3 Blood Producs

Question 1

Which blood products have no risk of transmitting HIV and hepatitis?

Answer 1

Albumin
Serum globulins
(They are heat treated)

Question 2

What diseases are donated blood screened for?

Answer 2

HIV, HepB, HepC, HTLV, syphilis, West nile virus

Question 3

Who should get CMV-negative blood?

Answer 3

Low-birth-weight infants
Bone marrow transplant patients
Other transplant patients

Question 4

What is the number one cause of death in blood transfusion reactions?

Answer 4

Clerical error leading to ABO incompatability

Question 5

What blood type is the universal donor?

Answer 5

Type O blood (contains no antigens)

Question 6

What blood type is the universal plasma donor?

Answer 6

Type AB blood (contains both antigens)

Question 7

What is stored blood low in? Effect?

Answer 7

2,3-DPG

Causes an left shift - increased affinity for Oxygen (deceased unloading)

Question 8

What causes acute hemolytic reaction?

Answer 8

ABO incompatibility - antibody mediated

Question 9

Symptoms of acute hemolytic reaction?

Answer 9

Back pain, chills, tachycardia, fever, hemoglobinuria

Question 10

Complications of acute hemolytic reaction?

Answer 10

Acute tubular necrosis
DIC
Shock

Question 11

Lab findings in acute hemolytic reaction?

Answer 11

Haptoglobin <50mg/dL (binds Hgb, then gets degraded)
Free hemoglobin >5g/dL
Increase in unconjugated bilirubin

Question 12

Treatment of acute hemolytic reaction?

Answer 12

Fluids
Diuretics
Bicarb
Pressors
Histamine blockers

Question 13

How do transfusion reactions present in an anestheized patient?

Answer 13

Diffuse bleeding

Question 14

Delayed hemolytic reactions - cause and treatment?

Answer 14

Antibody-mediated against minor antigens

Observe is stable

Question 15

Nonimmune hemolytic reactions - cause and treatment?

Answer 15

From squeezed blood

Treat with fluid and diuretics

Question 16

What is the most common transfusion reaction?

Answer 16

Febrile, non-hemolytic transfusion reaction

Question 17

Febrile, non-hemolytic reactions - cause and treatment?

Answer 17

Recipient antibody reaction against donor WBCs.
Treat by discontinuing the transfusion.
Future transfusions should go through WBC filters.

Question 18

Anaphylaxis transfusion reactions - cause and treatment?

Answer 18

Recipient antibodies against donor IgA in IgA-deficient recipient
Presents as bronchospasm, hypotension, urticaria
Treat: fluids, Lasix, pressors, steroids, epinephrine, histamine blockers

Question 19

Urticaria transfusion reactions - cause and treatment?

Answer 19

Recipient antibodies against donor plasma proteins

Treat: Histamine blockers, supportive

Question 20

What is the cause of TRALI?

Answer 20

Transfusion-related acute lung injury
Caused by DONOR antibodies to RECIPIENT WBCs
Clots occur in pulmonary capillaries

Question 21

When do you see dilutional thrombocytopenia?

Answer 21

After 10 uPRBCs

Question 22

Effect of cold on clotting?

Answer 22

Failure - patients need to be warm to clot correctly

Question 23

Effect of calcium on clotting?

Answer 23

Required for clotting cascade

Hypocalcemia occurs with massive transfusions

Question 24

What is the most common contaminate of blood products?

Answer 24

GNRs (usually E. coli)

Question 25

What is the most common blood product to contain contaminants?

Answer 25

Platelets (they are not refrigerated)