Modern transfusion medicine relies on the separation of whole blood into specific components, allowing targeted therapy and optimal use of each donation. This chapter covers the preparation, storage, and clinical applications of major blood components — including red blood cells, plasma, platelets, and cryoprecipitate — along with their quality control and storage requirements.
Understanding component preparation and indications ensures that patients receive the right product for the right purpose, minimizing risks and improving outcomes.
Topics Covered in This Chapter
- Whole blood collection and component separation
- Packed Red Blood Cells (PRBCs) – preparation, storage, and indications
- Fresh Frozen Plasma (FFP) and Plasma Derivatives
- Platelet Concentrates – random and apheresis platelets
- Cryoprecipitate – preparation and uses
- Leukocyte-reduced and irradiated products
- Additive and anticoagulant solutions (CPDA-1, SAGM, etc.)
- Quality control and storage conditions for each component
- Clinical indications and contraindications of blood components
Why It Matters
Component therapy allows clinicians to transfuse only what the patient needs — red cells for oxygen transport, plasma for coagulation, or platelets for bleeding disorders. Laboratory professionals play a key role in ensuring proper preparation, labeling, and storage of components to maintain efficacy and safety.
Learning Outcomes
After studying this section, learners should be able to:
- Apply quality control standards in component preparation.
- Explain how blood is separated into its components.
- Describe preparation, storage, and expiration of each product.
- Identify the appropriate clinical use of blood components.
- Understand special modifications (irradiation, leukoreduction).
60 MCQs (4721 – 4780):
- 1. What is the primary clinical indication for Cryoprecipitated AHF?
a) Factor V deficiency
b) Fibrinogen deficiency
c) Thrombocytopenia
d) Vitamin K deficiency - A unit of Red Blood Cells that expires in 32 days has just been irradiated. What is the new expiration date?
a) Remains the same (32 days)
b) 28 days from the date of irradiation
c) 24 hours from the time of irradiation
d) 14 days from the date of irradiation - According to AABB Standards, thawed Fresh Frozen Plasma (FFP) must be infused within what period of time?
a) 24 hours
b) 36 hours
c) 48 hours
d) 72 hours - Which of the following blood components must be stored at 20-24°C with continuous agitation?
a) Red Blood Cells, Leukocytes Reduced
b) Fresh Frozen Plasma
c) Apheresis Platelets
d) Cryoprecipitated AHF (thawed) - Irradiation of a unit of Red Blood Cells is performed to prevent the replication of donor:
a) Granulocytes
b) Lymphocytes
c) Red cells
d) Platelets - A patient with a platelet count of 10,000/µL receives one unit of Apheresis Platelets, Leukocytes Reduced. What is the expected post-transfusion platelet increment in a 70-kg adult?
a) 5,000-10,000/µL
b) 10,000-20,000/µL
c) 30,000-50,000/µL
d) 50,000-70,000/µL - Which of the following Apheresis Platelets products must be irradiated?
a) An autologous unit collected prior to surgery
b) A random stock unit going to a patient with DIC
c) A directed donation given by a mother for her son
d) A directed donation given by an unrelated family friend - Plasma Frozen Within 24 Hours After Phlebotomy (PF24) and thawed for transfusion has an expiration of:
a) 6 hours
b) 12 hours
c) 24 hours
d) 5 days - What is the primary role of leukoreduction in blood components?
a) To prevent transfusion-associated circulatory overload (TACO)
b) To reduce the risk of HLA alloimmunization
c) To prevent bacterial proliferation
d) To remove IgA for deficient patients - Upon expiration, a unit of thawed Plasma Frozen Within 24 Hours (PF24) is converted to Thawed Plasma. This Thawed Plasma can be stored for an additional:
a) 1 day
b) 4 days
c) 14 days
d) 28 days - Cryoprecipitated AHF must be transfused within what period of time following thawing and pooling without a sterile connection device?
a) 4 hours
b) 8 hours
c) 12 hours
d) 24 hours - Which of the following is the correct storage temperature for Cryoprecipitated AHF in the frozen state?
a) 1-6°C
b) 20-24°C
c) ≤ -18°C
d) ≤ -65°C - A patient with hemophilia B should be treated with:
a) Factor VIII concentrate
b) Cryoprecipitated AHF
c) Factor IX concentrate
d) Fresh Frozen Plasma - Which blood component is indicated for an IgA-deficient patient with a history of transfusion-associated anaphylaxis?
a) Irradiated Red Blood Cells
b) Washed Red Blood Cells
c) Leukocyte-Reduced Red Blood Cells
d) Fresh Frozen Plasma - What is the approximate volume of a single unit of Cryoprecipitated AHF?
a) 5-10 mL
b) 10-15 mL
c) 50-100 mL
d) 200-300 mL - A unit of Fresh Frozen Plasma is inadvertently thawed and immediately refrigerated. After 24 hours, it may be relabeled as Thawed Plasma but will have decreased levels of:
a) Factor I (Fibrinogen)
b) Factor V
c) Factor VIII
d) Factor XII - For which of the following would platelet transfusions be contraindicated?
