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Haematology > Blood transfusion > Flashcards

Blood transfusion Flashcards

1
Q

How are blood components obtained?

A

centrifugin anticoagulated blood to separate into red cells, buffy coat and plasma

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2
Q

How are blood products obtained?

A

subjecting human plasma to a manufacturing process to obtain various plasma fractions

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3
Q

What makes blood products more risky than blood components?

A

blood products are in batches from thousands of donations compared to 1-4 donors so higher risk of infection

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4
Q

How many people make up a pool of platelets?

A

4 standard blood donation

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5
Q

What is platelets-apheresis?

A

complete adult dose of platelets from a single donor

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6
Q

What are the anticoagulatns used in transfusion?

A

citrate-based

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7
Q

What tests are carried out on donated blood?

A

HIV 1 and 2; HCV; HBV; syphilis; HTVL 1 and 2; HEV

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8
Q

What temperature must red cells be stored at?

A

4 degrees +/-2

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9
Q

What is the shelf life of red cells?

A

35 days

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10
Q

How long can red cells be out of the fridge before thye cant be put back in?

A

30 minutes

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11
Q

Once out of the fridge, how long should red cells be transfused in?

A

within 4 hours

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12
Q

How are platelets stored?

A

22 degrees with continual agitation

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13
Q

What is the shelf life of platelets?

A

7 days if bacterial monitoring system is employed

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14
Q

When should you transfuse after taking platelets out of storage?

A

within 1 hour

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15
Q

what should FFP be stored at?

A

-30

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16
Q

What is the shelf life of FFP?

A

3 years

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17
Q

Why should platelets not be put in a fridge?

A

cold activates platelets and wontactivate again

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18
Q

What ABO blood group has no ABO antibodies?

A

AB

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19
Q

What type of antibody are ABO antibodies?

A

IgM as ABO antigens are constantly changing by small amounts

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20
Q

What chromosome is ABO blood group inherited on?

A

9

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21
Q

Why do most of us not have antibody against Rh in the blood?

A

no bacteria carry substance that resembles Rh(D)

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22
Q

What is blood group determination based on?

A

agglutination phenomenon

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23
Q

What are the commonest irregular red cell antibodies?

A

anti-D; anti-K; anti-c; anti-E; anti-Fya

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24
Q

What is length of time non-urgent transfusion of one unit of red cell conentrate generally?

A

2-3 hours

25
Q

What might bubbles in the blood bag indiacte?

A

bacterial contamination

26
Q

What rise of Hb is expected with each unit of red cells transfused?

A

10g/L

27
Q

what is the blood volume?

A

70ml/kg

28
Q

How long does normal sending for compatible blood take?

A

an hour

29
Q

Is cross-matching needed for platelet transufsion?

A

no

30
Q

what is the threshold for platelet transfusion?

A

10x10^9/L

31
Q

What would cause the threshold for platelet transfusion to go up?

A

if patient has fever as platelet survival is shorter with infection; or bleeding; or bruising;

32
Q

What is the commonest indication for FFP?

A

correct coag deficiency in patient with liver disease who are bleeding

33
Q

What are the indications for FFP?

A

bleeding or surgery in liver disease with impaired coag; coagulopathy following transfusion; DIC

34
Q

What happpens in immediate haemolytic transfusion reaction?

A

anti-ABO antibodies to wrong blood group transfusion bing and activate complemetn and rupture of the memrbane; this releases thromboplastins causing more complement and DIC; complement vasodilates

35
Q

What 3 systems are activated with an acute haemolytic tranfusion reaction?

A

kinin; complement and coagulation systems

36
Q

What are the net effects in acute haemolytic transfusion reaction

A

systemic hypotension; DIC; renal vasconstriction; renal intravascular thrombi; shock and renal failure

37
Q

What blood samples should be obtained with immediate haemolytic transfusion reaction?

A

blood to transfusion lab; blood cultures; FBC; coag screen; biochemistry; haptoglobin level

38
Q

What is the function of haptoglobin?

A

binds free Hb

39
Q

What are the features of an acute haemolytic reaction?

A

pyrexia/rigors; dizziness; tachy; hypotensive; pallor/sweating; HA/chest/lumbar pain; local pain at infusion; cyanosis

40
Q

What antibodies are usually implicated in delayed haemolytic transfusion reactions?

A

irregular antibodies

41
Q

What are the lab features of delayed haemolytic reactions?

A

anaemia; spherocytic red cells on blood film; elevated bilirubin and LDH; positive DAGT and/or red cell allo-antibody; renal failure

42
Q

What is the management of an immediate haemolytic transfusion reaction?

A

stop transfusion; start IV fluids; obtain blood samples

43
Q

What blood samples should be collected after an immediate haemolytic transfusion reaction?

A

transfusion lab; FBC and blood flim; coag screen; biochemistry; blood cultures and serum haptoglobin

44
Q

What are the features of a dleyaed haemolytic transfusion reaction?

A

symptoms similar but less acute than IHTR; unexplained fall in Hb; appearance of jaundice; renal failure of biochemical features; detection of positive DAGT or irregular antibodies in post-transfusion blood samples

45
Q

Why is complement not activated in delyaed haemolytic reactions?

A

most irregular antibodies do not activate complement

46
Q

Why is the lack of complement in delayed haemolytic reactions significant?

A

no intravascular red cell destruction but extravascular eg spleen

47
Q

why are there spherocytes with delayed haemolytic reaction?

A

when antibody coated RBCs go through spleen are destroyed by macrophages, but some excape back to circulation with damaged cell membrane–shape changes

48
Q

What is a postiive direct antiglobulin test?

A

addition of anti-human globulin to sensitised red cells to look for agglutination

49
Q

What causes febrile non-haemolytic transfusion reactions?

A

recipient has anti-HLA antibodies that bind to residual white cells within the component being transfused or vasoactive and pyrogenic substances being released from WBCs during storage

50
Q

What are the features of febrile non-haemolytic transfusion reaction?

A

rapid temperature rise 1-2 degrees; chills; rigors

51
Q

What is the prevention of febrile non-haemolytic transfusion reactions?

A

anti-pyretics and leucodepleted blood components

52
Q

What is an urticarial reaction to blood products?

A

mast cell IgE response to infused plasma proteins resulting in rash/weals within few minutes of starting transfusion

53
Q

What is the management of urticarial reaction to trasnfusion?

A

slow transfusion and consider anti-histamines

54
Q

What is the management of severe urticarial reactions?

A

need to wash blood components of all residual plasma and suspend cells in plasma

55
Q

What are the symptoms of bacterial infection of transfusion?

A

fever; immediate collapse; shock ; DIC

56
Q

What bacteria are associated with red cells?

A

pseudomonas; yersinia

57
Q

What bacteria are associated with platelets?

A

staph, strep, serratia, salmonellae

58
Q

What is the chance of blood components infecting a patietn with hIv?

A

1 in 6 million chance

Haematology (29 decks)

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