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Year 3 - Haematology > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

What is donated blood screened for?

A

Hep B, C, E
HIV
HTLV
Syphilis

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2
Q

How are red cells stored?

A

At 4 degrees Celsius for 35 days

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3
Q

How is FFP stored?

A

-30 degrees for 3 years

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4
Q

How are platelets stored?

A

At 22 degrees with agitation for 7 days

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5
Q

Name three blood products

A

Anti-D
Prothrombin
IV Igs
Human albumin

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6
Q

What are antigens made of?

A

Sugar and protein

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7
Q

Where is the ABO gene expressed?

A

Chromosome 9

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8
Q

What is substance H?

A

A transferase which is modified into A or B

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9
Q

Which ABO antibodies are present with blood group A?

A

anti-B

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10
Q

Which ABO antibodies are present with blood group B?

A

anti-A

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11
Q

Which ABO antibodies are present with blood group O?

A

anti-A

anti-B

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12
Q

Which blood groups can blood group A receive?

A

A and O

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13
Q

Which blood groups can group B receive?

A

B and O

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14
Q

Which blood groups can AB receive?

A

A, B, AB and O

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15
Q

Which ABO antibodies are present in blood group AB?

A

None

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16
Q

Which blood groups can O blood group receive?

A

O

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17
Q

What is Landsteiner’s law?

A

If there is no A or B antigen expressed, antibodies will be made to A or B in the plasma

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18
Q

What are anti-A and anti-B antibodies made in O blood groups?

A

Bacteria with a similar structure to A and B are present in the gut bacteria, so antibodies are made against these

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19
Q

What is used to determine ABO blood group?

A

Anti-A and anti-B antisera

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20
Q

How are D, K Jka and Fva antibodies tested for in blood?

A

Indirect anti-globulin test

21
Q

Why is anti-human globulin added to suspension in the indirect anti-globulin test?

A

IgG is used but as this only has two binding sites agglutination is not clear
Anti-human globulin binds to the IgG when bound to red cels to enhance the agglutination

22
Q

What are the indications for red cell transfusion?

A

Symptomatic anaemia Hb <70 (<80 in heart disease)
OR
Major bleed

23
Q

What are the indications for platelet infusion?

A

Prophylactically in marrow failure and very low platelet count or prior to surgery in thrombocytopenia
OR
In bleeding thrombocytopenic patient

24
Q

What are the indications for FFP transfusion?

A

Bleeding in coagulopathy with PT >1:5
Major haemorrhage
Early trauma
Prophylactically in coagulopathy before procedure

25
Q

What is the first thing to do in management of blood transfusion?

A

Stop the transfusion

26
Q

Why does fever occur in acute transfusion reactions?

A

Cytokine release

27
Q

How do acute transfusion reactions occur?

A 
Chills, rigors, fever
Flushing
Collapse
Loin pain
Resp distress
Tachycardia
Hypotension
28
Q

When should senior help be requested with transfusion reactions?

A

Airway/breathing problems
Shock
Evidence of bacterial infection

29
Q

What checks should be performed in transfusion reaction?

A

Compatibility tag should be checked against patient details

Inspect pack for evidence of bacterial contamination

30
Q

Which antibody causes acute haemolytic transfusion reactions?

A

IgM

31
Q

What does IgM cause in acute haemolytic transfusion reactions?

A

Complement activation

Lysis of transfused cells and cytokine release

32
Q

What tests should be performed in acute haemolytic transfusion reactions?

A

Coag screen
Blood cultures
Renal function

33
Q

What life-threatening conditions does acute haemolytic transfusion reaction lead to?

A

DIC

Renal failure

34
Q

How does TACO present?

A 
Resp distress within 6 hours
Increased BP and JVP
Positive fluid balance
Oedema
Bibasal crackles
35
Q

What risk factors are associated with TACO?

A 
Elderly 
Cardiac failure
Low albumin
Renal impairment
Pre-existing fluid overload
36
Q

How is TACO managed?

A

O2 and diuretics

Slow rate of future transfusions and give min volume req’d

37
Q

What are the criteria for a mild transfusion reaction?

A

Isolated temp rise >38 degrees and a rise of at least 1 degree
OR
rash only

38
Q

How are mild transfusion reactions managed?

A

Slow rate of transfusion

Paracetamol and anti-histamine

39
Q

What antibody is involved in delayed haemolytic transfusion reaction?

A

IgG

40
Q

When does delayed haemolytic transfusion reaction occur?

A

5-10 days post transfusion

41
Q

What investigation results confirm delayed haemolytic transfusion reaction?

A

Positive DAT scan

Alloantibody detection

42
Q

What type of reaction is an ABO incompatibility reaction?

A

Type II hypersensitivity

43
Q

Which antibody is involved in ABO incompatibility reactions?

A

IgM

44
Q

What does Hb appear in urine in ABO incompatibility reactions?

A

Membrane attack causes cell lysis and free Hb is excreted through the urine

45
Q

What occurs in transfusion associated lung injury?

A

Antibodies in donor blood directed against patients white cells

46
Q

What is the risk of viral transmission of Hep B through transfusion?

A

< 1 : 1.2mil

47
Q

What is the risk of viral transmission of HIV through transfusion?

A

<1: 7 mil

48
Q

What is the risk of Hep C transfusion through transfusion?

A

< 1: 28mil

Year 3 - Haematology (17 decks)

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