BB Test 4 Flashcards

1
Q

define transfusion reaction

A

physical reaction to the transfusion of blood.

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2
Q

what is the cause of immediate hemolytic reaction

A

transfusion of incompatible RBC/whole blood

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3
Q

what are the symptoms of immediate hemolytic reaction

A

are intravascular

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4
Q

how can immediate hemolytic reactions be prevented

A

by following all procedures/policies to ensure safe transfusion

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5
Q

what is the cause of delayed hemolytic reaction

A

it is a secondary response to transfused RBC

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6
Q

what are the symptoms of delayed hemolytic reactions

A

fever, chills, and mild jaundice

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7
Q

how can delayed hemolytic be prevented

A

thorough medical history documenting any previous, transfusions, pregnancies, and transplants

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8
Q

what does TRALI stand for

A

Transfusion-Related Acute Lung Injury

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9
Q

what is TRALI

A

pulmonary edema, not associated with cardiac failure, that is usually due to the transfusion of preformed donor leukoagglutinins in the plasma of blood compenets

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10
Q

what does TACO stand for

A

Transfusion Associated Circulatory Overload

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11
Q

what is a diuretic

A

substances that increase urine output either by increasing the rate of glomerular filtration or by decreasing tubular reabsorption

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12
Q

what is urticaria

A

hives

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13
Q

what is erythema

A

redmess of the skin caused by capillary dilation

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14
Q

what is dyspnea

A

shortness of breath

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15
Q

what is epinephrine

A

hormone produced by the adrenal medulla that can be used as a vasoconstrictor and bronchiole dilator

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16
Q

what is pulmonary edema

A

accumulation of fluid in the lungs

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17
Q

what is hypoxemia

A

condition of having low oxygen in the the blood

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18
Q

what is a vasopressors

A

substances that cuase the contration of the muscle fibers in capillaries and artheries, resulting diminished blood flow

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19
Q

what is cyanosis

A

bluish discoloration of the skin due to decreased oxygen saturation of the blood

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20
Q

what is orthopnea

A

difficulty breathing in any but an erect position

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21
Q

what is pancytopenia

A

decreased numbers of all blood cell lines

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22
Q

what is hemosiderosis

A

deposition of iron in the tissues and organs, which may result from the long-term administration of blood to patients with chronic anemia.

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23
Q

what is the cause of TRALI

A

transfusion of pre-formed donor HLA AB into a patient that cause respiratory compromise during or within 6 hours of transfusion

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24
Q

what are the symptoms of TRALI

A

respiratory distress, acute pulmonary edema, hypotension, and fever.

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25
Q

how can TRALI be prevented

A

possibility of deferring multiparous women from future donation of blood products, definitely stop TRALI donors from donating.

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26
Q

what are the causes of TACO

A

infusion of fluid volume beyond capacity of an inidividual’s cardiovascular system

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27
Q

what are the symptoms of TACO

A

shortness of breath, coughing, decreased O2 saturation, wheezing, cyanosis, elevated BP, decreased pulse, and peripheral edema.

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28
Q

how can TACO be prevented

A

slow infusion rate transfusion to 100mL/hr and use aliquot blood

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29
Q

what is the cause of Febrile reaction

A

anti-leukocytic antibodies in patient’s plasma

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30
Q

what are the symptoms of Febrile reaction

A

1C rise in temperature associated with transfusion and having no medial explanation

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31
Q

what is the cause of Anaphylactic or anaphylactoid reaction

A

anti-IgA in patient’s plasma

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32
Q

What is TACO

A

circulatory overload

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33
Q

what are the symptoms of Anaphylactic or anaphylactoid reaction

A

occurs after transfusionof only a few mL of plasma or plasma-containg components

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34
Q

how can Anaphylactic or anaphylactoid reaction be prevented

A

total plasma removal

35
Q

what is the cause of allergic reaction

A

allergen complexes

36
Q

what are the symptoms of allergic reaction

A

redness, itching, and hives

37
Q

how can allergic reactions be prevented

A

pre-medicate with Benadryl

38
Q

what is the cause of Bacterial contamination

A

endotoxins produced by bacteria capable of growing in cold; E. coli, Staphylococcus, and Yersinia enterocolitica

39
Q

what are the symptoms of bacterial contamination

A

warm reaction; dryness and flushing of the skin

40
Q

how can bacterial contamination be prevented

A

strict adherence to component collection, storage, handling and preparation procedures, visual observation of units, transfusion within standard maximum allowable times lime = 4 hours. Now culture platelets after collection to ensure safer products.

41
Q

what is the cause of Transfusion-Associated Graft vs. Host Disease

A

attack from donor T-cell lymphocytes against the patient, and recipient becomes foreigner

42
Q

what are the symptoms of Transfusion-Associated Graft vs. Host Disease

A

rash, fever, nausea, vomiting, or diarrhea days to weeks following transfusion, and CBC reveals pancytopenia, with liver enzymes abnormal

43
Q

how can Transfusion-Associated Graft vs. Host Disease be prevented

A

irradiation of blood products, especially of family members, neonates, and transplant patients, to inactivate leukocytes

44
Q

what is the cause of Posttransfusion Purpura

A

pre-fomred platelets-specific alloantibodies present in patient’s plasma that were induced from prior transfusion, pregnancy, or tissues exposure (often PLA-1)

45
Q

what are the symptoms of Posttransfusion Purpura

A

sudden onset of red to purple discoloration on the skin the size of a pencil eraser

46
Q

how can Posttransfusion Purpura be prevented

A

HLA negative platelets in future

47
Q

what is the first symptom of AHTR

A

Fever

48
Q

what is the cause of Alloimmunization to HLA Antigens

A

formation of HLA antibodies following exposure to antigens from transfusion, pregnancies, or transplants. Common in multiparous women.

