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Quizzes > Health & Medicine

Blood Transfusion MCQ: Test Your Knowledge

Quick, free transfusion medicine quiz to test your knowledge. Instant results.

Editorial: Review CompletedCreated By: Tara ArjonaUpdated Aug 23, 2025
Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art depicting elements related to Transfusion Medicine Knowledge Assessment Quiz

This blood transfusion quiz helps you check key concepts in transfusion medicine with 15 MCQs, from product choice to basic reaction steps. Build confidence before class, exams, or clinical practice. For more practice, explore blood typing practice questions, take a hematology practice quiz, or review with a blood anatomy and physiology quiz.

Which antigen is present on the red blood cells of a person with blood type A?
Rh antigen
Kell antigen
B antigen
A antigen
Blood type A is defined by the presence of the A antigen on red blood cells. The B antigen defines blood type B, while Rh and Kell are separate blood group systems.
Which ABO blood group is considered the universal donor for red blood cell transfusions?
B positive
O negative
AB positive
A negative
Type O negative red blood cells lack A, B, and Rh D antigens, making them compatible with most recipients. AB positive is the universal recipient, not donor.
At what temperature are packed red blood cells typically stored?
-20°C
37°C
1-6°C
20-24°C
Packed red blood cells are refrigerated and stored between 1 and 6°C to maintain cell viability. Frozen storage at -20°C is used for plasma, not standard red cell units.
Platelet units are stored at which of the following conditions?
20-24°C with gentle agitation
1-6°C without agitation
37°C in incubator
-30°C frozen
Platelets are stored at room temperature (20 - 24°C) with continuous gentle agitation to preserve function and prevent clumping. Refrigeration or freezing is not used for standard platelet storage.
Can a Rh-negative patient safely receive Rh-positive red blood cells?
No, it may cause alloimmunization
Only in emergencies
Only if ABO matched
Yes, without any risk
Transfusing Rh-positive red cells to an Rh-negative recipient can induce anti-D alloantibody formation. Even if ABO is matched, Rh incompatibility carries sensitization risk.
Which antibody is naturally present in the plasma of a person with blood group B?
Anti-D
Anti-A
Anti-B
Anti-K
Individuals with blood group B naturally produce anti-A antibodies. Anti-B would be in group A or O, and anti-D and anti-K are not naturally occurring in the ABO system.
What is the primary purpose of the indirect antiglobulin test in pretransfusion testing?
Detect RBC-bound antibodies in vivo
Detect free antibodies in patient serum
Determine ABO blood group
Measure hemoglobin level
The indirect antiglobulin test (indirect Coombs) detects antibodies in the patient's serum against red cell antigens. The direct antiglobulin test detects in vivo sensitization of patient red cells.
During a major crossmatch, what is being tested?
Patient plasma autoantibodies
Patient serum with donor red blood cells
Donor serum with patient red blood cells
Rh typing compatibility
A major crossmatch mixes patient serum with donor RBCs to detect incompatible antibodies. Donor serum with patient cells is the minor crossmatch, rarely used today.
Which maternal-fetal incompatibility is most commonly associated with hemolytic disease of the fetus and newborn?
Duffy antigen
Rh D antigen
ABO group A
Kell antigen
Anti-D antibodies against the Rh D antigen are the most severe cause of hemolytic disease of the fetus and newborn. ABO and other antigens can cause milder disease.
A patient develops fever and chills 2 hours after a transfusion with no evidence of hemolysis. Which reaction is most likely?
Allergic reaction
Acute hemolytic transfusion reaction
Febrile non-hemolytic transfusion reaction
Transfusion-related acute lung injury
Fever and chills without hemolysis shortly after transfusion suggest a febrile non-hemolytic reaction due to cytokine or leukocyte antibody interactions. Hemolytic reactions involve hemolysis and allergic reactions present with urticaria.
What is the first laboratory test performed when issuing a red blood cell unit for transfusion?
ABO and Rh typing
Direct antiglobulin test
Antibody screening
Crossmatch
ABO and Rh typing are performed first to establish basic compatibility. Antibody screens and crossmatches follow typing to identify any unexpected antibodies.
To prevent transfusion-associated graft-versus-host disease, which process should be applied to cellular blood components?
Washing
Leukoreduction
Freezing
Irradiation
Irradiation of cellular blood products inactivates donor lymphocytes and prevents graft-versus-host disease. Leukoreduction reduces febrile reactions but does not prevent GVHD.
Which electrolyte imbalance is most concerning in massive red blood cell transfusion from stored units?
Hypokalemia
Hyperkalemia
Hyponatremia
Hypercalcemia
Stored red blood cells leak potassium over time, and large-volume transfusion can cause hyperkalemia. Citrate and phosphate shifts cause other derangements but potassium is primary concern.
Fresh frozen plasma is typically usable for transfusion up to what duration after collection when stored at -18°C?
1 year
7 days
42 days
5 days
Fresh frozen plasma stored at âˆ'18°C or colder retains coagulation factor activity for up to one year. Shorter intervals apply to platelet concentrates and platelets.
Which antibody class is most likely to fix complement and cause intravascular hemolysis in an acute hemolytic transfusion reaction?
IgE
IgG
IgA
IgM
IgM antibodies effectively fix complement, leading to intravascular hemolysis in acute transfusion reactions. IgG usually causes extravascular hemolysis.
A patient develops a delayed hemolytic transfusion reaction 10 days after receiving RBCs. What is the most likely mechanism?
An anamnestic immune response to a non-ABO red cell antigen
Cytokine-mediated febrile reaction
Immediate IgM-mediated complement activation
Bacterial contamination of the unit
Delayed hemolytic reactions occur days to weeks post-transfusion due to a secondary immune response against antigens to which the patient was previously sensitized. IgM-mediated complement activation causes acute reactions.
Which crossmatching method can be used when the antibody screen is negative and no clinically significant antibodies are detected?
Major serologic crossmatch
Electronic crossmatch
Immediate spin crossmatch
Enzyme-treated crossmatch
When the antibody screen is negative and no alloantibodies are identified, an electronic crossmatch using computer compatibility is acceptable. Serologic crossmatches are reserved for positive screens or special cases.
Which finding is most consistent with transfusion-related acute lung injury (TRALI)?
Bradycardia and urticaria during infusion
Delayed fever and jaundice days later
Acute hypoxemia and pulmonary infiltrates within 6 hours
Sudden hypertension and hemolysis during transfusion
TRALI presents with acute respiratory distress and bilateral pulmonary infiltrates within six hours of transfusion. Hemolysis and hypertension suggest hemolytic reactions, and urticaria is allergic.
What is the mechanism by which amotosalen plus UVA treatment in plasma reduces pathogen transmission?
Physical filtration of pathogens
Intercalation into nucleic acids and prevention of replication
Denaturation of plasma proteins
Activation of complement cascade
Amotosalen intercalates into pathogen DNA and, upon UVA exposure, forms cross-links that prevent nucleic acid replication. It does not denature plasma proteins or filter pathogens physically.
In massive transfusion protocols, citrate toxicity can occur. What is the primary pathophysiological effect of citrate?
Hypothermia from cold stored blood
Hyperkalemia due to RBC lysis
Hypocalcemia due to calcium chelation
Metabolic acidosis from lactate accumulation
Citrate used as an anticoagulant chelates serum calcium, causing hypocalcemia in massive transfusion. Hyperkalemia arises from potassium load, while acidosis and hypothermia are separate complications.
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Learning Outcomes

  1. Analyse patient compatibility for safe transfusions
  2. Identify blood group antigens and antibody interactions
  3. Evaluate transfusion reactions and appropriate interventions
  4. Apply crossmatching principles in pre-transfusion testing
  5. Demonstrate proper handling and storage of blood products

Cheat Sheet

  1. Understand the ABO and Rh blood group systems - Knowing which antigens are present on red blood cells and which antibodies circulate in plasma is the cornerstone of safe transfusion. Dive into why type A blood has A antigens and anti-B antibodies, and how Rh factors influence compatibility.
  2. Master pre-transfusion testing - This process covers ABO and Rh typing, antibody screening, and crossmatching to confirm donor - recipient compatibility. Nail each step to prevent adverse reactions and ensure every unit you transfuse is a safe one.
  3. Recognize acute hemolytic transfusion reactions - These life-threatening reactions happen when recipient antibodies attack donor red cells, often due to ABO mismatch. Watch for fever, chills, back pain, and dark urine as urgent warning signs.
  4. Identify delayed hemolytic reactions - Occurring days to weeks after transfusion, these reactions stem from an immune response to minor antigens you might have missed. Monitor hemoglobin trends and use direct antiglobulin testing (DAT) to catch them early.
  5. Be aware of transfusion-associated graft-versus-host disease (TA-GvHD) - In this rare but often fatal condition, viable donor T-cells attack the recipient's tissues. Prevention through irradiation of cellular blood products is your best defense.
  6. Learn proper blood product storage - Red cells belong at 1-6 °C, while platelets need room temperature with constant gentle agitation. Mastering storage rules keeps your products viable and patients safe.
  7. Understand transfusion-related acute lung injury (TRALI) - Sudden lung inflammation and fluid overload can strike within hours, causing severe respiratory distress. It often involves donor antibodies reacting with recipient white cells.
  8. Recognize febrile non-hemolytic reactions - Common fevers and chills during or after transfusion usually result from recipient antibodies against donor leukocytes. Pre-storage leukoreduction is a proven way to lower this risk.
  9. Apply crossmatching principles - Mixing donor red cells with recipient serum helps you unearth unexpected antibodies before they cause harm. Perfecting this test is key to safe, personalized transfusion practices.
  10. Stay updated on transfusion medicine guidelines - Protocols evolve as science advances. Regularly review the latest standards from authoritative bodies to keep your practice cutting-edge and your patients protected.
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