BLOOD BANK Flashcards

1
Q

Replacement fluids used for therapeutic plasmapheresis (plasma exchange)

A

NSS, NSA, PPF, FFP

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2
Q

Therapeutic plasmapheresis helps remove the offending agents in cases of:

A

Paraproteinemia (e.g. Multiple Myeloma, Waldenstrom Macroglobulinemia, etc.)

Familial Hypercholesterolemia, etc.

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3
Q

Therapeutic __________ is beneficial in diseases that involves malfunction of the immune system (SLE, RA)

A

Plasmapheresis

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4
Q

Therapeutic indication:

Treat various complications of Sickle cell disease, such as priapism and impending stroke

Also in pxs with severe parasitic infections from malaria and babesia

A

Erythrocytapheresis

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5
Q

Therapeutic Indications:

for young pxs with certain hematologic disorders especially thalassemia syndromes

A

Neocytapheresis

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6
Q

Therapeutic Indications:

means of producing immunosuppression in conditions like RA, SLE, Kidney transplant rejection and autoimmune and alloimmunedisease.

A

Lymphocytapheresis

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7
Q

Therapeutic Indications:

Used to treat patients with leukemia such as Hairy cell leukemia, AML, Cutaneous T cell lymphoma

A

Leukapheresis

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8
Q

Leukapheresis wbc content:

A

> 100,000/uL

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9
Q

administered to the donors 12-24 hours before leukapheresis to increase the number of circulating granulocytes by pulling them from the marginal pool

A

corticosteroids

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10
Q

Sedimenting agent used for granulocyte collection which causes red cells to form rouleaux thus allowing wbcs to be harvested more efficiently

A

HES (Hydroxyethyl starch)

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11
Q

Therapeutic Indications: Used to treat patients who have abnormally elevated platelet counts such as in cases of Polycythemia vera

A

Plateletpheresis

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12
Q

Plateletpheresis is equivalent to _____ random platelet concentrates

A

6-10 random platelet concentrate

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13
Q

Contents of plateletpheresis:

A

3x10^11

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14
Q

Indications:

GVH reactions
BM transplant
Direct donation from a blood relative
Exchange transfusion
IUT
transfusion for immunocompromised patients

A

Irradiated blood

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15
Q

Target cells for irradiated blood

A

Lymphocytes

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16
Q

Cell responsible for the graft vs host reaction for immunocompromised patients

A

T-cells

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17
Q

Elements used for blood irradiation:

A

Cesium 137
Cobalt 60

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18
Q

Shelf life of Irradiated blood

A

28 days

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19
Q

Immunosuppressant that prevents antibody reaction of mother to prevent HDFN

A

Rho (D) Ig (Rhogam)

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20
Q

Shelf life of Rhogam

A

3 years

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21
Q

Storage temp of Rhogam

A

1-6 deg C

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22
Q

Indication:

Prevention of Rho (D) immunization

Given to Rh negative mothers due to incompatible pregnancy

A

Rho (D) Ig (Rhogam)

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23
Q

Full dose of Rhogam

A

300 ug Anti-D

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24
Q

Administration of Rhogam: Full dose

A

3rd trimester; full term delivery, 3 days after delivery

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25
Q

300 ug Anti-D can neutralize ____ of whole blood and ___ mL of PRBC FMH - fetomaternal hemorrhage/bleeding

A

30/15

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26
Q

Mini dose of Rhogam

A

50 ug Anti-D

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27
Q

Administration of Rhogam: Mini Dose

A

ectopic rupture, amniocentesis, miscarriage of rH negative (first born child)

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28
Q

Mini Dose of Rhogam can neutralize ____ mL of whole blood and ___ mL of FMH - fetomaternal hemorrhage/bleeding

A

5/2.5 mL

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29
Q

Synthetic Volume Expanders: Crystalloids (REN)

A

Ringer’s lactate
Electrolyte solution
NSS

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30
Q

Synthetic Volume Expanders: Colloids (HD)

A

Dextran
Hydroxyethyl Starch (HES)

