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Blood Bank Exam 6 Flashcards

1
Q

What is the purpose of transfusion therapy?

A

To alleviate patient sign/symptoms associated with bleeding, anemia, and hypoxia

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2
Q

Erythrocytapheresis

A

Removal of RBC

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3
Q

Leukocytapheresis

A

Removal of WBC

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4
Q

Thrombocytapheresis

A

Removal of platelets

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5
Q

Plamapheresis

A

Removal of plasma

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6
Q

How does apheresis work?

A

Removing blood components to take the portion of blood that we need (separate by centrifugation), and then putting the rest back into the donor

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7
Q

If you donate double RBC by apheresis, how long must you wait until you can donate again?

A

16 weeks (single would be 8 weeks)

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8
Q

If you donate plasma (frequent) by apheresis, how long must you wait until you can donate again?

A

2 days. No more than two times in 7 days

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9
Q

If you donate plasma (infrequent) by apheresis, how long must you wait until you can donate again?

A

4 weeks (no more than 13 times/year)

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10
Q

If you donate a single apheresis unit of platelets, how long must you wait until you can donate again?

A

2 days (no more than 2 times in 7 days and no more than 24 times in 1 year)

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11
Q

If you donate a double/triple apheresis unit of platelets, how long must you wait until you can donate again?

A

7 days

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12
Q

If you donate granulocytes, how long must you wait until you can donate again?

A

2 days

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13
Q

What is photopheresis?

A

Utilizes leukapheresis to collect the buffy coat layer from whole blood, cells are treated to UV light to kill DNA to limit WBC response in GvHD

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14
Q

Describe an intermittent apheresis machine. Name a disadvantage.

A

Uses a single venipuncture to collect quantity of blood and the pump is reversed to return all components not needed. Disadvantage: amount of blood leaving the body is greater than continuous flow apheresis.

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15
Q

Describe a continuous flow apheresis machine.

A

Uses 2 venipunctures - blood is drawn from one puncture site and returned components are sent back through second site

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16
Q

Name a few indications for therapeutic apheresis

A

Waldenstrom’s macroglobulinemia
Multiple myeloma
Sickle cell disease
Myasthenia gravis
Guillain barre
TTP

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17
Q

What are the advantages of frozen RBCs?

A

Able to preserve rare allogeneic or autologous blood and it has a long shelf life (10 years!)

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18
Q

What is the method of preservation for cryopreservation?

A

Glycerol (high or low concentration with differences)

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19
Q

Name some key differences between using low-concentration glycerol and high-concentration glycerol for cryopreservation.

A

Low concentration glycerol:
- much lower freezing temp (-196C)
- rapid freezing rate
- liquid nitrogen for freezing and shipping
- freezing rate controlled
- stored at much lower temp (-120C)
- critical if storage temp is changed
- no deglycerolizing equipment

High concentration glycerol:
- higher freezing temp (-80C)
- slow freezing rate
- mechanical freezer and dry ice for shipping
- freezing rate not controlled
- higher storage temp (-65C)
- can be thawed and refrozen if storage temp changes
- can use deglycerolizing equipment

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20
Q

What is the difference in storage requirements for deglycerolized RBCs in a closed system vs an open system?

A

Closed system: 1-6C for 14 days
Open system: 1-6C for 24 hours

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21
Q

What is the time requirements for a blood transfusion when a blood product is issued?

A

Must be transfused in <4 hours

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22
Q

When delivering whole blood, what is the mode of action and the special considerations?

A

Increases O2 carrying capacity and blood volume. MUST BE ABO IDENTICAL

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23
Q

When delivering RBC, what is the mode of action and the special considerations?

A

Increases O2 carrying capacity. MUST BE ABO COMPATIBLE

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24
Q

When delivering deglycerolized RBC, what is the mode of action/benefit of using this, and what is the special considerations?

A

Deglycerolization removes plasma proteins and reduces the risk of allergic/febrile reactions (IgA deficiency patients) MUST BE ABO COMPATIBLE

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25
When delivering leukocyte reduced RBC, what are the special considerations? Why are RBC leukocyte reduced?
LR RBCs must have a residual content of leukocytes <5 x 10^6 and >85% of the original RBC content. LR reduces transmission of CMV
26
What are the special considerations when delivering random donor platelets?
One unit of RDP derived from whole blood usually contains >5.5 x 10^10 platelets suspended in 40-70 mL of plasma
27
What are the special considerations when delivering single donor platelets (apheresis)?
One unit of apheresis platelets usually contains >3 x 10^11 platelets/unit and is the therapeutic equivalent of 4-6 units of platelets.
28
What are the special considerations when delivering liquid plasma?
Must be ABO compatible
29
What is the difference between FFP and PF24?
FFP is fresh frozen plasma (frozen within 8 hours) and PF24 is plasma frozen within 24 hours
30
What is the difference between a temporary, indefinite, and permanent deferral from donating blood?
Temporary: unable to donate blood for limited period of time (ex. tattoos) Indefinite: unable to donate blood for an unspecified period of time based off current regulation (ex. anyone living in england >1 yera in 1989 due to CJD exposure) Permanent: donor will never be able to donate blood again (ex. Hep C patients)
31
T/F: Indefinite and permanent deferrals may donate autologous blood only.
True
32
How long must you wait to donate again for a single donation? Double donation?
Single donation: 8 weeks or 56 days Double donation: 16 weeks
33
How long must you wait to donate again when you donate plasma, platelets, or leukocytes?
48 hours (2 days)
34
When are pregnant females deferred from giving blood and for how long?
They are deferred for 6 weeks after the end of the pregnancy. If they were transfused during the pregnancy, they are deferred for 12 months
35
If you are on aspirin, what can't you donate?
Platelets
36
If you are on coumadin, how long must you wait to donate blood once you get off the drug?
7 days
37
What are the regulations for donating blood after you are vaccinated?
- No deferral if asymptomatic - 4 week deferral for live, attenuated vaccines (MMR vaccine, polio, typhoid, Rubeola, chicken pox) - 12 month deferral for unlicensed vaccines and rabies - 2 week deferral for measles/rubeola by itself (not MMR vaccine)
38
What are some examples of indefinite deferrals for donating blood?
History of viral hepatitis after 11th birthday Confirmed positive for HBsAg Repeatedly reactive test for HBc History of HCV, HTLV, and/or HIV Evidence of IV drug use History of Babesiosis or Chagas disease Had CJD
39
What are some of the "12 month deferrals" for donating blood?
- Contaminated needle stick - tattoos and/or piercings (changed to 3 mo now) - sexual contact or lived with anyone confirmed positive for hep B - sexual contact/close contact with HCV pos person - if incarcerated in a correctional institution - history of syphilis or gonorrhea and treated - if traveled to malarial endemic area (12 months begin after departure)
40
What are the hemoglobin and hematocrit requirements for a person wanting to donate blood?
Hemoglobin: must be greater than 12.5 g/dl Hematocrit: must be greater than 38%
41
What are the hemoglobin and hematocrit requirements for autologous units of blood?
Hemoglobin: must be greater than 11 g/dL Hematocrit: must be greater than 33%
42
What are the blood pressure requirements for a person wanting to donate blood?
<180 systolic and <100 diastolic
43
What is the age requirement to donate blood?
>17 or 16 w/ parent consent
44
What is the weight requirement to donate blood?
> 110 pounds
45
What are director donor units?
Donors wanting to donate blood for a specific person; may be put into blood supply if not given to that specified patient
46
What are autologous units?
Donor wanting to donate specifically for themselves at a later time; unable to enter normal blood supply because it is a less quality product
47
Are they are deferred: Someone who has gotten the TDAP and influenza vaccine and are symptom free
No
48
Are they are deferred: someone who donated pRBCs last week
Yes; 8 weeks
49
Are they are deferred: A woman on birth control
No
50
Are they are deferred: A woman who is pregnant
Yes - 6 weeks after birth
51
Are they are deferred: A woman who gave birth 8 weeks ago
No
52
Are they are deferred: someone who has gotten the covid19 vaccine
Only if unlicensed - 12 months (now licensed, so no)
53
Are they are deferred: someone who has gotten the MMR vaccine
yes, 4 weeks
54
What size needle is used to collect blood? What is the normal time of collection? What is used to prep the site of injection?
16 gauge needle, usually 5-8 minutes, and provodone-iodine solution is used
55
Treatment for short term syncope during blood donation
