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Haematology > Blood transfusion > Flashcards

Blood transfusion Flashcards

1
Q

What 3 things do BTS check?

A
  1. ABO group
  2. RhD group
  3. Presence of alloantibodies to any red cell antigens in donations
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2
Q

What 6 things do hospital blood banks do?

A 
Full blood group
Antibody screen
Identification of antibodies
Cross matching
Issuing of blood products
Investigation of suspected transfusion reactions
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3
Q

What’s do octapharma and blood products Lab (BPL) do?

A

Prepare blood products from plasma

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4
Q

Define blood products/components.

A

Blood products/components are therapeutic substances prepared from human blood.

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5
Q

What are components?

A

Made from whole blood donations- rbcs ffp, cryoprecipitate and platelets.

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6
Q

What are products?

A

Plasma donations, albumin, coagulation factors, immunoglobulins

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7
Q

What is octaplas ?

A

An alternative ‘product’ to ffp

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8
Q

What is blood made up of? Give percentages

A

Plasma 55%
1% buffy coat made up of WBCs and platelets
45% rbcs

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9
Q

What is plasma made up of?

A

95% water, coagulation factors, immunoglobulins, serum albumin, fibrinogen

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10
Q

What is cryoprecipitate and does it need to be cross matched?

A

It is a blood component made up of clotting factors. Not usually- unlike ffp

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11
Q

Why are white blood cells removed for plasma products? What is this process called?

A

Removed to reduce risk of CJD. Process is called leucodepletion

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12
Q

How do u make cryoprecipitate?

A

Thawing FFP at 4 degrees producing a precipitate which s then frozen rapidly at -25 degrees

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13
Q

What is the supernatant from the FFP defrost processed to make?

A

Plasma products- eg albumin, specific immunoglobulins and coagulation factors

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14
Q

Cost, storage temp, storage length and suspension of Red blood cells?

A

£139, 4degrees, 35 days, resuspended in SAG-M or CPD

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15
Q

Cost, storage temp, storage length and suspension of Platelets?

A

£232, 22degrees, 7 days, suspended in plasma and agitated

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16
Q

Cost, storage temp, storage length and suspension of FFP?

A

£72, -30 degrees, 2 years, adult dose=2 bags

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17
Q

Cost, storage temp, storage length and suspension of cryoprecipitate?

A

£454 , -25degrees, 2 years, adult= 2 bags

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18
Q

When are red cells used?

A

Anaemia or haemorrhage

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19
Q

When is FFP used?

A

Replace clotting factors

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20
Q

When is cryoprecipitate used?

A

To replace fibrinogen or factor VIII

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21
Q

Why are platelets administered?

A

Prevention and treatment of haemorrhage in patients with thrombocytopenia or platelet function defects

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22
Q

What is SAG-M made of?

A

Saline(flow rate), adenine(maintain ATP levels), glucose, mannitol (maintain membrane solubility and prevent cell lysis)

23
Q

What is CPD made of?

A

Citrate, phosphate and dextrose (buffering system and anticoagulant)

24
Q

An RhD positive patient can receive blood from who?

A

RHD+ and RHD -

25
Q

What platelet range should a patient have for 1) operations, massive transfusions or DIC? 2) operations on critical regions or multiple trauma

A

1) >50 X 10^9/L

2) >100 X 10^9/L

26
Q

What is a TEG?

A

Thromboelastogram. Measures viscoelastic properties of clot.

27
Q

Name two conditions that don’t require a platelet transfusion

A

Thrombotic thrombocytopenia (TTP) and Heparin induced Thrombocytopenia (HIT)

28
Q

True or false: platelet transfusion requires RhD and ABO compatibility

A

True

29
Q

Fresh frozen plasma is used in what situations? (Name 3)

A

Replace clotting factors
Massive transfusion and surgical bleeding
Acute disseminated intravascular coagulopathy

30
Q

FFP should be ABO and RhD compatible

A

False. Only ABO compatible

31
Q

In under 16s what is FFP treated with to kill DNA and RNA?

A

Methylene blue treated

32
Q

Below what concentration of fibrinogen should cryoprecipitate be administered?

A
33
Q

Group A can receive cryoprecipitate from which groups?

A

A and AB

34
Q

How do u treat red cells and platelets to prevent transfusion associated graft versus host

A

Gamma irradiation

35
Q

What is CMV?

A

Cytomegalovirus. Virus in 50%. Causes chronic hepatitis and pneumonitis in immunocomprised.

36
Q

What is albumin used for and what is storage conditions and time?

A

Used for restoration and maintenance of blood volume. Store at 2-25 degrees and keep for 3 years.

37
Q

What does ant- d do and what is it used for?

A

Prevention of haemolytic disease f newborn. Given to RhD - woman within 72h of sensitising event. Neutralises any d+ antigens in mothers blood

38
Q

What is novoseven?

A

Reconstituted FVIIa used to stop uncontrolled bleeding

39
Q

What is octaplex?

A

Plasma derived prothrombin complex concentrate used to reverse warfarin

40
Q

What is ur front group and back group?

A

Front group =cells mix with anti a and anti b

Back group= plasma mix with B cells and a cells

41
Q

Blood group AB will agglutinate with what front group and back group?

A

Front group : Anti-a and anti-b

Back group: none

42
Q

How do you determine D grouping?

A

Test patients RBCs with two different monoclonal anti-d antibodies

43
Q

Why can’t you measure antibodies to D in plasma

A

Usually not present in circulation for long

44
Q

What method is used to screen for antibodies?

A

IAT - indirect antiglobulin test. Mix patient plasma with rbcs of known group.

45
Q

What do u do if patient sample tests positive to antibodies in IAT

A

Use antibody panel with panel of donor rbcs. Use IAT test and enzyme IAT.

46
Q

What reactions are enhanced by enzyme IAT and which are diminished?

A

Rh is enhanced and MNS and Duffy are diminished

47
Q

How is an antibody excluded or confirmed in an IAT?

A

Confirmed if 2 cells of either heterozygous or homozygous expression are positive. Negative if 2 cells of homozygous expression of antigen are negative

48
Q

If an antibody is detected in IAT screen what not?

A

Red cell phenotyping of patients red cells to make sure they don’t have antigen that detected (mistake)

49
Q

How do u carry out red cell phenotyping?

A

Mix patient sample with monoclonal anti sera and test for direct agglutination or indirect agglutination

50
Q

What are the 2 steps of crossmatching

A

1) select red cells- must be ABO and Rh matched
2) serological crossmatch- patient plasma tested against doner red cells
If patient has allo antibodies select antigen negative units.

51
Q

How to manually test ABO/d group?

A

1) mix one drop of antisera and one drop of red cell solution suspended in saline
2) mix
3) look for agglutination
4) grade agglutination

52
Q

Automated ABO detection.

A

Dextron acrylamide gel. Card contains anti a, b and d and a1 and b antigens. Patient rbc added to wells and plasma added to wells. Centrifuged- positive agglutination at top net at bottom

53
Q

In gel IAT where is IgM, IgG and negative cells?

A

Agglutinated IgM is at the top of gel, IgG pushed through gel, interact with anti-IgG in card. Negative cells pass through gel and at bottom

54
Q

An agglutination strength of 4+ = what?

A

Solid band of red cells at top of gel

Haematology (9 decks)

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