Cryoprecipitate is rich in fibrinogen, Factor VIII, von Willebrand factor, Factor XIII, and fibronectin. While it was historically used for hemophilia A (Factor VIII deficiency), the development of specific, virally inactivated factor concentrates has made that use obsolete.

The other options are incorrect:

• a) Factor V deficiency: Cryoprecipitate does not contain Factor V.

• c) Thrombocytopenia: This is a low platelet count, which is treated with platelet transfusions, not cryoprecipitate.

• d) Vitamin K deficiency: This leads to a deficiency of the vitamin K-dependent clotting factors (II, VII, IX, X), which is treated with vitamin K administration or fresh frozen plasma (FFP), not cryoprecipitate.

Leukocyte reduction removes white blood cells from blood components, which helps prevent:

• Alloimmunization: The development of antibodies against donor HLA antigens.

• Febrile non-hemolytic transfusion reactions: Often caused by cytokines from donor white blood cells.

Other options:

• (b) Increase oxygen delivery → done by RBC transfusion, not leukoreduction

• (c) Improve clotting time → FFP or cryoprecipitate, not leukoreduced products

• (d) Replace plasma proteins → plasma products, not leukoreduced cells

Fresh Frozen Plasma (FFP) is used to replace multiple coagulation factors in patients with demonstrated deficiencies, such as in liver disease, massive transfusion, or specific factor deficiencies when specific factor concentrates are not available.

Other options:

• (a) Red cells: → replaced with PRBCs

• (c) White cells: → not replaced by transfusion

• (d) Electrolytes: → replaced with IV fluids, not FFP

Irradiated blood components are used to prevent transfusion-associated graft-versus-host disease (TA-GVHD) in immunocompromised patients. The irradiation process inactivates donor lymphocytes, which could otherwise attack the recipient’s tissues.

Other options:

• (b) Anemia: → requires PRBCs, not irradiation

• (c) Routine transfusions: → irradiation unnecessary

• (d) Platelet donors: → not required; irradiation applies to the product, not the donor

1. PF24 is thawed and becomes “Thawed Plasma.” Its initial expiration is 24 hours after thawing if it is not transferred to a new storage container.

2. If this unit remains untransfused after 24 hours, it is relabeled as “Thawed Plasma.”

3. From the original time of thawing, this Thawed Plasma has a total shelf life of 5 days.

4. Therefore, since the first 24 hours have already passed, the additional storage time is 5 days – 1 day = 4 days.

The primary indication for platelet transfusion is to prevent or treat bleeding in patients with significantly low platelet counts (thrombocytopenia).

Other options:

• (a) Low hemoglobin: → treated with RBC transfusion

• (c) Low plasma proteins: → treated with plasma (FFP) or albumin

• (d) Blood loss over 2 liters: → initially requires RBCs and plasma, not platelets unless platelet count falls

According to standards from organizations like the AABB and the FDA, once a unit of Plasma Frozen Within 24 Hours After Phlebotomy (PF24) is thawed, it must be stored at 1–6°C and transfused within 24 hours.

Cryoprecipitate is a plasma-derived blood component that must be frozen to preserve its coagulation factors, especially fibrinogen, Factor VIII, Factor XIII, and von Willebrand factor.

Other options:

• (b) 1–6°C: used for thawed plasma or RBCs

• (c) 20–24°C: used for platelets

• (d) 37°C: only used for thawing, not storage

• Apheresis platelets are equivalent to a pooled dose of 4–6 whole blood–derived platelet units.

• In a 70-kg adult, a single apheresis platelet unit is expected to increase the platelet count by approximately 30,000–50,000/µL.

 The other options are incorrect:

• a) 5,000-10,000/µL: This is far too low and would suggest a poor increment, which could indicate platelet refractoriness, but it is not the expected increment in a patient without such complications.

• b) 10,000-20,000/µL: This is lower than the expected standard increment for an apheresis unit.

• d) 50,000-70,000/µL: This is on the very high end of expectation. While possible, the standard and most reliable expected range is 30,000-50,000/µL.

• The key rule is that the expiration date of a red blood cell unit is shortened to 28 days AFTER irradiation, regardless of its original expiration date.

