BLOOD TRANSFUSION MULTIPLE CHOICE QUESTIONS

PREPARED BY MWALIMU NKURIKIYIMANA STEPHENSON

EMAIL: SNKURIMANA2014@GMAIL.COM

CMLT, DMLT, DMGHT&LD, BMED, MVP, PHD FELLOW

1. A donor weighing 40 kg normally donates -------m/s of whole blood

a) 360

b) 450

c) 495

d) 415

2. All of the following are correct methods done to defrost a refrigerator except.

a) Taking out a paraffin tank and putting out the flame

b) Putting off electricity and removing the top plug

c) Removing ice away from the freezing cabinet using a sharp instrument

d) Leaving the door to the refrigerator open and removing everything from it

3. Which of the following is not a component of ACD anticoagulant for transfusion?

a) Trisodium citrate

b) Dextrose

c) Citric acid

d) Adenine

4. Blood collected in CPDA anticoagulant and kept at 40C in a refrigerator can be used up to

a) 21 days only

b) 35 days only

c) Within a few days only

d) Indefinitely

5. All of the following immunological tests are used to detect active infections in a donor blood

except one. Choose the correct answer.

a) Rapid plasma reagen

b) Enzyme linked immunosorbent assay

c) Hepatitis B surface antigens immuno chromatography

d) Unigold

6. All of the following are duties of a blood bank employee except one.

a) Storage of blood at the correct conditions

b) Safe collection and transportation of donor blood

c) Keep records of donations and transfusions

d) Utilize donated blood

7. Which of the following is not a good practice for proper layout of a blood bank refrigerator?

a) Store recently donated blood which has not yet been tested or screened for infectious agents

separately

b) Store blood packs upright to allow the separation of plasma and red blood cells to make it

easy to remove unwanted plasma when a manual plasma extractor is unavailable

c) Store tested screened blood of different blood groups in separate compartments

d) Storage of reagents and blood in the same refrigerator

8. Which one of the following would cause any deferral of a prospective blood donor?

a) Temperature 370C

b) Pulse 90 beats per minute

c) Blood pressure 110/70 mm Hg

d) Heamatocrit 20%

9. All of the following are donor reactions except one.

a) Haematoma

b) Fainting

c) Haemolytic transfusion reaction

d) Convulsions

10. All of the following are advantages of collection of blood in quadruple paediatric collection bags

except ;

a) Sterility during separation of blood is guaranteed as it is done in closed system

b) They are cheap compared to MRC bottles and risks of air embolism are reduced

c) The risks of transfusion reaction due to pyrogenes are eliminated

d) They are not bulky to store

11. The following are blood products except:

a) Cryoprecipitate

b) Factor VIII concentrates

c) Fresh frozen plasma

d) Dextran

12. A heamophilic patient is best transfused with----

a) Whole blood

b) Cryoprecipitate

c) Fresh frozen plasma

d) Packed red blood cells

13. The best standard gauge of a needle for use for collection of donor blood for transfusion is?

a) 20

b) 21

c) 19

d) 23

14. Aquadruple bag for collection of donor blood has.

a) Three satellite bags

b) Two satellite bags

c) Four satellite bags

d) Two bags

15. Which of the following anticoagulants is considered poisonous in blood banking……?

a) EDTA

b) Trisodium citrate

c) K or Na oxalates

d) Heparin

16. The following are the major criteria considered when preserving and standardizing antisera,

EXCEPT

a) Specificity

b) Potency

c) Haemolysins

d) Avidity

17. ------- is the method used to estimate haemoglobin of voluntary donors.

a) Specific gravity method

b) Oxyhaemoglobin method

c) Cynamethaemoglobin

d) Sahli’s method

18. Donor processing area is where testing is carried out to find the suitability of a blood product for

transfusion. The following are the test required, except.

a) ABO and Rh grouping

b) Serologic tests

c) Antibodies screen for clinically significant antibodies

d) Haemoglobin and Bp estimation

e) All of the above

19. --------- is a solution used inblood bank to preserve and store blood for 35-45 days when under

correct temperature.

a) Papain

b) SAG-M

c) Saline

d) Liss

20. The purpose of quality assurance in the laboratory practice is to provide test results that are;

except.

a) Reliable and reproducible

b) Relevant and timely

c) Interpreted correctly and accurate

d) None of the above

21. Blood transfusion may be best defined as;

A. The transfer of blood from donor to recipient

B. The giving of safe blood to a donor

C. The transfusion/infusion of safe blood from donor to a recipient

D. The transfer of safe blood from the recipient to the donor.

22. A group of genes representing a particular character is called;

A. Locus

B. Alleles

C. Dormant genes

D. Amorphic genes.

23. The best blood component for a person suffering from thrombocytopenia is;

A. White blood cell concentrates

B. Packed red blood cells

C. Plasma

D. Platelet concentrates.

24. The immunoglobin class that is capable of offering protection to the mucus membrane is;

A. IgA

B. IgM

C. IgG

D. IgD.

25. The immunoglobin class that exists both as a monomer and a dimer is;

A. IgA

B. IgM

C. IgG

D. IgD

26. During ABO antigen development, the H-gene codes for;

A. Fucose sugar

B. Fucosyltransferase enzyme

C. D.galactosamyl transferase enzyme

D. Fucose.

27. The immuno dominant sugar for B-antigen is;

A. N-acetyl D galactose

B. N-acetyl D galactosamine

C. D-galactose

D. Fucose.

28. A condition when there is antibody excess during antigen antibody reaction is called;

A. Post zone phenomenon

B. Prozone phenomenon

C. Equivalence

D. Pre-zone phenomenon.

29. The binding of antibody or complement component to a red blood cell antigen is called;

A. Agglutination

B. Sensitization

C. Neutralization

D. Elution.

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30. The immunoglobin class that is capable of agglutinating red cells in normal saline is;

A. IgD

B. IgE

C. IgM

D. IgA.

31. The concentration of sodium chloride used as blood banking is;

A. 0.8% sodium chloride

B. 0.9% sodium chloride

C. 10.0% sodium chloride

D. 0.85% sodium chloride.

32. The red cell concentration for tile grouping is;

A. 2-5 %

B. 3-5%

C. 20-40%

D. 5-10% .

33. Antiserum A used in grouping is coded with color;

A. Yellow

B. Green

C. Blue

D. Colorless.

34. The ability of an antisera to react with its corresponding antigen within a short time is called;

A. Potency

B. Avidity

C. Specificity

D. Titre.

35. The best blood sample for grouping an infant is;

A. Red blood cells from the mother

B. Red blood cells from the baby

C. Serum of the mother

D. Serum of the baby.

36. During tube grouping, we mix contents of the tube by;

A. Using an applicator stick breaking off the used part before transferring to the next

B. Mixing the contents using a pasteur pipette

C. Tapping the bottoms of the tube

D. Shaking vigorously.

37. The specific gravity of copper sulphate solution that corresponds to 12.0g/dl blood is;

A. 1.053

B. 1:055

C. 1:056

D. 1:052

38. Which one of the following blood groups is a universal donor?

A. Blood group O Rh (D) positive

B. Blood group O Rh (D) Negative

C. Blood group AB Rh (D) negative

D. Blood group AB Rh (D) positive.

39. The antigens of the Rhesus blood group are;

A. D,E,C only

B. D, E, C, c, e

C. A,B,H

D. D, d, E, e, C, c.

40. Which of the following represents a weak D antigen? (DU)

A. CDe/cde B. Cde/Dce

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C. cde/DCe D. edc/edc.

41. A gene (like gene O) that does not work to produce detectable substances is called:

A. Recessive gene

B. Dominant gene

C. Allelemorphic gene

D. Armorphic gene.

42. What is the likely cross outcome between a homozygous group B woman with a heterozygous

group A man:

A. 50% will be group O

B. 50% will be group AB

C. 50% will be group A

D. 25% will be group B.

43. The specific gravity of copper sulphate solution that corresponds to 12.0 g/dl for female donors

is:

A. 1.053

B. 1.055

C. 1.530

D. 1.550

44. The following are true about tile grouping, except:

A. The test is allowed to incubate at 370C for three minutes

B. The used part of the applicator stick is broken off before transferring to the next

C. If one is not careful hemolysis cab be missed

D. The test is time specific.

45. Which one of the following is not important when labeling a reagent?

A. Reagent name

B. Date of preparation

C. Date of use

D. Person who prepared the reagent.

46. Which one of the following is the immune dominant sugar for blood group A antigen?

A. Fucose

B. N-acetyl D – glucose

C. N-acetyl galactosamyl transferase

D. N-acetyl galactosamine.

47. The most common antibody specificity associated with haemolytic disease of the new born

(HDN) is:

A. Anti AB

B. Anti D

C. Anti JKa

D. Anti LUb

48. The reagents below are used for blood grouping, except:

A. Red blood cells

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B. Anti D

C. Anti A

D. Antihuman globulin.

49. The best cell suspension of red blood cells used in ABO tube grouping is:

A. 1 in 3

B. 1 in 4

C. 1 in 10

D. 1 in 19.

50. The genetic composition of a secret or individual can be the following, except:

A. SEse

B. Sese

C. seSe

D. b and c.

51. The best blood component for a patient with factor VIII deficiency is:

A. Fresh frozen plasma

B. Platelet concentrate

C. Cryoprecipitate

D. Whole blood.

52. The product of meiosis is:

A. Gametes with twice the genetic complement of the mother cell

B. Gametes with one half the genetic complement of the mother cell

C. Gametes with the same genetic complement as the mother cell

D. Cells identical to the mother cell.

53. Which one of the following statements is NOT true?

A. Blood group antigens are both particulate and soluble

B. Blood group antibodies are found on surfaces of red blood cells

C. Blood group antibodies are generally absent at birth

D. Blood group antigens are fully developed at birth.

54. Rouleaux applies to the following, except:

A. Appear microscopically as distinctive coin like stacks of RBCs

B. May be observed following transfusion of dextran

C. Is generally observed in the antiglobulin phase

D. Can be eliminated by washing red cells before test.

55. A place occupied by a gene on a chromosome is called:

A. Locus

B. Gene location

C. Centromere

D. Chiasmata.

56. One of the following is responsible for Du

A. Missing antibodies

B. Genetic climera

C. Cis position of the D and C producing gene

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D. Transposition of the D and C producing gene.

57. Which one of the following is represented by r, in Fisher and Race nomenclature?

A. DCE

B. DCe

C. dce

D. dCe.

58. Which of the following statements is NOT true of the H-antigen?

A. Inheritance of the H antigen is necessary for normal expression of the ABO antigens

B. The amount of the H- antigen varies for the different ABO types

C. The antibody directed towards the H- antigen is naturally occurring in the serum of most

adults

D. H-antigen may be present in the secretions.

59. The recommended blood sample when grouping an infant is:

A. Red blood cells from mother

B. Red blood cells of the baby

C. Serum of the mother

D. Serum of the baby.

60. The blood antigens are:

A. Found on surface of red blood cells only

B. Found both on red blood cell membranes and body fluids

C. Found only in body fluids

D. Not fully developed at birth.

61. The products of genes inherited at the ABO locus are:

A. Kinase

B. Glycolipids

C. Transferases

D. Carbohydrates.

62. The 1gG molecule usually occurs as a

a) Dimer

b) Monomer

c) Pentamer

d) Trimer

63. The following are characteristics of 1gm antibodies except

a) Most of them are naturally occurring

b) They react best at cold temperature

c) The cross the placenta and cause haemolytic disease of the new born

d) They cause agglutination of red cells in normal saline

64. The best sample for cross match of blood for an infant is

a) Baby’s red cells

b) Baby’s serum

c) Mother’s serum

d) Mother’s cells

65. The position occupied by a gene on a chromosome is known as

a) Gene position

b) Locus

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c) DNA position

d) Gene location

66. The 23 long threadlike structures found within the nucleus of most somatic cells are known as

a) Genes

b) RNA

c) Chromosomes

d) Nucleotides

67. Gene O has no detectable product and is the therefore termed as

a) Amorphic

b) Recessive

c) Co- dorminat

d) Dorminat

68. The major factor affecting the electrolastic repulsion between the red cells is

a) D. electric constant

b) PH of the medium

c) The ceta potential

d) Immunoglobulin class

69. Which one of the following blood groups contains both antibodies A and B

a) Blood group A

b) Blood group B

c) Blood group AB

d) Blood group O-

70. The basic reaction in the determination of secretor status is

a) Agglutination

b) Haemolysis

c) Neutralisation

d) Component fixation

71. What is the likely outcome between a heterozygous B mother and Homozygous A farther?

a) 25% offspring will be AB

b) 50% offspring will be AB

c) 50% offspring will be B

d) 50% of offspring will be O

72. Rhesus antibodies are indicated for the following except

a) Causing blood group incompatibility

b) Causing HDNB

c) Causing delayed haemolytic transfusion reaction

d) Infants who are Rhesus D negative

73. The following are reasons for washing red cells during grouping and cross match except

a) To remove plasma that tends to cause rouleaux formation

b) To remove anticoagulants which may interfere with detection of complement binding

antibodies

c) Saline provides red cells with energy to react best

d) To remove soluble substances present in plasma that may inhibit the corresponding reactions

74. The best way of removing un wanted antibody from antibody mixture is by

a) Elution

b) Absorption

c) Filtration

d) Warming the mixture at 370C

75. Saline at room temperature is designed to detect

a) 1gm antibodies

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b) 1gG antibodies

c) 1gA antibodies

d) Major ABO grouping errors and 1Ge antibodies

76. One of the following is not a characteristic of a good grouping antisera

a) Must be potent

b) Must be lipid free

c) Must react with all antigens (poly-agglutination)

d) Must be progen free

77. During cross matching, checked cells are added to

a) Act as a positive control

b) Rule out abnormal antibodies

c) Neutralize antiglobulin reagent

d) To check on potency of AHG

78. All the following can cause haemolytic transfusion reaction except

a) Transfusion of incompatible blood

b) Injection of water into the circulation

c) Transfusion with great pressure

d) Transfusing more than 5 units of blood

79. The best technique for detecting blood group of a neonate is

a) Serum grouping

b) Reverse grouping

c) Cell grouping

d) Direct combs test

80. Which one of the following refers to the removal of antibodies from the cells

a) Absorption

b) Adsorption

c) Elution

d) Sensitization

81. Which one of the following is not a heavy chain of immunoglobulin

a) Alpha

b) Delta

c) Lambda

d) MU

82. When storing blood units in the blood bank, ensure that the blood is:

A. Stored at suitable temperature of 37oC ready for use.

B. Kept at the freezing compartment to maintain right blood temperatures

C. Kept in special refrigerators with good thermostat to regulate temperatures at 2 -6oC

D. Stored in refrigerators of any desired temperature ranges

83. A suitable anticoagulant like CPDA plus manitol takes:

A. About 35-40 days when in right temperatures

B. About 45 days under correct temperatures

C. About 28 – 35 days at correct temperature

D. Up to 42 days only

84. A major aim of record keeping in blood bank is:

A. To avoid mixing records and causing transfusion reaction

B. To keep records under safe custody

C. To show the number of blood units grouped and cross matched

D. For the planning, research, requisition and show the level of performance

85. A blood donor is:

A. A person who has just recovered from a sick bed and donates blood

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B. A person who just gives blood to the recipient by force to save his life

C. A person who willingly gives blood to a person of his or her choice only

D. A healthy person who donates blood to save lives of other people at his or her will

86. Which of these colours when seen on a blood unit means group O?

A. Blue

B. Black

C. Yellow

D. Red.

87. Hemophilic patient is best transfused with:

A. Whole blood

B. Cryoprecipitate plasma

C. Fresh frozen plasma

D. Packed red blood cells

88. A universal donor is

A. Blood group AB

B. Blood group O

C. Blood group O Rhesus D positive

D. Blood group O Rhesus D negative

89. During blood donation, the blood pressure machine cuff should be maintained at:

A. 60 – 90mmHg

B. 40 – 60mmHg

C. 100 – 180mmHg

D. 90 – 50mmHg

90. Blood kept for transfusion in CPDA anticoagulant can be kept for:

A. 48 days

B. 21 days

C. 35 days

D. 30 days

91. Heparin protects the clotting of blood by

A. Coating blood vessels

B. Inhibiting action of thrombin

C. Chelating calcium ions

D. Activating prothrombin

92. ………………is a procedure that is involved in the collection, storing, processing and

distribution of blood.

A. Blood banking

B. Blood storage

C. Blood donor

D. Blood collection.

93. Which of the following is the correct temperature for the storage of packed red blood cells and

whole blood:

A. 10oC – 15oC

B. -5oC – 10oC

C. 1oC – 6oC

D. 7oC – 10oC.

94. The following are reactions that occur during and after blood donation except:

A. Dizzness

B. Nausea

C. Fainting

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D. Abdominal pain.

