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Blood > Blood group and transfusion > Flashcards

Blood group and transfusion Flashcards

1
Q

Types of blood transfusion

A

Packed RBC

WBC

Platelets

Frozen plasma

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2
Q

How is frozen plasma stored after it’s thawed?

A

Cryoprecipitates

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3
Q

What is an antigen?

A

Substances foreign to the immune system
- Ab generator

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4
Q

What is an Ab?

A

Y-shaped protein that recognises specific antigen

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5
Q

Why is transfusion rxn an immune response?

A

Surface antigens on RBCs stimulate immune rxn

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6
Q

What is blood grp antigens made of?

A

Glycoproteins

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7
Q

Where are ABO antigens coded?

A

Allele of chromosome 9

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8
Q

How is A antigen coded for?

A

A allele code for GalNAc transferase -> transferred to surface of RBC -> A antigen

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9
Q

How is B antigen coded for?

A

B allele code for Gal transferase -> transferred to surface of RBC -> B antigen

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10
Q

How is O antigen formed?

A

O allele code for dysfunctional enzyme -> glucose moiety not transferred -> absent glucose moiety on RBC surface results in O antigen

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11
Q

What Ab are coded for after person’s blood type is determined?

A

Body will code for Ab against antigen that is not present on RBC

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12
Q

What happens when there is a mismatched transfusion?

A

Recipient’s Ab binds and agglutinates donor’s RBC -> blood clumps up -> can’t squeeze through parts of capillary -> trapped in liver/spleen -> haemolytic transfusion rxn

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13
Q

What is haemolytic transfusion rxn?

A

Trapped RBCs are haemolysed by macrophages in spleen/liver -> RBCs burst

Intravascular haemolysis by complement system

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14
Q

Symptoms of haemolytic transfusion rxn (mild)

A

Fever/chills

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15
Q

Symptoms of haemolytic transfusion rxn (severe)

A

Jaundice, renal failure, disseminated intravascular coagulation (DIC)

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16
Q

Can donor’s agglutinin cause rxns?

A

Generally no

Exceptions:

Plasma transfused in low amts -> amt of foreign body introduced is so low it’s diluted.

For agglutination to happen -> need a lot of Ab to clump all the RBC tgt at a significant scale

17
Q

Is ABO the only blood antigen?

A

No

18
Q

Why is cross matching needed?

A

To screen for other reactive Ab

19
Q

How is cross matching done?

A

Cross match recipient’s serum w/ donor’s RBC -> screen for agglutination

20
Q

How is cross matching results interpreted?

A

RBC not clumping -> low risk of transfusion rxn

RBC clumps -> fatal

21
Q

Name another blood group

A

Rhesus (Rh)

22
Q

What are Rh antigens?

A

Transmembrane proteins on RBC surface

23
Q

Which Rh antigen is the most immunogenic?

A

Rh D

24
Q

What does Rh+ mean?

A

Rh D present

25
Q

What does Rh- mean?

A

Rh D absent

26
Q

How does delayed transfusion rxn happen?

A

When Rh- recipient receives Rh+ blood, anti-D Ab develops 2-4 weeks aft first exposure

27
Q

What is hemolytic disease of the newborn (HDN)?

A

Autoimmune condition involving Rh- mother and 2nd/3rd Rh+ newborn

28
Q

How is hemolytic disease of the newborn developed?

A

Exposure of mother to Rh+ RBC during 1st labour sensitizes mother to Rh D antigen -> 1st exposure is the 1st labour
- placenta breaks and exposes mum to Rh+

Anti-D IgG develops in btw pregnancy
- can cross placenta barrier

Anti-D IgG crosses placenta to attack RBC of foetus (during 2nd pregnancy)

29
Q

Possible symptoms/ complications of HDN and how they come abt

A

Haemolytic anemia

Jaundice
- RBC lyse -> bilirubin released

Spleno/hepatomegaly
- RBC lyse -> spleen and liver work more to produce more RBC

Erythroblastosis - erythroblast (premature RBC) seen in blood -> indicate sever anemia

Brain damage (kernicterus)
- accumulation of a lot of unconjugated bilirubin -> toxic to organ

Severe edema
- unconjugated bilirubin change osmotic pressure -> fluid build up

Hydrops fetalis - fetus drops out
- severe
- fetus drops out as a result of symptoms above

30
Q

How is HDN prevented?

A

Rh grp of newborn found in 3rd trimester, anti-D injection given at 3rd trimester if have mismatch

31
Q

Why does the anti-D injection not affect the fetus in the case of HDN?

A

Dose used won’t significantly impact fetus but can wipe out RBC being exposed to mum from fetus -> mom not sensitised

32
Q

How does anti-D injection prevent HDN?

A

Rh+ RBC that entered maternal circulation rapidly bound and cleared before immune system is stimulated -> fetus unaffected

33
Q

Can ABO incompatibility cause HDN and why?

A

No

ABO not fully developed during pregnancy -> Ab from mom won’t attack as antigen on baby’s not even formed yet

34
Q

What does anti-A mean?

A

It binds to A antigen

Blood (9 decks)

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