1.
The correct temperature for shipping RBCs is
Correct Answer
B. 1 to 10C
Explanation
The correct temperature for shipping RBCs is 1 to 10C. This range ensures that the red blood cells remain at a temperature that is neither too cold nor too warm, which could potentially damage the cells. Keeping the RBCs within this temperature range helps to maintain their integrity and viability during transportation, ensuring that they can be safely used for medical purposes upon arrival at their destination.
2.
RBC storage times vary with the anticoagulant/preservative used. Which of the following is properly paired?
Correct Answer
E. Citrate-pHospHate-dextrose-dextrose (CP2D): 21 days
Explanation
RBC storage times vary with the anticoagulant/preservative used. The correct answer is Citrate-phosphate-dextrose-dextrose (CP2D): 21 days. This means that when RBCs are stored with CP2D as the anticoagulant/preservative, they can be stored for a maximum of 21 days.
3.
Which of the following represents a change seen in a unit of RBCs stored with CPDA-1 at the end of its shelf life?
Correct Answer
A. Percentage of viable cells at 24 hours after transfusion decreases to 71%
Explanation
The correct answer is "Percentage of viable cells at 24 hours after transfusion decreases to 71%." This change is seen at the end of the shelf life of RBCs stored with CPDA-1. It suggests that the viability of the RBCs decreases over time, leading to a lower percentage of viable cells remaining after transfusion.
4.
A unit of RBCs is issued to the floor and returned without being transfused. How long can blood be out of the refrigerator and still be used for transfusion?
Correct Answer
B. 30 minutes
Explanation
Blood can be out of the refrigerator and still be used for transfusion for up to 30 minutes. After this time, the blood may start to deteriorate and lose its effectiveness. It is important to ensure that blood is properly stored and handled to maintain its quality and safety for transfusion.
5.
The maximal shelf life of irradiated RBCs is :
Correct Answer
E. 28 days
Explanation
The correct answer is 28 days because irradiation is a process that helps to prevent the proliferation of harmful pathogens in blood products. It extends the shelf life of red blood cells (RBCs) by reducing the risk of transfusion-associated graft-versus-host disease (TA-GVHD). TA-GVHD is a rare but serious complication that can occur when transfused lymphocytes attack the recipient's tissues. By irradiating RBCs, this risk is minimized, allowing the RBCs to be stored for a longer period of time, up to 28 days, before they expire.
6.
The preferred method for generating leukocyte- reduced RBC components is:
Correct Answer
B. Filtering using a leukocyte-reduction filter
Explanation
Filtering using a leukocyte-reduction filter is the preferred method for generating leukocyte-reduced RBC components. This method involves passing the blood product through a specialized filter that removes leukocytes (white blood cells) from the RBCs. Leukocyte reduction is important to minimize the risk of transfusion-related complications, such as febrile reactions, alloimmunization, and transmission of certain infectious diseases. Thawing and deglycerolizing a frozen unit, irradiation, centrifugation, and washing are not specifically designed for leukocyte reduction and may not effectively remove leukocytes from the RBC components.
7.
The most common concentration of glycerol used in the U.S. for freezing RBCs is:
Correct Answer
D. 40%
Explanation
The most common concentration of glycerol used in the U.S. for freezing RBCs is 40%. Glycerol is added to RBCs before freezing to protect them from damage caused by ice crystal formation. A concentration of 40% is commonly used because it provides optimal cryoprotection for the RBCs, allowing them to be stored at low temperatures without significant loss of viability. Higher concentrations of glycerol can be toxic to the cells, while lower concentrations may not provide sufficient protection. Therefore, 40% is the most commonly used concentration for freezing RBCs in the U.S.
8.
The rationale for deglycerolizing frozen RBCs with extensive washing is:
Correct Answer
C. Glycerol can cause hemolysis
Explanation
The rationale for deglycerolizing frozen RBCs with extensive washing is that glycerol can cause hemolysis. This means that glycerol can cause the rupture or destruction of red blood cells, leading to the release of hemoglobin into the surrounding fluid. Therefore, it is necessary to remove the glycerol from the frozen RBCs through washing to prevent any potential hemolysis and ensure the safety and effectiveness of the transfusion.
9.
Which of the following choices explains why a unit of blood may form an insoluble jelly-like mass during deglycerolization?
Correct Answer
E. Red cells from a donor with sickle cell trait
Explanation
Red cells from a donor with sickle cell trait can cause a unit of blood to form an insoluble jelly-like mass during deglycerolization. Sickle cell trait is a genetic condition where the red blood cells have an abnormal shape, resembling a sickle. These abnormal red blood cells can clump together and form aggregates, leading to the formation of a jelly-like mass. This can occur when the blood is subjected to deglycerolization, a process used to remove glycerol from frozen blood units before transfusion.
10.
