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Immunohematology Lec > [23] CHAPTER X LESSON 1 > Flashcards

[23] CHAPTER X LESSON 1 Flashcards

1
Q

is a broad term that encompasses all aspects of the transfusion of patients.

A

“Transfusion therapy”

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2
Q

Each blood component has specific indications for

A

use, expected outcomes, and other considerations

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3
Q

are considered drugs because of their use in treating diseases

A

Blood and blood products

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4
Q

The transfusion of blood cells is also [?], in that the cells must survive and function after transfusion to have a therapeutic effect.

A

transplantation

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5
Q

Transfusion therapy is used primarily to treat two conditions:

A

inadequate oxygen-carrying capacity because of anemia or blood loss and insufficient coagulation proteins or platelets to provide adequate hemostasis.

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6
Q

Preparation: Approx. 450mL of blood with anticoagulant (CPD or CPDA-1)

A

Whole Blood

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7
Q

Shelf life: CPD- 21 days at 1 to 6 degrees Celsius; CPDA-1: 35 days

A

Whole Blood

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8
Q

A unit of blood must be transfused within 24 hours if the seal on the bag is broken to remove plasma.

A

Whole Blood

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9
Q

Dilution: Eight parts circulating blood to one-part anticoagulant (8:1)

A

Whole Blood

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10
Q

Composition: RBC, plasma, WBC and platelets

A

Whole Blood

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11
Q

Indication: replace the loss of both RBC mass and plasma volume in actively bleeding patients

A

Whole Blood

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12
Q

Contraindication: not for patients with severe chronic anemia

A

Whole Blood

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13
Q

For a 70-kg (154-lb) adult, each unit of whole blood should increase the hematocrit level 3% or hemoglobin 1 g/dL.

A

Whole Blood

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14
Q

The increase is greater in a smaller person and less in a larger one.

A

Whole Blood

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15
Q

Preparation: Each unit of pRBC’s contains approximately 250 mL

A

Red Blood Cells

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16
Q

Prepared by removing 200 to 250 mL of plasma from a unit of WB.

A

Red Blood Cells

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17
Q

Shelf life: Cells prepared in an open system must be transfused within 24 hours

A

Red Blood Cells

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18
Q

If cells are prepared using the close system, they have the same expiration date as the original unit of the WB.

A

Red Blood Cells

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19
Q

Composition: RBC, reduced plasma, WBC and platelets

A

Red Blood Cells

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20
Q

Average hematocrit: 65-80%

A

Red Blood Cells

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21
Q

Indication: Increasing RBC mass requiring increased oxygen carrying capacity

A

Red Blood Cells

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22
Q

Critical level: 6g/dL or less

A

Red Blood Cells

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23
Q

Contraindication: well compensated patients (chronic renal failure)

A

Red Blood Cells

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24
Q

RBCs should not be used to treat nutritional anemia such as

A

o iron deficiency
o pernicious anemia, unless the patient show signs of decompensation (need for increased oxygen carrying capacity)

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25
Q

RBC transfusion is not to be used to enhance general well-being

A

o promote wound healing
o prevent infection
o expand blood volume when oxygen-carrying capacity is adequate, or prevent future anemia.

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26
Q

Increase:
o Hemoglobin level:
o Hematocrit level:

A

o Hemoglobin level: 1 g/dL
o Hematocrit level: 3%

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27
Q

In pediatric patients, a dose of 10 to 15 mL/kg will increase:
o Hemoglobin:
Hematocrit:

A

o Hemoglobin: 2 to 3 g/dL
o Hematocrit: 6% to 9%

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28
Q

Advantages over WB:
1. Equal oxygen carrying capacity in [?]
2. Significant reduction in level of [?] (safe transfusion of group O cells to nongroup O recipients)
3. Significant reduction in levels of [?] in patients with cardiac, renal or liver disease

A

half volume

isoagglutinin

acid, citrate and potassium load

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29
Q

Average unit of RBC contains approx. 2x109 leukocytes

A

Leukocyte- Reduced RBCs

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30
Q

Donor leukocytes may cause the following:
 [?] transfusion reactions
 Transfusion-associated [?]
 Transfusion-related [?]
 In addition, human leukocyte antigens (HLA) are responsible for [?]
 Leukocytes may harbor [?]

