Blood Trasnfusions

Question 1

Basic pathogenesis and presentation of haemolytic disease of the newborn?

Answer 1

Pathogenesis: Mother can produce Ab if fetal cells enter her circulation during pregnancy or delivery, if Ab level is high, it can destroy fetal RBCs if they have corresponding RBC Ag.
Fetal presentation: anaemia + Jaundice

Question 2

What antibodies can cause Haemolytic Disease of the Newborn?

Answer 2

Anti-D (most common), anti-C, anti-K, IgG ABO

Question 3

Which Immunoglobulin can cross the placenta? (only 1)

Answer 3

IgG

Question 4

Which women (blood type) are at risk of forming anti-D against their fetus? How is she treated?

Answer 4

RhD negative

Give mother intramuscular anti-D Ig when she is at high risk of feto-maternal haemorrhage

Question 5

At what points should a RhD negative woman be given anti-D Ig?

Answer 5

Routine antenatal prophylaxis at 28 and 34 weeks
During pregnancy if sensitizing event occurs (abortion, miscarriage, abdo trauma, ECV, amniocentesis etc._
At delivery if baby is RhD postivie

Question 6

What are the IMMEDIATE IMMUNE adverse reactions to Transfusions?

Answer 6

Wrong Blood: ABO
Febrile non-haemolytic
Allergic/Anaphylaxis
Transfusion related acute lung injury (TRALI)

Question 7

What are the DELAYED IMMUNE adverse reactions to Transfusions?

Answer 7

Delayed haemolytic transfusion reaction (DHTR)
Port-transfusion purpura
Transplant-associated GVHD

Question 8

What are the IMMEDIATE NON IMMUNE adverse reactions to Transfusions?

Answer 8

Bacterial Infection

Transfusion associated cardiac overload (TACO)

Question 9

What are the DELAYYED NON IMMUNE adverse reactions to Transfusions?

Answer 9

Viral Infections

Iron Overload