1. Which is not included on a properly labeled specimen? a. Two unique patient identifiers b. Date and time of draw © Phlebotomist initials d. Patients home address a. low many days before a pretransfusion specimen expires? 3. How many days must a pretransfusion specimen and donor unit segments be retained post-transfusion? a. 3 days b. Tidays M4 days 4. 1 month 4. Ifa blood type cannot be resolved, what ABO group should be selected for a red blood cell transfusion? a. Group A —_ b. Group B © 14 days en d. 1 month, pee 284 266 PARTI Blood Groups and Serologic Testing 5. Which antibody specificity iGoprequired in antibody detection tests? ak b. cry as 6. A patient has a history of antiJi¢, The antibody screen is currently negative. Which red blood cell unit should be selected, and what type of crossmatch should be per formed? a. Jk(@-) red blood cells, computer crossmatch b. Jk(a-) red blood cells, immediate spin crossmatch 4. ABO-compatible because the antibody screen is negative 7. Which is not true of rouleaux formation? a. Mimics agglutination b. Appears like a “stacking of coins” ¢ d. Can be dispersed by saline 8. A patients blood type is AB-negative, but there are no AB-negative red blood cell units available. What donor ‘units could be selected? & Acnegative b. O-positive © Bepositive . All of the above 9. A patient requires 15 units of thawed plasma for an apheresis procedure, The patient's blood type is O-negative. What donor units could be selected? a. O-negative b. AB-positive © Aenegative d. Albiof theabove 10. The lege of Surgeons recommends trans- fusion of red blood cells, thawed plasma, and platelets 12. Amother, nant, has anti-K with a titer of 32. An intrauterine Te blood cell transfusion isinclicated. The donor unit selected should be all of the following execpt a. O-negative b. Knegative Positive for sickling hemoglobin d. Inadiated 13. A patient with sickle cell disease is B-positive with a pos- itive antibody screen. The antibody identified is anti-D, and the autocontrol is negative. What is a possible explanation? 1 The patient is weak D-positive . Autoantibody is present Patient possesses the partial D phenotype 4. The patient has a positive DAT References 1, 21US.C. 8 321, US. Code. Title 21. Food and Drugs 2. Fung M, Eder AF, Spitalnik SL, Westhoff CM eds. Technical manual 19th ed. Bethesda (MD): AABB; 2017. 3. Ooley PW. Standards for blood banks and transfusion services. 3isted. Bethesda (MD): ABB; 2018, 4 Poles Debbi, Paula Bolton-Maggs. Annual SHOT Report 2016 [Internet]. Manchester (UK): Royal College of Pathologists; 2017. Available from: wwwishotku.org. 5. United States Food and Drug Administration. Fatalities reported \o FDA following blood collection and transfusion annual, summary for FY2015 [Internet]. Washington (DC): U.S. Food and Drug Administration, 2016, Available from: huups://sww {da govidownloads/BiologicsBloodVaccineySafetyAvailability/ ReportaPoblen/TransfusionDonationFatalite/UCMS18148 pal 6. Linden JW, Wagner K, Voytovich AE, Sheehan J. Transfusion error in New York State: an analysis of 10 years’ experience, Transfusion, 2000;40:1207-13, 7. The Joint Commission. 2017 National patient safety goals. Oakbrook (IL): The Joint Commission; 2017, Available from hups/Avwwjointcommnission org/hap_2017_npsgv. 8. ClinLabNavigatorcom (Internet). [updated 2013 Jan 13; cited 2017 Apr 6]. Kansas: Guidelines for Detecting IV Contamnisation ‘of Blood Samples. Available from: http/ewwclinlabnavigator ‘convguidelinesfor-detecuing-iv-contamination-of-blood-saumples html iv 9. Ramsey G, Smietana SJ. Long-term follow-up testing of red cell, in what ratio for a massive transtugign2 Leen ile2 10. a. Jk(a-) red blood cells, computer crossmatch b. © Jk(a-) red blood cells, immediate spin crossmatch 4. ABO-compatible because the antibody screen is negative Which is not true of rouleaux formation? a. Mimics agglutination b. Appears like a “stacking of coins” e 4. Can be dispersed by saline A patient’ blood type is AB-negative, but there are no AB-negative red blood cell units available. What donor units could be selected? Acnegative b. O-positive © Bepositive d. All of the above A patient requires 15 units of thawed plasma for an apheresis procedure. The patient's blood type is O-negative. What donor units could be selected? O-negative b. AB-positive c Acsmegative d. Allof the above The Ay lege of Surgeons recommends trans- fusion of red