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HA > Blood products > Flashcards

Blood products Flashcards

1
Q

Type 0 Antigen present on erythrocyte and Antibody present in serum

A

none

Anti-A, Anti-B

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2
Q

Type AB Antigen present on erythrocyte and
Antibody present in serum

A

A and B

None

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3
Q

Type B Antigen present on erythrocyte and
Antibody present in serum

A

B

Anti-A

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4
Q

Type A Antigen present on erythrocyte and
Antibody present in serum

A

A

Anti- B

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5
Q

RBC specific gravity

A

1.08-1.09

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6
Q

Plat Specific gravity

A

1.03-1.04

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7
Q

Blood Components Preparation based on

A

different specific gravities
By using differential centrifugated blood components separated into layers

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8
Q

AB donors reactions to serum of recipient

A

AB; -
B; +
A; +
O +

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9
Q

B donor cells reactions to serum of recipient

A

AB; -
B; -
A; +
O +

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10
Q

A donor cells reactions to serum of recipient

A

AB; -
B; +
A; -
O +

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11
Q

O donor cells reactions to serum of recipient

A

AB; -
B; -
A; -
O -

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12
Q

What settles at the bottom of the blood bag?

A

Plt is heavier than plasma & will settled at the bottom of the bag.

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12
Q

What settles at the bottom of the blood bag?

A

Plt is heavier than plasma & will settled at the bottom of the bag.

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13
Q

Saline was OG designed for…..

A

chlorea

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14
Q

OG name for ARDS….

A
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15
Q

blood product with shortest half life

A

plat

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16
Q

Storage of blood is achieved by adding …..

A

Citrate phosphate dextrose adenine (CPDA-1) (anticoagulant by chelation of ca)

Phosphate as a buffer
Dextrose as a fuel source
Adenine as a substrate for the synthesis of ATP extending storage time from 21 to 35 days

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17
Q

What happens to pts electrolytes from blood transfusion

A

calcium decreases = clotting issues

dextrose = increase bg

potassium increases from cells break down =

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18
Q

Packed red blood cells (PRBCs) are derived from …..

A

whole blood from which the plasma has been removed. “new life for whole blood”

Prepared by removing 200-250ml of plasma from a unit of W.B.

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19
Q

normal …..

A

500 ml

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20
Q

PRBC volume

A

200-350 ml

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21
Q

1 unit: increase Hb level about ….

A

1g/dL (10g/L)& Hct by 3%.

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22
Q

Fresh Frozen Plasma volume

A

200-250 mL

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23
Q

Fresh Frozen Plasma expires

A

Expires 12 months after donation

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24
Q

FFP dose

A

10-15 ml/kg

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25
Q

FFP stored at

A

-18C or below

Requires thawing which takes time

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26
Q

Each unit of FFP=increase the level of each clotting fx by….

A

2-3% in adults.

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27
Q

FFP contains….

A

Water, carbohydrates, fats, minerals
Proteins(all labile & stable clotting fx).

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28
Q

Treatment for angioedema

A

FFP and TXA

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29
Q

INR of FFP

A

1.5-1.8

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30
Q

What is Cryoprecipitate

A

Protein fraction taken off the top of the FFP when being thawed

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31
Q

Cryoprecipitate contains…..

A

Factor VIII: C
Factor VIII: vWF
Factor XIII
Fibrinogen

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32
Q

Cryo stored at

A

Stored at –18C & below.

Then refrozen for up to 1 year

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33
Q

Platelets prepared by

A

cytapheresis/by separating PRP from a unit of W.B w/in 8H of collection & recentrifuged to remove plasma.

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34
Q

Platelets contrains

A

plt only

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35
Q

One bag pheresis of plat

A

250-300 mL

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36
Q

One unit of plt increases PLT by

A

5,000 - 10,000

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37
Q

Spont bleeding starts at what plt level

A

<35,0000 = spont hemorrhage, no LP, no peripheral nerve block,

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38
Q

Lethal triad

A

Hypothermia
coagulopathy
acidosis

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39
Q

PH of saline

A

5.5

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40
Q

Preferred fluid to give with blood

A

Normosol
plasmalyte
NS

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41
Q

Blood product that is not warmed

A

plat

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42
Q

WHOLE BLOOD volume

A

400-500 ml

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43
Q

WHOLE BLOOD storage

A

1-6 C

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44
Q

indications for whole blood

A

to maintain blood volume & O2 carrying capacity in acute,massive blood loss.
Actively bleeding pt>20% of body blood volume.