• This is because irradiation damages the white blood cells and shortens the shelf life of the red blood cells.

The other options are incorrect:

• a) Remains the same (32 days): Incorrect. Irradiation always shortens the shelf life.

• c) 24 hours from the time of irradiation: Incorrect. This is the expiration rule for platelets after they are irradiated, not for red blood cells.

• d) 14 days from the date of irradiation: Incorrect. This is the expiration rule for red blood cells that are washed, not irradiated.

Cryoprecipitate is made from fresh frozen plasma (FFP) that is thawed slowly at refrigerated temperatures (usually 1–6 °C). This process causes the precipitation of certain clotting factors, including fibrinogen, factor VIII, von Willebrand factor, factor XIII, and fibronectin, which are then collected and suspended in a small amount of plasma.

Other options:

• (b) Centrifuged PRBCs: → used for RBC concentrates, not cryo

• (c) Platelet-poor plasma: → used for preparing FFP or PF24, not cryo

• (d) Leukocyte-rich plasma: → not used for any standard blood component

• During RBC storage, several biochemical and structural changes (called storage lesions) occur over time.

• The primary lesion is a decrease in pH, caused by accumulation of lactic acid from ongoing anaerobic glycolysis.

Other options:

• a) Decrease in plasma potassium →  Potassium actually increases

• b) Increase in 2,3-DPG →  It decreases with storage

• d) Increase in ATP →  ATP levels decline with time

• Thawed Plasma is FFP or PF24 that has been thawed and stored at refrigerated temperatures (1–6°C).

• Key points:

  • Not all labile factors remain at normal levels → Factor VIII decreases after thawing.

  • Stored at 1–6°C, not at room temperature (20–24°C).

  • Shelf-life → Up to 5 days after thawing, but factor levels (esp. VIII) decline.

Other options:

• a)  Factor VIII is labile and decreases after thawing

• b)  Room temperature storage is for platelets, not thawed plasma

• c)  Technically correct for 5-day storage, but this depends on lab protocols and is not the defining characteristic

Patients with IgA deficiency who have anti-IgA antibodies are at high risk for severe anaphylactic reactions upon transfusion. The goal is to provide blood components that are essentially free of IgA.

Here’s a breakdown of the options:

• a) Irradiated Red Blood Cells: Irradiation is performed to prevent Transfusion-Associated Graft-vs-Host Disease (TA-GVHD) by disabling lymphocytes. It does not remove IgA.

• b) Washed Red Blood Cells: Correct. The process of washing red blood cells with saline removes over 99% of the plasma proteins, including IgA. This is the standard and most effective method to prevent anaphylaxis in these sensitive patients.

• c) Leukocyte-Reduced Red Blood Cells: Leukoreduction removes white blood cells to reduce febrile reactions and HLA alloimmunization. It removes very little plasma and does not effectively remove IgA.

• d) Fresh Frozen Plasma: This is contraindicated. FFP contains a full load of donor plasma proteins, including IgA, and would likely trigger a severe anaphylactic reaction.

Rejuvenation solutions (containing substances like pyruvate, inosine, phosphate, and adenine) help restore 2,3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP) levels in red blood cells, improving oxygen release and viability before transfusion or freezing.

Other options:

• (b) Calcium and magnesium: not affected by storage lesion

• (c) Plasma proteins: absent in packed cells

• (d) Hemoglobin synthesis: occurs only in bone marrow, not in stored RBCs

Packed Red Blood Cells (PRBCs) typically have a hematocrit of about 55–65% due to the removal of most of the plasma from whole blood.

Cryoprecipitated AHF (Antihemophilic Factor) is specifically prepared from Fresh Frozen Plasma (FFP) to be a concentrated source of certain clotting factors. It is rich in:

• Factor VIII (the factor deficient in Hemophilia A)

• von Willebrand Factor (vWF)

• Fibrinogen (Factor I)

• Factor XIII

• Fibronectin

The other options are incorrect:

• a) Fresh Frozen Plasma: While FFP contains Factor VIII and vWF, it contains them in normal plasma concentrations. Cryoprecipitate provides a much higher concentration of these factors in a small volume.

