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Transfusion Medicine Exam Materials - 1413 Verified Questions

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Transfusion Medicine

Exam Materials

Course Introduction

Transfusion Medicine is a specialized field of clinical pathology that focuses on the collection, testing, processing, storage, and clinical administration of blood and blood components. This course covers the principles and practices of blood transfusion, including donor selection, blood banking procedures, compatibility testing, and management of transfusion reactions. It also explores the immunological aspects of transfusion, infectious disease screening, component therapy, and the application of transfusion practices in various clinical settings. Emphasis is placed on patient safety, regulatory requirements, and advancements in transfusion therapies, preparing students to understand and navigate the complexities of modern transfusion medicine.

Recommended Textbook

Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening

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27 Chapters

1413 Verified Questions

1413 Flashcards

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Chapter 1: Red Blood Cells and Platelet Preservation:

Historical Perspectives and Current Trends

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Sample Questions

Q1) Name the main lipid components of a red blood cell membrane.

A) Phospholipid

B) Sphingomyelin

C) Glycolipid

D) Glycophorin A

Answer: A

Q2) Which of the following is licensed additive solutions approved for the storage of red blood cells for 42 days?

A) Adsol (AS-1)

B) Nutricel (AS-3)

C) Optisol (AS-5)

D) All of the above

Answer: D

Q3) Which metabolic pathway permits the accumulation of 2,3 diphosphoglycerate (2,3-DPG)?

A) Glycolysis

B) Luebering-Rapoport shunt

C) Pentose phosphate shunt

D) Methemoglobin reductase

Answer: B

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Chapter 2: Basic Genetics

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Sample Questions

Q1) In Mendel's law of separation, the first-filial generation is:

A) recessive.

B) homozygous.

C) heterozygous.

D) autologous.

Answer: C

Q2) The condition in which one chromosome has a copy of the gene and the other chromosome has that gene deleted or absent is referred to as:

A) homozygous.

B) heterozygous.

C) hemizygous.

D) recessive.

Answer: C

Q3) How is RNA different from DNA?

A) RNA usually exists as one strand

B) Ribose is substituted for deoxyribose

C) RNA incorporates uracil

D) All of the above

Answer: D

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Chapter 3: Fundamentals of Immunology

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Sample Questions

Q1) Which of the following are produced after exposure to genetically different nonself antigens of the same species?

A) Alloantibodies

B) Autoantibodies

C) Drug-induced antibodies

D) All of the above

Answer: A

Q2) Which of the following corresponds to the basic structure of immunoglobulin?

A) Two light chains held together with an interlink disulfide bond

B) Two heavy chains held together with an interlink disulfide bond

C) One light chain and one heavy chain held together by covalent disulfide bonds

D) Two light chains and two heavy chains held together by covalent disulfide bonds

Answer: D

Q3) What test is used to remove autoantibodies from test serum?

A) Adsorption

B) Direct Coombs'

C) Elution

D) Indirect Coombs'

Answer: A

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Chapter 4: Concepts in Molecular Biology

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Sample Questions

Q1) In performing gene cloning for blood group genes, what is a possible source of RNA?

A) Lymphocytes

B) Reticulocytes

C) Neutrophils

D) Platelets

Q2) In this technique, fluorescent probes are used to detect homologous DNA or RNA sequences in chromosomes or intact cells.

A) PCR

B) FISH

C) RFLP

D) DNA sequencing

Q3) What is the function of helicases and gyrases in the polymerase chain reaction?

A) To unwind the DNA

B) To anneal to cDNA sequences

C) To extend the primer sequence

D) To generate blunt-ended, double-stranded products

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Chapter 5: The Antiglobulin Test

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Sample Questions

Q1) All of the following are important in evaluating a positive DAT except:

A) patient diagnosis.

B) drug therapy.

C) transfusion history.

D) donation history.

Q2) Why is the 37°C reading omitted when using PEG additive?

A) PEG may cause aggregation of RBCs at 37°C.

B) Antibodies detected by PEG do not react at 37°C.

C) Warm-reacting antibodies are not clinically significant.

D) Unwanted reactions due to C3b will be detected at 37°C.