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45
Q

immunologic transufsion rxn

A

febrile nonhemolytic
allergic
noncardiogenic pulmonary

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46
Q

nonimmunologic transfusion rxn

A

bacterial contamination
circulatory overload
physical/ chemical hemolysis

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47
Q

Hemolytic transfusion reactions
Mediators

A

IgM A/b (usually ABO), complement

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48
Q

Hemolytic transfusion reactions s/s

A

fever, chill, hemoglobinemia, hemoglobinuria, hypotension, dyspnea…..consider what anesthesia will mask

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49
Q

Hemolytic transfusion reactions
tx and prevention

A

decrease opportunities for error, treat ARF & DIC.

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50
Q

Nonhemolytic febrile transfusion reactions
mediators

A

A/b to HLA Class I Ag.

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51
Q

Nonhemolytic febrile transfusion reactions
s/s

A

fever, chill.

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52
Q

Nonhemolytic febrile transfusion reactions
Treatment and Prevention

A

antipyretics, leukocyte reduced.

53
Q

Allergic transfusion reactions.
mediators

A

plasma proteins(mild reactions), A/b to IgA(anaphylactic reactions).

54
Q

Allergic transfusion reactions.
s/s

A

urticaria, erythema, itching, anaphylaxis.

55
Q

Allergic transfusion reactions.
Tx and preventions

A

antihistamines; treat sx, transfuse IgA-deficient components

56
Q

Noncardiogenic pulmonary transfusion reactions
mediators

A

donor/recipient WBC A/b.

57
Q

Noncardiogenic pulmonary transfusion reactions s/s

A

ARDS, fever, chill, cyanosis, hypotension, noncardiogenic pulmonary edema.

58
Q

Noncardiogenic pulmonary transfusion reactions Treatment and Prevention

A

vigorous respiratory support (PEEP), steroids.

59
Q

TRALI is a ….

A

defined as an acute lung injury that is temporally related to a blood transfusion; specifically, it occurs within the first six hours following a transfusion

60
Q

Transfusion Related Acute Lung Injury occur in….

A

in 1:1300 to 1:5000 transfusions of plasma containing products

61
Q

The mortality rate from TRALI ranges from ….

A

5% to 25% with most patients recovering within 72 hours.

62
Q

Criteria for TRALI

A

Acute onset hypoxemia.

Ratio of Pao2/FiO2 <300 or SpO2 <90% on room air.

Occur during or within 6 hours of transfusion.

B/L diffuse pulmonary infiltrates

No evidence of left atrial hypertension(i.e. circulatory overload).

63
Q

Immediate Management for TRALI

A

stop transusion

support pt

cbc/chest xray/ pulmonary aspirate

notify blood bank

64
Q

Immediate Management for TRALI

A

stop transfusion

support pt

cbc/chest xray/ pulmonary aspirate

notify blood bank

65
Q

ACUTE NONIMMUNOLOGIC EFFECTS bacterial contamination Mediators

A

endotoxins produced by GN bact.

66
Q

ACUTE NONIMMUNOLOGIC EFFECTS bacterial contamination s/s

A

fever, shock, hemoglobinuria.

67
Q

ACUTE NONIMMUNOLOGIC EFFECTS bacterial ocntramination tx and prevention

A

IV ABX; treat hypotension & DIC

68
Q

TACO; Transfusion Associated Circulatory Overload
mediators

A

fluid overload

69
Q

Transfusion Associated Circulatory Overload s/s

A

coughing, cyanosis, orthopnea, severe headache, peripheral edema, diff breathing.

70
Q

TACO tx and prevention

A

administer subsequent Tx slowly & in a small volume.

71
Q

Hemolysis d/t physical/chemical means mediators

A

exogenous destruction of RBC.

72
Q

Hemolysis d/t physical/chemical means s/s

A

hemoglobinuria

73
Q

Hemolysis d/t physical/chemical means tx and prevention

A

document & rule out hemolysis d/t other causes; treat DIC.

74
Q

DELAYED IMMUNOLOGIC EFFECTS Hemolytic transfusion reactions mediators

A

IgG A/b.

75
Q

DELAYED IMMUNOLOGIC EFFECTS Hemolytic transfusion reactions s/s

A

shortened RBC survival, decreased Hb, fever, jaundice, hemoglobinuria

76
Q

DELAYED IMMUNOLOGIC EFFECTS Hemolytic transfusion reactions tx and prevention

A

Ig-negative blood for further transfusions.

77
Q

Transfusion associated Graft-versus-host disease mediators

A

viable donor lymphocytes.

78
Q

Transfusion associated Graft-versus-host disease s/s

A

fever, skin rash, desquamation, anorexia, nausea, vomiting, diarrhea, hepatitis, pancytopenia

79
Q

Transfusion associated Graft-versus-host disease tx and prevention

A

gamma irradiation of cellular components.

80
Q

Post-transfusion purpura MOA

A

platelet specific A/b.

81
Q

Post-transfusion purpura s/s

A

thrombocytopenia, clinical bleeding.

82
Q

Post-transfusion purpura tx and prevention

A

IV Ig, plasma exchange, corticosteroids

83
Q

TRALI characteristics

A

Fever
Hypotension
Acute dyspnea
JVP unchanged
Auscultation- rales
X-Ray- diffuse b/l infiltrates
EF- normal
Response to diuretic minimal

84
Q

TACO characteristics

A

No fever
Hypertension
Acute dyspnea
JVP Can be changed
Rales + S3
Diffuse b/l infiltrates
Decreased
Significant improvement

85
Q

Transfusion-Induced Hemosiderosis. MOA

A

Iron overload.

86
Q

Transfusion-Induced Hemosiderosis.
s/s

A

subclinical to death.

87
Q

Transfusion-Induced Hemosiderosis.
tx and prevention

A

decrease frequency of transfusion, neocytes, iron chelation therapy.

88
Q

STEPS TO BE FOLLOWED with transfusion rxn

A
  1. Discontinue the transfusion.
  2. Keep the IV line open.
  3. Check all labels, forms & pt identification.
  4. Report to Blood Bank personnel.
  5. Send requested blood samples.
89
Q

Class 1 and 2 shock fluid replacement (3:1) rule

A

cystalloid

90
Q

Class 3 and 4 shock fluid replacement (3:1) rule

A

crystalloid and blood

91
Q

MTP in Adults

A

1) Total blood volume is replaced within 24 hours
2) 50% of total blood volume is replaced in 3 hours
3) Rapid bleeding rate = 4 units RBCS transfused within 4 hours or 150 mL/min blood loss

92
Q

MTP in Children =

A

> 40 mL/kg transfusion

93
Q

balanced resuscitation is ….

A

1:1:1 ratio (platelets:plasma:RBC)
Multiple blood components  ”reconstituted” whole blood

94
Q

Significant losses of …..with MTP

A

coagulation factor + platelet function in reconstituted products

More anemic + thrombocytopenic + coagulopathic

95
Q

LTOWB levels in WB

A

1000 mg

96
Q

FFP levels in WB

A

400 mg

97
Q

CRY levels in WB

A

2500 mg

98
Q

Stored Whole blood (SWB) contains….

A

all components of blood products
Smaller amounts of anticoagulants

99
Q

Stored Whole blood (SWB) storage

A

Cold - 2-6 degrees C

for 21-35 days

100
Q

Stored Whole blood (SWB) Hemostatic capability

A

14-21 days

101
Q

Low-titer o Whole blood (LTOWB) is…..

A

Stored whole blood = preferred resuscitation product
Universal donor = Low-titer o Whole blood (LTOWB)

102
Q

what do you do with Trauma patients with unknown blood types

A

Pre-transfusion blood sample -> determine blood type
Additional transfusions require LTOWB or group O RBCs for 1 month after the initial transfusion

103
Q

TEG-ACT normal

A

80-140 seconds

104
Q

TEG-ACT description

A

activated clotting time to initial fibrin formation

105
Q

TEG- ACT measures

A

CLotting factors (extrinsic/ intrinsic pathways)

106
Q

R time (conventional) normal

A

5-10 min

107
Q

R time (conventional) description

A

reaction time to initial fibrin formation

108
Q

R time (conventional) measures

A

clotting factors (intrinsic pathway)

109
Q

K time normal

A

1-3 min

110
Q

K time description

A

“Kinetic time” for fibrin cross linkage to reach 20 mm clot strength

111
Q

K time measures

A

fibrinogen, platelet number

112
Q

alpha angle normal

A

53.0 - 72.0 degrees

113
Q

alpha angle description

A

Angle from baseline to slop of tracing that represents clot formation

114
Q

Alpha angle measures

A

fibrinogen, platelet number

115
Q

MA normal

A

50.0 - 70.0 mm

116
Q

MA description

A

Maximum amplitude of tracing

117
Q

MA measures

A

platelet number and function

118
Q

G value normal

A

5.3 - 12.4 dynes/cm2

119
Q

G value description

A

Calculated value of clot strength

120
Q

G value measures

A

entire coagulation cascade

121
Q

LY 30 normal

A

0 - 3%

122
Q

Ly 30 description

A

Clot lysis at 30 minutes following MA

123
Q

LY 30 measures

A

fibrinolysis

124
Q

TEG-ACT>140
transfuse

A

FFp

125
Q

R time >10
transfuse

A

FFP

126
Q

K time > 3 transfuse

A

Cryoprecipitate

127
Q

Alpha angle <53 transfuse

A

Cryoprecipitate +/- Platelets

128
Q

MA<50 transfuse

A

Platelets

129
Q

LY30>3% transfuse

A

tranexamic acid

HA (15 decks)

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