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BB LECT (finals) > blood component preparations > Flashcards

blood component preparations Flashcards

1
Q

a single blood unit can provide transfusion therapy to multiple patients in the form of? (4)

A
  • RBCs
  • platelets
  • fresh frozen plasma
  • cryoprecipitate
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2
Q

enumerate the approved preservatives

A
  • phosphate
  • adenine
  • dextrose
  • sodium citrate
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3
Q

binds calcium in exchange for sodium salt

A

sodium citrate

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4
Q

supports metabolism of RBCs

A

phosphate

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5
Q

preservative

function of dextrose

A
  • maintain RBC membrane
  • substrate for ATP production
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6
Q

provides energy for the RBCs and increaes ADP levels

A

adenine

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7
Q

provided by the manufacturer in the whole blood collection set and mixed with the donor blood during the collection process

A

anticoagulants

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8
Q

enumerate the approved anticoagulant preservative solutions

A
  • acid citrate-dextrose (formula A): ACD-A
  • citrate-phosphate dextrose: CPD
  • citrate-phosphate double dextrose: CP2D
  • citrate-phosphate-dextrose-adenine: CPDA-1
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9
Q

anticoagulant that has a storage time of 21 days

A
  • ACD-A
  • CPD
  • CP2D
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10
Q

storage time of citrate-phosphate-dextrose-adenine

A

CPDA-1
35 days

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11
Q

adenine is not present in what anticoagulant preservative?

A
  • ACD-A
  • CPD
  • CP2D
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12
Q

additive solutions is developed to further extend the —

this contains —

A

extend the shelf-life of RBCs
contains saline, adenine, and dextrose

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13
Q

whole blood contains all cellular and liquid element + anticoagulant and/or preservatives. this is intended to replace RBC to — and plasma for — on bleeding patience

A

replace RBC to provide oxygen-carrying capacity and replace plasma for volume expansion

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14
Q

whole blood

volume:
PCV:
stored at:

one unit can increase — PCV and — Hemoglobin

A

vol: 450 ml
PCV: 38%
stored at 1-6C

3–5% PCV | 1-1.5 g/dL hemoglobin

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15
Q

whole blood are not used for — replacements

why?

A

platelet, WBCs, and clotting factor

since it does not survive on stored whole blood

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16
Q

packed RBCs are prepared from whole blood via?

A

centrifugation or sedimentation after donation

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17
Q

this is intended for patient that needs to increase its RBC mass and oxygen carrying capacity without increasing the circulatory volume.

volume removed should be — of the total plasma

A

packed RBCs

volume removed should be 80% of the total plasma

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18
Q

packed RBCs

decreased RBC mass may be caused by?

A
  • decreased production
  • decreased RBC surviva
  • trauma or surgical bleeding
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19
Q

packed RBCs

critical levels that indicates transfusion

contraindicated in patients with well compensated?

A

<6 g/dl

well compensated anemia

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20
Q

packed RBCs

one unit can increase hemoglobin level to — and the hematocrit level to — in a typical 154 lbs. human

note: adjustment is quicked compared to whole blood

A

hemoglobin level to 1-1.5 g/dL and the hematocrit level to 3-5% in a typical 154 lbs

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21
Q

RBC aliquots are used for?

A

neonatal patients or infants under 4 months old

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22
Q

neonatal transfusion may require how many volume?

one aliqout can incr. the hgb and hematocrit of infants at what level?

A

10-25 mL

hgb: 2-3 g/dL hematocrit: 6-9%

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23
Q

irradiated RBCs

RBC units with irradiated T cells to prevent?

this is done with cesium— or —

A

to prevent graft-versus-host disease

done with cesium-137 or cobalt-60

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24
Q

irradiated RBCs are intended for? (3)

recommended minimum dose of gamma irradiation?

A
  • immunocompromised patients
  • bone marrow transplant patients
  • fetus undergoing intrauterine transfusion

recommended minimum dose of gamma irradiation: 25 Gy

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25
Q

irradiated RBCs

this is used to confirm irradiation (darkening of the film)

expiration date?

A

radiochromic film

28 days from the time of irradiation

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26
Q

this refers to the RBC unit with a WBC count reduced to <5 x 106 and with at least 85% of the original RBC mass

original unit may contain?

A

LEUKOREDUCED RBCs

orig unit: 2 x 109 reduced to 1 x 10^4

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27
Q

leukoreduced RBCs

donor WBCs can cause?
enumerate the 5

A
  • febrile non-hemolytic transfusion reactions
  • transfusion-associated graft-versus-host disease
  • transfusion-related immune suppression
  • HLA alloimmunization
  • may introduce cytomegalovirus
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28
Q

shelf life of leukoreduced RBCs

A

24 hours

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29
Q

this facilitates removal of 99.9% leukocytes, and via?

retains — of the RBC mass

A

PRE-STORAGE LEUKOREDUCTION

multiple layers of polyester or cellulose acetate nonwoven fibers

retains 85% of the RBC mass

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30
Q

enumerate the methods of pre-storage leukoreduction

A
  1. in-line method
  2. plasma removal
  3. sterile docking device
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31
Q

pre-storage leukoreduction

this method can be attached to the whole blood unit and filtered via gravity

A

in-line method (in-line filter)

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32
Q

pre-storage leukoreduction

plasma is initially removed, and the remaining cells pass thru an in-line filter, this method refers to?

A

plasma removal method

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33
Q

pre-storage leukoreduction

used to attach a leukocyte reduction filter to a unit of RBCs, which is allowed to flow via gravity. this method refers to?

A

sterile docking device

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34
Q

WBCs are removed in the blood bank prior to issuing blod or at the bedside before transfusion. this refers to?

this reduce leukocytes to 5 x 106 or lower

A

post-storage leukoreduction

third-generation filters

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35
Q

frozen RBCs can be stored up to?

A

10 years

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36
Q

frozen RBCs can be intended for? (3)

A
  • patients with rare phenotypes
  • backup blood supply
  • autologous use
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37
Q

chemicals in anticoagulant solutions

chelates calcium and prevents clotting.

this is present in?

A

CITRATE (sodium citrate | citric acid)

ACD-A, CPD, CP2D. CPDA-1

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38
Q

chemicals in anticoagulant solutions

maintains pH during storage; necessay for maintenance of adequate levels of 2,3-DPG

this is present in?

A

monobasic sodium phosphate

ACD-A, CPD, CP2D, CPDA-1

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39
Q

chemicals in anticoagulant solutions

substrate for ATP production (cellular energy)

this is present in?

A

DEXTROSE

ACD-A, CPD, CP2D, CPDA-1

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40
Q

chemicals in anticoagulant solutions

for production of ATP
extends shelf-life from 21-35 days

this is present in?

A

ADENINE

CPDA-1

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41
Q

RBC freezing

enumerate the advantages (4)

A
  • long-term storage (10 yrs)
  • maintenance of RBC viability and function
  • low residual leukocytes and platelets
  • removal of significant amounts of plasma proteins
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42
Q

RBC freezing

enumerate the disadvantages (4)

A
  • time-consuming process
  • higher cost of equipment and materials
  • storage requirements (-65C)
  • higher cost of product
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43
Q

cryoprotective agents

this involves small molecules that cross the cell membrane into the cytoplasm

A

penetrating

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44
Q

cryoprotective agents

the osmotic force of the agent prevents water from migrating outward as extracellular ice is formed, preventing cellular dehydration.

give an example of this cryoprotective agents

A

PENETRATING

glycerol

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45
Q

cryoprotective agents

this comprises large molecules that do not enter the cell but insted form a shell around it, preventing loss of water and nonsubsequent dehydration.

give an example of this cryoprotective agent

A

NONPENETRATING

hydroxyethyl starch

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46
Q

40% weight per volume
increases the cryoprotective power of glycerol

A

high glycerol

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47
Q

high and low glycerol

enumerate the initial temp of the two.

A

H: -80C
L: -196C

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48
Q

high and low glycerol

frozen units are stored at —
(freezing temp)

also freeze a serum of a donor for additional testing in the future.

A

HG: -65C
LW: -120C

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49
Q

low glycerol require — for the freezing process

LG refers to minimal glycerol cryoprotection

A

liquid nitrogen

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50
Q

thawing process takes about —
units are placed in a — and washed with solutions of decreasing osmolarity

expiration? stored at —

A

takes about 30 mins
units a placed in a 37C water bath

expiration: 24 hours | stored at 1-6C

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51
Q

this has rapid and more controlled freezing procedure
give the w/v

A

LOW GLYCEROL
20% w/v

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52
Q

this removes all WBC and plasma

A

deglycerolization

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53
Q

deglycerolization done at what temp? unit should be used within?

