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.
176. Mixed field agglutination encountered in ABO grouping with no history of transfusion would most likely be due to:
a. Bombay phenotype (Oh) ✅
b. T activation
c. A3 red cells
d. positive indirect antiglobulin test
a. Bombay phenotype (Oh) ✅
b. T activation
c. A3 red cells
d. positive indirect antiglobulin test
177. Which of the following is a characteristic of polyagglutinable red cells?
a. can be classified by reactivity with Ulex europaeus
b. are agglutinated by most adult sera ✅
c. are always an acquired condition
d. autocontrol is always positive
a. can be classified by reactivity with Ulex europaeus
b. are agglutinated by most adult sera ✅
c. are always an acquired condition
d. autocontrol is always positive
178. Consider the following ABO typing results:
Additional testing was performed using patient serum:
What is the most likely cause of this discrepancy?
a. A2 with anti-A1 ✅
b. cold alloantibody
c. cold autoantibody
d. acquired-A phenomenon
| Test | Patient’s cells vs | Patient’s serum vs |
|---|---|---|
| anti-A | 4+ | 1+ |
| anti-B | 0 | 4+ |
| A1 cells | N/A | 1+ |
| B cells | N/A | 4+ |
| Test | IS | RT |
|---|---|---|
| screening cell I | 1+ | 2+ |
| screening cell II | 1+ | 2+ |
| autocontrol | 1+ | 2+ |
a. A2 with anti-A1 ✅
b. cold alloantibody
c. cold autoantibody
d. acquired-A phenomenon
179. Consider the following ABO typing results:
Additional testing was performed using patient serum:
What should be done next?
a. test serum against a panel of group O cells
b. neutralization
c. perform serum type at 370C ✅
d. elution
| Test | Patient’s cells vs | Patient’s serum vs |
|---|---|---|
| anti-A | 4+ | 1+ |
| anti-B | 0 | 4+ |
| A1 cells | N/A | 1+ |
| B cells | N/A | 4+ |
| Test | IS | RT |
|---|---|---|
| screening cell I | 1+ | 2+ |
| screening cell II | 1+ | 2+ |
| autocontrol | 1+ | 2+ |
a. test serum against a panel of group O cells
b. neutralization
c. perform serum type at 370C ✅
d. elution
180. The following results were obtained on a patient’s blood sample during routine ABO and Rh testing:
Select the course of action to resolve this problem:
a. draw a new blood sample from the patient and repeat all test procedures
b. test the patient’s serum with A2 cells and the patient’s red cells with anti-A1 lectin ✅
c. repeat the ABO antigen grouping using 3x washed saline-suspended cells
d. perform antibody screening procedure at immediate spin using group O cells
| Test | Cell testing | Serum testing |
|---|---|---|
| anti-A | 0 | 4+ |
| anti-B | 4+ | 2+ |
| anti-D | 0 | N/A |
| autocontrol | 0 | N/A |
a. draw a new blood sample from the patient and repeat all test procedures
b. test the patient’s serum with A2 cells and the patient’s red cells with anti-A1 lectin ✅
c. repeat the ABO antigen grouping using 3x washed saline-suspended cells
d. perform antibody screening procedure at immediate spin using group O cells
181. Which of the following explains an ABO discrepancy caused by problems with the patient’s red blood cells?
a. an unexpected antibody
b. rouleaux ✅
c. agammaglobulinemia
d. Tn activation
a. an unexpected antibody
b. rouleaux ✅
c. agammaglobulinemia
d. Tn activation
182. The test for weak D is performed by incubating patient’s red cells with:
a. several different dilutions of anti-D serum
b. anti-D serum followed by washing and antiglobulin serum ✅
c. anti-Du serum
d. antiglobulin serum
a. several different dilutions of anti-D serum
b. anti-D serum followed by washing and antiglobulin serum ✅
c. anti-Du serum
d. antiglobulin serum
183. Refer to the following data:
Which of the following antibody screen results would you expect with the ABO discrepancy seen above?
a. negative
b. positive with all screen cells at the 370C phase
c. positive with all screen cells at the RT phase; autocontrol is negative ✅
d. positive with all screen cells and the autocontrol cells at the RT phase
| Test | Forward group | Reverse group |
|---|---|---|
| anti-A | 4+ | 0 |
| anti-B | 0 | 2+ |
| anti-A1 lectin | 4+ | N/A |
| A1 cells | N/A | 0 |
| A2 cells | N/A | 2+ |
| B cells | N/A | 4+ |
a. negative
b. positive with all screen cells at the 370C phase
c. positive with all screen cells at the RT phase; autocontrol is negative ✅
d. positive with all screen cells and the autocontrol cells at the RT phase
184. The following results were obtained when testing a sample from a 20-year-old, first-time blood donor:
What is the most likely cause of this ABO discrepancy?
a. loss of antigen due to disease
b. acquired B
c. phenotype Oh “Bombay” ✅
d. weak subgroup of A
| Test | Forward group | Reverse group |
|---|---|---|
| anti-A | 0 | 0 |
| anti-B | 0 | 3+ |
| A1 cells | N/A | 0 |
| B cells | N/A | 3+ |
a. loss of antigen due to disease
b. acquired B
c. phenotype Oh “Bombay” ✅
d. weak subgroup of A
185. A mother is Rh-negative and the father Rh-positive. Their baby is Rh-negative. It may be concluded that:
a. the father is homozygous for D
b. the mother is heterozygous for D
c. the father is heterozygous for D ✅
d. at least 1 of the 3 Rh typings must be incorrect
a. the father is homozygous for D
b. the mother is heterozygous for D
c. the father is heterozygous for D ✅
d. at least 1 of the 3 Rh typings must be incorrect
186. Some blood group antibodies characteristically hemolyze appropriate red cells in the presence of:
a. complement ✅
b. anticoagulants
c. preservatives
d. penicillin
a. complement ✅
b. anticoagulants
c. preservatives
d. penicillin
187. Review the following schematic diagram:
The next step would be to:
a. add “check cells” as a confirmatory measure ✅
b. identify the cause of the agglutination
c. perform an elution technique
d. perform a direct antiglobulin test
| Step | Action |
|---|---|
| 1 | PATIENT SERUM + REAGENT GROUP “O” CELLS |
| 2 | INCUBATE RED FOR AGGLUTINATION |
| 3 | WASH |
| 4 | ADD AHG AGGLUTINATION OBSERVED |
a. add “check cells” as a confirmatory measure ✅
b. identify the cause of the agglutination
c. perform an elution technique
d. perform a direct antiglobulin test
188. The following results were obtained in pretransfusion testing:
The most probable cause of these results:
a. rouleaux
b. a warm autoantibody ✅
c. a cold autoantibody
d. multiple alloantibodies
| Test | 37oC IAT |
|---|---|
| screening cell I | 0 3+ |
| screening cell II | 0 3+ |
| autocontrol | 0 3+ |
a. rouleaux
b. a warm autoantibody ✅
c. a cold autoantibody
d. multiple alloantibodies
189. A patient is typed as group O, Rh-positive and crossmatched with 6 units of blood. At the indirect antiglobulin (IAT) phase of testing, both antibody screening cells and 2 crossmatched units are incompatible. What is the most likely cause of the incompatibility?
a. recipient alloantibody
b. recipient autoantibody ✅
c. donors have positive DATs
d. rouleaux
a. recipient alloantibody
b. recipient autoantibody ✅
c. donors have positive DATs
d. rouleaux
190. Refer to the following data:
Which clinical condition is consistent with the lab results shown above?
a. cold hemagglutinin disease
b. warm autoimmune hemolytic anemia ✅
c. penicillin-induced hemolytic anemia
d. delayed hemolytic transfusion reaction
| Test | Result |
|---|---|
| Hemoglobin | 7.4g/dL (74g/L) |
| reticulocyte count | 22% |
| Direct Antiglobulin Test AB Screen –IAT | polyspecific: 3+ SC I: 3+ IgG: 3+ SC II: 3+ C3: 0 auto: 3+ |
a. cold hemagglutinin disease
b. warm autoimmune hemolytic anemia ✅
c. penicillin-induced hemolytic anemia
d. delayed hemolytic transfusion reaction
191. A patient received 2 units of Red Blood Cells and had a delayed transfusion reaction. Pretransfusion antibody screening records indicate no agglutination except after the addition of IgG sensitized cells. Repeat testing of the pretransfusion specimen detected an antibody at the antiglobulin phase. What is the most likely explanation for the original results?
