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3MB Haematology > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

Blood typing is a method of classifying blood into different blood groups depending on..

A

Presence of different antigens on the surface of red blood cells (RBCs)

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2
Q

Erythrocytes (RBCs) have multiple _______ antigens attached to their cell surface

A

Erythrocytes (RBCs) have multiple glycoprotein antigens attached to their cell surface

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3
Q

An individual inherits one _____ allele from each parent, with _____ and _____ alleles being co-dominant and producing the _____ and _____ antigens respectively

A

An individual inherits one ABO allele from each parent, with A and B alleles being codominant and producing the A and B antigens respectively

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4
Q

Group A – have antigen __ attached to the erythrocyte cell surface

A

Antigen A

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5
Q

Group B – have antigen ___ attached to the erythrocyte cell surface

A

Antigen B

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6
Q

Group AB – have antigen _____ attached to the erythrocyte cell surface

A

Both antigen A and B

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7
Q

Group O – have antigen ___ attached to the erythrocyte cell surface

A

Neither antigen

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8
Q

Each person also has ____ antibodies in their plasma

A

Each person also has ABO antibodies in their plasma

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9
Q

Function of ABO antibodies?

A

Recognise and attack RBCs expressing foreign antigens

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10
Q

A and B antibodies are predominantly IgG/ IgM/ IgA/ IgD, and IgE

A

IgM

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11
Q

Group A – have ____ antibodies

A

Anti-B

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12
Q

Group B – have ___ antibodies

A

Anti-A

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13
Q

Group AB – have ____ antibody

A

Neither

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14
Q

Group O – have _____ antibodies

A

Both anti-A and anti-B

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15
Q

Summary table (revision)

A
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16
Q

What is the most immunogenic antigen?

A

Rhesus D - most likely to precipitate a transfusion reaction

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17
Q

The presence or absence of Rh D antigen on the erythrocyte cell surface determines whether..

A

The person has Rh positive (Rh+) or Rh negative (Rh-) blood groups

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18
Q

Rh positive means..

A

Have the Rh D antigen and can receive both Rh+ and Rh- blood

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19
Q

Rh negative means..

A

Lack the Rh D antigen and should only receive Rh- blood

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20
Q

Rh negativity is generally more prevalent in ________ populations (15%), than ________ (8%) and ________ (1%) populations

A

Rh negativity is generally more prevalent in Caucasian populations (15%), than Afro-Caribbean (8%) and Asian (1%) populations

21
Q

Anti-D antibody is usually absent in Rh- patients until..

A

They have been exposed to Rh+ erythrocytes

22
Q

Rh- patients should not be transfused with Rh+ blood as this can cause them to develop..

A

Anti-D antibodies. This may cause transfusion reactions in the future

23
Q

Explain the rhesus incompatibility in pregnancy

A

Can lead to Haemolytic Disease of the Newborn (HDN)

24
Q

Anti-D injections should also be given at any time where sensitisation may occur, such as..

A

Antepartum haemorrhage
Amniocentesis procedures
Abdominal trauma

25
Q

Anti-D injections are given routinely on two occasions..

A

28 weeks gestation
Birth (if the baby’s blood group is found to be rhesus-positive)

26
Q

What does the Kleinhauer test do and when is it done?

A

To see how much fetal blood has passed into the mother’s blood + determine whether further doses of anti-D are required

After 20 weeks gestation

27
Q

How is the Kleinhauer test done?

A
  • Adding acid to a sample of the mother’s blood
  • Fetal haemoglobin is naturally more resistant to acid, so that they are protected against the acidosis that occurs around childbirth, while mothers haemoglobin is destroyed
  • The number of cells still containing haemoglobin (the remaining fetal cells) can then be calculated
28
Q

A person should NOT receive blood products containing antigens for which they have the..

A

Corresponding antibodies

29
Q

Transfusing an incompatible blood type will precipitate a..

A

Fatal transfusion reaction as the recipient’s ABO antibodies attack the donor’s antigen (seen as foreign)

30
Q

How to minimise blood transfusion complications?

A

Frequently monitored, particularly at the start of each unit.

31
Q

Which blood group are considered as universal donors and why?

A

O group - this is because their RBCs have no A, B, or RhD antigens which the recipient’s immune system could attack

32
Q

Which blood group are considered as universal recipients?

A

AB+ - their plasma does not contain anti-A, anti-B, or anti-D antibodies, so they will usually not mount an immune response to the donor blood

33
Q

What is Direct Antiglobulin Testing (DAT)?

A

Detects whether a patient’s RBCs have antibodies directly attached to them

Coombs’ reagent binds to specific immunoglobulins on the RBCs. It is added to the patient’s blood. A positive test results in the RBCs agglutinating (clumping together)

34
Q

A positive DAT indicates that..

A

Haemolysis has an immune aetiology, causes include autoimmune haemolytic anaemia, haemolytic transfusion reactions, and HDN

35
Q

What is Indirect Antiglobulin Testing (IAT)?

A

Detects antibodies present in the patient’s plasma. This can be used in cross-matching or to detect maternal anti-D IgG

Donor’s RBCs and Coombs’ reagent is combined with the patient’s isolated plasma. Test is positive if agglutination occurs

36
Q

What does a positive IAT indicate?

A

Patient has antibodies against the antigens present on the donor’s RBCs

37
Q

What are the blood components?

A

Red cells, FFP, platelets, cryoprecipitate

38
Q

What are the blood products?

A

Anti-D immunoglobulin, prothrombin complex concentrate

39
Q

What are the blood products from pharmacy?

A

IV immunoglobulin, human albumin, specific Ig

40
Q

How does blood processing occur?

A
41
Q

ABO occurs on chromosome __

A

9

42
Q

O and D group is dominant/silent

A

Silent

43
Q

Genotype of RhD+

A

DD or Dd

44
Q

Genotype of RhD-

A

dd

45
Q

Identify ABO and RhD group of a patient using..

A
46
Q

When is blood transfusion indicated?

A

Symptomatic anaemia Hb<70g/L (80g/L if cardiac disease)
Major bleeding
Always consider cause before transfusion - is there an alternative?

47
Q

When is platelet transfusion indicated?

A

Prophylaxis in patients with bone marrow failure and very low platelet counts
Treatment of bleeding in thrombocytopenic patient
Prophylaxis prior to surgery/ procedure in thrombocytopenic patient

48
Q

When is FFP transfusion indicated?

A

Treatment of bleeding in patient with coagulopathy (PT ratio >1.5)
Prophylaxis prior to surgery or procedure in patient with coagulopathy (PT ratio >1.5)
Management of massive haemorrhage
Transfuse early in trauma

49
Q

T or F: FFP transfusion is used in the absence of bleeding/ planned procedure

A

True

3MB Haematology (23 decks)

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