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31
Q

Indication: Plasma volume expansion

A

Plasma protein fraction

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32
Q

Contents of Plasma protein fraction:

A

80-85% albumin
15-20% globulin

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33
Q

Shelf life of Plasma Protein Fraction at 20-24 deg C

A

3 years

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34
Q

Shelf life of Plasma Protein Fraction at 1-6 deg C

A

5 years

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35
Q

Indications:

Plasma volume expansion:
surgery
trauma
burns

A

Normal Serum Albumin (NSA)

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36
Q

Shelf life of Normal Serum Albumin (NSA) at 20-24 deg C

A

3 years

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37
Q

Shelf life of Normal Serum Albumin (NSA) at 1-6 deg C

A

5 years

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38
Q

Content of NSA:

A

96% albumin
4% globulin

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39
Q

Indication:
prophylactic treatment to pxs exposed to hepatitis, measles, or chicken pox; treatment of congenital hypogammaglobulinemia

A

Immune Serum Globulin

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40
Q

Immune Serum Globulin (ISG) shelf life: Intramuscular

A

3 years

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41
Q

Immune Serum Globulin (ISG) shelf life: Intravenous

A

1 year

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42
Q

Factor IX Concentrate (Prothrombin complex) shelf life:

A

varies on expiration date on vial

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43
Q

Factor IX Concentrate (Prothrombin complex) storage temperature:

A

1-6 deg C (lyophilized)

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44
Q

Indication: Hemophilia B

A

Factor IX Concentrate (Prothrombin complex)

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45
Q

Indication: Hemophilia A

A

Factor VIII concentrate

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46
Q

Storage temp for Factor VIII concentrate

A

1-6 deg C lyophilized

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47
Q

Factor VIII concentrate shelf life

A

varies on expiration date on vial

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48
Q

Are concentrates of plasma proteins that are prepared from pools (many units) of plasma

A

Plasma derivatives

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49
Q

Indications: correct severe neutropenia, fever unresponsive to antibiotic therapy, and myeloid hypoplasia of the bone marrow

A

Granulocyte concentrate

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50
Q

Granulocyte concentrate shelf life:

A

24 hours

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51
Q

Granulocyte concentrate storage temp:

A

20-24 deg C without agitation

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52
Q

Contents of granulocyte concentrate:

A

1 x 10^10 wbc

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53
Q

Indications: Hemophilia A, vWF disease, Fibrinogen deficiency, Factor XIII deficiency

A

Cryoprecipitate

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54
Q

Cryoprecipitate content: Factor VIII:C

A

80-150 IU

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55
Q

Cryoprecipitate content: Factor VIII: vWF

A

40-70%

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56
Q

Cryoprecipitate content: Fibrinogen

A

150-250 mg

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57
Q

Cryoprecipitate content %: Factor XIII

A

20-30%

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58
Q

Storage temp: Frozen Cryoprecipitate

A

-18 deg C or colder

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59
Q

Storage temp: Thawed Cryoprecipitate

A

20-24 deg C

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60
Q

Shelf life Cryoprecipitate: Frozen

A

1 year

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61
Q

Shelf life Cryoprecipitate: Thawed

A

6 hours

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62
Q

Shelf life Cryoprecipitate: Pooled

A

4 hours

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63
Q

Fibrin glue is made with

A

Equal volume of cryoprecipitate and thrombin reagent

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64
Q

Active factors in cryoprecipitate

A

Factor I (fibrinogen) and XIII (fibrin stabilizing factor)

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65
Q

Promotes fibrin clot formation

A

Thrombin

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66
Q

Stabilizing factor in cryoprecipitate

A

FACTOR XIII

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67
Q

Used to stop further bleeding and other hemorrhagic conditions to the site of surgery

