💉 Blood Banking and Immunohematology Review for the MedTech Board Exam

What the Blood Banking course covers

1. Unit 1: Immunohematology Basics

   Red cell antigens and antibodies, how agglutination happens, and grading reactions.

   Antigens & antibodies in the blood bank · How agglutination happens · Reading & grading reactions

2. Unit 2: The ABO System

   ABO and H genetics, secretors, subgroups, Bombay, ABO typing and discrepancies.

   ABO & H genetics · Phenotypes, subgroups & Bombay · ABO antibodies & typing · ABO discrepancies

3. Unit 3: The Rh System

   Rh nomenclature, the D antigen and weak D, other Rh antigens, Rh antibodies and typing.

   Rh names & genetics · The D antigen & weak D · C, c, E, e & rare Rh types · Rh antibodies & typing

4. Unit 4: Other Blood Groups

   Lewis, MNS, P, I, Kell, Duffy, Kidd, Lutheran and the rarer systems.

   Lewis · MNS & P · I & cold antibodies · Kell · Duffy & Kidd · Lutheran & the rest

5. Unit 5: Antiglobulin Testing

   AHG reagents, the direct and indirect antiglobulin tests, enhancement media and errors.

   AHG reagents & the DAT · The indirect antiglobulin test · Check cells & errors

6. Unit 6: Antibody Detection & Identification

   Antibody screens, panels, ruling out, special techniques and panel troubleshooting.

   The antibody screen · Panels & ruling out · Special techniques · Panel troubleshooting

7. Unit 7: Compatibility Testing

   Specimens and identification, crossmatching, choosing ABO/Rh units, emergencies and incompatible crossmatches.

   The right patient, the right sample · Type & screen and crossmatch · Choosing ABO & Rh units · Incompatible crossmatches

8. Unit 8: Blood Donors

   Donor eligibility, deferrals, apheresis and autologous donors, donor reactions and donor testing.

   Who can donate? · Deferrals · Apheresis, autologous & donor reactions · Testing donated blood

9. Unit 9: Blood Components

   Anticoagulant-preservatives, red cell products and their modifications, plasma, cryo, platelets and granulocytes.

   Anticoagulants & red cells · Modified red cells · Plasma, cryo, platelets & granulocytes

10. Unit 10: Transfusion Reactions & Infections

    Acute and delayed transfusion reactions, investigating a reaction, and transfusion-transmitted infections.

    Acute reactions · Delayed reactions · Investigating a reaction · Transfusion-transmitted infections

11. Unit 11: HDFN & Immune Hemolysis

    Hemolytic disease of the fetus and newborn, RhIG, and autoimmune and drug-induced hemolytic anemia.

    HDFN: how it happens · Prenatal testing & RhIG · Treating HDFN · Autoimmune hemolytic anemia · Drug-induced hemolysis

12. Unit 12: HLA & Modern Methods

    HLA in transfusion and transplantation, paternity testing, and gel and solid-phase testing.

    HLA in the blood bank · Gel & solid phase testing

Sample Blood Banking board exam questions

A few practice questions from the course, with explanations. Thousands more are in the app.

1. 1. An antibody reacts 2+ at immediate spin in saline but is negative at the 37 °C and AHG phases. It is most likely:

   1. A complement-only reaction
   2. An IgM cold antibody such as anti-M or anti-P1
   3. An IgG Rh antibody
   4. An IgG antibody such as anti-K
   Show answer

   Answer: B. An IgM cold antibody such as anti-M or anti-P1

   Reactivity only at room temperature in saline is typical of IgM cold antibodies, which are usually clinically insignificant.

2. 2. Anti-A 4+, anti-B 0; A₁ cells 2+, B cells 4+; A₂ cells 0, O cells 0, autocontrol 0. The most likely explanation is:

   1. Group A with weak anti-B
   2. Group A₂ (or weak A) with anti-A₁
   3. Bombay phenotype
   4. Group O with a cold autoantibody
   Show answer

   Answer: B. Group A₂ (or weak A) with anti-A₁

   The extra antibody reacts with A₁ cells but not A₂ or O cells — anti-A₁ in an A₂ person. Confirm with Dolichos biflorus.

