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Blood Bank > Blood Bank Exam 6 > Flashcards

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
Q

When delivering leukocyte reduced RBC, what are the special considerations? Why are RBC leukocyte reduced?

A

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

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26
Q

What are the special considerations when delivering random donor platelets?

A

One unit of RDP derived from whole blood usually contains >5.5 x 10^10 platelets suspended in 40-70 mL of plasma

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27
Q

What are the special considerations when delivering single donor platelets (apheresis)?

A

One unit of apheresis platelets usually contains >3 x 10^11 platelets/unit and is the therapeutic equivalent of 4-6 units of platelets.

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28
Q

What are the special considerations when delivering liquid plasma?

A

Must be ABO compatible

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29
Q

What is the difference between FFP and PF24?

A

FFP is fresh frozen plasma (frozen within 8 hours) and PF24 is plasma frozen within 24 hours

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30
Q

What is the difference between a temporary, indefinite, and permanent deferral from donating blood?

A

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)

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31
Q

T/F: Indefinite and permanent deferrals may donate autologous blood only.

A

True

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32
Q

How long must you wait to donate again for a single donation? Double donation?

A

Single donation: 8 weeks or 56 days
Double donation: 16 weeks

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33
Q

How long must you wait to donate again when you donate plasma, platelets, or leukocytes?

A

48 hours (2 days)

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34
Q

When are pregnant females deferred from giving blood and for how long?

A

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

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35
Q

If you are on aspirin, what can’t you donate?

A

Platelets

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36
Q

If you are on coumadin, how long must you wait to donate blood once you get off the drug?

A

7 days

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37
Q

What are the regulations for donating blood after you are vaccinated?

A
  • 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)
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38
Q

What are some examples of indefinite deferrals for donating blood?

A

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

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39
Q

What are some of the “12 month deferrals” for donating blood?

A
  • 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)
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40
Q

What are the hemoglobin and hematocrit requirements for a person wanting to donate blood?

A

Hemoglobin: must be greater than 12.5 g/dl
Hematocrit: must be greater than 38%

41
Q

What are the hemoglobin and hematocrit requirements for autologous units of blood?

A

Hemoglobin: must be greater than 11 g/dL
Hematocrit: must be greater than 33%

42
Q

What are the blood pressure requirements for a person wanting to donate blood?

A

<180 systolic and <100 diastolic

43
Q

What is the age requirement to donate blood?

A

> 17 or 16 w/ parent consent

44
Q

What is the weight requirement to donate blood?

A

> 110 pounds

45
Q

What are director donor units?

A

Donors wanting to donate blood for a specific person; may be put into blood supply if not given to that specified patient

46
Q

What are autologous units?

A

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
Q

Are they are deferred: Someone who has gotten the TDAP and influenza vaccine and are symptom free

A

No

48
Q

Are they are deferred: someone who donated pRBCs last week

A

Yes; 8 weeks

49
Q

Are they are deferred: A woman on birth control

A

No

50
Q

Are they are deferred: A woman who is pregnant

A

Yes - 6 weeks after birth

51
Q

Are they are deferred: A woman who gave birth 8 weeks ago

A

No

52
Q

Are they are deferred: someone who has gotten the covid19 vaccine

A

Only if unlicensed - 12 months (now licensed, so no)

53
Q

Are they are deferred: someone who has gotten the MMR vaccine

A

yes, 4 weeks

54
Q

What size needle is used to collect blood? What is the normal time of collection? What is used to prep the site of injection?

A

16 gauge needle, usually 5-8 minutes, and provodone-iodine solution is used

55
Q

Treatment for short term syncope during blood donation

A

Recline donor chair and elevate donor legs

56
Q

What is the pulse requirement to donate blood?

A

50-100 bpm

57
Q

What is the temperature requirement to donate blood?

A

<37.5C or <99.5F

58
Q

What is the deferment for malaria?

A

12 months after departure from country

59
Q

What is the deferment for babesia, HIV, and CJD?

A

Indefinite (unable to donate blood for unspecified amount of time)

60
Q

What is the deferment for Hepatitis?

A

To be continued….

61
Q

What is the deferment for IV drug use?

