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SRNAPharmacology II > Blood Components and Sub > Flashcards

Blood Components and Sub Flashcards

1
Q

Antithrombin III deficiency

A

May give FFP to help get antithrombin III

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2
Q

Whole blood

A

For acute hemorrhage of 25% or more

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3
Q

RBC transfusion objective

A

Improvement of inadequate oxygen delivery

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4
Q

Diminished OXygen carrying capacity

A

Ischemic effects on heart and brain

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5
Q

Transfuse patient with HF or with decreased

A

Higher threshold

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6
Q

Patient with those medications are at known risk for decreased CO

A

Beta blockade

Non DHP CCB

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7
Q

Hemoglobin concentration increase will

A

increase O2 delivery

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8
Q

DO2

A

CaO2 x CO

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9
Q

Loss of 15%

A

Class 1 little hemodynamic effect other than vasoconstriction and mild tachycardia

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10
Q

Loss of 15-30%

A

Class 2 Tachycardia decrease pulse pressure

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11
Q

Loss 30-40%

healthy patients give

A

Class III hemorrhage, signs of hypovolemia, marked tachy, tachypnea
Crystalloids

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12
Q

Loss of more than 40%

A

life threatening, transfused

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13
Q

Acute anemia: O2 delivery adequate at hemoglobin concentration

A

as low as 7g/dl

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14
Q

Chronic anemia

A

better tolerated than acute

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15
Q

CO in chronic anemia does not change until

A

below 7g/dl

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16
Q

acute anemia no reductio in arterial O2 because

A

Well compensate in increased in CO

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17
Q

Factors that affect CO

A

Left Ventricular dysfunction
hypothermia
Vasoactive (BBlockers, CCB, anesthetics)

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18
Q

Effective of RBC transfusion

Keyword: NONBLEEDING

A

NON-bleeding, 1 unit of RBC

1g increase Hct by 3%

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19
Q

However, for anemia relationship with

A

Perioperative anemia with MI

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20
Q

Transfusion recommendations

A

Rarely indicated if hbg more than 10

Less than 6 when the anemia is acute.

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21
Q

The determinants of intermediate:

A

The determination of whether intermediate hemoglobin concentrations (6-10g/dl) justify or require RBC transfusion should be based on the patient’s risk for complications of
inadequate oxygenation

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22
Q

Most anesthetics cause

A

myocardial depression and
decrease arterial BP, cardiac output, stroke volume,
PVR.

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23
Q

The use of a single transfusion “trigger”

A

(i.e.. 10/30 rule) for all patients is not

recommended.

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24
Q

Hemoglobin <6 g/dL – T.

A

Transfusion recommended except in exceptional circumstances.

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25
Q

● Hemoglobin 6 to 7 g/dL

A

– Transfusion generally likely to be indicated

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26
Q

● Hemoglobin 7 to 8 g/dL –

A

Transfusion may be appropriate in patients undergoing orthopedic surgery or cardiac surgery, and in those with
stable cardiovascular disease, after evaluating the patient’s clinical status.

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27
Q

● Hemoglobin 8 to 10 g/dL

A

– Transfusion generally not indicated, but should be considered for some populations (eg, those with
symptomatic anemia, ongoing bleeding, acute coronary syndrome with ischemia, and hematology/oncology patients with severe thrombocytopenia who are at risk of bleeding).

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28
Q

● Hemoglobin >10 g/dL –

A

Transfusion generally not indicated except in exceptional circumstances.

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29
Q

Transfusion reactions, often manifested in
awake patients by_____, _____, ______
are the most common adverse reaction of
transfusion with CBC’s.

A

fever, chills, or urticaria,

30
Q

The more transfusion

A

the more risk of Hepatitis C

31
Q

The most common viral agent

Important for type of patients

A

Cytomegalovirus

HIV, immunosuppressed patients or autoimmune disease

32
Q

Platelets : patients

A

patients spontaneous bleeding is uncommon with a platelet count greater than 20,000.

33
Q

The probability of clinically significant thrombocytopenia i

A

Increases in proportion to the number of units of blood transfused because only parts of the blood is given

34
Q

ASA action

A

Inhibit platelet aggregation

35
Q

Patients with bleeding from ASA

A

Platelets

36
Q

With HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome associated with

A

preeclampsia the thrombocytopenia is usually more severe, but spontaneous resolution usually occurs by the
4th postpartum day.

37
Q

Transfusion of one platelet concentrate will increase

the platelet count by approximately

A

5,000-10,000 in an average adult.

38
Q

The usual therapeutic dose of platelets is

A

one platelet concentrate per 10kg body weight.

