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Blood transfusion Flashcards

1
Q

How many mls is a blood donation?

A

465ml

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2
Q

What is the minimum weight a blood donor must be?

A

50kg

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3
Q

What is the minimum Hb concentration a blood donor must have?

A

135 males

125 females

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4
Q

What time frame must a blood donation be collected in?

A

15 minutes
A longer bleed suggests poor venepuncture
It increases the risk of bacterial contamination and clotting

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5
Q

Why must donated blood be anticoagulated?

A

So it can be separated into components

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6
Q

How much iron does a standard blood donation contain?

A

250mg

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7
Q

What is a blood donation depleted of when it is passed through a filter?

A

White blood cells

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8
Q

Why are red cells kept in a nutrient solution?

A

To provide nutrition and maintain osmotic equilibrium to limit red cell damage

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9
Q

How long are red cells stored for and at what temperature?

A

35 days at 4 degrees

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10
Q

How long can a red blood cell unit be removed from controlled storage for before it must be transfused or discarded?
What time frame must a unit be transfused in after leaving controlled storage?

A

30 minutes

4 hours

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11
Q

At what temperature and for how long are platelets stored?

A

At 22 degrees, for 5 days

They are stored with continual agitation to promote gas exchange

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12
Q

Within what time frame must platelets be transfused after leaving controlled storage?

A

1 hour

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13
Q

At what temperature and for how long can fresh frozen plasma be stored?

A

-30 degrees

For up to 2 years

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14
Q

What time frame must fresh frozen plasma be transfused in after leaving controlled storage/being thawed?

A

4 hours

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15
Q

What is fresh frozen plasma used for?

A

To replace coagulation factors in patients:

  • who have been depleted of theirs (e.g. massive blood loss, replaced with clear fluids and red cell transfusion)
  • or cannot make their own (e.g. liver disease) and are actively bleeding
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16
Q

What infections is donated blood tested for, and what tests are used?

A 
HIV (antibody and PCR)
HCV (antibody and PCR)
HBV (antigen and PCR)
Syphilis (antibody)
HTLV I + II (antibody)
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17
Q

What main blood groups are patients and donors tested for?

A

ABO and Rh(D)

18
Q

What antigens does a patient with a) group A blood b) group B blood c) group AB blood and d) group O blood have on their red cells?

A

a) A antigens
b) B antigens
c) A and B antigens
d) no antigens

19
Q

What ABO antibodies does a patient with a) group A blood, b) group B blood c) group AB blood and d) group O blood have in their plasma?

A

a) anti-B
b) anti-A
c) no ABO antibodies
d) anti- A and anti-B

20
Q

Does a newborn with group O blood have anti-A and anti-B antibodies in their plasma?

A

No. These antibodies are developed after development of our gut flora, as some of the colonic bacteria carry sugars that our immune system recognises as being the same as A and B antigens. The gut flora develops in the first weeks-months of life, and we develop these antibodies by about 6 months.

21
Q

Which ABO blood group is the universal donor?

A

Group O (these cells do not carry any antigens)

22
Q

Which ABO blood group is the universal recipient?

A

Group AB (these patients do not have any ABO antibodies)

23
Q

What is the commonest blood type?

24
Q

What is the least common blood type?

25
What type of Ig are naturally occurring ABO antibodies?
IgM (pentameric structure), with a small proportion of IgG
26
What effect does IgM have on its antigens a) in the test tube b) in the body?
a) It can directly agglutinate target red cells | b) It can activate the complement cascade, causing formation of membrane attack complexes and haemolysis.
27
Are naturally occurring antibodies to blood group systems other than ABO common?
No, they are rare.
28
What type of immune antibodies may develop to blood group systems (other than ABO) after exposure? How might an individual develop these?
IgG Transfusion of blood expressing different blood group antigens Exposure to fetal red cells antigens (e.g. Rh (D))
29
What chromosome carries the ABO blood group genes? What do the A and B genes code for? What does the O gene code for? Which genes are dominant?
Chromosome 9 The A and B genes code for specific transferase enzymes which add a sugar residue to a precursor H substance on the red cell membrane. The O gene is silent - it doesn't code for anything A and B are codominant over O.
30
How is ABO blood group inherited?
Mendelian inheritance
31
Which chromosome carries the Rh gene?
Chromosome 1
32
How is Rh group inherited?
Mendelian inheritance
33
What Rh group alleles are there?
D (codes for presence of Rh(D) antigen on red cell surface) and d which is silent
34
Do most Rh (D) -ve people carry an antibody to Rh(D) in their blood?
No - no bacteria carry a substance that resembles Rh(D) so the only way Rh(D) -ve patients develop immunity is by being exposed to red cells that carry the antigen.
35
What test screens a patient's blood for irregular antibodies?
The indirect coomb's/anti-globulin test
36
What are the commonest irregular antibodies?
Anti-D, Anti-K, anti-c, anti-E, anti-Fya
37
Can irregular IgG antibodies crosslink red cells, as anti-A or anti-B IgM do?
No. Therefore in the indirect antiglobulin test for irregular antibodies, anti-human IgG must be added to cause crosslinking and agglutination of cells which have been bound by irregular IgG.
38
How many days can issued blood units remain in the blood fridge, ready for use for that patient? What happens to them if they are not used for that patient?
3 days they are retrieved, patient ID labels are removed and they are returned to the blood bank to be available to be crossmatched for another patient.
39
What must a prescription for a blood component include?
``` Component type Special requirements (e.g. irradiated cells or CMV-ve) Number of units When to be transfused Rate of transfusion ```
40
What medication may be required alongside a blood transfusion (e.g. particularly for elderly patients or patients with CCF)?
Diuretics
41
What is the average rate of non-urgent transfusion of red cell concentrate?
2-3 hours/unit
42
What checks should be made of the unit to be transfused?
Integrity of bag Contents - clots, gas bubbles, haemolysis Expiry date

Haematology (7 decks)

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