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Haematology Week 1 > Blood Transfusions > Flashcards

Blood Transfusions Flashcards

1
Q

A sample of blood from donation will undergo testing for what conditions?

A

HIV, Hep B, C and E, HTLV and syphilis

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2
Q

How many donors do blood components come from? Give some examples of these?

A

1 donor - red cells, FFP, platelets and cryoprecipitate

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3
Q

How many donors do blood products come from? Give some examples of these?

A

Up to 20,000 donors - anti-D immunoglobulin and prothrombin complex concentrate

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4
Q

What is cryoprecipitate?

A

A source of fibrinogen

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5
Q

What is Anti-D immunoglobulin used for?

A

Rhesus disease

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6
Q

What is prothrombin complex concentrate used for?

A

Warfarin reversal

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7
Q

What are responsible for determining our blood groups?

A

Antigens on the red cell surface

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8
Q

Our immune system normally ignores the antigens on our red cell surface. However, if we are exposed to antigens which are foreign - what happens?

A

Our bodies will forms antibodies against these antigens, which can be problematic if we encounter the same antigen again

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9
Q

What are some examples of how we could become exposed to foreign blood related antigens?

A

Blood transfusions or Rhesus disease

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10
Q

The antigens on our blood cells are determined from where?

A

Blood cell antigen genes which we get from our parents

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11
Q

The ABO system is coded for where?

A

On chromosome 9

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12
Q

In the ABO system, what relationship do A and B have over O?

A

They are dominant

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13
Q

In the ABO system, what relationship do A and B have with each other?

A

They are co-dominant

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14
Q

In the ABO system, O is silent. What does this mean?

A

There is no O antigen, just an absence of A or B

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15
Q

What could be the genotype of someone who was blood group O?

A

OO

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16
Q

What could be the genotype of someone who was blood group A?

A

AA or AO

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17
Q

What could be the genotype of someone who was blood group B?

A

BB or BO

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18
Q

What could be the genotype of someone who was blood group AB?

A

AB

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19
Q

What is Landsteiner’s law?

A

When an individual lacks the A or B antigen, the corresponding IgM antibody is present in their plasma

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20
Q

If an individual who had antibodies against A or B antigen were to be exposed to those antigens, what would happen?

A

There would be haemolysis of the red cells that expressed that antigen

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21
Q

If antibodies against A and B antigens are going to be produced - when does this happen?

A

As early as 6 months of age

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22
Q

What could be the genotype of someone who is rhesus positive?

A

DD or Dd

23
Q

What could be the genotype of someone who is rhesus negative?

A

dd

24
Q

What are the aims of pre-transfusion testing?

A

To identify the ABO and RhD group of a patient, and to identify the presence of any clinically significant red cell antibodies

25
Q

What is the most common way to identify an individual’s blood group?

A

Group and save

26
Q

What is the first step of ABO and Rh grouping of blood?

A

Use antisera reagent with a known antibody specificity to identify antigens present on the red cell

27
Q

When doing ABO and Rh grouping, if an antigen is present on a red cell, what happens?

A

The corresponding IgM antibody (in the reagent) will bind to the antigen and result in agglutination

28
Q

What is the second step of ABO and Rh grouping of blood?

A

Use reagent red cells with known antigen specificity to identify antibodies present in the plasma

29
Q

Antibodies to most things other than ABO and Rh are IgG antibodies which do not cause agglutination in the way that IgM does. What is added to the antibody/antigen complex to make the results of this test more obvious?

A

Anti-human globulin

30
Q

What investigation is performed to check that donor cells are compatible with patient plasma?

A

Crossmatch

31
Q

When doing a crossmatch, what would indicate that the donor cells are incompatible with the patient’s plasma?

A

Agglutination

32
Q

What are the reasons for doing a red cell transfusion?

A

Symptomatic anaemia with Hb < 70g/L OR major bleeding

33
Q

How should red cell transfusions be given?

A

Give one unit and reassess before giving another

34
Q

What are the reasons for a platelet transfusion?

A

Prophylaxis in patients with bone marrow failure, treatment of bleeding in thrombocytopenic patients, prophylaxis prior to surgery/procedures in a thrombocytopenic patient

35
Q

How should platelet transfusions be given?

A

Give one unit and reassess before giving another

36
Q

How many units of platelets are needed for prophylaxis?

A

One

37
Q

FFP transfusion contains what?

A

Clotting factors

38
Q

Why would you give an FFP transfusion?

A

Treatment of bleeding or prophylaxis prior to surgery/procedures in patients with a coagulopathy OR management of a massive haemorrhage

39
Q

Samples for blood transfusion should be sent off in what colour of tube?

A

Pink

40
Q

How often should observations be taken during a blood transfusion?

A

Every 15 minutes throughout

41
Q

If a patient becomes unwell or deteriorates during a blood transfusion, what should you do?

A

Pause the transfusion and investigate

42
Q

What are some symptoms of an acute transfusion reaction?

A

Rigors, rash/flushing, feeling of impending doom, collapse, loin pain

43
Q

What are some signs of an acute transfusion reaction?

A

Fever, tachycardia, hypotension, respiratory distress

44
Q

ABO incompatible transfusion reactions are the most serious to occur. What does this lead to?

A

Intravascular haemolysis of the transfused cells

45
Q

How should a bacterial contaminant of a blood component be treated?

A

Supportively, and give broad spectrum antibiotics

46
Q

What are some clinical features of a transfusion associated circulatory overload?

A

Respiratory distress (within 6 hours), raised BP, raised JVP

47
Q

What are some risk factors for a transfusion associated circulatory overload?

A

Elderly patient, cardiac failure, renal impairment

48
Q

How is transfusion associated circulatory overload treated?

A

Supportive therapy and diuretics

49
Q

What are some defining features of mild transfusion reactions?

A

An isolated temperature rise to > 38 degrees or a rise in temperature by 1-2 degrees OR an isolated rash

50
Q

What is the management of a mild transfusion reaction?

A

Continue the transfusion but consider slowing the rate, give paracetamol or anti-histamine depending on the cause and monitor closely

51
Q

What are some subtypes of mild transfusion reactions?

A

Febrile non-haemolytic transfusion reactions / mild allergic reactions

52
Q

In delayed haemolytic transfusion reactions, the patient mounts a delayed immune response to the red cell antigen - antibodies are usually what type?

A

IgG

53
Q

What type of haemolysis occurs in delayed haemolytic transfusion reactions? When does it occur?

A

Extravascular / 5-10 days post-transfusion

54
Q

What test will be positive in delayed haemolytic transfusion reactions? What will it show?

A

DAT - detection of alloantibody

Haematology Week 1 (11 decks)

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