A

temp: 1-6 C
used within 24 hours

54
Q

high glycerol: fill in the blanks

  • initial freezing temp:
  • need to control freezing rate:
  • type of freezer:
  • maximum storage temp:
  • shipping requirements:
  • effect of changes in storage temp:
A
  • initial freezing temp: -80C
  • need to control freezing rate: NO
  • type of freezer: MECHANICAL
  • maximum storage temp: -65C
  • shipping requirements: DRY ICE
  • effect of changes in storage temp: CAN BE THAWED AND REFROZEN
55
Q

low glycerol: fill in the blanks

  • initial freezing temp:
  • need to control freezing rate:
  • type of freezer:
  • maximum storage temp:
  • shipping requirements:
  • effect of changes in storage temp:
A
  • initial freezing temp: -196C
  • (yes/no) need to control freezing rate: YES
  • type of freezer: LIQUID NITROGEN
  • maximum storage temp: -120C
  • shipping requirements: LIQUID NITROGEN
  • effect of changes in storage temp: CRITICAL
56
Q

removes plasma proteins that cause most allergic reactions. this refers to?

A

WASHED RBCs

57
Q

washed RBCs are intended for patients with? (2)

shelf-life after washing: —

A
  • rare IgA deficiency and anti-IgA
  • anemic patients with history of febrile reaction

shelf-life after washing: 24 hours

58
Q

washed RBCs

T or F. 5-10% RBCs are lost in the process.

A

FALSE.
10-20% RBCs

59
Q

this is acquired from whole blood processing in which the platelets must be separated from the whole blood within 8 hours of collection.

A

platelet concentrate

60
Q

PLATELET CONCENTRATE are intended for patients with?

T or F: this may be contaminated with RBCs or WBCs

A
  • thrombocytopenic patients
  • cancer patient
  • thrombocytopenic preoperative patients

true! so follow transfusion rules.

61
Q

random-donor platelet concentrates contains about — platelets

this is stored in a — environment with —

A

5.5 x 10^10 platelets

stored in 20-24C environment with agitation

62
Q

platelet concentrate should contain adequate plasma of — and a pH of?

A

50-70 mL
pH: 6

63
Q

platelet concentrate

T or F: one unit should decrease platelet count to 5000-10000/ul in a 70 kg person.

A

FALSE.
one unit should increase

64
Q

platelet concentrate

facilitates oxygen transfer into the platelet bag and oxygen consumption of platelets

shelf-life: — | if opened: —

A

agitation

shelf life: 5 days | if opened: 6 hours

65
Q

T or F: platelets survive without agitation for a maximum of 24 hours

A

TRUE

66
Q

single-donor platelets contains at least — platelets that are stored in 22-24C environment with agitation and contains about — plasma. its shelf life is?

A

contains at least 3x10^11 platelets

contains about 300 mL plasma

shelf life: 5 days

67
Q

platelet concentrate: preparation

1st: whole blood is centrifuge at — light spin at — RPM in — mins.

what is the product of this step?

A

centrifuge at 22C
3200 RPM in 2-3 mins

platelet-rich plasma

68
Q

platelet concentrate: preparation

2nd: platelet rich plasma is centrifuge at:
- — C
- heavy spin or light spin
- — RPM in — mins

what is the product of this step?

A
  • 22C
  • heavy spin
  • 3600 RPM in 5 mins

platelets (50-70 mL)

69
Q

platelet concentrate: preparation

3rd: platelets is stand for how many hours and at what temp?
- after that, it is stored at — to avoid —

A

stand for 1-2 hrs at 20-24C
* stored at 20-24C with constant agitation to avoid CONTAMINATION

70
Q

platelet concentrate

6-8 units can be pooled in — bag.
shelf life is —

A

1 bag
shelf life: 4 hours

71
Q

why platelets can be leukoreduced?

A

to prevent febrile non-hemolytic reactions

done via leukoreduction filter designed for platelets.

72
Q

plasma can be prepared from whole blood via?