49
Q

what are the symptoms of Alloimmunization to HLA Antigens

A

platelet refractoriness- no increase in counts following transfusion of platelets

50
Q

what can Alloimmunization to HLA Antigens be prevented

A

irradiated HLA matched platelets and ABO-matched leukorodeuced platelets

51
Q

Name 2 reactions considered to be delayed non-hemolytic reactions

A

Post-transfusion purpura

52
Q

name some of the disease transmitted by blood

A

Hepatitis (B,C,D), HIV, HTLB-I/II, West Nile Virus, CMV, Babesiosis, Chagas disease, Leishmaniasis, Dengue, Syphilis, Malaria, Toxoplasmosis, Parvovirus, EBV, Lyme Disease, Parvovirus B19, CHikungunya, CJD

53
Q

Which hepatitis has a vaccine

A

Hepatitis B

54
Q

which hepatitis is bloodborne

A

Hepatitis B, D, and D

55
Q

which hepatitis is fecal-oral transmission

A

Hepatitis A and E

56
Q

which hepatitis has a chronic state to it

A

Hepatitis B, C, and D

57
Q

which hepatitis has a carrier state to it

A

Hepatitis B, C, and D

58
Q

which hepatitis has a long incubation period

A

Hepatitis B and C (40-150 and 20-90)

59
Q

Describe the procedure for a transfusion work up

A

1) check for any discrepancies in patient/donor ID; label and record checks.

60
Q

what fluids have HIV been isolated from

A

blood, semen, vaginal secretions, tears, sweat, breast milk

61
Q

what individuals are at risk for HIV infections

A

homosexuals, bisexuals, prostitutes, IV drug users, recipients of transfusion of blood products, sexual partners of above, healt-care workers, infants born to infected mothers

62
Q

describe the kernicterus of HDN

A

toxic levels of bilirubin in a newborn’s brain that causes permanent brain damage

63
Q

describe the process of HDN

A

1) destruction of RBC of the fetus and neonate by antibodies produced by the mother

64
Q

What are the 4 factors affecting the severity of HDN

A

Exposure, Host Factors, Immunoglobulin Class, and Antibody Specificity

65
Q

Describe the Exposure factor of HDN

A

trans-placental hemorrhage of fetal RBC into the maternal circulation occurs in up to 7% of pregnancies

66
Q

Describe the Host Factor of HDN

A

depends on complex genetic factors

67
Q

Describe the Immunoglobulin Class of HDN

A

IgG, crosses the placenta

68
Q

Describe Antibody Specificity of HDN

A

Rh [D] is the most immunogenic

69
Q

What are the 2 clinical symptoms of HDN

A

1) Hemolysis, anemia, and erythropoiesis

70
Q

Describe the clinical symptoms of HDN: Hemolysis, anemia, and erythropoiesis

A

*maternal IgG antibodies attach to specific antigens on fetal RBC

71
Q

Describe the clinical symptom of HDN; Bilirubin

A

*RBC destruction releases Hgb= metabolized to bilirubin [indirect]

72
Q

what are the 2 types of testing done during a workup when HDN is suspected for diagnosis

A

Serologic testing and Aminocentesis

73
Q

Describe the serologic testing done for the diagnosis of HDN

A

*ABO/Rh typing and AB screen at first prenatal visit during first trimester; medical history

74
Q

Describe the Aminocentesis testing done for the diagnosis of HDN

A

monitors concentration of bilirubin pigment in the amniotic fluid = degree of fetal anemai

75
Q

What are the ways that HDN is managed

A

Intrauterine transfusion- Photo-therapy with UV light,

76
Q

what is the Rh IG administration dose calculation

A

of fetal cells / # of adult cells X 5000/30 = # vials (only full vials)

77
Q

describe hypothermia reactions

A

significant decrease in core body temperature due to low temperature of blood products (stored in cold 1-6C). Can lead to heart failure, respiratory distress, neurological disturbances. Use blood warmer to warm blood.

78
Q

describe air embolism reactions

A

equipment malfunction or improper setup of infusion set or perioperative blood recovery. Infusion of as little as 100mL of air within intravascular space can be fatal.

79
Q

what are the symptoms of air embolism reactions

A

cough, difficulty breathing, choking, and potentially death.

80
Q

describe potassium abnormalities reactions

A

extracellular K concentration narrow range of 3.5-5.5 mEq/L to prevent cardiac failure. During storage of RBC units, some of intra cellular K leaks into small extracellular volume. May send patient into hyperkalemia

81
Q

describe transfusion-related Immunomodulation

A

patients who have been transfused have been exposed to more HLA antigens- have better acceptance of transplants. Some research shows increase risk of infection, malignancy, short-term mortality.

82
Q

what is a storage lesion

A

changes to cells in the bag

83
Q

how long can RBC be stored for

A

AABB standard allow packed RBC’s to be stored up to 42 days at 1-6C when using additive solutions