Blood Bank Exam 3 Flashcards
Terminology:
Blood unit collected as donation for someone other than the donor
Allogeneic or Homologous
Terminology:
Blood collected and labeled for a specific patient
Directed blood collection
Terminology:
Collection of blood for self use
Autologous
Terminology:
Only a specific group of cells are collected (platelets, granulocytes, stem cells)
Cytopheresis or Apheresis
Preferred method for platelet collection
Apheresis/Cytopheresis
Minimum donor weight
110 lbs
Maximum removal for donation from 110 lbs (minimum weight)
525 mL
What is the calculation to determine how much blood can be donated for someone weighing less than 110 lbs?
(donor’s weight x 450) / 110
A unit of whole blood contains how many mLs?
450 mL +/- 45 mL
If a donor weighs 100 pounds, what is the allowable amount?
(100 x 450) / 110 = 409 mL
How much anticoagulant is in each unit?
63 mL
What is the calculation to determine the amount of anticoagulant a unit needs?
(allowable amount of blood x 14) / 100
How much anticoagulant would be needed for a 400 mL draw? How much would anticoagulant would need to be removed from the unit?
(400 x 14) / 100 = 56 mL anticoagulant needed.
63 - 56 = 7 mL needs to be removed from the unit
Physical examination:
Temperature cannot exceed _____
99.5F (37.5C)
Physical examination:
Pulse between __ and ____ beats/minute
50 - 100 beat/minute
Physical examination:
Systolic blood pressure
90 - 180 mm Hg
Physical examination:
Diastolic blood pressure
50 - 100 mm Hg
Physical examination:
Females hemoglobin
12.5 g/dL
Physical examination:
Females hematocrit
> 38%
Physical examination:
Males hemoglobin
13 g/dL
Physical examination:
Males hematocrit
> 39%
Physical examination:
Minimum weight
110 lb
Where is it required to be at least 17 years old to donate? (4)
-Delaware
-Connecticut
-District of Columbia
-Florida
How often can you donate whole blood?
Every 56 days (8 weeks)
How often can you donate through apheresis?
After 48 hours
Terminology:
Donor will never be eligible to donate for someone else but they may donate autologous blood
Permanent deferral
Terminology:
Donor is unable to donate for someone else for an unspecified period of time due to current regulatory requirements
Indefinite deferral
Terminology:
Donor is unable to donate blood for someone else for an unspecified period of time due to current regulatory requirements. Usually due to recent tattoo, piercing, vaccinations, etc.
Temporary deferral
Which medication results in a deferral for 30 days?
Accutane
Which over the counter medication is not ok within 3 days of platelet pheresis?
Aspirin
If a patient has ever had bovine insulin manufactured in the United Kingdom, what would their deferral status be?
Permanent deferral
Length of deferral for tattoo or permanent makeup
3 months (used to be 12 months)
Length of deferral after receiving the MMR vaccine
4 weeks (mumps and measles are 2 weeks but rubella is 4 weeks)
Length of deferral after receiving the Hepatitis B vaccine
28 days
Length of deferral after receiving Hepatitis B immunoglobulin
12 months
0.7% aqueous scrub solution and what else are the 2 scrub solutions used for collection
10% povidone-iodine
Most common adverse donor reaction
Vasovagal
Terminology:
Tingling of lips during apheresis due to citrate
Paresthesia
How is paresthesia treated?
Tums to replace calcium
TRUE or FALSE:
Weak D testing is not a requirement for donor unit processing
FALSE - it prevents a weak D positive unit from being labeled as Rh negative
Which comes first: Hard spin or soft spin?
Soft spin
What does a soft spin centrifuge accomplish?
Separates platelet rich plasma from red cells
What is the hard spin centrifuge performed on? What’s the end result?
Hard spin is performed on the platelet rich plasma and results in platelet poor plasma that is frozen for FFP and platelets
How long is the soft spin and what RPM?
2800 RPM for 3 minutes
How long is the hard spin and what RPM?
3800 RPM for 6 minutes
TRUE or FALSE:
When a hospital receives a donor unit, they must repeat the ABO and Rh
TRUE
These decrease as red cells are stored (4)
-Glucose
-ATP
-pH
-2,3-DPG
These increase as red cells are stored
-Lactic acid
-plasma hemoglobin
-plasma potassium
What causes an increase in plasma hemoglobin and plasma potassium as red cells are stored?
