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.
126. ABO-hemolytic disease of the newborn:
a. usually requires an exchange transfusion
b. most often occurs in first born children
c. frequently results in stillbirth
d. is usually seen only in the newborn of group O mothers ✅
a. usually requires an exchange transfusion
b. most often occurs in first born children
c. frequently results in stillbirth
d. is usually seen only in the newborn of group O mothers ✅
127. Which of the following antigens is most likely to be involved in hemolytic disease of the newborn?
a. Lea
b. P1
c. M
d. Kell ✅
a. Lea
b. P1
c. M
d. Kell ✅
128. ABO hemolytic disease of the fetus and newborn (HDFN) differs from Rh HDFN in that:
a. Rh HDFN is clinically more severe than ABO HDFN
b. the direct antiglobulin test is weaker in Rh HDFN than ABO
c. Rh HDFN occurs in the first pregnancy
d. the mother’s antibody screen is positive in ABO HDN ✅
a. Rh HDFN is clinically more severe than ABO HDFN
b. the direct antiglobulin test is weaker in Rh HDFN than ABO
c. Rh HDFN occurs in the first pregnancy
d. the mother’s antibody screen is positive in ABO HDN ✅
129. The following results were obtained:
Which of the following is the most probable explanation for these results?
a. ABO hemolytic disease of the fetus and newborn
b. Rh hemolytic disease of the fetus and newborn; infant has received intrauterine transfusions
c. Rh hemolytic disease of the fetus and newborn, infant has a false-negative Rh typing
d. large fetomaternal hemorrhage ✅
| Test | Infant | Mother |
|---|---|---|
| anti-A | 0 | 4+ |
| anti-B | 0 | 0 |
| anti-D | 0 | 0 |
| weak D | NT | 0 |
| DAT | 4+ | NT |
| Ab screen | NT | anti-D |
a. ABO hemolytic disease of the fetus and newborn
b. Rh hemolytic disease of the fetus and newborn; infant has received intrauterine transfusions
c. Rh hemolytic disease of the fetus and newborn, infant has a false-negative Rh typing
d. large fetomaternal hemorrhage ✅
130. A group A, Rh-positive infant of a group O, Rh-positive mother has a weak positive direct antiglobulin test and a moderately elevated bilirubin 12 hours after birth. The most likely cause is:
a. ABO incompatibility ✅
b. Rh incompatibility
c. blood group incompatibility due to antibody to a low frequency antigen
d. neonatal jaundice not associated with blood group
a. ABO incompatibility ✅
b. Rh incompatibility
c. blood group incompatibility due to antibody to a low frequency antigen
d. neonatal jaundice not associated with blood group
131. In suspected cases of hemolytic disease of the newborn, what significant information can be obtained from the baby’s blood smear?
a. estimation of WBC, RBC, and platelet counts
b. marked increase in immature neutrophils (shift to the left)
c. a differential to estimate the absolute number of lymphocytes present
d. determination of the presence of spherocytes ✅
a. estimation of WBC, RBC, and platelet counts
b. marked increase in immature neutrophils (shift to the left)
c. a differential to estimate the absolute number of lymphocytes present
d. determination of the presence of spherocytes ✅
132. The Liley method of predicting the severity of hemolytic disease of the newborn is based on the amniotic fluid:
a. bilirubin concentration by standard methods
b. change in optical density measured at 450nm ✅
c. Rh determination
d. ratio of lecithin to sphingomyelin
a. bilirubin concentration by standard methods
b. change in optical density measured at 450nm ✅
c. Rh determination
d. ratio of lecithin to sphingomyelin
133. These laboratory results were obtained on maternal and cord blood samples:
Does the baby have HDN?