• b) Platelets: Platelets do not contain a significant, transfusable amount of these soluble plasma factors. They play a role in the clotting process but are not a source for replacing Factor VIII or vWF.

• d) Red Blood Cells: Red blood cells are for oxygen transport and do not contain coagulation factors.

• According to AABB Standards, thawed FFP (Fresh Frozen Plasma) must be kept at 1–6°C and infused within 24 hours after thawing.

• If not used within 24 hours, it can sometimes be relabeled as “Thawed Plasma” and stored for up to 5 days for certain coagulation factor uses, but for most purposes, 24 hours is the strict transfusion window.

The other options are incorrect:

• b) 36 hours: This is not a standard expiration time for any common blood component.

• c) 48 hours: This is not a standard expiration time for any common blood component.

• d) 72 hours: This is not a standard expiration time for any common blood component.

Component therapy means separating whole blood into its individual components — red cells, platelets, plasma, and cryoprecipitate — so that each patient receives only the specific component they need.

Other options:

• (a) Reduce donor exposure — a secondary benefit, not the primary purpose

• (c) Increase transfusion frequency — incorrect

• (d) Avoid donor screening — incorrect and unsafe

According to standard blood administration guidelines, the transfusion of plasma components (like FFP or Thawed Plasma) should be completed within 4 hours of starting the infusion to minimize the risk of bacterial growth or loss of component integrity.

Other options:

• (a) 2 hours: too short — not required unless patient-specific restriction

• (c) 6 hours / (d) 8 hours: too long — increased contamination risk

• 2,3-Diphosphoglycerate (2,3-DPG) binds to deoxygenated hemoglobin and stabilizes it in the T-state, which:

  • Decreases hemoglobin’s affinity for oxygen

  • Promotes oxygen unloading in peripheral tissues

• Other options:

  • Generate ATP anaerobically →  That’s done by glycolysis, not 2,3-DPG

  • Protect hemoglobin from oxidation →  That’s the role of glutathione

  • Maintain red cell membrane integrity →  Structural proteins like spectrin do that

Massive transfusion protocols typically use either:

• Whole blood (in some military or trauma settings), or more commonly

• A balanced ratio of components such as RBCs : Plasma : Platelets (often approaching 1:1:1) to mimic whole blood and correct coagulopathy.

Other options:

• (b) RBCs only: restores oxygen but causes coagulopathy if given alone

• (c) Plasma only: doesn’t provide oxygen or platelets

• (d) Cryoprecipitate only: provides fibrinogen only, not sufficient alone

While multiple additives are used in red blood cell storage solutions, adenine is a key preservative that helps maintain RBC viability by supporting ATP synthesis, which is essential for red cell survival and function during storage.

Common anticoagulant-preservative solutions like CPDA-1 contain Citrate (anticoagulant), Phosphate, Dextrose (glucose) (energy source), and Adenine (to maintain ATP levels).

In an ABO major incompatible hematopoietic progenitor cell (HPC) transplant, the recipient’s plasma contains antibodies against the donor’s red cell antigens.

• On day 1 post-transplant, the recipient’s own plasma and red cells still predominate, since donor red cells have not yet been produced in significant numbers.

• Therefore, red cell transfusions must be compatible with the recipient’s circulating antibodies to avoid hemolysis.

The key factor for Fresh Frozen Plasma (FFP) is the preservation of labile coagulation factors, particularly Factor V and Factor VIII. These factors begin to degrade if plasma is not frozen promptly.

The other options:

• a) Red Blood Cells: RBCs are typically prepared from whole blood, but they are not required to be frozen within 8 hours. They can be stored as liquid RBCs for weeks at 1-6°C.

• c) Cryoprecipitated AHF: Cryoprecipitate is made from FFP. Therefore, the initial FFP unit must meet the 8-hour freezing requirement first. The cryoprecipitate itself is then prepared by thawing the FFP later under controlled conditions.

• d) Platelets: Platelets are stored at room temperature (20-24°C) with agitation for up to 5-7 days. They are not frozen and have a completely different preparation timeline.

The shelf life of platelet concentrates (both apheresis and pooled whole blood-derived platelets) is 5 to 7 days when stored at 20-24°C with continuous agitation.

