ADMINISTRATION OF BLOOD COMPONENTS Flashcards
Which of the following is not a purpose of leukocyte reduction?
A.Decreases the risk of HL alloimmunization
B. Decreases the risk of transmission of cytomegalovirus (CMV)
C. Decreases the risk of febrile transfusion reactions
D. Decreases the risk of GVHD
D. Decreases the risk of GVHD
This is achieved through irradiation.
According to the AABB circular, which of the ff is a contraindication of FFP transfusion?
A. Management of patients with rare specific plasma protein deficiencies, such as C1 inhibitor
B. Management of preoperative or bleeding patients who require replacement of multiple plasma coagulation factors
C. To correct a minimally elevated international normalized ratio (INR).
D. Transfusion or plasma exchange in patients with thrombotic thrombocytopenic purpura
(TTP)
C. To correct a minimally elevated international normalized ratio (INR).
Which pre-medication is commonly used to reduce febrile non-hemolytic transfusion reactions?
Antipyretics (fever reducer)
This pre-medication is used for patients who have experienced allergic reactions in the past
Antihistamines
Which of the following is an indication for use of corticosteroids as premed?
A. Patients who have had prior anaphylactoid reactions
B. Recurrent febrile nonhemolytic transfusion reactions
C. patients who have experienced severe rigors during transfusion
D. All of the above
D. All of the above
A transfusion equipment used to prevent hypothermia
Blood warmers
A transfusion device to allow for a controlled infusion rate over a desired period
Infusion pumps
When are microaggregate filters used for transfusion?
Typically used for the theinfusion of shed autologous blood collected during or after surgery
True or false: Leuko reduction filters are universal and can be used for either red cells or platelets
False. Leukoreduction filters must be compatible with the component. filters designed for red cells or platelets may not be used interchangeably (when using LR filters during transfusion. See TM page 495)
True or false: leukoreduction filters can be used to administer granulocytes or HPCs (Hematopoietic progenitor cells).
False. LR filters should never be used for granulocytes.
Which of the following solutions can be used to flush the tubings and be used to administer at the same time as blood components(select the best choice)?
A. Dextrose
B. 0.9% sodium chloride
C. ABO compatible plasma
D. Lactated Ringer solution
B. 0.9% sodium chloride
Dextrose - May cause red cells to lose and swell
Lactated ringer solution - or other solution containing high levels of calcium may overcome the buffering capacity of the citrate anticoagulant in the blood preservative solution and cause clotting of the component.
ABO compatible plasma, 5% albumin, or plasma protein fraction are acceptable
What is the suggested flow rate of red blood cells within the first 15 minutes of transfusion in adults?
1-2 mL/ min
60 - 120 mL/ hr
After 15 minutes - as rapidly as tolerated
What is the suggested flow rate for platelets within the first 15 minutes of transfusion in adults?
2-5mL/min
120- 300 mL/hr
After 15 mins - as tolerated
What is the suggested flow rate for plasma within the first 15 minutes of transfusion in adults?
2 - 5 mL/min
120 - 300 mL/hr
After 15 minutes - as rapidly as tolerated
What is the suggested flow rate for granulocytes within the first 15 minutes of transfusion in adults?
1-2 mL/min
60 - 120 mL/hr
After 15 mins - as tolerated
What is the suggested flow rate for cryoprecipitate within the first 15 minutes of transfusion in adults?
As rapidly as tolerated
Which of the following is NOT specified/required by the AABB to be documented as part of transfusion in patient’s medical record?
A. Transfusion order B. Transfusion start and end times C. Date and time of transfusion D. Component name and volume transfused E. None of the above
B. Transfusion start and end times
Other documentation requirements: recipient consent, donation identification number, pre-and post transfusion vital signs, identification of the transfusion‘s, transfusion related adverse events if applicable.
_____ is a calculated measure of patient response to platelet
transfusion
The corrected count increment (CCI)
How much residual leukocytes is expected to be present in a leukocyte reduce platelet apheresis unit? A. <8.3 x 10^5 B. <5.0 x 10^6 C. <3.0 x 10^6 D. <1.0 x 10^5
B. <5.0 x 10^6
Which of the ff is a contraindication of granulocyte administration?
A. Patient with CGD
B. Patient with absolute granulocyte count of 0.5 x 10^9 / L
C. Phrophylaxis for patients fighting infections
D. Neutropenic patient
C. Phrophylaxis for patients fighting infections
Which of the ff is a NOT a purpose of leukocyte reduced components?
A. To decrease the frequency of recurrent febrile non- hemolytic transfusion reaction
B. Toreduce the risk of transfusion- transmitted CMV
C. To prevent TA-GVHD
D. To reduce the incidence of HLA alloimmunization
C. To prevent TA-GVHD
This is done by irradiation
How much increase in platelet count would a dose of whole blood derived platelets give for an adult?
5k - 10k / uL
Whole blood derived , also for random donor (RD) plts
A patient’s pre transfusion fibrinogen count is 20 mg/dL. What would his expected fibrinogen count be after transfusing 1 dose (1 unit) of cryoprecipitate?
70- 90mg/dL
1 dose = increase in fibrinogen by 50-70 mg/dL per 7-10 kg body weight
A unit (1 dose) of FFP will increase a patient’s factor levels by how much?
20-30% factor activity level
Which of the ff is NOT an indication of washed cellular components?
A. Intrauterine transfuion for a fetus with HDFN
B. Removal of potassium in pRBC unit to be transfused to neonate
C. A patient with severe anaphylactic reactions due to anti-IgA needing platelet transfusions
D. Platelets collected from mom to be transfused to newborn with FNAIT
C.
A. Intrauterine transfuion for a fetus with HDFN
Choice B - prevents hyperkalemia and its complications
Choice C - patients who ar IgA deficient, with anti-IgA may stimulate an allergic trxn when exposed to to plasma containing IgA
Choice D - washing allows transfusion of component without exposing the newborn to additional antibodies (coz platelet units have a small amount of plasma in it)
A neonate has a platelet count of 10,000 /mL. What would the expected platelet count be after transfusing 1 dose of platelet unit (aliquot)?
Between 60-110k /mL
What is the typical dose for red cell transfusion and platelet transfusion for neonates?
10-25 ml/ kg and 5-10ml/kg
Transfusion of one RBC unit costs about $600. Approximately how much does it cost for the Transfusion Medicine department to purchase that one unit of RBC? A. $150 B. $240 C. $300 D. $400
A. $150
Cost represents between 21-32% of the total cost to transfuse
What is the treatment of choice for patients with TTP? A. RBC transfusion B. Platelet transfusion C. Therapeutic plasma exchange D. Therapeutic RBC exchange
C. Therapeutic plasma exchange
What is the treatment of choice for patients with DIC? A. Treat underlying coagulopathy B. Platelet transfusion (HLA match) C. No Transfusion D. IVIG
A. Treat underlying coagulopathy
Which of the ff would NOT be absorbed when using rabbit rabbit erythrocyte stroma cells? A. Cold auto antibodies B. Warm auto antibodies C. Anti- Vel D. Anti-E
B. Warm auto antibodies
Rabbit erythrocyte stroma is usually used to adsorb cold auto ab, anti -I, -IH (these ag are present on rabbit cells)
Vel and -E can also be absorbed
Which of the ff is the least effective / not proven as an effective therapy for WAIHA? A. Splenectomy B. IVIG C. Immunosuppressive agents D. Plasma exchange
D. Plasma exchange
