Blood Banking MCQs:
These 300+ multiple-choice questions (MCQs) are designed to test your knowledge and understanding of various aspects of blood banking, a critical component of transfusion medicine. Blood banking involves the collection, processing, testing, storage, and distribution of blood and blood components to ensure their safe and effective use in medical treatments. The questions cover a wide range of topics, including blood typing, compatibility testing, transfusion reactions, blood component therapy, and the management of adverse events. By answering these questions, you will gain a deeper insight into the complexities and importance of blood banking in modern healthcare.
276. Fresh Frozen Plasma:
a. contains all labile coagulative factors except cryoprecipitated AHF
b. has a higher risk of transmitting hepatitis than does Whole blood
c. should be transfused within 24 hours of thawing
d. need not be ABO-compatible ✅
a. contains all labile coagulative factors except cryoprecipitated AHF
b. has a higher risk of transmitting hepatitis than does Whole blood
c. should be transfused within 24 hours of thawing
d. need not be ABO-compatible ✅
277. Ten units of group A platelets were transfused to a group AB patient. The pretransfusion platelet count was 12 x 103/uL (12 x 109/L) and the posttransfusion count was 18 x 103/uL (18 x 109/L). From this information, the laboratorian would most likely conclude that the patient:
a. needs group AB platelets to be effective
b. clinical data does not suggest a need for platelets
c. has developed antibodies to the transfused platelets ✅
d. should receive irradiated platelets
a. needs group AB platelets to be effective
b. clinical data does not suggest a need for platelets
c. has developed antibodies to the transfused platelets ✅
d. should receive irradiated platelets
278. Hypotension, nausea, flushing, fever, and chills are symptoms of which of the following transfusion reactions?
a. allergic
b. circulatory overload
c. hemolytic ✅
d. anaphylactic
a. allergic
b. circulatory overload
c. hemolytic ✅
d. anaphylactic
279. A patient has become refractory to platelet transfusion. Which of the following are probably causes?
a. transfusion of Rh-incompatible platelets
b. decreased pH of the platelets
c. development of an alloantibody with anti-D specificity
d. development of antibodies to HLA antigen ✅
a. transfusion of Rh-incompatible platelets
b. decreased pH of the platelets
c. development of an alloantibody with anti-D specificity
d. development of antibodies to HLA antigen ✅
280. A poor increment in the platelet count 1 hour following platelet transfusion is most commonly caused by:
a. splenomegaly ✅
b. alloimmunization to HLA antigens
c. disseminated intravascular coagulation
d. defective platelets
a. splenomegaly ✅
b. alloimmunization to HLA antigens
c. disseminated intravascular coagulation
d. defective platelets
281. Posttransfusion purpura is usually caused by:
a. anti-A
b. white cell antibodies
c. anti-HPA-1a (P1A1) ✅
d. platelet wash-out
a. anti-A
b. white cell antibodies
c. anti-HPA-1a (P1A1) ✅
d. platelet wash-out
282. An unexplained fall in hemoglobin and mild jaundice in a patient transfused with Red Blood Cells 1 week previously would most likely indicate:
a. paroxysmal nocturnal hemoglobinuria
b. posttransfusion hepatitis infection
c. presence of HLA antibodies
d. delayed hemolytic transfusion reaction ✅
a. paroxysmal nocturnal hemoglobinuria
b. posttransfusion hepatitis infection
c. presence of HLA antibodies
d. delayed hemolytic transfusion reaction ✅
283. In a delayed transfusion reaction, the causative antibody is generally too weak to be detected in routine compatibility testing and antibody screening tests, but is typically detectable at what point after transfusion?
a. 3-6 hours
b. 3-7 days ✅
c. 60-90 days
d. after 120 days
a. 3-6 hours
b. 3-7 days ✅
c. 60-90 days
d. after 120 days
284. The most serious hemolytic transfusion reactions are due to incompatibility in which of the following blood group systems?
