Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Health Assessment > Blood products and transfusions (3) > Flashcards

Blood products and transfusions (3) Flashcards

1
Q

Blood compositon

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What percent of blood is plasma?

A

55%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What percent of blood is formed elements?

A

45%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the makeup of plasma?

A
  • Proteins 7%
  • Water 92%
  • Other solutes 1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the makeup of formed elements?

A
  • Platelets (140k-340k)
  • Leukocytes (5k-10k)
  • Erythrocytes (4.2-6.2 million)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What proteins are in plasma?

A
  • Albumin
  • Globulins
  • Fibrinogen
  • Prothrombin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the “other solutes” in plasma?

A
  • ions
  • nutrients
  • waste products
  • gases
  • regulatory substances
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rh factor percentage:

A
  • Rh+ = ~85%
  • Rh- = ~15%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can cause a shift to the right on the oxyhemoglobin dissociation curve?

A
  • decreased pH (increased acid)
  • Increased CO2
  • increased temperature
  • increased 2,3 DPG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Blood Typing:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Blood compatibility (memorize)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Contents and use for whole blood:

A

Contents: all cells, platelets, clotting factors and plasma

Use: replace blood loss from hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Contents and use for PRBCs:

A

Contents: red blood cells and some plasma

Use: replace blood cells in anemic patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Contents and use for platelets:

A

Contents: thrombocytes and some plasma

Use: Replace platelets in a patient with thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Contents and use for FFP:

A

Contents: plasma, a combination of fluid, clotting factors and protein

Use: replace volume in a burn patient or in hypovolemia secondary to low oncotic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Contents and use for clotting factors:

A

Contents: specific clotting factors needed for coagulation

Use: replace factors missing due to inadequate production as in hemophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

RBC and platelet specific gravities:

A

RBC: 1.08-10.9
Platelet: 1.03-1.04

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Steps for separating a unit of whole blood:

A
  • The centrifuged product settle out into RBC, WBC and PRP
  • After separating PRP from the bag, PRP is centrifuged again for a longer time and is harder to spin
  • Platelets are heavier than plasma and will settle into the bottom of the bag
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is added to blood to help with storage?

What are their uses?

A

Citrate phosphate dextrose adenine

  • Citrate for chelation of calcium to prevent clotting
  • 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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What effect does blood storage have on oxygen delivery?

A

The longer blood is stored, the lower levels of 2,3 DPG are, which shift the oxyhemoglobin dissociation curve to the left and impairs oxygen delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PRBCs contain ____ unless they have been specifically ____.

A

Leukocytes; leukoreduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How are PRBCs prepared?

A

By removing 200-250 ml of plasma from a unit of whole blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Characteristics of PRBCs:

A
  • 1 unit = 200-350mL
  • Do not contain functional platelets or granulocytes
  • have the same O2 carrying capacity with whole blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is PRBCs given to anemic patients?

A

Intended to increase the O2 carrying capacity in anemic patients who require an increase in their red cell mass without increasing their blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How much does 1 unit of PRBCs increase hgb and hct?

A

1 unit = 1g/dL (10g/L) and hct by 3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How is FFP prepared?

A

Removing plasma from whole blood within 8 hours of collection
- one bag is 200-250 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

FFP is a good source of ____

A

antithrombin III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the dose for FFP?

A

10-15 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Storage for FFP:

A
  • stored at -18C or below
  • expires 12 months after donation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

1 unit of FFP increases ____

A

Level of each clotting factor by 2-3% in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

FFP contains:

A

Water, carbohydrates, fats, minerals, proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How is cryo prepared?

A
  • Protein fraction taken off the top of the FFP when being thawed
  • then refrozen for up to 1 year
  • stored at -18C and below
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is in cryoprecipitate?

A
  • Factor VIII: C
  • Factor VIII: vWF
  • Factor XIII
  • Fibrinogen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How much does cryo increase fibrinogen?

A

Two units of cryo/10 kg of body weight increases fibrinogen concentration by 100 mg/dL (except for DIC or continued bleeding with massive transfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Indications for the use of FFP:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Indications for use of cryo:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Indications for platelets transfusion:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How are platelets prepared?