• The exact duration depends on the type of plastic used for the storage container, which affects gas permeability and thus the maintenance of a proper pH.

• This relatively short shelf life is due to the risk of bacterial proliferation at room temperature.

The other options are incorrect:

• a) 3 days: This was the standard many years ago, but improvements in collection and storage systems have safely extended the shelf life.

• c) 10 days & d) 14 days: These are too long and are not permitted due to the unacceptably high risk of bacterial contamination and loss of platelet function.

Hemophilia B, also known as Christmas disease, is caused by a deficiency of Factor IX.

Here’s why the other options are incorrect:

• a) Factor VIII concentrate: This is used to treat Hemophilia A, not Hemophilia B.

• b) Cryoprecipitated AHF: Cryoprecipitate is rich in fibrinogen, Factor VIII, von Willebrand factor, and Factor XIII. It is not a reliable source of Factor IX and is not used to treat Hemophilia B.

• d) Fresh Frozen Plasma: While FFP contains all coagulation factors, including Factor IX, it is not the first-line treatment. It is less effective because a large volume must be transfused to achieve adequate factor levels, which increases the risk of transfusion reactions and volume overload.

• Platelets are living, metabolically active cell fragments that are essential for clotting.

• To maintain their viability and function, they must be stored at room temperature (20-24°C) to prevent clumping and loss of function that occurs at colder temperatures.

• Continuous agitation on a platelet rotator or agitator is required to keep them suspended and oxygenated, which prevents them from aggregating and helps maintain a proper pH level.

The other options are incorrect:

• a) Red Blood Cells, Leukocytes Reduced: These are stored in a refrigerator at 1-6°C without agitation.

• b) Fresh Frozen Plasma: This is stored in a freezer at -18°C or colder until it is thawed. Once thawed, it is stored at 1-6°C without agitation.

• d) Cryoprecipitated AHF (thawed): After thawing, it is stored at 20-24°C (room temperature) but does NOT require continuous agitation. It must be used within 4-6 hours of thawing.

• Irradiation of RBCs is done to inactivate donor T-lymphocytes.

• This prevents Transfusion-Associated Graft-versus-Host Disease (TA-GVHD), a rare but often fatal complication where donor lymphocytes attack the recipient’s tissues.

The other options are incorrect:

• a) Granulocytes: While granulocytes are present in some blood products, they are not the target of irradiation. In fact, a specialized product called Granulocyte Transfusions is sometimes irradiated, but the target is still the contaminating lymphocytes within that product.

• c) Red cells: Irradiation has no effect on the function or shelf-life of the red cells themselves; its target is the white blood cells (lymphocytes) within the unit.

• d) Platelets: This is incorrect in the context of a red blood cell unit. Furthermore, when a unit of platelets is irradiated, the goal is still the same: to inactivate the lymphocytes that are present as contaminants in the platelet product.

• Apheresis platelets collect a therapeutic dose from a single donor, which reduces the patient’s exposure to multiple donors compared to pooled, whole blood–derived platelets.

• Advantages of apheresis platelets:

  • Lower alloimmunization risk due to single donor

  • Easier to match HLA or CMV status

• Other options:

  • Lower risk of bacterial contamination →  Both products have similar risk; bacterial testing is needed for both

  • Longer shelf life →  Shelf life is similar (5–7 days)

  • No need for ABO compatibility →  ABO matching is preferred for better increments and reduced reactions

When thawing Fresh Frozen Plasma (FFP) in a 37°C water bath, the plastic overwrap acts as a barrier to prevent water from contacting the ports of the plasma bag. This is crucial because contaminated entry ports could introduce bacteria into the product during transfusion, posing a risk of infection to the patient.

Platelet concentrates are stored at 20–24°C (room temperature) and must be kept under continuous gentle agitation to:

• Prevent platelet clumping

• Maintain gas exchange (oxygen and CO₂)

• Preserve platelet viability and function

The correct answer is not listed perfectly, but the closest standard breakdown from a unit of whole blood (approx. 450-500 mL collection + anticoagulant) is roughly:

• Red Blood Cells: ~200-250 mL (hematocrit ~55-65%)

• Plasma: ~200-250 mL

• Platelets: from a platelet concentrate, not a direct 50 mL yield from whole blood—usually one whole blood donation yields one platelet unit in ~40-70 mL plasma.