blood cells, thawed plasma, and platelets in what ratio for a massive transfusion? ery unit of platelets + aminbadbiedaninamiinlahemeiame © Tunit Tonle i red blood cells to 3 units of thawed plasma d. It’s an emergency. Give the surgeon whatever she wants, A patient’ antibody screen was positive and an anti-e was identified. Antiglobulin crossmatches were per- formed with c-negative units and 1 of the 6 units was incompatible. What should be performed to resolve the incompatible crossmatch? Give O-negative red blood cells b. Retype the incompatible unit for the ¢ antigen © Perform a DAT on the incompatible unit 4. Perform additional identification testing to include low-specificity antigens e. byeandd explanation? a. The patient is weak D-positive b. Autoantibody is present © Patient possesses the partial D phenotype 4. The patient has a positive DAT References 10, nL. 12. B 285 21 US.C. 8 321, US. Code. Title 21. Food and Drugs. Fung M, Eder AF Spitalnik SL, Westhoil CM eds. Technical manual. 19th ed, Bethesda (MD): ABB; 2017. Coley PW. Standards for blood banks and uansfusion services 31st ed. Bethesda (MD): ABB; 2018, Poles Debbi, Paula Bolton-Maggs. Annual SHOT Report 2016 [Internet]. Manchester (UK): Royal College of Pathologists; 2017, Available from: wwwshotku.org, United States Food and Drug Administration, Fatalities reported to FDA following blood collection and transfusion annual summary for FY2015 [Internet]. Washington (DQ): U.S. Food and Drug Administration, 2016, Available from: hitps:/Arww {da govidownloadyBiologicsBloodVaccines/SaletyAvailability/ ReportaProblenyTransfusionDonationF atalitieyUCMS518148 pd, . Linden JV, Wagner K, Voytovich AE, Sheehan J. Transfusion error in New York State: an analysis of 10 years’ experience Transfusion. 2000,40:1207-13. The Joint Commission. 2017 National patient safety goals, Oakbrook (IL); The Joint Commission; 2017. Available from hups/Avwwjointeommission org/hap_2017_npsgst GlinkabNavigatorcom [Internet] [updated 2013 Jan 13; cited 2017 Apr6l. Kansas: Guidelines for Detecting TV Contamination of Blood Samples. Available from: http//vwwelinlabnavigator ccomvguidelines-for detecting. v-contamination-of-blood-samples, him Ramsey G, Smictana SJ. Long-term follow-up testing of red cell alloantibodies. Transfusion 1994:34:122.4 Dean L, Chapter 5, The ABO blood group. In: Blood groups and red cell antigens [Internet]. Bethesda (MD): National Cen- ter for Biotechnology Information (US); 2005. Available from hups//www.nebi.nlm.nih.gov/books/NBK2267/. Code of Federal Regulations (CFR), Title 21, Food and Drugs, Part 660, § 33, revised April 1, 2016. ‘Campbell-Lee SA, Kittles RA. Red blood cell alloimmunization in sickle cell disease: listen to your ancestors. Transfus Med Hemotherapy. 2014:41:431-35, Makroo RN, Arora B, Bhatia A, Chowdhry M, Luka RN. Clini- cal significance of antibody specificities to M, N and Lewis blood group system. Asian J Transfus Sei, 2014:8(2):96-9, doi 10.4103/0973-6247.137442, Kormoezi GE Mayr WR. responder individuality in red blood cell alloimmunization. Transfus Med Hemother. 2014;41 44651 Skeate R, Goldman M. Phenotype matching for sickle cel patient: a review and recommendation fo transfusion practice. Canadian. Blood Services [Internet]. 201+, Available from: hutps//professional education, blood.ca/en/transfusion/publications/phenotype- matching-sickle-cell-patients-review-anderecommendations280 PARTI Blood Groups and Serologic Testing Review Ques‘ « The endpoint of the CAT test is detected by: a. Agglutination. b. Hemolysis. c. Precipitation. d. Attachment of indicator cells. The endpoint of the SPRCA test is detected by: a. Agglutination. b. Hemolysis. c. Precipitation. d. Attachment of indicator cells. . The endpoint of the solid-phase protein A assay is: a. Agglutination. b. Hemolysis. c. Precipitation. d. v w * Protein A captures antibodies by binding to the: a. Fab portion of immunoglobulin. b. c. Surface of test cells. d. Surface of indicator cells. Mixed-field reactions can be observed in: a. Gel. b. SPRCA. c. Protein A technology. d. None of the automated technologies. 