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Fa: Sim 3 > 5. Transfusion > Flashcards

5. Transfusion Flashcards

1
Q

antigen is found on

A

RBC

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2
Q

antibody is found

A

in plasma for the antigen that they do not have

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3
Q

A: antibody

A

anti-B

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4
Q

A: antigen

A

A antigen

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5
Q

B: antibody

A

anti-A

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6
Q

B: antigen

A

B antigen

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7
Q

AB: antibody

A

none

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8
Q

AB: antigen

A

A antigen
B antigen

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9
Q

O: antibody

A

anti-A
anti-B

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10
Q

O: antigen

A

none

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11
Q

immunogemic

A

most likely to cause reaction due to incompatibility

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12
Q

which blood system is most important

A

ABO

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13
Q

which blood system is 2nd important

A

Rh system

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14
Q

Rh antigens are

A

highly immunogenic

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15
Q

Rh+ can receive

A

Rh+
Rh-

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16
Q

Rh- can receive

A

Rh- only

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17
Q

when do Rh antibodies develop

A

after exposure
- transfusion
- pregnancy

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18
Q

main cause of hemolytic disease in newborn

A

Rh

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19
Q

which blood type is universal recipient

A

AB+

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20
Q

which blood type is universal donor

A

O-

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21
Q

AB+ can receive

A

ALL blood

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22
Q

AB- can receive

A

O-
A-
B-
AB-

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23
Q

A+ can receive

A

O+
O-
A+
A-

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24
Q

A- can receive

A

O-
A-

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25
Q

B+ can receive

A

O+
O-
B+
B-

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26
Q

B- can receive

A

O-
B-

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27
Q

O+ can receive

A

O+
O-

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28
Q

O- can receive

A

O-

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29
Q

universal FFP recipient

A

O

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30
Q

universal FFP donor

A

AB

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31
Q

O can receive FFP

A

O
A
B
AB

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32
Q

A can receive FFP

A

A
AB

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33
Q

B can receive FFP

A

B
AB

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34
Q

AB can receive FFP

A

AB

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35
Q

does the Rh matter for FFP

A

no

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36
Q

agglutination

A

occurs if antigen is mixed with its corresponding antibody

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37
Q

type and screen purpose

A

to detect antibodies commonly associated w/non-ABO hemolytic reactions

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38
Q

type and screen time

A

45-90 mins

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39
Q

incidence of reaction after T+S

A

<1%

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40
Q

type and cross purpose

A
  1. confirm ABO/Rh typing
  2. detects antibodies to other systems
  3. detects antibodies in low titers
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41
Q

type and cross time

A

15 - 60 mins

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42
Q

which blood test is mixing pt blood with donor blood

A

type and cross

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43
Q

incidence of reaction after T+C

A

~ 0%

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44
Q

what are donor bloods tested for

A

Hep B
Hep C
HIV
syphilis

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45
Q

blood donation preservative

A

CPDA-1

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46
Q

CPDA -1

A

Citrate
Phosphate
Dextrose
Adenosine

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47
Q

CPDA shelf life

A

35d

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48
Q

Citrate function

A

anti-coag
binds Ca2+

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49
Q

Phosphate function

A

buffer

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50
Q

Dextrose function

A

red cell energy source

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51
Q

adenosine function

A

precursor for ATP synthesis

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52
Q

best blood to give if you have it

A

whole blood

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53
Q

PRBC shelf life

A

35 days

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54
Q

PRBC effect

A

1 unit will raise :
Hg 1g/dL
Hct 3%

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55
Q

PRBC SE

A

citrate toxicity
hypothermia
hyperkalemia
decr 2,3-DPG

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56
Q

when is transfusion considered

A

Hg 6-10 g/dL

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57
Q

which pts need higher Hg

A

CAD
cardiopulm
cerebrovascular
elderly

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58
Q

how many donors are needed for 1 bag of plts

A

6-8

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59
Q

plt storage

A

20-24C

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60
Q

Plt effect

A

1 unit will raise plts by 5k-10k

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61
Q

plt indication

A

thrombocytopenia
plt dysfunction

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62
Q

is ABO compatibility req for plts

A

no

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63
Q

only prophyaltic indication for plts

A

TBI

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64
Q

FFP contains

A

plasma proteins
most clotting factors

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65
Q

difference between FFP and albumi

A

FFP contains clotting factors

66
Q

FFP effect

A

1 unit will raise clotting factor by 2-3%

67
Q

is ABO compatibility needed for FFP?

A

yes

68
Q

is Rh compatibility needed for FFP?

A

no

69
Q

FFP indications

A

Tx of isolated factor deficiencies
warfarin reversal
coagulopathy (liver dz)
massive transfusio n

70
Q

FFP warfarin reversal dose

A

5-8 mL/kg

71
Q

cryo

A

prepicipitate remaining after FFP is thawed slowly

72
Q

cryo contains

A

F VIII
FXII
vWF
fibrinogen

73
Q

cryo effect

A

1 unit incr fibrinogen by 5-7 mg/dL

74
Q

cryo indications

A

F VIII deficiency
hemophilia A
fibrinogen deficiency (< 80-100 mg/dL)

75
Q

min required filter size for blood admin

A

170 micron

76
Q

fluids for blood admin

A

NS only

77
Q

why cant you give LR with blood?

A

LR contains Ca2+ which binds the citrate causing clots

78
Q

which blood products cannot be warmed

A

plts
cryo

79
Q

min IV size for blood amin

A

20 ga

80
Q

things you must check before blood admin (6)

A

Name
MRN
DOB
Unit #
Blood Type
Expiration Date

81
Q

how many people must check before blood admin

A

2

82
Q

what is the mandatory transfusion trigger

A

there is no mandatory transfusion trigger

83
Q

ABL =

A

ABL = EBV x [ (Hct i - Hct f) / Hct i ]

can use Hct or Hgb

84
Q

adult male Blood volume

A

75 mL/kg

85
Q

adult female blood volume

A

65 mL/kg

86
Q

infant blood volume

A

80 mL/kg

87
Q

full term neonate blood volume

A

85 mL/kg

88
Q

premie neonate blood volume

A

95 mL/kg

89
Q

which blood do you give if you dont know blood type

A

O-

90
Q

MTP

A

need to transfuse 1-2x the pt blood volume

91
Q

MTP other definitions

A

loss of 50% BV in 3 hr
need >4 u PRBCs in 1 hr
blood loss > 150 mL/hr

92
Q

Class 1 hemorrhage

A

loss of <15% BV
no change HR/BP

93
Q

class 1 hemorrhage treatment

A

no fluids needed

94
Q

class 2 hemorrhage

A

loss of 15-30% BV
sympathetic response
incr HR
incr DBP

95
Q

class 2 hemorrhage treatment

A

need to give fluid

96
Q

class 3 hemorrhage

A

loss of 30-40%
hypoperfusion
metabolic acidosis

97
Q

class 3 treatment

A

crystalloids
not-long term solution

98
Q

class 4 hemorrhage

A

loss of >40% BV

99
Q

class 4 treatment

A

needs blood products ASAP

100
Q

blood consumption score

A

+1 pt for:
- HR > 120bpm
- SBP < 90mmHg
- positive FAST
- penetrating injury

101
Q

which blood consumption score indicates need for MTP

A

+2

102
Q

belmont transfusion speed

A

1000 mL/min

103
Q

belmont SE

A

citrate tox
hypothermia
hyperkalemia
acid-base disturbances

104
Q

goal SBP

A

80-100 mmHg

105
Q

goal Temp

A

> 35 C

106
Q

goal Hb

A

> 7g/dL

107
Q

goal pH

A

> 7.2

108
Q

goal BE

A

> -6

109
Q

goal lactate

A

< 4 mmols/L

110
Q

goal Ca2+

A

> 1.1 mmol/L

111
Q

goal Plts

A

> 50K

112
Q

goal PT/PTT

A

< 1.5 x nL

113
Q

goal INR

A

< 1.5

114
Q

goal fibrinogen

A

> 1.0g/L

115
Q

how long before surgery do you need autologous transfusion

A

4-5 wks

116
Q

Hg for autologus

A

11

117
Q

Hct for autologus

A

34%

118
Q

how long between autologus donations

A

72 hrs

119
Q

cell saver blood is mixed with

A

heparin

120
Q

how much blood loss is needed for cell saver

A

> 1000 mL

121
Q

cell saver Hct

A

50-60%

122
Q

cell saver CI

A

cancer
sepsis

123
Q

citrate tox S+S

A

paresthesia
hyptension
arrythmias

124
Q

citrate tox treatment

A

CaCl
CaGlu

125
Q

transfusion immune SE

A

hemolytic
febrile
anaphylaxis
TRALI
TACO
GvH disease
post transfusion purpura

126
Q

transfusion infection SE

A

hepatitis
HIV
cytomegalovirus
epstein-barr
parasitic
bacterial

127
Q

transfusion other SE

A

hypothermia
L shift Hg-O2 curve
hyperkalemia
human error
iron overload

128
Q

hemolytic rxn

A

destruction of RBCs by recipients antibodies

129
Q

acute hemolytic timeline

A

w/i 24 hrs of transfusion
sometimes immediate

130
Q

acute hemolytic cause

A

ABO incompatibility

131
Q

acute hemolytic S+S

A

incr temp
incr HR
decr BP
hemoglobinuria
oozing

132
Q

acute hemolytic treatment

A

stop transfusion
labs
test urine for Hg
diuresis

133
Q

delayed hemolytic rxn timeline

A

> 24 hrs post-transfusion

134
Q

delayed hemolytic cause

A

Rh incompatibility

135
Q

delayed hemolytic S+S

A

malaise
jaundice
fever
decr Hg

136
Q

febrile rxn cause

A

pts develop antibodies to leukocytes

137
Q

febrile reaction S+S

A

temp incr >1 deg within 4hrs

138
Q

febrile rxn treatment

A

stop transfusion
labd
antipyretics
benadryl

139
Q

allergic rxn is common with which blood product

A

FFP

140
Q

anaphylacitc rxn is common is what pts

A

IgA-deficient pts with anti-IgA antibodies

141
Q

anaphylactic S+S

A

decr BP
incr HR
bronchospasm
hives

142
Q

anaphylactic treatment

A

100 mcg epi
fluids
steroid

143
Q

leading cause of death fron transfusions

A

TRALI

144
Q

TRALI timeline

A

w/i 6 hrs of transfusion

145
Q

TRALI is more common with which products

A

plt
FFP

146
Q

TRALI S+S

A

dyspnea
cyanosis
chills
fever
decr BP

147
Q

TRALI treatment

A

supp O2 (not 100%)
vent support
PEEP 5-7

148
Q

TACO cause

A

blood products given faster than CO can keep up

149
Q

TACO S+S

A

3 or more:
- resp distress
- pulm edema
- incr BNP
- incr CVP

150
Q

TACO treatment

A

stop infusion
supp O2
vent support
diuresis

151
Q

GvH diseasee common in what pts

A

immunocompromised

152
Q

GvH S+S

A

rash
fever
diarrhea
liver dysfunction

153
Q

GvH treatment

A

give irradiated products to avoid lymphocyte reactiojn

154
Q

post-transfusion purpura

A

plt alloantibodies destroy pts plts

155
Q

PTP plt levels

A

< 10,000

156
Q

PTP treatment

A

IV IgG
plasmapheresis (plasma exchange)

157
Q

which hepatitis are we most concerned with

A

Hep C

158
Q

how long after covid to donate blood

A

10d post + test

159
Q

how long after covid vax to donate blood

A

14 days post vax

160
Q

second leading cause of transfusion mortality

A

bacterial infection
most often cuse by bacteremia or contamination

161
Q

bacterial infection S+S

A

fever
chills
tachycardia
emesis
hypotension
shock

162
Q

bacterial infection treatment

A

stop transfusion
get cultures
give abx

Fa: Sim 3 (10 decks)

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