Medex Transfusion Medicine Mock Exam September 2023

1. Cellular components of adaptive immunity include
Eosinophils
Neutrophils
Natural killer cells
T lymphocytes
Dendritic cells
2. Antibodies that activate complement system include
IgG
IgE
IgM
IgA
IgD
3. Types of multipotent stem cells include
Neural stem cells
Epidermal stem cells
Embryonic stem cells
Mesenchymal stem cells
Haematopoietic stem cells
4. The following are disorders associated with autosomal recessive
Thalassaemia
Bernard-Soulier syndrome
Christmas disease
McLeod syndrome
Von Willebrand disease type 1
5. Iron absorption is reduced in the following condition
Atrophic gastritis
Helicobacter pylori infection
Vitamin C supplement
Consumption of histamine H2-receptor antagonist
Mutations of TMPRSS6
6. Causes of extravascular haemolysis include
Southeast Asian ovalocytosis
Paroxysmal nocturnal haemoglobinuria
March haemoglobinuria
G6PD deficiency with oxidant stress
Sickle cell disease
7. Investigations for macrocytic anaemia include
Haemoglobin electrophoresis
Vitamin B12 level
Blood lead level
Hepcidin level
Homocysteine level
8. Causes of neutrophilia include
Lymphoma
Myositis
Aplastic anaemia
Polycythaemia vera
Hypersplenism
9. Cells derived from myelocyte include
Eosinophil
Basophil
B lymphocyte
Monocyte
Macrophage
10. Regarding platelet
It has nucleus
Its life span is 20 days
It expresses ABO antigen
Its size is larger than red blood cell (RBC)
Its alpha granule contains fibrinogen
11. Causes of thrombocytopenia include
Disseminated intravascular coagulation
Hepatitis C infection
Hyposplenism
Penicillin
Essential thrombocythaemia
12. Causes of isolated prolonged activated partial thromboplastin time (APTT) include
Liver disease
Vitamin K deficiency
Heparin
Hypofibrinogenaemia
Haemophilia A
13. The following donor is ineligible to donate blood in Malaysia
A first-time donor age of 65 years
Thalassaemia trait
History of seizure
Living with person with Hepatitis C
Day 5 of menstruation
14. Adverse donor reactions of whole blood donation include
Haemolysis
Allergic reaction
Arterial puncture
Air embolism
Deep vein thrombosis
15. Products that are derived from human plasma include
Albumin
C1- esterase inhibitor
Factor V concentrate
Hepatitis B immunoglobulin
Antithrombin concentrate
16. Regarding acute haemolytic transfusion reaction
It is due to Lewis antibodies
Sign includes hypertension
Pains at the injection site is one of the symptoms
Investigation includes direct Coombs test
Intravenous hydrocortisone is one of the treatments
17. Dyspnoea during transfusion is a sign of
Anaphylactic transfusion reaction
Transfusion-related acute lung injury
Bacterial contamination of blood product
Acute haemolytic transfusion reaction
Transfusion-associated graft-versus-host disease
18. Routine pre transfusion testings for a group screen and hold (GSH) request from an adult patient include
RhD grouping
Antibody identification
ABO blood grouping
Crossmatching
Direct Coombs test
19. A blood group B RhD positive patient can be transfused with
O RhD positive RBC
B RhD negative whole blood
O RhD positive fresh frozen plasma (FFP)
AB RhD negative granulocytes
O RhD negative platelet
20. Compatibility card that is returned to the blood bank following completion of transfusion contains the following information
Hospital name
Full name of recipient
Time transfusion starts and ends
Recipient’s RBC antibody screening result
Volume remains in the blood bag
21. Regarding duration for transfusion of blood and blood components
Platelet transfusion is completed within one hour
FFP transfusion is completed within eight hours
Cryoprecipitate transfusion is completed within six hours
RBC transfusion is completed within four hours
Granulocyte transfusion is completed within two hours
22. Regarding exchange transfusion (ET)
Arterial line is used to inject the donor blood
It is indicated in severe anaemia without hypovolaemia
Blood warmer is used
The blood product requires irradiation to prevent TA-GVHD
Hypercalcaemia is one of the complications
23. Indications for RBC transfusion in infant include
Acute blood loss > 15% blood volume
Post operative symptomatic anaemia
Hypovolaemia not responsive to other treatment
Severe chronic anaemia with haemoglobin (Hb) < 10 g/dL
Hb < 12 g/dL in presence of severe cardiopulmonary disease
24. Regarding anaemia in pregnancy
It is defined as Hb level < 12 g/dL in second trimester
Dilutional anaemia is greatest in third trimester
Postpartum depression is one of the complications
Most common RBC morphology is normochromic normocytic
Transfusion is indicated in heart disease patient with Hb level of 9.0 g/dL
25. Strategies to minimise intraoperative blood loss during major surgery include
Permissive hypotension
Maintain hyperthermia intraoperatively (maintain normothermia)
Discontinue clopidogrel therapy before emergency surgery
Use of general anaesthesia as compared to neuraxial anaesthesia
Use of cell salvage if anticipated blood loss > 500 mL
26. Transfusion alternatives for patients who refuse blood components and products include
Tranexamic acid
Granulocyte colony stimulating factors
Prothrombin complex concentrate
Thrombopoietin receptor agonist
Pre-operative autologous blood donation
27. The following are target values of monitoring in massive trauma
Ca2+: > 1 mmol/L
Hb level: 8 g/dL
Platelet count: ≥ 50 x 109/L
Fibrinogen level: > 0.5 g/L
International normalised ratio (INR): ≤ 2.0
28. Blood transfusion indications in thalassaemia include
Confirmed diagnosis of thalassaemia major
Presence of clinically significant hepatosplenomegaly
Presence of significant intramedullary haematopoiesis
Hb < 8 g/dL with impaired growth in thalassasemia intermedia
Hb < 7 g/dL on two occasions within one week apart
29. Pre transfusion check includes
Identification of blood product integrity
Priming the blood administration set using Ringer’s lactate
Verification of the blood products by three independent staff
Positive patient identification by reading their details from clinical note
Identical matching details between blood bag label and blood request form
30. Surgical procedure that require blood products according to Maximum Surgical Blood Ordering Schedules (MSBOS) is
Ovarian cystectomy
Total knee replacement
Renal transplant
Atrial-septal defect repair
Mastectomy with axillary clearance
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