Blood Bank Flashcards
Donor reactions-
Vasovagal reaction
Bradycardia with hypotension, syncope, incontinence
Donor Reactions-
Hypovolemic shock
Tachycardia, hypotension, syncope, shock
Donor reactions-
Hyperventilation
common in children’s and first timers. Shortness of breath, twitching
Platelet donation time restrictions in donation
2-2-24.
At least 2 days between donations, no more then 2 donations per week, no more then 24 donations per year
Weeks needed between whole blood donations?
Weeks needed between double whole blood donations?
8 weeks
16 weeks
Needed Hgb and Hct for allogenic donors (donating to others)?
Needed Hgb and Hct for autogenic donors (donating to self)?
12.5/38%
11/33%
infection risk for HIV in blood products?
HCV?
HBV?
1 in 1.5 million
1 in 1 million
1 in 350,000
Donation deferral for 1-time anti-HBc (HepB core)?
Donation deferral for 2-time anti-HBc (HepB core)?
Donation deferral for confirmed HBsAG antigen?
None
indefinite
permanent
Deferral for Hep C +Anti-HCV (unconfirmed)?
Deferral for Hep C +Anti-HCV (confirmed)?
Deferral for Hep C +NAT only?
indefinite, may try again in 6 months
Permanent
indefinite, may try again in 6 months
Deferral for HIV +Anti-HIV (unconfirmed)?
Deferral for HIV +Anti-HIV (confirmed)?
Deferral for HIV +NAT only?
indefinite, may try again in 8 weeks
Permanent
indefinite, may try again in 8 weeks
Name the three blood preservatives that provide 21 day storage?
Name the one preservative that provides 35 days storage?
ACD, CPD, CP2D
CPDA-1
What preservative provides storage for 42 days for blood?
Adenine Saline, an “additive solution”. Several different types, AS-1, AS-3, AS-5, AS-7
How many platelets should be contained in one dose of random (whole blood) platelets?
The pH should be at least what for platelets?
> or = 5.5 x 10^10
pH > or = 6.2
How many platelets should be contained in one dose of apheresis platelets?
The pH should be at least what?
> or = 3.0 x 10^11 (more then the whole blood or “random” platelets
pH > or = 6.2
Name the 4 counterindications/disease conditions to platelet transfusion?
TTP (Have large multimers of vWF that can bind with platelets and form more thrombi)
HIT (Increases risk of thrombosis)
ITP (platelet count doesn’t increase)
Post Transfusion Purpura (Antibody vs platelets, most transfused platelets have an antigen that can get attacked)
What amount do you typically give a neonate of platelets, rbcs, etc….?
10-15 cc (mL/Kg)
What is the maximum number of leukocytes that should be in leuko reduced apheresis platelets, RBCs, etc. ..?
How about in a unit of whole blood derived platelets?
5 million (5 X 10^6)
830,000 (8.3 X 10^5) Since it takes 6 doses of whole blood derived platelets to equal one dose of apheresis platelets, this number is just 5 million divided by 6
What is the radiation dose for a bag of red cells?
At least 2500 cGy to the center of the bag, at least 1500 cGy to the periphery of the bag
Name 5 indications for FFP?
Bleeding patients with a coagulopathy
Bleeding patients on warfarin
Trauma (1:1 with pRBCs)
Dilutional coagulopathy (Giving a patient a bunch of fluids)
TTP/HUS
What is the problem with giving FFP to reverse Heparin?
It infuses Antithrombin which potentiates heparin!
What is the coagulation factor that has the shortness halflife in the body? (In vivo)
Factor 7
What are the factors that decreased the most rapidly in a bag of plasma?
Factor 5 and 8, especially 8
What is the main indication of cryo reduced plasma? (The stuff left over after cryo)
For replenishment of ADAMTS13 in TTP
Name the 4 important components of cryo?
Factor 8, factor 13, vWF, and fibrinogen
Every unit of cryo has to have at least ___ mg of fibrinogen and ____ IUs of factor 8
150
80
DDAVP causes release of ____ from the endothelial cells.
vWF
What are the two main uses for NovoSeven?
Hemophilia A and B
Congenital factor VII deficiency
Granulocytes must be typed and crossmatched because……..
It is hard to seperate the RBCs from WBCs completely as they have similar densities, therefore you should get some RBCs with each bag
Should Granulocyte products be irradiated? Why or why not?
Yes, because they may contain T-lymphs that can cause GVHD. The radiation kills these cells but NOT the granulocytes.
What is the number one cause of transfusion related mortality reported to the FDA?
TRALI
What are the four acute transfusion reactions presenting with fever?
Acute hemolytic
Febrile non-hemolytic
Transfusion-related Sepsis
TRALI
What are the four acute transfusion reactions typically without fever?
Allergic
Hypotensive
Tx associated dyspnea
TACO
A febrile non-hemolytic transfusion reaction is an increase of temperature by __ C or ___ F. It is caused by ____
1 C, 2 F.
Cytokines
The most common type of bacteria to infect red cells are gram ___ ____, like ____
The most common organisms to infect skin are gram ___ ____ because they come from the ____
gram negative rods like Yersinia
gram positive cocci, skin
What is interesting about the blood pressure readings in TRALI?
It usually goes up, then down
What are the two main theories of TRALI?
Transfused anti-HLA antibodies
Transfused stored blood with breakdown products that activate neutrophils
Either or both of these can stimulate the neutrophils in the lung to activation
What is the most common cause of severe allergic reactions?
Patients with IgA deficiency (rare)
Another is haptoglobin deficiency
What are the three antibodies that typically caused delayed hemolytic transfusion reactions?
What of these antibodies can sometimes fix complement and cause intravascular hemolysis?
Kidd, Duffy, Kell
Kidd
What is the difference between delayed hemolytic and delayed serologic transfusion reactions?
Hemolysis!
What is post transfusion purpura?
What is the pathophysiology?
Treatment?
Is this a contraindication to platelet transfusion?
Severe thrombocytopenia 10 days post transfusion
Someone exposed to a common platelet antigen that they do not have (HPA-1a). Then they make an antibody. When it forms it also starts coating that persons platelets for an unknown reason as an auto antibody.
IVIG
Yes
