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Haematology > Blood transfusion > Flashcards

Blood transfusion Flashcards

1
Q

What are the requirements of a blood donor?

A

Generally healthy
>50kg
Hb levels: Hb 135g/L men, Hb 125g/L women
17-65

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2
Q

What is all blood screened for?

A

HIV
Hep B/C/E
Human T-Lymphotropic Virus
Syphilis.

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3
Q

What components can blood be split into?

A 
Red Blood Cells
Fresh Frozen Plasma
Platelets
Cryoprecipitate
Factor VIII and IX concentrates
Albumin
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4
Q

How are RBC stored?

A

Stored at 4 degrees for 35 days.

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5
Q

How is FFP stored?

A

Stored at -30 degrees for 3 years.

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6
Q

What important product does FFP contain?

A

Contains coag factors.

Used to replace coag factors.

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7
Q

How are platelets stored?

A

Stored at room temp for 7 days with constant agitation.

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8
Q

How is cryoprecipitate created and stored?

A

Freeze thaw plasma and take off supernatant.

Store at 30 degrees.

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9
Q

What does cryoprecipitate contain and what is it used for?

A

Contains VIII, vWF, fibrinogen.

Use for DIC and other low fibrinogen conditions.

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10
Q

How are Factor VIII and IX concentrates stored and what are they used for?

A

Freeze dried.

Use for haemophilia and vW disease.

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11
Q

What is albumin used for?

A

Use for severe hypoalbuminemia and plasma exchange.

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12
Q

When should albumin not be used?

A

Do not use in malnutrition or severe renal impairment.

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13
Q

What products can be created from blood?

A

Anti-D immunoglobulin

Prothrombin complex concentrate

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14
Q

What is Anti-D immunoglobulin used for?

A

Important for treating RhesusD isoimmunisation.

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15
Q

What is prothrombin complex concentrate used for?

A

Used to treat warfarin OD

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16
Q

What are the two main blood type categories?

A

ABO

Rh

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17
Q

Which chromasome is ABO coded on?

A

Cromasome 9

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18
Q

What is the most common and rarest ABO blood types?

A

Most common- O

Rarest- AB

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19
Q

What is the genotype of A blood type?

A

AA or AO

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20
Q

What is the genotype of B blood type?

A

BB or BO

21
Q

What is the genotype of AB blood type?

A

AB

22
Q

WHat is the genotype of O blood type?

A

OO

23
Q

What are the two blood types in Rh blood group?

A

RhD+

RhD-

24
Q

Is RhD+ and RhD- more common?

A

RhD+ (85%)

25
Q

What do RhD- patients produce?

A

Produces IgG antibodies against D+

26
Q

What are some complications of RhD mismatching?

A

Transfusion reaction

Haemolytic disease of the fetus and newborn

27
Q

What is haemolytic disease of the foetus and newborn?

A

RhD baby and Rhd mother. Mother produced Ab against baby and kills it.

28
Q

What are the indications for transfusing RBC?

A

Symptomatic anaemia Hb<70g/L (80g/L if cardiac disease)

Major bleed

29
Q

How should RBC be transfused?

A

Transfuse single unit and reassess.

30
Q

What are some indications for transfusing platelets?

A
  • Prophylaxis in patients with bone marrow failure and very low platelet counts
  • Treatment of bleeding in thrombocytopenic patient
  • Prophylaxis prior to surgery/ procedure in thrombocytopenic patient
31
Q

What are some indications for transfusing FFP?

A
  • Treatment of bleeding in patient with coagulopathy (PT ratio >1.5)
  • Prophylaxis prior to surgery or procedure in patient with coagulopathy (PT ratio >1.5)
  • Management of massive haemorrhage
  • Transfuse early in trauma
32
Q

What needs tested before transfusing?

A

Blood group

Presence of clinically significant RBC antibodies

33
Q

How are RBC tested before transfusion?

A

Antisera- Reagents with known Ab to RBC antigens (AntiA/B/D)
Reagent RBC- Patient plasma and RBC with known antigens.
Indirect anti-globulin test- Add anti-human globulin (AHG) to plasma/red cells and see of agglutinate.

34
Q

What is the final test before transfusing a patient?

A

ITA crossmatch- Mix known donor cells with patient plasma and AHG.

35
Q

When should observations be taken when transfusing?

A

Observations before blood is commenced
Observations at 15 minutes while transfusing
Observations within 60 minutes of completion

36
Q

What is a common transfusion reaction?

A

Mild fever:
Isolated temp rise >38
Rise 1-2 degrees
Rash only

37
Q

How do you treat a mild transfusion reaction?

A

Reduce rate and give paracetamol but don’t stop.

38
Q

What are some severe transfusion reactions?

A

Acute transfusion reactions (ATR)
Acute haemolytic transfusion reactions (AHTR)
Bacterial contamination
Transfusion associated circulatory overload (TACO)

39
Q

What are acute transfusion reactions?

A 
Fever
Tachycardia
Hypotension
Chills
Rigor
Rash
Flushing
Feeling of impending doom
Collapse
40
Q

What causes Acute haemolytic transfusion reactions (AHTR)?

A

Wrong blood type given

41
Q

Give some main points of a bacterial contamination

A

More common with platelets
Culture patient and remaining product
Broad spectrum antibiotics

42
Q

What are some symptoms of Transfusion associated circulatory overload (TACO)?

A

Respiratory distress within 6 hours of transfusion
Raised blood pressure
Raised JVP
Positive fluid balance

43
Q

What are some risk factors for Transfusion associated circulatory overload (TACO)?

A 
Old
Cardiac failure
Low albumin
Renal impairment
Fluid overload
44
Q

How do you treat TACO?

A

O2
Support
Diuretics
Transfuse minimum volume required

45
Q

What are some symptoms of Delayed haemolytic transfusion reactions?

A

Hb may drop

Raised bili

46
Q

What causes Delayed haemolytic transfusion reactions?

A

IgG reaction 5-10 days after transfusion

47
Q

What viruses can be passed in a transfusion?

A

Hep B
HIV
Hep C

48
Q

What king of Ig are AntiA/B?

A

IgM

49
Q

What kind of antibodies are seen in alloimmunity?

A

IgG

Haematology (12 decks)

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