A
  • Cytapheresis - by separating PRP from a unit of whole blood within 8 hours of collection and recentrifuged to remove plasma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How much does one unit of platelets increase levels?

A

one unit = increase platelets by 5-10,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Why do you not want to give LR with blood products?

A

It has calcium in it so it can cause clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When would you use warming devices when administering blood products?

A
  • trauma patient receiving 4 or more units in 1 hour
  • 5 yo patient with a current temp of 98.1 receiving 2 units in 1 hour
  • a 90 yo patient with a temp of 97.5 receiving any unit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Preferred fluid for blood product administration:

A
  • Electrolyte-R pH 7.4 (normosol/plasmalyte)
  • Normal saline only used for priming blood tubing and flushing before and after
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Indications for giving whole blood:

A

To maintain blood volume and O2 carrying capacity in acute or massive blood loss
- actively bleeding patient greater than 20% of body blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Complications of blood transfusion:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Delayed complications of blood transfusion:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Mediators for a hemolytic transfusion reaction:

A

IgM A/b (usually ABO), complement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

S/S for hemolytic transfusion reactions:

A

Fever (late), chills, hemoglobinemia, hypotension, dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Treatment and prevention for hemolytic transfusion reactions:

A

Decrease opportunities for error - treat ARF and DIC

49
Q

Nonhemolytic febrile transfusion reactions:

A
  • Mediators: A/b to HLA class I Ag
  • S/S: fever, chills
  • Treatment and prevention: antipyretics, leukocyte reduced
50
Q

What is the most common transfusion reaction?

A

Allergic transfusion reaction

51
Q

Mediators for allergic transfusion reactions:

A
  • Plasma proteins (mild reactions)
  • A/b to IgA (anaphylactic reactions)
52
Q

S/S of allergic transfusion reactions:

A

Urticaria, erythema, itching, anaphylaxis

53
Q

Treatment and prevention for allergic transfusion reactions:

A
  • Antihistamines
  • treat sx
  • transfuse IgA deficient components
54
Q

Noncardiogenic pulmonary transfusion reactions:

A

Mediators: donor/recipient WBC A/b
S/S: ARDS, fever, chill, cyanosis, hypotension, noncardiogenic pulmonary edema
Treatment and prevention: vigorous respiratory support (PEEP), steroids

55
Q

What is TRALI?

A

Acute lung injury that is temporally related to a blood transfusion - specifically it occurs within the first 6 hours following a transfusion

56
Q

Incidence and mortality for TRALI:

A

Incidence: unknown - but estimated to occur in 1:1300-5000 transfusions

Mortality: ranges from 5-25% with most patients recovering within 72 hours

57
Q

What is the criteria for TRALI?

A
  • Acute onset hypoxemia (cyanosis common)
  • P/F ratio <300 or SpO2 <90% on RA
  • Occurs within 6 hrs of transfusion
  • Bilat diffuse pulmonary infiltrates
  • No Left atrial hypertension (circulatory overload)
  • Fever common
  • Hypotension
58
Q

What percent of TRALI patients require mechanical ventilation?

59
Q

What might lungs of a patient with TRALI sound like?

A

Pulmonary crackles (and no signs of CHF/ volume overload)

60
Q

What are priority action if TRALI is suspected?

A
  • Stop transfusion
  • Support patient
  • If patient is intubated → obtain undiluted edema fluid ASAP (within 15 min) and plasma to see total protein
  • CBC/ CXR
  • Notify blood bank (request different unit and quarantine other units from same donor)
61
Q

What are some other issues that mimic transfusion reactions?

A
  • Sepsis
  • Hemoglobinuria (trauma, AKI, muscle damage)
62
Q

What are the causes of acute non-immunologic transfusion reactions?

A
  • Bacterial Contamination
  • Circulatory overload (TACO)
  • Hemolysis from physical/chemical means
63
Q

What mediators are involved in acute non-immunologic bacterial contamination of blood products?

