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Hematology > Blood Groups, Donation > Flashcards

Blood Groups, Donation Flashcards

1
Q

What are the red cell antigens

A

Proteins found on the surface of the membrane of red cell of 400 different type

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2
Q

Two main antigen n red cell

A

ABO

Rh

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3
Q

Components of blood group antigens

A

Carbohydrates and

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4
Q

On which structure of the red cell membrane are the blood group antigens present on

A

The glycolipids and glycoproteins

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5
Q

Which type of antigens is found on the carbohydrate chains of the membrane glycolipid

A

ABO
Hh
Li
P systems

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6
Q

Antigens present on glycoproteins band 3

A

ABO
Hh
Li

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7
Q

Antigens present on glycoproteins glycophorin A

A

MN

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8
Q

Antigens present on glycophorin B

A

Ss

U

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9
Q

Events that stimulate antibodies

A

Blood transfusion
Fetal antigen in maternal circulation
Environmental factors

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10
Q

What does the h gene code for

A

A sugar fucose that’s added to terminal sugar of precursor substance

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11
Q

Precursor substance of rbc in order

A

Glucose - galactose - n acetylglucosamine - galactose

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12
Q

What structure added due to enzyme coded transferase by A GENE

A

N acetylglucosamine

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13
Q

Substance added enzyme coded by gene B

A

D galactose

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14
Q

WHAT IS THE BOMBAY PHENOTYPE

A

people lack Hh antigen which prevents attachment of group A and B

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15
Q

Bombay phenotype

A

O

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16
Q

Bombay serum

A

Anti A
Anti B
Anti AB
anti H

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17
Q

Dominant antigens of rh system

A

C D E

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18
Q

Recessive antigens of Rh system

A

c d e

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19
Q

Strongest antigen effect for for rh system

A

Antigen D
So if D present -> rh pos
If D absent -> rh neg

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20
Q

What are the concept of blood safety

A

Appropriate and low risk donors
screening test for markers of infection
elimination of any pathogens residual
optimize blood usage

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21
Q

When should you transfuse

A

Only when necessary

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22
Q

What substances should you use in deficiency anemia’s

A

Hemanitics

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23
Q

What should you use in aplastic anemia or renal failure

A

Erythropoietin to stimulate the marrow

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24
Q

When should you use crystalloids like normal Saline or colloid like dextran 70

A

When you want to increase intravascular volume

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25
Q

What percentage of blood loss should you use crystalloids or colloids

A

Between 21% to 30%

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26
Q

At what percentage of blood loss should you transfuse blood

A

Above 30

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27
Q

What is a autologous blood transfusion

A

Collection of blood from a single patient and retransfusion back to the same patient when required

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28
Q

When do you do autologous blood transfusion

A

Pre-operative deposit
Hemodilution
Intra-operative blood salvage

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29
Q

What are some principles used for bloodless Surgery

A

Meticulous surgery

Tourniquet

Diathermy

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30
Q

Who is the best donor

A

Voluntary repeated donor

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31
Q

What are the different types of blood donors

A

Voluntary non-remunerated donors
Family replacement donors
commercial donors
autologous donors

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32
Q

What are the immunologic transfusion risks

A 
Immune hemolytic reaction 
febrile non-hemolytic reaction’s
 anaphylactic reaction 
urticarial reaction 
posttransfusional  Purpura
GVHD Graft versus host disease
TRALI Transfusion related acute lung injury
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33
Q

non-immunology transfusion risks

A

Physical thermal injury
Chemical injury with calcium potassium citrate iron toxicity
Viruses bacteria helminthes protozoa prions infections
Acute hypotensive reactions bradykinin induced

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34
Q

Acute life-threatening transfusion reactions

A 
Acute hemolytic reaction 
acute anaphylactic reaction 
transfusion related sepsis 
transfusion related acute lung injury 
Iacute hyperkalemia and hypocalcemia 
acute hypervolemia
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35
Q