A

Fibrin glue

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68
Q

Indication: Treatment of stable clotting factor deficiencies

A

Single donor plasma (SDP) Liquid/Frozen

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69
Q

Single donor plasma (SDP) Liquid: Shelf-life and Storage

A

5 days beyond whole blood expiration

1-6 deg C

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70
Q

Single donor plasma (SDP) Frozen: Shelf life and Storage

A

5 years; -18 deg C or colder

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71
Q

Indication: Treatment of multiple coagulation factor deficiencies (caused by massive transfusion, trauma, liver dse, DIC). Also for treatment of antithrombin III deficiency, TTP, HUS

A

Fresh Frozen Plasma (Single Donor, prepared from whole blood)

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72
Q

Frozen plasma is thawed at water bath at: _____

A

37 deg C

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73
Q

Fresh Frozen Plasma (Single Donor, prepared from whole blood) Shelf life and Storage temperature: Frozen

A

1 year at -18 deg C

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74
Q

Fresh Frozen Plasma (Single Donor, prepared from whole blood) Thawed at Room temperature shelf life:

A

6 hours

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75
Q

Storage of Fresh Frozen Plasma (Single Donor, prepared from whole blood) Thawed at Room Temp:

A

6 hours

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76
Q

Fresh Frozen Plasma (Single Donor, prepared from whole blood): -65 deg C shelf life:

A

up to 7 years

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77
Q

Contents: Fresh Frozen Plasma (Single Donor, prepared from whole blood)

A

All coagulation factors; 400 mg Fibrinogen

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78
Q

Platelet additive solution:

A

Intersol

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79
Q

Intersol can extend shelf life of platelets from

A

5-7 days

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80
Q

Contents of platelets single donor prepared by pheresis:

A

3.0 x 10^11 platelets in approx. 300 mL of plasma

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81
Q

Indications: Thrombocytopenia; for pxs refractory to random plts. Due to platelet antibodies

A

Platelets (Single donor prepared by pheresis)

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82
Q

Shelf life of platelets closed system

A

5 days

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83
Q

Shelf life of platelets open system

A

24 hours

84
Q

Storage temp for platelets

A

20-24 deg C with constant agitation

85
Q

Platelet concentrate immediate effect: increase platelet count by

A

5,000 to 10,000 per uL/unit

86
Q

Indications: Thrombocytopenia, DIC, Platelet disorders, Bleeding

A

Platelet concentrate

87
Q

Contents of platelet concentrate:

A

5.5 x 10^10 platelets in 50-70 mL of plasma

88
Q

Storage temp for platelet concentrate:

A

20-24 deg C with constant agitation

89
Q

Shelf life of platelet concentrate

A

3 to 5 days (5 days with continuous agitation)

90
Q

pH of platelet concentrate

A

pH >= 6.2

91
Q

Plasma volume of platelet concentrate:

A

50-70 mL

92
Q

Indications: anemia, long term storage of “rare” units and/or autologous units

A

Frozen < Thawed < Deglycerolized RBCs

93
Q

Frozen RBC also known as

A

cryoprotected red blood cell, glycerolized RBC

94
Q

Frozen < Thawed < Deglycerolized RBCs: Frozen shelf life

A

10 years (longest)

95
Q

Deglycerolized RBC shelf life

A

24 hours

96
Q

Utilizes low molecular weight agent

A

Penetrating cryoprotective agent

97
Q

Most common penetrating cryoprotective agent:

A

glycerol

98
Q

Actions of glycerol:

A

Protects the cell membrane for extremely cold temperature storage

Prevents ice crystal formation in the cell

Prevents dehydration

99
Q

Utilizes high molecular weight

A

Non-penetrating cryoprotective agent

100
Q

Most commonly used non-penetrating cryoprotective agent

A

HES- Hydroxyethyl Starch

101
Q

Action of non-penetrating cryoprotective agent

A

protects the cell surface from extremely low temperature

102
Q

Storage temperature for freezing: Mechanical freezer (High Glycerol: 40%)

A

-65 deg C

103
Q

Mechanical freezer in Deglycerolized RBCs additive

A

79% glycerol with dextrose fructose and EDTA

104
Q

Storage temperature for freezing: Mechanical Freezer (low glycerol: 20%)