A

Endotoxins produced by gram negative bacteria

64
Q

What are s/s of patient with bacterial contamination from blood products?

A
  • Fever
  • Shock
  • Hemoglobinuria
65
Q

What is the treatment of bacterial contamination from blood product?

A
  • IV ABX
  • Treat hypotension
  • Treat DIC
66
Q

What mediators are involved in transfusion associated circulatory overload (TACO)?

A

Fluid volume

67
Q

What are s/s or TACO?

A

*Cough
* Cyanosis
* Orthopnea
* Severe headache
* Peripheral edema
* Difficulty breathing

68
Q

How can TACO be prevented?

A
  • Give transfusion slowing in a small volume
69
Q

What causes physical/chemical hemolysis following a blood transfusion and what are the S/S?

A
  • Caused by exogenous destruction of RBCs
    *S/S: Hemoglobinuria
70
Q

What are the delayed immunologic reaction discussed in lecture?

A
  • Hemolytic transfusion reactions
  • Transfusion associated graft-vs host disease
  • Post transfusion purpura
70
Q

What is the treatment for physical/chemical hemolysis?

A

Document and rule out hemolysis d/t other causes

Treat DIC

71
Q

What type of blood transfusion reactions are the most common in the operating room?

A

Delayed complications

72
Q

What mediators are involved in hemolytic transfusion reactions?

73
Q

What are symptoms of hemolytic transfusion reactions?

A
  • Shortened RBC survival
  • Decreased Hgb
  • Fever
  • Jaundice
  • Hemoglobinuria
74
Q

How are hemolytic transfusion reactions treated/prevented?

A

Ig-negative blood for further transfusions

75
Q

What mediators area associated with transfusion related Graft-vs host disease?

A

Viable donor lymphocytes

(pancytopenia and hepatitis)

76
Q

What are S/S of transfusion graft vs host?

A
  • Fever
  • Skin rash
  • Desquamation (Skin peeling)
  • Anorexia
  • N/V/D
  • Hepatitis
  • Pancytopenia
77
Q

What is the treatment for transfusion associated graft vs host?

A

Gamma irradiation of cellular components

78
Q

What is the MOA of post-transfusion purpura?

A
  • Platelet specific antibody
79
Q

What are S/S of post transfusion purpura?

A
  • Thrombocytopenia
  • Clinical bleeding
80
Q

What is the treatment for post-transfusion purpura?

A
  • IV Ig
  • Plasma exchange
  • Corticosteroids
81
Q

How can we differentiate TRALI and TACO?

A

TACO→ no fever, HYPERtension, acute dyspnea, JVD can be changed, Rales and S3, diffuse b/l infiltrates, decreased EF, improvement with diuretics

TRALI→ fever, HYPOtension, acute dyspnea, JVD unchanged, Rales, diffuse b/l infiltrates, normal EF, No improvement with diuretics

82
Q

What is a delayed non-immunologic effect associated with blood transfusions?

A

Transfusion-induced Hemosiderosis (iron deposition)

83
Q

What is the MOA of transfusion-induced hemosiderosis? What are the s/s?

A

Iron overload

  • S/S: subclinical to death (usually people who are getting repeated transfusions)
84
Q

What is the treatment for transfusion induced hemosiderosis?

A
  • Decreased frequency of transfusion
  • Neocytes (young RBC that have longer life than RBC)
  • Iron chelation therapy
85
Q

What are the steps to follow if suspect blood transfusion reaction?

A
  • Discontinue the transfusion
  • Keep IV line open
  • Check all labels, forms, and Pt ID
  • Report to blood bank
  • Send requested blood samples
86
Q

What class of hemorrhage starts to affect BP?

A

Class 3 and 4 (BP starts to drop)

87
Q

What is the blood loss in mL for class 1-4?

A

Class 1: 750mL
Class 2: 750-1500mL
Class 3: 1500-2000mL
Class 4: >2000mL

88
Q

Which class of hemorrhage do you start giving blood products with crystalloids?

A

Class 3 and 4

89
Q

What is the purpose of MTP in adults?

