MLT GlobeBlood Banking: Blood components & storage – page 3
109 Blood Banking MCQs on Blood components & storage with answers and explanations.
In which neonatal situation is fresh frozen plasma appropriately indicated?
FFP replaces multiple coagulation factors, so it suits bleeding neonates with DIC (or vitamin K deficiency bleeding, factor deficiencies). It carries no red cells and should not be used for volume alone.
What is the main reason for freezing red cells in glycerol for long-term storage?
Frozen glycerolised RBCs can be kept for 10 years, allowing rare units (and some autologous units) to be stockpiled. They are expensive and slow to prepare, so not for routine use.
Which patient is NOT an appropriate candidate for fresh frozen plasma?
FFP replaces clotting factors and ADAMTS13. Sensitisation to leukocyte or platelet antigens calls for leukoreduced or HLA-matched products, not plasma.
Which biochemical change is characteristic of refrigerated stored red cells?
Cold inhibits the Na⁺/K⁺-ATPase, so K⁺ moves out and Na⁺ moves in; 2,3-DPG and pH fall with storage.
For a bleeding patient with von Willebrand disease unresponsive to desmopressin, which product is preferred?
Plasma-derived concentrates rich in VWF replace the missing protein; cryoprecipitate is a fallback. Recombinant FVIII contains no VWF.
Which change occurs in red cells during prolonged refrigerated storage (storage lesion)?
Storage depletes ATP, cells lose membrane as microvesicles and become spheroechinocytes with increased osmotic fragility.
Which is a valid indication for fresh frozen plasma?
FFP replaces all coagulation factors in bleeding patients with liver disease, DIC or when concentrate is unavailable. ITP needs immunotherapy, not plasma.
Thawed FFP kept at 1–6 °C should be transfused within what period to retain its FFP labelling?
After 24 h the labile factor V and VIII levels fall; the unit may be relabelled thawed plasma and used within 5 days.
Which change occurs in red cells during storage at 1–6 °C?
The storage lesion includes potassium leak from cells, falling pH, and loss of ATP and 2,3-DPG. 2,3-DPG decreases, not increases.
During transport, red cell units must be kept at:
AABB allows red cells to be transported at 1–10 °C. The storage range in the refrigerator remains 1–6 °C.
FFP is thawed but not transfused. If kept at 1–6 °C in a closed system and relabeled as Thawed Plasma, it may be used for up to:
Thawed FFP is good for 24 hours as FFP; it can then be relabeled Thawed Plasma and kept at 1–6 °C for up to 5 days total, with lower levels of labile factors V and VIII.
Cryoprecipitate pooled in an open system and kept at 20–24 °C must be transfused within:
Open-system pooled cryoprecipitate expires in 4 hours. Single units or closed-system pools may be kept for 6 hours after thawing.
Quality control for each unit of cryoprecipitate requires a minimum of:
AABB standards require at least 150 mg fibrinogen and at least 80 IU factor VIII per unit of cryoprecipitate.
Apheresis platelet QC requires that at least 90% of tested units contain:
An apheresis platelet unit must contain at least 3.0 × 10^11 platelets. The 5.5 × 10^10 value applies to whole-blood-derived platelets.
What is the minimum platelet content required in a whole-blood-derived platelet concentrate unit?
Platelets prepared from a single whole-blood unit must contain at least 5.5 × 10^10 platelets. 3.0 × 10^11 is the requirement for an apheresis platelet unit.
At the end of storage, platelet units must have a pH of at least:
AABB requires pH ≥ 6.2 at the end of the allowed storage time. Low pH causes platelets to lose their disc shape and viability.
Why are platelets kept under continuous gentle agitation during storage?
Agitation in gas-permeable bags supports oxygen entry and CO2 loss, so lactic acid build-up and pH fall are limited. It does not prevent bacterial growth.
A patient has poor 1-hour platelet increments after several transfusions and has strong HLA class I antibodies. The best product is:
Immune refractoriness is most often due to HLA class I antibodies, so HLA-matched or crossmatch-compatible platelets are chosen. Washing or irradiation does not remove the antigens.
Under AABB standards, a leukocyte-reduced red cell unit must contain fewer than:
AABB requires < 5 × 10^6 WBCs per leukocyte-reduced red cell or apheresis platelet unit (Council of Europe uses < 1 × 10^6).
Leukocyte reduction helps prevent all of these EXCEPT one. Which complication is NOT prevented?
Filters leave enough viable T lymphocytes to cause TA-GVHD; only irradiation or approved pathogen reduction prevents it. Leukoreduction does reduce FNHTR, HLA alloimmunization and CMV risk.