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6. What are the current storage time and storage

IMMUNOHEMATOLOGY
temperature for platelet concentrates and apheresis
CHAPTER 1: Red Blood Cell and Platelet
platelet components?
Preservation: Historical Perspectives and a. 5 days at 1°C to 6°C
Current Trends b. 5 days at 24°C to 27°C
1. What is the maximum volume of blood that can be c. 5 days at 20°C to 24°C
collected from a 110-lb donor, including samples for d. 7 days at 22°C to 24°C
processing? 7. RBCs can be frozen for:
a. 450 mL b. 500 mL a. 12 months. b. 1 year.
c. 525 mL d. 550 mL c. 5 years. d. 10 years.
2. How often can a blood donor donate whole blood? 8. Whole blood and RBC units are stored at what
a. Every 24 hours b. Once a month temperature?
c. Every 8 weeks d. Twice a year a. 1°C to 6°C b. 20°C to 24°C
3. When RBCs are stored, there is a “shift to the left.” c. 37°C d. 24°C to 27°C
This means: 9. Additive solutions are approved for storage of red
a. Hemoglobin-oxygen affinity increases, owing to an blood cells for how many days?
increase in 2,3-DPG. a. 21 b. 42
b. Hemoglobin-oxygen affinity increases, owing to a c. 35 d. 7
decrease in 2,3-DPG. 10. One criterion used by the FDA for approval of new
c. Hemoglobin-oxygen affinity decreases, owing to a preservation solutions and storage containers is an
decrease in 2,3-DPG. average 24-hour post-transfusion RBC survival of
d. Hemoglobin-oxygen affinity decreases, owing to an more than:
increase in 2,3-DPG. a. 50%. b. 60%.
4. The majority of platelets transfused in the United c. 65%. d. 75%.
States today are: 11. What is the lowest allowable pH for a platelet
a. Whole blood–derived platelets prepared by the platelet- component at outdate?
rich plasma method. a. 6 b. 5.9
b. Whole blood–derived platelets prepared by the buffy c. 6.8 d. 6.2
coat method. 12. Which of the following occurs during storage of
c. Apheresis platelets. red blood cells?
d. Prestorage-pooled platelets. a. pH decreases b. 2,3-DPG increases
5. Which of the following anticoagulant preservatives c. ATP increases d. plasma K+ decreases
provides a storage time of 35 days at 1°C to 6°C for 13. Which of the following is approved for bacterial
units of whole blood and prepared RBCs if an additive detection specific to extending the expiration of
solution is not added? apheresed platelets to 7 days?
a. ACD-A b. CP2D a. BacT/ALERT
c. CPD d. CPDA-1 b. eBDS
c. Gram stain
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d. Pan Genera Detection (PGD) test
14. Which of the following is the most common cause
of bacterial contamination of platelet products?
a. Entry of skin plugs into the collection bag
b. Environmental contamination during processing
c. T in the donor
d. Incorrect storage temperature
15. The INTERCEPT pathogen reduction system uses
which of the following methods?
a. Riboflavin and UV light
b. Amotosalen and UV light
c. Solvent/detergent treatment
d. Irradiation
CHAPTER 2: Basic Genetics
1. Which statement best describes the process of
mitosis?
a. Cell division by which only one-half of the daughter
cells produced are identical to the parent cell
b. Cell division of germ cells by which two successive
divisions of the nucleus produce cells that contain half the
number of chromosomes of somatic cells
c. Cell division that produces four daughter cells having
the same number of chromosomes as the parent
d. Cell division that produces two daughter cells with
the same number of chromosomes as the parent cell
2. When a recessive trait is expressed:
a. One gene carrying the trait was present.
b. Two genes carrying the trait were present.
c. No gene carrying the trait was present.
d. The gene is hemizygous.
3. In a pedigree analysis, which statement about the
symbols used is true?
a. Deceased family members have a line crossed
through the symbol.
b. A consanguineous mating is indicated by a single line
between a male and female.
c. The propositus is always found in the last generation on
the pedigree.
d. A stillbirth is indicated by a triangle.
4. Which of the following nitrogenous bases make up
DNA?
a. Adenine, leucine, guanine, thymine
b. Alanine, cytosine, guanine, thymine
c. Adenine, lysine, uracil, guanine
d. Adenine, cytosine, guanine, thymine
5. Mutations can occur following DNA replication that
escapes the proofreading and repair systems. Which
statement about DNA mutations is true?
a. All mutations result in a phenotypic change.
b. A frameshift mutation at the beginning of the
coding sequence is most likely to result in a phenotypic
change.
c. A transversion always encodes for a stop codon.
d. A missense point mutation never encodes for a stop
codon.
6. Which phenotype would be expected from the
mating of a Jk(a+b–) female and a Jk(a–b+) male?
a. Jk(a+b–) b. Jk(a+b+)
c. Jk(a–b+) d. All of the above
7. Which statement describes an intron?
a. The part of a gene that contains nonsense mutations
b. The coding region of a gene
c. The noncoding region of a gene
d. The resting stage between cell divisions
8. Which statement about isolation of nucleic acids is
true?
a. All isolation methods involve the use of organic
solvents.
b. High protein concentration increases the DNA yield.
c. mRNA can be effectively isolated with the use of poly-
A–coated beads.
d. Silica particles bind DNA under high salt con -
centrations.
9. The purpose of transcription is to:
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a. Produce a protein. d. The codon UAA would terminate translation.

b. Read the mRNA by the ribosome. 15. The purpose of meiosis is to:
c. Synthesize RNA using DNA as a template. a. Generate two identical daughter cells after division.
d. Replicate DNA. b. Generate four identical daughter cells after division
10. When a male possesses a phenotypic trait that he with the same number of chromosomes as the parent cells.
passes to all his daughters and none of his sons, the c. Generate gametes with a diploid number of
trait is said to be: chromosomes.
a. X-linked dominant. d. Generate daughter cells that contain half the
b. X-linked recessive. number of chromosomes of somatic cells that contain
c. Autosomal dominant. new DNA sequences.
d. Autosomal recessive. 16. The pattern of inheritance most commonly
11. When a female possesses a phenotypic trait that expressed by blood group genes is:
she passes to all of her sons and none of her daughters, a. X-linked recessive.
the trait is said to be: b. Autosomal recessive.
a. X-linked dominant. c. Autosomal codominant.
b. X-linked recessive. d. X-linked codominant.
c. Autosomal dominant.
d. Autosomal recessive.
12. Which statement correctly describes DNA
replication in eukaryotes? CHAPTER 3: Fundamentals of Immunology
a. Semiconservative replication from RNA; requires 1. Which of the following is not involved in the
DNA polymerase acquired (adaptive) immune response?
b. Bidirectional replication; requires RNA primer a. Phagocytosis
c. Conservative replication from DNA; requires RNA b. Production of antibody or complement
polymerase c. Induction of immunologic memory
d. Occurs at the replication fork; both strands replicated in d. Accelerated immune response upon subsequent
the same direction exposure to antigen
13. How is tRNA different from other types of RNA? 2. Which cells are involved in the production of
a. It has a 3′ poly-T tail. antibodies?
b. The immature form contains introns. a. Dendritic cells b. T lymphocytes
c. It has a 3′ methylated cap. c. B lymphocytes d. Macrophages
d. It recognizes amino acids and nucleic acids. 3. Which of the following cells is involved in antigen
14. Which statement about translation of proteins is recognition following phagocytosis?
false? a. B lymphocytes b. T lymphocytes
a. It occurs on the ribosomes in the cytoplasm of the cell. c. Macrophages d. Granulocytes
b. Post-translation processing can include glycosylation. 4. The role of the macrophage during an antibody
c. mRNA delivers the amino acids to the growing response is to:
peptide chain during elongation. a. Make antibody.
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b. Lyse virus-infected target cells. 13. Which of the following immunoglobulin classes is
c. Activate cytotoxic T cells. capable of crossing the placenta and causing
d. Process antigen and present it. haemolytic disease of the newborn?
5. Which of the following immunoglobulins is a. IgA b. IgE
produced in the primary immune response? c. IgG d. IgM
a. IgA b. IgE 14. Which of the following refers to the effect of an
c. IgG d. IgM excess amount of antigen present in a test system?
6. Which of the following immunoglobulins is a. Postzone b. Prozone
produced in the secondary immune response? c. Zone of equivalence d. Endzone
a. IgA b. IgE 15. Which of the following refers to the presence of an
c. IgG d. IgM excess amount of antibody present in a test system?
7. Which of the following MHC classes encodes a. Postzone b. Prozone
complement components? c. Zone of equivalence d. Endzone
a. Class I b. Class II 16. Which one of the following properties of antibodies
c. Class III d. Class IV is NOT dependent on the structure of the heavy chain
8. Which of the following immunoglobulins is most constant region?
efficient at binding complement? a. Ability to cross the placenta
a. IgA b. IgE b. Isotype (class)
c. IgG d. IgM c. Ability to fix complement
9. Which portion of the immunoglobulin molecules d. Affinity for antigen
contains complement binding sites? 17. Molecules that promote the update of bacteria for
a. Heavy chain variable region phagocytosis are:
b. Light chain variable region a. Opsonins. b. Cytokines.
c. Heavy chain constant region c. Haptens. d. Isotypes.
d. Light chain constant region 18. Select the term that describes the unique
10. Which complement pathway is activated by the confirmation of the antigen that allows recognition by
formation of antigen-antibody complexes? a corresponding antibody.
a. Classical b. Alternative a. Immunogen b. Epitope
c. Lectin d. Retro c. Avidity d. Clone
11. Which of the following is known as the 19. Which of the following terms refers to the net
“recognition unit” in the classical complement negative charge surrounding red blood cells?
pathway? a. Dielectric constant
a. C1q b. C3a b. Van der Waals forces
c. C4 d. C5 c. Hydrogen bonding
12. Which of the following is known as the “membrane d. Zeta potential
attack complex” in the classical complement pathway?
a. C1 b. C3 CHAPTER 4: Concepts in Molecular Biology
c. C4, C2, C3 d. C5b, C6, C7, C8, C9 1. The central dogma of molecular biology states that:
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a. DNA is the genetic material.
b. RNA is the genetic material.
c. DNA is translated to mRNA.
d. Proteins are transcribed from mRNA.
2. Recombinant-DNA technology is possible because:
a. Restriction endonucleases cut RNA.
b. Restriction endonucleases cut proteins.
c. The genetic code is universal.
d. Bacteria are difficult to culture.
3. Agarose gel electrophoresis is a technique used for:
a. DNA synthesis.
b. RNA synthesis.
c. Separation of DNA molecules by size.
d. Oligonucleotide synthesis.
4. Restriction fragment length polymorphism (RFLP)
is based on the use of the enzymes:
a. Reverse transcriptases.
b. Bacterial endonucleases.
c. DNA polymerases.
d. RNA polymerases.
5. The polymerase chain reaction (PCR):
a. Is carried out in vivo.
b. Is used for peptide synthesis.
c. Requires RNA polymerase.
d. Is used for the amplification of DNA.
6. Plasmids are:
a. Vectors used for molecular cloning.
b. Antibiotics.
c. Enzymes.
d. Part of chromosomes.
7. Some model organisms:
a. Simplify the study of human disease.
b. Are used to produce recombinant proteins.
c. Are prokaryotes and some are eukaryotes.
d. All of the above
8. DNA sequencing:
a. Is more difficult than peptide sequencing.
b. Requires the use of RNA polymerase.
c. Can never be automated.
d. Is an enzymatic in vitro reaction.
9. RFLP and SSP are techniques used for:
a. Protein isolation. b. RNA isolation.
c. DNA typing. d. Protein typing.
10. Recombinant DNA techniques:
a. Are not used in a clinical setting.
b. Are useful research tools.
c. Are not used in blood banking.
d. Are useful only for research.
11. Transcription-mediated amplification:
a. Requires thermostable DNA polymerase.
b. Is an isothermal procedure.
c. Is an obsolete method currently replaced by SSOP.
d. Utilizes probes labeled with fluorescent tags.
12. Preseroconversion window:
a. Is the time when donors can be infected but do not yet
test positive by serologic methods.
b. May be narrowed by using molecular methods.
c. Refers mainly to viral pathogens.
d. All of the above
13. Red blood cell molecular antigen typing is useful in
all listed situations except:
a. In screening RBC inventory for antigen-negative units.
b. When reagent antibodies are weak or unavailable.
c. In quantitative gene expression analysis.
d. When resolving ABO discrepancies.
CHAPTER 5: The Antiglobulin Test
1. A description of the antiglobulin test is:
a. IgG and C3d are required for RBC sensitization.
b. Human globulin is completely eluted from RBCs
during saline washings.
c. Human globulin is injected into an animal.
d. AHG reacts with human globulin molecules bound
to RBCs.
2. Polyspecific AHG reagent contains:
a. Anti-IgG and anti-IgA.
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b. Anti-IgG and anti-IgM. a. Use of refrigerated, clotted blood samples in which

