Chapter 3: Blood Products

Question 1

All blood products carry the risk of HIV and hepatitis except..

Answer 1

Albumin and serum globulins (theses are heat treated)

Question 2

What is donated blood screened for?

Answer 2

HIV. HepB. HepC. HTLV. Syphillis. West Nile virus.

Question 3

When would you use CMV-negative blood?

Answer 3

Low birth-weight infants. Bone marrow transplant patients. Other transplant patients.

Question 4

1 cause of death from transfusion reaction

Answer 4

Clerical error leading to ABO incompatibility

Question 5

• Universal donor.

- Contains no antigents

Answer 5

Type O blood

Question 6

Is stored blood right or left shift of oxygen?

Answer 6

Left shift: stored blood is low in 2,3-DPG. (has increased affinity for oxygen).

Question 7

Three types of hemolytic reactions from blood transfusion

Answer 7

• Acute hemolysis
• Delayed hemolysis
• Nonimmune hemolysis

Question 8

• From ABO incompatibility; antibody mediated.
• S/S: back pain, chills, tachycardia, fever, hemoglobinuria.
• Can lead to ATN, DIC, shock.

Answer 8

Acute hemolysis

Question 9

Diagnosis of acute hemolysis from transfusion reaction

Answer 9

Haptoglobin 5g/dL, increase in unconjugated bilirubin

Question 10

Treatment for acute hemolysis from transfusion reaction

Answer 10

Fluids, diuretics, HCO3-, pressors, histamine blockers (Benadryl)

Question 11

How does acute hemolysis from blood transfusion present in anesthetized patients?

Answer 11

Diffuse bleeding

Question 12

Transfusion reaction:

• Antibody-mediated against minor antigens.
• Tx: observe if stable.

Answer 12

Delayed hemolysis

Question 13

Transfusion reaction:
- From squeezed blood.
Tx: fluids and diuretics

Answer 13

Nonimmune hemolysis

Question 14

Most common transfusion reaction

Answer 14

Febrile nonhemolytic transfusion reaction

Question 15

Transfusion reaction:
- Usually recipient antibody reaction against donor WBCs
Tx: discontinue transfusion
- Use WBC filters for subsequent transfusions

Answer 15

Febrile nonhemolytic transfusion reaction

Question 16

Transfusion reaction:
- Bronchospasm, hypotension, urticaria.
- Usually recipient antibodies against donor IgA in an IgA-deficient patient.
Tx: fluids, Lasix, pressors, steroids, epinephrine, histamine blockers (Benadryl)

Answer 16

Anaphylaxis

Question 17

Transfusion reaction:
- Usually non hemolytic
- Usually recipient antibodies against donor plasma proteins or IgA in an IgA-deficient patient
Tx: histamine blockers (Benadryl), supportive

Answer 17

Urticaria

Question 18

Transfusion reaction:

• Rare
• Caused by donor antibodies to recipient’s WBCs, clot in pulmonary capillaries

Answer 18

Transfusion-related acute lung injury (TRALI)

Question 19

What is the problem with hypothermia in transfusion?

Answer 19

Cold: poor clotting can be caused by cold products or cold body temperature; patient needs to be warm to clot correctly.

Question 20

When does dilution thrombocytopenia occur with blood transfusion?

Answer 20

Occurs after 10 units of PRBCs

Question 21

What is the problem with hypocalemia with clotting?

Answer 21

Can cause poor clotting.

- Occurs with massive transfusion, Ca is required fro the clotting cascade

Question 22

MC bacterial contaminate

Answer 22

GNRs (usually E. coli)

Question 23

MC blood product source of contamination

Answer 23

Platelets (not refrigerated)

Question 24

Can be transmitted with blood transfusion (sleeping sickness)

Answer 24

Chaga’s disease