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Haematology > Blood transfusion > Flashcards

Blood transfusion Flashcards

1
Q

What antibodies and antigens does a person with blood group A have?

A

A antigens

Anti-B antibodies

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2
Q

What antibodies and antigens does a person with blood group B have?

A

B antigens

Anti-A antibodies

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3
Q

What antibodies and antigens does a person with blood group O have?

A

No antigens

Anti A antibodies and anti-B antibodies

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4
Q

What antibodies and antigens does a person with blood group AB have?

A

A antigen and B antigen

No antibodies

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5
Q

Which blood group is considered to be the ‘universal donor’?

A

O-

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6
Q

Which blood group is considered to be the ‘universal recipient’?

A

AB+

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7
Q

What does is mean if someone is RhD +ve?

A

They have the RhD antigen

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8
Q

Why should people who are RhD -ve receive Rh-ve blood?

A

After exposure to RhD+ve blood, they can create the anti-D antibody which can cause problems with subsequent transfusions or pregnancy

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9
Q

What is the difference between group and save and fully crossmatched blood?

A

G&S - looks at ABO and RhD, avaliable within 10-15 means

Crossmatched - full antibody profile, but takes much longer

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10
Q

Why should donor blood be irradiated if given to an immunocompromised patient?

A

This will inactivate donor T cells

Active donor T cells may cause graft-versus-host disease

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11
Q

What is graft vs host disease?

A

White blood cells in the donated tissue (the graft) recognize the recipient (the host) as foreign
The transplanted immune cells then attack the host’s body cells

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12
Q

What is the shelf life of red blood cells and how should they be stored?

A

35 days

Stored at 4 degrees

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13
Q

What is the shelf life of platelets and how should they be stored?

A

5 days

Stored at 20-24 degrees on an agitation rack

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14
Q

What form do most naturally occurring ABO antibodies take?

A

IgM/pentameric form

Some IgG

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15
Q

What chromosome are genes that determine blood group located on?

A

Chromosome 9

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16
Q

What happens to red blood cells when e.g. there is addition of anti-A antibody to group A red cells?

A

They agglutinate

17
Q

Other than ABO, what other blood groups need to be considered?

A

Kells
Duffy
Kidd
Rhesus

18
Q

When do more obscure blood groups need to be considered to possibly cause disease?

A

Multiple transfusions - patient may have had time to develop obscure antibodies

19
Q

What is the difference between direct and indirect Coombs test?

A

The direct Coombs test is used to detect these antibodies or complement proteins that are bound to the surface of red blood cells
The indirect Coombs test detects antibodies against RBCs that are present unbound in the patient’s serum

20
Q

When is direct Coombs test used clinically?

A

Haemolytic disease of the newborn
Autoimmune haemolysis
Drug-induced, immune-mediated haemolysis

21
Q

When is the indirect Coombs test used clinically?

A

Antenatal antibody screening

Blood transfusion preparation

22
Q

What is the bag of blood inspected for at the bedside?

A 
Ensure correct patient
Ensure blood product in date
Look for bubbles (bacterial contamination)
Look for blood clots
Look for haemolysis
23
Q

What rise in haemoglobin would be expected with each bag of blood transfused?

A

10g/L

24
Q

What immune response is implicated in immediate haemolytic reaction?

A

IgM
Activates release of C3a and C5a and forms membrane attack complex
This leads to lysis of the red cell

25
Q

Which antibody is implicated in delayed haemolytic reaction?

A

IgG

26
Q

What are the symptoms and signs of immediate haemolytic reaction?

A 
Fever
Rigors
Pale 
Sweaty
Tachycardia
Hypotension
Dizziness
Tachypneoa
27
Q

What are the complications of immediate haemolytic reaction?

A

Shock
DIC
Renal failure

28
Q

What should be done when acute haemolytic reaction identified?

A

Stop transfusion
Start iv fluids to maintain BP and urine output
Obtain blood samples

29
Q

When does delayed haemolytic reaction occur?

A

5-10 days after transfusion

30
Q

What biochemical/haematological investigations might indicate delayed haemolytic reaction?

A

Reduced haemoglobin in isolation
Jaunice/increased bilirubin
Increased LDH

31
Q

What is the usual cause of delayed haemolytic reaction?

A

Unusual antibodies e.g. Kells, Kidd

32
Q

How does delayed haemolytic reaction present?

A

Similar to immediate haemolytic reaction, but not as acutely unwell

33
Q

What type of hypersensitivity reaction is immediate haemolytic reaction?

A

Type 2

34
Q

What other types of reaction might someone have to a blood transfusion?

A 
Febrile non-haemolytic
Urticarial
Bacterial infection
Viral infection
Fluid overload
35
Q

What is TRALI?

A

Transfusion-related acute lung injury

Acute onset of non-cardiogenic pulmonary oedema following transfusion

36
Q

How does a febrile non-haemolytic reaction present?

A

Temperature rise greater than 1-2 degrees from pre-transfusion baseline

37
Q

What are the risk factors for fluid overload?

A 
Low body weight
Age >70
Cardiac failure
Renal failure
Hypoalbuminaemia
38
Q

What are the signs and symptoms of fluid overload?

A 
Respiratory distress
Tachycardia
Hypertension
Pulmonary oedema
Ankle swelling

Haematology (9 decks)

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