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T's Haematology Y5 > Blood transfusion > Flashcards

Blood transfusion Flashcards

1
Q

what reacts with normal and abnormal RBC antigens

A

IgG reacts with normal

IgM reacts with abnormal

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2
Q

what are the pre-transfusion tests

A

Group and save (checks ABO group and plasma ab in pt blood, + Ab screen)
Cross matching checks pt vs donor blood specifically (pt plasma and donor RBCs incubated and spun)

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3
Q

What is IAT

A 
indirect antiglobulin testing 
pt serum plasma added to some donor reagent RBCs containing all important antigens 
add AHG (anti human golbulin) and watch for agglutination
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4
Q

Transfusion time + storage RBCs

A

2-3hrs

store at 4 degrees, for 35d

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5
Q

Transfusion time + storage platelets

A

20-30min

store at 20 deg for 7 days

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6
Q

Transfusion time + storage FFP

A

20-30min

store at

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7
Q

Transfusion time + storage cryoprecipitate

A

20-30min, store at

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8
Q

transfusion indications for RBCs

A

major haemorrhage (>30%) or Hb <70

give alternative if possible - iron, B12, folate, EPO

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9
Q

how much does 1 unit RBCs inc HB by

A

10g/L

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10
Q

transfusion indications platelets

A

massive haemorrhage
bleeding post chemo/surgery
thrombocytopaenia

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11
Q

transfusion indications FFP

A

massive haemorrhage
DIC with bleeding
liver disease

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12
Q

transfusion indications cryoprecipitate

A

bleeding plus dec fibrinogen
DIC
liver D

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13
Q

what blood would you give to intrauterine/neonatal/preg women

A

CMV neg

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14
Q

what blood would you give if patient immunosupp

A

irradiated

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15
Q

what blood would you give if IgA def pt

A 
washed blood 
(avoid severe allergic reaction to plasma prot)
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16
Q

3 main acute adverse reaction to transfusion

A

FAHR - febrile, allergic and hypotensive R
ABO incompatibility
BAc contam

17
Q

sympto and pathology of febrile acute adverse reaction to transfusion

A

WCs release cytokines in storage

-> fever chills, rigor

18
Q

tx for febrile acute adverse reaction to transfusion

A

paracetamol, slow/stop transfusion

19
Q

sympto of allergic acute adverse reaction to transfusion

A

urticaria -> wheeze -> anaphylaxis

20
Q

Tx for allergic acute adverse reaction to transfusion

A

antihistamines IV and slow/stop transfusion

21
Q

definition of hypotensive acute adverse reaction to transfusion

A

isolated fall in SBP in the absence of allergic/anaphylactic sympto

22
Q

what Ig mediates the adverse reaction in antibody incompatibility

A

IgM

23
Q

sympto of ABO incompatibility

A

restlessness, chest/loin pain, fever, vom, collapse

24
Q

blood finings in ABO incompatibility

A

dec BP, inc HR/temp, dec HB, inc billirubin/LDH, DAT+

25
Q

signs and sympto in bac contam after transfusion

A

sam sympto as ABO incompatibility
normal HB/bilirubin/LDH
DAT-

26
Q

signs/sympto in TACO

A

Transfusion assso circ overload
SOB. dec sats, inc HR, inc BP, Inc JVP
CXR - pulmo oedema and fluid overload

27
Q

signs/sympt in TRALI

A

T relted acute lung inj
SOB, dec sats, inc HR, inc BP, fever, no raised JVP
CXR - bilat pulmo infiltrates, no fluid overload

28
Q

response of TACO/TRALI to diruetics

A

TACO responds immediately

TRALI doesnt respond

29
Q

what antigens are involved in the delayed haemolytic reaction

A

duffy and kidd

30
Q

pathology of delayed haemolystic reaction

A

1 - alloimmunisation - abs form vs foreign RBC antigen

2 - repeat transfusion -> extravasc haemolysis (-> dec Hb, inc bilirubin, inc reticulocytes, inc LDH, DAT+)

31
Q

Sympto of HDFN (resus R)

A

jaundice, hepatosplenomeg, foetal hydrops

32
Q

what should you give if there has been a sensitising event (HFDN)

A

prophylatic anti-D Ig withing 72hrs

33
Q

test for fetomaternal haemorrhage (HFDN)

A

kelihauer test

34
Q

what should you test if mother/father are resus D +Ve

A

ffDNA

35
Q

what will happen if immunosuppressed pt given normal blood

A

T asso GVHD

36
Q

when does post transfusion purpura occur

A

7-10 days post transfusion

usually resolves but can cause life threatening bleeds

37
Q

Tx for post transfusion purpura

A

IV Ig infusion

38
Q

Tx for iron overload

A

occurs if >50 transfusions

Tx = iron chelation with ferritin

T's Haematology Y5 (16 decks)

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