Q3) All of the following complement proteins can be found on the red blood cell membrane except:

A) C3d

B) C4b

C) C4a

D) C4d

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Chapter 6: The Abo Blood Group System

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Sample Questions

Q1) Individuals with group B blood are more common among which populations?

A) Black/Asian

B) Asian/white

C) White/black

D) Hispanic/white

Q2) The ABO group antibodies are primarily:

A) alloantibodies.

B) autoantibodies.

C) naturally occurring.

D) drug induced.

Q3) The state in which an individual's red blood cells are agglutinated by all sera regardless of blood type is called:

A) panagglutination.

B) polyagglutination.

C) sensitization.

D) leukoagglutination.

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Chapter 7: The RH Blood Group System

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Sample Questions

Q1) Which gene combination is expressed in the greatest frequency in the black population?

A) DCe

B) dce

C) Dce

D) DCE

Q2) Which antigen represents Rh3 in Rosenfield terminology?

A) D

B) E

C) C

D) e

Q3) Which of the following genotypes is consistent with f antigen expression?

A) DcE/DCe

B) Dce/DCE

C) DCe/DcE

D) DCe/dCE

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Page 9

Chapter 8: Blood Group Terminology and the Other Blood Groups

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Sample Questions

Q1) What biochemical observations signify a protein composition to the Kell antigens?

A) Degradation with formaldehyde

B) Inactivation at 56°C

C) Cell-membrane orientation

D) None of the above

Q2) Why is it relatively easy to find compatible units for a patient with anti-K?

A) Kell is a low-frequency antigen.

B) Kell is a high-frequency antigen.

C) Anti-K does not react at 37°C.

D) Anti-K has a low avidity for its respective antigen.

Q3) What type of hemolytic transfusion reaction (HTR) occurs more frequently in patients with Jk antibodies?

A) Febrile

B) Delayed

C) Immediate

D) Bacterial

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Chapter 9: Detection and Identification of Antibodies

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Sample Questions

Q1) A person has developed an antibody to the LISS reagent. What test will not be affected by this circumstance?

A) Major ACT crossmatch

B) IAT

C) DAT

D) Antibody screen

Q2) What screening cells are used primarily for testing donor units for unexpected antibodies?

A) Pooled

B) 2-vial

C) 3-vial

D) 4-vial

Q3) Which is the second phase of a hemagglutination reaction?

A) Immunodiffusion

B) Precipitation

C) Sensitization

D) Agglutination

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11

Chapter 10: Pre-Transfusion Testing

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Sample Questions

Q1) What is an "electronic" crossmatch?

A) A database compiled by the American Red Cross for rare phenotype accessibility

B) Comparison of donor and patient ABO groups and serologic data from a computer file

C) A crossmatch performed in microtiter plates and read by a spectrophotometer

D) All of the above

Q2) In some institutions, compatibility testing may be eliminated in which type of patient?

A) Cardiac

B) Anemic

C) Massively transfused

D) Pregnant

Q3) What anticoagulant is used to eliminate false-negative reactivity caused by cold autoantibodies and rouleaux?

A) Heparin

B) Sodium citrate

C) EDTA

D) All of the above

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Chapter 11: Overview of the Routine Blood Bank Laboratory

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Sample Questions

Q1) In order to be considered fresh frozen plasma, the plasma needs to be prepared within _____ of collection?

A) 1 hour

B) 6 hours

C) 8 hours

D) 24 hours

Q2) All of the following procedures might be done in an investigation of an ABO discrepancy except:

A) increasing incubation time for reverse grouping.

B) secretor studies.

C) neutralization studies with urine.

D) testing with anti-A<sub>1</sub> lectin.

Q3) Why are monoclonal anti-D reagents preferred over the slide test reagents?

A) They contain a low protein concentration and are not prone to false-positive reactions.

B) They contain a high protein concentration and are not prone to false-negative reactions.

C) They contain albumin, which acts as a potentiator.

D) None of the above

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Chapter 12: Other Technologies and Automation

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Sample Questions

Q1) If you had a lipemic and icteric sample that needed to have an antibody screen done, which of the following would obtain the best results?