Nonlife threatening acute transfusion reactions

A

Febrile non hemolytic transfusion reaction

urticarial

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36
Q

What is acute hemolytic transfusion reaction

A

Hemolysis of transfused red cells due to pre-existing antibody in recipients serum

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37
Q

When does acute hemolytic transfusion reaction mostly occur

A

Mostly in ABO incompatibility especially in group O receiving non O blood

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38
Q

Most common form of transfusion reaction

A

Acute hemolytic transfusion reaction

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39
Q

Symptoms and signs of a cute hemolytic transfusion reaction

A 
Heat
Pain in vein 
 throbbing headache
 fever 
chest tightness 
dyspnea 
myalgia 
lung pain 
Hypotensiom
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40
Q

Immunoglobulin involved in acute hemolytic transfusion reaction

A

IgM Which mediates complement activation Intravascular hemostasis and the activation of coagulation cascade

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41
Q

Complications of acute hemolytic transfusion reaction

A

Shock
disseminated intravascular coagulation
acute renal failure

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42
Q

Management of acute hemolytic transfusion reaction

A 
Stop transfusion
 alert blood bank immediately 
maintain blood pressure and diuresis with normal-saline
Clerical checks 
Samples to blood bank 
Cardiac monitoring 
Full blood counts 
coagulation test - Platelets ,fibrinogen ,APTT, D dimers 
chemistries of renal and liver function 
urinalysis
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43
Q

How to prevent acute hemolytic transfusion reaction

A

Meticulous compatibility test

proper patient identification from sample collection to blood administration

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44
Q

Is acute anaphylactic reaction in blood transfusion a medical emergency

A

Yes

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45
Q

Symptoms and signs of a cute anaphylactic reaction in blood transfusion

A

Fever
chills
urticaria
hypotension

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46
Q

Management of a cute anaphylactic reaction

A

Stop transfusion
supportive care
antihistamines steroids epinephrine

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47
Q

What is the cause of transfusion related Sepsis

A

Asymptomatic bacteremic donors

Bacteremic venipuncture during collection of blood

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48
Q

Is transfusion related services commoner in platelets or red cell transfusion

A

Platelets transfusion

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49
Q

Common organism in traduction related sepsis

A 
Yersinia 
E. coli
Pseudomonas 
Staph
Strep
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50
Q

Symptoms and signs of transfusion related sepsis

A 
Fever
Hypotension 
Shock
DIC
complement activation
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51
Q

Management of transfusion related sepsis

A

Stop transfusion
Agressive IV broad spectrum antibiotics
Blood culture

52
Q

What is TRALI

A

Non cardiogenic pulmonary edema

53
Q

Cause of TRALI

A

HLA antibodies of donor reacting with recipients neutrophils antigens leading to complement activation

54
Q

Symptoms of TRALI in 1h

A

Dyspnea
Tachypnoea
Tachycardia
Hypotension

55
Q

CXR of TRALI

A

Patchy alveolar infiltrate

56
Q

Management of TRALI

A

supportive care
Mechanical ventilation
Diuretics

57
Q

Acute metabolic the arrangements in transfusion

A

Hyperkalemia

hypocalcemia

58
Q

When do you have a hyperkalemia in transfusion

A

Massive red cell transfusion
exchange transfusion in infants
renal failure
irradiated blood

59
Q

Risk of hyperkalemia

A

Cardiac arrest

60
Q

Management of hyperkalemia

A

ECG Management
Calcium gluconate
Insulin glucose

61
Q

Hypocalcemia causes

A

Massive transfusion of plasma products

62
Q

Symptoms of Hypocalcemia

A

Tetany
Convulsions
Hypotension

63
Q

Management of Hypocalcemia

A

Calcium

64
Q

Patient at risk of acute hypervolemia

A

Poor cardiac status

Old patient with décompensation

65
Q

Acute hypervolemia signs and symptoms

A

Shortness of breath

Crépitation lung base

66
Q

Management acute hypervolemia

A

Furosemide

67
Q

Cause of febrile non hemolytic rxn

A

HLA antibodies against contaminating white cells and inflammatory cytokines and transfused products