Recline donor chair and elevate donor legs
56
What is the pulse requirement to donate blood?
50-100 bpm
57
What is the temperature requirement to donate blood?
<37.5C or <99.5F
58
What is the deferment for malaria?
12 months after departure from country
59
What is the deferment for babesia, HIV, and CJD?
Indefinite (unable to donate blood for unspecified amount of time)
60
What is the deferment for Hepatitis?
To be continued....
61
What is the deferment for IV drug use?
12 months after stop usage
62
What is the deferment for transfusions?
12 months after transfusion
63
What is the autologous blood donation criteria compared to allogenic?
To donate blood to yourself there is no age limit or weight requirement, you can donate if you are pregnant, HGB and HCT are lower, and it is overall a less quality product since it is for yourself.
64
T/F: during the antibody screening process of donor blood, if there is a significant antibody found, plasma and platelets cannot be used, but RBCs can be.
TRUE
65
Indirect vs Sandwich EIA
Indirect detects antibodies Sandwich detects antigens
66
Formula to calculate sensitivity
TP/TP + FN x 100
67
Formula to calculate specificity
TN/TN + FP x 100
68
Hep B vs Hep C
Hep B and Hep C are both transmitted sexually, perinatally, and parenterally. Hep B is DNA virus and Hep C is RNA virus.
69
How much will whole blood donation raise the HCT and the HGB?
Will raise HCT 3-5% Will raise HGB 1-1.5 g/dL
70
How are RBC components prepped and stored?
Prepped by centrifugation to separate from plasma. Stored at 1-6C
71
How are Washed RBC prepped and stored?
Red cells washed with saline to remove almost all plasma; Stored at 1-6C
72
What is the purpose of LR?
To reduce TRALI and febrile reactions
73
What is the irradiation dose?
25 Gy to the center of unit and 15 Gy to any other part of the unit
74
How does irradiation change the expiration date of RBCs?
Unit expires 28 days after time of irradiation or the original expiration, whichever date occurs first
75
How is FFP prepared and stored? When do they expire?
Separated from RBCs within 8 hours of collection through centrifugation; frozen and stored at <-18C. Expiration is 12 months from collection date and once thawed expiration date is 24 hours when stored at 1-6C
76
Why would you transfuse FFP?
Replacement of multiple coag factors; DIC or liver disease
77
What is FFP that has reached its 1 year expiration date?
It is just re-labeled as "Frozen plasma"
78
What is the expiration date of PF24 after thawing?
5 days
79
What is cryoprecipitate/how is it prepped and stored?
The cold insoluble portion of plasma remaining after FFP has been slowly thawed that contains lots of coag factors; centrifuge to separate and freeze quickly at -18C or less. Expiration is 12 months and after thawing it is stored at room temp and expires in 6 hours
80
What patients is cryoprecipitate AHF given to?
Patients with factor XIII deficiency, FBG deficiency, vWD, DIC (pts with primary hemostatic disease)
81
What is the "quality control" of cryo?
Must have a minimum of 80 IU of factor VIII and 150mg of fibrinogen
82
Soft spin vs hard spin
Soft spin: separates RBC from plasma Hard spin: separates WBCs and PLTs from plasma
83
Function of dextrose as a RBC preservative
Supports ATP generation
84
Function of adenine as a RBC preservative
Substrate for ATP synthesis
85
Function of citrate as a RBC preservative
Chelates calcium and prevents clotting
86
Function of monobasic sodium phosphate as a RBC preservative
buffers pH and stabilizes 2,3 BPG
87
Function of mannitol as a RBC preservative
stabilizes the RBC membrane and reduces hemolysis
88
What components are in the preservative CPD and what is the expiration date?
Citrate, Phosphate, and Dextrose Expiration date 21 days
89
What components are in the preservative CPDA and what is the expiration date?
Citrate, Phosphate, Dextrose, Adenine Expiration date is 35 days due to adenine being added
90
What components are in the preservative AS? What is the expiration date?
Saline, Dextrose, Citric acid, Adenine Extends expiration up to 42 days at 1-6C and lowers blood viscosity
91
What is storage lesion?
Biochemical changes that occur during the storage of red cell products. They are not as good as they would be "fresh".
92
What does storage lesion affect?
pH, 2,3-DPG, ATP, Na, K
93
What "Shift" occurs during storage lesion?
Left shift
94
What components of RBC are increased during storage lesion?
Hemolysis, Potassium, Plasma hemoglobin, Lactic acid, Ammonia
95
What components of RBC are decreased during storage lesion?
pH, ATP, 2,3-DPG, Plasma glucose
96
What is the temp RBCs are stored at in the blood bank? What is the temp they are shipped in? What are they shipped in?
1-6C in blood bank 1-10C shipping Shipped on wet ice
97
How is FFP/Cryo shipped?
Dry ice
98
What temp are platelets/granulocytes stored in BB and shipped?
Room temp 20-24C

Blood Bank (7 decks)

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