Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4th year passmedicine by topic > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

When are red packed cells used?

A

transfusion in chronic anaemia

cases where infusion of large volumes of fluid may result in cardiovascular compromise

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

How are red packed cells obtained?

A

Product obtained by centrifugation of whole blood.

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

When is Platelet rich plasma used?

A

plasma Usually administered to patients who are thrombocytopaenic and are bleeding or require surgery.

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

How is Platelet rich plasma obtained?

A

obtained by low speed centrifugation.

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

When is Platelet concentrate used?

A

patients with thrombocytopaenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is Platelet concentrate obtained?

A

high speed centrifugation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does Fresh frozen plasma consist of?

A

clotting factors, albumin and immunoglobulin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is fresh frozen plasma prepared?

A

single units of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How much is in one unit of fresh frozen plasma? What is the usual dose?

A

200 to 250ml

12-15ml/Kg-1.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is fresh frozen plasma used?

A

Usually used in correcting clotting deficiencies in patients with hepatic synthetic failure who are due to undergo surgery.

most suited for ‘clinically significant’ but without ‘major haemorrhage’ in patients with a prothrombin time (PT) ratio or activated partial thromboplastin time (APTT) ratio > 1.5

can be used prophylactically in patients undergoing invasive surgery where there is a risk of significant bleeding

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

fresh frozen plasma is first line for hypovolaemia

A

NOOOOOO

it should not

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

Cryoprecipitate contains what?

A

Factor VIII:C, von Willebrand factor, fibrinogen, Factor XIII and fibronectin

Clinically it is most commonly used to replace fibrinogen

made from supernatant of FFP.

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

Cryoprecipitate is

used for?

A

most suited for patients for ‘clinically significant’ but without ‘major haemorrhage’ who have a fibrinogen concentration < 1.5 g/L

example use cases include disseminated intravascular coagulation, liver failure and hypofibrinogenaemia secondary to massive transfusion. It may also be used in an emergency situation for haemophiliacs (when specific factors not available) and in von Willebrand disease

can be used prophylactically in patients undergoing invasive surgery where there is a risk of significant bleeding where the fibrinogen concentration < 1.0 g/L

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

Giving cryoprecipitate allows allows which factor to be given at what rate?

A

large concentration of factor VIII to be administered in small volume.

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

What is SAG-Mannitol blood?

A 
Removal of all plasma from a blood unit and substitution with:
Sodium chloride
Adenine
Anhydrous glucose
Mannitol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is SAG-Mannitol administered?

A

Up to 4 units of SAG M Blood may be administered.

Thereafter whole blood is preferred.

After 8 units, clotting factors and platelets should be considered.

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

Which blood products must be cross matched?

A

Packed red cells Platelets
Fresh frozen
Cryoprecipitate
Whole blood

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

Which blood products can be given to ABO incompatible in adults

A

Platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are cell saver devices? What types?

A

collect patients own blood lost during surgery and then re-infuse it.

There are two main types:

Those which wash the blood cells prior to re-infusion. These are more expensive to purchase and more complicated to operate. However, they reduce the risk of re-infusing contaminated blood back into the patient.

Those which do not wash the blood prior to re-infusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the main advantage of cell saver devices? When are they contra-indicated?

A

may reduce risk of blood borne infection
may be acceptable to Jehovah’s witnesses.

It is contraindicated in malignant disease for risk of facilitating disease dissemination.

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

In some surgical patients the use of warfarin can pose specific problems and may require the use of specialised blood products

A

true

major bleeding

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

Outline steps in warfarin reversal for immediate or urgent surgery in patients taking warfarin(

A
  1. Stop warfarin
  2. Vitamin K

Human Prothrombin Complex

Fresh frozen plasma (Used less commonly now as 1st line warfarin reversal, Only use if human prothrombin complex is not available)

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

How long does Vitamin K take to reverse warfarin? (oral and IV)

A

IV takes 4-6h to work (at least 5mg)

Oral can take 24 hours to be clinically effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When prescribing FFP for warfarin reversal, what do you need to remember?

A

Prescribe 30ml/kg-1

Need to give at least 1L fluid in 70kg person (therefore not appropriate in fluid overload)

Need blood group

Only use if human prothrombin complex is not available

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

Human Prothrombin Complex can reverse the effects of Warfarin within?

A

1 hr

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

What is the brand name of Human Prothrombin Complex? How much should you give? What should you give it with?

A

Bereplex 50 u/kg

Rapid action but factor 6 short half life, therefore give with vitamin K

27
Q

What is the transfusion threshold and the target AFTER transfusion for patients WITH ACS?

A

Transfusion threshold: 80 g/L

Target after transfusion: 80-100 g/L

28
Q

What is the transfusion threshold and the target AFTER transfusion for patients WITHOUT ACS?

A

Transfusion threshold: 70 g/L

Target after transfusion: 70-90 g/L

29
Q

When should thresholds for blood transfusion not be used?

A

patients with ongoing major haemorrhage or patients who require regular blood transfusions for chronic anaemia.

30
Q

red blood cells should be stored at what prior to infusion

A

4°C

31
Q

in a non-urgent scenario, a unit of RBC is usually transfused over how long?

A

90-120 minutes

32
Q

What is the universal donor for FFP?

A

AB blood because it lacks any anti-A or anti-B antibodies

33
Q

When is prothrombin complex concentrate used?

A

used for the emergency reversal of anticoagulation in patients with either severe bleeding or a head injury with suspected intracerebral haemorrhage

can be used prophylactically in patients undergoing emergency surgery depending on the particular circumstanc

34
Q

Cytomegalovirus (CMV) is transmitted in

A

leucocytes

35
Q

As most blood products (except granulocyte transfusions) are now leucocyte depleted CMV negative products are rarely required.

A

true

36
Q

Irradiated blood products are depleted of

A

T-lymphocytes

37
Q

Why are irradiated blood products used?

A

used to avoid transfusion-associated graft versus host disease (TA-GVHD) caused by engraftment of viable donor T lymphocytes.

38
Q

Irradiated products can be used in which situations?

A

Granulocyte transfusions
Intra-uterine transfusions
Neonates up to 28 days post expected date of delivery
Bone marrow / stem cell transplants ✓
Immunocompromised (e.g. chemotherapy or congenital) ✓
Patients with/previous Hodgkins Disease

39
Q

CMV negative products can be used in which situations?

A

Granulocyte transfusions
Intra-uterine transfusions
Neonates up to 28 days post expected date of delivery
Pregnancy: Elective transfusions during pregnancy (not during labour or delivery)

40
Q

Blood product transfusion complications may be broadly classified into the following?

A

immunological: acute haemolytic, non-haemolytic febrile, allergic/anaphylaxis
infective
transfusion-related acute lung injury (TRALI)
transfusion-associated circulatory overload (TACO)
other: hyperkalaemia, iron overload, clotting

41
Q

Acute haemolytic transfusion reaction results from?

A

mismatch of blood group (ABO) which causes massive intravascular haemolysis. This is usually the result of red blood cell destruction by IgM-type antibodies.

42
Q

In Acute haemolytic transfusion reaction symptoms begin in?

A

minutes after the transfusion

43
Q

Acute haemolytic transfusion reaction what symptoms?

A

fever, abdominal and chest pain, agitation and hypotension.

44
Q

How do you treat acute haemolytic transfusion reaction?

A

immediate transfusion termination

Confirm diagnosis
check the identity of patient/name on blood product
send blood for direct Coombs test, repeat typing and cross-matching

generous fluid resuscitation with saline solution and informing the lab

45
Q

What are the complications Acute haemolytic transfusion

A

disseminated intravascular coagulation, and renal failure

46
Q

What causes Non-haemolytic febrile reaction?

A

Thought to be caused by antibodies reacting with white cell fragments in the blood product and cytokines that have leaked from the blood cell during storage

due to white blood cell HLA antibodies
often the result of sensitization by previous pregnancies or transfusions

47
Q

What are the features of Non-haemolytic febrile reaction?

A

Fever, chills

Red cell transfusion (1-2%)
Platelet transfusion (10-30%)
48
Q

How do you manage Non-haemolytic febrile reaction?

A

Slow or stop the transfusion

Paracetamol

Monitor

49
Q

What causes Allergic/anaphylaxis reaction

A

hypersensitivity reactions to components within the transfusion

50
Q

What are the features of Allergic/anaphylaxis reaction

A

Symptoms typically arise within minutes of starting the transfusion and severity can range from urticaria to anaphylaxis with hypotension, dyspnoea, wheezing, and stridor, or angioedema.

51
Q

How do you treat Allergic/anaphylaxis reaction

A

Simple urticaria should be treated by discontinuing the transfusion and with an antihistamine. Once the symptoms resolve, the transfusion may be continued with no need for further workup.

More severe allergic reaction or anaphylaxis should be treated urgently. The transfusion should be permanently discontinued, intramuscular adrenaline should be administered and supportive care. Antihistamine, corticosteroids and bronchodilators should also be considered for these patients.

52
Q

Transfusion-related acute lung injury (TRALI) is rare

A

true

A rare but potentially fatal complication of blood transfusio

53
Q

What isTransfusion-related acute lung injury (TRALI) characterised by? How long does it take to present?

A

Characterised by the development of hypoxaemia / acute respiratory distress syndrome within 6 hours of transfusion.

pulmonary infiltrates on chest x-ray

54
Q

What is TRALI’s symptoms?

A

hypoxia
fever
hypotension

55
Q

What causes Transfusion-related acute lung injury (TRALI)

A

Non-cardiogenic pulmonary oedema thought to be secondary to increased vascular permeability caused by host neutrophils that become activated by substances in donated blood

56
Q

How do you manage Transfusion-related acute lung injury (TRALI)

A

Stop the transfusion

Oxygen and supportive care

57
Q

What is Transfusion-associated circulatory overload (TACO)?

A

A relatively common reaction due to fluid overload resulting in pulmonary oedema.

58
Q

What is the key difference betweenTRALI & TACO?

A

In TACO as well as features of pulmonary oedema the patient may also by hypertensive, a key difference from patients with TRALI.

59
Q

What causes TACO?

A

Excessive rate of transfusion, pre-existing heart failure

60
Q

How do you treat TACO?

A

Slow or stop transfusion

Consider intravenous loop diuretic (e.g. furosemide) and oxygen

61
Q

What is a complication of blood transfusion in terms of infection?

A

although the absolute risk is very small, vCJD may be transmitted via blood transfusion

62
Q

from late 1999 onward, all donations have undergone removal of white cells (leucodepletion) in order to reduce any vCJD infectivity present

A

true

63
Q

from 1999, plasma derivatives have been fractionated from imported plasma rather than being sourced from UK donors. Fresh Frozen Plasma (FFP) used for children and certain groups of adults needing frequent transfusions is also imported

A

true

64
Q

from 2004 onward, recipients of blood components have been excluded from donating blood

A

true

4th year passmedicine by topic (96 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions