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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5565_Библиотеки_им_академика_М_И_Перельмана.pdf
2 PRACTICAL SELF-ASSESSMENT FOR TRANSFUSION MEDICINE PROFESSIONALS
D. 25%
E. 30%
________________________________ _____________________________ ___
夝
Question 4: Whole blood is collected into 450- or 500-mL bags containing ___mL
of anticoagulant/preservative solution, respectively.
A. 10/15
B. 20/25
C. 30/35
D. 45/50
E. 63/70
________________________________ _______________________________
夝
Question 5: How many milliliters of red cells are contained in 1 RBC unit?
A. 100-150
B. 150-230
C. 230-370
D. 250-300
E. 450-500
________________________________ _____________________________ ___
夝
Question 6: Why is platelet storage limited to 5 days?
A. Platelets do not function properly after this time.
B. Platelets release their contents (granules) into the bag after this time.
C. Risk of bacterial contamination becomes unacceptably high.
D. Platelets have a half-life of 10 days, so they are only 25% effective at 5 days.
E. It is not; apheresis platelets can be stored up to 10 days.
________________________________ _______________________________
夝
Question 7: Although units of platelets inherently contain some red cells and white
cells, a crossmatch does not have to be performed as long as the unit of platelets
contains less than __ mL of red cells.
A. 0.5
B. 1
C. 2
D. 3
E. 5
BLOOD COMPONENT PREPARATION 3
________________________________ ______________________ __________
夝
Question 8:
How many mg/mL of fibrinogen are contained in Fresh Frozen Plasma (FFP)?
A. 0.5-1
B. 2-4
C. 5-8
D. 8-10
E. 20-25
________________________________ ________________________________
夝
Question 9: Which of the following statements about storage is true?
A. Before Fresh Frozen Plasma (FFP) or Cryoprecipitated Antihemophilic Factor
(AHF) can be used, they must be thawed in a refrigerator.
B. After thawing, Cryoprecipitated AHF can be refrigerated for up to 24 hours.
C. After thawing, FFP can be stored at room temperature for up to 24 hours.
D. After thawing, FFP can be refrigerated for up to 24 hours, whereas Cryoprecip-
itated AHF can be stored at room temperature for up to 4 hours.
E. None of the above.
________________________________ ______________________ __________
夝
Question 10: Which of the following blood component/volume pairs is incorrectly
matched?
A. Whole blood ~ 450 mL.
B. RBCs ~ 320 mL.
C. Whole blood-derived (WBD) platelets ~ 120 mL.
D. FFP ~ 200 mL.
E. Cryoprecipitate ~ 10-15 mL.
________________________________ ________________________________
夝
ANSWERS
Question 1: Testing for which of the following infectious disease markers is NOT
currently required during the screening of donor blood units?
A. Anti-HIV-1 and -2; HIV-1 NAT.
B. Anti-HBc; HBsAg.
4 PRACTICAL SELF-ASSESSMENT FOR TRANSFUSION MEDICINE PROFESSIONALS
C. Anti-HCV and HCV NAT.
D. Anti-CMV.
E. Anti-HTLV-I and -II.
D. There is currently no requirement to test for CMV.
________________________________ _______________________________
夝
Question 2: Screening tests are not available for all transfusion-transmissible agents.
For some agents, the donor history should be consulted to determine if a blood
donor should be excluded. Which of the following diseases is NOT regularly
included in donor history questioning?
A. Malaria.
B. Filariasis.
C. Babesiosis.
D. Chagas’ disease.
E. Variant CJD.
B. No questions are asked about filariasis. There are several FDA-approved serologic
tests for Chagas’ disease. All American Red Cross RBC units are tested for Chagas’
disease and the FDA recommends (though does not require) testing for Chagas’ dis-
ease.
________________________________ ________________________________
夝
Question 3: What is the maximum amount of the donor’s estimated blood volume
that can be withdrawn?
A. 5%
B. 10%
C. 15%
D. 25%
E. 30%
C. The blood volume drawn should not exceed 15% of the donor’s estimated blood
volume.
________________________________ ________________________________
夝
Question 4: Whole blood is collected into 450- or 500-mL bags containing ___mL
of anticoagulant/preservative solution, respectively.
A. 10/15
B. 20/25
BLOOD COMPONENT PREPARATION 5
C. 30/35
D. 45/50
E. 63/70
E. Bags contain 63 mL and 70 mL of anticoagulant/preservative, respectively.
________________________________ ________________________________
夝
Question 5: How many milliliters of red cells are contained in 1 RBC unit?
A. 100-150
B. 150-230
C. 230-370
D. 250-300
E. 450-500
B. RBC units typically contain 150-230 mL of red cells with a final hematocrit of
55% to 60%.