Given the options, none match the typical 250-300 mL plasma and 200-250 mL RBCs exactly, but the best choice is:

b) 250 mL RBCs and 50 mL platelets — if we interpret “50 mL platelets” as the volume of a platelet concentrate derived from one whole blood donation.

According to AABB Standards, apheresis platelets must maintain a pH of ≥ 6.2 at the end of their storage period. This is a critical quality control measure.

• Platelets are stored at room temperature (20-24°C) with continuous agitation.

• During storage, platelets metabolize glucose, producing lactic acid, which causes the pH to drop.

• A pH below 6.2 is associated with a significant loss of platelet viability and function. Therefore, maintaining a pH at or above 6.2 ensures the platelets are still therapeutically effective when transfused.

While leukoreduction (the removal of white blood cells from blood components) has several benefits, its primary role is to reduce the risk of Human Leukocyte Antigen (HLA) alloimmunization in transfusion recipients.

Here’s a breakdown of the options:

• a) To prevent transfusion-associated circulatory overload (TACO): Incorrect. TACO is related to fluid volume overload, not the presence of white blood cells.

• b) To reduce the risk of HLA alloimmunization: Correct. When a patient is exposed to foreign white blood cells (leukocytes) from a donor, they can develop antibodies against the HLA on those cells. This can cause complications like febrile non-hemolytic transfusion reactions and make it very difficult to find compatible platelets for future transfusions.

• c) To prevent bacterial proliferation: Incorrect. Leukoreduction does not target bacteria. Bacterial contamination is managed through strict donor arm preparation and, for platelets, bacterial detection systems.

• d) To remove IgA for deficient patients: Incorrect. Patients with IgA deficiency who have anti-IgA antibodies require blood components from IgA-deficient donors, not simply leukoreduced ones.

The anticoagulant-preservative solution used determines the shelf life of Red Blood Cells.

• CPDA-1 (Citrate-Phosphate-Dextrose-Adenine) allows for the storage of Whole Blood and Packed Red Blood Cells (PRBCs) for 35 days at 1-6°C.

• This is an extension from the earlier CPD solution, which only allowed 21 days of storage. The addition of Adenine in CPDA-1 provides a substrate for RBCs to maintain ATP levels for a longer period, thus extending their viability and shelf life.

For comparison:

• CPD: 21 days

• CPDA-1: 35 days

• Additive Solutions (AS-1, AS-3, AS-5, AS-7): 42 days

Packed Red Blood Cells (PRBCs) are concentrated red cells obtained after removing most of the plasma from whole blood.
Their primary purpose is to restore or maintain oxygen delivery to tissues in patients with anemia or significant blood loss.

Other options:

• (a) Volume replacement → best achieved with crystalloids or colloids, not PRBCs

• (c) Clotting factor replacement → use Fresh Frozen Plasma (FFP)

• (d) Platelet production → use platelet concentrates

In a typical adult, one unit of platelet concentrate (derived from whole blood) is expected to increase the platelet count by approximately 5,000–10,000/μL, but the most commonly cited average is around 5,000/μL per unit.

Factors affecting response:

• Ongoing bleeding or consumption (e.g., DIC)

• Splenomegaly (sequestration)

• Immune destruction

• Sepsis or fever

When Fresh Frozen Plasma (FFP) is thawed at 37°C, it must ideally be used within 24 hours if it’s to retain all labile coagulation factors (especially Factors V and VIII).
However, if not used within 24 hours, it can be relabeled and stored as “Thawed Plasma.”

Other options:

• (a) Expired: incorrect — can still be used as thawed plasma

• (c) Platelet-rich plasma: made from whole blood, not from thawed FFP

• (d) Wasted component: only if >5 days post-thaw or mishandled

Platelet concentrates are very sensitive to temperature and storage conditions.
They must be kept at room temperature (20–24°C) with continuous gentle agitation to maintain platelet viability and function.

The other options are incorrect:

• a) 1–6°C: This is the storage temperature for red blood cells and thawed plasma. Chilling platelets renders them non-viable.

