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CAPSTONE > 300-314 > Flashcards

300-314 Flashcards

0
Q

What should be sent to the lab for a transfusion reaction investigation

A

A post-transfusion blood specimen, the blood bag, the administration set, and any attached IV soluutions.

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1
Q

What should be done at the first sign of a suspected transfusion reaction?

A

Transfusion should be stopped and the physician/blood bank should be notified

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2
Q

What is the preferred post-transfusion specimen for the DAT?

A

EDTA red cells to avoid reactionos due to complement

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3
Q

What is the most common type of transfusion reaction?/

A

Nonhemolytic febrile reaction

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4
Q

What is the definition of a febrile transfusion reaction

A

A rise in body temp of 1 degree celsius during or immediately after a transfusion, with no other explanation

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5
Q

Which patients have the most nonhemolytic febrile reactions

A

Multiply-transfused patients and multiparous women

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6
Q

How can nonhemolytic febrile reactions be prevented

A

By transfusion of leukoreduced RBCs

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7
Q

What is the 2nd most common type of transfusion reaction

A

Urticarial (hives)

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8
Q

Which transfusion reaction does not require that the transfusion be stopped or that a transfusion reaction investigation be performed

A

Urticarial

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9
Q

What course of action should be recommended when blood is ordered for a patient with history of previous allergic transfusion reactions?

A

An antihistamine may be administered half an hour before transfusion

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10
Q

What is the most frequent cause of fatal transfusion reactions

A

Hemolytic

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11
Q

What causes a hemolytic transfusion reaction

A

Immune destruction of donor cells by recipient antibody

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12
Q

Which antibody system is often implicated in immediate intravascular hemolytic transfusion reactions?

A

ABO

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13
Q

Group A RBCs are accidentally transfused to a Group O patient due to improper ID. What may happen?

A

A life-threatening hemolytic transfusion reaction. The naturally occuring anti-A in the recipient will destroy group A donor cells

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14
Q

Name a protein that is decreased in the blood of a patient following a hemolytic transfusion reaction.

A

Haptoglobin (binds free hemoglobin)

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15
Q

The cardiac ICU calls to report that a patient receiving blood is experiencing chillls, fever, difficulty breathing, and back pain. The urine in the catheter bag has a pink tinge. With which type of reaction are these signs of?

A

Intravascular hemolytic transfusion reaction

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16
Q

What lab findings would confirm that the patient had intravascular hemolytic transfusion reaction?

A

Hemoglobinemia and a positive DAT on post-transfusion specimen

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17
Q

What are the most serious consequences of hemolytic transfusion reactions?

A

Hypotension, shock, bleeding secondary to DIC, renal shutdown, and death

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18
Q

What is top priority in the management of a patient undergoing an acute hemolytic transfusion reaction?

A

Prevention of renal failure

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19
Q

A patient develops a fever during transfusion of RBCs. The transfusion is discontinued and lood bank is notified. A check of records show no misID or clerical errors. The post-trasfusion serum shows no hemolysis and the DAT is negative. What further testing is required?

A

None, the tests performed rule out a hemolytic transfusion reaction.

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20
Q

When is the best time to draw blood for a bilirubin in a transfusion reaction work-up?

A

5-7 hours after the tranfusion, it takes that long for sensitized RBCs to be removed from the circulation and destroyed by the RE system.

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21
Q

What special problems may be encountered in massive transfusion?

A

Dilutional thrombocytopenia, coagulopathy, citrate toxicity, hypothermia, potassium overload, acid-base imbalance, and reduced oxygen to tissues due to decreased 2,3 DPG.

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22
Q

Antibodies in which blood group system are most often associated with an anamnestic response?

A

Kidd

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23
Q

Who must evaluate all work performed as part of a transfusion reaction work-up?

A

Blood bank physician

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24
Q

How long must records of a transfusion reaction be retained?

A

indefinately

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25
Q

What can be done to prevent reactions due to bacterial contamination of blood or blood components?

A

Proper donor arm preparation, maintenance of sterility during component preparation, proper storage, and inspection of units prior to release

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26
Q

Which component carries the highest risk of bacterial cotamination

A

Platelets, because they are stored at room temp

27
Q

What is the most common transfusion-associated infectious risk in the U.S. today

A

Bacterial contamination of platelets

28
Q

When do platelets become contaminated?