A

Febrile nonhemolytic

graftversus-host disease

immune suppression

HLA alloimmunization

cytomegalovirus

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31
Q

To reduce HLA alloimmunization and CMV transmission, the leukocyte content must be reduced to less than 5 × 106

A

Leukocyte- Reduced RBCs

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32
Q

Use of leukocyte reduction filters

A

Leukocyte- Reduced RBCs

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33
Q

Decrease febrile nonhemolytic transfusion reactions

A

ACCEPTED

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34
Q

Decrease hospital length of stay

A

CONTROVERSIAL

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35
Q

Decrease alloimmunization to white blood cell antigens

A

ACCEPTED

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36
Q

Decrease incidence of wound infections postsurgery

A

CONTROVERSIAL

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37
Q

Decrease transmission of cytomegalovirus (CMV)

A

ACCEPTED

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38
Q

Decrease incidence of cancer recurrence postsurgery

A

CONTROVERSIAL

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39
Q

For neonates in the treatment of anemia secondary to spontaneous fetomaternal hemorrhage, obstetric accidents and internal hemorrhage

A

RBC aliquots

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40
Q

Reduced risk of TAGVHD in patients receiving allogeneic bone marrow transplants

A

Irradiated RBCs

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41
Q

Preparation: 70% of the original WBCs removed and at least 70% of the original RBC’s are left.

A

WBC poor RBC

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42
Q

Methods of obtaining leukocyte poor RBCs: centrifugation, filtration and washing

A

WBC poor RBC

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43
Q

WBC poor RBC
Reduction is done to avoid the following:

A
  1. Febrile non-hemolytic transfusion reactions
  2. HLA alloimmunization
  3. TRALI
  4. Transfusion related graft vs host disease
  5. Transfusion related immune suppression
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44
Q

Shelf-Life: Closed system- same as the original unit of blood; Open system: 24 hours

A

WBC poor RBC

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45
Q

WBC poor RBC
Donor WBC may harbor:

A

o CMV
o EBV
o HIV
o HTLV

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46
Q

Therapeutic uses: In addition to increasing RBC mass, leukocyte poor RBC’s also minimize febrile transfusion reactions in patients who have leukocyte antibodies as well as reducing CMV transmission.

A

WBC poor RBC

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47
Q

Preparation: Plasma is removed from WB after centrifugation

A

Washed RBC’s

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48
Q

Washing: removes plasma proteins

A

Washed RBC’s

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49
Q

Shelf Life: Washed RBC’s have a shelf life of 24 hours after the original unit is opened

A

Washed RBC’s

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50
Q

Stored at 1-6 degrees Celsius

A

Washed RBC’s

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51
Q

Washed RBC’s
Indications:

  1. Patients with [?]
  2. [?]
  3. Patients who have [?] to ordinary units of RBCs
A

IgA deficiency and anti-IgA antibodies

Anemia

severe allergic transfusion reactions

52
Q

Preparation: RBC’s to be frozen are collected in CPD, CPDA-1. Should be frozen within 6 hours

A

Frozen deglycerolized RBC

53
Q

Composition: RBCs, no platelets, no plasma

A

Frozen deglycerolized RBC

54
Q

o Begins with thawing the cells at 37 degrees Celsius, then washing multiple times in a gradient concentration of saline, beginning with hypertonic concentrations and ending with an isotonic solution containing glucose.

A

Deglycerolization

55
Q

o One unit of deglycerolized RBCs contain approximately 180 mL of cells.

A

Deglycerolization

56
Q

Shelf Life: Stored between 1 and 6 degrees Celsius and must be transferred within 2 hours of deglycerolization.

A

Frozen deglycerolized RBC

57
Q

Frozen with the use of glycerol

A

Frozen deglycerolized RBC

58
Q

 Freezer temperature
 -65 degrees Celsius

A

High glycerol (40% weight per volume)

59
Q

 Freezer temperature
 -120 degrees Celsius

A

Low glycerol (20% weight per volume)

60
Q

Frozen deglycerolized RBC
Indications:

  1. Increase [?]
  2. Minimize [?]
  3. Use of [?]
A

red cell mass

febrile or allergic transfusion reactions

prolonged RBC blood storage

61
Q

Allows for long term storage of rare blood donor units, autologous units

A

Frozen deglycerolized RBC

62
Q

Extended shelf-life: 10 years

A

Frozen deglycerolized RBC

63
Q

Deglycerolizing removes nearly all WBC and plasma

A

Frozen deglycerolized RBC

64
Q

Should be used within 24 hours

A

Frozen deglycerolized RBC

65
Q

Preparation: PRP is separated at RT by centrifugation from RBCs within 6 hours of collection of WB.

66
Q

The PRP is then centrifuged, and the resulting PPP supernatant is removed, which leaves approx. 50 mL of plasma with the platelet concentrate.

67
Q

Shelf Life: Platelets are stored at RT with continuous gentle agitation

68
Q

Indications for Platelet Transfusion
1. [?] with bleeding or invasive procedure
2. Chemotherapy for malignancy (?)
3. Disseminated intravascular coagulation (?)
4. Massive transfusion (?)

A

Thrombocytopenia

decreased production, less than 5,000 to 10, 000/uL

increased destruction, less than 50,000/uL

platelet dilution, less than 50,000 to 100,000/uL

69
Q

For adults: 6 to 8 units (single dose)

A

Platelet Concentrate

70
Q

Pooled specimen (in a single bag) must be transfused within 4 hours

A

Platelet Concentrate

71
Q

Each unit: 5.5 x 1010

A

Platelet Concentrate

72
Q

Each unit must increase the count 5,000 to 10,000/uL in a 70kg man in a 70kg man

A

Platelet Concentrate

73
Q

Washed platelets: remove plasma proteins transfused within 4 hours

A

Platelet Concentrate

74
Q

Preparation: may be prepared by Leukapheresis or from a freshly drawn donor unit.

A

Granulocyte Concentrate

75
Q

Administer corticosteroids to the donor 12-24 hours prior

A

Granulocyte Concentrate

76
Q

increase the number of circulating granulocytes by pulling them from the marginating pool

A

Granulocyte Concentrate

77
Q

Hydroxyethyl starch -sedimentating agent: increase separation between WBC and RBC facilitating recovery of buffy coat

A

Granulocyte Concentrate

78
Q

Granulocyte Concentrate
Indications:

  1. Neutrophil count [?]
  2. [?] unresponsive to antibiotic
  3. Reversible [?]
  4. Reasonable chance for [?]
  5. Neonates with[?]
A

less than 500/uL

Septicemia or bacterial infection

bone marrow

patient survival

impaired neutrophil function

79
Q

Shelf-life: 24 hours after separation at RT

A

Granulocyte Concentrate

80
Q

should be transfused ASAP because their half-life is only 6 hours

A

Granulocyte Concentrate

81
Q

Granulocyte Concentrate
Dose:
o Adults:
o Neonates:

A

o Adults: one WBC concentrate daily for 4 days or more
o Neonates: once or twice

82
Q

Contains all coagulation factors

A

Fresh Frozen Plasma

83
Q

Should be ABO compatible with the recipient’s RBC; not necessarily of same Rh type

A

Fresh Frozen Plasma

84
Q

Preparation:
o Must be frozen within 8 hours of collection
o Plasma is immediately frozen at or below -18 degrees Celsius

A

Fresh Frozen Plasma

85
Q

Shelf Life: 1 year if stored at -18 degrees Celsius

A

Fresh Frozen Plasma

86
Q

Plasma should be stored at or below -18 degrees Celsius

A

Fresh Frozen Plasma

87
Q

It should be thawed at 37 degrees Celsius and transfused within 24h of thawing.

A

Fresh Frozen Plasma

88
Q

Thawed FFP should be stored between 1 to 6 degrees Celsius it is not transfused immediately.

A

Fresh Frozen Plasma

89
Q

Fresh Frozen Plasma
Indications:
1) [?]
2) [?]
3) [?]
4) [?]
5) [?]
6) single factor deficiency: [?]

A

liver failure

DIC

vitamin K deficiency

warfarin toxicity/ overdose

massive transfusion

Factor XI deficiency

90
Q

Liquid plasma or cryoprecipitate poor plasma and small amounts of factors V and VIII

A

Plasma: Thawed/Liquid

91
Q

Plasma: Thawed/Liquid
Indications:
o Treatment of stable coagulation deficiency factors (?)
o Source of plasma for patients undergoing [?]

A

II, VII, IX, and X

plasma exchange

92
Q

Separated from WB at any time during the unit’s shelf life up to 5 days after the expiration date.

A

Plasma Derivatives

93
Q

Plasma may be pooled, purified or fractioned into albumin or plasma protein fraction.

A

Plasma Derivatives

94
Q

Shelf Life: Plasma derivatives have a shelf life of 5 years at 1 to 6 degrees Celsius

A

Plasma Derivatives

95
Q

Therapeutic Uses: Volume expanders

A

Plasma Derivatives

96
Q

Contains fibrinogen, factor VIII, factor XIII, vWF, and fibronectin

A

Cryoprecipitate

97
Q

Used primarily for fibrinogen replacement

A

Cryoprecipitate

98
Q

AABB: [?] of fibrinogen for each unit of cryoprecipitate

99
Q

should contain greater than or equal to 80 IU of factor VIII in each unit.

A

Cryoprecipitated antihemophilic factor (AHF)

100
Q

Pooled cryoprecipitated AHF: [?] are pooled

101
Q

Each pool: [?] of fibrinogen

A

750-1250 mg

102
Q

Each unit of cryoprecipitate must contain at least [?] of factor VIII.

103
Q

was used to treat patients with von Willebrand disease, a deficiency of vWF.

A

Cryoprecipitate

104
Q

Cryoprecipitate
Fibrinogen replacement may be required in patients with
1.[?]
2. [?]
3. Rare patients with [?]

A

Liver failure

DIC or massive transfusion

congenital fibrinogen deficiency

105
Q

Recombinant Human Product: Factor VIIa
o Indications:
-Inhibitors in [?]
- [?]deficiency
- [?]deficiency
 Liver disease
 Warfarin overdose
- [?]

A

hemophilia A or B

Factor VII

Acquired factor VII

Massive hemorrhage

106
Q

From fractionation and lyophilization of pooled plasma

A

Factor VIII Concentrate

107
Q

Stored at ref temp and is reconstituted with saline

A

Factor VIII Concentrate

108
Q

Patients with hemophilia A or factor VIII deficiency have spontaneous hemorrhages that are treated with recombinant or human plasma–derived factor VIII replacement.

A

Factor VIII Concentrate

109
Q

Indications: Treat patients with hemophilia A, von Willebrand’s disease

A

Factor VIII Concentrate

110
Q

Factor IX complex (prothrombin complex)

A

Factor IX Concentrate

111
Q

Prepared from pooled plasma using various methods of separation and viral inactivation

A

Factor IX Concentrate

112
Q

Contains: Factors II, VII, IX and X

A

Factor IX Concentrate

113
Q

Indication:
[?]
[?]
[?]
[?]

A

Hemophilia B/factor IX deficiency
Factor VII or X deficiency (rare)
Selected patients with factor VIII inhibitors or reversal of warfarin overdose

114
Q

The dose is calculated in the same manner as that for [?], using the assayed value of [?] on the label, with the caveat that half the dose of [?] rapidly diffuses into tissues and half remains within the intravascular space, so the initial dose must be doubled.

A

factor VIII concentrate

factor IX

factor IX

115
Q

The immunologically active lymphocytes present in most blood components can create special problems for immunocompromised patients.

A

Irradiation

116
Q

Irradiating blood products can help reduce the risk of GVHD and other complications

A

Irradiation

117
Q

Irradiation Indications for Use
o Patients receiving [?]
o [?] recipients who have been immunosuppressed
o Low [?]
o Patients with genetically [?]

A

chemotherapy or radiotherapy

Organ transplantation

birth weight neonates

deficient immune systems

118
Q

Blood components should be irradiated immediately before transfusion

A

Irradiation

119
Q

Doses of 1500-5000 rad are usually used

A

Irradiation

120
Q

Expiration date of 28 days from the date of irradiation or the original outdate of unit, whichever is sooner.

A

Irradiation

121
Q

Blood components are irradiated with gamma radiation to prevent graft-versus-host disease, which requires three conditions to occur:
1. Transfusion or transplantation of [?]
2. Histocompatibility differences between graft and recipient (?)
3. Usually, an [?]

A

immunocompetent T lymphocytes

major or minor HLA or other histocompatibility antigens

immunocompromised recipient1

122
Q

Equipments used in blood component preparation:

A
  1. Blood Separator
  2. Apheresis Equipments
  3. Blood Irradiators
123
Q

The Plasma Extractor is used to express blood components from collection containers.

A

Blood Separator

124
Q

The spring-loaded front panel exerts pressure on the collection container.

A

Blood Separator

125
Q

an apparatus that separates out one particular constituent and returns the remainder to the circulation

A

Apheresis Equipments

126
Q

Expose the blood to Caesium-137 in a blood irradiator machine.

A

Blood Irradiators

127
Q

radiation sensitive film that gives visual indication of dose received should be used at each irradiation procedure

A

Blood Irradiators

Immunohematology Lec (35 decks)

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