a. no, as indicated by the cord hemoglobin
b. yes, although the cord hemoglobin is normal, the DAT indicates HDN ✅
c. yes, the DAT and cord hemoglobin level both support HDN
d. no, a diagnosis of HDN cannot be established without cord bilirubin levels
| Sample | ABO | DAT | Cord Hemoglobin |
|---|---|---|---|
| Mother | AB+ | 3+ | N/A |
| Baby | N/A | N/A | 10 g/dL (100g/L) |
a. no, as indicated by the cord hemoglobin
b. yes, although the cord hemoglobin is normal, the DAT indicates HDN ✅
c. yes, the DAT and cord hemoglobin level both support HDN
d. no, a diagnosis of HDN cannot be established without cord bilirubin levels
134. The main purpose of performing antibody titers on serum from prenatal immunized women is to:
a. determine the identity of the antibody
b. identify candidates for amniocentesis or percutaneous umbilical blood sampling ✅
c. decide if the baby needs an intrauterine transfusion
d. determine if early induction of labor is indicated
a. determine the identity of the antibody
b. identify candidates for amniocentesis or percutaneous umbilical blood sampling ✅
c. decide if the baby needs an intrauterine transfusion
d. determine if early induction of labor is indicated
135. Which unit should be selected for exchange transfusion if the newborn is group A, Rh-positive and the mother is group A, Rh-positive with anti-c?
a. A, CDe/CDe
b. A, cDE/cDE
c. O, cde/cde ✅
d. A, cde/cde
a. A, CDe/CDe
b. A, cDE/cDE
c. O, cde/cde ✅
d. A, cde/cde
136. A mother is group A, with anti-D in her serum. What would be the preferred blood product if an intrauterine transfusion is indicated?
a. O, Rh-negative Red Blood Cells
b. O, Rh-negative Red Blood Cells, Irradiated
c. A, Rh-negative Red Blood Cells
d. A, Rh-negative Red Blood Cells, Irradiated ✅
a. O, Rh-negative Red Blood Cells
b. O, Rh-negative Red Blood Cells, Irradiated
c. A, Rh-negative Red Blood Cells
d. A, Rh-negative Red Blood Cells, Irradiated ✅
137. Laboratory studies of maternal and cord blood yield the following results:
If exchange transfusion is necessary, the best choice of blood is:
a. B, Rh-negative, E+
b. B, Rh-positive, E+
c. O, Rh-negative, E ✅
d. O, Rh-positive, E-
| Sample | ABO | Rh | Anti-E | DAT |
|---|---|---|---|---|
| Maternal Blood | O | Rh-negative | anti-E in serum | N/A |
| Cord Blood | B | Rh-positive | anti-E in eluate | 2+ |
a. B, Rh-negative, E+
b. B, Rh-positive, E+
c. O, Rh-negative, E ✅
d. O, Rh-positive, E-
138. A blood specimen from a pregnant woman is found to be group B, Rh-negative and the serum contains anti-D with a titer of 512. What would be the most appropriate type of blood to have available for a possible exchange transfusion for her infant?
a. O, Rh-negative ✅
b. O, Rh-positive
c. B, Rh-negative
d. B, Rh-positive
a. O, Rh-negative ✅
b. O, Rh-positive
c. B, Rh-negative
d. B, Rh-positive
139. Blood selected for exchange transfusion must:
a. lack red blood cell antigens corresponding to maternal antibodies ✅
b. be <3 days old
c. be the same Rh type as the baby
d. be ABO compatible with a father
a. lack red blood cell antigens corresponding to maternal antibodies ✅
b. be <3 days old
c. be the same Rh type as the baby
d. be ABO compatible with a father
140. When the main objective of an exchange transfusion is to remove the infant’s antibody-sensitized red blood cells and to control hyperbilirubinemia, the blood product of choice is ABO compatible:
a. Fresh Whole Blood
b. Red Blood Cells (RBC) washed ✅
c. RBC suspended in Fresh Frozen Plasma
d. heparinized Red Blood Cells
a. Fresh Whole Blood
b. Red Blood Cells (RBC) washed ✅
c. RBC suspended in Fresh Frozen Plasma
d. heparinized Red Blood Cells
141. To prevent graft-vs-host disease, Red Blood Cells prepared for infants who have received intrauterine transfusions should be:
a. saline-washed
b. irradiated ✅
c. frozen and deglycerolized
d. group- and Rh-compatible with the mother
a. saline-washed
b. irradiated ✅
c. frozen and deglycerolized
d. group- and Rh-compatible with the mother
142. Which of the following is the preferred specimen for the initial compatibility testing in exchange transfusion therapy?
a. maternal serum
b. eluate prepared from infant’s red blood cells ✅
c. paternal serum
d. infant’s postexchange serum
a. maternal serum
b. eluate prepared from infant’s red blood cells ✅
c. paternal serum
d. infant’s postexchange serum
143. Rh-Immune Globulin is requested for an Rh-negative mother who has the following results:
What is the most likely explanation?