6. An advantage for both CAT and solid-phase technology is: a. No cell washing steps. b. Standardization. c. Use of IgG-coated control cells. d, Specialized equipment. N A disadvantage for both CAT and solid-phase technol- ogy is: a. Decreased sensitivity. b. Inability to test hemolyzed, lipemic, or icteric samples. c d. Large sample requirement A safety feature in the SPRCA test is: a. Air bubble barrier. b. Viscous barrier. e d. Use of IgG-coated control cells.1. Which of the following information is not required for whole blood donation? a. Name b. Address: c d. Sex €. Date of Birth 323 2. Which of the following would be cause for deferral for a male donor? a. Temperature of 99.2°F bdleemataee an To Spent 2 weeks in the United Kingdom in 1998 4. Weighs 80 kg e. Received a blood transfusion 2 years ago 3. Which of the following would be cause for a permanent deferral? b. Received hepatitis B immune globulin «Is currently on warfarin 4. Diagnosis of habesiosis @. Traveled to Senegal 2 years ago 4. Immunization for rubella would result in a temporary deferral for: b. 8 weeks. ©. 6 months dL year, e. 3years 5. Which of the following donors is acceptable? a, Donor who had a first-trimester abortion 4 weeks ago b en a emo whe ee © Donor who was treated for gonorrhea 6 months ago 4. Donor who had a needte-stick injury 10 months ago 6. Which of the following tests is not required as part of the donor-processing procedure forallogencic donation? a. ABO b. Rh © STS dd. Ant-HTLV4 e 7. How long must a 2-unit RBC donor wait before donating red blood cells again? a. 8 weeks b. © 6 months d. 12 months 8. What is the deferral period for Plavix? a b. L month after last dose © 12 months after last dose d. 48 hours afier last dose iii Chapter 13 DonorSelection 305 11. Which of the following donors would be rejected for whole blood donation? a. A male who had sex with another male in 1988 b. A female who had sex with a male in 1992 4. A female who had sex with a male 9 months ago 12. What does “infrequent” refer to when talking about a plasmapheresis program? ATEN b. Donating once a year © Donating once every 6 months 4. Donating no more frequently than once every 8 weeks 13. A patient is having an exploratory laparotomy performed and donated blood for use in the patient’: upcoming surgery. Three units were collected, with the last unit collected 2 days before surgery. Given this information, ‘can the patient undergo surgery as planned? a. Yes 14, Which of the following refers to a temporary deferral? > Banari ea RS b. Donor had a confirmed positive test for HBsAg © Donor has a history of CID 4. Donor was diagnosed with babesiosis, 15. Which of the following carries a 12-month deferral? a eget ete gare ar) b. Donor received pituitary growth hormone from another human & Donor received the MMR vaccine 4. Donor spent 10 years in Africa References 1, Food and Drug Administration. Guidance for industry: Revised recommendations for reducing the risk of human immurodeli- ciency. virus transmission by blood and blood products, Rockville (MD): US Health and Human Services CBER; 2015, 2. AABB, Standards for blood banks and transfusion services, 31th ed. Bethesda (MD): AABB; 2018. istration, Guidance for industry: Recom1 Traveled to Senegal 2 years ago Immunization for rubella would result in a temporary deferral for: a b. 8 weeks, © 6 months, . 1 year, e. 3 years Which of the following donors is acceptable? , Donor who hada first-trimester abortion 4 weeks ago b © Donor who was treated for gonorrhea 6 months ago d. Donor who had a needle-stick injury 10 months ago 3. Which of the following tests is not required as part of the donor-processing procedure for allogeneic donation? a, ABO b. Rh ¢ STs 4. Anti-HTLY-1 e How long must a 2-unit RBC donor wait before donating red blood cells again? a. 8 weeks b. © 6 months. d. 12 months What is the deferral period for Plavix? a b. L month after last dose ¢ 12 months after last dose d. 48 hours after last dose All of the following records must be kept for 10 years, except: 4 Unique ID of each unit, b. Donor consent. « CRRA RoE. d. A signed statement from requesting physician for emergency release. ‘What is the causative agent of(Chagas disease? 2. Typaneoma gat b. Yersinia pestis © Treponema pallidum , Plasmodium falciparum 12. What does “infrequent” refer to when talking about a plasmapheresis program? a b. Donating once a year Donating once every 6 months 4. Donating no more frequently than once every 8 weeks 15. A patient is having an exploratory laparotomy performed and donated blood for use in the patient's upcoming surgery. Three units were collected, with the last unit collected 2 days before surgery. Given this information, ‘can the patient undergo surgery as planned? a. Yes D> Which of the following refers to a temporary deferral? 