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Surgical Recall > Blood & Blood Products > Flashcards

Blood & Blood Products Flashcards

1
Q

What is PT?

A

Prothrombin Time:

Tests extrinsic coagulation pathway

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2
Q

What is PTT?

A

Partial Thromboplastin Time:

Tests intrinsic coagulation pathway

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3
Q

What is INR?

A

International Normalized Ratio:

Reports PT results

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4
Q

What are packed RBCs?

A

One unit equals 300 mL.

No platelets or clotting factors, can be mixed with NS to infuse faster.

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5
Q

What is FFP?

A

Fresh Frozen Plasma:

Replaces clotting factors (no RBCs, WBCs, or platelets)

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6
Q

What is cryoprecipitate?

A

Replaces fibrinogen, von Willebrand factor, and some clotting factors

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7
Q

Which electrolyte is most likely to fall with the infusion of stored blood? Why?

A

Ionized calcium.

The citrate preservative used for the storage of blood binds serum calcium.

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8
Q

What changes occur in the storage of PRBCs?

A

Decreased Ca, 2,3-DPG, pH, PMNs.

Increased K, H.

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9
Q

What are general guidelines for blood transfusion?

A

Acute blood loss, Hgb < 10, and history of CAD/COPD, or

Healthy symptomatic patient with Hgb < 7.

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10
Q

What is the rough formula for converting Hgb to Hct?

A

Hgb X 3 = Hct

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11
Q

One unit of PRBC increases Hct by how much?

A

3-4%

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12
Q

Which blood type is the universal donor for PRBCs?

A

O negative

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13
Q

Which blood type is the universal donor for FFP?

A

AB

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14
Q

What is a type and screen?

A

Patient’s blood type is determined and the blood is screened for antibodies.
A type and cross from that sample can then be ordered if needed later.

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15
Q

What is a type and cross?

A

Patient’s blood is sent to the blood bank and cross-matched for specific donor units for possible blood transfusion

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16
Q

What is thrombocytopenia?

A

Low platelet count (< 100,000)

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17
Q

What are the common causes of thrombocytopenia in the surgical patient?

A

Sepsis, H2 blockers, heparin, massive transfusion, DIC, antibiotics, spurious lab value, Swann-Ganz catheter

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18
Q

What can be given to help correct platelet dysfunction from uremia, aspirin, or bypass?

A

DDAVP (desmopressin)

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19
Q

What common medication causes platelets to irreversibly malfunction?

A

Aspirin

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20
Q

What is Plavix?

A

Clopidogrel:

Irreversibly inhibits platelet P2Y12 ADP receptor (block fibrin cross-linking of platelets)

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21
Q

What platelet count is associated with spontaneous bleeding?

A

< 20,000

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22
Q

What should the platelet count be before surgery?

A

> 50,000

23
Q

When should prophylactic platelet transfusion be given?

A

With platelets < 10,000

24
Q

What is microcytic anemia, until proven otherwise, in a man or postmenopausal woman?

A

Colon cancer

25
Q

Why not infuse PRBCs with lactated Ringer’s?

A

Calcium in LR may result in coagulation within the IV line

26
Q

For how long can PRBCs be stored?

A

About 6 weeks

27
Q

What is the most common cause of transfusion hemolysis?

A

ABO incompatibility as a result of clerical error

28
Q

What is the risk of receiving a unit of blood infected with HIV?

A

1/1,000,000

29
Q

What are the symptoms of a transfusion reaction?

A

Fever, chills, nausea, hypotension, lumbar pain, chest pain, abnormal bleeding

30
Q

What is the treatment for transfusion hemolysis?

A

Stop transfusion; provide fluids; perform diuresis to protect kidneys; alkalinize urine; give pressors as needed

31
Q

What component of the blood transfusion can cause a fever?

A

WBCs

32
Q

What is the transfusion trigger Hct in young healthy patients?

A

21%

33
Q

What is the widely considered optimal Hct in a patient with a history of heart disease or stroke?

A

30%

34
Q

When should aspirin administration be discontinued preoperatively?

A

At 1 week because platelets live 7-10 days

35
Q

What can move the oxyhemoglobin dissociation curve to the right?

A

Acidosis, 2,3-DPG, fever, elevated PCO2,

36
Q

What is the normal life of RBCs?

A

120 days

37
Q

What is the normal life of platelets?

A

7-10 days

38
Q

What factor is deficient in hemophilia A?

A

Factor VIII

39
Q

How can the clotting factor for hemophilia A be remembered?

A

Eight sounds like A

40
Q

What is the preoperative treatment of hemophilia A?

A

Factor VIII infusion to 100% normal preoperative levels

41
Q

What coagulation study is elevated with hemophilia A?

A

PTT

42
Q

How do you remember which coagulation study is affected by the hemophilias?

A

There are 2 major hemophilias and 2 T’s in PTT

43
Q

What factor is deficient in hemophilia B?

A

Factor IX

44
Q

How are hemophilias A and B inherited?

A

X-linked recessive

45
Q

What is von Willenbrand disease?

A

Deficiency of von Willenbrand factor (vWF) and factor VIII:C

46
Q

How is von Willenbrand disease inherited?

A

AD

47
Q

What is used to correct von Willenbrand disease?

A

DDAVP or cryoprecipitate

48
Q

What coagulation study is elevated in von Willenbrand disease?

A

Bleeding time

49
Q

What is the effect on the coagulation system if the patient has a deficiency in protein C, protein S, or antithrombin III?

A

A hypercoagulable state

50
Q

What is a left shift on a CBC?

A

Juvenile polymorphonuclear leukocytes (bands).

51
Q

What is the usual therapeutic PT?

A

With coumadin, usually shoot for an INR of 2.0-3.0

52
Q

What is the acronym basis for the word “Warfarin”?

A

Wisconsin Alumni Research Foundation - ARIN

53
Q

What is the most common inherited hypercoagulable state?

A

Factor V Leiden

54
Q

What is Xigris?

A

Activated protein C, which is used in severe sepsis

Surgical Recall (68 decks)

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