Blood products and plasma substitutes MCQs With Answer is a concise, clinically focused introduction for B.Pharm students covering blood components, plasma expanders, transfusion pharmacology, and safe transfusion practices. This collection emphasizes key concepts such as red blood cells, platelets, fresh frozen plasma, cryoprecipitate, albumin, colloids (dextrans, hydroxyethyl starch, gelatins), crystalloids, compatibility testing, indications, dosing, storage, adverse reactions, and pathogen-reduction strategies. Designed to reinforce core hematology and clinical pharmacology principles, these questions promote critical thinking about mechanisms, indications, contraindications, and monitoring. Clear explanations prepare students for pharmacy roles in transfusion safety, inventory, and therapeutic decision-making. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which blood component is most appropriate to treat acute symptomatic anemia due to blood loss?
- Fresh frozen plasma
- Packed red blood cells
- Cryoprecipitate
- Platelet concentrate
Correct Answer: Packed red blood cells
Q2. Which product is primarily indicated for replacement of fibrinogen in hypofibrinogenemia?
- Fresh frozen plasma
- Albumin 5%
- Cryoprecipitate
- Platelet concentrate
Correct Answer: Cryoprecipitate
Q3. Which plasma substitute is a natural colloid commonly used to expand plasma volume and bind drugs?
- Dextran 70
- Hydroxyethyl starch (HES)
- Gelatin-based colloid
- Human serum albumin
Correct Answer: Human serum albumin
Q4. The main indication for transfusing platelets is:
- Hypovolemia due to trauma
- Thrombocytopenia with active bleeding or prophylaxis before invasive procedure
- Correction of coagulopathy from liver disease
- Replacement of immunoglobulins
Correct Answer: Thrombocytopenia with active bleeding or prophylaxis before invasive procedure
Q5. Which product would you transfuse to correct multiple coagulation factor deficiencies in a patient with disseminated intravascular coagulation (DIC)?
- Packed red blood cells
- Platelet concentrate
- Fresh frozen plasma
- Cryoprecipitate
Correct Answer: Fresh frozen plasma
Q6. Which plasma expander is associated with an increased risk of renal injury and coagulopathy when used in high doses?
- Isotonic saline
- Hydroxyethyl starch (HES)
- 5% Albumin
- Balanced crystalloid (Ringer’s lactate)
Correct Answer: Hydroxyethyl starch (HES)
Q7. Which blood product must be irradiated to prevent transfusion-associated graft-versus-host disease (TA-GVHD) in immunocompromised patients?
- Platelet concentrate
- Fresh frozen plasma
- Leukoreduced red cell or platelet units
- Albumin solution
Correct Answer: Leukoreduced red cell or platelet units
Q8. Which of the following best describes the storage requirement for platelet concentrates?
- Stored at -20°C
- Stored at 1–6°C with agitation
- Stored at 20–24°C with continuous gentle agitation
- Stored at room temperature without agitation
Correct Answer: Stored at 20–24°C with continuous gentle agitation
Q9. In ABO compatibility, which donor-recipient pairing is acceptable for packed red blood cell transfusion in emergencies when O negative is unavailable?
- Group A donor to group B recipient
- Group O donor to group AB recipient
- Group B donor to group A recipient
- Group AB donor to group O recipient
Correct Answer: Group O donor to group AB recipient
Q10. Which transfusion reaction is characterized by fever, chills, and non-hemolytic symptoms, often prevented by leukoreduction?
- Acute hemolytic transfusion reaction
- Transfusion-related acute lung injury (TRALI)
- Febrile non-hemolytic transfusion reaction (FNHTR)
- Allergic/anaphylactic reaction
Correct Answer: Febrile non-hemolytic transfusion reaction (FNHTR)
Q11. Which blood product is most appropriate to treat massive bleeding with hypofibrinogenemia and low platelet count?
- Cryoprecipitate and platelet concentrate along with FFP
- Packed red blood cells only
- Albumin infusion only
- IV immunoglobulin
Correct Answer: Cryoprecipitate and platelet concentrate along with FFP
Q12. Which laboratory test is essential before any non-emergency transfusion to detect clinically significant antibodies?
- Prothrombin time (PT)
- Crossmatch and antibody screen
- Serum albumin level
- Serum creatinine
Correct Answer: Crossmatch and antibody screen
Q13. Which plasma substitute is synthesized from starch and can interfere with coagulation tests by diluting clotting factors?
- Dextran 40
- Hydroxyethyl starch (HES)
- Gelatin-based colloids
- Normal saline
Correct Answer: Hydroxyethyl starch (HES)
Q14. What is the principal therapeutic action of intravenous albumin when used as a plasma expander?
- Improve oxygen-carrying capacity
- Increase plasma oncotic pressure and expand intravascular volume
- Provide clotting factors for coagulation
- Act as a vasoconstrictor
Correct Answer: Increase plasma oncotic pressure and expand intravascular volume
Q15. Which of the following is a major risk associated with transfusion of stored red blood cells that have been refrigerated for many weeks?