A

-120 deg C
Liquid Nitrogen Freezer

105
Q

Temperature for Deglycerolizing Process

A

1-6 deg C

106
Q

First wash procedure hypertonic cell shrinkage to remove glycerol from the cell membrane

percentage of saline solution

A

12% saline solution

107
Q

Second wash: (hypertonic)- used to completely remove glycerol from cells without modification

percentage of saline

A

1.6% saline solution

108
Q

Physiologic agent to provide additional source of ATP and does not change cell morphology:

A

0.2% dextrose in normal saline solution

109
Q

Minor crossmatch is no longer used and is replaced with

A

antibody screening

110
Q

Indications: anemia with history of febrile reactions
PNH (paroxysmal nocturnal hemoglobinuria)
for pxs with plasma proteins antibodies to reduce allergic reactions (for IgA- deficient pxs)

A

Washed Red Blood Cells

111
Q

Shelf life of Washed Red Blood Cells open system:

A

24 hours

112
Q

QC requirement for washed red blood cells

A

Plasma removal

113
Q

the only FDA approved rejuvenation solution

A

Rejuvesol

114
Q

To restore expired donor units

A

Rejuvenated Red Blood Cell

115
Q

PIPA for Rejuvenated RBCs

A

Phosphate, Inosine, Pyruvate, Adenosine

116
Q

Shelf life of Rejuvenated Red Blood Cells

A

can be prepared 3 days after expiration date

117
Q

Storage temp for Rejuvenated RBCs

A

1-6 deg C

118
Q

First generation filters

A

170 um

119
Q

Second Generation Filters

A

20-40 um

120
Q

Third generation filters

A

3-log filter

121
Q

Cells that are able to pass through filters

A

normal platelets, normal RBCs
WBC that are sized are RBCs

122
Q

Steps in leukocyte removal

A

1.Centrifugation

2.Washing procedures using saline or glycerol

3.Mechanical separation using leukoreduction filters (most effective)

123
Q

Indications: Anemia with history of febrile reactions; to decrease alloimmunization to WBC or HLA antigens or CMV transmission

A

Leukopoor Red Blood Cells

124
Q

Contents of Leukopoor Red Blood Cells

A

5 x 10^6 residual WBC

125
Q

Storage temp for Leukopoor Red Blood Cells

A

1-6 deg C

126
Q

Open system shelf life for Leukopoor Red Blood Cells

A

24 hours

127
Q

Immediate effect of PRBC transfusion

A

↑ Hematocrit by 3% ; ↑Hemoglobin by 1g

128
Q

Indication: Restore oxygen carrying capacity (anemia)

A

Packed Red Blood Cell

129
Q

Contents of PRBCs

A

Hematocrit should be 80% or less

130
Q

Shelf life of PRBC in CPD, ACD, CP2D

A

21 days (3 weeks)

131
Q

Storage temp of PRBCs

A

1-6 deg C

131
Q

Shelf life of PRBC in CPDA1

A

35 days

131
Q

Shelf life of PRBC in CPD-AS1, AS3, AS5

A

42 days

132
Q

Shelf life of PRBC in Heparin

A

2 days

133
Q

Components of Red Blood Cell Additive solution: (SAG-M)

A

Saline
Adenine
Glucose
Mannitol

134
Q

Result of a failed blood transfusion:

A

No increase in hematocrit

135
Q

Immediate effect of a successful whole blood transfusion:

A

↑ hematocrit by 1-3%

at least 70% of RBC remains viable after patient transfusion

136
Q

Indications: active bleeding, hemmorhagic shock, exchange transfusion. Both oxygen-carrying capacity and volume expansion are required

A

Whole blood

137
Q

WBC and PLT are no longer viable after _______

A

24 hours of storage

138
Q

Labile factors significantly decrease after ____ of storage

A

2 days

139
Q

Labile factors that decreases after 2 days of storage

A

FV, FVIII

140
Q

Whole blood shelf life in CPD, ACD, CP2D

A

21 days (3 weeks)