A

12 months after stop usage

62
Q

What is the deferment for transfusions?

A

12 months after transfusion

63
Q

What is the autologous blood donation criteria compared to allogenic?

A

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
Q

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.

A

TRUE

65
Q

Indirect vs Sandwich EIA

A

Indirect detects antibodies
Sandwich detects antigens

66
Q

Formula to calculate sensitivity

A

TP/TP + FN x 100

67
Q

Formula to calculate specificity

A

TN/TN + FP x 100

68
Q

Hep B vs Hep C

A

Hep B and Hep C are both transmitted sexually, perinatally, and parenterally. Hep B is DNA virus and Hep C is RNA virus.

69
Q

How much will whole blood donation raise the HCT and the HGB?

A

Will raise HCT 3-5%
Will raise HGB 1-1.5 g/dL

70
Q

How are RBC components prepped and stored?

A

Prepped by centrifugation to separate from plasma. Stored at 1-6C

71
Q

How are Washed RBC prepped and stored?

A

Red cells washed with saline to remove almost all plasma; Stored at 1-6C

72
Q

What is the purpose of LR?

A

To reduce TRALI and febrile reactions

73
Q

What is the irradiation dose?

A

25 Gy to the center of unit and 15 Gy to any other part of the unit

74
Q

How does irradiation change the expiration date of RBCs?

A

Unit expires 28 days after time of irradiation or the original expiration, whichever date occurs first

75
Q

How is FFP prepared and stored? When do they expire?

A

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
Q

Why would you transfuse FFP?

A

Replacement of multiple coag factors; DIC or liver disease

77
Q

What is FFP that has reached its 1 year expiration date?

A

It is just re-labeled as “Frozen plasma”

78
Q

What is the expiration date of PF24 after thawing?

A

5 days

79
Q

What is cryoprecipitate/how is it prepped and stored?

A

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
Q

What patients is cryoprecipitate AHF given to?

A

Patients with factor XIII deficiency, FBG deficiency, vWD, DIC (pts with primary hemostatic disease)

81
Q

What is the “quality control” of cryo?

A

Must have a minimum of 80 IU of factor VIII and 150mg of fibrinogen

82
Q

Soft spin vs hard spin

A

Soft spin: separates RBC from plasma
Hard spin: separates WBCs and PLTs from plasma

83
Q

Function of dextrose as a RBC preservative

A

Supports ATP generation

84
Q

Function of adenine as a RBC preservative

A

Substrate for ATP synthesis

85
Q

Function of citrate as a RBC preservative

A

Chelates calcium and prevents clotting

86
Q

Function of monobasic sodium phosphate as a RBC preservative

A

buffers pH and stabilizes 2,3 BPG

87
Q

Function of mannitol as a RBC preservative

A

stabilizes the RBC membrane and reduces hemolysis

88
Q

What components are in the preservative CPD and what is the expiration date?

A

Citrate, Phosphate, and Dextrose
Expiration date 21 days

89
Q

What components are in the preservative CPDA and what is the expiration date?

A

Citrate, Phosphate, Dextrose, Adenine
Expiration date is 35 days due to adenine being added

90
Q

What components are in the preservative AS? What is the expiration date?

A

Saline, Dextrose, Citric acid, Adenine
Extends expiration up to 42 days at 1-6C and lowers blood viscosity

91
Q

What is storage lesion?

A

Biochemical changes that occur during the storage of red cell products. They are not as good as they would be “fresh”.

92
Q

What does storage lesion affect?

A

pH, 2,3-DPG, ATP, Na, K

93
Q

What “Shift” occurs during storage lesion?

A

Left shift

94
Q

What components of RBC are increased during storage lesion?

A

Hemolysis, Potassium, Plasma hemoglobin, Lactic acid, Ammonia

95
Q

What components of RBC are decreased during storage lesion?

A

pH, ATP, 2,3-DPG, Plasma glucose

96
Q

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?

A

1-6C in blood bank
1-10C shipping
Shipped on wet ice

97
Q

How is FFP/Cryo shipped?

A

Dry ice

98
Q

What temp are platelets/granulocytes stored in BB and shipped?

A

Room temp 20-24C

Blood Bank (7 decks)

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