A
  • Total blood volume is replaces within 24 hours
  • 50% of total blood volume replaced in 3 hours
  • Rapid bleeding rate= 4units RBC transfused w/in 4 hours or 150mL/min blood loss
90
Q

MTP in kids is >____ mL/kg transfusion.

91
Q

What blood products are used with MTP? What is the goal of MTP?

A

Balanced resuscitation→ 1:1:1 ratio of platelets: plasma: RBC

Goal is to get all the components back to whole blood

92
Q

What is blood component therapy?

A

Basically MTP (using multiple blood products to try to get back to whole blood ratios)

93
Q

Why is blood component therapy not as good as whole blood?

A

Blood component therapy= loss of coagulation factors and platelet function in reconstituted products→ can lead to increased anemia, thrombocytopenia, and coagulopathy

Requires multiple products= higher risk of infection from multiple donors

Products diluted with anticoagulants and additives

94
Q

Why is whole blood superior for hemostatic potential?

A
  • Less dilution from anticoagulants and additives than combination of 1:1:1
  • Higher platelet count in whole blood (200 vs 88)
  • Higher coagulation factor levels in whole blood (90% vs 65%)
95
Q

What products are given as 1st, 2nd, 3rd choice for low fibrinogen levels?

A

1) Cryo (2500mg)
2) Whole blood (1000mg)
3) FFP (400mg)

96
Q

How does stored whole blood (SWB) have to be stored/tested?

A
  • Cold: 2-6 degrees C
  • Storage: 21-35 days
  • Hemostatic capability: 14-21 days
  • Testing: same as blood components
97
Q

Which type of whole blood is the universal donor?

A

Low titer type O whole blood (LTOWB)

98
Q

What is the preferred resuscitation product?

A

Stored whole blood

99
Q

What is the protocol for trauma patients with unknown blood types?

A
  • Pre-transfusion blood sample (determine blood type
  • Additional transfusions require LTOWB or group O RBCs for 1month after initial transfusion
100
Q

What is the blood product of choice for males?
What is the blood product of choice for females of child bearing years?

A

Rh positive blood for males
Rh negative blood for females of child bearing years

101
Q

Why are there a limited number of centers in the US that provide whole blood transfusion for massive hemorrhage?

A

*Highly regulated process

102
Q

How long is LTOWB good for?

103
Q

What is the recommendation for WB in peds?

A

Few studies on WB In pediatric populations:

Age <15 or weight <40kg: Limit WB to 30mL/kg

104
Q

How much calcium gluconate has to be given to get the same effect as calcium chloride?

A

3x calcium gluconate = calcium chloride

105
Q

What are some clinical usages for calcium chloride?

A
  • Hypocalcemia
  • Long QTc
  • Decreased cardiac output
  • Coagulopathy
  • Seizures
106
Q

____% of trauma patients are hypocalcemic

107
Q

What is associated with sever hypocalcemia?

A
  • More coagulopathy
  • More blood transfused
  • Double mortality
108
Q

T/F: One unit of citrated blood product drops iCa?

A

True: Would be a good idea to replace calcium after one unit is transfused

109
Q

What is the lethal triad?

A
  • Hypothermia
  • Acidosis
  • Coagulopathy
110
Q

________ + _______ = decreased citrate metabolism

A

Hypothermia (caused by hemorrhage)
Liver injury

citrate is metabolized in the liver

111
Q

What are the different components of TEG?

A

R: reaction time
K: time to clot firmness
Angle: kinetics of clot development
MA: Maximum amplitude (Max clot strength)
LY30: Percent lysis 30 min after MA

112
Q

What does TEG stand for?

A

Thromboelastography

113
Q

What is the treatment for TEG-ACT >140?

114
Q

What is the treatment for TEG R-time >10?

115
Q

What is the treatment for TEG K-time >3?

116
Q

Treatment for TEG Angle <53?

A

Cryo +/- Platelets

117
Q

What is the treatment for TEG MA <50?

118
Q

What is the treatment for LY30 >3%

Health Assessment (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions