Blood Groups / Transfusions

Question 1

What chromosome and what gene are responsible for blood groups?

Answer 1

Chromosome 9

A and B gene

Question 2

What do the A and B gene on chromosome 9 code for?

Answer 2

Transferases

Alter H substance on RBC membrane

Question 3

Which antigen genes are co-dominant? Which is silent

Answer 3

A and B dominant

O silent

Question 4

Name the 4 blood groups in order of population frequency in the UK

Answer 4

O
A
B
AB

Question 5

Which antigens and antibodies does blood group O have?

Answer 5

No antigens

A + B antibodies

Question 6

Which antigens and antibodies does blood group A have?

Answer 6

A antigen

B antibody

Question 7

Which antigens and antibodies does blood group B have?

Answer 7

B antigen

A antibody

Question 8

Which antigens and antibodies does blood group AB have?

Answer 8

A + B antigen

No antibodies

Question 9

What is Landsteiner’s law?

Answer 9

If someone lacks an antigen, the corresponding antibody is made in the plasma

Question 10

What blood groups can blood group O receive blood from?

Answer 10

O

Question 11

What blood groups can blood group A receive blood from?

Answer 11

O + A

Question 12

What blood groups can blood group B receive blood from?

Answer 12

O + B

Question 13

What blood groups can blood group AB receive blood from?

Answer 13

O + A + B

Question 14

Pregnancy and transfusion can cause what effect on blood groups?

Answer 14

Antibody sensitisation

Question 15

85% of the population is what blood antibody positive?

Answer 15

Rhesus RhD

Question 16

How is RhD inherited?

Answer 16

Positive dominant

Question 17

RhD negative can cause what reaction between a mother and fetus’s blood?

Answer 17

Haemolytic disease of the fetus / newborn

Question 18

What is the DAT direct Coomb’s test used for?

Answer 18

To identify Ab on red cell surfaces

Question 19

When is the DAT direct Coomb’s test used?

Answer 19

For haemolysis eg AIHA, transfusion reaction

Question 20

What is the method of the DAT direct Coomb’s test?

Answer 20

Add PTx RBC to anti-human globulin IgG

Question 21

What is a positive DAT direct Coomb’s test?

Answer 21

Agglutination (clump)

Question 22

What does the indirect Coomb’s test IAT identify?

Answer 22

Antibodies in the patient’s plasma

Question 23

When is the indirect Coomb’s test IAT used?

Answer 23

Crossmatch pre-transfusion

Question 24

What is the method of the IAT indirect Coomb’s test?

Answer 24

Add PTx’s plasma to RBC with known Ag specificity

Then add anti-human IgG

Question 25

What is a positive IAT indirect Coomb's test?

Answer 25

Agglutination (clump)

Question 26

What blood group is this patient? PTx RBC + anti-A agglutinate, + anti-B don't agglutinate + anti-D agglutinate

Answer 26

A positive

Question 27

What is the Hb and weight criteria for being a blood donor?

Answer 27

Hb >135 M Hb >125 F Wt >50

Question 28

How long can red blood cells be stored and at what temperature?

Answer 28

4 degrees | 35 days

Question 29

How long can platelets be stored and at what temperature?

Answer 29

22 degrees 7 days With agitation

Question 30

How long can FFP be stored and at what temperature?

Answer 30

-30 degrees | 3 years

Question 31

What is the standard dose of platelet or RBC transfusion?

Answer 31

1 unit

Question 32

Which blood product is transfused for symptomatic anaemia with a Hb less than 70 or in major bleeding?

Answer 32

RBCs

Question 33

What blood product is transfused as bleeding Tx in a PTx with a coagulopathy? What must the coagulopathy be?

Answer 33

FFP | PT ratio higher than 1.5

Question 34

When should observations be taken in transfusions?

Answer 34

Before 15 minutes in Within 60 minutes

Question 35

What is a complication of regular transfusions?

Answer 35

Fe overload

Question 36

What are the 2 types of haemolytic transfusion reaction?

Answer 36

Delayed extravascular or immediate intravascular

Question 37

What antibody is responsible for delayed extravascular haemolytic transfusion reactions?

Answer 37

IgG

Question 38

What antibody is responsible for immediate intravascular haemolytic transfusion reactions?

Answer 38

IgM

Question 39

Following a blood transfusion a raised JVP, raised BP, low albumin, resp distress and renal impairment indicate what?

Answer 39

Transfusion associated circulation overload

Question 40

What is the management of transfusion associated fluid overload?

Answer 40

O2 + diuretic

Question 41

What is the management of a mild transfusion reaction caused a small fever or mild rash?

Answer 41

Continue | Consider paracetamol, anti-histamine

Question 42

What drug class is salbutamol? What is its mechanism? Does it bronchodilate or bronchoconstrict?

Answer 42

SABA Beta agonist Bronchodilate

Question 43

What is the management of a severe type 1 hypersensitivity transfusion reaction?

Answer 43

Adrenaline Chlorampheniramine anti-histamine Salbutamol CCS

Question 44

What drug diverts blood to the cerebral and cardiac circulation? And causes peripheral vasoconstriction, bronchodilates and increases cardiac output

Answer 44

Adrenaline

Question 45

"IJ adrenaline at endoscopy, terlipressin, TIPSS" is the management of what cause of major haemorrhage?

Answer 45

Variceal bleed

Question 46

Disease of what GI organ causes a coagulopathy?

Answer 46

Liver