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(Amanda's)FINAL-Physical & Health Assessment (Spring 2025) > Blood Products and Transfusion (Exam III) > Flashcards

Blood Products and Transfusion (Exam III) Flashcards

1
Q

What is blood comprised of primarily?

A

Plasma

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2
Q

What percentage of blood volume is made up by plasma?

A

55%

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3
Q

True/False. the universal donor blood type for male patients is O- and/or O+.

A

True. they can get either one

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4
Q

What blood type is a universal donor? Universal acceptor?

A
  • Donor = O neg
  • Acceptor = AB +
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5
Q

Why do we avoid giving O+ to females?

If we have to how can we compensate for this?

A
  • Pregant women d/t increased risk for fetal incompatibility.
  • Rhogam
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6
Q

What would be the blood product of choice for a bleeding patient?

A

WHOLE BLOOD. they aren’t bleeding packed red blood cells, they need allllll the stuff from whole blood

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7
Q

What are the possible blood antigen types? What are possible Rh factors?

A
  • Antigen → A B AB O
  • Rh → Rh+ and Rh-
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8
Q

Is the general population primarily Rh+ or Rh- ?

A

Rh+ (85%) and Rh- (15%)

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9
Q

What 4 things can cause a right shift of the OxyHb curve?

A
  • ↓ pH (bc increase acid)
  • ↑ CO2
  • ↑ temp
  • ↑ 23-DPG
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10
Q

For blood type O which Antigen is present on erythrocyte and which Antibody is in the serum?

A
  • Antigen: none
  • Antibody: Anti-A and Anti-B
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11
Q

For blood type AB which Antigen is present on erythrocyte and which Antibody is in the serum?

A
  • Antigen: A and B
  • Antibody: none
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12
Q

For blood type B, which Antigen is present on erythrocyte and which Antibody is in the serum?

A
  • Antigen: B
  • Antibody: Anti-A
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13
Q

For blood type A which Antigen is present on erythrocyte and which Antibody is in the serum?

A
  • Antigen: A
  • Antibody: Anti-B
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14
Q

AB donor blood will react with which other blood types?

A
  • A, B, and O

(No reaction with AB)

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15
Q

B donor blood will react with which blood types?

A
  • A
  • O

(no reaction with AB or B)

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16
Q

A donor blood will react with which blood types?

A
  • B
  • O

(No reaction from AB or A)

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17
Q

O donor blood will react with which blood types?

A
  • none
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18
Q

When whole blood is centrifuged what separation products result?

A
  • Platelet rich plasma (PRP)
  • WBC
  • RBC
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19
Q

What happens if we centrifuge platelet rich plasma (PRP) again?

A
  • Centrifuge PRP again → Separates plasma from platelets
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20
Q

What are the 5 different blood components we can use for treatments?

A
  • RBC
  • FFP
  • Cryo
  • PLT
  • LTOWB - Low titer Group O Whole Blood
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21
Q

What was the primary resuscitation fluid in military settings during WW1 and Vietnam

A

Whole blood

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22
Q

What is the lifespan of WB?

A

~ 3-5 wks

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23
Q

How does CPDA-1 prolong shelf life of blood?

A

CPDA-1 → Citrate phosphate dextrose adenine.

  • Citrate → chelates Ca++ to prevent clotting
  • Phosphate → used as buffer
  • Dextrose → fuel source
  • Adenine → to support ATP synthesis (extends storage from 21 to 35 days)
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24
Q

The longer blood is stored, the lower the levels of ______, shifting the oxyhemoglobin dissociation curve to the _____, which impairs oxygen delivery.