68
Q

Symptoms of febrile non hemolytic rxn

A

Chills
nausea
vomiting
myalgia

69
Q

Management of febrile none hemolytic reaction

A

Stop transfusion
exclude acute hemolytic transfusion reaction
repeats GXM
coombs test

70
Q

Delayed transfusion rxn

A

Delayed hemolytic transfusion
Transfusion associated graft vs host disease
Post transfusion purpura
Transfusion transmitted Protozoa

71
Q

Cases where there is delayed hemolytic transfusion reaction

A

Pregnancy

previous transfusion

72
Q

Cause of post transfusion Purpera

A

Antibodies against HPA1a

73
Q

Signs and symptoms and labs of post transfusion purpura

A

Low platelets

evident mucocutaneous bleeding

74
Q

In which cases do you mostly have post transfusion purpura

A

In cardiac bypass surgery

75
Q

Treatment of POST transfusion PURPURA

A

Immunoglobulin Iv
Steroids
plasma exchange

76
Q

Can you do platelet transfusion in post transfusion purpura

A

No

77
Q

Implicated protozoa in transfusion transmitted protozoa

A

Plasmodium species

Babesia species

78
Q

Where do you see transfusion associated graft versus host disease

A

In immunocompromise patients

79
Q

Presentation of transfusion associated graft versus host

A

Skin liver git symptoms

Bone marrow aplasia

80
Q

Prevention of transfusion associated graft versus host

A

Grant gamma irradiation

Leucodepletion

81
Q

Late complications of transfusion

A

Transfusion Haemosiderosis
Transfusion transmitted infections
Allo immunization

82
Q

What is transfusion Haemosiderosis

A

Iron overload in patients with high red cell transfusion requirements

83
Q

In which conditions requiring hi red cell transfusion is there a transfusion Haemosiderosis

A

Thalassemia major
aplastic anemia
refractory anemia

84
Q

Amount of iron per unit of blood

A

250 mg

85
Q

At what amount of blood is there organ damage

A

20 units

86
Q

Risks of transfusion hemosiderosis

A

Cardiomyopathy
Cirrhosis
Endocrine dysfunction
skin hyperpigmentation

87
Q

Prevention of transfusion Haemosiderosis

A

Iron chelation

88
Q

Virus is present in allogeneic leukocytes only

A 
Cytomegalovirus 
Epstein bar virus 
human T lympha traffic virus
 human herpesvirus type six 
human herpesvirus type 8
89
Q

Viruses present in both allogeneic leukocytes and as virions in plasma so transmitted by all type of blood products

A

Human immunodeficiency virus

90
Q

Viruses present in plasma only as free virions

A 
Hepatitis A 
hepatitis B 
hepatitis C 
hepatitis D 
hepatitis E 
hepatitis G
 b19 parvovirus
91
Q

Pathogens present in red cells

A

Yersinia enterolotica
pseudonomas fluoresces
salmonella species

92
Q

Pathogens present in platelets

A

Staphylococci
salmonella and serratia species
b cereus

93
Q

Miscellaneous of blood

A

T pallidum syphilis
borrelia Lyme disease
waterbath or platelet back contamination

94
Q

Protozoa in blood

A 
Plasmodia malaria
 Trypanosoma cruzi Chagas disease 
Brancrofti babesiosis 
L donovani African leischmaniasis
 T Gambiense Trypanosomiasis 
T gondi toxoplasmosis
95
Q

Helminths in blood

A

W bancrofti filariasis

96
Q

What is allo immunization

A

Development of antibodies to red cell and HLA antigens within weeks of transfusion

