3.10 Blood Transfusion Flashcards

1
Q

What antigens will group A blood type patients have on their RBCs, and what antibodies in their plasma?

A

A antigens
Anti-B antibodies

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2
Q

What antigens will group B blood type patients have on their RBCs, and what antibodies in their plasma?

A

B antigens
Anti-A antibodies

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3
Q

What antigens will group AB blood type patients have on their RBCs, and what antibodies in their plasma?

A

A and B antigens
No antibodies

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4
Q

What antigens will group O blood type patients have on their RBCs, and what antibodies in their plasma?

A

No antigens
Anti-A and anti-B antibodies

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5
Q

Why can AB+ take blood from anyone?

A

AB people do not have any antibodies in their plasma, so there is nothing to attack the foreign RBCs when they are transfused

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6
Q

How do you cross match a sample of blood for transfusion?

A

Take a sample of the patient’s serum (contains antibodies) and the donor’s RBCs

If they agglutinate then the samples are incompatible

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7
Q

During blood testing, what infections are tested for?

A

HIV, HEP B C E, HTLV And Syphillis

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8
Q

Do we test for Creutzfeldt-Jacob Disease?

A

Yes

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9
Q

Who do we give red cells to?

A

Patients with anaemia

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10
Q

What RhD group are you if you lack the D antigen?

A

Negative

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11
Q

Do RhD negative patients have Anti-D antibodies in their plasma?

A

No, but they can make Anti-D antibodies

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12
Q

How do RhD Negative People make anti D antibodies?

A

RhD negative mother with an RhD positive baby

Transfusion of RhD positive blood

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13
Q

If a RhD negative patient has a blood transfusion with a RhD positive person, what implications does this have for their future transfusion?

A

Exposure to D antigen produces anti-D antibodies

Thus next transfusion must be with RhD negative blood to prevent haemolytic transfusion reaction

Haemolysis can cause anaemia, high bilirubin and jaundice

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14
Q

What is haemolytic disease of the newborn?

A

If a RhD negative mother has an RhD positive first child, anti-D antibodies are produced

If the second child is also RhD positive, anti-D antibodies cross the placenta and cause haemolysis of foetal red blood cells

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15
Q

What can haemolytic disease of the newborn cause?

A

If severe – hydrops fetails and death before birth

If less severe – high bilirubin thus brain damage, leading to death

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16
Q

Why can Anti-D antibodies cross the placenta?

A

They are class IgG

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17
Q

How can the formation of Anti-D antibodies in mothers be prevented?

A

Give them Anti-D Immunoglobins

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18
Q

How does giving the mother Anti-D immunoglobins work to prevent HDN?

A

Anti-D works by destroying any RhD positive blood in the mother’s circulation, before it can be recognized by the mothers systems and therefore before the mothers own Anti-D antibodies can be made, thus preventing HDN

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19
Q

Which blood component will patients need to replace all their clotting factors which have been depleted during massive bleeding?

A

Fresh frozen plasma

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20
Q

In an emergency which group of Fresh Frozen Plasma should we give when we do not know their blood group?

A

AB negative as the plasma will not contain any antibodies

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21
Q

In an emergency, which group of red cells can we give to any patients?

A

O Negative Blood - this is because O negative Red Cells do not have A or B antigens on the surface of the Red cells which could be attacked by the patients Anti-A Antibodies or Anti-B Antibodies

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22
Q

What gene controls blood group?

A

The ABO gene

23
Q

How do genes code for ABO?

A

Adding a sugar residue to a common glycoprotein and fucose stem (H antigen) on the RBC membrane

24
Q

What is added to the the common H antigen to make it an A antigen?

A

N-acetyl galactosamine

25
Q

What is added to the the common H antigen to make it an B antigen?

A

Galactose

26
Q

Which carbohydrate stem does group O have?

A

Only the H stem

27
Q

Which ABO gene is recessive?

A

O

28
Q

Which RhD group can be given to both positive and negative?

A

Negative

29
Q

Which blood groups can RhD positive blood be given to?

A

Only RhD positive

30
Q

What is group and screen?

A

Identify ABO antigens (forward group) and ABO antibodies (reverse group)

Find out RhD group

Perform antibody screen on plasma

31
Q

How is antibody screening carried out?

A

Patient plasma is incubated with RBCs with all blood group antigens on them

If antibody screen is negative – any ABO and RhD compatible blood is given

If positive – identify antibody and give correct blood lacking antigen

32
Q

Every donation is tested for what?

A

Infections, viruses, other clinically significant red cell antibodies

33
Q

What is one unit of blood?

A

The whole blood or blood products derived from one single blood donation

34
Q

What is the shelf life of red cells?

A

35 days

35
Q

What is fresh frozen plasma used for?

A

Patients with prolonged PT and aPTT

Reversal of warfarin (vit K antagonist)

36
Q

What is the shelf life of FFP and CRP?

A

3 years

37
Q

What blood component should be given when there is a abnormal PT and aPTT?

A

FFP to replace all clotting factors

38
Q

What is cryoprecipitate used for?

A

Replacing FVIII, FXIII, VWF and fibrinogen

Used in heavy bleeding

39
Q

Why does cryoprecipitate not contain all the clotting factors?

A

Most degenerate at room temperature

Since cryoprecipitate has been thawed, it doesn’t contain these factors

40
Q

Why is factor 8 and 9 heat treated for haemophilia treatment?

A

To inactivate viruses that may be present

41
Q

When are patients given platelets?

A

Thrombocytopenia
Bone marrow failure
Massive bleeding
Disseminated intravascular coagulation (DIC)

42
Q

When are patients given RBCs?

A

Anaemia

43
Q

When are patients given factor 8 and 9?

A

Haemophilia A – factor 8
Haemophilia B – factor 9

44
Q

When are patients given immunoglobulins?

A

To protect against hepatitis A

45
Q

What two forms are platelets available in?

A

Pooled platelets or from a single donor

46
Q

What class of antibodies are the ones found in plasma?

A

IgM

47
Q

What condition can IgM antibodies cause?

A

Massive Intravascular Haemolysis

48
Q

Due to risk of viral transmission, what are haemophilia patients now treated with?

A

Recombinant factor 8 and 9

49
Q

What are the four stages of pre-transfusion testing that needs to be done?

A

ABO group
RhD group
Alloantibody screen
Cross matching

50
Q

How many donors would be involved in 4 units of red cells?

A

4 donors

51
Q

How many donors would be involved in 3 units of FFP?

A

3 donors

52
Q

How many donors could be involved in 1 unit of platelets?

A

Either 4 donors pooled
or 1 donor with apheresis machine

53
Q

What is the shelf life of platelets?

A

7 days

54
Q

How many donors would be involved in 1 unit of cryoprecipitate?

A

5 for group pool
1 if apheresis machine used