39
Q

Heparin induced thrombocytopenia and ITP

A

should not receive platelets.

40
Q

To assess risk of HIT

A

4 Ts

41
Q

Prophylactic platelet transfusion is rarely indicated in surgical patients with thrombocytopenia due to decreased platelet production when the platelet count is greater
than_______ and is usually indicated when less than _______

A

100,000; 50,000.

42
Q

The determination of whether patients with intermediate (50,000-100,000) require therapy should be based on the

A

risk of bleeding.

43
Q

Platelet transfusions may be indicated despite an apparently adequate platelet count if there is

A

known platelet dysfunction and microvascular bleeding.

44
Q

Most major surgeries

A

50000 threshold for platelets tx

45
Q

Epidural anesthesia –plt threshold

A

80,000/microL

46
Q

Replacement of an entire blood volume leaves the

patient with approximately

A

1/3 of the original concentration of coagulation factors.

47
Q

Although lab values such as PT and PTT may be
abnormal, clinical coagulopathy from dilution usually
does not occur until replacement

A

exceeds one blood volume or when the PT and PTT exceeds 1.5-1.8 times control then start giving FFPs

48
Q

In preoperative patients with no history of bleeding,
retrospective studies show that abnormal PT and PTT
are

A

poor predictors of bleeding

49
Q

______is indicated for urgent reversal of warfarin therapy.

A

FFP

50
Q

FFP should be given in doses calculated
to achieve a minimum of ________except
for urgent

A

30% of plasma concentration (10-15ml/kg of FFP),
Except for urgent reversal of warfarin anticoagulation, for which (5-8ml/kg of FFP) will usually suffice. 4-5 platelet
concentrations, or one unit of whole blood provide a quantity of coagulation factors

51
Q

FFP is contraindicated for

A

augmentation of plasma volume or albumin concentration.

52
Q

Most patients with factor VIII deficiency will be treated with___________ and patients with some subtypes of vWD respond to DDAVP.

A

factor VIII concentrates

53
Q

_______ _____________, _____, is
used for correction of inherited and acquired
coagulopathy.

A

Cryoprecipitate contains factors VIII, fibrinogen,

fibronectin, von Willibrand’s factor, and factor XIII,

54
Q

Albumin 25g (100ml of 25% solution), is equivalent

A

osmotically to 500ml of plasma, but contains about 1/7 the amount of sodium present in the same amount of plasma.

55
Q

25% reserved for

A

Kidney , liver

56
Q

The administration of 25% albumin will draw

A

3-4ml of fluid from the interstitial space into
the vascular space for every 1ml of albumin
given.

57
Q

Best way to correct albumin deficiency

A

by feeding the patient

58
Q

PPF is a 5% pooled solution of stabilized plasma proteins in saline containing at

A

least 83% albumin and no
more than 17% globulins, of which <1%
are gamma globulins.

59
Q

● PPF 5% is administered to treat

A

hypovolemic shock

60
Q

Imnunoglobulin is a concentrated solution of _______ and ________prepared from large pools of ________

A

Immune globulin is a concentrated solution of

globulins, primarily immunoglobulins, prepared from large pools of human plasma

61
Q

● Immune globulin protects against clinical manifestations of

A

hepatitis A when given before or within 2 weeks of exposure.

62
Q

● Replacement therapy for patients with

hypogammaglobulinemia is another use of

A

immune globulin.

63
Q

Immune Globulin SOME indications

A 
● Idiopathic thrombocytopenia purpura (ITP)
CLL
Myasthenia Gravis
SLE
***Guillian barre syndrome
64
Q

Prothrombin Complex Concentrate

(Human) Factors

A

II, VII, IX, X), Protein C, and Protein S];

65
Q

PCC also known as

A

Kcentra

66
Q

Indications for Kcentra

A

Indications; Vitamin K antagonist (VKA) reversal in patients with acute major bleeding or need for an urgent
surgery/invasive procedure.

67
Q

Increase INR require surgery

A

Kcentra

68
Q

Patient require emergent surgery with warfarin BETTER AND FASTER

A

KCENTRA, given faster; but expensive

69
Q

Use Reversal of dabigatran: Reversal of the

anticoagulant effects of

A

dabigatran for emergency surgery/urgent procedures or in life-threatening or uncontrolled bleeding

70
Q

Dosing Reversal of dabigatran: IV:

A

5 g
(administered as 2 separate 2.5 g doses no
more than 15 minutes apart)

71
Q

Xa rivaroxaban, xarelta

A

REVERSAL KNOW

SRNAPharmacology II (32 decks)

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