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
2
Q
Two main antigen n red cell
A
ABO
Rh
3
Q
Components of blood group antigens
A
Carbohydrates and
4
Q
On which structure of the red cell membrane are the blood group antigens present on
A
The glycolipids and glycoproteins
5
Q
Which type of antigens is found on the carbohydrate chains of the membrane glycolipid
A
ABO
Hh
Li
P systems
6
Q
Antigens present on glycoproteins band 3
A
ABO
Hh
Li
7
Q
Antigens present on glycoproteins glycophorin A
A
MN
8
Q
Antigens present on glycophorin B
A
Ss
U
9
Q
Events that stimulate antibodies
A
Blood transfusion
Fetal antigen in maternal circulation
Environmental factors
10
Q
What does the h gene code for
A
A sugar fucose that’s added to terminal sugar of precursor substance
11
Q
Precursor substance of rbc in order
A
Glucose - galactose - n acetylglucosamine - galactose
12
Q
What structure added due to enzyme coded transferase by A GENE
A
N acetylglucosamine
13
Q
Substance added enzyme coded by gene B
A
D galactose
14
Q
WHAT IS THE BOMBAY PHENOTYPE
A
people lack Hh antigen which prevents attachment of group A and B
15
Q
Bombay phenotype
A
O
16
Q
Bombay serum
A
Anti A
Anti B
Anti AB
anti H
17
Q
Dominant antigens of rh system
A
C D E
18
Q
Recessive antigens of Rh system
A
c d e
19
Q
Strongest antigen effect for for rh system
A
Antigen D
So if D present -> rh pos
If D absent -> rh neg
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
21
Q
When should you transfuse
A
Only when necessary
22
Q
What substances should you use in deficiency anemia’s
A
Hemanitics
23
Q
What should you use in aplastic anemia or renal failure
A
Erythropoietin to stimulate the marrow
24
Q
When should you use crystalloids like normal Saline or colloid like dextran 70
A
When you want to increase intravascular volume
25
What percentage of blood loss should you use crystalloids or colloids
Between 21% to 30%
26
At what percentage of blood loss should you transfuse blood
Above 30
27
What is a autologous blood transfusion
Collection of blood from a single patient and retransfusion back to the same patient when required
28
When do you do autologous blood transfusion
Pre-operative deposit
Hemodilution
Intra-operative blood salvage
29
What are some principles used for bloodless Surgery
Meticulous surgery
Tourniquet
Diathermy
30
Who is the best donor
Voluntary repeated donor
31
What are the different types of blood donors
Voluntary non-remunerated donors
Family replacement donors
commercial donors
autologous donors
32
What are the immunologic transfusion risks
```
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
```
33
non-immunology transfusion risks
Physical thermal injury
Chemical injury with calcium potassium citrate iron toxicity
Viruses bacteria helminthes protozoa prions infections
Acute hypotensive reactions bradykinin induced
34
Acute life-threatening transfusion reactions
```
Acute hemolytic reaction
acute anaphylactic reaction
transfusion related sepsis
transfusion related acute lung injury
Iacute hyperkalemia and hypocalcemia
acute hypervolemia
```
35
Nonlife threatening acute transfusion reactions
Febrile non hemolytic transfusion reaction
| urticarial
36
What is acute hemolytic transfusion reaction
Hemolysis of transfused red cells due to pre-existing antibody in recipients serum
37
When does acute hemolytic transfusion reaction mostly occur
Mostly in ABO incompatibility especially in group O receiving non O blood
38
Most common form of transfusion reaction
Acute hemolytic transfusion reaction
39
Symptoms and signs of a cute hemolytic transfusion reaction
```
Heat
Pain in vein
throbbing headache
fever
chest tightness
dyspnea
myalgia
lung pain
Hypotensiom
```
40
Immunoglobulin involved in acute hemolytic transfusion reaction
IgM Which mediates complement activation Intravascular hemostasis and the activation of coagulation cascade
41
Complications of acute hemolytic transfusion reaction
Shock
disseminated intravascular coagulation
acute renal failure
42
Management of acute hemolytic transfusion reaction
```
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
```
43
How to prevent acute hemolytic transfusion reaction
Meticulous compatibility test
| proper patient identification from sample collection to blood administration