A) Tube method

B) Gel

C) Solid phase

D) SPRCA

Q2) Which of the following statements is the most accurate? A mixed-field in the gel system:

A) can be ignored without further workup.

B) can be caused by fibrin found in plasma and can be corrected by using fresh serum.

C) needs to have further testing performed.

D) can be resolved by respinning the gel card.

Q3) When performing an antibody screen by gel technology, the following steps are eliminated:

A) the AHG reagent and control checked cells.

B) the saline wash and control check cells.

C) the cells I and II and saline wash.

D) the centrifugation and saline wash.

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Chapter 13: Donor Screening and Component Preparation

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Sample Questions

Q1) Leukoreduced packed RBCs must have an absolute white blood cell count of less than and contain at least what percent of original RBC mass?

A) 5 \(\times\) 10<sup>8</sup>/85

B) 5 \(\times\) 10<sup>6</sup>/85

C) 5 \(\times\) 10<sup>8</sup>/80

D) 5 \(\times\) 10<sup>6</sup>/80

Q2) Which of the following are approved preservative solutions for blood storage at 1°C to 6°C for 21 days?

A) ACD

B) CPD

C) CP2D

D) All of the above

Q3) Normally what percentage of 35-day-old red blood cells should be circulating 24 hours after transfusion?

A) 100%

B) 50%

C) 65%

D) 70%

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Chapter 14: Apheresis

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Sample Questions

Q1) A normal healthy donor undergoes a procedure to obtain platelets that will be transfused to a patient is representative of:

A) therapeutic apheresis collection.

B) component apheresis collection.

C) whole blood donation.

D) None of the above.

Q2) All of the following statements are consistent with photopheresis except:

A) the patient is given an oral dose of psoralen, which binds to the DNA of all nucleated cells.

B) collected white blood cells are exposed to ultraviolet light, which activates psoralen, preventing replication.

C) the patient is given an oral dose of piroxicam, which binds to the RNA of all nucleated cells.

D) treated cells are returned to the patient, inducing an immune response against the abnormal lymphocyte clone.

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Chapter 15: Transfusion Therapy

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Sample Questions

Q1) Who is at risk for transfusion-associated graft-versus-host disease (TAGVHD)?

A) Hodgkin's lymphoma patients

B) Bone marrow transplant recipients

C) Persons receiving nonirradiated directed donations

D) All of the above

Q2) In anemia uncomplicated by low plasma proteins or shock, the transfusion of:

A) whole blood is most desirable.

B) plasma is desirable.

C) packed red blood cells is most desirable.

D) fresh frozen plasma is most desirable.

Q3) All coagulation factors are produced in the liver except:

A) antihemophilic factor (AHF).

B) factor I.

C) vWF.

D) factor VII.

Q4) All of the following are characteristics of protein C except:

A) it has a vitamin K dependent factor.

B) it has a serine protease inhibitor.

C) it enhances factors V and VIII.

D) it produces a hypercoagulable state.

Page 17

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Chapter 17: Cellular Therapy

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Sample Questions

Q1) When checking out a unit of blood to the floor:

A) the nurse must provide a piece of paper with at least two patient identifiers and preferably, depending on the system, a unique blood bank band number

B) you must visually check and document that the unit is free from hemolysis or possible bacterial contamination

C) you must document who is checking out the blood and transporting it

D) All of the above

Q2) All of the following are symptoms of an allergic reaction except:

A) pruritus.

B) local erythema.

C) anemia.

D) hives.

Q3) Alloimmunization is categorized as what type of transfusion reaction?

A) Immediate nonhemolytic

B) Immediate hemolytic

C) Delayed nonhemolytic

D) Delayed hemolytic

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18

Chapter 18: Transfusion-Transmitted Diseases

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Sample Questions

Q1) A blood donor's serologic tests were reactive for HIV-1/2 antibodies. The test was repeated, and both were reactive. A Western blot confirmatory test was done and was negative. What is the protocol for this donor?

A) Unit is discarded.

B) Health department is notified.

C) Unit is OK to use.

D) Donor is permanently deferred.

Q2) A person with acute hepatitis B infection is immune to infection from other hepatitis viruses.

