Blood Transfusion Flashcards

1
Q

what blood product is given to a severe burn patient

A

albumin

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2
Q

what must be included from blood donors blood

A

infective risk
- bacterial, viral, protozoal infection

risk of transmitting disease
- malignancy, neurological conditions (MS)

HIV
HEP C
HEP B
Syphillis

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3
Q

what are the 4 blood groups and what differentiates them

A

A - RBC membrane carries A antigen

B - RBC membrane carries B antigen

AB - RBC membrane carries A and B antigen

O - RBC membrane does not carry A or B antigen

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4
Q

what blood can be given to any recipient

A

group O

i.e. universal donor

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5
Q

what blood group can receive blood from any other donor ABO group

A

AB recipient

i.e. universal recipient

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6
Q

if the body was to launch an autoimmune attack against a wrong ABO transfusion, what antibodies would be seen

A

IgG

IgM - majority

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7
Q

what chromosome codes for our blood group

A

chr 9

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8
Q

what are the phenotype of the blood groups

A

O gene = silent
A gene = dominant
B gene = dominant

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9
Q

what would you need to be an O blood group

A

OO

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10
Q

what would you need to be an A blood group

A

AA or AO

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11
Q

what would you need to be a B blood group

A

BB or BO

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12
Q

what would you need to be a AB blood group

A

AB

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13
Q

what is chromosome is responsible for Rh(D) grouping

A

Chromosome 1

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14
Q

what determines your Rh(D) status

A

The presence or absence of the Rh(D) protein on the surface of one’s red cells determines whether one is Rh(D) positive or Rh(D) negative

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15
Q

what is the phenotype of Rh(D) and what are the combinations of this

A

D - dominant
d - recessive

DD = Rh(D) positive 
Dd = Rh(D) positive 
dd = Rh(D) negative
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16
Q

what reaction in the lab do we rely on to determine blood group

A

agglutination

17
Q

what blood group is the following patient:

red cells + Anti-A = no agglutination

red cells + Anti-B = no agglutination

red cells + Anti-AB = no agglutination

red cells + Anti-D = agglutination

A

Group O

RhD positive

18
Q

what colour is anti A and what colour is anti B

A

anti A = blue

anti B = yellow

19
Q

what are indications for red cell transfusion

A

1 - anaemia (severe)

2 - acute blood loss

20
Q

what are indications for fresh frozen plasma

A

1 - bleeding or surgery in liver disease with impaired coagulation

2 - coagulopathy following massive transfusion

3 - DIC

21
Q

what are potential side effects of blood transfusion

A

1 - immediate haemolytic transfusion reaction
2 - delayed haemolytic transfusion reactions
3 - febrile non-haemolytic transfusion reaction
4 - urticarial reactions
5 - circulatory overload
6 - bacterial infection
7 - viral infection

22
Q

what happens in immediate haemolytic transfusion reaction

A

i.e. say A blood is transfused to a group O recipient

1 - group A red cells reach the recipient’s circulation
2 - IgM anti-A binds to the cells
3- activates complement cascade
4 - formation of membrane-attack complex (MAC)
5 - release of C3a and C5a
6 - act on blood vessels to cause leakage and dilatation
7 - fluid leaks into circulation
8 - BP drops

23
Q

what are the net effects of immediate haemolytic transfusion reaction

A
systemic hypotension
DIC
renal vasoconstriction
formation of renal intravascular thrombi
shock
renal failure
- OFTEN FATAL
24
Q

what are Sx a patient will complain of in immediate haemolytic transfusion reaction

A
pyrexia / rigors
faintness / dizziness
tachycardia / tachypnoea / hypotension
pallor / sweating
headaches / chest or lumbar pain
local pain at infusion site
cyanosis
patient may say “something is wrong”
25
what is the Mx of immediate haemolytic transfusion reaction
stop transfusion start iv fluids to maintain BP and urine output obtain blood samples - for transfusion lab - FBC and blood film - coagulation screen - biochemistry - blood cultures - serum haptoglobin
26
what are features of delayed haemolytic transfusion reactions
symptoms / signs similar to, but less acute than, a IHTR unexplained fall in Hb value as transfused red cells are destroyed appearance of jaundice, renal failure or biochemical features associated with IHTRs
27
what are lab features of a delayed haemolytic transfusion reactions
anaemia, spherocytic red cells on blood film elevated bilirubin and LDH positive DAGT and/or appearance of red cell allo-antibody +/- a degree of renal failure
28
what are features of a febrile non-haemolytic transfusion reaction
rapid temp rise 1-2 degrees chills rigors
29
what causes a febrile non-haemolytic transfusion reaction
recipient has anti-HLA antibodies that bind to residual white cells within the component being transfused or as a result of vasoactive and pyrogenic substances being released from white blood cells during storage of blood components
30
what causes a urticarial reaction in a blood transfusion reaction
mast cells releasing IgE in response to infused plasma proteins
31
Sx of a urticarial reaction
Rash / weals within few minutes of starting transfusion
32
Tx of a urticarial reaction
Slow the transfusion Consider anti-histamines
33
who is at risk of circulatory overload from a blood transfusion
people with circulatory impairment | - elderly, CCF
34
what is the main Sx of circulatory overload
pulmonary oedema
35
what are Sx of a bacterial infection caused by blood transfusion
fever immediate collapse shock DIC Fever, chills, vomiting, tachycardia, hypotension
36
how should an acute bacterial infection caused by blood transfusion be treated
same as immediate-type haemolytic transfusion reaction once lab shows patient has not had an ABO-incompatible transfusion then broad spectrum antibiotics should be started