141
Q

Whole blood shelf life in CDPAS1, AS3, AS5

A

42 DAYS

142
Q

Most commonly used additive in whole blood

A

CPDA1

143
Q

PLASMA PRODUCTS: (FFCS)

A

Fresh Frozen Plasma (FFP)
Frozen Plasma (FP)
Cryoprecipitate
Stored Plasma

144
Q

Platelet Products (2)

A

Platelet Rich Plasma (PRP)

Platelet Concentrates (PC)

145
Q

Oxygen Carrying Component Products (3)

A

Red cell concentrates

Leukocyte-poor red blood cells

Frozen-thawed red cells

146
Q

Whole blood collected should be processed at _____

A

6 to 8 hours

147
Q

ACD anticoagulant processing time:

A

6 hours

148
Q

CPDA-1, CPD, CP2D processing period:

A

8 hours

149
Q

Decreased coagulation factors in cryosupernate:

A

FI (fibrinogen)
FVIIIc
FXIII
vWF
fibronectin

150
Q

Present factors in Cryoprecipitate:

A

FI (fibrinogen)
FVIIIc
FXIII (fibrin clot stabilizing factor)
vWF
Fibronectin

151
Q

Fresh frozen plasma is transferred at ref temp for thawing __________ component

A

cryoprecipitate

152
Q

Platelet agitation is done to _________

A

prevent aggregation

153
Q

Hard/Heavy Spin is done to obtain:

A

Platelet Poor Plasma (Upper portion)

Platelet concentrate (lower portion)

154
Q

Soft Spin to whole blood:

A

PRBC
Platelet rich plasma

155
Q

Frozen component transport:

A

Transported with dry ice

156
Q

RBC components transport:

A

Wet ice

157
Q

Platelet and WBC components transport

A

Without ice

158
Q

Storage for:

Platelet concentrate with continuous agitation

WBC or granulocyte concentrate

A

Room temperature (20-24 deg C)

159
Q

Components stored at Freezer temperature (-20 deg C or colder)

A

Plasma containing components:

Fresh Frozen Plasma

Cryoprecipitate

Frozen Red Blood Cell

160
Q

Storage temperature for Red Blood Cell Components:

Whole blood
PRBC
Washed Red blood cell
Liquid plasma

A

Refrigerator temperature (1.5 deg C to 5.5 deg C)

161
Q

Blood Bank Refrigerator is maintained at _____

A

1-6 deg C

162
Q

Blood Bank Refrigerator quality control: maintain the temperature at

A

+/- 0.5 deg C

163
Q

Used for cleaning site for blood donation:

A

PVP iodine complex

164
Q

PVP iodine complex should cover ______ of the site

A

4 cm

165
Q

PVP apply in all direction for ____ seconds

A

30

166
Q

Alternative to iodine:

A

chlorhexidine gluconate solution

167
Q

alternative to iodine and chlorhexidine gluconate solution:

A

70% isopropyl alcohol

168
Q

Velcro application to the site:

A

3 to 4 inches above the site

169
Q

Needle gauge for blood collection

A

16 gauge

170
Q

Amount of blood collected during blood donation:

A

450 to 500 mL

171
Q

Blood donation average time of collecting blood

A

10 minutes

172
Q

Patient with clotted blood unit during blood connection, the ff blood units are not allowed:

A

Plasma component

Platelet component

173
Q

Soft spin time and RPM

A

3000 rpm at 2 to 3 minutes

174
Q

Soft spin is performed on

A

whole blood

175
Q

Soft spin is performed to obtain

A

Platelet Rich Plasma (PRP)

Packed Red Blood cell components

176
Q

Hard spin time and RPM

A

Time and RPM: 3500-3600 RPM for 5 minutes

177
Q

Hard spin is performed on:

A

Platelet Rich Plasma (PRP)

178
Q

Hard Spin is done to obtain

A

Platelet Poor Plasma

Platelet Concentrate

179
Q

Most common cause of death associated with transfusion

A

Transfusion-related acute lung injury (TRALI)

Transfusion-associated circulatory overload (TACO)

Transmission-transmitted bacterial infections (TTBIs)

180
Q

“the collection of information on the complications of transfusion, analysis of these data, and subsequent data-driven improvements in transfusion practices.”