A)True

B)False

Q3) What marker usually is not detected when the hepatitis B-infected patient enters the convalescent phase?

A) Anti-HBc

B) HBsAg

C) HBeAg

D) Anti-HBe

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Chapter 19: Hemolytic Disease of the Fetus and Newborn

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Sample Questions

Q1) Cannulation of the umbilical vein under ultrasound guidance is known as:

A) cordocentesis.

B) amniocentesis.

C) apheresis.

D) pericardiocentesis.

Q2) Which of the following antibodies have not been known to cause HDFN?

A) Anti-C

B) Anti-S

C) Anti-D

D) Anti-Le<sup>a</sup>

Q3) What is the cause of HDFN?

A) Destruction of the mother's RBCs by autoantibody

B) Destruction of the fetus's RBCs by antibody produced by the mother

C) Destruction of the fetus's RBCs by autoantibody

D) Destruction of the mother's RBCs by antibody produced by the fetus

Q4) How are units for exchange transfusion prepared?

A) Group O red blood cells and group O plasma

B) Group O red blood cells and group A plasma

C) Group O red blood cells and group AB plasma

D) Group O red blood cells and group B plasma

Page 20

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Chapter 20: Autoimmune Hemolytic Anemias

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Sample Questions

Q1) What is the mechanism by which thiol reagents, such as dithiothreitol (DTT), disperse agglutination caused by cold-reactive autoantibody?

A) Dissociation of IgG molecules from the red blood cell with no damage to the membrane

B) Cleavage of the intersubunit disulfide bonds of dimeric IgG molecules

C) Cleavage of the intersubunit disulfide bonds of pentameric IgM molecules

D) Dissociation of IgM molecules from the red blood cell with no damage to the membrane

Q2) How is RBC destruction characterized in drug-induced immune hemolytic anemia via immune complex mechanism?

A) Extravascular hemolysis via macrophage ingestion of drug complex

B) Red blood cell death due to toxic granules released by neutrophils

C) Intravascular hemolysis precipitated by complement activation

D) None of the above

Q3) What is the most frequent antibody specificity in CHD?

A) Anti-IH

B) Anti-i

C) Anti-I

D) Anti-P

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Chapter 21: The Hla System

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Sample Questions

Q1) What is meant by the term public as applied to HLA antibodies?

A) Antibodies that detect a single HLA gene product

B) Binding to an epitope unique to one HLA gene product

C) Binding to epitopes shared by more than one HLA gene product

D) All of the above

Q2) Which MHC region encodes for complement proteins?

A) Class I

B) Class II

C) Class III

D) None of the above

Q3) The HLA-A locus antigens A2, A23, A24, and A28 make up the:

A) A4-CREG

B) A3-CREG

C) A2-CREG

D) A8-CREG

Q4) Patients who have been presensitized to HLA antigens have a much higher graft survival rate in liver transplantation than nonsensitized patients.

A)True

B)False

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Chapter 22: Relationship Testing

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Sample Questions

Q1) Which of the following is consistent with a low probability of paternity?

A) Only 1 POG and 1 MOG were found to exist in the Rh system.

B) More than 3 POGs were found in the HLA and MNS groups.

C) The POG had a gene frequency of 0.0004 in the random population.

D) None of the above

Q2) CODIS stands for:

A) Convicted Offender Digital Identifying System

B) Combined Offender DNA Index System

C) Combined Operation Digital Index System

D) None of the above

Q3) Apparent opposite homozygosity is also known as:

A) direct exclusion.

B) apparent exclusion.

C) indirect exclusion.

D) direct homozygous transition.

Q4) What is the statistical basis of the Hardy-Weinberg principle?

A) Selection of mates is dependent on blood types and therefore is random.

B) Selection of mates is dependent on blood types and therefore is biased.

C) Selection of mates is independent of blood types and therefore is random.

D) Selection of mates is independent of blood types and therefore is biased.

Page 23

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Chapter 23: Quality Management

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Sample Questions

Q1) Which of the following is not regarded as an instrument?

A) Automated analyzer

B) Pipette

C) Washer

D) Cuvette

Q2) As part of postemployment departmental training, a medical technologist was given 10 known blood samples to analyze for ABO specificity. This is referred to as:

A) recertification.