A

centrifugation or sedimentation
(HEAVY SPIN)

73
Q

plasma is the liquid portion of whole blood which contains?

A

all coagulation factors

74
Q

PLASMA is used to treat patients with? (6)

A
  • liver failure
  • DIC
  • vitamin K deficiency
  • warfarin overdose
  • single factor deficiencies
  • massive transfusion
75
Q

plasma is frozen shortly after — or within — of collection

frozen within 6 hours if the preservative is?

A

after separation from the whole blood or within 8 hours of collection

preservative: ACD

76
Q

FRESH FROZEN PLASMA is intended for patients? (2)

one unit contains — mL of plasma

A

who are actively bleeding and have multiple clotting factor deficiencies

1 unit of plasma: 150-250 mL plasma

77
Q

fresh frozen plasma: storage

temperatures
* if stored up to 1 yr after collection: ?
* for 7 yrs: ?
* liquid plasma: ?

A
  • -18C: 1 yr after collection
  • -65C: 7 years
  • 1-6C: liquid plasma
78
Q

how liquid plasma obtained?

A

from whole blood to the extraction of plasma, the plasma is not frozen, therefore all plasma is liquid

79
Q

thawing of fresh frozen plasma

thawed at what temp:
shelf-life:
stored at:

A

thawed at what temp: 30-37C
shelf-life: 24 hrs
stored at: 1-6C

if done in water bath, cover the unit to protect the bag from water contamination

80
Q

thawing is less with what factor/s?

A

Factor V, VII, VIII, X

81
Q

cryoprecipitate is used primarily for? (4)

this contains what factors?

A
  • fibrinogen replacement
  • factor XIII deficiency
  • treatment for hemophilia A
  • Von Willebrand disease

VIII, XIII, FIBRINOGEN, VON WILLEBRAND FACTOR, FIBRONECTIN

82
Q

AABB requires that at least — of fibrinogen must be in each unit of cryoprecipitate

A

150 mg

83
Q

cryoprecipitate

once thawed, the cryoprecipitate is stored at RT and must be transfused asap because?

A

factor VIII levels decline 2 hours after thawing

84
Q

cryprecipitate

when plasma is thawed at 4C, the — that precipitate out of the plasma can be collected by?

A

the cold-insoluble proteins
can be collected by centrifugation at 1-6C

85
Q

cryoprecipitate

the supernatant is removed via — to the next bag to maintain the close system.

supernatant is also known as?

A

via INTERNAL ACCESS PORT

cryo-poor plasma

86
Q

cryprecipitate

about — of plasma is retained on the cryoprecipitate. the cryoprecipitate must be refrozen within — of being removed from the cold environment, and stored at — or lower for up to 1 year

A

about 5-15 mL of plasma is retained on the cryoprecipitate. the cryoprecipitate must be refroen within 1 hour of being removed from the cold environment, and stored at -18C or lower for up to 1 year.

87
Q

cryoprecipitate

shelf-life thawed

A

6 hours or 4 hours if pooled

88
Q

fibrinogen replacement is done in patients with?

A
  • liver failure
  • DIC
  • congenital fibrinogen deficiency
89
Q

cryo-poor plasma product contains?

this is refrozen within — and stored at — or colder for 1 year.

A

albumin, factor II, V, VII, IX, X, XI

refrozen within 24 hrs and stored at -18C

90
Q

factor VIII is from?

this is acquired via?

A

plasmapheresis of donors

acquired via fractionation and lyophilisation of pooled plasma.

91
Q

factor VIII is intended for?

A

factor VIII deficiency patients
HEMOPHILIA A

92
Q

Factor IX concentrate (prothrombin complex)

shelf life: ?
storage temp: ?
indication: ?

A

shelf life: varies on expiratio n date on the vial
storage temp: 1-6C
indication: hemophilia B

93
Q

Immune Serum Globulin

enumerate the indications (3)

A

indications:
- prophylactic treatment to patients exposed to hepatitis
- measles or chickenpox
- treatment of congenital hypogammaglobulinemia

94
Q

Normal Serum Albumin

storage: ?

this contains — (enumerate)

A

stored 20-24C: 3 yrs
stored 1-6C: 5 yrs

96% albumin | 4% globulin

95
Q

rejuvenation is the regeneration of?

