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A Haematology and Immunology > Blood Transfusions > Flashcards

Blood Transfusions Flashcards

1
Q

Why do we transfuse blood?

A
  • mainly because of bleeding
  • but also because of failure of production
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2
Q

Describe the inheritance of blood groups.

A

A and B are co-dominant whilst O is recessive

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3
Q

What does blood group B have antibodies against?

A

A

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4
Q

What does blood group A have antibodies against?

A

B

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5
Q

What does blood group O have antibodies against?

A

A and B

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6
Q

What does blood group AB have antibodies against?

A

No antibodies

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7
Q

Who is universal red cell donor?

A

Blood group O negative

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8
Q

Who is the universal red cell recipient?

A

Blood group AB positive

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9
Q

Who is the universal FFP donor?

A

Blood group AB positive

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10
Q

Who is the universal FFP recipient?

A

Blood group O negative

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11
Q

What can happen to RhD negative individuals during pregnancy or transfusion?

A
  • They can make anti-D if exposed to RhD cells
  • This can lead to transfusion reactions or haemolytic disease of the new-born
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12
Q

What screening do blood donors undergo?

A
  • Extensive ‘behavioural’ screening
  • Sex, age, travel, tattoo
  • Tested for ABO and Rh blood groups
  • Screened for HepB/C/E, HIV, syphilis
  • Variably screened for: HTLV1, malaria, West Nile virus, Zika virus…
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13
Q

What are the components and products of blood?

A
  • Plasma
    • Clotting or coagulation factors
    • Albumin
    • Antibodies
  • Buffy Coat
    • Platelets
    • White cells
  • Red Blood Cells
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14
Q

What are some indications for RBC transfusion?

A
  • Severe acute anaemia
  • Uncorrectable anaemia
  • Prepare patient for surgery or speed up recovery
  • Sickle cell disease
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15
Q

How are RBCs stored and transfused?

A
  • Stored at 4oC
  • Transfuse over 2-4 hours
  • 1 unit increments ~5 g/L
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16
Q

How are platelets stored and transfused?

A
  • 1 dose platelets (=4 pooled or 1 apheresis donor)
  • Increments 20-40 x 10^9/L
  • Stored at ~22oC, shelf life 7 days
  • Transfuse over 20-30 minutes
17
Q

What are the components of plasma?

A
  • Fresh frozen plasma
  • Cryoprecipitate
18
Q

What are the indications for FFP?

A
  • Massive haemorrhage
  • DIC with bleeding
  • Prophylactic
19
Q

How is FFP used?

A
  • 1 unit from 1 unit of blood
  • Stored frozen, allow 30 minutes to thaw
20
Q

What are the lab tests for FFP?

A

PT and APTT

21
Q

What is the lab test for cryoprecipitate?

A

Fibrinogen

22
Q

How is cryoprecipitate stored?

A

Frozen, allow 20 minutes to thaw

23
Q

How are patients grouped and screened?

A
  • ABO and RhD type
  • Checked against historical records
  • Screen for allo-antibodies in serum
24
Q

What is the direct Coombs test used for?

A
  • Autoimmune haemolytic anaemia
  • Passive anti-D
  • Haemolytic transfusion reactions
25
Q

What is the indirect Coombs test used for?

A

Cross matching

26
Q

At what temperature do the ABO and Rh blood group systems usually react?

A

37C

27
Q

What blood is usually available within minutes?

A

O- red cells (AB plasma)

28
Q

What bloods take time and are non-urgent?

A
  • Full cross match to select the correct ABO/RhD type
  • If allo-antibodies choose antigen negative blood
29
Q

Once a massive haemorrhage protocol has been activated what is there an immediate supply of?

A
  • 6 units red cells
  • 4 units FFP
  • 1 unit platelets
30
Q

What should decision to transfuse be based on?

A

The decision to transfuse should be based on a careful assessment of patient’s clinical state and must be justified as essential to prevent major morbidity or mortality.

31
Q

How is prion disease transmittable?

A

By blood transfusion from early in the disease

32
Q

How should transfusion reactions be managed?

A
  • Stop transfusion
  • Check patient identity against component label
  • Consider: anaphylaxis, circulatory overload (TACO), acute haemolytic transfusion reaction (AHTR), bacterial infection, lung injury (TRALI)
33
Q

What is sensitisation in rhesus disease?

A

Development of maternal anti D antibodies

34
Q

Does IgG cross the placenta?

A

Yes

35
Q

How does haemolytic disease of the new-born present at birth?

A
  • Positive direct antiglobulin test
  • Jaundice
  • Anaemia
36
Q

How is HDN prevented?

A

Using prophylactic anti-D at 28/40 weeks or during sensitising events

37
Q

What is the treatment for HDN?

A
  • Careful monitoring
  • Antibody titres
  • Doppler ultrasound
  • Intrauterine transfusions

A Haematology and Immunology (20 decks)

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