97
Q

What are the principles of donor selection

A

Blood donation should not harm the donor
Donated blood should be replaced rapidly and completely
The bloods should not harmed the recipients

98
Q

What are the sites of donation

A

Walk in donations at blood center

Mobile blood donation for targeted and untargerted population group

99
Q

What type of blood donors

A

Voluntary donors
replacement donors
commercial donors

100
Q

Type of screening test of bloods collected at blood center

A 
HIV one and two 
hepatitis B 
hepatitis C 
syphilis 
blood grouping
101
Q

What are the constituent of blood separated from whole blood

A 
Packed red blood cells 
fresh frozen plasma 
cryoprecipitate 
platelet concentrates 
granulocytes 
other plasma derived product
102
Q

What is the transfusion chain

A

Request for transfusion
collection of blood sample from pre-transfusion compatibility testing
collection of blood component from blood banks to the word administration of blood components with documentation monitoring management

103
Q

type of information important in a request for transfusion

A

Patient identification
type of component required
number of units or volume required
unmatched in emergency situations

104
Q

Information required in sample taking

A

Patient identification especially on the sample
date and time of collection
name of the person who took the sample

105
Q

Three test meet at the blood bank

A

ABO/RH
Antibody detection and identification
Cross matching

106
Q

Dangerous blood donor

A

group O because anti a and b in blood which causes hemolysis of rbc

107
Q

Indications for whole blood

A

’ Hb rise & volume replacement needed
Acute massive blood loss
Severe anemia
Exchange blood transfusion of neonates

108
Q

Whole blood dosage in children

A

Reavined Hb rise x child’s weight

109
Q

Adult owhole blood dosage

A

1 unit for 1g/dl Hb

110
Q

Concentrated red cells

A

Whole blood centrifuged which separates red cell from plasma components
1 unit has 150-200ml cvolume

111
Q

Concentrated red cell indication

A

Acute anemia ( blood loss, trauma, surgery, DIC, acute hemolysis)

Chronic anemia ( malnutrition, renal impairment, chronic disease, bone marrow d failure)

112
Q

Contra indication of concentrantes Red cela

A

Never volume replacement or other disease than the ones indicated

113
Q

Dosage concentrantes Red cell in children

A

Hb x 3 x child’s weight

114
Q

Adult dosage concentrated red cell

A

One unit for 1g/dl hb

115
Q

Platelets concentrâtes

A

Platelet suspende in 20-50mls of original plasma

116
Q

R amont of platelet per unit

A

’ 55x10^9

117
Q

Indication of platelet transfusion

A

Bleeding in thrombocytopenia
Prevention of spontaneous bleeding
Impending surgery or invasive procedures involving the central nervous system the eye or the spine
Open heart surgery with microvascular bleeding and platelet count lower than 150x109
Treatment of platelet function defect

118
Q

What is fresh frozen plasma

A

Blood products made from the liquid portion of whole blood

119
Q

William a fresh frozen plasma per unit

A

To 200 -250 mL

120
Q

Is crossmatch necessary in fresh frozen plasma

A

No

121
Q

Is fresh frozen plasma transfusion ABORH specific

A

Yes

122
Q

Indication for fresh frozen plasma

A

Treatment of clotting deficiencies
Liver disease DIC warfarin overdose
Coagulation factor depression in massive transfusion thrombotic
thrombocytopenic Purpera e

Hemolytic uremic syndrome

123
Q

Components of cryoprecipitate

A

factor VIII
fibrinogen
factor XIII
vWF

124
Q

Is cryoprecipitate group specific or crossmatch

A

No crossmatch but group specific

125
Q

Indication of cryoprecipitate

A

Hemophilia a
fibrinogen source in DIC
Von Willebrand factor deficiency
Factors 13 deficiency

126
Q

When should you check for vital sign and document it

A

Within one hour prior to transfusion
after first 15 minutes of transfusion
every hour during transfusion
one hour after transfusion

Hematology (24 decks)

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