________________________________ ________________________________
夝
Question 6: Why is platelet storage limited to 5 days?
A. Platelets do not function properly after this time.
B. Platelets release their contents (granules) into the bag after this time.
C. Risk of bacterial contamination becomes unacceptably high.
D. Platelets have a half-life of 10 days, so they are only 25% effective at 5 days.
E. It is not; apheresis platelets can be stored up to 10 days.
C. Platelets are allowed to be stored up to 5 days because the risk of bacterial con-
tamination for both whole-blood-derived and apheresis platelets becomes unac-
ceptably high after that. Studies show that platelets actually remain viable for at least
7 days in storage. There exist FDA-approved collection bags and storage systems for
the storage of platelets up to 7 days, but they are not widely used.
________________________________ ________________________________
夝
Question 7: Although units of platelets inherently contain some red cells and white
cells, a crossmatch does not have to be performed as long as the unit of platelets
contains less than __ mL of red cells.
A. 0.5
B. 1
C. 2
6 PRACTICAL SELF-ASSESSMENT FOR TRANSFUSION MEDICINE PROFESSIONALS
D. 3
E. 5
C. As long as the unit contains less than 2 mL of red cells, a crossmatch does not
need to be performed. (The determination is actually made by looking at the platelet
bag to see if it is grossly bloody.)
________________________________ ________________________________
夝
Question 8:
How many mg/mL of fibrinogen are contained in Fresh Frozen Plasma (FFP)?
A. 0.5-1
B. 2-4
C. 5-8
D. 8-10
E. 20-25
B. There is 2-4 mg of fibrinogen per mL of FFP along with 1 U/mL of all the major
coagulation (both procoagulant and anticoagulant) factors.
________________________________ _______________________________
夝
Question 9: Which of the following statements about storage is true?
A. Before Fresh Frozen Plasma (FFP) or Cryoprecipitated Antihemophilic Factor
(AHF) can be used, they must be thawed in a refrigerator.
B. After thawing, Cryoprecipitated AHF can be refrigerated for up to 24 hours.
C. After thawing, FFP can be stored at room temperature for up to 24 hours.
D. After thawing, FFP can be refrigerated for up to 24 hours, whereas Cryoprecip-
itated AHF can be stored at room temperature for up to 4 hours.
E. None of the above.
D. After thawing, FFP (as well as plasma left over after Cryoprecipitated AHF has
been collected) can be refrigerated for up to 24 hours, whereas Cryoprecipitated
AHF can be stored at room temperature for up to 4 hours.
________________________________ ________________________________
夝
Question 10: Which of the following blood component/volume pairs is incorrectly
matched?
A. Whole blood ~ 450 mL.
B. RBCs ~ 320 mL.
C. Whole blood-derived (WBD) platelets ~ 120 mL.
BLOOD COMPONENT PREPARATION 7
D. FFP ~ 200 mL.
E. Cryoprecipitate ~ 10-15 mL.
C. One unit of WBD platelets has a volume of approximately 50 mL. (Apheresis
platelet units have an approximate volume of 300 mL.)
________________________________ ________________________________
夝
SUGGESTED READING
AABB, American Red Cross, America’s Blood Centers, and the Armed Services
Blood Program. Circular of information for the use of human blood and blood com-
ponents. Bethesda, MD: AABB, 2008.
Blajchman MA. Immunomodulatory effects of allogeneic blood transfusions: Clini-
cal manifestations and mechanisms. Vox Sang 1998;74(Suppl 2):315-19.
Blajchman MA. Transfusion-associated immunomodulation and universal white cell
reduction: Are we putting the cart before the horse? Transfusion 1999;39:665-70.
Bowden RA, Slichter SJ, Sayers M, et al. A comparison of filtered leukocyte-reduced
and cytomegalovirus (CMV) seronegative blood products for the prevention of trans-
fusion-associated CMV infection after marrow transplant. Blood 1995;86:3598-603.
Carson TH, ed. Standards for blood banks and transfusion services. 27th ed.
Bethesda, MD: AABB, 2011.
Food and Drug Administration. Code of Federal Regulations, title 21, parts 600-799.
Washington, DC: US Government Printing Office, 2011 (revised annually).
Lozano M, Blajchman MA, Cid J, eds. Blood component preparation: From bench-
top to bedside. Bethesda, MD: AABB Press, 2010.
Roback JD, Grossman BJ, Harris T, Hillyer CD, eds. Technical manual. 17th ed.
Bethesda, MD: AABB, 2011.
Trial to Reduce Alloimmunization to Platelets (TRAP) Study Group. Leukocyte
reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and
refractoriness to platelet transfusions. N Engl J Med 1997;337:1861-9.