a. red cells were overwashed
b. centrifugation time was prolonged
c. patient’s serum was omitted from the original testing ✅
d. antiglobulin reagent was neutralized
a. red cells were overwashed
b. centrifugation time was prolonged
c. patient’s serum was omitted from the original testing ✅
d. antiglobulin reagent was neutralized
192. At the indirect antiglobulin phase of testing, there is no agglutination between patient serum and screening cells. One of 3 donors units was incompatible. The most probable explanation for these findings is that the:
a. patient has an antibody directed against a high incidence antigen
b. patient has an antibody directed against a low incidence antigen ✅
c. donor has an antibody directed against donor cells
d. donor has a positive antibody screen
a. patient has an antibody directed against a high incidence antigen
b. patient has an antibody directed against a low incidence antigen ✅
c. donor has an antibody directed against donor cells
d. donor has a positive antibody screen
193. The major crossmatch will detect a(n):
a. group A patient mistyped as group O
b. unexpected red cell antibody in the donor unit
c. Rh-negative donor unit mislabeled as Rh-positive
d. recipient antibody directed against antigens on the donor red cells ✅
a. group A patient mistyped as group O
b. unexpected red cell antibody in the donor unit
c. Rh-negative donor unit mislabeled as Rh-positive
d. recipient antibody directed against antigens on the donor red cells ✅
194. A 42-year-old female is undergoing surgery and her physician requests that 4 units of Red Blood Cells be crossmatched. The following results were obtained:
What is the most likely cause of the incompatibility of donor 1?
a. single alloantibody ✅
b. multiple alloantibodies
c. Rh incompatibilities
d. donor 1 has a positive DAT
| Test | IS | 37oC | IAT |
|---|---|---|---|
| screening cell I | 0 | 0 | 0 |
| screening cell II | 0 | 0 | 0 |
| screening cell III | 0 | 0 | 0 |
| Crossmatch donor 1 | 2+ | 1+ | 1+ |
| Crossmatch donors 2,3,4 | 0 | 0 | 0 |
a. single alloantibody ✅
b. multiple alloantibodies
c. Rh incompatibilities
d. donor 1 has a positive DAT
195. Which of the following would most likely be responsible for an incompatible antiglobulin crossmatch?
a. recipient’s red cells possess a low frequency antigen
b. anti-K antibody in donor serum
c. recipient’s red cells are polyagglutinable
d. donor red cells have a positive direct antiglobulin test ✅
a. recipient’s red cells possess a low frequency antigen
b. anti-K antibody in donor serum
c. recipient’s red cells are polyagglutinable
d. donor red cells have a positive direct antiglobulin test ✅
196. A reason why a patient’s crossmatch may be incompatible while the antibody screen is negative is:
a. the patient has an antibody against a high-incidence antigen ✅
b. the incompatible donor unit has a positive direct antiglobulin test
c. cold agglutinins are interfering in the crossmatch
d. the patient’s serum contains warm autoantibody
a. the patient has an antibody against a high-incidence antigen ✅
b. the incompatible donor unit has a positive direct antiglobulin test
c. cold agglutinins are interfering in the crossmatch
d. the patient’s serum contains warm autoantibody
197. A blood specimen types as A, Rh-positive with a negative antibody screen. 6 units of group A, Rh-positive Red Blood Cells were crossmatched and 1 unit was incompatible in the antiglobulin phase. The same result was obtained when the test was repeated. Which should be done first?
a. repeat the ABO grouping on the incompatible unit using a more sensitive technique
b. test a panel of red cells that possesses low-incidence antigens
c. perform a direct antiglobulin test on the donor unit ✅
d. obtain a new specimen and repeat the crossmatch
a. repeat the ABO grouping on the incompatible unit using a more sensitive technique
b. test a panel of red cells that possesses low-incidence antigens
c. perform a direct antiglobulin test on the donor unit ✅
d. obtain a new specimen and repeat the crossmatch
198. During emergency situations when there is no time to determine ABO group and Rh types on a current sample for transfusion, the patient is known to be A, Rh-negative. The technologist should:
a. refuse to release any blood until the patient’s sample has been typed
b. release A Rh-negative Red Blood Cells ✅
c. release O Rh-negative Red Blood Cells
d. release O Rh-positive Red Blood Cells
a. refuse to release any blood until the patient’s sample has been typed
b. release A Rh-negative Red Blood Cells ✅
c. release O Rh-negative Red Blood Cells
d. release O Rh-positive Red Blood Cells
199. A 29-year-old male is hemorrhaging severely. He is AB, Rh-negative. 6 units of blood are required for STAT. Of the following types available in the blood bank, which would be most preferable for crossmatch?
a. AB, Rh-positive
b. A, Rh-negative
c. A, Rh-positive
d. O, RH-negative ✅
a. AB, Rh-positive
b. A, Rh-negative
c. A, Rh-positive
d. O, RH-negative ✅
200. A patient is group A2B, Rh-positive and has an antiglobulin-reacting anti-A1 in his serum. He is in the operating room bleeding profusely and group A2B Red Blood Cells are not available. Which of the following blood types is first choice for crossmatching?
a. B, Rh-positive ✅
b. B, Rh-negative
c. A1B, Rh-positive
d. O, Rh-negative
a. B, Rh-positive ✅
b. B, Rh-negative
c. A1B, Rh-positive
d. O, Rh-negative
