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Haematology Year 3 > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

how are blood components obtained

A

centrifuging anti-coagulated blood

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2
Q

which cells are the most dense

A

red blood cells

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3
Q

which cells are the least dense

A

plasma

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4
Q

which cells form the Buffy coat separating the RBC from plasma after centrifuging

A

white blood cells + platelets

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5
Q

until what time after collection must plasma be frozen to be used as fresh frozen plasma

A

within 8 hours- will contain almost the same concentration of coagulation proteins as in the original donor

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6
Q

how long can fresh frozen plasma be stored for

A

3 years

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7
Q

who is fresh frozen plasma given to

A

Used to replace coagulation factors in people who:
have been depleted of their own ( e.g. have had massive blood loss)
who cannot make their own and are actively bleeding (e.g. due to liver disease)

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8
Q

shelf life and storage temperature of:
RBCs
Platelets

A

RBCs 4 degrees, 35 days

Platelets room temperature, 7 days

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9
Q

what blood product is given to a severe burn patient

A

albumin

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10
Q

what are the 4 blood groups and what differentiates them

A

Group A- RBC membrane carries A antigen

Group 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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11
Q

what blood group can be given to any recipient

A

Group O

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12
Q

which blood group is least common

A

Group AB

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13
Q

which blood group can receive blood from any other donor

A

Group AB

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14
Q

If the wrong ABO transfusion was given, which antibody would be seen

A

IgM primarily

small proportion of IgG

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15
Q

what chromosome codes for our blood group

A

chromosome 9

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16
Q

which blood group alleles are dominant

A

A and B are both co-dominant

O is silent

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17
Q

what would the genotype need to be to have blood group O

A

OO

as A and B are dominant

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18
Q

what would the genotype need to be to have blood group A or B

A

AA or AO

BB or BO

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19
Q

what would the genotype need to be to have blood group AB

A

AB

20
Q

what chromosome is responsible for Rh(D) grouping

A

Chromosome 1

21
Q

what determines your Rh(D) status

A

The presence or absence of the Rh(D) protein on the surface of RBCs

22
Q

what are the possible genotypes and their corresponding phenotypes for Rh(D)

A

D- dominant
d- recessive

DD= rhesus +ve
Dd = rhesus +ve
dd = rhesus -ve
23
Q

what Rh(D) phenotype is the majority of the population

A

Rh(D) +ve

24
Q

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

A

agglutination

i.e. addition of Anti-A antibody to group A RBCs will cause them to stick together

25
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

26
Q

what colour is anti- A and what colour is anit-B

A

Anti A = blue

Anti B = yellow

27
Q

indications for red cell transfusion

A

anaemia (severe)

acute blood loss that is unpredictable. (i.e. likely to lose a lot more)

28
Q

indications for fresh frozen plasma

A

bleeding or surgery in a patient with liver disease causing impaired coagulation

Coagulopathy following massive transfusion

Disseminated Intravascular Coagulation (DIC) - small blood clots throughout blood steam causing blockage of small blood vessels

29
Q

What antibody would we expect to find in the plasma in a patient with blood group A

A

Anti-B antibody

30
Q

what antibody would we expect to find in the plasma in a patient with blood group B

A

Anti-A antibody

31
Q

which antibodies might develop after previous exposure to red cells either by transfusion or pregnancy

A 
Anti-D
Anti-K
Anti-c
Anti E
Anti- Fya
32
Q

technique used to detect irregular antibodies

A

indirect Coombs test

33
Q

potential side effects of blood transfusion

A
  1. immediate haemolytic transfusion reaction
  2. delayed haemolytic transfusion reaction
  3. febrile non-haemolytic transfusion reaction
  4. urticarial reactions
  5. circulatory overload
  6. bacterial/viral infection
34
Q

what happens in an immediate haemolytic transfusion reaction

A

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

  1. group A red cells reach recipients circulation
  2. IgM anti A binds to the cells
  3. activates compliment cascade
  4. formation of membrane attack complex (MAC)
  5. release of C3a and C5a
  6. act on blood vessels to cause leakage + dilatation
  7. fluids leak into circulation
  8. BP drops
35
Q

what are the effects of an immediate haemolytic transfusion reaction

A

OFTEN FATAL

Systemic hypotension, renal vasoconstriction, formational of renal intravascular thrombi, renal failure, shock, DIC

36
Q

Symptoms of immediate haemolytic transfusion reaction

A

pyrexia, dizziness, tachycardia, tachypnoea, hypotension, pallor, chest pain, cyanosis

37
Q

Management of immediate haemolytic transfusion reaction

A

Stop transfusion
start IV fluids to maintain BP + urine output
Obtain blood samples for transfusion lab

38
Q

features of delayed haemolytic transfusion reaction

A

similar symptoms to acute but less severe

Unexplained fall in Hb value[ transfused RBCs are destroyed

Jaundice/renal failure

39
Q

lab features of delayed haemolytic transfusion reaction

A

anaemia, spherocytic red cells on blood film, elevated bilirubin

40
Q

features of febrile non-haemolytic transfusion reaction

A

rapid temperature rise
chills
rigors

41
Q

what causes a febrile non-haemolytic transfusion reaction

A

recipient has anti HLA antibodies that bind to residual cells within the component being transfused
Or
a result of vasoactive/pyrogenic substances being released from white blood cells during storage of blood components

42
Q

what causes an urticarial reaction in blood transfusion

A

mast cells releasing IgE in response to infused plasma proteins

43
Q

symptoms of urticarial rash

A

rash/weals within few minutes of starting transfusion

44
Q

treatment of urticarial reaction

A

slow the transfusion

consider anti-histamines

45
Q

who is at risk of circulatory overload from blood transfusion

A

people with circulatory impairment e.g. elderly/CCF

46
Q

main symptom of circulatory overload

A

pulmonary oedema

47
Q

symptom of bacterial infection caused by blood transfusion

A

fever, shock, chills, vomiting, tachycardia, hypotension, collapse

Haematology Year 3 (21 decks)

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