In: Leonard G, Licata M.
Practical Self-Assessment for Transfusion Medicine Professionals
Bethesda, MD: AABB Press, 2012
2
Blood Component Storage
QUESTIONS
Question 1: By regulation, the processing of whole blood into components must be
completed within __ hours of collection.
A. 2
B. 4
C. 8
D. 12
E. 24
________________________________ ________________________________
夝
Question 2: Once the seal on a RBC unit is broken, the unit can be issued for up to
__ hours if stored at room temperature, or up to __ hours if refrigerated.
A. 4; 12
B. 4; 24
C. 8; 24
D. 12; 24
E. 12; 48
________________________________ ________________________________
夝
Question 3: If RBCs are stored in ACD or CPD storage solution, what is the maxi-
mum number of days the unit can be stored?
A. 5
B. 14
C. 21
D. 35
E. 42
10 PRACTICAL SELF-ASSESSMENT FOR TRANSFUSION MEDICINE PROFESSIONALS
________________________________ _______________________________
夝
Question 4: If RBCs are stored in CPDA-1 storage solution, what is the maximum
number of days the unit can be stored?
A. 5
B. 14
C. 21
D. 35
E. 42
________________________________ _______________________________
夝
Question 5: If RBCs are stored in an additive solution, what is the maximum number
of days the unit can be stored?
A. 5
B. 14
C. 21
D. 35
E. 42
________________________________ _______________________________
夝
Question 6: Rejuvenating solutions, which often contain pyruvate, inosine, phos-
phate, and adenine, can extend the expiration date of CPDA-1 RBCs by ___ days.
A. 1
B. 3
C. 7
D. 10
E. 14
________________________________ _______________________________
夝
Question 7: Which statement about cryopreservation of RBC units is true?
A. Liquid nitrogen is replacing glycerol as a commonly used cryopreservative.
B. If red cells freeze too slowly, ice crystals may damage the cells.
C. If red cells freeze too slowly, the cells may become dehydrated.
D. Glycerol protects red cells by coating the outer surface of the cells, preventing
them from freezing too slowly.
E. Glycerol is generally removed from thawed frozen RBC units only in larger
hospitals that have purchased the necessary equipment.
BLOOD COMPONENT STORAGE 11
________________________________ ________________________________
夝
Question 8: Which statement about Fresh Frozen Plasma (FFP) is true?
A. If frozen within 8 hours of collection, FFP can be stored for up to 5 years at −18
C or colder.
B. If stored at −65 C or colder, FFP can be retained for up to 10 years.
C. If not frozen within 8 hours of collection, levels of Factors VII and X are usually
greatly reduced.
D. If FFP is not frozen within 8 hours of collection, it can still be used but must be
labeled “Plasma Frozen Within 24 Hours After Phlebotomy.”
E. FFP may be stored at 1-6 C for up to 8 hours after thawing.
________________________________ ________________________________
夝
Question 9: Which of the following is NOT found in significant amounts in Cryo-
precipitated AHF?
A. Factor I.
B. Factor VIII.
C. Factor X.
D. von Willebrand factor.
E. Fibrinogen.
________________________________ ________________________________
夝
Question 10: Which statement about blood component storage is true?
A. Refrigerators, freezers, and incubators should have monitoring systems that
monitor and record temperature continuously.
B. Refrigerators and freezers should have alarm systems that are triggered before
the temperature becomes unacceptable.
C. Temperature records must be maintained for at least 10 years.
D. Alternative storage in the event of system failure is not an acceptable substitute
for an independent emergency power source.
E. All of the above are true.
12 PRACTICAL SELF-ASSESSMENT FOR TRANSFUSION MEDICINE PROFESSIONALS
________________________________ _______________________________
夝
ANSWERS
Question 1: By regulation, the processing of whole blood into components must be
completed within __ hours of collection.
A. 2
B. 4
C. 8
D. 12
E. 24
C. 8 hours. Components must be prepared within 8 hours of collection in order to
preserve the coagulation factors in Fresh Frozen Plasma.
________________________________ _______________________________
夝
Question 2: Once the seal on a RBC unit is broken, the unit can be issued for up to
__ hours if stored at room temperature, or up to __ hours if refrigerated.
A. 4; 12
B. 4; 24
C. 8; 24
D. 12; 24
E. 12; 48
B. Once the seal is broken, blood can be kept up to 4 hours at room temperature, or
refrigerated for 24 hours.
________________________________ _______________________________
夝
Question 3: If RBCs are stored in ACD or CPD storage solution, what is the maxi-
mum number of days the unit can be stored?
A. 5
B. 14
C. 21
D. 35
E. 42