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AIH1 > AIH1 > Flashcards

AIH1 Flashcards

1
Q

What is accepted for orders

A

complete accurate legible oral paper or electronic requests

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2
Q

How is the blood sample labelled

A

two independent identifiers, mechanism to identify phlebotomist and date/time of collection

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3
Q

How many determinants of blood group for allogeneic transfusion

A

two: 2nd sample taken at separate time or retest same sample if using electronic patient verification

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4
Q

How long to keep patient samples and segments

A

Saved for at least 7 days from the last possible day of transfusion

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5
Q

Neonate testing

A

Initial sample to test ABO and Rh and antibody screen using maternal or neonate serum, repeat not needed if same hospital stay within 4 months

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6
Q

Neonate has initial antibody screen negative, what to crossmatch?

A

Crossmatch not required up to 4 months

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7
Q

Neonate has initial antibody screen positive, what to crossmatch?

A

AHG compatible or antigen negative until antibody NLD

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8
Q

Non group O neonate is receiving non group O RBC that is not compatible with the maternal ABO group, what to test

A

Test neonate’s serum for anti-A, anti-B by AHG

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9
Q

ARDP participation requirements

A
  1. Ship 15 units through the ARDP
  2. Register at least 10 donors
  3. Screen at least 1000 donors for high prevalence antigens
  4. Provide anti-sera to another ARDP member
  5. Perform at least 1 family study
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10
Q

ARDP submission requirements

A

High prevalence: all ABO groups acceptable, all common antigen negative results tested x 2, molecular (e variants, DO)
Multiple common antigen negative: Group O and A (Caucasian), Group O, A and B (African)
IgA deficient: IgA < 0.05mg/dL on 2 occasions

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11
Q

ARDP uncommon donor requirements

A
  1. R1R1, R2R2, R0, or rr and K- and one negative in Ss, Duffy, Kidd
  2. R1R1, R2R2, rr and K- and Fya-b-
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12
Q

ARDP Top 10 High prevalence antigen negative requests

A
  1. U
  2. Lub
  3. hrB
  4. Yta
  5. Jsb
  6. JK3
  7. k
  8. Vel
  9. Hy
  10. Joa
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13
Q

Needle for transfusion

A

Adult: 18-19g
Child: 21-23g

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14
Q

Requirements for consent

A

Informed consent obtained and documented (description of risks, opportunity to ask questions, right to accept or refuse transfusion)

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15
Q

Pretransfusion medications

A

Antihistamines (mild allergic reactions)
Corticosteroids (severe allergic reactions)
Antipyretics (febrile reactions)

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16
Q

Pretransfusion unit verification at bedside

A

2 licensed staff members must check, patient must state name, baseline vitals (temp not above 99F, pulse, blood pressure)

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17
Q

IV solutions

A

Normal 0.9% saline only
D5W: causes RBC to swell, possible clumping
Ringers lactate: contains calcium, gelling effect
Drugs: unknown pH can cause hemolysis
Hypertonic/hypotonic: hemolysis

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18
Q

Filters

A

Routine 150-260 micron

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19
Q

Pressure infusion devices

A

Never use more than 300 mm Hg

Smaller the needle bore, the less pressure can be used (or will cause hemolysis)

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20
Q

Adult infusion rates

A

first 15 min: 2mL/min

Complete within 4 hours

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21
Q

Pediatric infusion rates

A

RBC: 2-5mL/kg/hr
PLT/FFP: 60-120mL/hr
Cryo: as rapidly as tolerated

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22
Q

Rapid transfusion

A

Pressure infusion, large bore, type 8 FR double lumen intravenous catheters

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23
Q

Liver transplant stages

A

Pre-anhepatic (prep), anhepatic (transplant), post anhepatic (blood flow assessed)

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24
Q

Minor mismatch

A

Donor antibodies against patient

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25
Q

Major mismatch

A

Recipient antibodies against donor

26
Q

Describe the bloody vicious cycle of massive transfusion

A

Hemorrhage –> hemodilution –> coagulopathy

27
Q

Massive transfusion complications

A

coagulopathy, hypothermia, acidosis (from shock), acidemia, hypocalcemia, hyperkalemia

28
Q

Disaster response

A
  1. Contact AABB task force within 1 hour (convenes conference call with level 1 members)
  2. Determine what is the hospital admissions, current O inventory
29
Q

TA anticoagulant of choice

A

Citrate

30
Q

Physiological effects of citrate

A

Transient hypocalcemia

Management: IV infusion of calcium gluconate

31
Q

TA adverse effect

A

Vasovagal reaction, hematoma, leukapheresis (fluid retention from HES), allergic reaction

32
Q

TA Class I

A

TA is standard and acceptable: TTP/HUS, acute sickle stroke

33
Q

TA Class I

A

TA is generally acceptable: renal transplantation antibody mediated rejection

34
Q

TA Class III

A

Evidence is insufficient: acute liver failure

35
Q

TA Class IV

A

TA is discouraged: ITP, atypical HUS

36
Q

ITP description

A

Platelet specific autoantibodies bind to platelets then cleared by the spleen

37
Q

ITP clinical picture

A

Petechiae, intracranial hemorrhage, gingival bleeding, spontaneous bleeding, epixtaxis

38
Q

ITP laboratory picture

A

Low platelets, abnormal size, MPV increased

39
Q

Acute ITP

A

Childhood disease proceeded by infection (VZ, EBV)

Usually self limiting & benign

40
Q

Chronic ITP

A

Females 2x as likely as males

41
Q

Child ITP treatment

A

IVIG to flood Fc receptors, short cause of steroids

42
Q

Adult ITP treatment

A

Steroids, high IVIG dose, rituximab (causes B cell depletion)

43
Q

TTP description

A

Autoimmune inhibitors or ADAMTS13 or reduced activity

44
Q

TTP clinical picture

A

MAHA, thrombi, neurologic abnormalities, renal dysfunction, petechiae, purpura

45
Q

TTP syndrome triad

A
  1. Thrombocytopenia and mucous membrane bleeding
  2. MAHA sufficient to cause jaundice
  3. Neurologic abnormalities
46
Q

TTP laboratory picture

A

Schistocytes, intravascular hemolysis, severe thrombocytopenia

47
Q

TTP treatment

A

Plasma exchange

Never give platelets

48
Q

Granulocyte transfusion reason

A

Provide granulocytes to phagocytize and kill bacteria

49
Q

Granulocyte collection by apheresis drugs

A

HES: sedimentation and increase removal
Corticosteroids: increase production
G-CSF

50
Q

Granulocyte collection

A

TTD testing done beforehand
CMV negative required for immunocompromised patient
20-24C >24 hours no agitation irradiated

51
Q

Granulocyte indication

A

Neutropenia <500/uL associated with fever unresponsive to antibiotic treatment, neonate with sepsis

52
Q

Granulocyte transfusion side effects

A

HLA alloimmunization, GVHD, transmission of CMV

53
Q

How much blood loss can be controlled with crystalloid solutions?

A

20%, losing 30% or more can cause hypovolemic shock

54
Q

Diastole

A

Relaxation of the heart

55
Q

Systole

A

Contraction of the heart

56
Q

Diastolic pressure

A

80mmHg average, lowest systemic arterial pressure

57
Q

Systolic pressure

A

120mmHg average, highest systemic arterial pressure

58
Q

Blood volue

A

5L average

59
Q

Pulse pressure

A

maximum systemic arterial pressure - minimum systemic arterial pressure (systolic - diastolic)

60
Q

Mean arterial pressure

A

Average pressure during a cardiac cycle, 60mmHg minimum

AIH1 (7 decks)

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