95. When transporting blood for donation always use:

A. A well-insulated box at room temperature

B. A well-insulated cool box with sufficient freezer packs

C. A box while blood bags are touching directly the freezer packs

D. All the above.

96. Most collection bags contain……………………of CPDA which is sufficient to preserve and

ensure the viability of blood cells:

A. 200ml

B. 5ml

C. 100ml

D. 63ml.

97. Blood donor cards have the following features except:

A. Donor’s name

B. Gender of the donor

C. Age of the donor

D. The skin colour of the donor

98. The following are protozoan infections tested when selecting blood for donation except:

A. Balantidium coli

B. Plasmodium species

C. Trypanasoma species

D. Filarial worms

99. ……………is done in patients to control bleeding associated with deficiencies of platelets or

dysfunction of platelets:

A. Fresh frozen plasma transfusion

B. Platelet transfusion

C. Whole blood transfusion

D. Packed red cell transfusion.

100. The following are physical requirements that are used when selecting the donor except:

A. Weight

B. Temperature

C. Height

D. Blood pressure

101. Blood donations may be taken from individuals between ages of:-

A. 25 – 80 years only

B. 17 – 65 years only

C. 17 – 50 years only

D. 18 – 30 years only

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ESSAY QUESTIONS

1. Define the following terms: Quality assurance, Record keeping, Blood substitute, Blood products,

Monoclonal antibodies, Polyclonal antibodies

2. Outline the importance of CPDA ingredients in blood bank.

3. List the steps followed when recruiting a prospective suitable donor.

4. Outline the steps to follow when preparing donor packed red blood cells for pediatric Transfusion.

5. Describe the transportation and storage of processed donor of blood units up to the hospital blood

bank.

6. Describe the vein puncture procedure of collecting venous blood from a suitable donor.

7. Define the following terms: Gene, Locus, Agglutination, Heterozygous & Antigen

8. Complete the table below.

Blood group Antigen present Antibody present

A ..................................... B

.......................................... A & B ............................................

O NONE .............................................

B ....................................... A

9. Define five (5) antigen antibody reactions in blood transfusion.

10. List five (5) qualities of a good blood grouping antisera.

11. Discuss the development of ABH antigens.

12. Explain the causes of false results in ABO grouping.

13. Describe the procedure for ABO and Rhesus cell grouping using tile method.

14. Discuss the preparation of normal saline used in blood transfusion and give five (5) reasons

for washing red cells in Blood Transfusion.

15. Give four (4) uses of blood transfusion.

16. List the different classes of immunoglobulin heavy chains.

17. Give four (4) properties of immune antibodies.

18. Match the following.

i. Blood group B a) Color coded Yellow

ii. Anti D reagent b) Contains anti h

iii. Anti A reagent c) Used in paternity testing

iv. Bombay d) Used for rhesus grouping

e) Naturally occurring

f) Has antigens B

19. List and define four antigen - antibody reactions in blood banking.

20. Explain the method of tile grouping patient’s red blood cells to determine the ABO group.

Include controls in your procedure.

21. Describe the procedure for preparing red blood cells used in tube grouping.

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22. Describe the criteria for selecting and standardizing grouping antisera.

23. Discuss ten factors that influence antigen antibody reactions.

24. Discuss normal saline under the following headings: Principle, Preparation, Quality control

& Uses

25. State four functions of ingredients in CPDA anticoagulants.

26. Give six Blood transmissible Diseases

27. State five Blood records kept in the Blood Bank

28. List five features of Good Blood refrigerator.

29. Outline five causes of false results in Blood Bank.

30. State the process of defrosting Blood Bank refrigerator.

31. Discuss the anticoagulants used in Blood Banking.

32. Explain five different component used in blood transfusion, state the storage conditions and shelf life

of each component.

33. With relevant examples define the term plant lactins

34. Discuss the storage of antisera

35. Discuss the preparation of antihuman globulin

36. Discuss the developed blood antigens from precursor substance

37. Discuss the preparation of copper sulphate solution whose SG 1.053female & 1.055 Male).

38. Definition and state the blood transfusion

39. Outline the history of blood transfusion

40. Discuss the discovery of Rhesus blood grouping system

41. Describe the causes and detection of Haemolytic disease of new born

42. State the principle of ABO blood grouping system

43. Discuss the term Du antigen and its detection

44. Discuss factors that affect ABO blood grouping system

45. State the laws of heredity

46. State the purposes of x-matching blood

47. Discuss the demerits of Rhesus D blood group system

48. Discuss the subgroups of ABO

49. Discus the importance of reverse blood grouping in blood bank

50. Discuss the forward and back ward blood grouping in blood bank

51. With examples explain the following terms: dominant gene, recessive gene, phenotype,

genotype, chromosomes, allele and mitosis and meiosis

52. Discuss who is Du Donor

53. Discuss the preparation of the following: packed cells, fresh frozen plasma, platelets

54. Discuss the tests done on donor blood

55. Describe the packaging and transportation of blood

Success

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