• c) –20°C: This is a temperature used for freezing plasma, not platelets. Platelets are not stored frozen under standard conditions.

• d) 37°C without agitation: This is far too warm and would promote bacterial growth. Without agitation, the platelets would quickly aggregate and become useless.

Packed Red Blood Cells (PRBCs) are stored at a temperature of 1–6°C to preserve cell viability and reduce bacterial growth.

Other options:

• (b) –18°C → for FFP

• (c) 20–24°C → for platelets

• (d) Room temperature → unsuitable; leads to bacterial growth and hemolysis

According to AABB Standards and FDA regulations, Cryoprecipitated AHF stored at -18°C or colder has a shelf life of 1 year (12 months) from the date of collection of the original whole blood unit.

This contrasts with Fresh Frozen Plasma (FFP), which must be stored at -18°C or colder and has a shelf life of 12 months, or at -65°C or colder for an extended shelf life of 7 years.

• Platelet transfusions are generally contraindicated in TTP because:

  • The underlying problem is microvascular platelet aggregation due to ADAMTS13 deficiency, not lack of platelets.

  • Transfused platelets can worsen thrombosis and organ damage.

• Other scenarios:

  • Bone marrow transplant with platelets <10,000/µL →  Indicated to prevent spontaneous bleeding

  • Actively bleeding patient with platelets 55,000/µL →  May be transfused depending on clinical situation

  • Patients with platelet function defects →  May benefit from transfusion with functional platelets

Cryoprecipitated AHF is the insoluble protein fraction that precipitates when a single unit of Fresh Frozen Plasma (FFP) is thawed between 1–6°C. This process leaves behind a very small, concentrated volume.

• A single unit of FFP has a volume of approximately 200-300 mL.

• After the plasma is removed from the cryoprecipitate, the remaining product is only about 10-15 mL.

Cryoprecipitate (cryo) is the cold-insoluble portion of plasma proteins that precipitate when Fresh Frozen Plasma (FFP) is thawed slowly at 1–6°C.

Main contents of Cryoprecipitate:

• Fibrinogen

• Factor VIII (Antihemophilic factor)

• von Willebrand factor (vWF)

• Factor XIII

• Fibronectin

Other options:

• (b) Platelets and red cells → absent in cryo

• (c) Albumin and antibodies → found in plasma, not cryo

• (d) Calcium and potassium → not plasma proteins

Granulocyte transfusions are used to temporarily increase neutrophil counts in patients who are severely neutropenic and have life-threatening infections that are not responding to antibiotics.

Other options:

• Prophylactic treatment →  Granulocyte transfusions are not routinely used prophylactically.

• All chemotherapy patients →  Only if severe infection develops.

• Autoimmune neutropenia →  Typically managed with immunosuppressive therapy, not transfusions.

• Irradiation of platelets is required when there is a risk of Transfusion-Associated Graft-versus-Host Disease (TA-GVHD). This is especially a concern for immunologically vulnerable patients receiving related donor products.

Breakdown of options:

• a) Autologous unit →  Not needed; the patient’s own cells pose no TA-GVHD risk.

• b) Random stock unit for DIC patient →  Not necessary; DIC does not increase TA-GVHD risk.

• c) Directed donation by mother to son →  Related donor → high TA-GVHD risk → irradiate.

• d) Directed donation by unrelated family friend →  Unrelated donor → lower risk; irradiation usually not required unless the patient is immunocompromised.

Granulocyte transfusions are used in patients with severe, persistent neutropenia and a documented bacterial or fungal infection that has not responded to appropriate antimicrobial therapy.

Other options:

• (a) Thrombocytopenia: → treat with platelet transfusion

• (c) Anemia: → treat with PRBCs

• (d) Coagulation disorders: → treat with FFP or cryoprecipitate

• When a unit of Red Blood Cells (RBCs) is divided into aliquots using a sterile connecting device, the closed system is maintained, meaning no bacterial contamination risk is introduced.

• Therefore, each aliquot retains the same expiration date as the original (parent) unit.

Other options:

• 6 hours →  Applies when aliquots are prepared using an open system (non-sterile connection).

• 24 hours →  Also for open systems or certain thawed plasma products.

