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Haematology > Blood transfusion > Flashcards

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?

A

Group O

24
Q

What is the least common blood type?

A

Group AB

25
Q

What type of Ig are naturally occurring ABO antibodies?

A

IgM (pentameric structure), with a small proportion of IgG

26
Q

What effect does IgM have on its antigens a) in the test tube b) in the body?

A

a) It can directly agglutinate target red cells

b) It can activate the complement cascade, causing formation of membrane attack complexes and haemolysis.

27
Q

Are naturally occurring antibodies to blood group systems other than ABO common?

A

No, they are rare.

28
Q

What type of immune antibodies may develop to blood group systems (other than ABO) after exposure?
How might an individual develop these?

A

IgG
Transfusion of blood expressing different blood group antigens
Exposure to fetal red cells antigens (e.g. Rh (D))

29
Q

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?

A

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
Q

How is ABO blood group inherited?

A

Mendelian inheritance

31
Q

Which chromosome carries the Rh gene?

A

Chromosome 1

32
Q

How is Rh group inherited?

A

Mendelian inheritance

33
Q

What Rh group alleles are there?

A

D (codes for presence of Rh(D) antigen on red cell surface) and d which is silent

34
Q

Do most Rh (D) -ve people carry an antibody to Rh(D) in their blood?

A

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
Q

What test screens a patient’s blood for irregular antibodies?

A

The indirect coomb’s/anti-globulin test

36
Q

What are the commonest irregular antibodies?

A

Anti-D, Anti-K, anti-c, anti-E, anti-Fya

37
Q

Can irregular IgG antibodies crosslink red cells, as anti-A or anti-B IgM do?

A

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
Q

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?

A

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
Q

What must a prescription for a blood component include?

A 
Component type
Special requirements (e.g. irradiated cells or CMV-ve)
Number of units
When to be transfused
Rate of transfusion
40
Q

What medication may be required alongside a blood transfusion (e.g. particularly for elderly patients or patients with CCF)?

A

Diuretics

41
Q

What is the average rate of non-urgent transfusion of red cell concentrate?

A

2-3 hours/unit

42
Q

What checks should be made of the unit to be transfused?

A

Integrity of bag
Contents - clots, gas bubbles, haemolysis
Expiry date

Haematology (7 decks)

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