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Year 5 😊✌🏼 > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

Types of transfusion reaction

A

acute
chronic

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2
Q

What happens if you give an ABO incompatible blood transfusion?

A

massive intravascular haemolysis - can be fatal

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3
Q

What proportion of people have RhD +ve blood?

A

85%

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4
Q

What happens in an anti-D reaction?

A

delayed haemolytic transfusion rection

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5
Q

Other blood group markers than ABO and Rh

A

xxx

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6
Q

How many red cells anigens are there

A

100s

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7
Q

antibodies to red cells - what type?

A

IgG

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8
Q

Which patents are more likely to develop antibody against the other RBC antigens than ABO and RhD?

A

many transfusions

e.g. sickle cell disesae

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9
Q

How is blood grouped in hospitals?

A

automated blood grouping and antibody screening - safer and quicker than people doing it

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10
Q

IAT technique

A

???

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11
Q

G&S

A

group and save/screen

more info

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12
Q

Electronic crossmatch

A

selection and issue of red cell units where compatibility is determined by IR system without physical testing of donor cells against patient plasm,a

only for patient that had a negative antibody screen

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13
Q

How do you crossmatch blood if someone has antibodies?

A

serological crossmatch

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14
Q

types of crossmatch

A

electronic
serological

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15
Q

serological crossmatch - finding when not compatible

A

agglutination or haemolysis -> not crossmatch

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16
Q

What are donor RBCs labelled with?

A
  1. ABO nad D type
  2. Kell
  3. other Rh antigens
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17
Q

Pillars of patient blood management

A
  • optimise haemopoiesis
  • minimise blood loss and bleeding
  • harness and optimises physiological tolerance of anaemia e.g. optimise cardiac outer, restrictive transfusion threshold
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18
Q

When can you use cell salvage?

A
  • no cancer
  • clean surgery i.e. not bowel
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19
Q

how long are transfusion records of patients kept in the UK?

A

30 y

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20
Q

How long in advance should you let the lab know when you need large amounts of blood for a planned surgery?

A

at least 24-48 h

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21
Q

post transplant or immunosuppression - what special requirements for blood transfusion?

A

irradiated components

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22
Q

can people with sickle cell trait donate blood?

A

yes

but this blood cannot be given to someone with a sickle cell crisis because it will not help them.

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23
Q

why are bacterial infection concerns higher for platelets than red cells?

A

platelets are kept at room temp rather than 4C

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24
Q

pts with fever post transfusion - mx

A
  1. take blood cultures
  2. treat with blood spectrum abx
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25
Q

FFP

A

need 20 mins to thaw out
can be kept at 4 degrees for 24h
transuse
….

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26
Q

trigger for blood transfusion in major blood loss

A

if >30% blood volume is lost

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27
Q

post chemo - trigger for transfusion

A

Hb <80 g/L

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28
Q

Indications to give platelets

A

Massive transfusion - aim puts > 75 x 10^9/L
prevent bleeding post chemo 0 if < 10 x 10^9/L (<20 if sepsis)
prevent bleeding (surgery - <50 x 10^9/L (<100 if critical site: eye, CNS, poly trauma)

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29
Q

when is platelet transfusion contraindicated?

A

HiTT (heparin induced thrombocytopenia thrombosis)
TTP

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30
Q

by how much does a unit of platelets increase the platelet count?

A

30-40

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31
Q

what is octoplast?

A

???

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32
Q

Indications for FFP

A
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33
Q

dosage for FFP

A
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34
Q

What is cryoprecipitate

A

has more fibrinogen than FFP

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35
Q

Doses of fibrinogen

A
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36
Q

autologous vs allogenic blood donation

A

autologous - own
allogenic - donor

37
Q

is autologous blood donation e.g. prior to planned OP possible?

A

yes BUT not done in the uk

38
Q

what is post op cell salvage?

A

collect blood lost post op into wound drain, filer and re-infuse

mainly used in orthodox surgery

does not have clotting faactors

39
Q

When do you need CMV -ve blood?

A

intraunterine/ neonataal transfusions

40
Q

irradiated blood

A

for highly uimmunsuppressed

TAA_GvHD

41
Q

When do we used washed red cells?

A

xxx

42
Q

WBIT

A

wrong blood in tube

can happen in labelling issues; can be detrimental/fatal for patient and career changing for healthcare professional

43
Q

communists blood group in UK?

A

0 47%

44
Q

how common is O, A, B and AB in

A

O - 47%
A - 42%
B - 8%
AB - 3%

45
Q

Why is a rather than AB the universal donor for plasma?

A

Because AB is rare in the population in the UK

46
Q

O- how much of population?

A

7%

47
Q

what is the % demand for O- blood?

A

13.3%

48
Q

What are some specific/special requirements for all blood?

A
49
Q

What is the universal donor for plasma?

A

A RhD +

50
Q

What are acute and chronic transfusion reactions?

A

acute within 24 h
chronic >24h

51
Q

name some acute transfusion reactions

A

§xxx

52
Q

name some chronic transfusion reactions/complicatosn

A

xxx

53
Q

What is more common, TACO or TRALI?

A

TACO is 100x more common than TRALI

54
Q

What is the name of a transfusion reaction affecting the lungs?

A
55
Q

TACO

A

transfusion associated circulatory overload

56
Q

what are the commonest causes of transfusion reaction

A

errors e.g. giving wrong group

57
Q

How do you recognise an acute transfusion rct/

A

rise in pulse, temp

fall in BO

pain at side
fever
risgors
flushing
vomiting
loin pain
chest pain
urticaria
itching
headache
collapse

58
Q

obs for transfusion

A

get baseline boss

repeat 15 mins after start of transfusion

repeat …

59
Q

FNHTR

A

febrile non-haemolytic transfusion reCTION

1 degree rise in temp
chills
rigorss

common before leiucodelepted, now rare

slow/ stop the transfusion and give practemaol

60
Q

allergic transfusion reaction

A

common, especially with planma

mild urticarial or itchy rash sometimes with a wheeze

during or after transfusion

treat with IV antihistamaiens

61
Q

wrong blood reaction Sx

A

restlessness
chest loin pain
fever
vomiting
flushing
collapse
rise in HR
fall in BP
risse in temp
haaemoglobinuria (later)

62
Q

commonest respiratory related complication of transfusion

A

TACO

63
Q

Sx of transfusion of blood with bacterial contaamination

A

BO fall
HR and temp rise

bacterial growth can cause endotoxin prosucion which causes immediate collapses

64
Q

How do we prevent bacterial contamination in transfusion?

A

clean arm of donor
ask if they had recent infections

test first 20mls for bacteria

look for abnormalities e.g. climbs, discolouration, debris

store at 4 degrees celsius, can be out of fridge for 30 mins

65
Q

shelf life of platelets

A

7 days

66
Q

commonest blood product associated with bacterial infection

A

platelets

67
Q

anaphylaxis to blood products

A

shock
breathless
wheeze
often laryngeal &/or facial oedema

68
Q

What are respiratory complications of transfusion?

A

TACO
TRALI
TAD

69
Q

timeframe of TACO presentation

A

within 6h of transfision

70
Q

how does TACO look clinically

A

like pulm oedema
SOB

….

71
Q

who is at risk of TACO?

A

weigh less than 50kg
pulmonary oedema
liver disease
positive fluid balance/on IV fluid
…

72
Q

What is TRALI?

A

SOB
decreased O2 stats
increased HR and BP

73
Q

CXR finding in TRALI

A
74
Q

infectons associated with transfusion

A

Hep B
Hep C
malaria
HIV 1, 2
HEV, HTLV1+2, Parvovirus,
CMV (reserved for pregnant women)
WNV, Zika
v-CJD

75
Q

is there a test of v-CJD?

A

no

76
Q

can you get COVID-19 from transfusion?

A

no

77
Q

TTI

A

transfusion transmitted infectio

78
Q

delayed haemolytic transfusion reactions

A

1-3%
…

day 7 post

raised bill, LDH, fall in Hb, +ve dat, Hb-uria and clears in subsequent days

caan cause renal problems

check if they developed a new antibody

79
Q

TA-GvHD

A

rare, but always fatal (w-m post traaansfussion)

donor’s blood contains some lymphocytes (able to divide)

prevented by irradiating blood components, leucodepletion and HLA matched blood if necessary

80
Q

Which antibodies cross placenta?

A

IgG

81
Q

when in pregnancy do G&S?

A

at booking
at 28w

82
Q

What to do if an antibody is present during pregnancy?

A

check father
monitor level of antibody
check ffDNA sample at around 28w

83
Q

Where are intrauterine transfusions performed?

A

at highly specialised centres

84
Q

What antibody most commonly causes HDFN?

A

Anti-D

85
Q

when does anti-D have to be given in pregnancy?

A

within 72h of the sensitising event

86
Q

sensitising vents during pregnancy

A

spontaneous miscarriage or surgical evacuation
abdominal trauma in pregnancy
delivery
CVS/amnioi

87
Q

Doses of Anti-D

A

ata leas 250 ui before 20w
eat least 400 iu for any events after 20w, including delivery.

Kleihauer teste used to determine how much?

88
Q

What other antibodies can cause HDFN?

A

anti-c
anti-Kell (stops erythropoiesis)

usually less severe than anti-D

Year 5 😊✌🏼 (53 decks)

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