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DNB Immunohematology Previous Year Questions

These are the DNB Immunohematology (Immunohematology & Blood Transfusion) theory questions asked by NBEMS in the December 2025 and June 2025 exams, listed paper by paper as they appeared. The Prep DNB app has all 19 DNB sessions from December 2014 to December 2025 — 760 questions in total — with repeat-question tracking, examiner keywords and MCQs.

Jump to: December 2025 · June 2025 · Important topics · Older papers

DNB Immunohematology December 2025 Question Paper

Paper 1

  1. Describe the structure and function of red cell membrane with a well labelled diagram. Explain the principles of underlying antigen-antibody interactions. [5+5]
  2. Describe briefly IgG immunoglobulins under following headings: a) Structure. [3] b) Subclasses and allotypes. [3] c) Effector functions and their role in transfusion medicine. [4]
  3. What are antigen presenting cells? Explain the role of inflammatory cytokines in transfusion medicine. [4+6]
  4. Describe the human neutrophil antigens and explain how they are associated with immune neutrophil disorders giving examples. [10]
  5. Explain the role of T- lymphocytes in adaptive immunity and its significance in transfusion medicine. [5+5]
  6. Discuss various blood group systems, collections and series as per ISBT criteria. [10]
  7. Explain Hardy Weinberg equation and its use in population genetics with an example. [10]
  8. What is meant by the secretor status of an individual? Explain how the secretor status of a person is determined. [5+5]
  9. Discuss in detail the steps involved in conducting a scientific research study, including formulation of a research problem, study design, data collection, analysis, and ethical considerations. [10]
  10. Explain the role of the ABO blood group system in paternity testing and forensic science. Discuss how blood group inheritance patterns are applied to determine biological relationships, and describe the limitations of using ABO typing compared to modern DNA-based techniques. [4+6]

Paper 2

  1. Explain the various types and techniques of autologous transfusion, highlighting predeposit autologous donation, intraoperative cell salvage and acute normovolemic hemodilution (ANH). [10]
  2. Compare and contrast a fixed massive transfusion protocol with targeted therapy for managing massive hemorrhage. Describe how you would provide blood component support to a patient with acute blood loss following a road traffic accident (RTA). [10]
  3. a) Therapeutic plasma exchange (TPE) - enumerate the indications and describe the different types of replacement fluids used. [5] b) Leukapheresis - discuss the clinical indications, outline the procedure, and mention the precautions necessary to ensure donor and patient safety. [5]
  4. Discuss the measures which can be implemented by blood centres to prevent bacterial contamination of blood components. [10]
  5. What do you mean by Transfusion probability (TP), Transfusion index (TI) and Cross-match to transfusion Ratio (CTR)'? What is their significance in transfusion medicine? [5+5]
  6. Describe blood unit selection for emergency transfusion. Briefly discuss the electronic crossmatch along with the pros and cons for its adoption in our country. [5+5]
  7. How would you diagnose a patient with cold agglutinin disease? Describe the steps to select compatible red cell units for transfusion in a patient with circulating cold agglutinins. [5+5]
  8. a) Direct Antiglobulin Test (DAT) - causes and clinical significance of a positive result. [4] b) Antibody titration - principle, procedure and relevance. [3] c) Anti-Human Globulin (AHG) test - common sources of error and limitations [3]
  9. Describe Transfusion-Associated Acute Gut Injury (TRAGI) with emphasis on pathophysiology, diagnosis and its prevention. [4+3+3]
  10. Explain cold chain management and storage conditions for blood components, emphasizing quality maintenance in modern blood centers. [5+5]

Paper 3

  1. List the main indications for blood transfusion in neonates and mention the special precautions that must be taken when selecting blood for neonatal transfusion and various strategies to decrease donor exposure in neonatal transfusion. [10]
  2. Define cryopreservation. Describe the methods, cryoprotective agents used and applications of cryopreservation in transfusion medicine. [6+4]
  3. Define hematopoietic stem cell transplantation (HSCT). Mention advantages and disadvantages of various sources of HSCT for therapeutic use. [4+6]
  4. Describe the principle of flow cytometry and discuss its applications in hematopoietic stem cell transplantation. [10]
  5. Define the Maximum Surgical Blood Ordering Schedule (MSBOS). Discuss its principle, advantages and role in effective blood inventory management in transfusion medicine. [4+6]
  6. Discuss the pathogenesis and laboratory diagnosis of drug induced auto immune hemolytic anemia. [10]
  7. Discuss the different types of ABO mismatch peripheral blood stem cell transplant (PBSCT). Discuss its immunohematological work up and transfusion support in ABO mismatch PBSCT. [5+5]
  8. Describe the pathophysiology of hemolytic disease of the fetus and newborn (HDFN). Compare between ABO and RhD types of HDFN. [5+5]
  9. Discuss the role of HLA and granulocyte antigens in transfusion and transplantation. [10]
  10. Define GVHD. Discuss the utility of donor lymphocyte infusion in hematopoietic stem cell transplant. [3+7]

Paper 4

  1. a) Validation and calibration in blood center operations. [5] b) ISO 15189:2022 and NABH accreditation requirements. [5]
  2. Describe the concept of hemovigilance and its legal importance in ensuring transfusion safety. [10]
  3. a) Uses of next generation sequencing (NGS) in Transfusion Medicine. [5] b) Fluorescence assisted cell sorting (FACS). [5]
  4. a) Stem cell plasticity. [5] b) Induced pluripotent stem cells. [5]
  5. Proteomics and its application in transfusion medicine. [10]
  6. Discuss the role of the Hospital Transfusion Committee in promoting rational blood use and outline the key features of the Patient Blood Management (PBM) program, including component transfusion indications as per institutional guidelines. [5+5]
  7. ISBT128 standards in blood center automation. [10]
  8. CRISPR-Cas system in transfusion medicine. [10]
  9. Describe indications and principle of extra corporeal photopheresis. Discuss its efficacy in the treatment of graft-versus-host disease. [5+5]
  10. What is pegylated G-CSF? What are other pegylated products used in hematology? [5+5]

DNB Immunohematology June 2025 Question Paper

Paper 1

  1. Describe factors affecting antigen-antibody reactions in red cell serology. [10]
  2. Describe expression of various antigens on platelets and their clinical significance. [5+5]
  3. Describe the natural process of affinity maturation of antibodies and factors affecting affinity maturation. [5+5]
  4. Describe the production of monoclonal antibodies by hybridoma technology. What are the advantages and disadvantages of using monoclonal antibodies in red cell serology? [4+(3+3)]
  5. a) Describe bilirubin metabolism. [5] b) Enumerate the disorders of bilirubin metabolism. [5]
  6. a) What are the methods of assessment of blood loss in a trauma patient? [6] b) Describe the role of transfusion medicine specialist in massive transfusion. [4]
  7. Discuss the association of blood group systems with diseases. [10]
  8. Discuss the hemostatic changes in liver disease. What are its implications on transfusion therapy in liver disease? [6+4]
  9. What is INR (International normalized ratio)'? Discuss its utility & limitations as a measure of coagulopathy. [4+(3+3)]
  10. Discuss the pathology of hyperfibrinolysis, laboratory assessment and management. [4+3+3]

Paper 2

  1. What is directed donation? When is it clinically indicated? What are the advantages and disadvantages of directed donation? [3+2+5]
  2. Describe the approach to blood management in a patient planned for a liver transplant in three months. [10]
  3. Describe the adverse events which may be encountered during blood donation. Discuss their management. What precautions should be taken to prevent the adverse events? [4+3+3]
  4. Discuss the labelling requirements for: a) Packed red cells. [3] b) Platelet concentrates. [3] c) Cryoprecipitate. [2] d) Fresh frozen plasma. [2]
  5. Discuss preparation and quality control of platelet concentrate. [5+5]
  6. Discuss the role of transfusion medicine specialist in the management of thalassemia. Describe the process of setting up comprehensive thalassemia care center at a tertiary care hospital. [5+5]
  7. Enumerate the indications for irradiation of blood components. Describe quality control of an irradiated packed red cells. [6+4]
  8. Discuss platelet additive solution (PAS) under the following heads: a) Constituents and their functions. [5] b) Advantages and limitations. [5]
  9. Describe the types of auto-immune hemolytic anemias. Give a detailed account of approach to diagnosis and the role of transfusion medicine specialist in the management. [4+3+3]
  10. Discuss the preparation and quality parameters of Intravenous Immunoglobulin (IVIG). What are the clinical indications for its use? [(4+3)+3]

