MLPAO Transfusion Medicine Case-Based Practice

Question 1

A patient types as group A on forward typing but group O on reverse typing. What should the technologist investigate?

Accepted Answer

Investigate the ABO discrepancy — possible weak A subgroup, missing anti-B, cold antibodies, or technical error

Answer

Report as group A

Answer

Report as group O

Answer

Repeat forward typing only

Question 2

A nurse calls reporting that a patient is having rigors and fever 15 minutes into a red cell transfusion. What are the immediate steps?

Accepted Answer

STOP the transfusion immediately, keep the IV line open with saline, check patient and unit identification, notify the physician and blood bank, and send required post-reaction specimens

Answer

Slow the transfusion rate

Answer

Continue transfusion and give acetaminophen

Answer

Administer epinephrine immediately

Question 3

An antibody screen is positive at the antiglobulin (AHG) phase. The antibody identification panel shows reactivity with all Jk(a)-positive cells and no reactivity with Jk(a)-negative cells. What is the antibody?

Accepted Answer

Anti-Jk(a)

Answer

Anti-K

Answer

Anti-D

Answer

Anti-Fy(a)

Question 4

A D-negative pregnant woman at 28 weeks gestation has a negative antibody screen. What action should be taken?

Accepted Answer

Administer antenatal Rh immune globulin (RhIg) at 28 weeks as prophylaxis

Answer

No action needed

Answer

Perform a Kleihauer-Betke test immediately

Answer

Induce labour early

Question 5

A patient with known anti-E requires 2 units of red blood cells for surgery. How should compatible blood be provided?

Accepted Answer

Select E-negative, ABO/Rh-compatible units and perform an antiglobulin crossmatch

Answer

Any ABO/Rh-compatible blood is acceptable

Answer

Use O-negative blood without crossmatch

Answer

Only autologous blood can be used

Question 6

A post-transfusion DAT is positive with anti-IgG but negative with anti-C3d. The eluate contains anti-c. What type of reaction is this?

Accepted Answer

Delayed hemolytic transfusion reaction due to an anamnestic anti-c response

Answer

Febrile non-hemolytic transfusion reaction

Answer

Autoimmune hemolytic anemia

Answer

Bacterial contamination