• 5 days →  Not applicable to RBC aliquots.

Fresh Frozen Plasma (FFP) must be stored at -18°C or colder (typically at or below -25°C in many standards) to preserve the activity of coagulation factors for up to one year.

Other options:

• (a) 1–6°C: for RBCs or thawed plasma

• (c) Room temperature: for platelets

• (d) 37°C: used only for thawing, not storage

• Fresh Frozen Plasma (FFP) contains all coagulation factors.

• After thawing, plasma can be stored at 1–6°C for up to 24 hours and relabeled as Thawed Plasma.

• Most coagulation factors remain stable, but labile factors—primarily Factor VIII and to a lesser extent Factor V—decline during refrigerated storage.

• Factor VIII is the most sensitive and is considered the primary factor decreased after thawing and storage.

Other options:

• Fibrinogen (Factor I) →  Stable for the 24-hour period

• Factor V → Some decrease may occur, but less significant than Factor VIII

• Factor XII → Very stable, not affected

According to standards (such as those from AABB), Fresh Frozen Plasma (FFP) must be frozen at -18°C or colder within 8 hours of whole blood collection to preserve labile coagulation factors effectively. If produced from apheresis, it also must be frozen within 6–8 hours.

• Hypofibrinogenemia (low fibrinogen) in DIC requires fibrinogen replacement.

• Cryoprecipitated AHF is rich in fibrinogen, Factor VIII, von Willebrand factor, and Factor XIII, making it the preferred product for correcting fibrinogen deficiency.

Other options:

• Whole Blood →  Not ideal; contains relatively low fibrinogen and unnecessary red cells

• Fresh Frozen Plasma →  Contains fibrinogen, but in lower concentration than cryoprecipitate

• Platelets → Only replace platelets, not fibrinogen

The SAGM (Saline-Adenine-Glucose-Mannitol) additive solution helps maintain red cell viability and typically extends the shelf life of packed red blood cells to 42 days when stored at 1–6°C.

Whole blood is separated into its components — red blood cells, plasma, and platelets — by centrifugation, which uses centrifugal force to separate the components based on their density.

Process:

• Light spin: separates platelet-rich plasma from red cells.

• Heavy spin: separates platelet concentrate from plasma.

Cryoprecipitate is primarily used to treat bleeding or as prophylaxis in patients with significantly low fibrinogen levels (e.g., in disseminated intravascular coagulation, massive transfusion, or certain surgical settings).

Other options:

• (b) Anemia: → treat with PRBCs

• (c) Leukopenia: → not treated with blood components

• (d) Hypovolemia: → treat with IV fluids or plasma expanders

Washed red blood cells have most of the plasma proteins and electrolytes removed, which helps prevent recurrent febrile non-hemolytic transfusion reactions or allergic reactions in sensitive patients.

Other options:

• (b) Iron overload: managed by iron chelation therapy, not washed RBCs

• (c) Sepsis: not an indication; transfusion avoided unless absolutely necessary

• (d) High platelet count: not treated with RBC products

• Cryoprecipitated Anti-Hemophilic Factor (Cryo AHF) is rich in fibrinogen, factor VIII, vWF, and factor XIII.

• After thawing and pooling without a sterile connection device, it must be transfused within 4 hours to minimize the risk of bacterial contamination.

• If pooled using a sterile connection device, storage can be extended up to 24 hours.

Other options:

• 8, 12, 24 hours →  Only applicable if sterile pooling devices are used; otherwise, 4 hours is the safe transfusion window.

Cryoprecipitated AHF must be stored at -18°C or colder to maintain the stability and function of the clotting factors, particularly fibrinogen and Factor VIII.

The other options:

• a) 1-6°C: This is the standard storage temperature for liquid plasma and thawed blood components, not frozen ones.

• b) 20-24°C: This is the storage temperature for platelet components.

• d) ≤ -65°C: This is the required storage temperature for Fresh Frozen Plasma (FFP), which is much colder than the requirement for Cryoprecipitated AHF.

Platelets carry the highest risk for bacterial contamination because they are stored at room temperature (20–24°C), which can promote bacterial growth, unlike other components that are refrigerated or frozen.