44
Is acute anaphylactic reaction in blood transfusion a medical emergency
Yes
45
Symptoms and signs of a cute anaphylactic reaction in blood transfusion
Fever
chills
urticaria
hypotension
46
Management of a cute anaphylactic reaction
Stop transfusion
supportive care
antihistamines steroids epinephrine
47
What is the cause of transfusion related Sepsis
Asymptomatic bacteremic donors
| Bacteremic venipuncture during collection of blood
48
Is transfusion related services commoner in platelets or red cell transfusion
Platelets transfusion
49
Common organism in traduction related sepsis
```
Yersinia
E. coli
Pseudomonas
Staph
Strep
```
50
Symptoms and signs of transfusion related sepsis
```
Fever
Hypotension
Shock
DIC
complement activation
```
51
Management of transfusion related sepsis
Stop transfusion
Agressive IV broad spectrum antibiotics
Blood culture
52
What is TRALI
Non cardiogenic pulmonary edema
53
Cause of TRALI
HLA antibodies of donor reacting with recipients neutrophils antigens leading to complement activation
54
Symptoms of TRALI in 1h
Dyspnea
Tachypnoea
Tachycardia
Hypotension
55
CXR of TRALI
Patchy alveolar infiltrate
56
Management of TRALI
supportive care
Mechanical ventilation
Diuretics
57
Acute metabolic the arrangements in transfusion
Hyperkalemia
| hypocalcemia
58
When do you have a hyperkalemia in transfusion
Massive red cell transfusion
exchange transfusion in infants
renal failure
irradiated blood
59
Risk of hyperkalemia
Cardiac arrest
60
Management of hyperkalemia
ECG Management
Calcium gluconate
Insulin glucose
61
Hypocalcemia causes
Massive transfusion of plasma products
62
Symptoms of Hypocalcemia
Tetany
Convulsions
Hypotension
63
Management of Hypocalcemia
Calcium
64
Patient at risk of acute hypervolemia
Poor cardiac status
| Old patient with décompensation
65
Acute hypervolemia signs and symptoms
Shortness of breath
| Crépitation lung base
66
Management acute hypervolemia
Furosemide
67
Cause of febrile non hemolytic rxn
HLA antibodies against contaminating white cells and inflammatory cytokines and transfused products
68
Symptoms of febrile non hemolytic rxn
Chills
nausea
vomiting
myalgia
69
Management of febrile none hemolytic reaction
Stop transfusion
exclude acute hemolytic transfusion reaction
repeats GXM
coombs test
70
Delayed transfusion rxn
Delayed hemolytic transfusion
Transfusion associated graft vs host disease
Post transfusion purpura
Transfusion transmitted Protozoa
71
Cases where there is delayed hemolytic transfusion reaction
Pregnancy
| previous transfusion
72
Cause of post transfusion Purpera
Antibodies against HPA1a
73
Signs and symptoms and labs of post transfusion purpura
Low platelets
| evident mucocutaneous bleeding
74
In which cases do you mostly have post transfusion purpura
In cardiac bypass surgery
75
Treatment of POST transfusion PURPURA
Immunoglobulin Iv
Steroids
plasma exchange
76
Can you do platelet transfusion in post transfusion purpura
No
77
Implicated protozoa in transfusion transmitted protozoa
Plasmodium species
| Babesia species
78
Where do you see transfusion associated graft versus host disease
In immunocompromise patients
79
Presentation of transfusion associated graft versus host
Skin liver git symptoms
| Bone marrow aplasia
80
Prevention of transfusion associated graft versus host
Grant gamma irradiation
| Leucodepletion
81
Late complications of transfusion
Transfusion Haemosiderosis
Transfusion transmitted infections
Allo immunization
82
What is transfusion Haemosiderosis
Iron overload in patients with high red cell transfusion requirements
83
In which conditions requiring hi red cell transfusion is there a transfusion Haemosiderosis
Thalassemia major
aplastic anemia
refractory anemia
84
Amount of iron per unit of blood
250 mg
85
At what amount of blood is there organ damage
20 units
86
Risks of transfusion hemosiderosis
Cardiomyopathy
Cirrhosis
Endocrine dysfunction
skin hyperpigmentation
87
Prevention of transfusion Haemosiderosis
Iron chelation
88
Virus is present in allogeneic leukocytes only
```
Cytomegalovirus
Epstein bar virus
human T lympha traffic virus
human herpesvirus type six
human herpesvirus type 8
```
89
