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MULTIPLE CHOICE QUESTIONS IN TRANSFUSION MEDICIANE

1. The characteristic features of hyperfibrionlysis, which differentiate it from

disseininated intravascular coagulation include all of the following except:-
a. Association with pelvic and prostate surgery
b. Normal platelet count
c. Prothrombin time and APTT are only mildly prolonged
d. Marked reduction of factors V and VIII
e. Iatrogenic bleeding may occur after streptokinase
Key; d, level; C2

2. Acute haemolytic transfusion reactions:-

a. May occur, secondary to high titre anti-I cold agglutinins
b. Can lead to hepatic failure
c. Are rarely due to incorrect identification of recipient
d. Are characterized by a negative Coomb's test
e. Can present with uncontrollable hypotension in anaesthetized patients
Key: e, Level: C2

3. A patient has the following results on ABO grouping:-

a. Anti-A Anti-B Anti-AB A Cells B Cells O Cells
0 0 0 4+ 4+ 4+

The most likely explanation of these results is the following:-

a. Sample of a neonate
b. An elderly patient
c. Bombay blood group
d. Patient with intestinal tumour
e. Acute haemolytic transfusion reaction
Key: c, Level: C1
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4. Treatment of red cells with proteolytic enzymes:-
a. Leads to weakening of Duffy antigens M, N
b. Can destroy RhD antigen
c. Is routinely employed in crossmatch testing
d. Is advised to prevent febrile transfusion reactions
e. Is synonymous with use of low ionic strength saline
Key: a, Level: C1
5. Donor criteria for predeposit autologous donation include:-
a. Donation can be made every 48 hours
b. There is no minimum weight requirement or upper age limit
c. Haemoglobin should be more than 14g/dl
d. Congestive cardiac failure is not a contraindication
e. Acceptable if candidate is having aortic stenosis
Key: b, Level: C2
6. Occult Hepatitis B virus infection may be transmitted by:-
a. Transfusion of blood component which in HBsAg Negative
b. Transfusion of only those blood components containing white cells
c. Interferon therapy
d. A blood donation which is Hepatitis B DNA PCR negative
e. Only in the presence of delta virus
Key: a, Level: C3
7. Which of the following will suggest the presence of an autoantibody:-
a. Positive indirect antiglobulin test (IAT) and negative direct antiglobulin
test (DAT)
b. Presence of anti-cardiolipin antibodies
c. Haemolytic disease of newborn
d. Graft versus host disease
e. Positive Direct Coomb's test
Key: e, Level C1
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8. Warm autoimmune haemolytic anaemia may be associated with:-
a. Mycoplasma infection
b. Paroxysmal nocturnal haemoglobinuria
c. Lymphoproliferative disorders
d. Raynaud's phenomenon
e. Presence of anti-I antibodies
Key: c, Level: C3
9. The recommended method for disposal of blood unit which is positive for viral
markers is:-
a. Draining the bag in laboratory sink
b. Emptying the bag in 12.5% sodium hypochlorite
c. Burial in a landfill
d. Incineration
e. To autoclave at 64°C and then burial in landfill
Key: d, Level: C1
10. All of the following are examples of computer control functions except:-
a. Prevention of release of ABO incompatible blood
b. Printing of crossmatch report
c. Prevention of release of blood which is HBsAg positive
d. Alerting if patient has red cell antibodies
e. Prevention of release of expired blood components
Key: b, Level: C3
11. Which of the following antibodies can cause Haemolytic disease of newborn
(HDN):-
a. Anti-A,B
b. Anti-Leb
c. Anti-P
d. Anti-I
e. Anti-HPA-1b
Key: a, Level C3
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12. The shelf life of red cells in CPD- A1 blood bags is:-
a. 15 days
b. 30 days
c. 35 days
d. 28 days
e. 48 hours
Key: c, Level: C1
13. The best method to achieve leucoreduction of red cell concentrates is:-
a. Use of WBC filter
b. Inverted centrifugation
c. Spin cool filtration
d. Saline washing
e. Cryopreservation at -20°C
Key: a, Level: C3
14. Which of the following is not part of routine pre transfusion screening by the
blood bank?
a. Testing of HBsAg, anti-HCV, and anti-HIV
b. Major crossmatch
c. Minor crossmatch
d. Blood ABO and Rh grouping
e. Donor history
Key:c, Level:C2

15. While scrubbing a donor’s arm, the phlebotomist was distracted by another
donor’s reaction and did not use the second cleansing solution. What potential
problems could this cause to the recipient?
a. TACO
b. TRALI
c. Transfusion associated sepsis
d. Febrile non hemolytic transfusion reactions
e. Allergic reactions
Key: c, Level: C3
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16. A severely immunosuppressed adult patient has been transfused with a pool of
10 units of platelets, pooled. The pretransfusion platelet count was 6000. One
bag of random donor platelets should raise platelets by about 5000/uL. If the
platelet count does not increase as expected, what is some potential cause?
a. Platelet refractoriness
b. Inappropriate dose of platelets
c. Leukocyte contamination
d. RBC contamination
e. Wrong centrifugation speed
Key: a, Level:C3

17. Plateletpheresis must contain a minimum of how many platelets to be

acceptable?
a. 5.5 x 1010
b. 3.3 x 1011
c. 5.0 x 1011
d. 3.0x1011
e. 2.5x1011
Key: d, Level: C1

18. Temperature limits for shipping RBCs are:-

a. 1o to 6o C
b. 1o to 10o C

c. 20o to 24o C
d. 2 o to 8o C
e. 2 o to 8o C

Key: b, Level: C1
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19. A patient experiences chills and fever, nausea, flushing, and lower back pain
following the infusion of 350 mL of blood. To rule out a transfusion reaction
because of acute hemolysis, one should immediately:-
a. Perform a DAT and observe serum on post-transfusion sample
b. Measure serum haptoglobin on pre reaction and postreaction samples
c. Repeat crossmatches on pre reaction and post reaction samples
d. Gram stain and culture the unit
e. Perform CBC of recipient
Key: a, Level: C3

20. Dyspnea, severe headache, and peripheral edema occurring soon after
transfusion are indicative of which type of transfusion reaction?
a. Hemolytic transfusion reaction
b. Febrile reaction

c. Transfusion associated Circulatory overload

d. Anaphylactic reaction
e. Allergic reaction
Key: c, Level: C3

21. Which of the following adverse complications of transfusion is prevented by the

irradiation of blood components?
a. Circulatory overload
b. Hyperkalemia
c. Iron overload
d. TA-GVHD
e. AHTR
Key: d, Level: C2
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22. What blood groups system’s antibodies are commonly associated with delayed
HTRs?
a. High titer, low avidity
b. ABO
c. P
d. MNS
e. Kidd
Key: e; Level: C3

23. What microorganism grows at 4o C and may result in a transfusion-transmitted

sepsis?
a. Staphylococcus aureus
b. Yersinia enterocolitica
c. Staphylococcus epidermidis
d. Bacillus cereus
e. Streptococcus epidermidis
Key:b, Level:C3

24. What is the expected therapeutic effect in the recipient’s hematocrit following
the transfusion of 1 unit of RBCs?
a. Increase of 0.5%
b. Increase of 1%

c. Increase of 3%
d. Increase of 2%
e. Increase of 2%

Key: c, Level: C1