Collection, processing and storage of whole human blood is a core module for B. Pharm students focused on safe transfusion practices, blood component preparation, and laboratory quality control. This introduction covers donor selection, phlebotomy technique, anticoagulants (e.g., CPD, CPDA-1, SAGM), component separation, leukoreduction, irradiation, storage conditions, shelf life, and transfusion safety. Emphasis is placed on infection control, storage lesions (potassium rise, decreased 2,3-DPG), bacterial contamination risks, and regulatory aspects that impact clinical outcomes. Understanding these principles helps pharmacists participate in blood banking, rational transfusion, and hemovigilance. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which anticoagulant-preservative solution extends the maximum storage time of whole blood to 35 days?
- CPD (Citrate-Phosphate-Dextrose)
- CPDA-1 (Citrate-Phosphate-Dextrose-Adenine)
- SAGM (Saline-Adenine-Glucose-Mannitol)
- ACD-A (Acid-Citrate-Dextrose, Solution A)
Correct Answer: CPDA-1 (Citrate-Phosphate-Dextrose-Adenine)
Q2. What is the recommended storage temperature range for packed red blood cells (RBCs)?
- -20°C to -30°C
- 20°C to 24°C with agitation
- 1°C to 6°C
- Room temperature (15°C to 25°C)
Correct Answer: 1°C to 6°C
Q3. Which blood component has the highest risk of bacterial contamination during storage?
- Fresh frozen plasma
- Platelets stored at room temperature
- Frozen red cells
- Cryoprecipitate
Correct Answer: Platelets stored at room temperature
Q4. What is the typical shelf life of platelet concentrates stored at 20–24°C with continuous agitation?
- 24 hours
- 5 days (standard)
- 35 days
- 12 months
Correct Answer: 5 days (standard)
Q5. Which additive solution is commonly used to extend red cell shelf life to about 42 days?
- EDTA
- SAGM (Saline-Adenine-Glucose-Mannitol)
- Heparin
- ACD-B
Correct Answer: SAGM (Saline-Adenine-Glucose-Mannitol)
Q6. Leukoreduction of blood products primarily reduces the risk of which complication?
- Transfusion-transmitted malaria
- Febrile non-hemolytic transfusion reactions
- Immediate hemolytic transfusion reaction
- Volume overload
Correct Answer: Febrile non-hemolytic transfusion reactions
Q7. What cellular change is characteristic of the storage lesion in refrigerated red blood cells?
- Increased 2,3-DPG levels
- Decreased extracellular potassium
- Decreased 2,3-DPG and increased potassium
- Increased pH
Correct Answer: Decreased 2,3-DPG and increased potassium
Q8. Fresh frozen plasma (FFP) should be frozen within what time after collection to preserve clotting factors?
- Within 1 hour
- Within 8 hours
- Within 24 hours
- Within 48 hours
Correct Answer: Within 8 hours
Q9. At what temperature is FFP typically stored for up to 12 months?
- ≤ -18°C
- 1–6°C
- 20–24°C with agitation
- -5°C to 0°C
Correct Answer: ≤ -18°C
Q10. Gamma irradiation of cellular blood components is performed to prevent which transfusion complication?
- Transfusion-associated circulatory overload (TACO)
- Transfusion-associated graft-versus-host disease (TA-GVHD)
- Hemolytic disease of the newborn
- Allergic urticarial reactions
Correct Answer: Transfusion-associated graft-versus-host disease (TA-GVHD)
Q11. What is the standard irradiation dose used to inactivate donor lymphocytes in blood products?
- 1 Gy
- 5 Gy
- 25 Gy
- 100 Gy
Correct Answer: 25 Gy
Q12. Which test is primarily used to confirm ABO compatibility between donor and recipient?
- Indirect antiglobulin test only
- Immediate spin crossmatch
- Bacterial culture
- Serum protein electrophoresis
Correct Answer: Immediate spin crossmatch
Q13. During component separation, which technique is used to separate plasma, buffy coat, and red cells?
- Gravity sedimentation
- Centrifugation
- Filtration only
- Heat shock
Correct Answer: Centrifugation
Q14. What is the primary purpose of adding mannitol in some red cell additive solutions?
- Act as an anticoagulant
- Prevent hemolysis and improve red cell recovery
- Sterilize the blood product
- Increase bacterial growth
Correct Answer: Prevent hemolysis and improve red cell recovery
Q15. Which practice classifies a blood unit as an ‘open system’ and reduces its post-opening shelf life?