RBCs should be — after expiration

A

ATP and 2,3 DPG

less than 3 days after expiration

96
Q

rejuvenation

incubate for — hrs at —C with rejuvesol

enumerate the rejuvesol (4)

A

incubate for 1-4 hrs 37C

Rejuvesol is only the FDA approved rejuvenation solution in U.S.

rejuvesol: phosphate, inosine, pyruvate, adenine

97
Q

the impact of this altered environment on the blood product is referred as?

A

storage lesions

98
Q

RBC storage lesion

enumerate the “decreased” (5)

A
  • % viable cells
  • glucose
  • ATP
  • pH
  • 2,3-DPG
99
Q

RBC storage lesion

enumerate the “increased”

A
  • lactic acid
  • plasma K+
  • plasma hemoglobin
100
Q

RBC storage lesion

oxygen dissociation curve

A

shift to the left
increase in hemoglobin and oxygen affinity; less oxygen delivered to tissues.

101
Q

added storage lesions

  • 50% decrease of factor — in 24 hrs
  • 50% decrease of factor — in 10-14 days

T or F : platelets and WBCs loss of function after few hours.

A
  • factor VIII in 24 hrs
  • factor V in 10-14 days

TRUE!

102
Q

duration of storage depend on the lifespan of the —?

A

anticoagulant

103
Q

RBC do not contain enough —- to support its life

A

organelles and nutrients

104
Q

lifespan of RBC

A

+/- 120 days

105
Q

centrifuge used to separate blood components inside a blood bag

A

floor type centrifuge

106
Q

first step in separating blood components

A

separate plasma from the cells

107
Q

some blood bags have an extra bag connected with it, what is its purpose?

A

after separation, the tube connecting the primary blood bag and the extra bag will transfer the separated plasma from the red cells on the primary bag unto the extra bag

108
Q

the second bag that contain plasma will undergo another centrifugation to?

A

separate the platelets which is then placed on another bag

109
Q

why do we need to separate whole blood unto components?i

A

there are instances that the patient only need a specific component, not the entire whole blood itself

110
Q

consequences of transfusing all components of blood instead of only transfusing the needed component

A

circulatory overload

111
Q

fresh whole blood can be separated into

A

platelet rich plasma (200-250 cc)
packed RBC (200-250 cc)

112
Q

platelet rich plasma can be separated into

A

platelet poor plasma (200 cc)
platelet concentrate (50-70 cc)

113
Q

platelet poor plasma can also be stored as

A

fresh frozen plasma

114
Q

fresh frozen plasma can be separated into

A

cryosupernate (180-200 cc)
cryoprecipitate (15-20 cc)

115
Q

fresh whole blood is given to patients experiencing

A

hypovolemia

116
Q

hypovolemia is usually due to

A

patients experiencing accidents

117
Q

T or F: the half-life of coagulation factors are the same

A

false; it varies, because there are labile in certain conditions while some are stable

118
Q

if the patient needs cellular element and volume expansion, what is the best blood component to be given?

A

the whole blood

119
Q

if there is no centrifuge, how can you separated pRBCs from whole blood?

A

sedimentation

120
Q

how is sedimantation done?

A

allow the blood bag to stand and the RBCs will then sink at the bottom of the tube due to gravity

121
Q

disadvantage of sedimentation

A

time consuming

122
Q

why do pRBCs have better adjustment compared to whole blood?

A

because the RBC is already separated

123
Q

define a graft-vs-host disease

A

where the organs transplanted are incompatible with the recipient

124
Q

this can trigger a graft-vs-host disease

A

transfused RBCs

125
Q

immune serum globulin

shelf life if intravenous or intramuscular

A

intramuscular: 3 yrs
intravenous: 1 yr

126
Q

washed RBC is considered as (open/closed) system?

A

open system

127
Q

consequences of transfusing unwashed rbc

A

allergic reactions
transfusion reactions

128
Q

most of the storage lesions are caused by

A

RBC metabolism

129
Q

RBC storage lesion: explain why there is decreased pH

A

active metabolism result to increased acidity

130
Q

RBC storage lesion: explain why there is increased K and hgb

A

lysed RBCs during storage release K and hgb

131
Q

cryprecipitate

AABB requires — of fibrinogen must be in each unit of cryoprecipitate

A

150 mg of fibrinogen

BB LECT (finals) (6 decks)

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