a) A bone marrow transplant patient with a platelet count of 9,000/µL
b) An actively bleeding patient with a platelet count of 55,000/µL
c) A patient with thrombotic thrombocytopenic purpura (TTP)
d) A patient with functionally abnormal platelets - The primary function of 2,3-DPG in red blood cells is to:
a) Generate ATP anaerobically
b) Increase the release of oxygen from hemoglobin to tissues
c) Protect hemoglobin from oxidation
d) Maintain red cell membrane integrity - Which of the following components must be prepared from Whole Blood within 8 hours of collection?
a) Red Blood Cells
b) Fresh Frozen Plasma
c) Cryoprecipitated AHF
d) Platelets - A patient with hypofibrinogenemia due to DIC would best be treated with:
a) Whole Blood
b) Fresh Frozen Plasma
c) Cryoprecipitated AHF
d) Platelets - Which of the following is an advantage of apheresis platelets over whole blood-derived platelets?
a) Lower risk of bacterial contamination
b) Exposure to a single donor per therapeutic dose
c) Longer shelf life
d) No need for ABO compatibility - What is the shelf life of Cryoprecipitated AHF if maintained frozen at –18°C or below?
a) 42 days
b) 6 months
c) 12 months
d) 36 months - Granulocyte transfusions are primarily indicated for:
a) Prophylactic treatment for infection
b) Severe neutropenia with an infection unresponsive to antibiotics
c) All patients undergoing chemotherapy
d) Autoimmune neutropenia - Which of the following statements about Thawed Plasma is true?
a) It contains all labile coagulation factors at normal levels.
b) It is stored at 20-24°C after thawing.
c) It has a shelf-life of 5 days after thawing.
d) It is prepared from Fresh Frozen Plasma that has been thawed and stored at 1-6°C. - What is the minimum pH that Apheresis Platelets must maintain at the time of issue, according to AABB Standards?
a) 6.0
b) 6.2
c) 6.8
d) 7.0 - Which of the following components is rich in Factor VIII and von Willebrand Factor?
a) Fresh Frozen Plasma
b) Platelets
c) Cryoprecipitated AHF
d) Red Blood Cells - A unit of Red Blood Cells is split into 5 aliquots using a sterile connecting device. The expiration date for each aliquot is:
a) 6 hours
b) 24 hours
c) The original expiration date of the parent unit
d) 5 days - Which of the following is the primary storage lesion that occurs in Red Blood Cells during storage?
a) Decrease in plasma potassium
b) Increase in 2,3-DPG
c) Decrease in pH
d) Increase in ATP - For a patient who is day 1 post-ABO major incompatible hematopoietic progenitor cell (HPC) transplant, red cell components selected should be:
a) ABO identical to the donor
b) ABO identical to the recipient
c) Group AB only
d) Based on the ABO antibodies circulating in the recipient - Plastic bag overwraps are recommended when thawing Fresh Frozen Plasma in a 37°C water bath to prevent:
a) The FFP bag from cracking
b) Water from contaminating the entry ports
c) The label from peeling off
d) Rapid denaturation of coagulation factors - The primary purpose of component therapy in transfusion medicine is to:
a) Reduce donor exposure
b) Provide targeted treatment and efficient blood use
c) Increase transfusion frequency
d) Avoid donor screening - Whole blood is separated into components by:
a) Freezing
b) Centrifugation
c) Filtration
d) Evaporation - The main additive used to preserve red blood cell viability is:
a) Sodium citrate
b) Adenine
c) Calcium chloride
d) Glucose phosphate - Packed Red Blood Cells (PRBCs) are primarily used for:
a) Volume replacement
b) Oxygen-carrying capacity restoration
c) Clotting factor replacement
d) Platelet production - Fresh Frozen Plasma (FFP) must be frozen within:
a) 1 hour of collection
b) 6–8 hours of collection
c) 12 hours of collection
d) 24 hours of collection - The storage temperature for PRBCs is:
a) 1–6°C
b) –18°C
c) 20–24°C
d) Room temperature - The maximum storage time for PRBCs in CPDA-1 solution is:
a) 21 days
b) 28 days
c) 35 days
d) 42 days - Platelet concentrates must be stored at:
a) 1–6°C
b) 20–24°C with gentle agitation
c) –20°C
d) 37°C without agitation - The shelf life of platelet concentrates is approximately:
a) 3 days
b) 5–7 days
c) 10 days
d) 14 days - Cryoprecipitate is prepared from:
a) Plasma frozen and thawed at cold temperatures
b) Centrifuged PRBCs
c) Platelet-poor plasma
d) Leukocyte-rich plasma - Cryoprecipitate is rich in:
a) Fibrinogen, Factor VIII, and von Willebrand factor
b) Platelets and red cells
c) Albumin and antibodies
d) Calcium and potassium - Leukocyte-reduced blood components are used to:
a) Prevent alloimmunization and febrile reactions
b) Increase oxygen delivery
c) Improve clotting time
d) Replace plasma proteins - Irradiated blood components are required for:
a) Patients with immune suppression
b) Patients with anemia
c) Routine transfusions
d) Platelet donors - The primary indication for platelet transfusion is:
a) Low hemoglobin
b) Thrombocytopenia
c) Low plasma proteins
d) Blood loss over 2 liters - FFP is primarily used to replace:
a) Red cells
b) Coagulation factors
c) White cells
d) Electrolytes - Cryoprecipitate is indicated in:
a) Fibrinogen deficiency
b) Anemia
c) Leukopenia
d) Hypovolemia - The temperature for storing Fresh Frozen Plasma (FFP) is:
a) 1–6°C
b) –18°C or colder
c) Room temperature
d) 37°C - A unit of whole blood yields approximately:
a) 150 mL plasma, 200 mL RBCs, and 50 mL platelets
b) 250 mL RBCs and 50 mL platelets
c) 300 mL FFP and 100 mL plasma
d) 400 mL plasma and 100 mL red cells - The hematocrit of a standard PRBC unit is approximately:
a) 20–25%
b) 40–50%
c) 55–65%
d) 70–80% - Which blood component requires continuous gentle agitation during storage?