B) a competence assessment.

C) education.

D) a proficiency test.

Q3) Process improvement teams address all of the following issues except:

A) becoming "team players."

B) quality and reliability of service.

C) filing a grievance.

D) interdepartmental communication.

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Page 24

Chapter 24: Transfusion Safety and Federal Regulatory Requirements

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Sample Questions

Q1) What is the primary focus of quality assurance?

A) To place blame on employees who make recurring errors

B) To amend the system, procedure, or standard operating procedures, if deemed faulty

C) To analyze post-market stability

D) To rewrite employee job descriptions as needed

Q2) Blood grouping reagents are considered medical devices according to the CBER.

A)True

B)False

Q3) The FDA-directed civil action that calls for removal of products from distribution channels is known as:

A) injunction.

B) seizure.

C) prosecution.

D) quarantine.

Q4) In what year did the FDA take over biologics regulation?

A) 1976

B) 1980

C) 1972

D) 1985

25

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Chapter 24: Utilization Management

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Sample Questions

Q1) Blood utilization management programs are designed to do all but which of the following?

A) Increase safety

B) Decrease component availability

C) Reduce expenditure

D) Manage limited blood resources

Q2) Upon review at the end of the quarter, you note that one physician's C/T ratio was high. You discuss this with the medical director, and he has you draft a letter to this physician. This is an example of what kind of review?

A) Retrospective

B) Concurrent

C) Interpreted

D) Prospective

Q3) Which of the following is not part of a blood utilization review?

A) Retrospective review

B) Concurrent review

C) Interpreted review

D) Prospective review

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26

Chapter 25: Laboratory Information Systems

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Sample Questions

Q1) What is the function of a system manager?

A) To implement new software updates

B) To assign access codes to new users

C) To add new data items to the database

D) All of the above

Q2) Which of the following best describes software?

A) Physical pieces of equipment that can be seen and touched

B) The "core" of the information system

C) Programmed instructions that tell computer how to operate and manipulate the data

D) A mechanism for connecting one computer system to another through a telephone line

Q3) What kind of software allows the interchange of information between two different computer systems?

A) Application

B) Interface

C) Operating system

D) HIS

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27

Chapter 26: Medicolegal and Ethical Aspects of Providing

Blood Collection and Transfusion Services

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Sample Questions

Q1) How is battery conceptualized in transfusion medicine?

A) A patient develops a fever after being transfused.

B) A donor claims never to have agreed to be stuck by a needle.

C) A donor develops a hematoma after phlebotomy.

D) A patient develops an antibody 2 months after being transfused.

Q2) What is the rationale surrounding the Doctrine of Charitable Immunity?

A) State legislatures are more lenient toward select specialty areas of medicine with regard to excessive legal damages.

B) Courts provide immunity from excess liability for nonprofit organizations.

C) Blood collecting facilities entice donors by agreeing to donate 5% of plasma revenues to their favorite charity.

D) None of the above

Q3) Many transfusion-transmitted acquired immunodeficiency syndrome (TTAIDS) lawsuits have been dismissed because of:

A) inability to prove negligence.

B) lack of precedence.

C) blood shield statutes.

D) statute of limitations.

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Chapter 27: Tissue Banking: A New Role for the Transfusion Service

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Sample Questions

Q1) Donors for cornea transplants must be tested for all but which of the following diseases prior to transplant?

A) HIV-1 and -2

B) Hepatitis B

C) Hepatitis C

D) Chlamydia trachomatis

Q2) A bone flap is harvested by a physician for a patient at hospital X. The patient has an issue with hospital X and requests to go to hospital Y. The patient is transferred, but the physician wants to continue with the treatment. Which of the following scenarios is possible?

A) Hospital X would need to be registered with the FDA as a tissue vendor in order to transfer the bone flap to hospital Y.

B) The patient is allowed to take the bone flap with him to hospital Y, because it is autologous.

C) The physician is licensed to practice at both hospitals, so he is allowed to transfer the bone flap.

D) There is no tissue with transfer from one hospital to the next, because the material being transferred is bone.

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