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1) Blood Bank 2 Exam 1 > Components - Plasma > Flashcards

Components - Plasma Flashcards

1
Q

True or False: Each blood component has specified indications for use and expected outcomes

A

True

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2
Q

True or False: Blood and Blood Products are drugs that don’t required a Drs. Order to be infused.

A

False. Blood and Blood Products are drugs that REQUIRED a Drs. Order to be infused.

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3
Q

True or False: Transfusion = Transplantation

A

True

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4
Q

True or False: Some patients require individual transfusion plans

A

False. EACH patient requires individual transfusion plans.

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5
Q

What is Plasma Dosage?

A
  • It is assumed that every mL of plasma will contain 1 IU of coagulation factors.
  • Dosage is determined based on body weight.
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6
Q

What is Cryoprecipitate Dosage?

A
  • Cryo is utilized for fibrinogen replacement. For surgery or trauma a patient’s fibrinogen should be 100 mg/dL.
  • Each donor bag contains 150 mg/dL. A person’s plasma volume can be estimated at 30 dL.

If a patient has a fibrinogen reading of 45mg/dL, they will need 100-45 = 55mg/dL fibrinogen.

55 mg/dL x 30 dL = 1650 mg fibrinogen needed.

If each donor bag has 150 mg in it,

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7
Q

If a patient has a fibrinogen reading of 45 mg/dL, how much fibrinogen units/bags will they needed?

A

11 units.

Step 1) 100-45 mg/dL = 55 mg/dL fibrinogen
Step 2) 55mg/dL x 30 dL = 1650 mg fibrinogen needed
Step 3) If each donor has 150 mg in it, then the patient needs infusion of 1650mg/150 mg/bag = 11 bags.

–
Step 1: the patent has a fibrinogen reading of 45 mg/dL, they will need 100-45 = 55 mg/dL
Step 2: A person’s plasma volume is estimated to be 30 dL, so we multiple 55mg/dL by 30 dL (volume) = volume of fibrinogen needed –> 1650 mg
Step 3: We divide 1650 mg by the amount of fibrinogen in one bag to know how many bags we actually need.

  • Donor’s are often pooled into bags that contain 5 donors. Which would mean this patient would need 2 pools
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8
Q

True or False: Donor’s are often pooled into bags that contain 5 donors.

A

True

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9
Q

List the steps of component preparation specific to plasma components from whole blood donation

A
  1. Whole blood collected
  2. Centrifuge 5 min Heavy spin (3600 rpm)
  3. Freeze in such as way that evidence of thaw is apparent
  4. Store at -18C or colder for up to 1 year. (1. Has 150-200 mL plasma 2.) 400 mg fibrinogen
  5. Thaw at 37C. Upon thaw, store at 1-6 C for expiration indicated

–
2) - Express of platelet rich plasma (50-70mL) via sterile multipage system.
3) - 8 hours (FFP) -24 hours (FP24)

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10
Q

True or False: FFP contains maximum levels of clotting factors both stable and labile expect one IU/mL.

A

True

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11
Q

True or False: FP24 contains all stable clotting factors, normal V, slightly reduced factor VIII.

A

True

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12
Q

In order to use Frozen plasma, what must one do?

A

-They must be thawed at 30-37C and must be used within 24 hours.

  • Or 5 days for “thawed plasma”

–
According to the FDA, either product has only a 24 hour shelf life after we thaw it. However, the “”Circular of Information” and AABB Standards both describe a pathway to allow us to use that thawed product beyond the FDA limit of 24 hours. The trick, though, is that if you are going to transfuse it more than 24 hours after you thaw it, you have to give the product a new name! That new name? You guessed it: “Thawed Plasma.”

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13
Q

How long is liquid plasma good for? Does it have coagulation factors?

A
  • Expiration date is 5 days after whole blood unit expires. So about 26 days (CPD -> 21 days)
  • Many coagulation factors are diminished
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14
Q

What is liquid plasma mainly used for?

A

It is used to bridge the gap during massive transfusion situations until FFP can be thawed.

–
Fresh Frozen Plasma has the maximum level of clotting factors both stable and labile.

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15
Q

What is Cryoprecipitate?

A
  • This is another plasma frozen product.
  • This is a portion of plasma (Fibrinogen, Factor VIII, Factor XIII, vWF)
  • It is used to prevent or control bleeding in people whose own blood does not clot properly.
  • Cryo is also a source of fibrinogen for patients who cannot produce the necessary amount of this important clotting protein on their own.
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16
Q

How is Cryoprecipitate prepared?