a. ABO ✅
b. Rh
c. MN
d. Duffy
a. ABO ✅
b. Rh
c. MN
d. Duffy
285. Severe intravascular hemolysis is most likely caused by antibodies of which blood group system?
a. ABO ✅
b. Rh
c. Kell
d. Duffy
a. ABO ✅
b. Rh
c. Kell
d. Duffy
286. Which of the following blood group systems is most commonly associated with delayed hemolytic transfusion reactions?
a. Lewis
b. Kidd ✅
c. MNS
d. I
a. Lewis
b. Kidd ✅
c. MNS
d. I
287. After receiving a unit of Red Blood Cells, a patient immediately developed flushing, nervousness, fever spike of 1020F (38.90C), shaking, chills, and back pain. The plasma hemoglobin was elevated and there was hemoglobinuria. Laboratory investigation of this adverse reaction would most likely show:
a. an error in ABO grouping ✅
b. an error in Rh typing
c. presence of anti-Fya antibody in patient’s serum
d. presence of gram-negative bacteria in blood bag
a. an error in ABO grouping ✅
b. an error in Rh typing
c. presence of anti-Fya antibody in patient’s serum
d. presence of gram-negative bacteria in blood bag
288. A trauma patient who has just received ten units of blood may develop:
a. anemia
b. polycythemia
c. leukocytosis
d. thrombocytopenia ✅
a. anemia
b. polycythemia
c. leukocytosis
d. thrombocytopenia ✅
289. Five days after transfusion, a patient becomes mildly jaundiced and experiences a drop in hemoglobin and hematocrit with no apparent hemorrhage. Below are the results of the transfusion reaction workup:
In order to reach a conclusion, the technician should first:
a. retype the pre- and posttransfusion patient samples and donor #1
b. request an EDTA tube be drawn on the patient and repeat the DAT ✅
c. repeat the pretransfusion antibody screen on the patient’s sample
d. identify the antibody in the serum and eluate from the posttransfusion sample
| Test | Patient pretransfusion | Patient postransfusion | Donor 1 | Donor 2 |
|---|---|---|---|---|
| anti-A | neg | neg | neg | neg |
| anti-B | 4+ | 4+ | 4+ | 4+ |
| anti-D | 3+ | 3+ | 3+ | 3+ |
| A1 cells | 4+ | 4+ | 4+ | 4+ |
| B cells | neg | neg | neg | neg |
| AB screen | neg | neg | neg | neg |
| DAT | neg | 1+ | neg | neg |
a. retype the pre- and posttransfusion patient samples and donor #1
b. request an EDTA tube be drawn on the patient and repeat the DAT ✅
c. repeat the pretransfusion antibody screen on the patient’s sample
d. identify the antibody in the serum and eluate from the posttransfusion sample
290. The most appropriate laboratory test for early detection of acute posttransfusion hemolysis is:
a. visual inspection for free plasma hemoglobin ✅
b. plasma haptoglobin concentration
c. examination for hematuria
d. serum bilirubin concentration
a. visual inspection for free plasma hemoglobin ✅
b. plasma haptoglobin concentration
c. examination for hematuria
d. serum bilirubin concentration
291. During initial investigation of a suspected hemolytic transfusion reaction, it was observed that the posttransfusion serum was yellow in color and the direct antiglobulin test was negative. Repeat ABO typing on the posttransfusion sample confirmed the pretransfusion results. What is the next step in this investigation?
a. repeat compatibility testing on suspected unit(s)
b. perform plasma hemoglobin and haptoglobin determinations ✅
c. use enhancement media to repeat the antibody screen
d. no further serological testing is necessary
a. repeat compatibility testing on suspected unit(s)
b. perform plasma hemoglobin and haptoglobin determinations ✅
c. use enhancement media to repeat the antibody screen
d. no further serological testing is necessary
292. Which of the following transfusion reactions is characterized by high fever, shock, hemoglobinuria, DIC, and renal failure?
