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Blood transfusion and haematology on the RCSI theory paper

Bedside checks, observations, 4-hour and 12-hour rules, blood groups, reactions from mild fever to TACO and ABO haemolysis, iron deficiency anaemia.

30 multiple-choice questions, each with an explanation and the document it was checked against. Three questions are free; the pass opens the other 27 and every other topic. Wrong answers come back first the next time you practise, and a question counts as mastered after two correct answers in a row.

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Question 1
Which blood group is sometimes called the universal red cell donor, and why?
1. AGroup A, because it is the most common group in Ireland
2. BGroup AB, because its plasma has no anti-A or anti-B
3. CGroup O, because its red cells carry no A or B antigen
4. DGroup O RhD positive, because most people are RhD positive
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Answer: C. OpenStax: group O red cells carry neither A nor B antigen, so a recipient’s anti-A or anti-B have nothing to attack, and O negative is called the universal donor. Group O plasma, on the other hand, contains both antibodies, which is why the label applies to red cells and not plasma. AB positive is the universal recipient for the mirror-image reason: no anti-A or anti-B of their own. Matching groups is still preferred whenever there is time.
Source: OpenStax Anatomy and Physiology 2e, 18.6 Blood typing, Universal donors and recipients
Question 2
What does the laboratory do in a "group and screen"?
1. AScreens the sample for hepatitis B, hepatitis C and HIV
2. BCross-matches two units of red cells against the patient’s sample
3. CChecks haemoglobin and platelet count before issuing blood
4. DDetermines ABO and RhD group and screens plasma for red cell antibodies
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Answer: D. BSH: ABO grouping is the single most important serological test on a pre-transfusion sample, and antibody screening is always performed as part of pre-transfusion testing because it detects red cell antibodies more reliably than a serological crossmatch. With a negative screen, red cells can be selected by electronic issue, where the laboratory system determines compatibility without testing donor cells against the patient’s plasma. If the patient was transfused or pregnant in the previous 3 months, the sample must be no more than 3 days old.
Source: BSH, Pre-transfusion compatibility procedures in blood transfusion laboratories (2012, reviewed 2017), s. 5 Antibody screening and s. 7.5 Electronic issue
Question 3
Why must RhD negative women of child-bearing potential not receive RhD positive red cells except in extreme emergency?
1. ARhD positive cells are destroyed within hours in these women
2. BThey would need lifelong anti-D injections afterwards
3. CAnti-D formed now can cause haemolytic disease in a future baby
4. DRhD positive cells clot faster in RhD negative plasma
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Answer: C. OpenStax: an Rh negative person makes anti-Rh antibodies only after exposure to Rh positive red cells, by an Rh-incompatible transfusion or, more commonly, the birth of an Rh positive baby. In a later pregnancy with an Rh positive fetus those antibodies cross the placenta and destroy fetal red cells: haemolytic disease of the newborn, which can be fatal without treatment. About 85% of people are Rh positive, so the risk is real for every RhD negative woman who may yet have children.
Source: OpenStax Anatomy and Physiology 2e, 18.6 Blood typing, Rh blood groups and haemolytic disease of the newborn

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Blood transfusion and haematology: RCSI aptitude test practice questions

Blood transfusion and haematology on the RCSI theory paper

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