperature range of 4-6 degrees
Celsius. A high refrigerator temperature will lead to
faster spoilage of blood products.
You were about to finish a patient’s crossmatch procedure Immediately stop the procedure and just repeat
when you realized that you forgot to add the patient’s crossmatching
serum on the major crossmatch. Do you:
a) Proceed regardless because the patient is about The goal of crossmatching is to detect incompatibility
to die anyways of donor red cells with the patient’s serum/plasma. No
b) Immediately stop the procedure and just repeat serum/plasma = False negative.
crossmatching
c) Proceed regardless and just add more AHG
d) Proceed regardless because the patient’s serum
is not important at all on this procedure

ACTIVITY 2
The patient No
has been
transfused
with one
unit of O
positive
Packed
Red Cell
recently
with no
notable
transfusion
reaction.
Can this
patient be
transfused
with O
positive
red cells
once more?
No
Yes
Refer to the image below: Reverse Typing

Are these reagents used for forward typing or reverse typing?

Forward Typing
Reverse Typing
Refer to the image below: "B" Positive
What is Positive
the Negative
patient’s
blood
type?
Based
on this
forward
blood
type
reaction,
what
would be
the
result of
Known A
cells in reverse typing.
Based on this forward blood type reaction, what would be the result of
Known B cells in reverse typing.
A patient about to undergo dialysis has been requested to be "O" Positive
transfused with 1 unit of packed red cells. You performed the Positive
crossmatch, and got the following results: Positive

Patient’s Blood Type:

Type O

Compatible

Based on this forward blood type reaction, what is the patient’s

ABO/Rh blood type?
Based on this forward blood type reaction, what would be the result of
Known A cells in reverse typing.
Based on this forward blood type reaction, what would be the result of
Known B cells in reverse typing.

Based on these 2 results, what is the blood donors ABO type?

Crossmatching Result
What is the interpretation or result of the cross-matching?

ACTIVITY 2
Match the the following Donor's Medical History and
other Important Findings with their corresponding
deferral period.
(Based on DOH Guidelines and as followed in VMMC
Policy)
Gastroenteritis
1 month
Tattoos
12 months
Syphilis
Permanent
Hepatitis B
Permanent
Upper Respiratory Tract Infection
1 week
Pregnancy
12 months
Common Colds
1 week
Cancers
Permanent
Infectious Diarrhea
1 month
SLE
Permanent
Hepa B Vaccine (upon completion)
1 week
Body Piercings
12 months
HIV
Permanent
Filariasis
Permanent
Former Resident of a Malaria Endemic Area
12 months

POST TEST
What is the color of the AHG typing sera? Green
a) Colorless
b) Green
c) Yellow
d) Blue
When doing plateletpheresis in VMMC, 1 unit of 6 Bags/Units
apheresed platelet is equivalent to how many bags of
platelet concentrate?
a) 8 Bags/Units
b) 2 Bags/Units
c) 3 Bags/Units
d) 6 Bags/Units
The Blood Bag Refrigerator should be kept and 4 - 6 degree celsius
maintained at what temperature?
a) 35 - 37 degree celcius
b) 20 - 25 degree celcius
c) 20 degree celcius
d) 4 - 6 degree celsius
The Ultra Low Freezer should be kept and maintained at -86 degree celcius
what temperature?
a) 4 - 6 degree celsius
b) -20 degree celcius
c) -86 degree celcius
d) -120 degree celcius
The Mindray MR-96A ELISA microplate reader and Malaria
Rayto microplate washer are used in determining the
analyte:
a) HbsAg
b) HIV 1+2
c) Malaria
d) Syphilis
Blood bag containing CPDA-1 can preserve the 35 days
collected blood for at least:
a) 32 days
b) 33 days
c) 34 days
d) 35 days
What needle gauge is used in doing blood donor 16 gauge
collection?
a) 16 gauge
b) 23 gauge
c) 21 gauge
d) 25 gauge
What is the color of the Anti-B typing sera? Yellow
a) Colorless
b) Green
c) Yellow
d) Blue
The dry block, used in crossmatching, has a 37 degree celcius
temperature of:
a) -20 degree celcius
b) 4 degree celcius
c) 20 degree celcius
d) 37 degree celcius
What is the acceptable hemoglobin value for male? 12.5. g/dL
(VMMC Policy)
a) 12.5. g/dL
b) 10 g/dL
c) 11.0 g/dL
d) 12.0 g/dL

SHIFTING EXAM
Cryoprecipitate contains 110 mg of fibrinogen and 70 False
IU/bag of factor VIII
True
False
What is the correct PH that must be maintained for pH >6.2
platelets through the end of storage?
 a) pH < 5.2
b) None of the above
c) pH >6.2
d) pH >7.2
FFP and Cryoprecipitate components are stored inside True
the Ultra Low Freezer.
True
False
Cell washing is the process to remove excess proteins True
that could interfere with crossmatching.
True
False
Thawed FFP must be transfused within?
a) 60 mins
b) None of the above
c) 48 hours
d) 24 hours
True about Platelet concentrate.
a) Store with continuous gentle agitation at 1-6C
b) Store at 20-24C without agitation
c) None of the above
d) Store at 20-24C without agitation
Washed rbc expired 12 hours after seal of original unit False
broken.
True
False
Reactive samples for HIV are sent to? RITM
a) RITM
b) PBC
c) NKTI
d) San Lazaro hospital
Serum from yellow tube can be used in cross matching. False
True
False
A potential blood donor who had been transfused True
recently is deferred to donate for a period of one year.
True
False
Dat is the basis of the major crossmatch and weak D False
testing.
True
False
A unit of packed RBC is split into 2 aliquots under closed Same as the original date of the unsplit unit
system conditions. The expiration time of each aliquot is
now what?
a) 24 hours
b) 6 hours
c) Same as the original date of the unsplit unit
d) 48 hours
RhC is the most immunogenic of Rh antigens. False
True
False
Cryoprecipitate must be transfused 24 hours after False
thawing.
True
False
Grading of Agglutination: ++++
 a) +++
b) +
c) ++
d) ++++
In emergency cases of RH transfusion, which blood Group O negative
group can be given?
a) Neither A or B
b) Both a and B
c) Group O negative
d) Group O positive
Over-centrifugation in blood typing will lead to false True
positive result.
True
False
FFP expires one year from the date of collection when False
stored at <-18 degrees.
True
False
Most common demonstration of Ag-ab reaction in Blood Agglutination
bank.
a) Precipitation
b) Flocculation
c) Agglutination
d) Neutralization
It is mandatory to screen blood units for TTIs prior to True
issuance.
True
False
Best component to use if patient has history of febrile Leukocyte-reduced Red cells
reaction during blood transfusion.
a) Washed rbc
b) None of the above
c) Leukocyte-reduced Red cells
d) Packed RBC
Whole blood, when spun light, results to? Platelets Rich Plasma
a) Platelet Poor Plasma
b) PRBC
c) Leukoreduced PRBC
d) Platelets Rich Plasma
Matching Type:

For treatment of anemia with no volume loss PRBC

Component used for the rare patient with IgA deficiency WASHED RBC
Given to anemia patient with history of febrile non LEUKOREDUCED PRBC
hemolytic transfusion rxn
Used for actively bleeding pxs who lost >30% blood WHOLE BLOOD
volume
Component of choice for pxs with DIC FFP
Component choice given for a patient with Hemophilia A CRYOPRECIPITATE
Component has a storage time of 120 hours PLATELET CONCENTRATE
basis of major crossmatch and weak D testing IAT