Blood transfusions

Question 1

enzyme for A type

Answer 1

N-acetylgalactosamine

Question 2

enzyme for B type

Answer 2

galactose

Question 3

RhoGAM

Answer 3

prevents anti-D antibodies from being produced in an RhD negative women if the baby is Rh +

Question 4

major indications for transfusing RBC

Answer 4

acute anemia- acute loss, hemolysis, aplastic crisis

chronic anemia- chemo, renal failure

Question 5

major indications for platelet transfusion

Answer 5

thrombocytopenia with bleeding
prophylaxis for thrombocytopenia without bleeding
platelet function disorders

Question 6

signs for transfusion by platelet count

Answer 6

> 20k spontaneous bleeding (rare)
10k- stable thrombocytopenia oncology patients
50k active bleeding
100k neurosurgery

Question 7

contraindicated to give platelets to

Answer 7

DIC
ITP
TTP
HIT

Question 8

fresh frozen plasma

Answer 8

replaces clotting factors

Question 9

fresh frozen plasma indication

Answer 9

DIC
liver disease
massive transfusion
isolated factor deficiency
TTP
reverse warfarin effects

Question 10

PT/PTT guidance for FFP transfusion

Answer 10

> 1.5 normal

Question 11

cryoprecipitate

Answer 11

collected precipitate from FFP

F8, fibrinogen, vWF, F13

Question 12

blood typing

Answer 12

ABO and RhD status

Question 13

front type

Answer 13

monoclonal antibodies for A, B, D to look for antigens on the RBC

Question 14

back type

Answer 14

look for expected antiA antiB in the plasma

Question 15

blood screen

Answer 15

look for unexpected antibodies in the plasma

Question 16

hemolytic disease of new born

Answer 16

mom’s IgG antibodies cross placenta and cause hemolysis in fetus

Question 17

crossmatch

Answer 17

check patient’s plasma with transfusion unit

Question 18

P antigen

Answer 18

parvovirus B19

Question 19

mononucleuosis

Answer 19

cold agglutinins against i antigen

Question 20

I antigen

Answer 20

mycoplasma pneumonia- cold agglutinins

Question 21

Duffy

Answer 21

receptor for plasmodium vivax

Question 22

hemolytic tx reaction

Answer 22

ABO incompatibility
fever, back pain
stop the transfusion
leads to intravascular hemolysis and DIC

Question 23

febrile tx reaction

Answer 23

cytokines from leukocytes accumulate in stored blood
fever, shaking chills
stop transfusion and treat symptoms

Question 24

prevention of febrile tx rx

Answer 24

remove WBC

Question 25

allergic tx rx

Answer 25

hypersensitivity to allergen in it
IgE mediated
parities, urticaria

Question 26

TRALI

Answer 26

transfusion related acute lung injury
tachypnea, cyanosis, dyspnea, fever, hypoxemia
HLA or granulocyte antibodies react with patients white cells leading to aggregates

Question 27

prevention of TRALI

Answer 27

don’t use products with anti-HLA antibodies

Question 28

TACO

Answer 28

transfusion associated circulatory overload
fluid overload from blood products causes cardiac failure and pulmonary compromise
increased BNP

Question 29

GVHD

Answer 29

antibodies in the transfusion attack host cells

Question 30

symptoms of GVHD

Answer 30

8-10d post transfusion
pancytopenia with marrow aplasia
fever
rash
mucositis, NVD
hepatitis

Question 31

higher risk GVHD with

Answer 31

similar HLA types

Question 32

prevention of GVHD

Answer 32

irradiation- inactivates T lymphocytes

Question 33

septic tx rx

Answer 33

bacteria in transfusion product

Question 34

prevention septic rx

Answer 34

test for bacteria

Question 35

lab test for HIV

Answer 35

anti HIV1/2

PCR

Question 36

lab test for HCV

Answer 36

antiHCV

PCR

Question 37

lab test for hepatitis B

Answer 37

HBsAg
antiHBc
PCR

Question 38

lab test for HTLV

Answer 38

antiHTLV1/2

Question 39

lab test for spyphilis

Answer 39

PCR

Question 40

lab test for west nile

Answer 40

PCR