Two S-s-U- units are deglycerolized in preparation for possible transfusion. The patient, however, is stabilized and transfusion is no longer required. The medical director should:
Correct Answer
C. Document the value of the antigen-negative units and refreeze for up to another 10 years
Explanation
The correct answer is to document the value of the antigen-negative units and refreeze them for up to another 10 years. This is because the patient no longer requires transfusion, but the units are rare and valuable. By documenting their value, the medical director ensures that they can be made available for another patient in the future if needed. Refreezing them for up to another 10 years allows for their preservation and potential use in the future.
11.
According to the AABB standards, the maximum allowable shelf-life of platelets without gentle agitation is:
Correct Answer
D. 24 hours
Explanation
According to the AABB standards, platelets can be stored without gentle agitation for a maximum of 24 hours. This means that after 24 hours, the platelets need to be gently agitated to prevent clumping and maintain their viability. After this time, the platelets may start to lose their effectiveness and may not be suitable for transfusion.
12.
According to AABB standards, 90% of the units of random-donor platelets prepared from whole blood should contain a minimum of _______ platelets per unit.
Correct Answer
B. 5.5 x 10 ^ 10
Explanation
According to AABB standards, 90% of the units of random-donor platelets prepared from whole blood should contain a minimum of 5.5 x 10 ^ 10 platelets per unit.
13.
The minimum acceptable pH of platelet units at the end of the storage period is:
Correct Answer
C. 6.2
Explanation
The minimum acceptable pH of platelet units at the end of the storage period is 6.2. This pH level ensures that the platelets remain stable and viable during storage. A pH below 6.2 could indicate a decrease in platelet quality and function, making them less effective when transfused to patients. Maintaining a pH of 6.2 or higher helps ensure that the platelets are in optimal condition for use in medical treatments.
14.
Which of the following is a change associated with platelet storage?
Correct Answer
B. Platelet activation
Explanation
Platelet activation is a change associated with platelet storage. During storage, platelets can become activated, leading to the release of various substances such as adenosine diphosphate (ADP), thromboxane A2, and serotonin. This activation can result in platelet aggregation and the formation of a platelet plug, which is essential for clot formation and hemostasis. Platelet activation is a normal physiological response to injury or inflammation, but it can also occur during storage due to various factors such as temperature changes, exposure to certain chemicals, or prolonged storage time.
15.
Transfusion of one platelet concentrate (ie the platelets present in one whole blood donation) into a hematologically stable adult of average size with no history of transfusion and/or pregnancy is expected to increase the platelet count by:
Correct Answer
D. 5000 to 10000/ uL
Explanation
The correct answer is 5000 to 10000 /uL. Platelet concentrates are used to increase the platelet count in individuals with low platelet counts. The average increase in platelet count after transfusing one platelet concentrate is expected to be between 5000 to 10000 /uL. This increase is within the normal range and helps to improve the clotting ability of the blood.
16.
Which of the following is a theoretical advantage associated with transfusion of a whole-blood derived pooled-platelet unit compared with an apheresis platelet unit?
Correct Answer
B. Decreased risk of TRALI
Explanation
Transfusion-related acute lung injury (TRALI) is a potentially life-threatening complication of blood transfusion. It is characterized by the sudden onset of respiratory distress and non-cardiogenic pulmonary edema. The theoretical advantage of transfusing a whole-blood derived pooled-platelet unit compared with an apheresis platelet unit is a decreased risk of TRALI. This is because whole-blood derived pooled-platelet units contain a mixture of platelets from multiple donors, whereas apheresis platelet units come from a single donor. TRALI is thought to be caused by the presence of donor antibodies in the transfused blood, and pooling platelet units reduces the concentration of these antibodies, thereby decreasing the risk of TRALI.
17.
FFP that has been thawed and is being stored at 1 to 6 C should be transfused within
Correct Answer
E. 24 hours
Explanation
Thawed FFP (Fresh Frozen Plasma) should be transfused within 24 hours when stored at 1 to 6 degrees Celsius. This is because FFP contains labile clotting factors that can degrade over time, leading to a decrease in its effectiveness. Therefore, it is important to use thawed FFP within the designated time frame to ensure optimal patient outcomes.
18.
Which of the following is true?
Correct Answer
B. If an additive solution is used, the expiration date for RBCs stored at 1 to 6 C is 42 days after pHlebotomy
Explanation
The correct answer states that if an additive solution is used, the expiration date for RBCs stored at 1 to 6 C is 42 days after phlebotomy. This means that if a specific additive solution is used to store red blood cells at a temperature range of 1 to 6 degrees Celsius, the expiration date for these cells is 42 days after they are collected through phlebotomy. This information suggests that the use of an additive solution can extend the shelf life of red blood cells, allowing them to be stored for a longer period of time before they expire.
19.
A group B Rh positive patient requires FFP. Group B FFP is not available. The substitute component of choice is:
Correct Answer
D. Group AB FFP
Explanation
When a group B Rh positive patient requires FFP and group B FFP is not available, the substitute component of choice would be Group AB FFP. This is because Group AB FFP can be safely transfused to any blood type without causing an adverse reaction. Group O FFP is not compatible with the patient's blood type and may cause a transfusion reaction. Group B, Rh positive cryo is not a suitable substitute for FFP as it does not provide the necessary clotting factors. Group A FFP and Group A, Rh negative cryo are also not compatible with the patient's blood type and may cause adverse reactions.
