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Medical Diagnostics > Blood Transfusions > Flashcards

Blood Transfusions Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the only indication of for transfusing whole blood?

A

Trauma

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2
Q

What part of the blood is normally transfused?

A

What the patient NEEDS!!

*Examples: platelets, PRBC’s, etc

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3
Q

What is pretransfusion compatibility?

A

Type and screen of procedure:

  • ABO
  • Rh type
  • Antibodies
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4
Q

What is and how do you cross match?

A
  • Cross matching verifies the donor blood is compatible with the recipients
  • Drop of donor blood mixed with drop of recipients plasma –> observed for 30 mins to see if any clumping occurs
  • Imprt to save patients sample for at least 3 days post transfusion in case of an acute reaction
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5
Q

Is there evidence to support the use of acetaminophen and diphenhydramine prior to transfusions to prevent transfusion reactions?

A

NO. Start low, go slow

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6
Q

What should you do for any transfusion reactions? (except minor allergic)

A

Stop transfusion!!

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7
Q

What are the signs of a acute hemolytic reaction?

A

Fever, hypotension, flank pain, renal failure

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8
Q

When would a acute hemolytic rxn occur?

A

<24 hours after transfusion ACUTE (short time)

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9
Q

What causes a acute hemolytic rxn?

A

Due to ABO incompatibility (Rare)

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10
Q

How should you treat a acute hemolytic rxn?

A
  • Vigorous IV fluids
  • Maintain urine output with diuretics
  • Mannitol or dopamine
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11
Q

What should you look at if you suspect a acute hemolytic rxn?

A
  • Check for a fever

- Check how long ago the pt received blood

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12
Q

When would a delayed hemolytic rxn occur?

A

5-7 days after transfusion

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13
Q

What causes a delayed hemolytic rxn?

A

Undetected alloantibodies against minor antigens

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14
Q

How should you treat a delayed hemolytic rxn?

A

No specific therapy required, just document for future

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15
Q

What are the signs of a febrile nonhemolytic rxn?

A

Fever and rigors (intense shivering)

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16
Q

When would a febrile nonhemolytic rxn occur?

A

0-6 hours after transfusion

17
Q

What causes a febrile nonhemolytic rxn?

A
  • Antibodies against donor WBC’s

- Cytokines released from cells in blood product

18
Q

What is the treatment for a febrile nonhemolytic rxn?

A

Acetaminophen +/- meperidine

Rule out infection and hemolysis

19
Q

What are the signs of a allergic transfusion rxn?

A

Urticaria (rarely anaphylaxis), bronchospasm, laryngeal edema, hypotension

20
Q

What causes a allergic transfusion rxn?

A

It is a reaction to plasma proteins in blood products

21
Q

When would anaphylaxis be seen?

A

IgA deficient patients who have pre-formed anti-IgA antibodies

22
Q

What is the treatment for a allergic transfusion rxn?

A 
Urticaria = diphenhydramine (Benadryl) 
Anaphylaxis = epinephrine +/- glucocorticoids
23
Q

What is TACO?

A

Transfusion Associated Cardiac Overload

24
Q

What is TRALI?

A

Transfusion-Related Acute Lung Injury

25
Q

Is TACO or TRALI less serious?

A

TACO

26
Q

What would you see on a chest x-ray of a person with TRALI?

A

White space

27
Q

What causes TRALI?

A

Donor antibodies that bind recipient WBCs aggregate in pulmonary vasculature and release mediators causing increased capillary permeability (the liquid portion of blood seeps into the lungs…has nothing to do with the heart itself)

28
Q

What is the tx for TACO?

A

Give O2 (difficult for pt to breath), diuretics

29
Q

When would you give Packed Red Blood Cells (PRBC’s)?

A
  • Acute blood loss OR

- To increase O2 carry capacity if end organ ischemia

30
Q

One unit PRBC’s increases Hgb by how much?

A

1 g/dL (goal is to get pt Hgb above 7….so if their Hgb is 5 you would want to give 2 units PRBC’s)

31
Q

When would you give platelets?

A

<20,000 with infection or increased risk of bleeding

<50,000 with active bleeding or preprocedure

32
Q

How much does 6U increase platelet count by?

A

30,000-60,000

33
Q

What does Fresh Frozen Plasma (FFP) contain?

A

All coagulation factors

34
Q

When would you give FFP?

A

Bleeding due to deficiency of multiple coagulation factors (liver disease, DIC, etc)

35
Q

What signs and symptoms are associated with TRALI?

A
  • Fever
  • Hypotension
  • Does NOT respond to diuretics
  • Transudate
36
Q

What signs and symptoms are associated with TACO?

A
  • No fever
  • Hypertension
  • Vascular congestion, pleural effusion
  • Responds to diuretics
  • Exudate

Medical Diagnostics (10 decks)

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