MLPAO Transfusion Medicine Advanced Practice 2

Question 1

What is gel column technology (gel test) and how does it work in blood banking?

Accepted Answer

A method using dextran gel-filled microtubes where agglutinated red cells are trapped in the gel while non-agglutinated cells pass through to the bottom

Answer

Gel column technology (DiaMed/Bio-Rad) uses microtubes containing dextran acrylamide gel. After incubation, tubes are centrifuged: agglutinated red cells are trapped in the gel matrix (positive result), while non-agglutinated cells pass through to the bottom (negative result). This standardized method reduces subjective interpretation and is widely used for typing, antibody screening, and crossmatching.

Question 2

What is transfusion-related acute lung injury (TRALI)?

Accepted Answer

Acute respiratory distress occurring within 6 hours of transfusion, caused by donor antibodies activating recipient neutrophils in pulmonary capillaries

Answer

TRALI is a serious complication characterized by acute bilateral pulmonary edema and hypoxia within 6 hours of transfusion, without other risk factors for acute lung injury. It is caused by donor anti-HLA or anti-HNA antibodies that activate recipient neutrophils in pulmonary capillaries. Risk reduction strategies include using male-only plasma donors.

Question 3

What is the significance of the Duffy blood group system in relation to malaria?

Accepted Answer

The Duffy antigen Fy(a)/Fy(b) serves as the receptor for Plasmodium vivax; Duffy-negative individuals are resistant to P. vivax malaria

Answer

The Duffy glycoprotein (DARC) serves as the receptor for P. vivax merozoite invasion of red blood cells. The Fy(a-b-) phenotype (common in individuals of West African descent due to a GATA-1 binding site mutation) confers resistance to P. vivax malaria. This selective advantage has maintained the high frequency of the Duffy-null phenotype in malaria-endemic regions.

Question 4

What is the role of Canadian Blood Services (CBS) in the Canadian blood system?

Accepted Answer

CBS is responsible for collecting, testing, processing, and distributing blood and blood products across Canada (except Québec, which is served by Héma-Québec)

Answer

Canadian Blood Services (CBS) is the national, not-for-profit blood operator responsible for the collection, testing, processing, and distribution of blood and blood products for all Canadian provinces and territories except Québec (served by Héma-Québec). CBS also manages the national stem cell, organ, and tissue donation programs.

Question 5

What infectious disease testing is performed on all donated blood in Canada?

Accepted Answer

HIV, Hepatitis B, Hepatitis C, HTLV-I/II, Syphilis, West Nile Virus, and additional tests as required

Answer

All Canadian blood donations are tested for: HIV-1/2 (antibody and NAT), Hepatitis B (HBsAg, anti-HBc, NAT), Hepatitis C (antibody and NAT), HTLV-I/II (antibody), Syphilis (antibody), and West Nile Virus (NAT). Additional testing (e.g., Babesia, Zika) may be implemented based on risk assessment. Nucleic acid testing (NAT) has significantly narrowed the window period.

MLPAO - Medical Laboratory Professionals Association of Ontario Practice Test

MLPAO - Medical Laboratory Professionals Association of Ontario Practice Test

MLPAO Transfusion Medicine Advanced Practice 2