Blood and Therapy

Question 1

What is not functional in whole blood?

Answer 1

platelets and granulocytes

Question 2

What is whole blood used for

Answer 2

volume replacement

Question 3

RBC collection

how much to raise Hgb 1 g/dl?

Answer 3

through aphaeresis
- stored in CPDA1 or AS for better survival

One unit should raise Hbg

Question 4

What is RBC infusion used for

Answer 4

raising oxygen carrying capacity

Question 5

How are platelets obtained?

Answer 5

Apheresis and Random donor platelets (not as much)

Question 6

When do you use platelets?

Answer 6

Active bleeding, platelet disorders, surgery

Question 7

When do you NOT use platelets?

Answer 7

HIT

ITP, TTP

Question 8

What is fresh frozen plasma used for?

Answer 8

coagulation

reversal of warfarin

Question 9

What does FFP contain?

Answer 9

coagulation factors
fibrinogen
albumin

Question 10

What is cryoprecipitate used for?

Answer 10

DIC, low fibrinogen

Question 11

What does Albumin treat?

Answer 11

acute hypovolemia

NOT CHRONIC

Question 12

where does CMV persist in infected hosts?

Answer 12

monocytes

Question 13

Transfusion associated graft vs. host disease

Answer 13

TAG vs. HD

• 4-30 days post transfusion, fever, rash, V/D, bone marrow dysfunction
• donor lymphocytes on recipients Ag presenting tissue
• supportive treatment

Question 14

Acute Hemolytic transfusion reaction

what is it caused by?

Answer 14

most dangerous

• due to error of incompatible donor RBC into patient
• rigor or chills, confusion, low back pain, death

Question 15

Febrile Nonhemolytic reaction of transfusion

what is this caused by? what are the symptoms?

Answer 15

Sudden chills, temp increase, headache, muscle pain

• sensitization to donor WBC, platelets, or plasma
• caused by prior transfusions, transplants..

Question 16

Febrile non hemolytic reaction management

Answer 16

antipyretics

Question 17

Allergic Reaction

Answer 17

seen mainly with urticaria and sometimes angioedema

- caused by sensitization to foreign plasma antigen

Question 18

Allergic reaction management

Answer 18

give antihistamines and restart if symptoms are mild

Question 19

Anaphylactic Reaction to transfusion

Answer 19

immediate and increase in pulmonary symptoms

- caused by infusion of IgA to patient with Ab to IgA

Question 20

Transfusion related Acute lung injury

symptoms and cause?

Answer 20

Fairly severe with bilateral non cariogenic pulmonary edema, hypotension

• most common cause of death
• caused by donor Ab activating recipient WBC –> ARDS

Question 21

How do you manage TRALI?

Answer 21

steroids and ventilation

Question 22

Circulatory overload

signs and management

Answer 22

cough, pulmonary congestion, and distended neck veins

• caused by the physician
• fluids are administered too quickly
• provide oxygen and put patient upright

Question 23

Transfusion associated dyspnea

Answer 23

Respiratory distress within 24 hours

• no temp increase
• diagnosis of exclusion

Question 24

Septic reaction

Answer 24

rapid onset of fever and chills, N/V/D, hypotension, shock

- caused by transfusion of contaminated blood

Question 25

How do you manage sepsis?

Answer 25

obtain BC and treat with antibiotics, fluids, and vasopressors

Question 26

Delayed Hemolytic Transfusion Reaction

Answer 26

fatigue, malaise, increased conjugated bilirubin
- caused by immune response to antigen on donor cells –> reticuloendothelial system removes them –> extravascular hemolysis

Question 27

Post transfusion Purpura (PTP)

Answer 27

Symptomatic thrombocytopenia after transfusion 5 days
- caused by alloantibodies to HPA or platelet antigen
-

Question 28

Management of PTP

Answer 28

IVIG and steroids

Question 29

What does CD34 mark

Answer 29

surface glycoprotein for hematopoietic progenitor stem cells

Question 30

Filgrastim and plerixafor action

Answer 30

granulocyte growth factor that helps release SC from bone marrow stroma

Question 31

What do you use to treat graft vs host disease

Answer 31

cyclosporine/tacrolimus

methotrexate