Blood transfusion

Question 1

What are most blood transfusions for?

Answer 1

RBC

bleeding

Question 2

ABO antigens

Answer 2

expressed on surface which can provoke antibodies

Question 3

A, B, O - dominant, recessive

Answer 3

A and B are co-dominant

O is recessive

Question 4

blood group A antibodies against

Answer 4

B

Question 5

Blood group B antibodies against

Answer 5

A

Question 6

Blood group AB antibodies against

Answer 6

no antibodies

Question 7

Blood group O antibodies against

Answer 7

A +B

Question 8

Red cell recipient - group A

Answer 8

donor A and O

Question 9

Red cell recipient - group B

Answer 9

donor B and O

Question 10

Red cell recipient - AB

Answer 10

donor AB, A, B, O

Question 11

Red cell recipient - O

Answer 11

donor O

Question 12

FFP recipient A, B, AB, O

Answer 12

A - A and AB
B - B and AB
AB - AB
O - all

Question 13

When can RhD negative make anti-D?

Answer 13

exposed to RhD+ cells ie transfusion/pregnancy

Question 14

What can Anti-D cause?

Answer 14

transfusion reactions

haemolytic disease of newborn

Question 15

Blood donors screening

Answer 15

behaviours - sex, tattoo, travel
ABO and Rh
Hep E/B/C, HIV, syphilis
variable - eg malaria, zika

Question 16

4 indications for red cell transfusion

Answer 16

correct severe acute anaemia - may otherwise cause organ damage
improve QOL for uncorrectable anaemia
prepare for surgery/speed up recovery
reverse damage eg sickle cell

Question 17

RBC - storage and giving

Answer 17

4 degrees, transfuse over 2-4 hours

1 unit increments 5g/L

Question 18

Fresh frozen plasma

Answer 18

1 unit from 1 unit of blood

30 minutes to thaw

Question 19

platelets - storage and giving

Answer 19

22 degrees, 20-30 mins transfusion

Question 20

cryoprecipitate

Answer 20

fibrinogen

stored frozen - 20 mins to thaw

Question 21

“practical” blood banking

Answer 21

second sample
group and screen/save
cross match

Question 22

group and screen

Answer 22

ABO and RhD
historical records
alloantibodies

Question 23

coombs test

Answer 23

detect antibody on surface of RBC

anti human immunoglobulin

Question 24

direct coombs

Answer 24

autoimmune haemolytic anaemia

Question 25

indirect coombs

Answer 25

cross matching

Question 26

How many blood group systems are there?

Answer 26

21

Question 27

red cell availability - minutes

Answer 27

O RhD neg red cells (AB plasma)

Question 28

red cell availability - urgent

Answer 28

type specific - ABO/RhD

Question 29

red cell availability - non urgent

Answer 29

full crossmatch including alloantibodies

Question 30

massive haemorrhage

Answer 30

call 2222
rapid control
6 units RBC, 4 units FFP, 1 unit platelets

Question 31

Risks

Answer 31

TACO, TRALI, fever, febrile, allergic etc

Question 32

TACO

Answer 32

transfusion associated circulatory overload

Question 33

prion disease

Answer 33

transmitted by blood transfusion from early disease in sheep
imported FFP now used

Question 34

Pregnancy - Rh D

Answer 34

if mother -ve and baby +ve

Anti D given at sensitising events and 28/40

Question 35

tests done with haemolytic disease of newborn

Answer 35

antibody titres
doppler USS
intrauterine infusion

Question 36

cellular therapies

Answer 36

leucapheresis - bone marrow harvests
other banks eg faecal, bone, milk, heart valves
gene therapies