2. Ganga ere ES b. Donor had a confirmed positive test for HBsAg, . Donor has a history of CJD 4. Donor was diagnosed with babesiosis Which of the following carries 2 12-month deferral? 2 ALLA AAT b. Donor received pituitary growth hormone from another human. Donor received the MMR vaccine . Donor spent 10 years in Africa References 1. Food and Drug Administration. Guidance for industry. Revised recommendations for reducing the risk of human imimunodel- ciency virus transmission by blood and blood products, Rockville (MD): US Health and Human Services CBER; 2015. ABB. Standards for blood banks and transfusion services, 31th ed. Bethesda (MD): ABB; 2018, 3. Food and Drug Administration, Guidance for industry. Recom- ‘mendations for deferral of donors and quarantine and retrieval of blood and blood products in recent recipients of smallpox ‘vaccine (vaccinia virus) and certain contacts of smallpox vaccine recipients. Rockville (MD): US Health and Human Services BER; 2002. 4. AABB. AABB on quarantine release errors [Internet]. White paper. Bethesda (MD): AABB; 2013. Available from: hitp:// ‘wwwaabb org/research/whitepapersdocuments/quarantine- lease-errors-white-paper pdl#searclqre Advisory Commitce on Blood and Tissue Safety and Availability Results from the Uniform Donor History Questionnaire [Internet). Washington (DC): Olfice of the HIVAIDS an Infe tious Disease Policy; 2013, hup:/wwyihhs.gov/bloodsalety? advisoryeommittee/achisa_201312meeting_agenda hl 6. Custer B, Kessler D, Vahidnia F Lepare G, Rrysciof DE, Shaz B, etal. NHLBI Retrovirus Epidemiology Donor study 11 (REDS 1,328 PARTI 1. The fecal-oral route is common in transmitting which of these hepatitis viruses? Transfusion Practices b. HBV and HCV < EDV 4. HGV 2. Which of the following is the component of choice for a Jow-birth-weight infant with a hemoglobin of 8 g/dL. if tome soaee 'V negative? ‘Whole blood from a donor with ant b © Leukoreduced platelets d, Solvent detergent-treated plasma 3. Which of the following is an FDA-licensed screening test for icv? a. NAT + anti-HBe b. RIBA €. Lymph node biopsy 4 4, Currently, which of the following does the ABB con- sider to be the most significant infectious threat from transfusion? b. CMY Hepatitis nv 5. Which of the following is the most frequently transmitted. virus from mother to fetus? a HIV b. Hepatitis ——- 4. EBV 6. Jaundice due to HAV is seen most often in the: Adolescent b —_ younger than 6 years old d. Newborn 7. Currently, steps taken to reduce transfusion-transmitted CMV include 2, Plaque reduction neutralization test NAT testing 4. Minipool screening 8 HBY remains infectious on environmental surfaces for 1 a. Day b. © Month, d. Year 9. HBV is transmitted most frequently: By nee sharia ting 1 dro b. Through blood transfusions By unkoown methods 4 Cealacien HO Whickof the Iulloning Wise wake careaabe,couse-af chronle hepatitis, cirrhosis, and hepatocellular cael- ‘Thoma in the United States? 7 a Hav ‘b. HBV 4 EDV 11. ThEfirstyetrovirus to be associated with human dis- a Hcy b. HIV d Wey 12. All of the following statements are true concerning, WRV except a. 1 in 150 infections results in severe neurological disease b. Severe disease occurs most frequently in the over- 50 age group Deaths occur more often in those over 65 years who present with encephalitis ag eR 15. The primary host for WNV is: b. Horses < Humans d. Bats 14, Tests for WNV include all of the following except a. ELISA b. NAT Plaque reduction neutralization test a 15. Individuals exposed to EBV maintain an asymptomatic latent infection in: € All lymphocytes d. Monocytes 16. Filth disease is caused by: a CMV b. EBV HTLV.17. Transient aplastic crisis can occur with 18. 20. 2 22. 23. 