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MTAP > Blood Component Preparation and Therapeutic Cytapheresis > Flashcards

Blood Component Preparation and Therapeutic Cytapheresis Flashcards

1
Q

used to treat patients who have abnormally elevated platelet counts (plt ct > 1,000,000/uL) such as polycythemia vera

equivalent to 6-10 random plt conc

A

plateletpheresis

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2
Q

used to treat patients with leukemia (wbc > 100,000/uL) such as Hairy cell leukemia, AML, Cutaneous T cell lymphoma

uses either HES or corticosteroids

A

leukapheresis

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3
Q

means of producing immunosuppression in conditions like RA, SLE, kidney transplant rejection, and autoimmune and alloimmune dses

A

lymphocytapheresis

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4
Q

sedimenting agent used for granulocyte collection w/c causes red cells to form rouleaux thus allowing WBCs to be harvested more efficiently

A

HES (hydroxyethyl starch)

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5
Q

administered to the donors 12-24hrs before pheresis to increase the number of circulating granulocytes by pulling them from the marginal pool

A

Corticosteroids

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6
Q

for young pxs w/ certain hematologic disorders especially thalassemia syndromes

transfusion of young rbcs “neocytes”

A

neocytapheresis

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7
Q

used to treat various complications of sickle disease such as priapism, impending stroke. Also in pxs w/ severe parasitic infections from malaria or babesia

A

erythrocytapheresis

an exchange transfusion

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8
Q

Predetermined quantity of red cells is removed from px and replaced w/ homologous blood

A

erythrocytapheresis

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9
Q

o To remove the offending agent in the plasma causing clinical symptoms in cases of paraproteinemia (e.g. multiple myeloma, waldenstrom macroglobulinemia, etc.)
o To collect rare red and white cell abs
o Beneficial particularly in disease that involve malfunction of the immune system (SLE, RA)

A

Therapeutic Plasmapheresis

(Plasma Exchange)

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10
Q

Replacement fluids used are NSS, NSA, PPF, FFP

A

Therapeutic Plasmapheresis (Plasma Exchange)

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11
Q

each unit of blood bag contains?

A

450 mL blood
63 mL anticoagulant

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12
Q

what is the reference lab for patient who tested reactive for infectious screening

A

std/aids cooperative central laboratory - san lazaro hospital

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13
Q

how often do you mix blood bag?

A

mix periodically - 1-2x per min. or every 30-45 sec.

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14
Q

what blood components are transferred to transfer bag 1 and 2?

A

1 - PRP
2 - PPP

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15
Q

if acid-citrate-dextrose anticoagulant is used, the unit must be processed within how many hours?

A

within 6 hours

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16
Q

In refrigerated centrifuge. for plasma concentrate temperature should be adjusted at?

A

room temp

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17
Q

skin to vein insertion using 16 gauge of needle in a __ degrees angle

A

20 degrees angle

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18
Q

why patients with in-vitro clotting only suitable to donate red cell components?

A

platelets and coag factprs are partially consumed and will be insufficient for patient use

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19
Q

the blood donation duration procedure is about 8 to 12 minutes with an average of _?

A

10 minutes

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20
Q

hard or heavy spin

A

3500-3600 rpm for 5 minutes

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21
Q

soft or light spin

A

3000-3200 rpm for 2-3 minutes

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22
Q

storage temp of leukoreduced rbcs

A

1-6C

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23
Q

storage temp of cryoprecipitate

A

-18C or colder

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24
Q

required temp for transport or shipping of blood bag

A

1-10C

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25
Q

shipped with dry ice

A

plasma components

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26
Q

shipped with no ice

A

buffy components

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27
Q

shipped with wet ice

A

red cell components

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28
Q

fresh whole blood (450-500 cc) will undergo:
a) soft spin
b) hard spin

A

a) soft spin

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29
Q

what will be the upper and lower layer after soft or light spinning of fresh whole blood?

A

upper: platelet-rich plasma (transferred into transfer bag 1)

lower: packed red blood cells (left in the main bag)

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30
Q

what spin will PRP undergo?

A

hard or heavy spin
5 mins @ 3500-3600 rpm

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31
Q

what are the upper and lower layer of PRP after hard spin?