A
  • 1) FFP is thawed slowly at 1-6 C
  • 2) Liquid is removed and the solid components are resuspended in 15mL of left over plasma.
  • Often pooled into 5 donors units.
  • Dosing using is performed in factor of 10.
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17
Q

What does Cryoprecipitate contain?

A
  • 80 units of factor 8 and 150 mg Fibrinogen
  • Factor 13 and VWF also are in major quantity.
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18
Q

How is Cryoprecipitate stored?

A
  • Frozen < -18C and for 1 year
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19
Q

At what temperature is Cryoprecipitated thaw at?

A
  • 37C (body temp)
  • Stored at Room temperature once thawed
  • Must be used within 4 hours for pools, 6 hours for singles.
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20
Q

How is Cryo-Reduced plasma prepared?

A
  • Left over plasma from making cryo
  • Cryo-Reduced plasma is removing cryoprecipitate from the plasma.
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21
Q

What does Cryo-reduced Plasma contain and what is it best used for?

A
  • Contains: plasma proteins and ADAMTS13 (deficient in cry factors)
  • Best use for patients who have TTP.

–
- (Thrombotic Thrombocytopenia Purpura): severe deficiencies of ADAMTS13.
- The ADAMTS13 enzyme is helps with clotting. When there’s a lack of activity in the ADAMTS13 gene, it leads to overactive blood clotting, causing small clots to form in the small vessels throughout your body. Platelets started to stick to vWF and not many are left over to help with clotting when you cut your skin. As a result, you may bleed longer than normal.

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22
Q

How is Plasma Fractions prepared?

A
  • Fractions are made from plasma collected from whole blood or apheresis.
    – pH/alcohol/temp separations
    – Viral inactivation: heat/detergent/filtration
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23
Q

How are Plasma Fractions stored?

A
  • Plasma Fractions are stored liopholized for long expirations
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24
Q

True or False: Plasma Fractions are issued by pharmacy

A

True

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25
Q

What are Plasma Fractions used for?

A
  • Utilized widely for diagnosed factor deficiencies
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26
Q

What is Factor VII used for in clinical situations?

A
  • used for massive bleeding situations

If used incorrectly, it can cause spontaneous thromboli

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27
Q

What is Factor VIII used for in clinical situations?

A
  • used for hemophilia A treatment, replacing cryoprecipitate treatment.

A pro is that it is safe from HIV now.

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28
Q

What is Prothrombin complex used for in clinical situations?

A
  • It is utilized for massive bleeding for it contains vitamin K dependent factors (II, VII, IX, X).

If used incorrectly, it may cause DIC or Thrombosis.

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29
Q

What does FIX contain and what is it used in a clinical setting?

A
  • FIX contains factor IX.
  • FIX is utilized for Hemophilia B
30
Q

What does Antithrombin II used for in clinical setting?

A
  • Antithrombin II used to prevent thromboembolismism in surgical cases.
  • Antithrombin II inhibits factors IX, X, XI, XII
31
Q

True or False: Immunoglobulin “IVIG” or “IMIG” is concentrated IgG for patients that are immunocompromised or to provide passive antibody prophylaxis or thrombocytopenia.

A

True.

The Con of IVIG/IMIG is that IgA deficiency may be at risk of allergic reaction.

32
Q

True or False: Rhogam has special IgG anti-D used to prevent HDFN associated with maternal anti-D formation.

A

True

33
Q

Normal Serum Albumin “NSA” utilized for ______________ patients or those that are hypovolemic or hypoproteinemic.

A
  • shock and burn

Con: 25 % not good for dehydration because it enhances water uptake

34
Q

What are Lactated Ringers?

A
  • crystalloid containing Na, K, Cl, Ca, and Lactate.
35
Q

If Lactated ringers are mixed with red cell product, what will happen?

A
  • It will clot
36
Q

What is Dextran?

A
  • It is colloid containing sugar solution.
  • If mixed with red cell product, will hemolyze
37
Q

What is Hydroxyl ethyl starch “HES”?

A
  • colloid containing starch.
  • Con: difficult for kidney failure patients, hard to excrete, can activate clotting cascade
38
Q

Identify the clinical purpose of volume expanders: Lactated Ringer’s solution, Dextran, HES

A
39
Q

What is convalescent plasma?