24, b. WNV < CMY d. EBV . Reasons why syphilis is so rare in the U.S. blood supply include all of the following except: a. 4°C storage conditions b. Donor questionnaire € Short spirochetemia d. ‘Nucleic acid amplification testing for HIV was instituted in donor testing protocols to: a. Identify donors with late-stage HIV who lack antibodies b. Confirm the presence of anti-HIV in asymptomatic HIV-infected donors d. Detect antibodies to specific HIV viral proteins, including anti-p24, anti-gp41, and anti-gp120 Screening for HIV is performed using the following technique: a. Radio immunoassay b. WB Immunofluorescent antibody assay 2 The first form of pathogen inactivation was: ‘a. Chemical © Cold-ethanol fractionation d. Anion-exchange chromatography What is the most common parasitic complication of transfusion? a. Babesia microti b. Trypanosoma cruzi < Cae 4d. Toxoplasma gondii Which organism has a characteristic C- or U-shape on stained blood smears? b. Plasmodium vivax Plasmodium falciparum d. Babesia microti Which transfusion associated parasite may have asymp- tomatic carriers? ‘a Babesia microti b. Trypanosoma cruzi Plasmodium species Chapter 14. Transfusion‘Tansmitted Diseases 329 25. Which disease is naturally caused by the pite of a deer tick? 2. Chagas disease ©. Malaria d. Leishmaniasis References L 1. 2 B 4 5 16, American Association of Blood Banks. Standards for blood banks and transfusion services, 31st ed, Bethesda (MD): AABB; 2018, Fung MK, Eder AF, Spitalnik SL, Westhoff CM (eds). Technical manual, 19th ed. Bethesda (MD); American Association of ‘Blood Banks; 2017. Cuthbert JA. Hepatitis 4: old and new. Clin Microbiol Rev 2001:14(1):38-58. Centers for Disease Control and Prevention [Internet]: Atlanta (GA): The CDC [cited 2017 Jul 13]. Surveillance for viral itis United States, 2014. Available from: wwakede gov/ tisfstatistic/201 4survaillance/index him. Centers for Disease Control and Prevention [Internet]: Atlanta (GA): The CDC [cited 2017 May 15]. Hepatitis A~ questions and answers for health professionals, Available from: www «cde gov/hepatitisfhav/havlag hinvgeneral. Freidl G5, Sonder GI, Bovee LR, Friesema IH, van Rlickevorsel RL, Ruijs WL. eta Hepatitis A outbreak among men who have sex ‘with men (MSM) predominantly linked with the EuroPride in the Netherlands. July 2016 to February 2017. Euro Surveil 2017:22(8):30408. Centers for Disease Control and Prevention (Internet|: Atlanta (GA): The CDC [cited 2017 May 11]. Sutisties and surveillance Available from: www cde gov/epattis/statstcsindexhtm, Bishop ML, Fody EP. Schoelf LE. Clinical chemistry tech- ‘niques, principles and correlations, 6th ed. Baltimore (MD) Lippincott Williams & Wilkins; 2010. Miller LE. Serology of viral infections. In: Stevens CD, editor. Clinical immunology and serology: a laboratory perspective 2nd ed. Philadelphia: FA Davis Company; 2003. p. 324 Food and Drug Administeation [Internet]: Rockville (MD): FDA [eited 2017 May 13]. Guidance for industry: use of ‘clei acid tess on pooled and indivicual samples from donors ‘of whole blood and blood components, including source plasma, to reduce the isk of transmission of hepatitis 8 virus Available rom: wwewtla gov/BiologiesBlood VaccinestGuidance ComplianceRegulatoryiniormation/Guidances/Blood/cm32750 ‘hum. Lox ASE MeMahon BE AASLD practice guidelines: chronic hepatitis B. Hepatology. 2001;34:1225, Marcellin, Chang T, Lim SG, Tong Mj, Sieverc W, Shiffiman ML, eval. Adelovir dipivonil for teatment of hepatitis B antigen: positive chronic hepatitis B. N Engl J Med. 2003;348:808. Gerlach JT, Diepolder HM, Zachoval R, Gruener NH, Jurg MC, Ulsenheimer A, etal. Acute hepatitis C: high rate of both spon- taneous and treatment-induced viral clearance. Gastroenterol ‘ogy 2003;12580-8 Ankeorn Mj, Tedder RS. Hepatitis F the current state of play. ‘Transfus Med. 2017:2702)'84-95. Centers for Disease Control and Prevention [Incernet|: Atlanta (GA): The CDC [eited 2010 Aug 9] Viral hepattis-Hepatitis E Virus, Available from: www.ede.gow/hepatitis/HEV?HEVEag hhumésection! Alter Ii), Nakatsuji Y, MelpolerJ, Wages J, Westey R, Shih JW, etal. The incidence of transfusion associated hepatitis G virus2. Each unit of cryoprecipitate prepared from whole blood bac should contain a minimum of how many units of AHF 1. Which of the following lists the correct shelf life for the ica a. 401U component? ‘ompone: : ie 801 —— — Se . Platelet concentrate—10 days a Ba 4. FFP—5 years e e. RBCs (CPDA-1)—21 days, 371 Chapter 15. Component Preparation 353 3. Platelet concentrates prepared by apheresis should con- 10. RBCs that have been leukoreduced must contain less tain how many platelets? than Jeukocytes and retain at least of a. 535x100 original RBCs, b. 6x 1010 8 8x 109/85% « b. 8x 109/00% 4.5510" RAED fe 6x10! 45x 4. The required storage temperature for frozen RBCs using 11. Random-donor platelets that have been leukoreduced the high-glycerol method is: must contain less than leukocytes. a #C b. <-20°C ae <18°C 5x10 4. 120°C 4. 