A

upper: platelet-poor plasma
(transferred to 2nd transfer bag)

lower: platelet concentrate
(left in the 1st transfer bag)

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32
Q

It will be directly put inside freezer to freeze and yield a fresh frozen plasma

A

Platelet-poor plasma

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33
Q

it contains all coagulation factors

A

FFP

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34
Q

FFP will undergo ___ to give cryosupernate and cryoprecipitate

A

cold thawing

- slow cold thawing from freezer temp to ref temp

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35
Q

it is rich in fibronectin, F1, F8, F13, vWF

A

cryoprecipitate

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36
Q

it has same coagulation factors as FFP, however it precipitated so it specifically decreased in some.

A

cryosupernate

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37
Q

what is the immediate effect of WB?

A

1-3% increase in hematocrit

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38
Q

what are indications for use of fresh whole blood?

A

active bleeding, hemorrhagic shock, exchange transfusion, when both oxygen-carrying capacity and volume expansion is required

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39
Q

labile factors significantly decreases after __

A

2 days of storage

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40
Q

white blood cells and platelets are no longer viable after _

A

24 hours of storage

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41
Q

what is the shelf life of these anticoagulants?
ACD, CPD, CP2D

A

21 days

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42
Q

anticoagulant that is mostly used in apheresis

A

ACD

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43
Q

most commonly used anticoagulant in whole blood prep

A

CPDA-1

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44
Q

shelf life of CPDA-1

A

35 days

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45
Q

enumerate the RBC additives and its contents

A

RBC additives - adsol (AS-1), nutricel (AS-3), optisol (AS-5), SOLX (AS-7)

contents: SAMG
saline
adenine
mannitol
glucose

AS-1 and AS-5 has mannitol
AS-3 has citrate & phosphate

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46
Q

what are the contents of PRBCs?

A

hematocrit should be 80% or less

should retain small vol of plasma, otherwise rbcs not supported

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47
Q

what is the immediate effect of PRBCs after transfusion?

A

3% increase in hematocrit
and
1g increase in hemoglobin

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48
Q

what is the indication for use of PRBCs?

A

anemia

PRBCs restores oxygen carrying capacity

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49
Q

what is the indication for use of leukopoor or leukoreduced RBCS?

A

for anemic patients with history of febrile reactions

for patients in need to decrease alloimmunization to WBC, HLA antigens, and CMV transmission

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50
Q

what is the best technique in removing WBCs?

A

mechanical separation using leukoreduction filters

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51
Q

what is the content of leukoreduced or leukopoor RBCs?

A

5x10^6 residual WBC

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52
Q

rejuvenated red blood cells involve the addition of a rejuvenation solution, what is the action of this solution?

A

to regenerate ATP and 2,3 DPG

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53
Q

PIPA AND PIGPA stands for?

A

phosphate, inosine, pyruvate, and adenosine

PIGPA - G for glucose

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54
Q

what is the primary use of rejuvenated RBCs?

A

to salvage rare blood units

55
Q

what is the storage temp of rejuvenated RBCs?

A

1-6C

56
Q

it’s the only FDA approved rejuvenation solution

A

REJUVESOL

57
Q

do you wash rejuvenated RBCs prior transfusion? yes or no? and why?

A

yes, we have to wash it properly to remove rejuvesol.

after washing it must be transfused within 24hrs

58
Q

what is the shelf-life of washed red blood cells?

A

open system - 24hrs

59
Q

what is the QC of washed RBCs?

A

plasma removal

60
Q

what are the indications for use of washed red blood cells?

A

for anemic patients with hx of febrile rxns

patients with PNH

for px w/ plasma proteins abs reduced to allergic rxns (for IGA-deficient px)

61
Q

frozen RBC is also known as _

A

glycerolized or cryoprotected RBC

62
Q

what are two common cryoprotective agents of frozen RBCs?

A

penetrating and non-penetrating cryoprotective agents

63
Q

utilizes low molecular weight agent, most commonly used: GLYCEROL

A

penetrating

64
Q

utilizes high molecular weight, most commonly used: hydroxyethyl strach

A

non-penetrating

65
Q

its action is to protect the cell’s surface against extremely low temp

A

sole action of non-penetrating agent

66
Q

it prevents dehydration, formation of ice crystals, and also protects cell membrane from extremely low temp storage

A

penetrating cryoprotective agent

67
Q

what is the shelf life of deglycerolized RBCs?

A

24 hrs

68
Q

shelf life of frozen RBCs?

A

10 yrs

69
Q

temp storage of low glycerol 20%

A

-120C using liquid nitrogen

70
Q

temp storage of high glycerol 40%

A

-65C using mechanical freezer

71
Q

temp storage of 79% glycerol with dextrose fructose and EDTA

A

-65C

72
Q

what is deglycerolizing process?

