Blood donation is the cornerstone of transfusion medicine, and donor screening plays a vital role in ensuring both donor safety and recipient protection. This chapter focuses on the selection, evaluation, and care of blood donors, as well as the technical aspects of blood collection, labeling, and storage.
Understanding the process from donor selection to post-donation care helps ensure a safe, high-quality blood supply that meets international standards.
Topics Covered in This Chapter
- Donor eligibility criteria: age, weight, hemoglobin, and health status
- Medical history and physical examination of donors
- Donor deferral: temporary and permanent reasons
- Infectious disease screening (HIV, HBV, HCV, syphilis, malaria, etc.)
- Phlebotomy procedure: equipment, venipuncture, and donor care
- Anticoagulant and preservative solutions used in collection
- Labeling, identification, and documentation
- Donor reactions and management
- Autologous and directed donations
Why It Matters
Blood safety begins with donor selection. Effective screening minimizes the risk of transmitting infections through transfusion and ensures the donor’s health is not compromised.
Laboratory professionals and phlebotomists must be familiar with donor deferral criteria and proper collection techniques to maintain blood quality and safety.
Learning Outcomes
After studying this section, learners should be able to:
- Understand infectious disease testing and labeling procedures.
- Describe donor eligibility and screening procedures.
- Identify criteria for temporary and permanent deferrals.
- Explain safe blood collection techniques and equipment.
- Recognize and manage donor reactions.
60 MCQs (4661 – 4720):
- 1. What is the minimum hemoglobin concentration required for a male blood donor?
a) 12.0 g/dL
b) 12.5 g/dL
c) 13.0 g/dL
d) 13.5 g/dL - Which of the following is a cause for indefinite deferral from blood donation?
a) Reactive test for Babesia species
b) Residence in an endemic malaria region for 5 years
c) Positive test for Trypanosoma cruzi
d) History of chicken pox vaccination - A prospective donor with which of the following health histories would be accepted for blood donation?
a) Hepatitis B immune globulin 2 months ago
b) HIV prevention drugs 6 months ago
c) Blood transfusion 2 months ago
d) Travel to a malaria-endemic country 1 month ago - Which of the following constitutes permanent deferral status of a donor?
a) Tattoo 5 months previously
b) Recent close contact with a patient with viral hepatitis
c) 2 units of blood transfused 4 months previously
d) Confirmed positive test for HBsAg 10 years previously - In order to be a plateletpheresis donor, the platelet count must be at least:
a) 150,000/µL
b) 200,000/µL
c) 250,000/µL
d) 300,000/µL - Prior to blood donation, the intended venipuncture site must be cleaned with a scrub solution containing:
a) Hypochlorite
b) Green soap
c) 10% acetone
d) Povidone iodine - A donor who has just donated 2 units of Apheresis Red Blood Cells will be deferred from further blood donation for a minimum of how many weeks?
a) 8
b) 12
c) 16
d) 24 - Which of the following infectious agents relies solely on donor questioning to avoid transmission from transfused blood products?
a) Trypanosoma cruzi
b) Plasmodium falciparum
c) HCV
d) CMV - Which of the following practices at the time of blood collection helps minimize bacterial contamination of platelet products?
a) Use of 18-gauge needle
b) Diversion pouch
c) Green soap scrub
d) UV irradiation - If a unit of autologous Red Blood Cells is collected and transfused in the same facility, which of the following is NOT required?
a) ABO and Rh typing
b) A physician’s order
c) Infectious disease screening
d) Evaluation for risk of bacteremia - According to AABB Standards, what is the minimum hemoglobin level for an autologous donor?
a) 11.0 g/dL
b) 12.0 g/dL
c) 12.5 g/dL
d) 13.0 g/dL - Which of the following must be included on the label of a unit of Red Blood Cells Leukocytes Reduced?
a) Known leukocyte count for the unit
b) Phlebotomist identification
c) Unique collection facility identifier
d) Date of blood collection - All donor blood testing must include which of the following?
a) Complete Rh phenotyping
b) Anti-CMV testing
c) Direct antiglobulin test
d) Serological test for syphilis - Which of the following is NOT a useful strategy to reduce bacterial contamination in platelet components?
a) Using green soap scrub to disinfect the venipuncture site
b) Diverting the first 10-40 mL of donor blood from the main blood bag
c) Performing culture-based testing on all platelet components
d) Applying pathogen reduction technology to platelet components - In allogeneic blood donation, which of the following infectious agents must also include a nucleic acid testing (NAT) assay?
a) HBV
b) HTLV I/II
c) Syphilis
d) Cytomegalovirus - What is the primary reason that infectious agents can be transmitted following blood transfusion?
a) Pathogen reduction technology failure
b) Donor in the window period of early infection
c) Leukocyte-reduction failure
d) Donor history questionnaire not completed - Apheresis Platelets that will undergo pathogen reduction technology do NOT require:
a) Hepatitis B virus NAT
b) Culture-based testing for bacteria
c) West Nile virus NAT
d) ABO and Rh testing - A sample from an Apheresis Platelet undergoing culture-based testing indicates bacterial growth. What must be done immediately?
a) Set up another culture to confirm positivity
b) Determine sensitivity to antibiotics
c) Retrieve the unit if issued for transfusion
d) Identify the organism - A sample of blood from each allogeneic donation is tested for which of the following infectious disease agents?
a) HIV-1/2, HTLV-I/II, WNV, HCV
b) HBV, HCV, CMV, T. cruzi
c) HBsAg, HIV-1/2, P. falciparum, Babesia species
d) Dengue virus, syphilis, HCV, HBV - Which of the following prospective donors would be accepted for blood donation?
a) 62-year-old female with a blood pressure of 210/80
b) 18-year-old female who weighs 100 lb
c) 40-year-old male with a pulse of 115
d) 82-year-old male with a hemoglobin of 13.5 g/dL - The transport temperature for Red Blood Cells Leukocytes Reduced is:
a) 1-6°C
b) 1-10°C
c) 18-20°C
d) 20-24°C - Which of the following is the correct storage temperature for Fresh Frozen Plasma (FFP)?
a) 4°C
b) –20°C
c) –40°C
d) 37°C - Six units of Red Blood Cells are issued to the OR in a validated cooler and returned 40 minutes later. What should be done?
a) Discard the units as they were issued to a specific patient
b) Inspect units and establish that appropriate temperature has been maintained
c) Continue to store in cooler since surgery is rescheduled for tomorrow
d) Put units back into inventory as only 40 minutes has elapsed since issue - When platelets are stored on a rotator on an open bench top, the ambient air temperature must be recorded:
a) Once a day
b) Twice a day
c) Every 4 hours
d) Every hour - A unit of Red Blood Cells expiring in 35 days is split into 5 aliquots using a sterile connecting device. Each aliquot expires in:
a) 6 hours
b) 12 hours
c) 5 days
d) 35 days - Upon inspection, a unit of Apheresis Platelets is noted to have visible clots. The technologist should:
a) Issue without concern
b) Filter to remove the clots
c) Centrifuge to express off the clots
d) Quarantine for Gram stain and culture - According to AABB Standards, Red Blood Cells Leukocytes Reduced must be prepared by a method known to reduce the leukocyte count to:
a) <8.3 × 10⁵
b) <5.0 × 10⁶
c) <5.5 × 10¹⁰
d) <3.0 × 10¹¹ - Methods for preparing Red Blood Cells Leukocytes Reduced must retain at least what percentage of the original red cells?
a) 50%
b) 70%
c) 85%
d) 100% - Which of the following blood components must be prepared within 8 hours after phlebotomy?
a) Red Blood Cells
b) Fresh Frozen Plasma
c) Red Blood Cells, Frozen
d) Cryoprecipitated AHF - Quality control of Apheresis Granulocytes must demonstrate which of the following granulocyte counts in 75% of units tested?
