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CR2 > Blood Groups And Blood Transfusion > Flashcards

Blood Groups And Blood Transfusion Flashcards

1
Q

What is a blood group

A

Classification of blood based on structures on surface of RBCs

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2
Q

What structures on the surface of RBCs act as antigens

A

Carbohydrates
Proteins
Glycolipids
Glycoproteins

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3
Q

What determines which antigens are present on an RBC

A

genes

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4
Q

What are the 2 most clinically important blood group systems

A

ABO
Rhesus

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5
Q

What are blood group antibodies

A

Immunoglobulins to RBC surface antigens

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6
Q

What are the 2 types of blood group antibodies

A

Acquired
Natural

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7
Q

Are natural blood group antibodies innate

A

No

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8
Q

When are acquired blood group antibodies formed

A

Immune response to exposure

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9
Q

How are neonates believed to gain natural blood group antibodies

A

Small amounts of antigens entering body through food, bacteria, and mosquito bites

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10
Q

What happens in the blood antibody- antigen reaction

A

Antibodies cross link to antigens causing RBC agglutination

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11
Q

What happens when an antibody antigen reaction occurs in vitro

A

RBC Clumping

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12
Q

What happens when an antibody antigen reaction occurs in vivo

A

RBC Haemolysis or phagocytosis

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13
Q

What defines a persons ABO blood group

A

A and B antigens on RBCs
Anti A and anti B antibodies in serum

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14
Q

When do patients have anti A or anti B antibodies in their plasma

A

When they don’t have the corresponding A or B antigen

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15
Q

How are ABO blood groups inherited

A

A and B Co dominant
O recessive

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16
Q

Which ABO blood type is the universal donor

A

Type O

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17
Q

Which ABO blood type is the universal recipient

A

AB

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18
Q

Which 3 proteins are the most important in the Rhesus system

A

C D and E

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19
Q

What protein determines rhesus +/- state

A

D protein

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20
Q

What does Rhesus positive mean

A

Express immunogenic D antigen

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21
Q

What does Rhesus dpnegative mean

A

No expression of D antigen

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22
Q

When d genotypes are Rhesus positive

A

DD or Dd

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23
Q

Which d genotype is Rhesus negative

A

dd

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24
Q

How does haemolytic disease of the newborn occur

A

Rh- mother carrying Rh+ baby -> Rh antigens from Cetus enter mothers blood -> mother produces anti Rh antibodies -> anti Rh antibodies attack RBCs of subsequent Rh+ foetus

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25
Q

What blood type mothers and foetuses can haemolytic disease of the newborn occur in

A

RH- mother
Rh+ feotus

26
Q

How is haemolytic disease of the newborn prevented

A

Anti d immunoglobulin administered to mother

27
Q

How does anti d immunoglobulin prevent haemolytic disease of the newborn

A

Neutralises RhD positive antigens so mother doesn’t produce antibodies

28
Q

When is anti d immunoglobulin administered

A

Risk d antigens have crossed into blood
Routine prophylaxis

29
Q

Types of blood used for transfusion

A

Red cells
Platelets
Plasma - fresh frozen, cryoprecipitate, clotting factor concentrates

30
Q

When are packed red cells used

A

Haemorrhage
Bone marrow failure
Haemolysis
Inherited Hb disorders
Anaemia

31
Q

When are platelets used

A

surgery/invasive procedure w no active bleeding
Stable, non bleeding

32
Q

What is the most common cause of transfusion mismatch

A

Transfusion being given to wrong patient

33
Q

How is blood typed

A

Plasma mixed with special detector RBCs expressing all common blood group antigens -> plasma antibodies bind to detector RBCs -> positive result = agglutination

34
Q

What observations are monitored during transfusion

A

Pulse
Blood pressure
Temp

35
Q

Which transusion complication is a NHS never event

A

Acute haemolytic reaction

36
Q

What causes acute haemolytic reaction

A

Transfusion of wrong ABO blood type

37
Q

acute haemolytic reaction

A

Massive intravascular haemolysis mediated through IgM due to incompatible ABO blood transfusion

38
Q

Acute haemolytic reaction signs and symptoms

A

Fever
Abdominal pain
Hypotension

39
Q

How quickly does acute haemolytic reaction occur

A

Minutes

40
Q

Acute haemolytic reaction management

A

Stop transfusion
Supportive care
Fluid resuscitation
Repeat blood typing, recheck patient and blood details

41
Q

Non haemolytic febrile reaction

A

Antibodies react with white cell fragments in transfused blood product and cytokines that have leaked from blood cells during storage

42
Q

Non haemolytic febrile reaction signs and symptoms

A

fever
chills

43
Q

Non haemolytic febrile reaction management

A

Slow down transfusion
Paracetamol

44
Q

Blood transfusion minor allergic reaction

A

Reaction to foreign plasma protein

45
Q

Transfusion minor allergic reaction signs and symptoms

A

Pruritus
Urticaria

46
Q

Transfusion minor allergic reaction management

A

Temporarily stop transfusion
Antihistamine
Monitoring

47
Q

Transfusion anaphylaxis cause

A

Patient with IgA deficiency who has anti IgA antibodies given blood with IgA

48
Q

What deficiency mediates anaphylaxis from transfusion

A

IgA

49
Q

Transfusion anaphylaxis symptoms

A

Hypotension
Dyspnoea
Wheezing
Angioedema

50
Q

Anaphylaxis management

A

IM adrenaline
ABC support

51
Q

Transfusion associated circulatory overload - TACO

A

Fluid overload caused by excessive rate of transfusion into pre existing heart failure

52
Q

Which patients can get TACO

A

Heart failure patients

53
Q

TACO signs and symptoms

A

Pulmonary oedema
Hypertension

54
Q

TACO management

A

Slow/stop transfusion
IV Loop diuretic
Oxygen

55
Q

How does transfusion cause TACO in HF patients

A

Transfusion increases blood volume
Electrolytes in transfusion cause kidneys to resorb more fluid

56
Q

Transfusion related acute lung injury - TRALI

A

Non cardiogenic pulmonary oedema secondary to neutrophil activation

57
Q

TRALI signs and symptoms

A

Hypoxia
Pulmonary infiltrates in CXR
Fever
Hypotension

58
Q

TRALI management

A

Stop transfusion
Oxygen
Supportive care

59
Q

How does neutrophil activation cause TRALI

A

WBC degranulation increases vascular permeability causing inflammation and oedema

60
Q

Infectious complications of transfusion

A

Bacterial contamination
Bacterial transmission
Viral transmission
Parasites

61
Q

Why are RBCs inspected before administration

A

Check for contamination

CR2 (33 decks)

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