a. bacterial contamination ✅
b. circulatory overload
c. febrile
d. anaphylactic
a. bacterial contamination ✅
b. circulatory overload
c. febrile
d. anaphylactic
293. Hemoglobinuria, hypotension, and generalized bleeding are symptoms of which of the following transfusion reactions?
a. allergic
b. circulatory overload
c. hemolytic ✅
d. anaphylactic
a. allergic
b. circulatory overload
c. hemolytic ✅
d. anaphylactic
294. When evaluating a suspected transfusion reaction, which of the following is ideal sample collection time for a bilirubin determination?
a. 6 hours posttransfusion
b. 12 hours posttransfusion
c. 24 hours posttransfusion ✅
d. 48 hours posttransfusion
a. 6 hours posttransfusion
b. 12 hours posttransfusion
c. 24 hours posttransfusion ✅
d. 48 hours posttransfusion
295. A patient’s record shows a previous anti-Jkb, but the current antibody screen is negative. What further testing should be done before transfusion?
a. phenotype the patient’s red cells for the Jkb antigen
b. perform a cell panel on the patient’s serum
c. crossmatch type-specific units and release only compatible units for transfusion ✅
d. give Jkb negative crossmatch compatible blood
a. phenotype the patient’s red cells for the Jkb antigen
b. perform a cell panel on the patient’s serum
c. crossmatch type-specific units and release only compatible units for transfusion ✅
d. give Jkb negative crossmatch compatible blood
296. A posttransfusion blood sample from a patient experiencing chills and fever shows distinct hemolysis. The direct antiglobulin test is positive (mixed field). What would be most helpful to determine the cause of the reaction?
a. auto control
b. elution and antibody identification ✅
c. repeat antibody screen on the donor unit
d. bacteriologic smear and culture
a. auto control
b. elution and antibody identification ✅
c. repeat antibody screen on the donor unit
d. bacteriologic smear and culture
297. A patient is readmitted to the hospital with a hemoglobin level of 7g/dL (70g/L) 3 weeks after receiving 2 units of red cells. The initial serological tests are:
Which test should be performed next?
a. antibody identification panel on the patient’s serum
b. repeat the ABO type on the donor units
c. perform an elution and identify the antibody in the eluate ✅
d. crossmatch the post-reaction serum with the 3 donor units
| Test | Result |
|---|---|
| ABO/Rh | A+ |
| antibody screen | negative |
| DAT | 1+ mixed field |
a. antibody identification panel on the patient’s serum
b. repeat the ABO type on the donor units
c. perform an elution and identify the antibody in the eluate ✅
d. crossmatch the post-reaction serum with the 3 donor units
298. In a delayed hemolytic transfusion reaction, the direct antiglobulin test is typically:
a. negative ✅
b. mixed-field positive
c. positive due to complement
d. negative when the antibody screen is negative
a. negative ✅
b. mixed-field positive
c. positive due to complement
d. negative when the antibody screen is negative
299. A patient has had massive trauma involving replacement of 1 blood volume with Red Blood Cells and crystalloid. She is currently experiencing oozing from mucous membranes and surgical incisions. Laboratory values are as follows:
What is the blood component of choice for this patient?
a. Platelets ✅
b. Cryoprecipitated AHF
c. Fresh Frozen Plasma
d. Prothrombin Complex
| Test | Result |
|---|---|
| PT | normal |
| APTT | normal |
| bleeding time | prolonged |
| platelet count | 20 x 103/uL (20 x 109/L) |
| hemoglobin | 11.4g/dL (114g/L) |
a. Platelets ✅
b. Cryoprecipitated AHF
c. Fresh Frozen Plasma
d. Prothrombin Complex
300. For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment goal should be to:
a. prevent alloimmunization
b. diminish chills and fever
c. prevent hemoglobinemia
d. reverse hypotension and minimize renal damage ✅
a. prevent alloimmunization
b. diminish chills and fever
c. prevent hemoglobinemia
d. reverse hypotension and minimize renal damage ✅