A

-2,3-DPG

-Left

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25
PRBCs contain ______ unless they have been specifically ________?
* Leukocytes (WBCs) * Leukoreduced
26
How much does 1 unit of PRBCs ↑ H&H level?
* Hb: ↑ 1 g/dL * Hct: ↑ 3%
27
Which blood transfusion product is a source of antithrombin III?
FFP
28
What is the dose of FFP?
* 10-15 mL/kg
29
How much will 1 unit of FFP ↑ level of each clotting factor?
* ↑ 2 to 3% for each factor
30
What are two specific uses of FFP Dr. C mentioned in class?
* Heparin resistance d/t antithrombin deficiency * Treat angioedema (also use TXA along with FFP)
31
What is the INR of FFP?
* 1.5 to 1.8
32
What is cryoprecipitate?
Protein fraction taken off the top of the FFP when being thawed
33
What clotting factors does cryoprecipitate have?
* Factor VIII: C * Factor VIII: vWF * Factor XIII * Fibrinogen
34
How much will two units of cryo raise fibrinogen levels?
* 2 units of cryo/10 kg body weight = 100 mg/dL ↑ in fibrinogen
35
Which patient population is cryo really important for?
* Pregnant women who are bleeding
36
How much will one unit of PLT increase PLT count by?
* 5000 to 10000
37
What needs to be done prior to administration of blood products?
Get a warming device! warm up everything except for platelets
38
What should we use to flush tubing before and after blood product delivery? First choice, second choice, avoid?
1. Something that is normal pH (Normosol/plasmalyte) 2. NS. Avoid LR
39
When is WB indicated for transfusion?
* To maintain volume and O2 carrying capacity in acute massive hemorrhage (> 20% blood volume loss )
40
What are S/Sx of Hemolytic transfusion reaction?
* fever * chill * hemoglobinemia * hemoglobinuria * hypotension * dyspnea.
41
What are mediators of  Hemolytic transfusion reactions?
IgM antibodies
42
What are the S/S of nonhemolytic febrile transfusion reactions?
Fever and chills
43
What are the mediators of non-hemolytic febrile transfusion reactions?
HLA Class Ag antibodies
44
How do we treat  Non-hemolytic febrile transfusion reactions?
* Antipyretics * Use leukocyte reduced products
45
What are some S/S of an allergic transfusion reaction?
* urticaria * erythema * itching * anaphylaxis.
46
What are the mediators of allergic transfusion reactions?
* plasma proteins (mild reactions) * IgA antibodies (anaphylactic reactions)
47
How do we treat allergic transfusion reactions?
* antihistamines * treat symptoms * transfuse IgA-deficient components
48
What are S/S of  Non-cardiogenic pulmonary transfusion reactions?
* ARDS * Fever * Chill * Hypotension * Cyanosis *NONCARDIOGENIC PULMONARY EDEMA
49
What are the mediators for a non-cardiogenic pulmonary transfusion reaction?
Donor/Recipient WBC antibodies
50
How do we treat Non-cardiogenic pulmonary transfusion reactions?
* Vigorous resp support (PEEP) * Steroids
51
What is TRALI?
Transfusion Related Acute Lung Injury - temporarily r/t to blood transfusion within first 6 hrs following a transfusion
52
What types of blood products is TRALI most associated with this?
* FFP * PLTs
53
What is the criteria for TRALI
1. Acute onset hypoxemia 2. Occur during or within 6hrs of transfusion 3. B/L diffuse pulmonary infiltrates 4. No volume overload
54
What are the 3  acute  nonimmunologic effects of transfusion reaction?
* Bacterial contamination * Circulatory overload (TACO) * Hemolysis d/t physical /chemical means
55
What are the three delayed immunologic effects of transfusion reaction?
* Hemolytic transfusion reactions * Transfusion associated Graft-versus-host disease * Post-transfusion purpura
56
What are some quick ways to differentiate between TRALI and TACO? (This is very cut down from the main list)
* TRALI → Fever and ↓BP, no vol overload (no response to diruretics) * TACO → HTN, ↑JVP, ↓ EF, volume overload (WILL respond to diuretics)
57
What is the one delayed nonimmunologic effect discussed in lecture?
Transfusion-induced hemosiderosis (Iron overload)
58
What classes of hemorrhage are there and what is associated blood loss for each?
* Class 1 = up to 750 mL (< 15%) * Class 2 = 750 to 1500 mL (15-30%) * Class 3 = 1500 to 2000 mL (30-40%) * Class 4 = > 2000 mL (>40%)
59
What are 3 definitions of MTP in Adults?
1. Total blood volume is replaced within 24 hours 2. 50% of total blood volume is replaced in 3 hours ← Most common 3. Rapid bleeding rate = 4 units RBCS transfused within 4 hours or 150 mL/min blood loss
60
What is considered MTP for Kids?
* > 40mL/kg transfusion
61
What is balanced resuscitation?
* 1:1:1 ratio (PLT:Plasma:RBC)
62
What are the fibrinogen levels of Cryo, LTOWB and FFP?
* Cryo = 2500 mg * LTOWB = 1000 mg (low-titer type O whole blood) * FFP = 400 mg
63
What are the recommendations for whole blood transfusion in kids?
* If they are <15 yr old or <40 kg then limit WB to 30 mL/kg
64
Which clotting factors require Ca++ to work?
2 7 9 10
65
97.4% of trauma MTP patients are ______.
Hypocalcemic
66
What are the components of the lethal triad in trauma patients?
1. Hypothermia 2. Acidosis 3. Coagulopathy
67
Citrate is metabolized in the _____. Hypothermia + ______ injury = decreased Citrate metabolism
Liver
68
Which drug has more elemental calcium; Ca gluconate or CaCl?
* CaCL
69
TEG: If R is prolonged this means there is delayed clot formation. What would we give the pt for this?
FFP or PCC
70
TEG: If MA is too low this would indicate a weak clot, what would we give for this?
Cryo if FF is low Platelets is FF is normal
71
TEG: If LY30 is too high this indicates there is too much lysis, what would we give the pt?
TXA
72
What is the value for TEG-ACT?
* 80-140 sec
73
What is the normal value for R time?
* 5.0 - 10.0 min
74
What is the normal value for K time?
* 1-3 minutes
75
What is the normal value for α angle?
* 53 - 72°
76
What is the normal value for MA?
* 50-70mm
77
What is the normal value for G value?
* 5.3-12.4 dynes/cm2
78
What is the normal value for LY 30?
* 0-3%
79
If TEG-ACT is > 140 what do we transfuse?
* FFP
80
If R time is > 10 what do we transfuse?
* FFP
81
If K time is > 3 what do we transfuse?
* Cryo
82
If α angle < 53° what do we transfuse?
* Cryo and platelets
83
If MA < 50 what do we transfuse?
* PLT
84
If LY30 > 3% what do we transfuse?
TXA (Tranexamic Acid)

(Amanda's)FINAL-Physical & Health Assessment (Spring 2025) (31 decks)

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