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Path - Haematology > Blood Transfusions 2 > Flashcards

Blood Transfusions 2 Flashcards

1
Q

What are adverse reactions to transfusions split into, timing wise?

A

Acute (<24h)

Delayed (>24h)

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2
Q

What are causes of ACUTE adv reactions to transfusion?

A
  • Acute haemolysis (ABO incompatible)
  • Allergy/anaphylaxis
  • Infection
  • Febrile non-haemolytic
  • Respiratory (TACO, TRALI)
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3
Q

What are causes of DELAYED adv reaction to transfusion?

A
  • delayed haemolytic transfusion reaction
  • infection
  • TA-GvHD
  • Iron overload
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4
Q

What happens to OBS at the start of an acute reaction?

A

HIGH temp, HIGH HR, low BP

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5
Q

What monitoring needs to be done for adverse reaction?

A

BASELINE temp, HR, RR, BP
Repeat after 15 mins
Repeat hourly and at end of transfusion

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6
Q

How do you treat FNHTR?

A

STOP transfusion

give paracetamol

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7
Q

How do you treat allergic TR?

A

Stop/slow transfusion

give IV antihistamine

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8
Q

What are the most common causes of giving wrong blood for a transfusion?

A

FAILURE of bedside check
Wrongly labelled blood
lab error

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9
Q

What all giving the wrong blood cause?

A

Acute IgM intravascular haemolysis

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10
Q

What component is likely to cause bacterial infection following transfusion?

A

PLATELET - as stored at room temp

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11
Q

What condition is an allergic reaction to transfusion severe to?

A

IgA deficiency

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12
Q

What is TACO?

A

Transfusion Associated circulatory Overload

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13
Q

What does TACO cause?

A

pulmonary oedema/fluid overload

Due to lack of attention to fluid balance

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14
Q

What is TRALI?

A

Transfusion Related Acute Lung injury

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15
Q

What does a TRALI CXR look like?

A

bilateral pulmonary infiltrates

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16
Q

How is TRALI distinguishable from TACO?

A

Will NOT respond to furosemide

No elevated JVP

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17
Q

What is a delayed haemolytic transfusion reaction caused by?

A

Development of an antibody against RBC antigen that patient lacks

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18
Q

What are symptoms of GvHD?

A 
Diarrhoea 
LF 
skin desquamation 
BM failure
DEATH
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19
Q

How do u prevent GvHD?

A

Irradiate blood components to very immunocompromised patients (get rid of donor WBC)

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20
Q

How do you prevent iron overload?

A

With Iron Chelators e.g exjade

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21
Q

What causes haemolytic disease of the newborn?

A

Prior maternal sensitisation to RhD+ when she is RhD-

22
Q

What does haemolytic disease of the newborn present as after birth?

A

Anaemia

High bilirubin

23
Q

When are G&S scheduled for pregnant women?

A

12, 28 wks

24
Q

How do you treat extreme anaemia in the foetus from this?

A

Intrauterine Blood transfusion

25
Q

How do you prevent haemolytic disease of the newborn

A

IM injection of Anti D Ig to mother at times of high risk sensitisation events

26
Q

How does Anti D Ig work?

A

RhD positive cells of foetus are coated by exogenous Anti D Ig
These cells are then removed by the mothers spleen without sensitisation of the mother

27
Q

What time frame must Anti D be given to be successful?

A

max 72 h from sensitisation event

28
Q

When is anti-D given as RAPPD?^

A

28 week gestation

29
Q

What is the immediate cause of adverse reeaction to transfusion

A

Anaphylaxis

30
Q

What are symptoms of anaphylaxis as adverse reaction to transfusion

A

Breathlessness, wheeze, aangioedema, laryngeeal oedema

31
Q

What is the next ATR likely to occur after anaphylxis

A

Acute haemolytic due to ABO incompativility

32
Q

What symptoms occur with Acute haemolytic ( ABO incompativility) reaction

A

ABDO PAIN

Chills, rigors

33
Q

What antibodies mediate Acute haemolytic (ABO incompatibility)

A

IgM

34
Q

What is bacterial contamination commonest with

A

Platelet transfusion

35
Q

What is the presentation of a FNHTR

A

Rise in temperature by less than 1 degree

Patient stable, no circulatory collapse

36
Q

What is FNHTR caused by

A

Caused by release of cytokines by leukocytes

37
Q

How can you prevent FNHTR

A

Leukodepletion

38
Q

What antibodies are responsible for delayed haemolytic reaction

A

Kell

Duffy

39
Q

Who is CMV in a blood transfusion fatal in

A

Immunodeficient patient

40
Q

How can you avoid giving CMV to an immunodeficient blood transfusion patient

A

LEUKOCEPLETION

It removes CMV from WBC

41
Q

What is the presentation of an acute haemolytic reaction

A

Abdo pain, chills, rigors

within mins - 2h

42
Q

What mediates acute haemolytic reaction

A

IgM antibodies > cause IV haemolysis

43
Q

how does anaphylaxis reaction present

A

breathlessenss with wheeze
laryngeal and facial oedema
symptoms within minutes

44
Q

What IgE is anaphylaxis due to

A

IgE

45
Q

what igE def makes anaphylaxis worse

A

IgA

46
Q

What are symptoms of FNHTR

A

rise in temp less than 1 degree

no circulatory collapse

47
Q

WHat causes FNHTR and how do you prevent it

A

release of cytokines by leukocytes

prevented by leukodepletion

48
Q

What are symptoms of TACO

A

fluid overload > dyspnoea, raised JVP, pink frothy sputum

49
Q

What are symptoms of trali

A

dry cough
dyspnoea
fever

50
Q

what are symptoms of delayed haemolytic transfusion reaction

A

same as acute, but milder

within 1 week

Path - Haematology (17 decks)

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