CMT CMT Blood Banking and Transfusion Medicine 2 — Questions and Answers
Question 1: A transfusion reaction presenting with fever, chills, and flank pain minutes after starting a transfusion most suggests:
- Febrile non-hemolytic transfusion reaction
- Acute hemolytic transfusion reaction (Correct answer)
- Allergic transfusion reaction
- Transfusion-associated circulatory overload (TACO)
Correct answer: Acute hemolytic transfusion reaction
Fever, chills, and flank pain (from renal involvement) occurring rapidly after transfusion onset are classic signs of an acute hemolytic transfusion reaction due to ABO incompatibility.
Question 2: Which test is performed to detect unexpected alloantibodies in a patient's plasma before transfusion?
- Forward ABO typing
- Reverse ABO typing
- Antibody screen (indirect antiglobulin test) (Correct answer)
- Direct antiglobulin test
Correct answer: Antibody screen (indirect antiglobulin test)
The antibody screen (indirect antiglobulin test) tests the patient's serum against reagent red cells expressing known antigens to detect unexpected alloantibodies.
Question 3: Cryoprecipitate is the product of choice for which deficiency?
- Factor IX deficiency (hemophilia B)
- Fibrinogen deficiency or von Willebrand disease (Correct answer)
- Protein C deficiency
- Factor VII deficiency
Correct answer: Fibrinogen deficiency or von Willebrand disease
Cryoprecipitate is rich in fibrinogen, Factor VIII, von Willebrand factor, and Factor XIII, making it the preferred product for fibrinogen deficiency and vWD.
Question 4: Irradiation of blood products is performed primarily to prevent:
- Bacterial contamination
- CMV transmission
- Transfusion-associated graft-versus-host disease (TA-GvHD) (Correct answer)
- Febrile non-hemolytic reactions
Correct answer: Transfusion-associated graft-versus-host disease (TA-GvHD)
Gamma irradiation inactivates donor T lymphocytes in blood products, preventing them from engrafting and attacking the immunocompromised recipient in TA-GvHD.
Question 5: The Kleihauer-Betke test is used to:
- Detect fetal-maternal hemorrhage by quantifying fetal cells in maternal blood (Correct answer)
- Type and screen Rh antigens
- Detect sickle cell trait
- Diagnose G6PD deficiency
Correct answer: Detect fetal-maternal hemorrhage by quantifying fetal cells in maternal blood
The Kleihauer-Betke acid elution test differentiates fetal (HbF-containing) from adult red cells in maternal blood to estimate the degree of feto-maternal hemorrhage and guide Rh immunoglobulin dosing.
Question 6: The maximum storage time for packed red blood cells (pRBCs) in CPDA-1 additive solution at 1–6°C is:
- 21 days
- 35 days (Correct answer)
- 42 days
- 14 days
Correct answer: 35 days
pRBCs stored in CPDA-1 solution have a shelf life of 35 days at 1–6°C; extended additive solutions (AS-1, AS-3, AS-5) extend storage to 42 days.
CMT CMT Blood Banking and Transfusion Medicine 2
A transfusion reaction presenting with fever, chills, and flank pain minutes after starting a transfusion most suggests: