Blood transfusion is a critical clinical intervention involving administration of whole blood or separated components—red blood cells, platelets, plasma, and cryoprecipitate—to manage anemia, hemorrhage, coagulopathy, and clotting factor deficiencies. For B. Pharm students, a clear grasp of ABO and Rh compatibility, crossmatching, component selection, storage conditions, transfusion reactions, leukoreduction, irradiation, and hemovigilance is essential. Pharmacists ensure safe prescribing, compatibility verification, inventory management, and adverse‑event reporting. These MCQs focus on immunohematology, laboratory testing, clinical indications, safety measures, and pharmacist responsibilities to deepen your practical understanding of transfusion medicine. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which antigenic determinants define the ABO blood group system?
- Only A antigen
- Only B antigen
- A and B antigens
- Rh (D) antigen
Correct Answer: A and B antigens
Q2. The most clinically significant antigen in the Rh blood group system is:
- Rh C antigen
- Rh E antigen
- D antigen (RhD)
- Rh G antigen
Correct Answer: D antigen (RhD)
Q3. The Direct Antiglobulin Test (Direct Coombs) is used to detect:
- Free antibodies in the patient’s plasma
- Antibodies or complement bound to patient red blood cells
- Donor antibody screening
- Blood group antigen expression on platelets
Correct Answer: Antibodies or complement bound to patient red blood cells
Q4. What is the primary clinical purpose of leukoreduction (leukodepletion) of blood products?
- Increase red cell oxygen-carrying capacity
- Reduce febrile non-hemolytic reactions and HLA alloimmunization
- Extend red cell shelf life beyond 42 days
- Eliminate ABO incompatibility risk
Correct Answer: Reduce febrile non-hemolytic reactions and HLA alloimmunization
Q5. At what temperature are packed red blood cells (RBCs) normally stored?
- -20°C
- 1–6°C
- 20–24°C
- -80°C
Correct Answer: 1–6°C
Q6. Platelet concentrates are stored under which conditions?
- -18°C without agitation
- 1–6°C with agitation
- 20–24°C with constant gentle agitation
- Room temperature in static storage
Correct Answer: 20–24°C with constant gentle agitation
Q7. Fresh frozen plasma (FFP) should be stored at which temperature to preserve clotting factors?
- 4°C
- 0 to 6°C
- -18°C or colder
- Room temperature
Correct Answer: -18°C or colder
Q8. Which blood component is most appropriate for rapid replacement of fibrinogen in severe hypofibrinogenemia?
- Packed red blood cells
- Platelet concentrate
- Fresh frozen plasma
- Cryoprecipitate
Correct Answer: Cryoprecipitate
Q9. Which compatibility test primarily detects antibodies in the recipient serum against donor red cells?
- Immediate spin crossmatch
- Major crossmatch
- Minor crossmatch
- Direct antiglobulin test
Correct Answer: Major crossmatch
Q10. The most common cause of acute intravascular hemolytic transfusion reaction is:
- ABO incompatibility
- Bacterial contamination
- CMV transmission
- Transfusion-associated circulatory overload
Correct Answer: ABO incompatibility
Q11. Transfusion-related acute lung injury (TRALI) is most often mediated by:
- Volume overload causing pulmonary edema
- Donor anti-leukocyte (anti-HLA/anti-neutrophil) antibodies activating recipient neutrophils
- Acute hemolysis due to ABO mismatch
- Hypersensitivity to donor plasma proteins without lung injury
Correct Answer: Donor anti-leukocyte (anti-HLA/anti-neutrophil) antibodies activating recipient neutrophils
Q12. TACO (transfusion-associated circulatory overload) primarily results from:
- Immune-mediated hemolysis
- Excessive transfusion volume relative to cardiac reserve
- Bacterial contamination of blood units
- Anti‑leukocyte antibody reaction
Correct Answer: Excessive transfusion volume relative to cardiac reserve
Q13. A febrile non-hemolytic transfusion reaction is most commonly caused by:
- Recipient antibodies to donor leukocytes or cytokines in stored blood
- Acute ABO incompatibility
- Bacterial endotoxin in the unit
- Transfusion-associated GVHD
Correct Answer: Recipient antibodies to donor leukocytes or cytokines in stored blood
Q14. CMV-seronegative or leukoreduced blood products are especially recommended for which patients?
- Healthy adult donors
- Immunocompromised patients and neonates
- All elective orthopedic surgery patients
- All individuals receiving FFP
Correct Answer: Immunocompromised patients and neonates
Q15. What is the primary rationale for irradiating cellular blood components?
- Prevent bacterial growth
- Inactivate donor lymphocytes to prevent transfusion‑associated graft-versus-host disease (TA-GVHD)
- Extend storage time to 42 days
- Remove plasma proteins to reduce allergic reactions
Correct Answer: Inactivate donor lymphocytes to prevent transfusion‑associated graft-versus-host disease (TA-GVHD)
Q16. Hemovigilance is best defined as:
- Routine blood typing of donors
- Surveillance and reporting system for transfusion-related adverse events and near misses
- Automated blood bank inventory software
- Only laboratory testing for infectious agents
Correct Answer: Surveillance and reporting system for transfusion-related adverse events and near misses
Q17. For stable, non-bleeding patients, a commonly used prophylactic platelet transfusion threshold is:
- 150,000/µL
- 50,000/µL
- 10,000/µL
- 75,000/µL
Correct Answer: 10,000/µL
Q18. Which laboratory test is used to screen a patient’s serum for unexpected alloantibodies prior to transfusion?
- Direct antiglobulin (Direct Coombs) test
- Indirect antiglobulin (Indirect Coombs) test
- Blood culture
- Complete blood count
Correct Answer: Indirect antiglobulin (Indirect Coombs) test
Q19. Which of the following is a documented benefit of universal prestorage leukoreduction?
- Increases platelet counts in stored units
- Reduces febrile reactions and decreases risk of CMV transmission
- Replaces need for crossmatching
- Extends RBC storage to over 60 days
Correct Answer: Reduces febrile reactions and decreases risk of CMV transmission
Q20. The typical maximum shelf life of packed RBCs collected in CPDA-1 anticoagulant is:
- 7 days
- 21 days
- 35 days
- 120 days
Correct Answer: 35 days
Q21. In massive transfusion protocols for severe hemorrhage, a balanced component ratio frequently used is:
- 4 RBC : 1 FFP : 0 platelets
- 1 RBC : 1 FFP : 1 platelets
- 10 RBC : 1 FFP : 1 platelets
- RBCs only until bleeding stops
Correct Answer: 1 RBC : 1 FFP : 1 platelets
Q22. Which intervention or product allows extension of red blood cell storage to about 42 days?
- CPDA-1 anticoagulant
- Additive solutions (e.g., AS-1, AS-3)
- Leukoreduction alone
- Irradiation
Correct Answer: Additive solutions (e.g., AS-1, AS-3)
Q23. A positive Direct Antiglobulin Test in a transfused patient most likely indicates:
- Transfusion-associated infection
- Antibody or complement coating of recipient red cells consistent with immune hemolysis
- Low platelet function
- Vitamin K deficiency
Correct Answer: Antibody or complement coating of recipient red cells consistent with immune hemolysis
Q24. Sudden fever, hypotension, flank pain, and hemoglobinuria within hours of a transfusion most likely indicate:
- Acute hemolytic transfusion reaction
- Allergic urticarial reaction
- Transfusion-associated circulatory overload (TACO)
- Delayed hemolytic reaction
Correct Answer: Acute hemolytic transfusion reaction
Q25. Which anticoagulant used in blood collection functions primarily by chelating calcium?
- Heparin
- EDTA
- Sodium citrate
- Warfarin
Correct Answer: Sodium citrate
Q26. Which blood component has the highest risk of bacterial contamination due to storage conditions?
- Fresh frozen plasma
- Packed red blood cells
- Platelet concentrates
- Cryoprecipitate
Correct Answer: Platelet concentrates
Q27. The universal donor for red blood cell transfusion in emergency situations, when crossmatching is not possible, is generally:
- Type O negative
- Type O positive
- Type AB negative
- Type AB positive
Correct Answer: Type O negative
Q28. Administration of anti‑D immunoglobulin (RhIg) to an Rh-negative mother prevents:
- ABO hemolytic disease of the newborn
- Maternal alloimmunization to RhD and hemolytic disease of future fetuses
- Transmission of HIV via transfusion
- Febrile non-hemolytic transfusion reactions
Correct Answer: Maternal alloimmunization to RhD and hemolytic disease of future fetuses
Q29. Which infectious agent is universally screened for in donated blood in most countries?
- Epstein-Barr virus
- HIV (antibody/antigen)
- Helicobacter pylori
- Human papillomavirus
Correct Answer: HIV (antibody/antigen)
Q30. Which of the following best describes a pharmacist’s role in transfusion safety?
- Only dispensing blood products without clinical oversight
- Verifying compatibility, advising on component selection and dosing, ensuring proper storage, and participating in hemovigilance
- Performing blood typing in place of the blood bank
- Administering transfusions without monitoring
Correct Answer: Verifying compatibility, advising on component selection and dosing, ensuring proper storage, and participating in hemovigilance
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com