Cell lysis
All of the current anticoagulants can maintain 2,3-DPG for how long?
1 week
What is the expiration for blood products with CPD or CP2D?
21 days
What is the expiration of blood products with CPDA?
35 days
Why does CPDA extend blood product expiration from 21 days to 35 when compared to CPD/CP2D?
Adenine nucleotide pool increases synthesis of ATP
CPD and CP2D stand for?
Citrate-Phosphate-Dextrose
and Citrate-Phosphate-2-Dextrose
CPDA stands for
Citrate-Phosphate-Dextrose-Adenine
What is in ADSOL/AS-1/AS-3/AS-5?
Saline, adenine, glucose and mannitol coupled with citrate-phosphate-dextrose
What is the shelf life of Adsol?
42 days
AS-1 is not recommended for which patient population?
Pediatric
Additives such as AS-1 or AS-5 must be added within how many hours of the whole blood collection?
72 hours
At what temperature are red cell products stored?
1-6C
Whole blood with CPD or CP2D will have what expiration?
21 days
Whole blood with CPDA-1 will have what expiration?
35 days
RBCs with CPD or CP2D will have what expiration?
21 days
RBCs with CPDA-1 will have what expiration?
35 days
RBCs with AS-1, AS-3, or AS-5 will have what expiration?
42 days
Frozen RBCs are stored at what temperature?
Less than or equal to -65C
Frozen RBCs have what expiration?
10 years
Deglycerized or washed RBCs have what expiration?
24 hours
Irradiated RBCs have what expiration?
28 days from irradiation or original outdate - whichever is first
Plasma frozen within 24 hours (PF24) is stored at what temperature?
Less than or equal to -18C
Plasma frozen within 24 hours has what expiration?
1 year
Fresh frozen plasma (FFP) can be stored at which 2 temperatures?
Less than or equal to -18C
OR
Less than or equal to -65C
If FFP is stored at or below -18C, what is the expiration?
1 year
If FFP is stored at or below -65C, what is the expiration?
7 years
FFP or PF24 thawed is stored at what temperature?
1-6C
FFP or PF24 thawed has what expiration?
24 hours
What temperature is thawed plasma kept at?
1-6C
Thawed plasma has what expiration?
5 days from thawing
TRUE or FALSE:
Thawed plasma is NOT an FDA licensed product
TRUE
What temperature is cryoprecipitate AHF kept at?
Less than or equal to -18C
What is the expiration for cryoprecipitate AHF?
1 year
Pooled cryoprecipitate is kept at what temperature?
20-24C
What is the expiration for pooled cryoprecipitate?
4 hours
Platelets are kept at what temperature?
20-24C
Platelets have what expiration?
5 days
Pooled platelets are kept at what temperature?
20 -24C
Pooled platelets have what expiration?
4 hours
Leukoreduced apheresis platelets are kept at what temperature?
20-24C
Leukoreduced apheresis platelets have what expiration?
5 days
Apheresis granulocytes are kept at what temperature?
20-24C
What is the expiration for apheresis granulocytes?
24 hours
What is the volume collected for whole blood?
500 mL
What does whole blood contain?
-RBCs
-Plasma
-Platelets
-WBCs
What should the hematocrit of a whole blood unit be?
36-40%
Whole blood should increase hemoglobin by ___ gm/dL and hematocrit by ___%
Hemoglobin: 1 mg/dL
Hematocrit: 3%
Packed Red Cells & what anticoagulant/preservative:
250 mL with hematocrit of 75%
CPDA-1
Packed Red Cells & what anticoagulant/preservative:
330 mL with hematocrit of 55%
ADSOL
TRUE or FALSE:
Packed red cells contain no viable platelets, granulocytes, or coagulation factors.
TRUE
What diseases are blood product units tested for? (8)
-HIV-1&2
-HBsAg
-HBcAb
-HCV
-HTLV I/II
-p24 Ag
Syphilis
-West Nile virus
4 ways that red cells are modified for specific patient requirements
-Washed
-Leukoreduced
-Irradiated
-Frozen and deglycerized
What occurs in leukoreduced red cell preparation?
99.99% of WBCs are removed through filtration
What percentage of red cells must remain after filtration for leukoreduced red cells?
85%
The following are uses of which type of modified red cell product?:
-Prevent febrile reactions due to HLA antibodies
-Decrease alloimmunization to HLA antigens in those who will need a large number of transfusions
-Decrease likelihood of CMV infection in susceptible patients
Leukoreduced
Which red cell product does not prevent transfusion-associated Graft vs. Host disease?
Leukocyte-reduced RBCs
Why do leukoreduced RBCs not prevent transfusion-associated GVHD?
Normal mature lymphocytes are too small
Acceptable donor cells for a patient with type A blood
A or O
Acceptable donor cells for a patient with type B blood
B or O
Acceptable donor cells for a patient with type AB blood
AB, A, B, or O
Acceptable donor cells for a patient with type O blood
O
Universal red cell donor blood type
Type O
Universal red cell recipient blood type
Type AB
Acceptable plasma type for a patient with type A blood
A or AB
Acceptable plasma type for a patient with type B blood
B or AB
Acceptable plasma type for a patient with type AB blood
AB
Acceptable plasma type for a patient with type O blood
O, A, B, or AB
Universal plasma donor type
AB
Which red cell donation type removes some of the WBCs but is not as efficiently as filters
Washed red cells
Which red blood cell product is used mostly when we want to remove all of the plasma?
Washed red cells
Which red cell product is used for IgA deficient patients and for patients with paroxysmal nocturnal hemoglobinuria (PNH) to remove plasma and complement?
Washed red cells
Which modified red cell product prevents transfusion associated Graft vs Host Disease?
Irradiated red cells
What type of irradiation is used to prevent proliferation of T cells in irradiated blood?:
-Alpha
-Gamma
-Beta
-Gamma (cesium or cobalt radio isotopes, UV-A or x-ray)
Which modified red blood cell product is used for the following:
-transfusions from first degree blood relative
-bone marrow transplants
-intrauterine transfusions
-preemies
-severe immunocompromised/deficient patients
Irradiated red cells
Which modified red cell product is required for the following:
-seronegative preemies
-intrauterine transfusions
-bone marrow transplants
-HIV
-solid organ transplant and other severely immunosuppressed patients?
CMV Negative blood
This modified red cell product provides extended storage for rare blood cells or autologous blood
Frozen/Deglycerolized red cells
TRUE or FALSE:
If red cells are not properly deglycerolized, the glycerol can cause intravascular hemolysis if transfused.
TRUE
What gauge needle should be used for transfusion?
18 gauge
Transfusion should be limited to a max of how many hours?
4 hours
Random platelets must have how many platelets per unit?
At least 5.5 x 10^10 platelets/unit
To achieve a therapeutic dose, a patient usually needs how many units of random platelets?
6-10 units
What are random platelets used for?
Bleeding due to thrombocytopenia or platelet function defect
A patient should receive a platelet transfusion when their count is how low?
10,000-20,000/uL
Random platelet transfusions will usually increase the platelet count by how much?
30,000-60,000/uL
What is platelet apheresis also known as?
Single-donor platelets (SDP)
What volume is usually collected for platelet apheresis?
300 mL
TRUE or FALSE:
Platelet products are kept at 20-24C and must be agitated
TRUE
What blood product:
-Comes from a single donor
-Contains leukocytes, platelets, and some 20-50 mL RBCs
-Kept between 20-24C without agitation
-Has an expiration period of 24 hours
Graunulocytes, apheresis
What blood product:
-Given to patients with severe infections and severe neutropenia
-Used mostly for neonates
-Severe infections (sepsis) that is unresponsive to antibiotics
Apheresis granulocytes
Fresh frozen plasma contains all coagulation factor including Factor V and Factor VIII when frozen within what timeframe from collection?
Within 8 hours
When plasma is frozen within 24 hours, what factors are reduced? Why?
Factor V and Factor VIII because they are labile
The following are uses for which blood product?:
-Coagulation disorders (liver disease/factor deficiencies)
-Abnormal coagulation assays resulting from massive transfusion
-Replacement therapy for TTP and HUS
-DIC
Fresh frozen plasma (FFP)
Cryoprecipitate contains what concentrated factors? (4)
-Fibrinogen (Factor I)
-Factor VIII
-Factor XIII
-Von Willebrand Factor
The following are quality controls for which blood product?:
- >150 mg of fibrinogen
- 80 IU of Factor VIII
Cryoprecipitate AHG
