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Haematology and Immunology > Blood transfusion > Flashcards

Blood transfusion Flashcards

1
Q

What blood groups are dominant and recessive?

A

A and B are dominant

O is recessive

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2
Q

a patient is blood group A and requires blood due to haemorrhage.
what blood types can she receive blood from?

A

A and O

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3
Q

a patient is blood group AB and requires blood due to haemorrhage.
what blood types can she receive blood from?

A

A, B, AB and O

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4
Q

a patient is blood group O and requires blood due to haemorrhage.
what blood types can she receive red cells from?

A

group O

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5
Q

a patient is at high risk of haemorrhage so you decide to give FFP.
their blood group is O. what type of donor can they receive FFP from?

A

A, B, AB and O

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6
Q

a patient is at high risk of haemorrhage so you decide to give FFP.
their blood group is AB. what type of donor can they receive FFP from?

A

group AB

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7
Q

a patient is at high risk of haemorrhage so you decide to give FFP.
their blood group is A. what type of donor can they receive FFP from?

A

A and AB

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8
Q

what type of antibody is anti-A / anti-B in blood?

A

IgM

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9
Q

what infections are blood donors screened for?

A

HIV
syphillis
hep B, C, E

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10
Q

what are the 3 blood components?

A

plasma - clotting factors, albumin and antibodies

buffy coat - leukocytes (WC’s) and platelets

red blood cells

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11
Q

what are some of the indications for a red cell transfusion?

A

severe anaemia which might otherwise cause organ damage

improve quality of life in someone with uncorrectable anaemia

prepare a patient for surgery or speed up recovery

reverse damage caused by the patients own cells i.e. sickle cell

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12
Q

how much is unit of red blood cells?

A

5 g/l

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13
Q

over how long is red blood cells transfused?

A

2-4 hours

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14
Q

over how long is platelets transfused?

A

20 - 30 mins

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15
Q

how much is 1 dose of platelets ?

A

20-40 x 10(9) /L

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16
Q

what are the indications of a platelet transfusion?

A

massive haemorrhage

bone marrow failure

prophylaxis for surgery

if bleeding with cardiopulmonary bypass

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17
Q

if a patient is blood group A+ and requires platelet transfusion due to bone marrow failure.
from what donor can she receive platelets from?

A

any blood group

you don’t require specific cross match for platelet transfusion as there are no antibodies/antigens in the buffy coat

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18
Q

what test can be used as an indicator of a patient requiring FFP?

A

PT and APTT

measure of clotting of the blood

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19
Q

when would a patient require FFP?

A

massive haemorrhage
DIC with bleeding
prophylactic

20
Q

what transfusion is given to correct fibrinogen deficiency?

A

cryoprecipitate

21
Q

how long does it take for FFP to thaw?

A

30 mins

22
Q

when donating blood, how long is the sample valid for?

A

samples kept for 7 days but only valid for 2 days if recent transfusion

23
Q

what happens when someone who is Rh-D negative becomes pregnant and the baby is Rh-D positive?

A

the mixi

24
Q

what are the indications of the direct and indirect Coombs test?

A

direct;

  • alloiummune haemolysis (i.e. HDN)
  • drug induced immune-mediated haemolysis (i.e. penicillin, methyldopa)
  • autoimmune haemolysis (i.e. SLE)

indirect;

  • cross matching for blood transfusions
  • antenatal screening for IgG causing potential HDN
25
Q

in a massive haemorrhage, what immediate supply of blood products should you ask for?

A

6 units red cells
4 units FFP
1 unit platelets

26
Q

in an emergency situation what blood type should you give a patient whose blood type you don’t know?

A

group O -ve

27
Q

what is TA-GvsHD

A

transfusion associated graft vs host disease

a rare life threatening reaction in which the immunological competent donors T lymphocytes mount an immune response against the recipients lymphoid tissue

28
Q

shortly after receiving a blood transfusion, a patient becomes breathless. what are the possible complications that could account for this?
how would you treat?

A

Transfusion associated circulatory overload (TACO)

Anaphylaxis

Transfusion related acute lung injury (TRALI)

  • 02
  • diuretic
  • ventilation
  • adrenaline
29
Q

shortly after receiving a blood transfusion, urticaria develops on the patients arm. what are the possible complications that could account for this?
how would you treat?

A

mild allergic reaction
anaphylaxis

  • anti-histamine
30
Q

shortly after receiving a blood transfusion, a patient becomes pyrexic. what could be the cause of this?
how would you treat?

A

febrile non-haemolytic transfusion reaction

  • anti-pyretic
31
Q

what are the 2 main complications that can arise if a baby is coombs test positive at birth?

A

anaemia

jaundice

32
Q

if a mother is Rh-D negative and the baby is Rh-D positive, what prophylaxis is given to prevent HDN?

A

the mother is given prophylactic anti-D at 28 weeks

33
Q

at birth the baby presents healthily but starts to show pupura on their skin and on a blood test shows low platelets.
what is the diagnosis?

A

neonatal alloimmune thrombocytpenia (NAIT)

34
Q

what is the difference between direct and indirect Coombs test? (anti globulin test)

A

used to detect antibodies which are bound to RBC surface

used to detect in vitro antibody-antigen reactions

35
Q

what does a positive direct Coombs test indicate?

A

an immune mechanism is attacking the patients own RBC

36
Q

what are the indications of cryoprecipitate?

A

bleeding due to thrombolytic therapy
hypofibrinogen
bleeding disorder i.e. von willibrands

37
Q

would you transfuse a 76 year old with Hb 54 g/L and blood film consistent with megaloblastic anaemia?

A

no because she has either folic acid or vitamin B12 deficiency so you would give folate supplements and vitamin B12 injections
this will improve Hg within a week

38
Q

would you transfuse a 48 year old lady admitted for a planned hysterectomy with Hb of 95 g/L?

A

no because she is obviously bleeding from her uterus hence why she is probably receiving a hysterectomy
e.g. menorrhagia
therefore just give some iron supplements and it will improve

39
Q

what is the main way to determine clinically if a patient requires a blood transfusion?

A

if their blood volume is severely compromised
check pulse and blood pressure
they could lose a lot of blood but there Hg may still be normal therefore don’t reply on Hg level to determine if they require a blood transfusion

40
Q

at what platelet level would you give platelet transfusion?

A

platelets < 15 x 10(9)

41
Q

how is FFP stored and why is this of clinical significance?

A

frozen at -22 degrees and takes 30 minutes to thaw so have to pre plan if you are going to use it

42
Q

would you transfuse a patient with DIC ?

A

only if they were bleeding

43
Q

would you transfuse a patient with FFP who is hypotensive with an albumin content of 16 g/L?

A

no you would give human albumin as a plasma expander

44
Q

would you give a patient FFP who is bleeding due to warfarin?

A

no you would give vitamin K + factor III and IV

45
Q

what coagulation factors does cryoprecipitate contain?

A

Factor VIII and XIII
von willebrand factor
fibrinogen
fibronectin

46
Q

why may platelets and red cells be irradiated before transfusion?

A

to decrease the risk of graft vs host disease in patients who are at risk i.e. immunosuppressed

Haematology and Immunology (15 decks)

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