A

During phlebotomy procedure

29
Q

Which bacteria are most likely to cause contamination of platelets?

A

Normal flora of skin, such as coagulase negative stap and P. acnes

30
Q

Which bacteria are most likely to cause severe sepsis in recipients?

A

Gram-negative organisms because they produce endotoxins

31
Q

Does the FDA require blood blanks to test platelets for bacterial contamination?

A

As of this date, no.

32
Q

What should be used to decontaminate the skin prior to blood collection?

A

Alcohol/tincture of iodine and chlorhexidine for donors who are allergic

33
Q

How soon after collection can platelets be cultured?

A

Platelets are held for 24-48 hours before they are cultured

34
Q

What is the most common transfusion-transmitted viral infection?

A

Hep C

35
Q

Which infectious disease is unlikely to be transmitted in blood components that have been refridgerated

A

Syphilis

36
Q

Which components pose a risk of tranfusion-associated graft versus host disease?

A

All components contain sufficient lymphs to pose a risk except FFP and cryoprecipitate

37
Q

How can transfusion-associated graft vs host disease be prevented?

A

By irradiation of blood components that contain leukocytes

38
Q

What is TRALI?

A

Transfusion-related acute lung injury

39
Q

To whom must fatalities related to transfusions be reported

A

FDA’s center for biologics evaluation and research

40
Q

What are donor requirements for age?

A

Over the age of 17

41
Q

What are donor requirements for pulse

A

50-100 beats per minutes

42
Q

What are donor requirements for blood pressure

A

Less than 100/180

43
Q

Temp of donor should be?

A

< or equal to 37.5

44
Q

Hemoglobin/hematocrit requirement for donor

A

Greater than or equal to 38%

HCT should be greater than 12.5

45
Q

What volume of blood do most blood center routinely collect

A

450-550 mL. Usually 500 mL!

46
Q

How often may a person donate a unit of blood

A

Every 56 days or eight weeks

47
Q

What is the specific gravity of copper sulfate used for hemoglobin screening on blood donors?

A

1.053

48
Q

In the copper sulfate method for hemoglobin screening, in order to be accepted for donation, how quickly must the drop of blood sink

A

Within 15 seconds

49
Q

What is the minimum hgb leveel for an autologous donation

A

greater than 11 mg/dl

50
Q

What are the age limits for autologous donation

A

There is no age limit

51
Q

What is the weight minimum for autologous donation

A

No minimum

52
Q

how often can blood be drawn for autologous donation

A

Every three days but not within 72 hrs of surgery

53
Q

Name 2 conditions that would preclude a patient from donating blood for autologous transfusion

A

Hgb less than 11 mg/dl and bacteremia

54
Q

What criteria must directed donors meet

A

Same as regular blood donors

55
Q

An MLT student had a mucous membrane exposure to blood. How long must he be deferred as a blood donor?

A

12 months

56
Q

A prospective donor reports that she was treated for gonorrhea two months ago. How long must she be deferred as a blood donor?

A

12 months after completion of therapy

57
Q

A prospective donor had TB as a child. If he meets all other criteria, can he donate?

A

Yes as long as he was successfully treated and the infection is no longer active

58
Q

How long must a prospective donor with a history of malaria be deferred

A

Three years after becoming asymptomatic

59
Q

How long must a donor be deferred if they had babesiosis?

A

Forever

60
Q

Can a person with Chagas’ disease donate blood?

A

No

61
Q

After receiving blood, how long must a person wait before donating

A

Twelve months

62
Q

How long must a donor be deferred after receiving Hep B vaccine

A

No deferral is required

63
Q

How long must a donor who has had sex with an IV drug user be deferred

A

Twelve months

64
Q

How long must a man who has had sex with a man be deferred

A

Foreveer

65
Q

A woman reports that she had sexual relations with a bisexual man. How long must she be deferred

A

12 months

66
Q

What is confidential unit exclusion

A

An opportunity for donor to indicate confidentially that his/her blood may be unsuitable for transfusion

CAPSTONE (5 decks)

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