a) Plasma
b) PRBCs
c) Platelets
d) Cryoprecipitate - Washed red blood cells are indicated for patients with:
a) Febrile reactions to plasma proteins
b) Iron overload
c) Sepsis
d) High platelet count - The additive SAGM extends red cell shelf life up to:
a) 21 days
b) 35 days
c) 42 days
d) 56 days - Granulocyte transfusions are indicated in patients with:
a) Thrombocytopenia
b) Severe neutropenia and infection unresponsive to antibiotics
c) Anemia
d) Coagulation disorders - The component used for massive transfusion protocols includes:
a) Whole blood or balanced component therapy (RBCs, plasma, platelets)
b) RBCs only
c) Plasma only
d) Cryoprecipitate only - One unit of platelet concentrate increases the platelet count by approximately:
a) 1,000/μL
b) 5,000/μL
c) 10,000/μL
d) 50,000/μL - Plasma thawed but not used within 24 hours becomes:
a) Expired
b) Thawed Plasma (usable for 5 days)
c) Platelet-rich plasma
d) Wasted component - Rejuvenation solutions for RBCs restore:
a) 2,3-DPG and ATP levels
b) Calcium and magnesium
c) Plasma proteins
d) Hemoglobin synthesis - Which component contains the highest risk for bacterial contamination?
a) Platelets
b) Plasma
c) RBCs
d) Cryoprecipitate - Cryoprecipitate should be stored at:
a) –18°C or below
b) 1–6°C
c) 20–24°C
d) 37°C - The transfusion of plasma components must be completed within:
a) 2 hours
b) 4 hours
c) 6 hours
d) 8 hours
📌 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) Fibrinogen deficiency
- b) 28 days from the date of irradiation
- a) 24 hours
- c) Apheresis Platelets
- b) Lymphocytes
- c) 30,000-50,000/µL
- c) A directed donation given by a mother for her son
- c) 24 hours
- b) To reduce the risk of HLA alloimmunization
- b) 4 days
- a) 4 hours
- c) ≤ -18°C
- c) Factor IX concentrate
- b) Washed Red Blood Cells
- b) 10-15 mL
- c) Factor VIII
- c) A patient with thrombotic thrombocytopenic purpura (TTP)
- b) Increase the release of oxygen from hemoglobin to tissues
- b) Fresh Frozen Plasma
- c) Cryoprecipitated AHF
- b) Exposure to a single donor per therapeutic dose
- c) 12 months
- b) Severe neutropenia with an infection unresponsive to antibiotics
- d) It is prepared from Fresh Frozen Plasma that has been thawed and stored at 1-6°C.
- b) 6.2
- c) Cryoprecipitated AHF
- c) The original expiration date of the parent unit
- c) Decrease in pH
- d) Based on the ABO antibodies circulating in the recipient
- b) Water from contaminating the entry ports
- b) Provide targeted treatment and efficient blood use
- b) Centrifugation
- b) Adenine
- b) Oxygen-carrying capacity restoration
- b) 6–8 hours of collection
- a) 1–6°C
- c) 35 days
- b) 20–24°C with gentle agitation
- b) 5–7 days
- a) Plasma frozen and thawed at cold temperatures
- a) Fibrinogen, Factor VIII, and von Willebrand factor
- a) Prevent alloimmunization and febrile reactions
- a) Patients with immune suppression
- b) Thrombocytopenia
- b) Coagulation factors
- a) Fibrinogen deficiency
- b) –18°C or colder
- a) 150 mL plasma, 200 mL RBCs, and 50 mL platelets
- c) 55–65%
- c) Platelets
- a) Febrile reactions to plasma proteins
- c) 42 days
- b) Severe neutropenia and infection unresponsive to antibiotics
- a) Whole blood or balanced component therapy (RBCs, plasma, platelets)
- c) 10,000/μL
- b) Thawed Plasma (usable for 5 days)
- a) 2,3-DPG and ATP levels
- a) Platelets
- a) –18°C or below
- b) 4 hours
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
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