Turgeon: Clinical Laboratory Science, 9th Edition
Chapter 18: Immunohematology and Transfusion Medicine
Student Review Questions
MULTIPLE CHOICE
1. A donor unit must be tested for HBsAg, anti-HBc, anti-HCV to aid in the identification of a
donor with which condition?
a. Hepatitis
b. Syphilis
c. Human immunodeficiency virus (HIV)
d. West Nile virus
ANS: A
Transmission of hepatitis remains a risk in transfusion and for this reason, donated blood is
screened with several tests for the hepatitis virus. At present, these include a test for hepatitis B
surface antigen (HBsAg), and antibody tests for HCV and hepatitis B core antibody (HBc).
2. A healthy 35-year-old female that weighs 145 pounds and is currently taking birth control pills
is wondering if she is eligible to donate blood. How would the technologist respond?
a. Acceptable. She is within the age and weight and the medication is acceptable for donation.
b. Reject. She is within the age and weight, but the medication she is currently taking is not
acceptable for donation.
c. Reject. She is not within the age range for donation.
d. Reject. She is not within the weight range for donation.
ANS: A
The general guidelines to donate blood for transfusion to another person are that you must be
healthy, be at least 17 years of age, weigh at least 110 pounds, and not have donated whole blood
in the last 8 weeks (56 days). Birth control is an acceptable medication for a donor to be eligible
for donating blood.
3. A patient is having orthopedic surgery and the physician suggests that they donate a unit of
blood in the chance they may need it during surgery. This is known as which type of donation?
a. Directed donation
b. Volunteer donation
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Student Review Questions 17-2
c. Autologous donation
d. None of these
ANS: C
Patients who meet certain criteria are encouraged to donate blood for themselves before a
surgical procedure if they are likely to need a transfusion. This is a type of autologous donation
as the safest blood a recipient can receive is his or her own blood.
4. A patient is undergoing chemotherapy treatment for leukemia. The physician obtains
laboratory results that demonstrate the patient has a low platelet count. Which blood product
would the physician transfuse to the patient to improve their count?
a. Packed red blood cells (RBCs)
b. Fresh frozen plasma
c. Platelets
d. Cryoprecipitate
ANS: C
Platelet concentrates are used for patients who are bleeding as a result of low platelet counts or,
occasionally, abnormal functioning of platelets. Chemotherapy is a type of treatment that
destroys the cells and patients typically require platelet transfusions to prevent bleeding episodes
due to the low platelet count due to treatment.
5. A male donor has been typed as Group B and also possesses the secretor gene (Se). His saliva
will contain which blood group substance when tested?
a. H
b. B, H
c. A, H
d. A, B, H
ANS: B
The ABO system is concerned with substances A, B, and H. Genetically the ABO system is
controlled by at least three sets of genes. Another set is described as H and h. The H gene is
extremely common. The Se and se genes regulate the presence of A, B, and H in the body
secretions. If an individual inherits the Se gene, they are secretors who have H, A, or B
substances produced by their secretory cells. The H gene is the precursor to the blood type and so
a Group B individual will have B and H in their secretions because they carry the secretor gene.
6. A 29-year-old female is being seen by her physician for prenatal care. The patient is Rh
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Student Review Questions 17-3
positive and this indicates she has what antigen on her RBCs?
a. C
b. D
c. E
d. C
ANS: B
The presence or absence of the D antigen identifies a person’s cells as being Rh positive or Rh
negative.
7. A patient is brought to the emergency department after sustaining injuries in a motor vehicle
accident. The physician notices the patient is bleeding from their wounds and orders a blood
transfusion. The blood bank types the patient and the results are A positive. Which blood type
would the blood bank crossmatch to the patient?
a. A positive
b. B positive
c. B negative
d. AB positive
ANS: A
When blood is selected for transfusion, the patient and donor are tested for ABO type and the
presence or absence of the D antigen. The ABO group is matched and the Rh type selected with
respect to the D antigen. Patients whose cells contain the D antigen are given red cells positive
for the D antigen and patients who are negative for the D antigen are always given red cells
negative for the D antigen. The patient is A positive and so A positive packed RBCs would be
crossmatched to the patient.
8. Most of the errors encountered in the blood bank are due to clerical errors. Which is a
transfusion reaction in which the patient receives the wrong unit of blood due to a clerical error?
a. Febrile
b. Allergic
c. Delayed transfusion reaction
d. Hemolytic
ANS: D
The result of RBC destruction is a transfusion reaction. The most life-threatening transfusion
reaction is the hemolytic reaction that occurs with the destruction of incompatible RBCs by
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Student Review Questions 17-4
antibodies in the patient’s serum (usually ABO incompatibility, wrong blood type transfused).
9. A pregnant female has fallen on the ice and the physician is concerned that she may have
developed a fetal-maternal hemorrhage. Which stain would be useful to determine how much
fetal blood is in the mother’s circulation?
a. Wright stain
b. Supravital stain
c. Acid elution stain
d. Gram stain
ANS: C
An acid elution stain (modified Kleihauer-Betke method) is based on the fact that fetal
hemoglobin is resistant to acid elution whereas adult hemoglobin is not. After staining, the
percentage of fetal cells in the maternal RBCs is used to calculate the approximate volume of
fetal hemorrhage into the maternal circulation.
10. An Rh negative female has just delivered a healthy Rh positive infant. Which blood bank
product will she need?
a. Packed RBCs
b. Rh immune globulin (RhIG)
c. Platelets
d. Fresh frozen plasma
ANS: B
Rh immune globulin (RhIG) could prevent immunization to the D antigen during and
immediately after pregnancy. RhIG is injected into an Rh negative woman who delivers an Rh
positive baby.
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