A

Hemovigilance

181
Q

The development of non-ABO anti - bodies following RBC transfusion, pregnancy, or transplantation.

A

Alloimmunization

182
Q

Healthy blood donors have an incidence of alloimmunization of ____

A

less than 3 %

183
Q

30% or greater alloimmunization is seen in chronically transfused patients with: SMAT

A

Sickle cell disease

Myelodysplastic syndrome

Thalassemia

Autoimmune hemolytic disease

184
Q

Accelerated destruction of transfused RBCs due to antibody-mediated incompatibility.

A

Acute Hemolytic Transfusion Reaction (AHTR)

185
Q

Most common symptom in AHTR and often occurs with chills or rigors

A

Fever

186
Q

Acute kidney injury is usually detected biochemically by elevated

A

Bood urea nitrogen (BUN)

187
Q

Main causes of renal dysfunction after hemolysis

A

Shock and Disseminated intravascular coagulation (DIC)

188
Q

A positive DAT 24 hours to 28 days after transfusion with either a positive eluate or a newly identified alloantibody in the plasma or serum and evidence of hemolysis

A

Delayed Hemolytic and Serologic Transfusion Reaction (DHTR)

189
Q

Defined as the same serologic findings as DHTR but without evidence of hemolysis

A

Delayed serologic transfusion reaction (DSTR)

190
Q

DHTR appears ______ post transfusion

A

7-10 days

191
Q

Rare event associated with acute respiratory distress but a leading cause of mortality due to adverse reactions to transfusion

A

Transfusion-Related Acute Lung Injury (TRALI)

192
Q

Second most common cause of transfusion related deaths

A

Transfusion-Associated Circulatory Overload (TACO)

193
Q

Diagnosed when dyspnea occurs within 24 hours after transfusion and all other diagnoses are excluded

A

Transfusion-Associated Dyspnea (TAD)

194
Q

A nonspecific sign that could be seen in a variety of other transfusion reactions or as part of the patient’s underlying condition

A

Hypotensive Transfusion Reaction

195
Q

One of the most common adverse transfusion reactions

defined as fever greater than 100.4°F (38°C) or a change of at least 1.8°F (1.0°C) from the pretransfusion level occurring during or within 4 hours after the end of the transfusion or chills and/or rigors are present

A

Febrile Nonhemolytic Transfusion Reaction (FNHTR)

196
Q

Mimic more serious and severe transfusion reactions, such as, AHTR, TRALI, TACO, and transfusion-transmitted bacterial infection.

A

Febrile Nonhemolytic Transfusion Reaction (FNHTR)

197
Q

Most common reactions seen with platelet and plasma transfusions, occurring in about 2% of transfused platelets, and are second to FNHTRs in RBC transfusions

A

Allergic Transfusion Reactions (ATRs)

198
Q

Are generally mild to moderate reactions and refer to signs and symptoms limited to the skin and gastrointestinal tract

A

Allergic reactions

199
Q

Moderately severe reactions that include oral and throat symptoms, more severe GI symptoms, and respiratory complaints

A

Anaphylactoid reactions

200
Q

Severe, life-threatening reactions in which there is profound hypotension and shock.

A

Anaphylactic reactions

201
Q

It i used for managing mild cutaneous reactions

A

Diphenhydramine

202
Q

Associated with severe hypotensive reactions in patients receiving ACE inhibitors

A

Albumin

203
Q

A rare but devastating event with a very high mortality rate compared to other transfusion reactions

A

Transfusion-Associated Graft-Versus-Host Disease

204
Q

A rare transfusion reaction in which there is a severe and sudden drop in the platelet count, usually occurring 5 to 10 days after transfusion due to alloimmunization to platelet-specific antibodies from prior transfusion or pregnancy

A

Post transfusion Purpura

205
Q

Most frequent infection associated with transfusion

A

Transfusion-Transmitted Bacterial Infections (TTBI)