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Transfusion Exam > Blood Products > Flashcards

Blood Products Flashcards

1
Q

What are allogenic blood donations?

A

Homologous donations collected within 15 min

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2
Q

What are autologous blood donations?

A

Blood collections intended to be self used

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3
Q

How frequent can someone donate for autologous blood donations?

A

4 in the span of 4 weeks, up to 3 days prior to surgery.

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4
Q

What are directed blood donations?

A

Blood donations intended for a child or sibling, from a close relative.

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5
Q

What is the risk associated to directed blood donations?

A

Graft versus host disease is at a greater risk

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6
Q

What are designated blood donations?

A

Antigen specific products

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7
Q

What are dedicated blood donations?

A

HLA matched products

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8
Q

How often can you donate PLT?

A

Every 2 weeks

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9
Q

How often can you donate plasma?

A

Every 7 days

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10
Q

What is the purpose of using anticoagulants and preservatives in blood products?

A
  • Prevent clotting
  • Maintaining cell viability
  • Maintain cellular function
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11
Q

What is the purpose of using citrate?

A

Prevent clotting by chelating calcium

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12
Q

What is the purpose of adenine and dextrose?

A

Support ATP generation

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13
Q

What is the purpose of sodium biphosphate?

A

Buffer agent, buffer change in pH due to increase in lactic acid from glycolysis.

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14
Q

What tests are done on donors?

A
  • ABO/ Rh
  • Antibody screening
  • Hep B/C
  • WNV
  • Syphilis
  • HTLV-I /HTLV- II
  • CMV
  • Bacterial culture of PLT only
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15
Q

What is NAT testing? and what can we use NAT testing for?

A

PCR, identification of HIV, HCV, and WNV

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16
Q

Who is most at risk for CMV?

A
  • Low birth weight neonate
  • Organ & Bone marrow transplant PT
  • Renal dialysis PT
  • Immunocompromised PT
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17
Q

What are methods to prevent bacterial contamination of blood products?

A
  • Take donor temperature prior to donation
  • Skin disinfection
  • Diversion pouch
  • BacT/Alert system for aphaeresis PLT
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18
Q

What is the purpose of leukoreducing RBC products?

A
  • Prevent non-hemolytic febrile transfusion reactions,
  • alloimmunization of HLA antigens
  • Decrease risk of leuko-borne viruses (CMV)
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19
Q

What are the 4 components in SAGM ?

A
  • Sodium Chloride
  • Adenine
  • Glucose
  • Mannitol
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20
Q

What are the two methods for filtering RBC?

A
  • Whole blood filtration
  • Buffy coat extraction
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20
Q

What is the difference between Whole blood filtration and Buffy coat extractions?

A

WB: leukoreduced by filtering prior to centrifugation
BC: whole blood cooled rapidly, centrifuged then filtered and separated.

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21
Q

When leukoreduction is done in either method what will the be the WBC count?

A

< 5 x 10^9/L per unit

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22
Q

What is the shelf life of red cell unit with SAGM?

A

42 days if stored at 1-6C

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23
Q

What is the shelf life of PLT units?

A

7 days from the date of collection

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24
Q

What are the criteria for pooling PLT?

A

4 pools
- Rh (-)
- CMV (-)
pH 6.2

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25
Q

What is the purpose of the constant agitation of PLT units?

A

Prevent pH drop

26
Q

How much does the patient PLT count increase after each unit transfused?

A

15 x 10^9/L

27
Q

At what temperature should PLT be stored at?

A

22-24 C

28
Q

What should be done to paediatric units preserved with SAGM undergo prior to transfusing in emergency situations?

A

Washed to remove the SAGM and replaced with saline or 5% albumin or plasma.

29
Q

How long are irradiated units good for?

A

28 days after irradiation or till the units expiry date which ever comes first.

30
Q

What is the shelf life of frozen plasma?

A

1 year

31
Q

How should units of frozen plasma be thawed?

A

in a water bath sealed in a plastic bag

32
Q

What are some clinical uses for frozen plasma units?

A
  • Urgent reversal of Warfarin
  • active bleeding
  • Mass transfusion to replace missing factors
33
Q

What is the purpose of treating frozen plasma with detergent?

A

Remove cells, debris, and dilute/ neutralize allergens & antibodies
- Reduces the risk of TRALI

34
Q

Who might be in need of solvent detergent plasma?