c. Anti-IgG and anti-C3d. complement components coat RBCs in vitro.
d. Anti-IgA and Anti-C3d. b. A recipient of a recent transfusion manifesting an
3. Monoclonal anti-C3d is: immune response to recently transfused RBCs.
a. Derived from one clone of plasma cells. c. Presence of antispecies antibodies from administration
b. Derived from multiple clones of plasma cells. of immune globulin (IVIG).
c. Derived from immunization of rabbits. d. A positive autocontrol caused by polyagglutination.
d. Reactive with C3b and C3d. 9. Polyethylene glycol (PEG) enhances
4. Which of the following is a clinically significant antigenantibody reactions by:
antibody whose detection has been reported in some a. Decreasing zeta potential.
instances to be dependent on anticomplement activity b. Concentrating antibody by removing water.
in polyspecific AHG? c. Increasing antibody affinity for antigen.
a. Anti-Jka b. Anti-Lea d. Increasing antibody specificity for antigen.
c. Anti-P1 d. Anti-H 10. Solid-phase antibody screening is based on:
5. After the addition of IgG-coated RBCs (check cells) a. Adherence. b. Agglutination.
to a negative AHG reaction during an antibody screen, c. Hemolysis. d. Precipitation.
a negative result is observed. Which of the following is 11. A positive DAT may be found in which of the
a correct interpretation based on these findings? following situations?
a. The antibody screen is negative. a. A weak D-positive patient
b. The antibody screen cannot be interpreted. b. A patient with anti-M
c. The saline washings were adequate. c. HDFN
d. AHG reagent was added. d. An incompatible crossmatch
6. RBCs must be washed in saline at least three times 12. What do Coombs’ check cells consist of?
before the addition of AHG reagent to: a. Type A-positive cells coated with anti-IgG
a. Wash away any hemolyzed cells. b. Type A-negative cells coated with anti-IgG
b. Remove traces of free serum globulins. c. Type O-positive cells coated with anti-D
c. Neutralize any excess AHG reagent. d. Type B-negative cells coated with anti-D
d. Increase the antibody binding to antigen. 13. Which of the following IAT methods requires the
7. An in vivo phenomenon associated with a positive use of check cells?
DAT is: a. Manual tube method with albumin
a. Passive anti-D detected in the maternal sample. b. Gel
b. Positive antibody screen tested by LISS. c. Automated solid-phase analyzer
c. Identification of alloantibody specificity using a panel d. Enzyme-linked
of reagent RBCs. 14. Which uncontrollable factor can affect AHG
d. Maternal antibody coating fetal RBCs. testing?
8. False-positive DAT results are most often associated a. Temperature
with: b. Antibody affinity
c. Gravitational force in the centrifuge
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d. Incubation time d. Uridine diphosphate-N-acetyl-D-galactose.

15. Which would be the most efficient method for a 5. What ABH substance(s) would be found in the
laboratory staffed by medical laboratory technicians? saliva of a group B secretor?
a. LISS b. Polybrene a. H b. H and A
c. Solid-phase or gel d. Enzyme-linked c. H and B d. H, A, and B
16. A 27-year-old group O mother has just given birth 6. An ABO type on a patient gives the following
to a group A baby. Since the mother has IgG anti-A, reactions:
anti-B and anti-A, B in her plasma, which of the Patient Cells With Patient Serum With
following methods and tests would be most effective at Anti-A Anti-B Anti-A1 A1 cells B cells
detecting the anti-A on the baby’s RBCs? 4+ 4+ Neg 2+ Neg
a. DAT using common tube technique The reactions above may be seen in a patient who is:
b. DAT using gel a. A1 with acquired B.
c. IAT using common tube technique b. A2B with anti-A1.
d. IAT using gel c. AB with increased concentrations of protein in the
serum.
CHAPTER 6: The ABO Blood Group System d. AB with an autoantibody
1. An ABO type on a patient gives the following 7. Which of the following ABO blood groups contains
reactions: the least amount of H substance?
Patient Cells With Patient Serum With a. A1B b. A2
Anti-A Anti-B A1 cells B cells c. B d. O
4+ 4+ Neg Neg 8. You are working on a specimen in the laboratory
What is the patient’s blood type? that you believe to be a Bombay phenotype. Which of
a. O b. A the following reactions would you expect to see?
c. B d. AB a. Patient’s cells + Ulex europaeus = no agglutination
2. The major immunoglobulin class(es) of anti-B in a b. Patient’s cells + Ulex europaeus = agglutination
group A individual is (are): c. Patient’s serum + group O donor RBCs = no
a. IgM. b. IgG. agglutination
c. IgM and IgG. d. IgM and IgA. d. Patient’s serum + A1 and B cells = no agglutination
3. What are the possible ABO phenotypes of the 9. An example of a technical error that can result in an
offspring from the mating of a group A to a group B ABO discrepancy is:
individual? a. Acquired B phenomenon.
a. O, A, B b. A, B b. Missing isoagglutinins.
c. A, B, AB d. O, A, B, AB c. Cell suspension that is too heavy.
4. The immunodominant sugar responsible for blood d. Acriflavine antibodies.
group A specificity is: 10. An ABO type on a patient gives the following
a. L-fucose. reactions:
b. N-acetyl-D-galactosamine. Patient Cells With Patient Serum With
c. D-galactose. Anti-A Anti-B A1 cells B cells O cells Autocontrol
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4+ Neg 2+ 4+ 2+ Neg 8. Rh antibodies are primarily of which

These results are most likely due to: immunoglobulin class?
a. ABO alloantibody. a. IgA b. IgD
b. Non-ABO alloantibody. c. IgG d. IgM
c. Rouleaux. 9. Rh antibodies have been associated with which
d. Cold autoantibody clinical condition?
a. Hemolytic disease of the fetus and newborn
CHAPTER 7: The Rh Blood Group System b. Thrombocytopenia
1. The Rh system genes are: c. Hemophilia A
a. RHD and RHCE. b. RHD and LW. d. Stomatocytosis
c. RHD and RHAG. d. RHCE and RHAG. 10. What do Rhnull cells lack?
2. What Rh antigen is found in 85% of the Caucasian a. Lewis antigens
population and is always significant for transfusion b. Normal oxygen-carrying capacity
purposes? c. Rh antigens
a. d b. c d. Hemoglobin
c. D d. E 11. Convert the following genotypes from Wiener
3. How are weaker-than-expected reactions with anti- nomenclature to Fisher-Race and Rosenfield
D typing reagents categorized? nomenclatures, and list the antigens present in each
a. Rhmod b. Weak D haplotype.
c. DAT positive d. Dw a. R1r b. R2R0
4. Cells carrying a weak D antigen require the use of what c. RzR1 d. rr
test to demonstrate its presence? 12. Which Rh phenotype has the strongest expression
a. Indirect antiglobulin test of D?
b. Direct antiglobulin test a. DCe/ce b. DCe/DCe
c. Microplate test c. DcE/DcE d. D–
d. Warm autoadsorption test 13. An individual has the following serologic reactions:
5. How are Rh antigens inherited? D+C+E+c+e+f–. What is the most probable genotype?
a. Autosomal recessive alleles a. R1R2 b. Rory
b. Sex-linked genes c. Rzr d. R1r
c. Codominant alleles 14. Which of the following is the most common
d. X-linked haplotype in the African American population?
6. Biochemically speaking, what type of molecules are a. DCe b. DcE
Rh antigens? c. Dce d. ce
a. Glycophorins b. Simple sugars 15. If a patient who is R1R1 is transfused with RBCs
c. Proteins d. Lipids that are Ror, which antibody is he most likely to
7. Rh antibodies react best at what temperature (°C)? produce?
a. 15 b. 18 a. Anti-D b. Anti-c
c. 22 d. 37 c. Anti-e d. Anti-G
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7. A type 1 chain has:

CHAPTER 8: Blood Group Terminology and a. The terminal galactose in a 1-3 linkage to
Common Blood Groups subterminal N-acetylglucosamine
1. The following phenotypes are written incorrectly b. The terminal galactose in a 1-4 linkage to subterminal
except for: N-acetylglucosamine
a. Jka+ b. Jka+ c. The terminal galactose in a 1-3 linkage to subterminal
c. Jka(+) d. Jk(a+) N-acetylgalactosamine
2. Which of the following characteristics best describes d. The terminal galactose in a 1-4 linkage to subterminal
Lewis antibodies? N-acetylgalactosamine
a. IgM, naturally occurring, cause HDFN 8. Which of the following best describes Lewis
b. IgM, naturally occurring, do not cause HDFN antigens?
c. IgG, in vitro hemolysis, cause hemolytic transfusion a. The antigens are integral membrane glycolipids
reactions b. Lea and Leb are antithetical antigens
d. IgG, in vitro hemolysis, do not cause hemolytic c. The Le(a+b–) phenotype is found in secretors
transfusion reactions d. None of the above
3. The Le gene codes for a specific glycosyltransferase 9. Which of the following genotypes would explain
that transfers a fucose to the N-acetylglucosamine on: RBCs typed as group A Le(a+b–)?
a. Type 1 precursor chain a. A/O Lele HH Sese b. A/A Lele HH sese
b. Type 2 precursor chain c. A/O LeLe hh SeSe d. A/A LeLe hh sese
c. Types 1 and 2 precursor chains 10. Anti-LebH will not react or will react more weakly
d. Either type 1 or type 2 in any one individual but not with which of the following RBCs?
both a. Group O Le(b+) b. Group A2 Le(b+)
4. What substances would be found in the saliva of a c. Group A1 Le(b+) d. None of the above
group B secretor who also has Lele genes? 11. Which of the following best describes MN antigens
a. H, Lea b. H, B, Lea and antibodies?
c. H, B, Lea, Leb d. H, B, Leb a. Well developed at birth, susceptible to enzymes,
5. Transformation to Leb phenotype after birth may generally saline reactive
be as follows: b. Not well developed at birth, susceptible to enzymes,
a. Le(a–b–) to Le(a+b–) to Le(a+b+) to Le(a–b+) generally saline reactive
b. Le(a+b–) to Le(a–b–) to Le(a–b+) to Le(a+b+) c. Well developed at birth, not susceptible to enzymes,
c. Le(a–b+) to Le(a+b–) to Le(a+b+) to Le(a–b–) generally saline reactive
d. Le(a+b+) to Le(a+b–) to Le(a–b–) to Le(a–b+) d. Well developed at birth, susceptible to enzymes,
6. In what way do the Lewis antigens change during generally antiglobulin reactive
pregnancy? 12. Which autoantibody specificity is found in patients
a. Lea antigen increases only with paroxysmal cold hemoglobinuria?
b. Leb antigen increases only a. Anti-I b. Anti-i
c. Lea and Leb both increase c. Anti-P d. Anti-P1
d. Lea and Leb both decrease
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13. Which of the following is the most common a. M+N+S+s– b. M+N–S–s–

antibody seen in the blood bank after ABO and Rh c. M–N+S–s+ d. M+N–S+s+
antibodies? 22. A patient with an M. pneumoniae infection will
a. Anti-Fya b. Anti-k most likely develop a cold autoantibody with
c. Anti-Jsa d. Anti-K specificity to which antigen?
14. Which blood group system is associated with a. I b. i
resistance to P. vivax malaria? c. P d. P1
a. P b. Kell 23. Which antigen is destroyed by enzymes?
c. Duffy d. Kidd a. P1 b. Jsa
15. The null Ko RBC can be artificially prepared by c. Fya d. Jka
which of the following treatments?
a. Ficin and DTT CHAPTER 9: Uncommon Blood Groups
b. Ficin and glycine-acid EDTA 1. The antibody to this high-prevalence antigen
c. DTT and glycine-acid EDTA demonstrates mixed-field agglutination that appears
d. Glycine-acid EDTA and sialidase shiny and refractile under the microscope.
16. Which antibody does not fit with the others with a. Vel b. JMH
respect to optimum phase of reactivity? c. Jra d. Sda
a. Anti-S b. Anti-P1 2. What red blood cell treatment can be used to
c. Anti-Fya d. Anti-Jkb differentiate between anti-D and anti-LW?
17. Which of the following Duffy phenotypes is a. Ficin b. Trypsin
prevalent in blacks but virtually nonexistent in c. DTT d. Papain
whites? 3. Which of the following has been associated with
a. Fy(a+b+) b. Fy(a–b+) causing severe immediate HTRs?
c. Fy(a–b–) d. Fy(a+b–) a. Anti-JMH b. Anti-Lub
18. Antibody detection cells will not routinely detect c. Anti-Vel d. Anti-Sda
which antibody specificity? 4. Which of the following antibodies would more likely
a. Anti-M b. Anti-Kpa be found in a black patient?
c. Anti-Fya d. Anti-Lub a. Anti-Cra b. Anti-Ata
19. Antibodies to antigens in which of the following c. Anti-Hy d. All of the above
blood groups are known for showing dosage? 5. Which of the following antigens is not in a blood
a. I b. P group system?
c. Kidd d. Lutheran a. Doa b. LKE
20. Which antibody is most commonly associated with c. JMH d. Kx
delayed hemolytic transfusion reactions? 6. A weakly reactive antibody with a titer of 128 is
a. Anti-s b. Anti-k neutralized by plasma. Which of the following could
c. Anti-Lua d. Anti-Jka be the specificity?
21. Anti-U will not react with which of the following a. Anti-JMH b. Anti-Ch
RBCs? c. Anti-Kna d. Anti-Kpa
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7. An antibody reacted with untreated RBCs and c. Diego d. Vel

DTTtreated RBCs but not with ficin-treated RBCs. 15. Which antigen was returned to the 901 series
Which of the following antibodies could explain this because there was no determined linkage to the
pattern of reactivity? SMIM1 gene?
a. Anti-JMH b. Anti-Yta a. JMH b. Ata
c. Anti-Cra d. Anti-Ch c. ABTI d. MAM
8. The following antibodies are generally considered 16. The FORS blood group system was first thought to
clinically insignificant because they have not been be part of what system due to the addition of N-
associated with causing increased destruction of acetylgalactosamine (GalNAc) to the P antigen?
RBCs, HDFN, or HTRs. a. ABO b. Lewis
a. Anti-Doa and anti-Coa c. P1PK d. Globoside
b. Anti-Ge3 and anti-Wra 17. What glycophorin expresses the MN CHO
c. Anti-Ch and anti-Kna collection antigens that are associated with altered
d. Anti-Dib and anti-Yt levels of sialic acid (NeuNAc) or GlcNAc?
9. Which antigen is the receptor for Haemophilus a. GPA b. GPB
influenza? c. GPC d. GPD
a. AnWj b. PEL 18. What techniques can be used to remove the
c. FORS d. Kna reactivity of Bg antigens?
10. Which antigen is not absent or is weakened on a. EDTA/glycine-HCL
RBCs of individuals with PNH? b. Platelet adsorption
a. Yta b. Cra c. Chloroquine treatment
c. CD59 d. Coa d. All of the above
11. Which of the following blood groups is carried on a 19. ABTI was thought to be classified with which
structure that helps to maintain the RBC membrane antigen prior to it gaining system status?
integrity through interaction with protein band 4.1? a. Jra b. FORS1
a. Di b. Kn c. Vel d. Lan
c. Ge d. Vel 20. The Jr(a–) phenotype is found more commonly in:
12. What is the name of the Knops system serologic a. Japanese.
null phenotype? b. African Americans.
a. Gregory b. Leach c. South American Indians.
c. Helgeson d. McLeod d. Caucasians.
13. Which antigen when absent produces a null in the
Dombrock system? CHAPTER 10: Detection and Identification of
a. Hy b. Joa Antibodies
c. Dob d. Gya 1. Based on the following phenotypes, which pair of
14. Which antigens are strongly expressed on placental cells would make the best screening cells?
tissue, allowing for the adsorption of antibodies?
a. Cromer b. Knops
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a. Cell 1: Group A, D+C+c–E–e+, K+, Fy(a+b–), c. Urine d. Human breast milk