Paper 3

  1. Describe serological course of hepatitis B and hepatitis C infection. Discuss the implications of these infections on blood safety. [6+4]
  2. Discuss antenatal red cell antibody screening and its implications in clinical practice. [6+4]
  3. Discuss transfusion support in hemopoietic stem cell transplantation and its challenges. [6+4]
  4. What are the clinical indications for therapeutic plasma exchange? What are the parameters to be monitored during and after the procedure? What are the methods of assessing response to the procedure? [4+3+3]
  5. Define quality assurance. Discuss the quality assurance measures to be implemented in the Transfusion Transmitted Infections (TTI) testing laboratory. [2+8]
  6. Describe erythromagnetic technique (EMT) for blood group serology testing. What are the advantages and limitations of this technique? [4+(3+3)]
  7. Discuss blood substitutes. Write a note on recent advances in blood substitutes. [7+3]
  8. Describe the composition of a Hospital Transfusion Committee (HTC). Discuss its role in hospital transfusion practices. [4+6]
  9. Discuss the role of transfusion medicine specialist in cellular therapies. [10]
  10. Compare and contrast granulocyte concentrates prepared by buffy coat pooling and granulocytapheresis. What are the clinical indications for the transfusion of granulocyte concentrate? List the adverse effects of granulocyte concentrate transfusion. [6+2+2]

Paper 4

  1. Describe the medico-legal aspects of donor notification. What is donor lookback? [5+5]
  2. Describe a plan for total quality management in a blood donation camp setting. [10]
  3. Describe the process of capturing near-miss events at the blood center. What are the strategies to be implemented for their resolution? [5+5]
  4. Describe the role of barcoding system in making blood safer. What are the challenges in its implementation? [7+3]
  5. Describe the types and features of viscoelastic testing methods and their role in assessing coagulopathy. [6+4]
  6. Describe the role of accreditation in improving the quality of blood transfusion services. [10]
  7. a) Radio Frequency Identification (RFID) technology in blood transfusion. [6] b) Quality parameters for autoclave and methods to assess them. [4]
  8. Describe the organogram of blood transfusion services in India. [10]
  9. Describe the requirements for establishment of blood storage centre. [10]
  10. Describe the method used for cell free fetal DNA screening. Enumerate its uses in clinical transfusion practice. [5+5]

High-Yield DNB Immunohematology Topics

A selection of 23 of the 36 important topics curated in the app from repeated DNB Immunohematology questions.

Blood banking fundamentals — highest yield

  • ABO system: inheritance, subgroups, Bombay phenotype; forward and reverse grouping discrepancies
  • Rh system: D variants (weak D, partial D), clinical significance
  • Minor blood group systems: Kell, Kidd, Duffy — clinical relevance in HDFN and transfusion

Blood components and processing

  • Packed RBCs: storage lesions, additive solutions, indications
  • FFP and cryoprecipitate: preparation, indications, thawing, dosage
  • Platelet concentrates: apheresis vs random donor, bacterial contamination prevention, storage

Transfusion reactions

  • Acute hemolytic transfusion reaction: investigation, management, prevention
  • Delayed hemolytic reaction and alloantibody formation
  • FNHTR, allergic/anaphylactic reactions (IgA deficiency)

Special clinical situations

  • HDFN: ABO vs Rh, anti-D quantification, intrauterine transfusion, exchange transfusion
  • Neonatal alloimmune thrombocytopenia (NAIT)
  • AIHA: warm vs cold, drug-induced; cold agglutinin disease transfusion challenges

Apheresis and cellular therapy

  • Therapeutic plasma exchange: ASFA indications, replacement fluids
  • Plateletpheresis, leukapheresis, red cell exchange, photopheresis
  • HSCT support: ABO-incompatible transplant, CD34 enumeration, stem cell processing

TTI and quality

  • Mandatory TTI testing: HIV, HBV, HCV, syphilis, malaria; NAT (ID-NAT vs MP-NAT)
  • Window period and residual risk; emerging pathogens (dengue, Zika, SARS-CoV-2)
  • Hemovigilance (HvPI): reporting, imputability, lookback policy

Coagulation and patient blood management

  • Coagulation cascade and laboratory tests (PT, aPTT, fibrinogen)
  • TEG/ROTEM: interpretation in bleeding and massive transfusion
  • DIC: diagnosis and transfusion support; hyperfibrinolysis and TXA

Regulatory aspects

  • Drugs and Cosmetics Act: blood bank licensing, donor selection/deferral, donor notification
  • Biomedical waste in blood bank; research methodology basics

Older DNB Immunohematology Question Papers

The remaining 17 papers are available in the Prep DNB app, organized paper-wise with repeat-question tracking.

Get all 19 papers in the app

Previous Year Questions for Other DNB Subjects