a. mother is a genetic weak D
b. mother had a fetomaternal hemorrhage of D+ cells ✅
c. mother’s red cells are coated weakly with IgG
d. anti-D reagent is contaminated with an atypical antibody
| Test | D | D control | Weak D | Weak D control |
|---|---|---|---|---|
| Mother’s postpartum sample | 0 | 0 | 1+mf | 0 |
a. mother is a genetic weak D
b. mother had a fetomaternal hemorrhage of D+ cells ✅
c. mother’s red cells are coated weakly with IgG
d. anti-D reagent is contaminated with an atypical antibody
144. The following results are seen on a maternal postpartum sample:
The most appropriate course of action is to:
a. report the mother as Rh-negative
b. report the mother as Rh-positive
c. perform an elution on mother’s RBCs ✅
d. investigate for a fetomaternal hemorrhage
| Test | D | D control | Weak D | Weak D control |
|---|---|---|---|---|
| Mother’s postpartum sample | 0 | 0 | 1+mf | 0 |
a. report the mother as Rh-negative
b. report the mother as Rh-positive
c. perform an elution on mother’s RBCs ✅
d. investigate for a fetomaternal hemorrhage
145. What is the most appropriate interpretation for the laboratory data given below when an Rh-negative woman has an Rh-positive child?
The most appropriate interpretation is:
a. mother is not a candidate for RhIg
b. mother needs 1 vial of RhIg ✅
c. mother needs 2 vials of RhIg
d. the fetal-maternal hemorrhage needs to be quantitated
| Test | Mother’s sample | Positive control | Negative control |
|---|---|---|---|
| Rosette fetal screen using enzyme-treated D+ cells | 1 rosette/3 fields | 5 rosettes/3 fields | no rosettes observed |
a. mother is not a candidate for RhIg
b. mother needs 1 vial of RhIg ✅
c. mother needs 2 vials of RhIg
d. the fetal-maternal hemorrhage needs to be quantitated
146. Refer to the following information:
What is the interpretation for the laboratory data given above?
a. mother is Rh-positive
b. mother is weak D+
c. mother has had a fetal-maternal hemorrhage ✅
d. mother has a positive DAT
| Test | Mother | Newborn |
|---|---|---|
| Postpartum anti-D | 0 | 4+ |
| Rh-control | 0 | 0 |
| Weak D | +micro | NT |
| Weak D control | 0 | NT |
| Rosette fetal screen | 20 rosettes/5 fields | NT |
a. mother is Rh-positive
b. mother is weak D+
c. mother has had a fetal-maternal hemorrhage ✅
d. mother has a positive DAT
147. A weakly reactive anti-D is detected in a postpartum specimen from an Rh-negative woman. During her prenatal period, all antibody screening were negative. These findings indicate:
a. that she is a candidate for Rh immune globulin
b. that she is not a candidate for Rh immune globulin
c. a need for further investigation to determine candidacy for Rh immune globulin ✅
d. the presence of Rh-positive cells in her circulation
a. that she is a candidate for Rh immune globulin
b. that she is not a candidate for Rh immune globulin
c. a need for further investigation to determine candidacy for Rh immune globulin ✅
d. the presence of Rh-positive cells in her circulation
148. The results of Kleihauer-Betke stain indicate a fetomaternal hemorrhage of 35 mL of whole blood. How many vials of Rh immune globulin would be required?
a. 1
b. 2 ✅
c. 3
d. 4
a. 1
b. 2 ✅
c. 3
d. 4
149. A fetomaternal hemorrhage of 35 mL of fetal Rh-positive packed RBCs has been detected in an Rh-negative woman. How many vials of Rh immune globulin should be given?
a. 0
b. 1
c. 2 ✅
d. 3
a. 0
b. 1
c. 2 ✅
d. 3
150. Criteria determining Rh immune globulin eligibility include:
a. mother is Rh-positive
b. infant is Rh-negative
c. mother has not been previously immunized to the D antigen ✅
d. infant has a positive direct antiglobulin test
a. mother is Rh-positive
b. infant is Rh-negative
c. mother has not been previously immunized to the D antigen ✅
d. infant has a positive direct antiglobulin test