20.
Which of the following is true?
Correct Answer
C. CRP and cryo can not be prepared from FFP collected by apHeresis
21.
Cryo should be stored at
Correct Answer
A.
Explanation
Cryo should be stored at 1 to 6°C. This temperature range is ideal for preserving the integrity and viability of cryogenic materials, such as cells, tissues, or biological samples. Storing cryo at lower temperatures helps to slow down metabolic processes and prevent degradation or damage to the samples. Higher temperatures, such as 20 to 22°C, 30°C, or 37°C, can lead to the loss of cell viability and compromise the quality of the cryo.
22.
After thawing cryo should be stored at:
Correct Answer
C. 20 to 24 C
Explanation
After thawing cryo, it should be stored at a temperature range of 20 to 24 degrees Celsius. This temperature range is ideal for maintaining the stability and integrity of the cryo material. Storing it at this temperature helps to prevent any degradation or damage to the cryo, ensuring its effectiveness and usability when needed.
23.
According to AABB standards each bag of cryo must contain a minimum of how many Internation Units of Factor VIII?
Correct Answer
B. 80
Explanation
According to AABB standards, each bag of cryo must contain a minimum of 80 International Units of Factor VIII. This standard ensures that the cryo product meets the necessary quality and potency requirements for safe and effective use in medical treatments.
24.
Cryo contains which of the following?
Correct Answer
D. Factor XIII
Explanation
Factor XIII is a clotting factor that plays a crucial role in the final stages of blood clot formation. It helps stabilize the clot by cross-linking fibrin strands, making them stronger and more resistant to breakdown. This process is important for preventing excessive bleeding and promoting wound healing. Therefore, Factor XIII is present in Cryo, which is a blood product derived from plasma and used for various medical purposes, including treating bleeding disorders and surgical procedures.
25.
Which is true regarding cryo?
Correct Answer
D. It is prepared by centrifuging thawed FFP at 1 to 6 C
Explanation
Cryo is prepared by centrifuging thawed FFP at 1 to 6 C. This means that after thawing the fresh frozen plasma (FFP), it is subjected to centrifugation at a temperature between 1 to 6 degrees Celsius. This process helps to separate the cryoprecipitate from the FFP. The cryoprecipitate is then collected and used for therapeutic purposes. Thawed cryo is stored at 1 to 6 C during transport to maintain its stability and effectiveness.
26.
Granulocytes are stored at
Correct Answer
C. 20 to 24 C without continuous agitation
Explanation
Granulocytes are a type of white blood cells that play a crucial role in the immune response against infections. They are stored at a temperature range of 20 to 24 degrees Celsius without continuous agitation. This specific temperature range helps to maintain the viability and function of the granulocytes. Continuous agitation is not required as it may lead to cell damage or activation. Therefore, storing granulocytes at 20 to 24 degrees Celsius without continuous agitation is the optimal condition for their preservation.
27.
The shelf life of granulocytes is:
Correct Answer
D. 24 hours
Explanation
Granulocytes are a type of white blood cells that play a crucial role in the immune system by fighting off infections. The shelf life of granulocytes refers to the time period during which they can be stored and used for medical purposes, such as transfusions. The correct answer of 24 hours indicates that granulocytes have a relatively short shelf life and must be used within a day of collection. This is because granulocytes are highly sensitive and their effectiveness decreases over time, making them less viable for medical use after 24 hours.
28.
Granulocytes should:
Correct Answer
C. Be ABO-compatible with the intended recipient
Explanation
Granulocytes should be ABO-compatible with the intended recipient because ABO incompatibility can lead to severe transfusion reactions, including hemolysis, which can be life-threatening. ABO compatibility ensures that the recipient's immune system does not recognize the transfused granulocytes as foreign and mount an immune response against them. This compatibility reduces the risk of adverse reactions and allows for a successful transfusion.
29.
Which of the following statements concerning optimizing the collection of granulocytes is true?
Correct Answer
E. All of the above are true
30.
Which of the following is an adverse reaction caused by the infusion of HES during granulocyte collection?
Correct Answer
B. Weight gain
Explanation
Weight gain is a known adverse reaction caused by the infusion of HES during granulocyte collection. HES (hydroxyethyl starch) is a type of colloid solution that is sometimes used during blood transfusions or infusions. It can cause fluid retention in the body, leading to an increase in weight. This adverse reaction is typically temporary and resolves once the infusion is stopped. Other adverse reactions may include allergic reactions, kidney damage, and coagulation disorders.
31.
Which of the following is true regarding the irradiation of granulocytes?
Correct Answer
C. It prevents TA-GVHD
Explanation
TA-GVHD, or transfusion-associated graft-versus-host disease, is a rare but serious complication that can occur when immunocompetent T cells from the donor attack the recipient's tissues. Irradiation of granulocytes is a method used to prevent TA-GVHD by inactivating the T cells present in the granulocyte product. This process helps to ensure the safety of the transfusion and minimize the risk of complications for the recipient.