3. 3. A White donor’s cells react: anti-D +, anti-C +, anti-E 0, anti-c +, anti-e +. The most probable Rh genotype is:

   1. R⁰R⁰ (Dce/Dce)
   2. R¹r (DCe/dce)
   3. R¹R¹ (DCe/DCe)
   4. R²r (DcE/dce)
   Show answer

   Answer: B. R¹r (DCe/dce)

   D, C, c and e without E fits DCe/dce — R¹r is the most common way to inherit this phenotype in White populations.

4. 4. A pregnant woman has anti-Leᵃ. The risk to her baby is:

   1. Moderate — it suppresses erythropoiesis
   2. Only if the baby is group O
   3. Negligible — Lewis antibodies don’t cause HDFN
   4. High — anti-Leᵃ causes severe HDFN
   Show answer

   Answer: C. Negligible — Lewis antibodies don’t cause HDFN

   Lewis antibodies are usually IgM, which cannot cross the placenta, and Lewis antigens are barely expressed on fetal and newborn red cells. Lewis antigens are absorbed from plasma rather than built into the cell, so there is little target.

5. 5. Polyspecific DAT positive; monospecific anti-IgG negative, anti-C3d positive. This is most consistent with:

   1. Warm AIHA due to IgG
   2. ABO HDFN
   3. Penicillin-induced hemolysis
   4. A cold autoantibody such as in cold agglutinin disease
   Show answer

   Answer: D. A cold autoantibody such as in cold agglutinin disease

   IgM cold autoantibodies bind red cells in cool peripheral blood, fix complement, then fall off when warmed. The cells keep C3d but no IgG, giving a DAT positive only with anti-C3d. Warm AIHA usually shows IgG.

6. 6. A panel reacts only with the three K-positive cells, and all other specificities are ruled out. What confirms anti-K?

   1. Repeating the panel at room temperature
   2. Doing a DAT on the panel cells
   3. Typing the patient’s red cells as K-negative
   4. Treating the plasma with DTT
   Show answer

   Answer: C. Typing the patient’s red cells as K-negative

   A person can’t make an alloantibody to an antigen they carry; a K-negative phenotype supports anti-K.

7. 7. A 25-year-old group A, D-negative woman needs red cells. Only A-positive and O-negative units are available. Which should she receive?

   1. Either — D status doesn’t matter
   2. A-positive
   3. Neither; wait for A-negative
   4. O-negative
   Show answer

   Answer: D. O-negative

   Avoiding D sensitization in a woman of childbearing age matters more; group O red cells are ABO-compatible.

8. 8. A female donor has a hemoglobin of 12.0 g/dL. She should be:

   1. Permanently deferred
   2. Accepted for double red cells only
   3. Accepted
   4. Deferred (minimum 12.5 g/dL)
   Show answer

   Answer: D. Deferred (minimum 12.5 g/dL)

   US rules require a minimum hemoglobin of 12.5 g/dL for female donors and 13.0 g/dL for male donors (or a hematocrit of 38% and 39%). A value of 12.0 g/dL is too low, so she is temporarily deferred to protect her health.

Practice more Blood Banking questions

How you review in MedTech Reviewer

• Learning path: short lessons, each followed by questions, with a checkpoint at the end of every unit.
• Spaced repetition: questions you miss come back sooner, so key facts stick for exam day.
• Flashcards and timed quizzes in exam style, with an explanation for every answer.
• Board-readiness score per subject, so you know where to focus.
• Arcade games, PvP battles and Guilds to keep reviewing fun with classmates.

Other MedTech subjects

🩸 Hematology 🩹 Coagulation ⚗️ Clinical Chemistry 🧪 Urinalysis & Body Fluids 🛡️ Immunology & Serology 🦠 Microbiology 🪱 Parasitology, Mycology & Virology 🧬 Molecular Diagnostics 🧮 Laboratory Math 📋 Laboratory Management