A

use of hypertonic solution in decreasing concentration until isotonic solution conc is reached

73
Q

enumerate the 3 steps cell washing and its corresponding use

A
  1. 12% hypertonic solution - removes glycerol
  2. 1.6% saline - completely removes glycerol without rbc shrinking
  3. 0.2% dextrose in NSS - serves as energy while maintaining rbc morphology
74
Q

after washing off cyroprotective agents, it should be transfuse within how many hrs?

A

24hrs

75
Q

what are the indications for use of frozen<thawed<deglycerelized RBC?

A
  1. anemia
  2. long term storage of rare units and autologous units
76
Q

what is the shelf life and storage temp of platelet concentrates from random donor prepared from WB?

A

20-24C for 3-5 days with constant agitation

77
Q

platelet concentrate random donor prepared from WB is composed of _

A

5.5 x 10^10 plts in 50-65 ml of plasma

78
Q

what are the indications for use of plt conc random donor?

A
  1. Thrombocytopenia
  2. DIC
  3. Bleeding disorder
  4. Platelet disorder
79
Q

what is the immediate effect of random donor plt conc after transfusion?

A

increase plt ct by 5,000 to 10,000 per unit corrected plt ct (plt/ul)

80
Q

what is the formula used in calculations of random donorplt conc?

A

posttransfusion - pretransfusion x BSA /
no. bags x 0.55

81
Q

what is the shelf life and storage temp of plt conc single donor prepared by pheresis?

A

5 days (closed system)
24 hrs (open system)
3-5 days 20-24C with constant agitation

82
Q

what is the content of plt conc from a single donor prepared by pheresis?

A

3.0 x 10^11 in approx. 300mL of plasma

83
Q

what are the indications for use of plt conc from single donor prepared by pheresis

A
  1. Thrombocytopenia
  2. px refractory to random plts due to plts abs
84
Q

what is the immediate effect after transfusion with plt conc from single donor prepared by pheresis?

A

30,000 to 60,000 increase in plt ct

85
Q

it extends shelf life of plt conc from 5 days to 7 days

A

intersol

86
Q

give the shelf life and storage temp of FFP.

A
  • thawed - 24hrs at 1-6C
  • frozen - 1yr at -18C
87
Q

give the contents of FFP.

A
  • all coagulation factors
  • 400mg fibrinogen
88
Q

what are the indications for use of FFP?

A
  1. treatment for multiple coagulation factor deficiencies (caused by massive transfusion, trauma, liver disease, DIC)
  2. treatment for antithrombin III deficiency, TTP, HUS.
89
Q

give the shelf life and storage temp of SDP liquid and frozen.

A
  • liquid - 5 days beyond at WB 1-6C
  • frozen - 5 years at -18C
90
Q

what is the indication for use of SDP liquid / frozen?

A

treatment of stable clotting factor deficiencies

91
Q

What is the most possible blood component to administer to your patient suffering from graft-versus-host disease?

A

Irradiated blood

92
Q

give the shelf life and storage temp of cryoprecipitate.

A
  1. frozen - 1 yr at -18C
  2. thawed - 6hrs at 20-24C
  3. pooled - 4hrs
93
Q

what are the contents of a cryoprecipitate?

A
  • FVIII:C - 80-150 IU
  • FVIII:vWF - 40-70%
  • fibrinogen - 150-250 mg
  • FXIII - 20-30%
94
Q

what are the indications for use of cryoprecipitate?

A
  1. hemophilia A
  2. von willebrand’s disease
  3. fibrinogen deficiency
  4. FXIII deficiency
95
Q

what is the shelf life and storage temp of a granulocyte concentrate?

A
  • 24 hrs
  • 20-24C without agitation
96
Q

what is the content of granulocyte concentrate?

A

1 x 10^10 wbc

97
Q

what are the indications for use of granulocyte concentrate?

A
  • to correct severe neutropenia
  • fever unresponsive to antibiotic therapy
  • myeloid hypoplasia of BM
98
Q

what are plasma derivatives?

A

concentrates of plasma proteins that are prepared from pools of plasma

99
Q

enumerate the plasma derivatives.

A
  • FIX conc
  • FVIII conc
  • NSA
  • PPF
  • Rhogam
  • ISG
100
Q

They have the same shelf life that varies on vial and 1-6C (lyophilized) temp storage.