Jk(a+b–), M+N–S+s– Cell 2: Group O, D+C–c+E+e–, 6. Patient JM appears to have a warm autoantibody.
K–, Fy(a–b+), Jk(a–b+), M–N+S–s+ She was transfused 2 weeks ago. What would be the
b. Cell 1: Group O, D–C–c+E–e+, K–, Fy(a–b+), next step performed to identify any alloantibodies that
Jk(a+b+), M+N–S+s+ Cell 2: Group O, D+C+c–E–e+, might be in her serum?
K–, Fy(a+b–), Jk(a+b–), M–N+S–s+ a. Acid elution
c. Cell 1: Group O, D+C+c+E+e+, K+, Fy(a+b+), b. Warm autoadsorption using autologous cells
Jk(a+b+), M+N–S+s+ Cell 2: Group O, D–C–c+E–e+, c. Warm differential adsorption
K–, Fy(a+b–), Jk(a+b+), M+N+S–s+ d. RESt adsorption
d. Cell 1: Group O, D+C+c–E–e+, K+, Fy(a–b+), Jk(a– 7. What is the titer and score for this prenatal anti-D
b+), M–N+S–s+ Cell 2: Group O, D- C–c+E+e–, K–, titer? (Refer to Fig. 10–17.)
Fy(a+b–), Jk(a+b–), M+N–S+s– a. Titer = 64; score = 52
2. Antibodies are excluded using RBCs that are b. Titer = 1:32; score = 15
homozygous for the corresponding antigen because: c. Titer = 64; score = 21
a. Antibodies may show dosage d. Titer = 32; score = 52
b. Multiple antibodies may be present 8. Select the antibody(ies) most likely responsible for
c. It results in a P value of 0.05 for proper identification of the reactions observed.
the antibody a. Anti-E and anti-K b. Anti-Fya
d. All of the above c. Anti-e d. Anti-Jkb
3. A request for 8 units of RBCs was received for 9. What additional cells need to be tested to be 95%
patient LF. The patient has a negative antibody confident that the identification is correct?
screen, but 1 of the 8 units was 3+ incompatible at the a. Three e-negative cells that react negatively and one
AHG phase. Which of the following antibodies may be additional e-positive cell that reacts positively
the cause? b. One additional E-positive, K-negative cell to react
a. Anti-K b. Anti-Lea positively and one additional K-positive, E-negative cell
c. Anti-Kpa d. Anti-Fyb to react positively
4. The physician has requested 2 units of RBCs for c. Two Jkb homozygous positive cells to react positively
patient DB, who has two antibodies, anti-L and anti-Q. and one Jkb heterozygous positive cell to react negatively
The frequency of antigen L is 45%, and the frequency d. No additional cells are needed
of antigen Q is 70% in the donor population. 10. Using the panel (Fig. 10–18), select cells that would
Approximately how many units will need to be make appropriate controls when typing for the C
antigen-typed for L and Q to fill the request? antigen.
a. 8 b. 12 a. Cell number 1 for the positive control and cell number
c. 2 d. 7 2 for the negative control
5. Anti-Sda has been identified in patient ALF. What b. Cell number 1 for the positive control and cell number
substance would neutralize this antibody and allow 6 for the negative control
detection of other alloantibodies? c. Cell number 2 for the positive control and cell number
a. Saliva b. Hydatid cyst fluid 4 for the negative control
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d. Cell number 4 for the positive control and cell number 3. How many days must a pretransfusion specimen
5 for the negative control and donor unit segments be retained post-transfusion?
11. Which of the following methods may be employed a. 3 days b. 7 days
to remove IgG antibodies that are coating a patient’s c. 14 days d. 1 month
red blood cells? 4. If a blood type cannot be resolved, what ABO group
a. Adsorption b. Elution should be selected for a red blood cell transfusion?
c. Neutralization d. Titration a. Group A b. Group B
12. A technologist has decided to test an enzyme- c. Group O d. Group AB
treated panel of RBCs against a patient’s serum. 5. Which antibody specificity is not required in antibody
Which of the following antibody pairs could be detection tests?
separated using this technique? a. K b. Cw
a. Anti-Jka and anti-Jkb c. Fya d. S
b. Anti-S and anti-Fya 6. A patient has a history of anti-Jka. The antibody
c. Anti-D and anti-C screen is currently negative. Which red blood cell unit
d. Anti-Jka and anti-Fya should be selected, and what type of crossmatch
13. An antibody demonstrates weak reactivity at the should be performed?
AHG phase when the tube method is used with no a. Jk(a-) red blood cells, computer crossmatch
enhancement reagent and monospecific anti-IgG AHG b. Jk(a-) red blood cells, antiglobulin crossmatch
reagent. When repeating the test, which of the c. Jk(a-) red blood cells, immediate spin crossmatch
following actions may increase the strength of the d. ABO-compatible because the antibody screen is
positive reactions? negative
a. Adding an enhancement reagent, such as LISS or PEG 7. Which is not true of rouleaux formation?
b. Decreasing the incubation time from 30 minutes to 10 a. Mimics agglutination
minutes b. Appears like a “stacking of coins”
c. Employing the prewarm technique c. Can be seen in the antiglobulin test
d. Decreasing the incubation temperature to 18°C d. Can be dispersed by saline
8. A patient’s blood type is AB-negative, but there are
CHAPTER 11: Pretransfusion Testing no AB-negative red blood cell units available. What
1. Which is not included on a properly labeled donor units could be selected?
specimen? a. A-negative b. O-positive
a. Two unique patient identifiers c. B-positive d. All of the above
b. Date and time of draw 9. A patient requires 15 units of thawed plasma for an
c. Phlebotomist’s initials apheresis procedure. The patient’s blood type is O-
d. Patient’s home address negative. What donor units could be selected?
2. How many days before a pretransfusion specimen a. O-negative b. AB-positive
expires? c. A-negative d. All of the above
a. 3 days b. 7 days
c. 14 days d. 1 month
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10. The American College of Surgeons recommends CHAPTER 12: Blood Bank Testing Technologies and
transfusion of red blood cells, thawed plasma, and Automation
platelets in what ratio for a massive transfusion? 1. The endpoint of the CAT test is detected by:
a. 2 units of red blood cells for every unit of platelets a. Agglutination.
b. 1 unit of red blood cells to 1 unit of thawed plasma b. Hemolysis.
to 1 unit of platelets c. Precipitation.
c. 1 unit of red blood cells to 3 units of thawed plasma d. Attachment of indicator cells.
d. It’s an emergency. Give the surgeon whatever she 2. The endpoint of the SPRCA test is detected by:
wants a. Agglutination.
11. A patient’s antibody screen was positive and an b. Hemolysis.
anti-c was identified. Antiglobulin crossmatches were c. Precipitation.
performed with c-negative units and 1 of the 6 units d. Attachment of indicator cells.
was incompatible. What should be performed to 3. The endpoint of the solid-phase protein A assay is:
resolve the incompatible crossmatch? a. Agglutination.
a. Give O-negative red blood cells b. Hemolysis.
b. Retype the incompatible unit for the c antigen c. Precipitation.
c. Perform a DAT on the incompatible unit d. Attachment of cells to microwell.
d. Perform additional identification testing to include low- 4. Protein A captures antibodies by binding to the:
specificity antigens a. Fab portion of immunoglobulin.
e. b, c, and d b. Fc portion of immunoglobulin.
12. A mother, 30 weeks’ pregnant, has anti-K with a c. Surface of test cells.
titer of 32. An intrauterine red blood cell transfusion is d. Surface of indicator cells.
indicated. The donor unit selected should be all of the 5. Mixed-field reactions can be observed in:
following except: a. Gel.
a. O-negative b. SPRCA.
b. K-negative c. Protein A technology.
c. Positive for sickling hemoglobin d. None of the automated technologies.
d. Irradiated 6. An advantage for both CAT and solid-phase
13. A patient with sickle cell disease is B-positive with technology is:
a positive antibody screen. The antibody identified is a. No cell washing steps.
anti-D, and the autocontrol is negative. What is a b. Standardization.
possible explanation? c. Use of IgG-coated control cells.
a. The patient is weak D-positive d. Specialized equipment.
b. Autoantibody is present 7. A disadvantage for both CAT and solid-phase
c. Patient possesses the partial D phenotype technology is:
d. The patient has a positive DAT a. Decreased sensitivity.
b. Inability to test hemolyzed, lipemic, or icteric samples.
c. Inability to detect C3d complement–coated cells.
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d. Large sample requirement. 6. Which of the following tests is not required as part
8. A safety feature in the SPRCA test is: of the donor-processing procedure for allogeneic
a. Air bubble barrier. donation?
b. Viscous barrier. a. ABO b. Rh
c. Color change of the LISS. c. STS d. Anti-HTLV-I
d. Use of IgG-coated control cells. e. Anti-CMV
7. How long must a 2-unit RBC donor wait before
CHAPTER 13: Donor Selection donating red blood cells again?
1. Which of the following information is not required a. 8 weeks b. 16 weeks
for whole blood donation? c. 6 months d. 12 months
a. Name b. Address 8. What is the deferral period for Plavix?
c. Transfusion history d. Sex a. 14 days after last dose
e. Date of Birth b. 1 month after last dose
2. Which of the following would be cause for deferral c. 12 months after last dose
for a male donor? d. 48 hours after last dose
a. Temperature of 99.2°F 9. All of the following records must be kept for 10
b. Hematocrit of 37% years, except:
c. Spent 2 weeks in the United Kingdom in 1998 a. Unique ID of each unit.
d. Weighs 80 kg b. Donor consent.
e. Received a blood transfusion 2 years ago c. Request for blood or blood component.
3. Which of the following would be cause for a d. A signed statement from requesting physician for
permanent deferral? emergency release.
a. Received a dura mater graft 9 months ago 10. What is the causative agent of Chagas disease?
b. Received hepatitis B immune globulin a. Trypanosoma cruzi
c. Is currently on warfarin b. Yersinia pestis
d. Diagnosis of babesiosis c. Treponema pallidum
e. Traveled to Senegal 2 years ago d. Plasmodium falciparum
4. Immunization for rubella would result in a 11. Which of the following donors would be rejected
temporary deferral for: for whole blood donation?
a. 4 weeks. b. 8 weeks. a. A male who had sex with another male in 1988
c. 6 months. d. 1 year. b. A female who had sex with a male in 1992
e. 3 years. c. A male who had sex with another male last month
5. Which of the following donors is acceptable? d. A female who had sex with a male 9 months ago
a. Donor who had a first-trimester abortion 4 weeks ago 12. What does “infrequent” refer to when talking
b. Donor whose husband is a hemophiliac who about a plasmapheresis program?
regularly received cryoprecipitate before 1989 a. Donating no more frequently than once every 4
c. Donor who was treated for gonorrhea 6 months ago weeks
d. Donor who had a needle-stick injury 10 months ago b. Donating once a year
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c. Donating once every 6 months a. NAT + anti-HBc b. RIBA

