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MLS > Blood Bank Exam 3 > Flashcards

Blood Bank Exam 3 Flashcards

1
Q

pRBC unit volume

A

250 mL

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1
Q

Whole Blood unit volume

A

450 mL

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2
Q

HLA Antigens

A

Antigens associated with leukocytes, especially important in transplant patients

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3
Q

Irradiating blood components

A
  • eliminates T cells
  • prevents graft vs. host
  • Directed units from blood relatives
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4
Q

Frozen RBC

A
  • <180 mL
  • must wash to remove glycerol
  • Expires 24 hours after thaw and wash
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5
Q

Washed RBCs

A
  • prevent allergic reaction
  • expires 24 hours after wash
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6
Q

FFP

A
  • 1 year expiration
  • 220 mL
  • Must be ABO compatible
  • does not care about Rh compatibility
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7
Q

Cryo

A
  • “Cryoprecipitate”
  • Concentration of Factors: VIII, I, Vwf, XIII
  • 15 mL
  • Frozen at 18C or lower
  • Expires 6 days after thaw (store at RT)
  • Must be ABO compatible
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8
Q

Factor Concentrates

A
  • handled by pharmacy
  • one factor at a time
  • ABO not an issue
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9
Q

Platelet Concentrates

A
  • 300 mL
  • ABO compatible if possible
  • Avoid Rh pos units given to Rh neg patients
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10
Q

Compatibility Testing sample

A
  • labeling + armband
  • no hemolysis
  • XM sample expires after 72 hours
  • sample kept for 7 days after transfusion
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11
Q

Neonate transfusion requirements

A
  • Low volume (50-80 mL)
  • Fresh (<7 days old, low K+, high 2,3 DPG)
  • prewarmed units
  • CMV negative
  • Irradiated
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12
Q

Donor testing

A
  • infectious diseases
  • ABO/Rh
  • weak D
  • antibody screen (if antibody, not for transfusion)
  • DAT?
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13
Q

Major Crossmatch

A

Patient serum + donor cells

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14
Q

Minor Crossmatch

A

Patient cells + donor serum

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15
Q

Abbreviated Crossmatch

A
  • IS testing only
  • no history or evidence of antibody EVER
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16
Q

Extended Crossmatch

A
  • IS and AHG testing
  • history or evidence of antibody
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17
Q

Computer Crossmatch

A
  • no testing, computer runs an algorithm
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18
Q

If there is an unexpected incompatibility

A

you must investigate!!!

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19
Q

Possible causes of incompatibility

A
  • ABO
  • Autoantibody
  • Alloantibody
  • Positive DAT on donor cells (slipped through collection screening)
  • Rouleaux
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20
Q

Whole Blood compatibility

A

Must meet both RBC and plasma compatibility requirements

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21
Q

How long can blood be returned after it is checked out if not used?

A

30 minutes

22
Q

How many units triggers a massive transfusion protocol?

A

5 units

23
Q

Describe a massive transfusion protocol

A
  • 1 unit FFP per unit pRBCs (catch up if needed)
  • 1 unit platelets and 1 unit cryo every 10 units
24
Q

Name for massive transfusion in neonates

A

Exchange Transfusion

25
Q

Emergency Transfusion allows

A

uncrossmatched O negative pRBCs to be given

26
Q

Who can receive uncrossmatched O positive pRBCs in an emergency?

A

Males and women over 65

27
Q

TACO

A
  • “Transfusion Associated Circulatory Overload”
  • most common in elderly and infants
28
Q

TRALI

A
  • “Transfusion Related Acute Lung Injury”
  • Anti-WBC antibodies
29
Q

PTP

A
  • “Post Transfusion Purpura”
  • platelet allo-antibody
  • depletion of platelets and coag factors
30
Q

Immediate Intravascular Hemolysis

A
  • IgM (via complement), IgG, or ABO mixup
  • anti-A, K, Jka, Fya are most common
    we don’t talk about Bruno nonono
31
Q

Delayed Extravascular Hemolysis

A
  • anamnestic response
  • Rh antibodies, anti-Jka, K, Fya
  • 3-7 days post txn
32
Q

Damage to Transfused Cells

A
  • Heat Damage (blood warmers, storage)
  • Physical Damage (pumps, heart valves, ECMO)
33
Q

What would indicate a “dead” unit on visual inspection?

A

Brown, purple, clotted, or severely hemolyzed

34
Q

Proceed to Extended Evaluation if:

A
  • Discrepancy in Clerical Check
  • Post DAT pos and pre DAT neg or weaker
  • Visual hemolysis in post sample
  • Post serum HGB is 20mg/dL higher than Pre
35
Q

If there are RBCs in the urine with a transfusion reaction

A

it likely is unrelated to the reaction

36
Q

Transfusion Reaction Reporting

A
  • physician
  • blood bank director
  • accrediting agencies
  • (if fatal) FDA
  • (if fatal) Center for Biologic Evaluation & Research
37
Q

If a post-transfusion reaction sample is hemolyzed

A

call for second collection to eliminate possibility of phlebotomist error

38
Q

Febrile Transfusion Reaction

A
  • > 1 degree C rise in temp (fever)
  • anti-WBC antibody (complement activated)
39
Q

Erythroblastosis fetalis

A

neonate with HGB <15 g/dL

40
Q

Kernicterus

A

brain damage from extremely high bilirubin, usually in neonates

41
Q

What types of HDN require antibody titers?

A

Rh and ‘other’

42
Q

Critical antibody titer level

A

1:32

43
Q

How can you tell allo-anti-D from Rhogam on an IAT?

A

You can’t. You need patient history.

44
Q

Rhogam dosage during term

A
  • 50 ug at <12 weeks
  • 300 ug at >= 12 weeks
45
Q

What indicates need for transfusion on the Liley graph?

A

zone 3

46
Q

What in amniotic fluid can indicate severity of HDN?

A

bile pigment, measured with optical density at 450 nm

47
Q

PUB sample testing

A
  • “Percutaneous Umbilical Blood”
  • needle guided with ultrasound, drawn from umbilical vein
48
Q

Fetal Lung Maturity

A

Ratio of Lecithin to Sphingomyelin (L/S Ratio)
- >2.0:1 = mature
- 1.5:1 = 40% chance of respiratory distress
- <1.5:1 = 70% chance of respiratory distress

49
Q

FMH Screen

A
  • “Fetal Maternal Hemorrhage”
  • Positive = >15mL fetal bleed, reflex to KB stain
50
Q

KB Stain

A
  • “Kleihauer Betke”
  • count 4k cells, determine % fetal cells
51
Q

1 vial of Rhogam covers

A

15 mL pRBC or 30 mL WB

52
Q

Rhogam dosage calculation

A

(% fetal cells x 50) / 30
Round Up

MLS (18 decks)

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