A
  • Pt receiving an increase plasma volume transfusion.
  • for patient with allergic reactions to FP and FFP
35
Q

How long can frozen RBC units be stored for?

A

10 years at -80C

36
Q

What is the purpose of adding glycerol in frozen RBC units?

A
  • Prevents dehydration cells
  • Prevents crystal formation
37
Q

What is the criteria for blood products “shelf life”?

A

75% of RBC in recipient circulation 24 hours post transfusion

38
Q

When shipping blood products, how long does the shipmen have to reach it’s destination?

A

Received within 24 hours after being issued from the supplier.

39
Q

When blood products are being shipped, if their temperatures go uncontrolled for an hour mins what must happen to the shipment?

A

Discarded, because blood products were outside of controlled temperatures for greater than 30 mins.

40
Q

What criteria must storage equipment in the lab must have?

A
  • recording temperatures at least every 4 hours
  • audible alarms
  • alarm checks
  • emergency power backup system
  • calibrated thermometers
  • procedures
41
Q

What are 4 reasons that blood might need to be transported?

A
  • Hospital inventory
  • Re-distribution of expiring units
  • Accompany PT transferring hospital
  • Lab to PT care area
42
Q

When transfusing, what would happen if a nurse decided to hang ringer’s lactate with the blood product?

A

Ringer’s lactate promotes clotting by increasing Ca+ and counteracting citrate

43
Q

When transfusing, what would happen if a nurse decided to hang glucose with the blood product?

A
  • risk acute hemolytic reaction
  • decrease RBC survival
44
Q

What four factors determine the RBC ability to deliver oxygen?

A
  • blood pH
  • Hgb structure
  • 2-3-BPG level
  • ATP concentration
45
Q

What role does 2-3-BPG play in the blood?

A

2-3-BPG is required to release oxygen from Hgb

46
Q

Which way would the oxygen saturation curve shift if 2-3-BPG levels are low?

A

Left shift as Hgb affinity for oxygen increases.

47
Q

Which way would the oxygen saturation curve shift if 2-3-BPG levels are high?

A

Right shift as Hgb affinity for oxygen decreases.

48
Q

What factors are likely to change in a unit of blood during storage?

A
  • Glucose metabolism
  • increase lactic acid
  • decrease pH
  • increased sodium in the cell, decreased in serum
  • Decreased potassium in the cell, increased in the serum
49
Q

Who would be the most affected by blood products reaching the end of their shelf life?

A

Neonatals, which is why they receive units less than 7 days old.

50
Q

What is the purpose of Albumin?

A
  • volume expander
  • useful for hypotenstion and hypovolemic shock
  • fluid and protein replacement
51
Q

What is the shelf life of albumin?

A

3 years at RT

52
Q

What are alternative to albumin (colloid) therapy?

A

Crystalloids:
- Ringer’s lactate
- 0.9% NaCl

Colloids:
- Dextran
- Pentastarch

53
Q

What is the advantages and disadvantages of using a crystalloid?

A

ADV:
-urine output

DISADV:
- edema
- hyperchloremia - acidosis

54
Q

What is the advantages of using a crystalloid?

A

increased ability of retaining water

55
Q

What are the uses for pentastarch?

A
  • plasma volume expander
  • Prime bypass pump
56
Q

What are the uses for IVIG?

A
  • substitution
  • prophylaxis
  • Treating TTP
  • Children with kawasaki disease
  • pediatric HIV infection
57
Q

What is Immune serum globulin?

A

Intra muscular injection source of IgG, useful to boost immunocompromised patients

58
Q

What are examples of hyperimmune globulins?

A
  • Varicella zoster
  • Hep B immune globulin
  • CMV immune globulin
  • Anti-RSV immune globulin
59
Q

What are 3 products that can be given to patients with Haemophilia A?

A
  • Kogenate FS
  • Hemofil M
  • Desmopressin
60
Q

What are products that can be given to a patient with Christmas disease?

A
  • Immunine VH
  • Mononine
  • Benefix
61
Q

What are products that can be given to a patient with von willebrand disease?

A
  • desmopressin
  • frozen plasma
  • cryopercipitate
  • humate-P
62
Q

What is fibrin glue?

A

Topical solution of thrombin and cryopercipitate

Transfusion Exam (5 decks)

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