d. Donating no more frequently than once every 8 weeks c. Lymph node biopsy d. HCV RNA
13. A patient is having an exploratory laparotomy 4. Currently, which of the following does the AABB
performed and donated blood for use in the patient’s consider to be the most significant infectious threat
upcoming surgery. Three units were collected, with from transfusion?
the last unit collected 2 days before surgery. Given this a. Bacterial contamination b. CMV
information, can the patient undergo surgery as c. Hepatitis d. HIV
planned? 5. Which of the following is the most frequently
a. Yes b. No transmitted virus from mother to fetus?
14. Which of the following refers to a temporary a. HIV b. Hepatitis
deferral? c. CMV d. EBV
a. Donor received varicella zoster live attenuated 6. Jaundice due to HAV is seen most often in the:
vaccine a. Adolescent b. Adult
b. Donor had a confirmed positive test for HBsAg c. Child younger than 6 years old d. Newborn
c. Donor has a history of CJD 7. Currently, steps taken to reduce transfusion-
d. Donor was diagnosed with babesiosis transmitted CMV include:
15. Which of the following carries a 12-month a. Plaque reduction neutralization test
deferral? b. NAT testing
a. Donor received Hepatitis B immune globulin c. Leukoreduction
b. Donor received pituitary growth hormone from d. Minipool screening
another human 8. HBV remains infectious on environmental surfaces
c. Donor received the MMR vaccine for 1:
d. Donor spent 10 years in Africa a. Day b. Week
c. Month d. Year
CHAPTER 14: Transfusion-Transmitted Diseases 9. HBV is transmitted most frequently:
1. The fecal-oral route is common in transmitting a. By needle sharing among IV drug users
which of these hepatitis viruses? b. Through blood transfusions
a. HAV and HEV b. HBV and HCV c. By unknown methods
c. HDV d. HGV d. By sexual activity
2. Which of the following is the component of choice 10. Which of the following is the most common cause
for a low-birth-weight infant with a hemoglobin of 8 of chronic hepatitis, cirrhosis, and hepatocellular
g/dL if the mother is anti-CMV negative? carcinoma in the United States?
a. Whole blood from a donor with anti-CMV a. HAV b. HBV
b. RBCs from a donor who is anti-CMV negative c. HCV d. HDV
c. Leukoreduced platelets 11. The first retrovirus to be associated with human
d. Solvent detergent–treated plasma disease was:
3. Which of the following is an FDA-licensed screening a. HCV b. HIV
test for HCV? c. HTLV-I d. WNV
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12. All of the following statements are true concerning b. Confirm the presence of anti-HIV in asymptomatic
WNV except: HIV-infected donors
a. 1 in 150 infections results in severe neurological c. Reduce the window period by detecting the virus
disease earlier than other available tests
b. Severe disease occurs most frequently in the over50 d. Detect antibodies to specific HIV viral proteins,
age group including anti-p24, anti-gp41, and anti-gp120
c. Deaths occur more often in those over 65 years who 20. Screening for HIV is performed using the
present with encephalitis following technique:
d. Fatalities occur in approximately 38% of infected a. Radio immunoassay
individuals b. WB
13. The primary host for WNV is: c. Immunofluorescent antibody assay
a. Birds b. Horses d. NAT
c. Humans d. Bats 21. The first form of pathogen inactivation was:
14. Tests for WNV include all of the following except: a. Chemical
a. ELISA b. Heat
b. NAT c. Cold-ethanol fractionation
c. Plaque reduction neutralization test d. Anion-exchange chromatography
d. Immunofluorescent antibody assay 22. What is the most common parasitic complication
15. Individuals exposed to EBV maintain an of transfusion?
asymptomatic latent infection in: a. Babesia microti
a. B cells b. T cells b. Trypanosoma cruzi
c. All lymphocytes d. Monocytes c. Plasmodium species
16. Fifth disease is caused by: d. Toxoplasma gondii
a. CMV b. EBV 23. Which organism has a characteristic C- or U-shape
c. Parvovirus B19 d. HTLV-II on stained blood smears?
17. Transient aplastic crisis can occur with: a. Trypanosoma cruzi
a. Parvovirus B19 b. WNV b. Plasmodium vivax
c. CMV d. EBV c. Plasmodium falciparum
18. Reasons why syphilis is so rare in the U.S. blood d. Babesia microti
supply include all of the following except: 24. Which transfusion-associated parasite may have
a. 4°C storage conditions asymptomatic carriers?
b. Donor questionnaire a. Babesia microti
c. Short spirochetemia b. Trypanosoma cruzi
d. NAT testing c. Plasmodium species
19. Nucleic acid amplification testing for HIV was d. All of the above
instituted in donor testing protocols to: 25. Which disease is naturally caused by the bite of a
a. Identify donors with late-stage HIV who lack deer tick?
antibodies a. Chagas disease b. Babesiosis
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c. Malaria d. Leishmaniasis a. 4 b. 6
CHAPTER 15: Component Preparation c. 8 d. 12
1. Which of the following lists the correct shelf life for e. 24
the component? 7. Quality control for nonadditive RBCs requires a
a. Deglycerolized RBCs—24 hours maximum hematocrit level of:
b. RBCs (CPD)—35 days a. 75% b. 80%
c. Platelet concentrate—10 days c. 85% d. 90%
d. FFP—5 years e. 95%
e. RBCs (CPDA-1)—21 days 8. AHF concentrates are used to treat:
2. Each unit of cryoprecipitate prepared from whole a. Thrombocytopenia
blood should contain a minimum of how many units of b. Hemophilia A
AHF activity? c. Hemophilia B
a. 40 IU b. 80 IU d. von Willebrand’s disease
c. 120 IU d. 160 IU e. Factor XIII deficiency
e. 180 IU 9. Prothrombin complex concentrates are used to treat
3. Platelet concentrates prepared by apheresis should which of the following?
contain how many platelets? a. Factor IX deficiency
a. 5.5 × 1010 b. 6 × 1010 b. Factor VIII deficiency
c. 3 × 1011 d. 5.5 × 1011 c. Factor XII deficiency
e. 6 × 1011 d. Factor XIII deficiency
4. The required storage temperature for frozen RBCs e. Factor V deficiency
using the high-glycerol method is: 10. RBCs that have been leukoreduced must contain
a. 4°C b. ≤–20°C less than ______ leukocytes and retain at least ______
c. ≤–18°C d. ≤–120°C of original RBCs.
e. ≤–65°C a. 8 × 106/85%
5. How does irradiation affect the shelf life of red b. 8 × 106/90%
blood cells? c. 5 × 106/85%
a. Irradiation has no effect on the shelf life d. 5 × 106/80%
b. The expiration date is 28 days from the date of 11. Random-donor platelets that have been
irradiation or the original outdate, whichever is later leukoreduced must contain less than ______
c. The expiration date is 28 days from the date of leukocytes.
irradiation or the original outdate, whichever is sooner a. 8.3 × 105 b. 8 × 106
d. The expiration date is 25 days from the date of c. 5 × 106 d. 3 × 1011
irradiation or the original outdate, whichever is later 12. A single unit of FFP or PF24 should contain
e. The expiration date is 25 days from the date of ______ mL of plasma.
irradiation or the original outdate, whichever is sooner a. 100–150 b. 200–400
6. Once thawed, FFP must be transfused within c. 150–250 d. 50–150
__________ hours unless relabeled as thawed plasma:
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13. Cryoprecipitate that has been pooled in an open b. 24-hour expiration date after thawing
system must be transfused within ______ hours. c. Used for rare antigen-type donor blood
a. 24 b. 6 d. Used for IgA-deficient recipient with history of severe
c. 4 d. 8 reaction
8. Select the appropriate product for a bone marrow
CHAPTER 16: Transfusion Therapy transplant patient with anemia:
1. Leukocyte-reduced filters can do all of the following a. RBCs
except: b. Irradiated RBCs
a. Reduce the risk of CMV infection c. Leukoreduced RBCs
b. Prevent or reduce the risk of HLA alloimmunization d. Washed RBCs
c. Prevent febrile, nonhemolytic transfusion reactions 9. Which blood product should be selected for vitamin
d. Prevent TA-GVHD K deficiency?
2. Albumin should not be given for: a. Cryoprecipitate b. Factor VIII
a. Burns b. Shock c. Factor IX d. Plasma
c. Nutrition d. Plasmapheresis 10. Which fluid should be used to dilute RBCs?
3. Of the following, which blood type is selected when a. 0.9% saline
a patient cannot wait for ABO-matched RBCs? b. 5% dextrose and water
a. A b. B c. Immune globulin
c. O d. AB d. Lactated Ringer solution
4. Which patient does not need an irradiated
component? CHAPTER 17: Adverse Effects of Blood Transfusion
a. Bone marrow transplant recipient 1. What component is most frequently involved with
b. Neonate weighing less than 1,200 g transfusion-associated sepsis?
c. Adult receiving an RBC transfusion a. Plasma b. Packed red blood cells
d. Adult receiving an RBC transfusion from a blood c. Platelets d. Whole blood
relative 2. Fatal transfusion reactions are mostly caused by:
5. RBC transfusions should be given: a. Serologic errors
a. Within 4 hours b. Improper storage of blood
b. With lactated Ringer solution c. Clerical errors
c. With dextrose and water d. Improper handling of the product
d. With cryoprecipitate 3. Early manifestation of an acute hemolytic
6. Which type of transplantation requires all cellular transfusion reaction can be confused with:
blood components to be irradiated? a. Allergic reaction
a. Bone marrow b. Heart b. Febrile nonhemolytic reaction
c. Liver d. Kidney c. Anaphylactic shock
7. Characteristics of deglycerolized RBCs include the d. Sepsis
following except: 4. Pain at infusion site and hypotension are observed
a. Inexpensive with what type of reaction?
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a. Delayed hemolytic transfusion reaction c. Infectious or noninfectious

b. Acute hemolytic transfusion reaction d. All of the above
c. Allergic reaction 11. With febrile nonhemolytic transfusion reactions:
d. Febrile nonhemolytic reaction a. They are self-limited
5. Irradiation of blood is performed to prevent: b. Fever resolves within 2–3 hours
a. Febrile nonhemolytic transfusion reaction c. Treatment is required
b. Delayed hemolytic transfusion reaction d. a and b are correct
c. Transfusion-associated graft-versus-host disease e. All of the above
d. Transfusion-associated circulatory overload 12. Absolute IgA deficiency is a classic example of a
6. The only presenting sign most often accompanying a severe allergic reaction. A result indicating an absolute
delayed hemolytic transfusion reaction is: IgA deficiency is:
a. Renal failure a. <0.05 mg/Dl b. <0.50 mg/dL
b. Unexplained decrease in hemoglobin c. <0.50 gm/dL d. <5 mg/dL
c. Active bleeding 13. How are mild allergic transfusion reactions with
d. Hives isolated symptoms or hives and urticaria treated?
7. Which transfusion reaction presents with fever, a. Transfusion is stopped and transfusion reaction
maculopapular rash, watery diarrhea, abnormal liver workup is initiated
function, and pancytopenia? b. Transfusion is stopped and antihistamines
a. Transfusion-associated sepsis administrated; when symptoms improve, transfusion
b. Transfusion-related acute lung injury is restarted
c. Transfusion-associated graft-versus-host disease c. Stop transfusion and prepare washed red blood cells
d. Transfusion-associated allergic reaction d. Continue transfusion with a slower infusion rate
8. A suspected transfusion-related death must be 14. TRALI presents with the following symptoms:
reported to: a. Respiratory distress
a. AABB b. Severe hypoxemia and hypotension
b. Federal and Drug Administration (FDA) c. Fever
c. College of American Pathologists (CAP) d. All of the above
d. The Joint Commission (TJC) 15. Which of the following is characteristic of iron
9. Nonimmune hemolysis can be caused during overload?
transfusion by: a. Delayed, nonimmune complication occurs
a. Use of small bore size needle b. Chelating agents are used
b. Use of an infusion pump c. Multiorgan damage may occur
c. Improper use of a blood warmer d. All of the above
d. All of the above
10. Transfusion reactions are classified according to: CHAPTER 18: Apheresis
a. Signs or symptoms presenting during or after 1. The most common anticoagulant used for apheresis
24 hours procedures is:
b. Immune or nonimmune a. Heparin b. Sodium fluoride
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c. Warfarin d. Citrate a. Binding calcium ions

2. Therapeutic cytapheresis has a primary role in b. Increasing intracellular potassium
treatment of patients with: c. Binding to antithrombin III
a. Sickle cell disease and acute chest syndrome d. Inactivating factor V
b. Systemic lupus erythematosus to remove immune 9. Peripheral blood stem cells are:
complexes a. Responsible for phagocytosis of bacteria
c. Leukemia to help increase granulocyte production b. Removed during erythrocytapheresis
d. Myasthenia gravis to increase antibody production c. Pluripotential hematopoietic precursors that
3. The minimum interval allowed between circulate in the peripheral blood
plateletpheresis component collection procedures is: d. Lymphocytes involved with the immune response
a. 1 day b. 2 days 10. Which of the following can be given to an apheresis
c. 7 days d. 8 weeks donor to increase the number of circulating
4. In plasma exchange, the therapeutic effectiveness is: granulocytes?
a. Greatest with the first plasma volume removed a. DDAVP
b. Affected by the type of replacement fluid used b. Hydroxyethyl starch (HES)
c. Enhanced if the unwanted antibody is IgG rather than c. Immune globulin
IgM d. G-CSF
d. Independent of the use of concomitant
immunosuppressive therapy CHAPTER 19: Cellular Therapy in the Hematopoietic
5. The replacement fluid indicated during plasma Transplant Setting
exchange for TTP is: 1. When an HPC donor is unrelated to the recipient of
a. Normal (0.9%) saline an HPC transplantation, the transplant is categorized
b. Hydroxyethyl starch (HES) as:
c. FFP a. Allogeneic b. Autologous
d. Albumin (human) 5% c. Syngeneic d. Hematopoietic
6. The most common adverse effect of plateletpheresis 2. Stem cells from HPC donors may be mobilized with:
collection is: a. Plerixafor b. Filgrastim (GCSF)
a. Allergic reaction b. Hepatitis c. Chemotherapy d. All of the above
c. Hemolysis d. Citrate effect 3. Which is an advantage of an HPC transplant using
7. Apheresis technology can be used to collect each of umbilical cord blood as the HPC source?
the following components except: a. Recipient weight of no concern
a. Leukocytes b. Donor screening and testing abbreviated
b. Macrophages c. Higher risk of GVHD
c. Hematopoietic progenitor cells d. No significant risk to the donor or mother
d. Platelets 4. The recommended minimum number of CD34+
8. The anticoagulant added to blood as it is removed cells required in an HPC-apheresis collection to ensure
from a donor or patient during an apheresis timely engraftment is:
procedure acts by: a. 2 × 102 CD34+ cells/kg
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b. 2 × 104 CD34+ cells/kg CHAPTER 20: Hemolytic Disease of the Fetus and
c. 2 × 106 CD34+ cells/kg Newborn (HDFN)
d. 2 × 108 CD34+ cells/kg 1. The etiology of HDFN is characterized by:
5. The cellular marker used to quantify the collection a. IgM antibody
of HPCs using flow cytometry is: b. Nearly always anti-D
a. CD4 b. CD33 c. Different RBC antigens between mother and father
c. CD34 d. CD59 d. Antibody titer less than 32
6. An A patient received an HPC transplant from a B 2. An important difference between the fetus and the
donor. What type of ABO mismatch does this newborn physiology is:
represent? a. Bilirubin metabolism
a. Major b. Minor b. Maternal antibody level
c. Bidirectional d. Any of the above c. Presence of anemia
7. Which of the following terms describe an HPC d. Size of RBCs
transplant where donor and recipient are the same 3. Kernicterus is caused by the effects of:
person? a. Anemia
a. Allogeneic b. Autologous b. Unconjugated bilirubin
c. Syngeneic d. Hematopoietic c. Antibody specificity
8. Three weeks after sustaining a car accident that d. Antibody titer
required emergency transfusion of blood products for 4. The advantage of middle cerebral artery peak
resuscitation, an allogeneic HPC transplant recipient systolic velocity Doppler (MCA-PSV) is that it is:
developed a fever, erythematous skin rash, diarrhea, a. Able to measure fetal hemoglobin and haematocrit
and cytopenias, which ultimately were fatal. What levels
intervention may have prevented this outcome? b. Able to support antigen typing of fetal blood using
a. The use of leukoreduced blood products DNA
b. The use of irradiated of blood products c. Helpful for direct transfusion of fetal circulation
c. The use of CMV-negative blood products d. Noninvasive and decreases risk of adverse events
d. The use of washed blood products 5. Blood for intrauterine transfusion (IUT) should be:
9. What common cryoprotectant is added to HPC a. Irradiated, leukocyte reduced, more than 7 days old,
products for freezing? HbS negative
a. Dimethyl sulfoxide b. Polyethylene glycol b. Irradiated, leukocyte reduced, less than 7 days old, HbS
c. Glycerol d. Normal saline positive
10. An O patient received an HPC transplant from a B c. Irradiated, leukocyte reduced, less than 7 days old,
donor. What type of ABO mismatch does this HbS negative
represent? d. Irradiated, leukocyte reduced, more than 7 days old,
a. Major b. Minor HbS positive
c. Bidirectional d. Any of the above 6. RhIG is indicated for:
a. Mothers who have anti-D due to allosensitization
b. Infants who are RhD-negative
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c. Infants who have anti-D a. Dithiothreitol

d. Mothers who are RhD-negative b. Ficin
7. RhIG is given to RhD-negative mothers without c. Phosphate-buffered saline at pH 9
regard for fetal RhD type in all of the following d. Bovine albumin
conditions except: 3. The blood group involved in the autoantibody
a. Ectopic pregnancy rupture specificity in PCH is:
b. Full-term delivery a. P. b. ABO.
c. Amniocentesis c. Rh. d. Lewis.
d. Induced abortion 4. Which of the following blood groups reacts best
8. A Kleihauer-Betke test or flow cytometry indicates with an anti-H or anti-IH?
10 fetal cells per 1,000 adult cells. For a woman with a. O b. B
5,000-Ml blood volume, the proper dose of RhIG is: c. A2 d. A1
a. One regular-dose (300 µg) vial 5. With cold-reactive autoantibodies, the protein
b. Two regular-dose vials coating the patient’s cells and detected in the DAT is:
c. Three regular-dose vials a. C3. b. IgG.
d. Four regular-dose vials c. C4. d. IgM.
9. ABO HDFN is usually mild because: 6. Problems in routine testing caused by cold-reactive
a. ABO antigens are poorly developed in the fetus autoantibodies can usually be resolved by all of the
b. ABO antibodies prevent the disease itself following except:
c. ABO antibodies readily cross the placenta a. Prewarming.
d. ABO incompatibility is rare b. Washing with warm saline.
10. A woman without prenatal care delivers a healthy c. Using anti-IgG antiglobulin serum.
term infant. A cord blood sample shows the infant is d. Testing clotted blood specimens.
A-positive with a positive DAT. The workup of the 7. Pathological cold autoagglutinins differ from
unexpected finding should include: common cold autoagglutinins in:
a. Anti-C3 antiglobulin test a. Immunoglobulin class.
b. ABO testing of the mother b. Thermal amplitude.
c. Direct antiglobulin testing of the mother’s specimen c. Antibody specificity.
d. ABO and Rh typing of the father d. DAT results on EDTA specimen.
8. Cold AIHA is sometimes associated with infection
CHAPTER 21: Autoimmune Hemolytic Anemias by:
1. Immune hemolytic anemias may be classified in a. Staphylococcus aureus.
which of the following categories? b. Mycoplasma pneumoniae.
a. Alloimmune b. Autoimmune c. Escherichia coli.
c. Drug-induced d. All of the above d. Group A Streptococcus.
2. When preparing cells for a cold autoadsorption 9. Many warm-reactive autoantibodies have a broad
procedure, it is helpful to pretreat the cells with which specificity within which of the following blood groups?
of the following? a. Kell. b. Duffy.
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c. Rh. d. Kidd.
10. Valid Rh typing can usually be obtained on a
patient with WAIHA using all of the following
reagents or techniques except:
a. Slide and modified tube anti-D.
b. Chloroquine-treated RBCs.
c. Rosette test.
d. Monoclonal anti-D.
11. In pretransfusion testing for a patient with
WAIHA, the primary concern is:
a. Treating the patient’s cells with chloroquine for reliable
antigen typing.
b. Adsorbing out all antibodies in the patient’s serum to
be able to provide compatible RBCs.
c. Determining the exact specificity of the autoantibody
so that compatible RBCs can be found.
d. Discovering any existing significant alloantibodies
in the patient’s circulation.
12. Penicillin given in massive doses has been
associated with RBC hemolysis. Which of the classic
mechanisms is typically involved in the hemolytic
process?
a. Immune complex.
b. Drug adsorption.
c. Membrane modification.
d. Autoantibody formation.
13. Which of the following drugs has been associated
with complement activation and rapid intravascular
hemolysis?
a. Penicillins. b. Quinidine.
c. Alpha-methyldopa. d. Cephalosporins.
14. A patient is admitted with a hemoglobin of 5.6
g/dL. Initial pretransfusion workup appears to
indicate the presence of a warm autoantibody in the
serum and coating his RBCs. His transfusion history
indicates that he received 6 units of RBCs 2 years ago
after an automobile accident. Which of the following
would be most helpful in performing antibody
detection and compatibility testing procedures?
a. Adsorb the autoantibody using the patient’s
enzymetreated cells.
b. Perform an elution and use the eluate for compatibility
testing.
c. Crossmatch random units until compatible units are
found.
d. Collect blood from relatives who are more likely to be
compatible.
15. A patient who is taking Aldomet has a positive
DAT. An eluate prepared from his RBCs would be
expected to:
a. React only with Aldomet-coated cells.
b. Be neutralized by a suspension of Aldomet.
c. React with all normal cells.
d. React only with Rhnull cells.
16. One method that can be used to separate a
patient’s RBCs from recently transfused donor RBCs
is:
a. Chloroquine diphosphate treatment of the RBCs.
b. Reticulocyte harvesting.
c. EGA treatment.
d. Donath-Landsteiner testing.
17. Monoclonal antisera is valuable in phenotyping
RBCs with positive DATs because:
a. Both polyspecific and monospecific antihuman serum
can be used in antiglobulin testing.
b. Anti-C3 serum can be used in antiglobulin testing.
c. It usually does not require antiglobulin testing.
d. It does not require enzyme treatment of the cells prior
to antiglobulin testing.
18. Autoadsorption procedures to remove either warm
or cold autoantibodies should not be used with a
recently transfused patient. Recently means:
a. 3 days. b. 3 weeks.
c. 6 weeks. d. 3 months.
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CHAPTER 22: Tissue Banking as a Part of the
Transfusion Service
1. Implant records must be kept for what duration?
a. Ten years after the tissue has been harvested
b. Indefinitely
c. For a reasonable time to ensure that the recipient is not
still alive when records are destroyed
d. Ten years following the disposition or expiration of
the tissue
2. FDA CFR 1270 and 1271 include all of the following
tissues except:
a. Cancellous bone chips
b. Blood vessels associated with vascular organs for
transplant
c. Cornea
d. Heart valve
3. Hospital tissue banks must register with the FDA if:
a. Tissue for transplant is stored
b. Autologous tissue is stored and issued
c. Tissue is transferred to another facility
d. The tissue bank is located outside the blood bank
4. The Joint Commission requires all of the following
except:
a. Hospital tissue banks must ensure that suppliers are
complying with applicable state laws
b. Tissue-manufacturing establishments must register
with the FDA
c. Hospitals must assign responsibility for overseeing the
tissue program throughout the organization
d. Hospital tissue banks must verify supplier’s registration
with the FDA yearly
5. The American Association of Tissue Banks (AATB)
is:
a. A mandatory accrediting agency for all tissue banks
b. A voluntary accrediting agency for tissue-
manufacturing establishments
c. An historic name for the U.S. Navy Tissue Bank
d. A subdivision within the AABB
6. Transmission of malignancy in tissue:
a. Is most likely to occur with the use of bone
b. Is relatively common (1/10,000 cases)
c. Is more likely to occur in whole organ transplant
d. Has never been reported in cornea transplant
7. The medical director for the tissue bank can be:
a. Any individual appointed by the hospital medical
director
b. The lead supervisor in the blood bank
c. The head nurse/transplant coordinator from surgical
nursing
d. A qualified physician involved in tissue transplant
or blood banking
8. Notification of a recipient of tissue that has been
recalled because of possible contamination:
a. Should be conducted by the tissue bank director
only
b. Should be conducted by the patient’s transplanting
surgeon
c. The patient does not need to be told unless an infection
develops
d. The informed consent covers this contingency and no
further notification is necessary
9. Tissue receipt records must include all of the
following except:
a. Unique tissue identification number
b. Name and address of tissue supplier
c. Expiration date
d. Tissue supplier’s FDA registration number
10. Records that must be reviewed to determine donor
eligibility by the tissue manufacturer include:
a. Donor family history
b. Records from any source pertaining to risk factors
for communicable diseases
c. Interview of next-of-kin
d. Consent to harvest tissue
CHAPTER 23: The HLA System
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1. The HLA genes are located on which chromosome? b. Cord blood

a. 2 b. 4 c. Autologous
c. 6 d. 8 d. HLA haploidentical
2. The majority of HLA antibodies belong to what 10. The SAB describes the amount of bound antibody
immunoglobulin class? on each bead as:
a. IgD b. IgE a. MCS b. MFI
c. IgG d. IgM c. CDC d. AHG
3. What is the test of choice for HLA antigen testing?
a. Agglutination b. Molecular
c. Cytotoxicity d. ELISA CHAPTER 24: Relationship Testing
4. Of the following diseases, which one has the highest 1. Among the combinations of attributes described
relative risk in association with an HLA antigen? below, select the one that would not be suitable for a
a. Ankylosing spondylitis genetic system used in parentage testing analysis.
b. Juvenile diabetes a. The system has multiple alleles in Hardy-Weinberg
c. Narcolepsy equilibrium
d. Rheumatoid arthritis b. The system has a high mutation rate
5. Why is HLA matching not feasible in cardiac c. Databases of allele frequencies are available for all
transplantation? ethnic groups tested by the laboratory
a. No HLAs are present on cardiac cells d. All systems selected are genetically independent from
b. No donors ever have HLA antibodies each other
c. Total ischemic time is too long 2. In which of the following genetic systems is the allele
d. Total ischemic time is too short frequency distribution continuous (not discrete)?
6. DR52 molecules are the product of which alleles? a. DNA polymorphisms by RFLP
a. DRA and DRB1 b. DRA and DRB3 b. DNA polymorphisms by PCR
c. DRA and DRB4 d. DRA and DRB5 c. RBC antigens
7. What is the molecular technique that detects d. RBC enzymes
undefined alleles? 3. A false direct exclusion in RBC antigen genetic
a. Restriction fragment length polymorphism systems can be caused by:
b. Sequence-specific primer typing a. A silent allele
c. Sequence-specific oligonucleotide typing b. A lack of precursor substance
d. Direct nucleotide sequencing c. An alternate untested allele
8. What represents the association of the alleles on the d. Weak reagents
two C6 chromosomes as determined by family studies? 4. Among the following organizations, which one
a. Haplotype b. Genotype offers an accreditation program for parentage testing
c. Phenotype d. Xenotype laboratories?
9. Which type of HSCT can be performed within a a. AABB b. ASCP
relatively short period of time? c. FDA d. HCFA
a. Matched unrelated
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CHAPTER 25: Quality Management in the Blood a. Problem resolution b. Process control
Bank c. Validation d. Auditing
1. A compliance program: 9. ___________________is a set of planned actions that
a. Evaluates how effectively the facility meets ensure that systems and elements that influence the
regulatory requirements quality of service are working as expected.
b. Always identifies quality problems a. Quality control
c. Is part of quality control b. Quality assurance
d. Is an evaluation of efficiency c. Quality indicator
2. The quality system essentials are applied to: d. Quality management system
a. The blood bank’s management staff 10. The Centers for Medicare and Medicaid Services
b. Blood bank quality control activities (CMS) developed an alternative quality control option,
c. Blood component manufacturing an individualized quality control plan (IQCP). How is
d. The blood bank’s path of workflow the minimum frequency of running quality controls
3. cGMP refers to: determined?
a. Regulations pertaining to laboratory safety a. Through risk assessment
b. Validation of testing b. By the quality control plan
c. Nonconformance reporting c. After quality assessment
d. Manufacturing blood components d. By the manufacturer
4. Internal and external failure costs are:
a. Readily identifiable in facility reports CHAPTER 26: Patient Blood Management
b. Controlled through prevention and appraisal 1. Which type of review does not require direct
c. Built into the facility’s operating budget discussion between the ordering clinician and
d. Part of prevention and appraisal transfusion service personnel?
5. Which one statement below is correct? a. Discontinuous prospective
a. A process describes how to perform a task b. Targeted prospective
b. A procedure simply states what the facility will do c. Concurrent
c. A procedure informs the reader how to perform a d. Retrospective
task e. Prospective
d. A policy can be flowcharted 2. Which of the following is the most important first
6. A blank form is a: step in developing a comprehensive PBM/BUM
a. Record b. Procedure program?
c. Flowchart d. Document a. Identification of a qualified transfusion safety officer
7. An example of a remedial action is: with excellent blood banking bench skills
a. Applying the problem-solving process b. Determination of patient populations within the
b. Starting a process improvement team hospital with the highest blood utilization
c. Resolving the immediate problem c. Creation of a multidisciplinary transfusion committee
d. Performing an internal audit to determine the category of blood utilization review
8. The DMAIC methodology is used for:
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d. Meet with key physician and nursing leadership to
facilitate the creation of a hospital-wide transfusion
guideline
e. Determine the estimated cost savings through the
implementation of an anemia clinic for elective surgical
patients
3. Optimal value as it relates to blood utilization is best
obtained by which of the following:
a. Development of standardized cost metric for blood
utilization
b. Reduction in variabilities in transfusion ordering
practice from evidence-based standards
c. Consistent reporting of outcome metrics such as
decreased sepsis or emergency room admissions
d. Decreasing peril and waste by encouraging bloodless
surgery and conversion to lower volume phlebotomy
tubes
e. Use of LEAN practices to improve value and prevent
waste by considering the ordering clinician as a customer
4. To receive benefit from a transfusion the patient
must have:
a. A hemoglobin level less than 8 g/dL
b. An invasive procedure planned
c. A pathological lesion or deficiency that can be
remedied by functioning stored components
d. A blood order signed by the attending physician
e. Understood the risks, benefits and alternatives, and
given informed consent
5. Which of the following statements best describes the
most important reason for creating a PBM/BUM
program?
a. PBM/BUM decreases blood bank exposure to risk
management and litigation by promoting optimal
documentation of transfusion indication and expected
outcome within the electronic medical record
b. PBM/BUM reduces patient exposure to transfusion
associated acute lung injury (TRALI) through physician
education and by prospectively encouraging mitigation
strategies from the blood supplier
c. PBM/BUM improves patient safety by promoting
evidence-based transfusion, transfusion avoidance
strategies, and prevention of inappropriate transfusion
d. PBM/BUM are laboratory and hospital regulatory
requirements that are essential for ensuring a hospital
culture that promotes patient safety through the periodic
direct observation and assessment of transfusion
administration by nursing staff
e. PBM/BUM provides significant and substantial direct
and indirect cost savings to both patients and blood banks
by reducing the number of unnecessary or inappropriate
transfusions
6. Which of the following is an example of targeted
prospective review as it related to blood utilization?
a. Continuing education on the proactive use of iron to
correct anemia in presurgical patients
b. Viscoelastic testing to assess real-time platelet need for
cardiac surgery patients
c. Hematologist directed erythropoietin clinic for anemic
cancer patients prior to chemotherapy
d. Decision support pop-up restricted to routine orders
for two or more units of RBCs
e. Report of average RBC usage per patient for a targeted
procedure or physician group
7. Which of the following pairs best describes an
intervention strategy that is best paired with a
utilization review category?
a. Minimize unnecessary phlebotomy loss, discontinuous
prospective review
b. Periodic physician feedback, retrospective review
c. Annual continuing education for medical residents,
prospective review
d. Predictive modeling, retrospective review
e. Automatic cancellation of surgical blood orders,
concurrent review
8. The PBM program planning team should include:
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a. Nursing representatives
b. Representatives from the facility’s practicing clinicians
c. The blood bank medical director
d. A laboratorian who is knowledgeable in blood bank
policies and procedures
e. All of the above
9. Metrics should be:
a. Chosen to indicate progress during the process of
continuous improvement
b. Tracked and disseminated only to members of the
blood utilization management team
c. The same for all institutions
d. Selected only by the transfusion service leadership
e. Only qualitative in nature, since medical decision
making is a complex process
10. Which statement is most accurate regarding
continuous improvement as it relates to PBM/BUM?
a. Blood utilization metrics should be periodically
converted to national standardized metrics
b. An example of an ideal PBM metric is the ratio of the
facility cost of one unit of RBCs divided by the regional
red blood cell cost
c. Continuous improvement should be performed by a
different set of players than were used in the planning
process
d. Outcomes during prospective review should be limited
to the transfusion committee
e. Feedback loops and appropriate metrics are
required to achieve long-term improvements
CHAPTER 27: Transfusion Safety and Federal
Regulatory Requirements
1. Which of the following is responsible for overseeing
the safety of the nation’s blood supply?
a. Joint Commission on Accreditation of Healthcare
Organizations
b. Food and Drug Administration
c. College of American Pathologists (CAP)
d. Occupational Safety and Health Administration
2. Where are the regulations for blood and blood
components published?
a. The AABB Technical Manual
b. CAP inspection checklist
c. The Code of Federal Regulations
d. State Inspectional Guidance Documents
3. What was the important tragedy that led to the
regulation of biological products?
a. Three patients contracted hepatitis C following
transfusion
b. A child died following transfusion of hemolyzed red
blood cells
c. A group O patient received group A blood
d. Thirteen children died after receiving diphtheria
antitoxin contaminated with tetanus
4. What is required to ship blood and blood
components across state lines (interstate)?
a. AABB accreditation
b. State license
c. CMS certification
d. Approved biologics license application
5. Which of the following government organizations
inspect blood and blood component manufacturers?
a. CBER b. ORA
c. CMS d. All of the above
6. Which of the following is true about CGMP?
a. CGMP is the minimum current practice for
methods and facilities used to manufacture a drug to
ensure that it is safe, pure, and potent
b. The FDA will approve a biologics license application if
the manufacturer does not have a quality control plan
c. The quality control unit must perform all the quality
functions
d. Blood and blood components do not have to be in
compliance with the drug CGMP regulations
7. A donor calls the blood bank and informs them that
within a year prior to his donation, he had intimate
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contact with a person diagnosed with HIV. Which of information systems, blood banks must maintain SOPs
the following actions is not required by the FDA? for all of the following except:
a. Identify and quarantine all blood and blood components a. Vendor validation testing
produced from the blood supplied by the donor b. Computer downtime
b. Report the biological product deviation to CBER if the c. System maintenance
product has been distributed d. Personnel training
c. Enter the donor in a record so that he can be identified 3. A validation test case that assesses the system’s
and his product not be distributed while he is deferred ability to recognize an erroneous input is called:
d. Notify the AABB a. Normal b. Boundary
8. A patient dies following transfusion of ABO- c. Stress d. Invalid
incompatible blood. To whom should this event be 4. An example of interface software functionality is:
reported? a. The entry of blood components into the blood bank
a. The Center for Biologics Evaluation and Research database
b. Center for Medicare and Medicaid Services b. The transmission of patient information from the
c. The AABB central office HIS into the blood bank system
d. The Occupational Safety and Health Administration c. The printing of a workload report
9. Which federal agency has the responsibility to d. Preventing access to the system by an unauthorized
routinely inspect an unregistered transfusion service user
that does not collect blood? 5. Backup copies of the information system:
a. Food and Drug Administration a. Can be used to restore the information system data
b. Centers for Medicare and Medicaid Services and software if the production system is damaged
c. Occupational Safety and Health Administration b. Are used to maintain hardware components
d. State health department c. Are performed once a month
10. Which of the following is not one of the FDA layers d. Are created any time changes are made to the system
of safety? 6. User passwords should be:
a. Donor screening a. Shared with others
b. Biologics License Application b. Kept confidential
c. Investigation of manufacturing problems c. Posted at each terminal
d. Testing for relevant transfusion-transmitted infections d. Never changed
7. Preventing the issue of an incompatible blood
CHAPTER 28: Laboratory Information Systems in component is an example of:
the Blood Bank a. Inventory management
1. Components of an information system consist of all b. Utilization review
of the following except: c. System security
a. Hardware b. Software d. Control function
c. Validation d. People 8. Information is stored in a collection of many
2. To be in compliance with regulatory and different files called the:
accreditation agency requirements for blood bank a. Database b. Configuration
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c. Hardware d. Disk drive a. Are evolving and will continue to result in litigation
9. Application software communicates with this type of in the foreseeable future
software to retrieve data from the system disks: b. Frequently result in plaintiff verdicts
a. Interface b. Operating system c. Have all been litigated
c. Security d. Program d. Are known and avoidable
10. Validation testing for software should consider all
of the following items except:
a. Data entry methods
b. Control functions
c. Performance of testing in production database
d. Invalid data

CHAPTER 29: Medicolegal and Ethical Aspects of

Providing Blood Collection and Transfusion Services
1. Transfusion-transmitted diseases can result in
lawsuits claiming:
a. Battery b. Invasion of privacy
c. Negligence d. a, b, and c
2. Laws applicable to blood banking and transfusion
medicine can arise:
a. In state and federal courts
b. In the U.S. Congress, state legislatures, and state
and federal courts
c. In state legislatures and courts
d. In state legislatures and the U.S. Congress
3. The reasons patients have sued for transfusion
injury include:
a. Failure to perform surrogate testing
b. Failure to properly test blood components
c. Failure to properly screen donors
d. All of the above
4. Blood banking professionals may increase the threat
of litigation by:
a. Following published regulations and guidelines
b. Knowing the legal bases for liability
c. Disclosing all information about patients and donors
d. Practicing good medicine
5. Issues about transfusion-transmitted diseases:
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