3x10" Sd 12. Asingle unit of FFP or PF24 should contain. mL 5. How does irradiation affect the shelf life of ved blood of plasma cells? a. 100-150 2, Irradiation has no effect on the shelf life b. GARE © “ecco dr 28 dys am he eet ae 4 ation or the original outdate, whichever is later 4. 50-150 = 3 15. Cryoprecipitate that has been pgoled in an open system 4. The expiration date is 25 days from the date of irtad arg Dei fephpas ts __—_—_ Ai ation or the original outdate, whichever is later eis . The expiration date is 25 days from the date of irradi- b 6 ation or the original outdate, whichever is sooner = 6. Once thawed, FEP must be transfused within hours unless felabeled as thawed plasma References a4 1, AABB (Intermed). Bethesda (MD): AABB, <2017 [cited 2017 b.6 May 6]. Highlights of transfusion medicine history. Available cB from: hup:/wuwaabb.org/tm/Pages/highlights aspx 412 2 Spinella PC, Perkins JG, Grathwohl, KW, Beekley AC, Holcomb |B. Warm fresh whole blood is independently asso- edt ‘lated with improve survival for patents wit combat fated traumatic injuries. J Trauma, 2009; 66(4 Suppl):S69-6 3, Spinella PC, Perkins JG, Grathwohl KW, Repine T, Beckley AC, Sebesta DJ, eal. Fresh whole blood wanslusions in coalition % Quality control for nonadditive RBCs requires a maxi- mum hematocrit level of: a. 75% military, foreign national, and enemy combatant patients, b. during Operation Iraqi Freedom at a U, S. Combat Support - Hoga rid) Sr 20083229 4.90% 4, Perkins JG, Cap AB. Spinella PC, Shorr AF, Beekley AC, Grathwohl KW, etal Comparison of platelet wansfsion sy fresh ©. 95% ‘whole blood versus apheresis platelets for massively transfused Combat trum patiems,Transtusion. 2011-41(2)242.52, 8. AHF concentrates are wsed to treat: 5. Seheult J, Trulzi DJ, Alarcon LH, Sperry JL, Murdock 4, Yazer 2. Thrombocytopenia MH. ABO Antibody-mediated hemolysis is not detectable fol lowing cold stored uncrossmaiched whole blood transfusion in civilian trauma patients, Transfusion. 2016; 16A. 6, ABB, ARC, ASBR, and ABC, Ciucular of information forthe 4. von Willebrand's disease tuse of human blood and blood components, Bethesda (MD): e. Factor XIII deficiency sealsacdey se d. 55x10" e. 6x 10! 4, The required storage temperature for frozen RBCs using the high-glycerol method is: a 4c b. <20% © 18°C 20°C eee) 5. How does irradiation affect the shelf life of red blood cells? a. Irradiation has no effect on the shelf life . The expiration date és 28 days from the date of irradi ation or the original outdate, whichever is later d. The expiration date is 25 days from the date of irra ation or the original outdate, whichever is later . The expiration date is 25 days from the date of irra ation or the original outdate, whichever is sooner 6. Once thawed, FFP must be transfused within hours unless relabeled as thawed plasma: a4 6 8 12 7. Quality control for nonadditive RBCs requires a maxi- mum hematocrit level of: a. 75% ad e d. 90% e. 95% 8 AHF concentrates are used to treat ‘a. Thrombocytopenia b © Hemophilia B d. von Willebrand's disease . Factor XIll deficiency Prothrombin complex concentrates are used to treat which of the following? a. b. Factor VIII deficiency Factor XII deficiency d. Factor XIII deficiency . Factor V deficiency b. 8x 10700% a a sy 11. Random-donor platelets that have been leukoreduced ‘must contain less than leukocytes. —— 3x10 4. 3x10" 12. A single unit of FEP or PF2¢ should contain. of plasma. 2. 100-150 a 4. 50-150 13. Cryoprecipitate that has been pooled in an open system ‘must be transfused within Tours. a4 b6 1. ABB [Internet]. Bethesda (MD): AABB; €2017 |eited 2017 May 6], Highlights of transfusion medicine history Available from: hups/twwwaabb onytn/Pages/highlights aspx 2 Spinella PC, Perkins JG, Grathwobl, KW, Beckley AC, Holcomb JB. Warm fresh whole blood is independently 2ss0- ciated with improved survival for patents with combat-related ‘waurnatie injuries. J Trauma. 2009: 66(4 Supp) 569-6 3. Spinella PC, Perkins JG, Grathwobl KW, Repine T, Beckley AC, Sebesta DJ etal. Fresh whole blood transfusions in coalition rultary, foreign national, and enemy combatant patients during Operation Iraqi Freedom at a U. S. Combat Suppor. Hospital World ) Surg. 2008.32: 4. Perkins JG, Cap AP. Spinella PC, Shorr AF Beekley AC, Grathwvobl KW. etl. Comparison of platelet transfusion as fresh whole blood versus apheresis platelets for massively transfused Combat trauma patents. Transhision,2011;41(2):242-52 5. Scheult J, Tulzi DJ, Alarcon LH, Sperry JL, Murdock A, Yazer MIL. ABO Anubody-mediated hemolysis is not detectable fol lowing cold-stored unerossmatched whole blood transfusion in civilian trauma patients. Transfusion. 