A
  • Collected from patients recently recovered from a specific disease
  • Offers passive immunity
  • Stops-gap treatment, when no known treatment exists.
  • Good for immunocompromised
40
Q

When is convalescent plasma used?

A
  • Used in the US under emergency FDNA authorization eIND
  • Individuals use only based on severity of symptoms
  • Under direction of physician for research purposes
41
Q

What must convalescent plasma should be in conjunction with?

A
  • Convalescent plasma must work in conjunction with Blood Center and Transfusion Service

–
- Same level donor virus testing
- Directed Donation Collection - labeled for specific patients
- Tested for antibody titer

42
Q

True or False: Convalescent plasma must be ABO compatible

A

True
- Testing at Donor Center for labeling
- Testing at Hospital for infusion

43
Q

What type of label is this called?

A
  • Full Face label
44
Q

What type of ISBT labeling is this called?

A

Ecode

45
Q

Why type of ISBT labeling is this called?

A

Sticker label

46
Q

Components that are label and stored in blood bank include any of the following plasma and its fractions

A
  • Fresh Frozen
  • FP24
  • Liquid plasma
  • Cyroreduced plasma
  • Cryoprecitate
47
Q

Processing a component is any of the following changes:

A
  • thaw
  • spilt
  • irradiate
  • pool
48
Q

True or False: Red cells won’t hemolyze during freezing process.

A

False. Red cells will hemolyze during freezing process. Residual red cells may tinge pink.

49
Q

Bacterial contamination in plasma products will appear as excessive …

A
  • bubbles
  • clots
  • fibrin strands
50
Q

In plasma products, particular matter can _____ in the product

A
  • float
  • If it does not dissipate upon shaking, the coagulation cascade has been activated.
51
Q

Cryoprecipitate when not fully thawed may exhibit white ____ that will plug the transfusion filter, continue to thaw before issue.

A
  • white clumps
52
Q

True or False: color can vary from Orange/Brown (_____) to Green (_____)

A
  • icterus
  • birth control
53
Q

True or False: Plasma must be reverse type match.

A

True

54
Q

Blood type must be completed every _____ hours

A

72 hours

55
Q

True or False: Rh does not matter for matching products

A

True

56
Q

Antibody screen is not relevant because no ____ cells containing immune stimulating antigens are in the products (plasma products).

A

red

57
Q

Is crossmatch required for Pre-transfusion testing for plasma products?

A

No crossmatch required, no segments to be tested

58
Q

What type of plasma type can a patient with AB receive?

A

AB

59
Q

What type of plasma type can a patient with A receive?

A

AB, A

60
Q

What type of plasma type can a patient with B receive?

A

AB, B

61
Q

What type of plasma type can a patient with O receive?

A

AB, A, B, O

62
Q

True or False: All orders for blood products need to be made by a physical or qualified designee.

A

True

63
Q

True or False: The final end state of all blood products doesn’t needs to be tracked by the blood bank.

A

False.

The final end state of all blood products NEED to be tracked by the blood bank.

64
Q

All blood products need to be verified at issue by confirming:

A
  • Patient ID
  • Unit ID
  • Blood Types
  • Visual Inspection
65
Q

True or False: Products that are issued from the blood bank have a patient assignment take, similar to that of a crossmatch tag.

A

True

66
Q

True or False: Plasma may be infused at the same time as another blood product.

A

True

  • It is infused through the same filtration set as red cells.
67
Q

How fast is plasma infused? And is it faster than red cells?

A

Plasma is infused 20-30 minutes/bag
- It is often unfused much quicker than red cells.

68
Q

What are the laboratory tests for monitoring of transfusion of plasma?

A
  • Coagulation Tests: PT/INR, PTT, Fibrinogen, Bleeding Time, DDimer,
  • Hematology Tests: Hematocrit, Platelet count
69
Q

What is monitor during plasma transfusion at bedside?

A
  • Visual determination of oozing (from IV)
  • ROTEM/TEG (point of care devices that analyze whole clotting properties and assesses a patient’s overall coagulation status.
  • ACT (activated clotting time)
70
Q

What is the dosage for plasma?

A

+15-20% factor

71
Q

What is the composition and volume of plasma?

A
  • All coagulation factors 1U/mL
  • 250 mL
72
Q

What is plasma mainly used for? (summary table)

A
  • TTP
  • Factor deficiency

1) Blood Bank 2 Exam 1 (6 decks)

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