- Single bag collection with sterile connection intact
- Separation into components within closed system
- Removing a segment or spiking the bag without sterile welding
- Freezing the unit immediately after collection
Correct Answer: Removing a segment or spiking the bag without sterile welding
Q16. What is the recommended maximum volume of whole blood normally collected from an adult donor?
- 100 mL
- 350 mL
- 450–500 mL
- 1000 mL
Correct Answer: 450–500 mL
Q17. Which screening is essential to prevent transfusion-transmitted infections before blood collection?
- Blood bag color check
- Donor medical history and serologic testing
- Complete blood count only
- Crossmatch with all blood groups
Correct Answer: Donor medical history and serologic testing
Q18. Cryoprecipitate is primarily used to replace which blood component?
- Platelets
- Factor VIII and fibrinogen
- Albumin
- Red cell mass
Correct Answer: Factor VIII and fibrinogen
Q19. What is the main effect of decreased 2,3-DPG in stored red blood cells when transfused?
- Enhanced oxygen release to tissues
- Reduced oxygen affinity of hemoglobin
- Increased oxygen affinity of hemoglobin, impairing release
- Immediate hemolysis on transfusion
Correct Answer: Increased oxygen affinity of hemoglobin, impairing release
Q20. In blood banking, what is the purpose of performing a leukocyte count on a filtered unit?
- To verify ABO type
- To confirm effective leukoreduction (residual WBCs below threshold)
- To test for bacterial contamination
- To measure hemoglobin concentration
Correct Answer: To confirm effective leukoreduction (residual WBCs below threshold)
Q21. Which storage condition is appropriate for units labeled ‘thawed plasma’ intended for transfusion within 24 hours?
- Store at room temperature uncovered
- Store at 1–6°C and use within 24 hours
- Refreeze immediately at ≤ -18°C
- Keep at 20–24°C with agitation
Correct Answer: Store at 1–6°C and use within 24 hours
Q22. Which component separation bag system helps produce platelet concentrates and plasma without breaking sterility?
- Single blood collection bag without tubing
- Triple or quadruple blood bag with sterile connections
- Open beaker separation
- Manual decanting into open containers
Correct Answer: Triple or quadruple blood bag with sterile connections
Q23. Which measurement is most likely monitored to detect early bacterial contamination in platelet units?
- pH drop and swirling loss
- Hemoglobin concentration
- Plasma sodium level
- 2,3-DPG increase
Correct Answer: pH drop and swirling loss
Q24. What is the correct action if a blood unit shows visible hemolysis before transfusion?
- Transfuse immediately after warming
- Label as ‘for research only’ and discard per protocol
- Filter and use for neonates only
- Top up the bag with saline and transfuse
Correct Answer: Label as ‘for research only’ and discard per protocol
Q25. Which test detects unexpected antibodies in a recipient’s serum prior to transfusion?
- ABO forward typing only
- Antibody screening (indirect antiglobulin test)
- Direct antiglobulin test on donor cells
- Platelet function assay
Correct Answer: Antibody screening (indirect antiglobulin test)
Q26. After separating components in a closed system, what is the usual shelf life of platelet concentrates prepared from whole blood?
- Up to 24 hours
- 5 days under standard conditions
- 35 days refrigerated
- 12 months frozen
Correct Answer: 5 days under standard conditions
Q27. Which of the following is a primary objective of hemovigilance programs related to blood storage?
- Maximizing product sales
- Monitoring and reducing transfusion-related adverse events
- Extending storage beyond validated limits
- Promoting off-label transfusion practices
Correct Answer: Monitoring and reducing transfusion-related adverse events
Q28. Which parameter is commonly used to assess red cell quality at the end of storage?
- Residual platelet count
- Hemolysis percentage
- Plasma fibrinogen level
- White cell differential
Correct Answer: Hemolysis percentage
Q29. If a blood unit is issued but not transfused and the bag is opened at bedside, what is the typical policy regarding reissue?
- Reissue after visual check and refrigerate
- Cannot be reissued; discard per open system policy
- Refreeze and reissue later
- Use for any other patient immediately
Correct Answer: Cannot be reissued; discard per open system policy
Q30. Which intervention reduces both febrile reactions and CMV transmission risk in transfusions?
- Washing red cells only
- Leukoreduction (pre-storage filtration)
- Storing RBCs at room temperature
- Adding extra adenine to preservative
Correct Answer: Leukoreduction (pre-storage filtration)
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