Viruses present in both allogeneic leukocytes and as virions in plasma so transmitted by all type of blood products
Human immunodeficiency virus
90
Viruses present in plasma only as free virions
```
Hepatitis A
hepatitis B
hepatitis C
hepatitis D
hepatitis E
hepatitis G
b19 parvovirus
```
91
Pathogens present in red cells
Yersinia enterolotica
pseudonomas fluoresces
salmonella species
92
Pathogens present in platelets
Staphylococci
salmonella and serratia species
b cereus
93
Miscellaneous of blood
T pallidum syphilis
borrelia Lyme disease
waterbath or platelet back contamination
94
Protozoa in blood
```
Plasmodia malaria
Trypanosoma cruzi Chagas disease
Brancrofti babesiosis
L donovani African leischmaniasis
T Gambiense Trypanosomiasis
T gondi toxoplasmosis
```
95
Helminths in blood
W bancrofti filariasis
96
What is allo immunization
Development of antibodies to red cell and HLA antigens within weeks of transfusion
97
What are the principles of donor selection
Blood donation should not harm the donor
Donated blood should be replaced rapidly and completely
The bloods should not harmed the recipients
98
What are the sites of donation
Walk in donations at blood center
| Mobile blood donation for targeted and untargerted population group
99
What type of blood donors
Voluntary donors
replacement donors
commercial donors
100
Type of screening test of bloods collected at blood center
```
HIV one and two
hepatitis B
hepatitis C
syphilis
blood grouping
```
101
What are the constituent of blood separated from whole blood
```
Packed red blood cells
fresh frozen plasma
cryoprecipitate
platelet concentrates
granulocytes
other plasma derived product
```
102
What is the transfusion chain
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
type of information important in a request for transfusion
Patient identification
type of component required
number of units or volume required
unmatched in emergency situations
104
Information required in sample taking
Patient identification especially on the sample
date and time of collection
name of the person who took the sample
105
Three test meet at the blood bank
ABO/RH
Antibody detection and identification
Cross matching
106
Dangerous blood donor
group O because anti a and b in blood which causes hemolysis of rbc
107
Indications for whole blood
' Hb rise & volume replacement needed
Acute massive blood loss
Severe anemia
Exchange blood transfusion of neonates
108
Whole blood dosage in children
Reavined Hb rise x child’s weight
109
Adult owhole blood dosage
1 unit for 1g/dl Hb
110
Concentrated red cells
Whole blood centrifuged which separates red cell from plasma components
1 unit has 150-200ml cvolume
111
Concentrated red cell indication
Acute anemia ( blood loss, trauma, surgery, DIC, acute hemolysis)
Chronic anemia ( malnutrition, renal impairment, chronic disease, bone marrow d failure)
112
Contra indication of concentrantes Red cela
Never volume replacement or other disease than the ones indicated
113
Dosage concentrantes Red cell in children
Hb x 3 x child’s weight
114
Adult dosage concentrated red cell
One unit for 1g/dl hb
115
Platelets concentrâtes
Platelet suspende in 20-50mls of original plasma
116
R amont of platelet per unit
' 55x10^9
117
Indication of platelet transfusion
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
What is fresh frozen plasma
Blood products made from the liquid portion of whole blood
119
William a fresh frozen plasma per unit
To 200 -250 mL
120
Is crossmatch necessary in fresh frozen plasma
No
121
Is fresh frozen plasma transfusion ABORH specific
Yes
122
Indication for fresh frozen plasma
Treatment of clotting deficiencies
Liver disease DIC warfarin overdose
Coagulation factor depression in massive transfusion thrombotic
thrombocytopenic Purpera e
Hemolytic uremic syndrome
123
Components of cryoprecipitate
factor VIII
fibrinogen
factor XIII
vWF
124
Is cryoprecipitate group specific or crossmatch
No crossmatch but group specific
125
Indication of cryoprecipitate
Hemophilia a
fibrinogen source in DIC
Von Willebrand factor deficiency
Factors 13 deficiency
126
When should you check for vital sign and document it
Within one hour prior to transfusion
after first 15 minutes of transfusion
every hour during transfusion
one hour after transfusion