a) 1.0 × 10¹⁰
b) 2.0 × 10¹⁰
c) 3.0 × 10¹⁰
d) 4.0 × 10¹⁰ - The primary goal of donor screening is to:
a) Increase blood donation frequency
b) Ensure donor and recipient safety
c) Identify rare blood groups
d) Detect Rh antibodies only - The minimum age requirement for blood donation in most countries is:
a) 15 years
b) 16–17 years
c) 18 years
d) 21 years - The minimum hemoglobin level required for whole blood donation is approximately:
a) 10.0 g/dL
b) 11.0 g/dL
c) 12.5 g/dL
d) 13.5 g/dL - The minimum weight required for a standard 450 mL blood donation is:
a) 45 kg
b) 50 kg
c) 55 kg
d) 60 kg - The standard interval between whole blood donations is:
a) 4 weeks
b) 6 weeks
c) 8 weeks
d) 12 weeks - The term “donor deferral” refers to:
a) A donor who is temporarily or permanently ineligible to donate
b) A donor who fails to complete paperwork
c) A donor with low platelet count
d) A donor with rare blood group - Temporary deferral may occur for:
a) Recent vaccination
b) HIV infection
c) Positive hepatitis B surface antigen
d) Heart disease - Permanent deferral applies to donors who:
a) Have mild anemia
b) Have positive tests for hepatitis B or HIV
c) Recently donated platelets
d) Traveled abroad - The primary test used for detecting HIV infection in donors is:
a) Western blot
b) ELISA
c) PCR only
d) Coombs test - The screening for hepatitis B includes detection of:
a) Anti-HCV
b) HBsAg and anti-HBc
c) Anti-HBs only
d) ALT levels - Blood pressure limits for donation are generally:
a) Below 80/40 mmHg
b) Between 90/50 and 180/100 mmHg
c) Over 200/120 mmHg
d) Exactly 120/80 mmHg - Before donation, a brief physical exam includes:
a) Temperature, pulse, blood pressure, and hemoglobin
b) Full body exam
c) X-ray and ECG
d) Chest and abdomen check - The maximum temperature allowed for donation eligibility is:
a) 98°F (36.7°C)
b) 99.5°F (37.5°C)
c) 100.5°F (38.0°C)
d) 101°F (38.3°C) - The anticoagulant most commonly used in blood collection bags is:
a) Heparin
b) EDTA
c) CPDA-1 (Citrate Phosphate Dextrose Adenine)
d) Sodium citrate - A standard whole blood collection typically draws:
a) 250 mL ± 10%
b) 350 mL ± 10%
c) 450–500 mL ± 10%
d) 600 mL ± 10% - During blood collection, the recommended time to complete donation is:
a) Less than 2 minutes
b) 5–10 minutes
c) 15–20 minutes
d) 30 minutes - The usual gauge of the needle used for blood donation is:
a) 14 gauge
b) 16 gauge
c) 18 gauge
d) 20 gauge - The first few milliliters of collected blood are used for:
a) Storage
b) Laboratory testing and pilot tubes
c) Platelet separation
d) Crossmatching only - Donor reaction with fainting is most often due to:
a) Vasovagal response
b) Cardiac disorder
c) Hemolysis
d) Bacterial infection - After donation, the donor should be advised to:
a) Drink plenty of fluids and avoid strenuous activity
b) Take antibiotics
c) Sleep immediately
d) Apply cold compress to arm - A donor who received a live vaccine may be deferred for:
a) 3 days
b) 2 weeks
c) 4 weeks
d) 6 months - Which infectious disease is NOT routinely tested in donor screening?
a) Syphilis
b) Malaria
c) West Nile virus
d) Common cold virus - Plasma units are tested for syphilis using which method?
a) RPR or VDRL
b) ELISA
c) Coombs test
d) Western blot - The collection bag is placed below the donor arm to:
a) Maintain sterility
b) Allow gravity-assisted flow
c) Measure oxygen saturation
d) Avoid hemolysis - Which component of CPDA-1 solution preserves red cell ATP levels?
a) Citrate
b) Dextrose
c) Phosphate
d) Adenine - The maximum storage period for whole blood collected in CPDA-1 is:
a) 21 days
b) 28 days
c) 35 days
d) 42 days - The donor should be observed for at least:
a) 5 minutes
b) 10 minutes
c) 15 minutes
d) 30 minutes - Directed donations are:
a) Blood donations given for the general blood supply
b) Donations made for a specific recipient
c) Donations collected for research
d) Apheresis donations only - Autologous donations refer to:
a) Blood donated for one’s own future use
b) Blood given to relatives only
c) Crossmatched donor blood
d) Platelet-only donation - Donor identification and labeling must include:
a) Donor number, collection date, and volume
b) Donor age only
c) ABO group only
d) Technician name only
📌 How to Use This Practice Set
- Answer each question before checking the key.
- Focus on why the correct answer is right and the others are wrong.
- Use this set as timed practice to simulate the real exam environment.
Answer Key
Answer Key:
- b) 12.5 g/dL
- c) Positive test for Trypanosoma cruzi
- b) HIV prevention drugs 6 months ago
- d) Confirmed positive test for HBsAg 10 years previously
- a) 150,000/µL
- d) Povidone iodine
- c) 16
- b) Plasmodium falciparum
- b) Diversion pouch
- c) Infectious disease screening
- a) 11.0 g/dL
- a) Known leukocyte count for the unit
- d) Serological test for syphilis
- a) Using green soap scrub to disinfect the venipuncture site
- a) HBV
- b) Donor in the window period of early infection
- b) Culture-based testing for bacteria
- c) Retrieve the unit if issued for transfusion
- a) HIV-1/2, HTLV-I/II, WNV, HCV
- d) 82-year-old male with a hemoglobin of 13.5 g/dL
- b) 1-10°C
- b) –20°C
- b) Inspect units and establish that appropriate temperature has been maintained
- c) Every 4 hours
- d) 35 days
- d) Quarantine for Gram stain and culture
- a) <8.3 × 10⁵
- c) 85%
- b) Fresh Frozen Plasma
- a) 1.0 × 10¹⁰
- b) Ensure donor and recipient safety
- b) 16–17 years
- c) 12.5 g/dL
- b) 50 kg
- c) 8 weeks
- a) A donor who is temporarily or permanently ineligible to donate
- a) Recent vaccination
- b) Have positive tests for hepatitis B or HIV
- b) ELISA
- b) HBsAg and anti-HBc
- b) Between 90/50 and 180/100 mmHg
- a) Temperature, pulse, blood pressure, and hemoglobin
- b) 99.5°F (37.5°C)
- c) CPDA-1 (Citrate Phosphate Dextrose Adenine)
- c) 450–500 mL ± 10%
- b) 5–10 minutes
- b) 16 gauge
- b) Laboratory testing and pilot tubes
- a) Vasovagal response
- a) Drink plenty of fluids and avoid strenuous activity
- c) 4 weeks
- d) Common cold virus
- a) RPR or VDRL
- b) Allow gravity-assisted flow
- d) Adenine
- c) 35 days
- c) 15 minutes
- b) Donations made for a specific recipient
- a) Blood donated for one’s own future use
- a) Donor number, collection date, and volume
Top 8 Medical Laboratory Scientist (MLS) Exams:
Top 8 Medical Laboratory Scientist (MLS) Exams that are recognized globally and can help professionals validate their credentials and enhance their career opportunities:
1. ASCP – American Society for Clinical Pathology (USA)
- Exam Name: MLS(ASCP)
- Eligibility: Bachelor’s degree with clinical laboratory experience.
- Global Recognition: High
- Purpose: Certifies Medical Laboratory Scientists in the United States and internationally.
2. AMT – American Medical Technologists (USA)
- Exam Name: MLT(AMT) or MT(AMT)
- Eligibility: Academic and/or work experience in medical laboratory technology.
- Global Recognition: Moderate
- Purpose: Credentialing for medical technologists and technicians.
3. AIMS – Australian Institute of Medical and Clinical Scientists
- Exam Name: AIMS Certification Exam
- Eligibility: Assessment of qualifications and work experience.
- Recognition: Required for practice in Australia.
- Purpose: Certification and registration in Australia.
4. CSMLS – Canadian Society for Medical Laboratory Science
- Exam Name: CSMLS General or Subject-specific Exams
- Eligibility: Graduation from a CSMLS-accredited program or equivalent.
- Recognition: Canada
- Purpose: Entry-to-practice certification in Canada.
5. IBMS – Institute of Biomedical Science (UK)
- Exam Name: Registration and Specialist Portfolio Assessment
- Eligibility: Accredited degree and lab experience.
- Recognition: UK and some Commonwealth countries.
- Purpose: Biomedical Scientist registration with the HCPC (UK).
6. HAAD / DOH – Department of Health, Abu Dhabi (UAE)
- Exam Name: DOH/HAAD License Exam
- Eligibility: Degree in medical laboratory science and experience.
- Recognition: UAE (Abu Dhabi)
- Purpose: Licensure for medical laboratory practice in Abu Dhabi.
7. DHA – Dubai Health Authority (UAE)
- Exam Name: DHA License Exam for Medical Laboratory Technologists
- Eligibility: Relevant degree and experience.
- Recognition: Dubai, UAE
- Purpose: Professional license for clinical laboratory practice in Dubai.
8. MOH – Ministry of Health (Gulf Countries like UAE, Saudi Arabia, Kuwait)
- Exam Name: MOH License Exam
- Eligibility: BSc/Diploma in Medical Laboratory + experience.
- Recognition: Varies by country.
- Purpose: Required for practicing in public and private sector labs.
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#ASCPMLS #MLSexam #LabTech #MedicalLaboratory #BOCexam #FreePracticeQuestions #QualityControl #LaboratorySafety
