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ABSITE Cell Biology > Blood Products > Flashcards

Blood Products Flashcards

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1
Q

Appropriate hemoglobin for coronary ischemia

A

hgb 10-12 adequate

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2
Q

Appropriate hemoglobin for ongoing blood loss

A

hgb 10-12 (target: room for loss)

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3
Q

Appropriate hemoglobin for critical illness

A

hgb 7-9 adequate

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4
Q

1 unit of PRBC raises hgb by how much

A

1gm/dl

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5
Q

What is PRBC stored in for preservation and what electrolyte decreases with massive transfusion

A

citrate (CDPA) and can get hypocalcemia

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6
Q

how long do PRBC’s last

A

3 weeks, storage decreases 2,3 DPG, decreases pH, and increases potassium and lactic acid

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7
Q

what is the max temperature PRBC can be stored at?

A

49 C because protein denaturation occurs at temps higher than this

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8
Q

Indications for platelet transfusion

A

<50 w/ active bleeding or preop

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9
Q

Contraindications to platelets

A

TTP, HUS, HELLP, HITT (may need to give plts to control severe bleeding)

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10
Q

how much does a 6 pack of platelets increase platelet lab value by

A

50,000

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11
Q

If there is a <5000 increase with a 6 pack of platelets this suggests what

A

alloimmunization, so tx is ABO matched platelets, and if still < 5000 check panel reactive antibody for HLA antibodies (may need HLA matched platelets)

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12
Q

Fresh frozen plasma contains what

A

all coagulation factors (includes factor C, S, and ATIII) good for deficiencies of all factors (dilutional coagulopathy from massive transfusion, DIC, liver disease, Warfarin, PT > 17 preop

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13
Q

what blood product has highest levels of vWF, fibrinogen, Factor VIII, and Factor XIII

A

cryoprecipitate, good for bleeding with low fibrinogen < 100 or bleeding in vWD

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14
Q

What are irradiated blood products for

A

Kills T cells in blood product, used in pts at risk for transfusion related graft versus host disease (hematopoietic stem cell TXP, hematologic malignancies, congenital immunodeficiency)

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15
Q

what are CMV negative used for?

A

(from CMV neg donors), used for CMV sero neg pregnancy, organ and bone marrow txp candidates/recipients, AIDS, low birth weight infants

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16
Q

what are leukoreduced used for

A

WBCs can cause HLA allo immunization, fever (cytokine release) and carry CMV, used for chronically transfused pts, potential txp recipients, previous febrile non hemolytic transfusion reaction, or when CMV products are desirable but unavailable

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17
Q

what are immunoglobulin products used for?

A

(intravenous, IV-Ig), used for post exposure prophylaxis (eg Hep A), some autoimmune D/Os (eg ITP, myasthenia gravis)

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18
Q

What is plasmapheresis used for

A

removes immunoglobulins (eg TTP)

19
Q

symptoms and tx for febrile non hemolytic transfusion reaction

A

MC transfusion reaction, Sx’s of fever and rigors 0-6 hrs after transfusion, preformed recipient Ab’s against donor WBC’s, causes cytokine release, tx=stop transfusion, tylenol (R/O infx, and hemolysis), WBC filters for subsequent transfusions.

20
Q

symptoms and tx for transfusion allergic reaction

A

MC sx - urticaria (rash), rare anaphylaxis (sx’s - bronchospasm and hypotension) reaction to plasma proteins in blood product, MCC - IgA deficient pt (w/ preformed Ab’s to IgA) receiving IgA blood, Tx: urticaria - diphenhydramine, H2 blockers, and Anaphylaxis - epinephrine, fluids, possible steroids.

21
Q

Sx and tx for delayed hemolytic transfusion reaction?

A

sx’s-usually minimal (often goes unnoticed), possibly unexplained fever, jaundice, or drop in hct, usually get sx’s 5-10 days after transfusion. Preformed recipient Ab’s against donor minor RBC antigens HLA, urinalysis shows urobilinogenuria, W/U includes LFT’s, clotting and red cell antibody screens, Tx: nonspecific, Dx important for future transfusion HLA match next time.

22
Q

Sx and Tx of transfusion related acute lung injury (TRALI)

A

Sx’s - hypoxia, diffuse alveolar infiltrates, fever, non cardiogenic pulmonary edema < 6 hours after transfusion, Donor Ab’s bind recipient WBCs and lodge in lung release mediators causing increased capillary permeability. Tx: may require intubation, tx same as ARDS

23
Q

Sxs, Dx and Tx for acute hemolytic transfusion reaction

A

sx’s: fever, hypotension, tachycardia, flank pain, hematuria, can lead to renal failure, shock and DIC, anesthetized pts can present as diffuse bleeding.
Cause: ABO incompatibility, preformed recipient Ab’s against donor RBCs, results in acute hemolysis.
Dx: haptoglobin < 50 (binds Hgb, then gets degraded), free hemoglobin > 5, increased unconjugated bilirubin.
Tx: stop transfusion, fluid resuscitation for BP and to maintain good UOP, Diuretics (lasix and mannitol), HCO3 to prevent Hgb precipitation in kidney and ATN, Pressors for refractory hypotension.

24
Q

what is incidence of fatal hemolytic transfusion reaction

A

1:500,000

25
Q

MCC of death from transfusion reaction

A

clerical error resulting in ABO compatibility

26
Q

what causes non immune hemolysis

A

from squeezing the blood bag and severity of transfusion reactions are inversely proportional to frequency

27
Q

What is rate of bacterial infection complication in platelets transfusion

A

1:50,000

28
Q

what is rate of bacterial infection complication in pRBC transfusions

A

1:500,000

29
Q

What is rate of Hep B complications with transfusions

A

1:200,000

30
Q

What is rate of Hep C infectious complication with transfusions

A

1:2,000,000

31
Q

what is rate of HIV in transfusions

A

1:2,000,000

32
Q

Platelets are stored at what temperature

A

room temperature

33
Q

How long are platelets stored for

A

5 days

34
Q

what is MC bacterial contaminant in transfusions

A

GNRs (MC E. coli)

35
Q

What transfusion problems does cold body temp cause

A

poor clotting due to slowing of enzymatic reactions

36
Q

What is treatment for dilutional thrombocytopenia due to pRBC transfusion

A

platelets

37
Q

Treatment for hypocalcemia due to massive transfusion

A

calcium for Ca is required for clotting cascade

38
Q

What type of antibodies develop in 20% after 10-20 plt transfusion

A

antiplatelet antibodies

39
Q

Fx of hetastarch (he span)

A

volume expander, can use up to 1L without risk of bleeding complications

40
Q

All blood products carry risk of HIV and Hepatitis except

A

albumin and immunoglobulins (these are heat treated)

41
Q

chagas disease can be transmitted with ?

A

blood transfusions

42
Q

What can be used to raise hemoglobin without giving blood (eg Jehovah’s Witness)

A

Epoeitin, Fe supplementation, which should raise hgb 1-2 pts/wk

43
Q

What should be screened for in an iron deficient anemia post menopausal female or male

A

colon CA or another GI source

ABSITE Cell Biology (3 decks)

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