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Haematology and Immunology > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

What are the main blood group phenotypes?

A

A
B
O
AB

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2
Q

What do the A and B blood antigen genes code for?

A

Transferase enzymes

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3
Q

What is the A blood antigen?

A

N-acetly-galactosamine

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4
Q

What is the B blood antigen?

A

Galactose

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5
Q

What is the O blood gene?

A

Non-functional allele

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6
Q

What blood group is the universal donor?

A

O

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7
Q

What blood group is the universal recipient?

A

AB

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8
Q

What can those who are RhD negative do?

A

Individuals can make anti-D if exposed to RhD+ cells (transfusion or pregnancy)

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9
Q

What is the effect if anti-D?

A

Can cause transfusion reactions or haemolytic disease of the newborn

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10
Q

What are blood donors screened for?

A 
HepB 
HepC 
HIV 
Syphilis 
HepE 
West Nile virus 
HTLV1
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11
Q

What is the shelf life of red cells?

A

35 days

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12
Q

Over what time period should red cells be transfused?

A

2-4 hours

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13
Q

What are the indications for red cells?

A 
Anaemia 
Surgery, obstetric, trauma 
GI haemorrhage 
Bone marrow failure 
Chemotherapy 
HDN 
Sickle cell anaemia 
Thalassaemia
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14
Q

What is the shelf life of platelets?

A

5 days

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15
Q

Over what period of time are platelets transfused?

A

20-60 minutes

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16
Q

What are the indications for platelets transfusion?

A

Massive haemorrhage
Bone marrow failure
Prophylaxis for surgery
Cardiopulmonary bypass

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17
Q

What are the components of plasma?

A

Fresh frozen platelets (FFP)

Cyroprecipitate

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18
Q

What are the indications for FFP?

A

Massive haemorrhage

DIC with bleeding

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19
Q

What blood group are the universal donor for FFP?

A

AB

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20
Q

What blood group are the universal recipient for FFP?

A

O

21
Q

What steps have to be taken when blood is given at a blood bank?

A

Blood sent to lab
Group and save
Crossmatched
Samples kept for 7 days

22
Q

What is a direct Coombs test used for?

A

Autoimmune haemolytic anaemia
Passive anti-D
Haemolytic transfusion reactions

23
Q

What is an indirect Coombs test used for?

A

Cross matching

24
Q

What red cells should be available within minutes of request?

A

O RhD neg red cells, AB plasma

25
Q

What red cells should be available urgently?

A

Type specific

26
Q

What red cells should be available as a non-urgent request?

A

Full cross match

27
Q

What should be in immediate supply during a massive haemorrhage?

A

6 until red cells
4 units FFP
1 unit platelets

28
Q

What volumes of blood products should be transfused in neonates and young children?

A

Red cells 15ml/kg
FFP 15-20ml/kg
Platelets 15ml/kg

29
Q

What are the minor reactions to blood transfusion?

A

Fever usually <38c

Urticarial rash

30
Q

What are the major reactions to blood transfusion?

A 
Fever 
Urticaria 
Respiratory distress 
Hypotension 
Tachycardia 
oliguria 
Bleeding 
Collapse
31
Q

What are the management options for a minor reactions to blood transfusions?

A

Slow down transfusion
Antihistamine (urticaria)
Paracetamol (febrile non haemolytic transfusion reaction)

32
Q

What are the management options for a major reactions to blood transfusions?

A

Stop transfusion
Check patient identity against component label
Consider anaphylaxis, circulatory overload, acute haemolytic transfusion reaction, bacterial infection, lung injury (TRALI)

33
Q

What are the clinical signs of anaphylaxis?

A

Wheeze
Increased pulse
Decreased BP
Laryngeal/facial oedema

34
Q

What is the treatment for anaphylaxis?

A 
Oxygen 
IM adrenaline 
Bronchodilator 
Fluid challenge 
IM/IV hydrocortisone 
Antihistamine
35
Q

What is the treatment for transfusion associated circulatory overload (TACO)

A

Slow rate, IV diuretic

Oxygen

36
Q

What are the clinical signs of an acute haemolytic reaction?

A

Shock
High fever
Renal failure

37
Q

What is the treatment for acute haemolytic reaction?

A 
Oxygen 
IV fluids 
Diuretics 
Inotropes 
Dialysis 
Notify blood service to investigate, send blood back
38
Q

What are the clinical signs of delayed haemolytic reaction?

A

Anaemia and jaundice 7-10 days post-transfusion

39
Q

How would you test for delayed haemolytic reaction?

A

Positive direct antiglobulin test (DAT)

40
Q

What is the treatment for bacterial infection?

A

IV antibiotics
Oxygen
IV fluids
Notify blood service to investigate/ initiate recalls

41
Q

What is transfusion related acute lung injury?

A

Transfused anti-leukocyte Abs in donor plasma interact with patient’s WBC

42
Q

What is post transfusion purpura?

A

HPA 1 negative patients forms antibodies after transfusion or pregnancy

43
Q

What are the clinical signs of haemolytic disease of the newborn?

A

Positive DAT at birth
Anaemia
Jaundice
Stillbirth

44
Q

How is HDN prevented?

A

Prophylactic anti-D

45
Q

What is the treatment for HDN?

A

Antibody titres
Doppler USS
Intrauterine transfusions

46
Q

What is used for warfarin reversal?

A

Prothrombin complex concentrate

47
Q

What is the Coombs test?

A

Direct antiglobulin test

Tests if there are any antibody stuck to the surface of the red cells

48
Q

What can be given to manage a minor blood reaction?

A

Paracetamol

Antihistamine

49
Q

What is neonatal alloimmune thrombocytopenia (NAIT)?

A

Similar process to HDN but with platelets

Haematology and Immunology (16 decks)

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