- Transfusion-transmitted viral infection
- Hyperkalemia due to potassium leak from stored RBCs
- Immediate allergic reaction
- Increase in fibrinogen levels
Correct Answer: Hyperkalemia due to potassium leak from stored RBCs
Q16. Which technique reduces white cell-mediated febrile and alloimmunization reactions in blood products?
- Washing red cells
- Leukoreduction (leukocyte reduction filtration)
- Irradiation
- Fresh frozen plasma pooling
Correct Answer: Leukoreduction (leukocyte reduction filtration)
Q17. For a patient with severe hypoalbuminemia requiring volume support and oncotic restoration, which preparation is appropriate?
- Normal saline bolus
- Albumin 20% infusion
- Hydroxyethyl starch in high dose
- Platelet transfusion
Correct Answer: Albumin 20% infusion
Q18. What is the main therapeutic use of fresh frozen plasma (FFP)?
- Increase hemoglobin concentration
- Provide all coagulation factors for correction of coagulopathy
- Increase platelet count
- Provide albumin and immunoglobulins
Correct Answer: Provide all coagulation factors for correction of coagulopathy
Q19. Which plasma substitute is most likely to cause anaphylactic reactions in patients with IgA deficiency?
- Albumin solutions
- Plasma-containing blood products like FFP
- Crystalloid fluids
- Synthetic gelatins
Correct Answer: Plasma-containing blood products like FFP
Q20. Which intervention is most appropriate immediately when acute hemolytic transfusion reaction is suspected?
- Continue transfusion and observe
- Stop transfusion, maintain IV access with saline, notify transfusion service
- Administer diuretics and give more blood
- Give intravenous albumin
Correct Answer: Stop transfusion, maintain IV access with saline, notify transfusion service
Q21. Which of the following is a characteristic advantage of crystalloids over colloids?
- Longer intravascular retention time
- Lower cost and wide availability
- Better oncotic pressure restoration
- Less total volume required for resuscitation
Correct Answer: Lower cost and wide availability
Q22. What is the primary mechanism by which dextran functions as a plasma expander?
- Increasing oxygen affinity of hemoglobin
- Raising plasma oncotic pressure and reducing blood viscosity
- Directly providing clotting factors
- Stimulating erythropoiesis
Correct Answer: Raising plasma oncotic pressure and reducing blood viscosity
Q23. Which infectious pathogen is of greatest concern in plasma-derived products and requires specific screening and inactivation steps?
- Plasmodium falciparum
- Hepatitis B and C viruses
- Clostridium difficile
- Varicella zoster virus
Correct Answer: Hepatitis B and C viruses
Q24. Which blood product is indicated for reversal of warfarin-associated coagulopathy with major bleeding when prothrombin complex concentrate (PCC) is unavailable?
- Packed red blood cells
- Fresh frozen plasma
- Albumin 5%
- Platelet concentrate
Correct Answer: Fresh frozen plasma
Q25. What is the main contraindication for using hydroxyethyl starch (HES) solutions?
- Sepsis and critical illness with risk of kidney injury
- Hypovolemia due to hemorrhage
- Hypoalbuminemia correction
- Fluid maintenance in pediatrics
Correct Answer: Sepsis and critical illness with risk of kidney injury
Q26. Which test directly measures compatibility of donor red cells with recipient serum before transfusion?
- Type and screen only
- Direct antiglobulin test (DAT) on recipient
- Crossmatch (major compatibility test)
- Prothrombin time
Correct Answer: Crossmatch (major compatibility test)
Q27. What is the recommended initial management fluid for hypovolemic shock in most settings before blood products are available?
- Colloid only (albumin)
- Balanced crystalloid (e.g., Ringer’s lactate) or normal saline bolus
- Platelet transfusion
- Immediate fresh frozen plasma
Correct Answer: Balanced crystalloid (e.g., Ringer’s lactate) or normal saline bolus
Q28. Which component is primarily responsible for immune-mediated acute hemolytic transfusion reactions?
- Major ABO incompatibility antibodies in the recipient
- High potassium levels in stored blood
- Bacterial contamination of the unit
- Excess plasma volume
Correct Answer: Major ABO incompatibility antibodies in the recipient
Q29. Which modification of blood components removes plasma proteins and reduces allergic reactions in sensitized patients?
- Leukoreduction
- Washing of red cells or platelets
- Irradiation
- Freezing
Correct Answer: Washing of red cells or platelets
Q30. Which practice improves transfusion safety by reducing the risk of bacterial contamination of platelet units?
- Storage at 4°C
- Single-donor apheresis collection and bacterial screening or pathogen reduction
- Using older pooled random-donor platelets without testing
- Adding albumin to platelet units
Correct Answer: Single-donor apheresis collection and bacterial screening or pathogen reduction
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