A

FIX conc & FVIII conc

101
Q

indication for FIX conc

A

hemophilia B

102
Q

indication for FVIII conc

A

hemophilia A

103
Q

what is the shelf life and temp storage of both NSA and PPF?

A

shelf life:
3 yrs at 20-24C
5 yrs at 1-6C

104
Q

what is the same indication for use of both PPF and NSA?

A

plasma volume expansion: trauma, burns, surgery

105
Q

what are the contents of NSA?

A

96% albumin
4% globulin

106
Q

what are the contents of PPF?

A

80-85% albumin
15-20% globulin

107
Q

what are synthetic volume expanders?

A

crystalloids:
Ringer’s lactate
Electrolyte solution
NSS

colloids:
Dextrans
HES

108
Q

what is the storage temp and shelf life of Rhogam?

A

3 yrs at 1-6C

109
Q

what are the contents of rhogam?

A

full dose 300ug anti-d
mini dose 50ug anti-d

110
Q

rhogam full dose 300ug anti-d

A

neutralize 30ml WB or 15ml of PRBCs FMH

antenatal administration at 3rd trimester, full term deliver within 3d

111
Q

rhogam mini dose 50ug anti-d

A

neutralize 5ml WB or 2.5ml PRBCs

amniocentesis, ectopic rupture, 1st preg the miscarriage

112
Q

what are the indications for use of rhogam?

A
  • prevents Rho (D) immunization
  • prevent HDFN
113
Q

what is the target of irradiated blood?

A

lymphocyte t cells

114
Q

what is the shelf life of irradiated blood?

A

28 days or the normal dating period of blood whichever comes first

115
Q

irradiation uses?

A

cesium-137
cobalt-60

116
Q

what are the indications for use of irradiated blood?

A
  1. GVH reactions
  2. exchange transfusion
  3. IUT
  4. direct donation from relative
  5. transfusion for immunocompromised px
  6. BM transplant
117
Q

how ISG can be administered and give its shelf life?

A
  • IM - 3yrs
  • IV - 1yr
118
Q

what are the indications for use of ISG?

A
  1. prophylactic treatment for px exposed to hepatitis
  2. measles and chicken pox
  3. treament of hypogammaglobulinemia
119
Q

In RBC additive solution, if glucose is for energy, then adenine is for what?

A

To support ATP levels

120
Q

This is recommended if patient is actively bleeding, has hemorrhagic shock, or will undergo exchange transfusion. Also indicated when both oxygen-carrying capacity and volume expansion is required.

A

Whole Blood (450-500 mL)

121
Q

what is the shelf-life of CPD-AS (Additive Solution)?

A

42 days

122
Q

True or False

After 36 hours of storage, the WBC and platelets in WB are no longer viable.

A

True

after 24 hrs of storage wbcs and plts are no longer viable

123
Q

what is the expected increase in coagulation factors when patient is administered with FFP?

A

20-30% increase in coagulation factors

for every unit of FFP

124
Q

what is the immediate effect of cryoprecipitate?

A

5-10 g/dL increase in fibrinogen

125
Q

immediate effect of granulocyte concentrate

A

it will increase WBC ct by 1-2 x 10^10 per infusion 4 daily doses

126
Q

equivalent to 6-10 random platelet concentrates

content: 3 x 10^10 plts

A

plateletpheresis

127
Q

It is used to treat patients who have abnormally elevated platelet count

e.g. patients with polycythemia vera

A

plateletpheresis

128
Q

It is used to treat patients with leukemia

e.g. patients with hairy cell leukemia / AML / cutaneous T cell lymphoma

A

leukapheresis

129
Q

It is used as means of immunosuppression in conditions like SLE, RA, autoimmune & alloimmune disease, or transplant rejection

A

lymphocytapheresis

130
Q

transfusion of neocytes or young rbcs

A

neocytapheresis

131
Q

it is used for young patients with certain hematologic disorders especially thalassemia syndromes

A

neocytapheresis

132
Q

it is used to treat various complications of SCD. Also used in patients with severe parasitic infections from babesia & malaria

A

erythrocytapheresis

133
Q

It is used to remove offending agent in the plasma causing clinical symptoms in cases of paraproteinemia

e.g. multiple myeloma, waldenstrom macroglobulinemia

A

therapeutic plasmapheresis

134
Q

confimatory laboratory for donors who tested reactive in infectious screening.

A

Transfusion Transmissible Infection - National Reference Laboratory - Research Institute for Tropical Medicine

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