Medical Laboratory Technician Blood Banking and Transfusion Questions and Answers

Question 1

A patient with a known IgA deficiency requires a transfusion of packed red blood cells. To prevent a potential anaphylactic transfusion reaction, which modification should be performed on the blood product?

Accepted Answer

Washing

Answer

Washing red blood cells with sterile saline removes the majority of the plasma, which contains proteins like IgA. In an IgA-deficient patient who has developed anti-IgA antibodies, transfusing plasma-containing products can trigger a severe anaphylactic reaction. Irradiation prevents transfusion-associated graft-versus-host disease, and leukoreduction minimizes febrile reactions and CMV transmission, but neither process removes plasma proteins.

Question 2

A blood sample from a 28-year-old, Rh-negative female who is 28 weeks pregnant shows a positive antibody screen. An antibody panel is performed, and the technologist identifies anti-D. What is the most likely reason for this finding?

Accepted Answer

The patient received a routine antenatal dose of Rh Immune Globulin (RhIG).

Answer

Rh Immune Globulin (RhIG) is a concentrated solution of IgG anti-D, given to non-sensitized Rh-negative mothers at approximately 28 weeks gestation to prevent immunization to the D antigen. This passively administered anti-D will cause the antibody screen to be positive. While the other options are possible causes for a positive antibody screen, the patient's specific history (Rh-negative, 28 weeks pregnant) makes the recent administration of RhIG the most probable cause.

Question 3

During the crossmatch process, an MLT receives the following ABO typing results for a patient: Anti-A: 4+, Anti-B: 0, A1 Cells: 0, B Cells: 2+. What is the most likely cause of this ABO discrepancy?

Accepted Answer

The patient is likely an A2 subgroup with anti-A1.

Answer

The forward type indicates the patient is Group A. The reverse type shows an expected reaction with B cells but an unexpected weak (2+) reaction with A1 cells. This pattern is characteristic of a Group A2 individual who has produced an anti-A1 antibody. This is a relatively common and clinically benign discrepancy. A cold alloantibody would likely react with both A1 and B cells if the corresponding antigen was present, and missing antibodies would result in no reaction with B cells.

Question 4

An immunocompromised patient is scheduled to receive a unit of packed red blood cells from a blood relative. To prevent transfusion-associated graft-versus-host disease (TA-GVHD), which of the following is the most critical modification for this blood product?

Accepted Answer

Gamma irradiation

Answer

Gamma irradiation is the only method that effectively prevents TA-GVHD by inactivating donor T-lymphocytes, rendering them incapable of proliferating and attacking the recipient's tissues. This is especially critical for immunocompromised recipients and when receiving blood from a relative, where there is a higher chance of shared HLA types. Leukoreduction reduces the number of white cells but does not eliminate the risk.

Question 5

A patient experiences a fever and chills 30 minutes after the start of a red blood cell transfusion. The transfusion is stopped immediately. A post-transfusion reaction workup reveals a negative DAT and no visual evidence of hemolysis in the post-transfusion specimen. This clinical picture is most consistent with which type of transfusion reaction?

Accepted Answer

Febrile non-hemolytic transfusion reaction (FNHTR)

Answer

A febrile non-hemolytic transfusion reaction (FNHTR) is characterized by a fever and chills during or shortly after a transfusion, without evidence of red cell destruction (hemolysis). The negative DAT and lack of hemolysis rule out an AHTR. An allergic reaction typically involves hives and itching, and TACO involves respiratory distress and signs of fluid overload.

Medical Laboratory Technician Exam Practice Test

Medical Laboratory Technician Exam Practice Test

Medical Laboratory Technician Blood Banking and Transfusion Questions and Answers