2016; 104. 6. AABB, ARC, ASBP.and ARC. Circular of information for the use of human blood and blood components. Bethesda (MD) [AABB Press: 2017, 7. AABB. Standatds for blood banks and transfusion services Sst ed. Bethesda (MD): ABD Press; 2018. 8. Whitaker BI, Hinkins 5. The 2011 national blood collection and wilization survey eport. Rockville (MD): US Department of Health and Human Services 9. Code of Federal Regulations. Eighty of donors, 21. CER Seet 640.21 Q010). 10, Murphy 5. Platelets from pooled bully coats an update, Trans- fusion, 2005, 634.9.w Questions 1. Leukocyte-reduced filters can do all of the following except a Reduce the risk of CMV infection b. Prevent or reduce the risk of HLA alloimmunization Prevent febrile, nonhemolytic transfusion reactions 4. 2. Albumin should not be given for: a. Bums b. Shock . Plasmapheresis 3. Of the following, which blood type is selected when a patient cannot wait for ABO-matched RBCs? aa b.B ae 4, Which patient does not need an irradiated component? a. Bone marrow transplant recipient b. Neonate weighing less than 1,200 4 —— receiving an RBC transfusion from a blood relative 390 372 PARTI Transfusion Practices 5. RBC transfusions should be given: a ‘SED b. With lactated Ringer solution © With dextrose and water d. With cryoprecipitate 6 Which type of transplantation requires all cellular blood. components to be irradiated? : a b. Heart Liver . Kidney Characteristics of deglycerolized RBCs include the following except: 1 b. 24-hour expiration date afier thawing Used for rare antigen-type donor blood 4. Used for IgA-deficient reeipient with history of severe reaction 8. Select the appropriate product for a bone marrow trans plant patient with anemia a. RBCs a Leukoreduced RBCs d. Washed RBCS 9 Which blood product should be selected for vitamin K, deliciency? a. Cryoprecipitate b. Factor VIIL © Factor IX em 10. Which fluid should be used to dilute RBCs? aegapaleam b. 5% dextrose and water © Immune globulin d. Lactated Ringer solution lineal practice guidelines: Soc Conservation Guideline Task Foi 91).944-82. 4. Weiskopf R, Feiner J, Hopf H, Viele M, Watson J, Kramer J, et al. Oxygen reverses deficits of cognitive function and mem= ory and increased heat rate inducec! by acute severe isovolemic anemia. Anesthesiology. 2002,96(4):871. 5. AABB. Standards for blood banks and transfusion se 31st ed. Bethesda, (MD): AABB; 2018, 6. Friday J, editor. A'compenlium of transfusion practice guide- lines. 3td ed. Washington (DC): American National Red Cross; 2017. 7. Kaufman R, Djulbeyovic B, Gernsheimer T, Kleinman S, Tinmouth A, Capocelli K etal. Platelet transfusion: a clinical practice guideline from the AABB. Ann Intern Med. 2015; 162(3):205-13. 8. Roback JD, Caldwell S, Carson J, Davenport R, Drew M, Eder A, et al. Evidence-based practice guidelines for plasma transfu- sion. Transfusion, 2010;50:1227-38 9, Nascimento B, Goodnough L, Levy J. Cryoprecipltate therapy. Br J Anaesth, 2014,113(6):922-34, 10, Mannnueci P Hemophilia: treatment options in the twenty-first century. J Thromb Haemost. 2003;1(7):1349-93 11, Knezevic-Maramica 1, Kruskall’ M, Intravenous immune globulins: an update for clinicians. Transfusion, 2003:43(10) 1490-80. 12. Roberts H. Recombinant factor Vila (Novoseven) and the safety of treatment, Semin Hematol. 2001;384 Suppl 12):48-50. 13, Mayer S, Brun N, Begtrup K, Broderick J, Davis S, Diringer M, et al. Efficacy and safety of recombinant activated factor VIL for acute intracerebral hemorthage. N Engl J Med. 2008; 358(20):2127-37. 14. Sharma R, Marwaha N. Leukoreduced blood components: advantages and strategies for its implementation in developing countries. Asian } Translus Sci, 2010, 4(1):3-8, 15. Laupacis A, Brown J, Costello B, Delage G, Freedman J, Hume H, et al, Prevention of postiransfusion CMV in the era of Universal WBC reduction: a consensus statement. Transfusion, 2001:41(4):360-9. 16. Cid J, Prevention of transfusion-associated graft-versus-host disease with pathogen-reduced platelets with amotosalen and ultraviolet light: a review: Vox Sang. 2017:18. doi: 10.111/ vox.12558. PMID: 28833219. [Epub ahead of print] 17. Food and Drug Administration, CBER [Internet]. Rockville (MD): FDA [cited 2016 November 2]. Fatalitics reported to FDA following blood collection and ansfusion annuals { Thoracie Surgeons Blood ‘Ann Thorac Surg. 2011; ieemtsictcete 2h) (ron: hip //www ida gov/liologics414 PARTI 1. The most common anticoagulant used for apheresis procedures is: a. Heparin b. Sodium fluoride Warfarin eum 2. Therapeutic eytapheresis has a primary role in treatment of patients with: Transfusion Practices b, Systemic lupus erythematosus to remove immune complexes Leukemia to help increase granulocyte production d. Myasthenia gravis to increase antibody production 3. The minimum interval allowed between plateletpheresis component collection procedures is: a. Iday b. © 7 days d. 8 weeks A. In plasma exchange, the therapeutic effectiveness is: 2. Grease USEC SANTEE b. Alfected by the type of replacement fluid used ¢. Enhanced if the unwanted antibody is 1gG rather than IgM d. Independent of the use of concomitant immunosup- pressive therapy 5. The replacement fluid indicated during plasma exchange for TTP is: a, Normal (0.9%) saline b. Hydroxyethyl starch (HES) « 4. Albumin (human) 5% 6. The most common adverse effect of plateletpheresis col- lection is: a, Allergic reaction b. Hepatitis ¢. Hemolysis: {Cae 7. Apheresis technology can be used to collect each of the following components except: 2. Leukocytes ‘ ——. progenitor cells d. Platelets 8. The anticoagulant added to blood as it is removed from a donor or patient during an apheresis procedure acts by 2. ius b. Increasing intracellular potassium, ¢. Binding to antithrombin IIL d, Inactivating factor V 9. Peripheral blood stem cells are: a, Responsible for phagocytosis of bacteria b. Removed during erythrocytapheresis « 4. Lymphocytes involved with the immune response 10. Which of the following can be given to an apheresis donor to increase the number of circulating granulocytes? a. DDAVP b. Hydroxyethyl starch (HES) cc Immune globulin 1am References 1. MeLeod BC. Therapeutic apheresis: history, clinical applica- tion, and lingering uncertainties. Transfusion. 2009;50(7) 1413.25. 2. Hester J. Apheresis: the first 30 years. ‘Transfus Apher Sei 2001,24:155-6. 3. Malchesky PS, Koo AP, Skibinski Cl, Hadsell AT, Rybicki LA Apheresis technologies and clinical applications: the 2007 international apheresis registry. Ther Apher Dial. 2009. 14(0):92-73. +. Chen ¥, Bieghmayer C, Hocker P, Deuike M. Effect of acute cit- rate load on markers of bone metabolism in healthy volunteers, ‘Vox Sang, 2009,97:324-9, Bell AM, Nolen JD, Knudson CM, Raife TJ. Severe citrate toxicity complicating volunteer apherests platelet donation J Clin Apher. 2007:22:15-6. 6. Tomita 1, Takayanagi M, Kiwada K, Mieda A, Takahashi C Hata T. Vasovagal reactions in apheresis donors, Transfusion 2002:42(12):1561-66, 7. Reiss RF, Harkin R, Lessig M, Mascari J. Rates of vaso-vagal reactions among first time teenaged whole blood, double red cell, and platelet pheresis donors, Ann Clin Lab Sei 2009;39(2):138-43, 8. Price TH. Centrifugal equipment for the performance of therapeutic hemapheresis procedures. In; MacPherson JL, Kaspirisin DO, editors. Therapeutic hemapheresis, vol 1. Boca Raton (FL): CRC Press; 1985. p. 123. 9. Ooley PW, editor. Standards for blood banks and transfusion services. 29th ed. Bethesda (MD): American Association of Blood Banks; 2015, 10. Rock G, Tittley F; MeCombie N. Plasma collection using an automated membrane device. Transfusion, 1986;26:269-71, 11. Burgstaler EA. Blood component collection by apheresis. J Clin Apher. 2006:21:142-51. 12. Code of Federal Regulations. Tile 21 Pants CFE 606, 610, ‘Washington (DO): U.S. Government Printing Office; 2006, 13, Balint B. Apheresis in donor and therapeutic settings: Recruit- ments ys. possibilities—a multicenter study. Transfus Apher Sci. 2005:33:181-9. 14, Eder AF Benjamin RF Safety and risks of automated collection of blood components, In: Eder AF Goldman M, editors, Blood donor health and safety. Bethesda (MD): AABB Press, 2009. pp. 103-21 15, Rossmann SN, Talking with the donor: information, consent, and counseling, In: Eder AF Goldman M, editors, Blood donor health and safety. Bethesda (MD): AABB Press. 2009. pp 1-20, 16. Food and Drug Administration. Guidance for industry and FDA review staff, Technical correction: recommendations for collecting red blood cells by automated apheresis methods. Rockville (MD): FDA; 2001 Feb 13.