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Immunohematology 480 > Components, Preparation, Donors > Flashcards

Components, Preparation, Donors Flashcards

1
Q

450 mL size donor bag maximum/minimum amount

A

450 mL +/- 45mL

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2
Q

500 mL size donor bag maximum/minimum amount

A

500 mL +/- 50 mL

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3
Q

How many hours after collection must the plasma be frozen if making fresh frozen plasma from units that have CPD, CD2D, or CPDA-1 as the anticoagulant?

A

8 hours

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4
Q

How many hours after collection must the plasma be frozen if making fresh frozen plasma from units that have ACD as the anticoagulant?

A

6 hours

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5
Q

Single donor plasma has lost the viability of what labile coagulation factors

A

V and VIII

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6
Q

NSA (normal serum albumin):
Contains?
Expiration time/temp?
Purpose?

A

Contains: 80% albumin, 17% globulin
Expiration time/temp: 5 years at 2-10 degree C
Purpose: volume expander (rare) and used with apheresis donors

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7
Q

What are the two categories of synthetic volume expanders and what products are included in each group?

A

Crystalloids: ringer’s lactate and normal isotonic saline
Colloids: dextran and HES

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8
Q

How many RBC’s are expected to be in a unit of packed cells?

A

250 mL

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9
Q

Why are the colloid volume expanders used?

A

Hemorrhagic shock and burn patients

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10
Q

What is the hermetic seal?

A

Completely enclosed system-reducing exposure to microbes/contaminants. If broken, the unit must be used within 24 hours

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11
Q

Washed RBC indications for use

A

If patient has history of plasma protein antibodies, PNH diagnosis, severe allergies

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12
Q

Fresh frozen plasma indications for use

A

For multiple or unknown coagulation factor deficiency

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13
Q

Single donor plasma indication for use

A

For treatment of stable clotting factor deficiencies

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14
Q

Platelet concentrates indication for use

A

Thrombocytopenia

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15
Q

Cryoprecipitated Anti-hemophiliac Factor indications for use

A

Correct FVIII, FXIII deficiencies

Fibrinogen

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16
Q

Packed RBCs indication for use

A

Restore O2 carrying capacity

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17
Q

Whole blood indication for use

A

Used for massive blood loss

Treatment of cardiopulmonary bypass patients either intraoperatively or up to 6 hours post operatively

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18
Q

Leukocyte reduced RBC indication for use

A

History of febrile transfusion reactions, reduced exposure to MHC antigens

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19
Q

Irradiated RBC indication for use

A

Graft vs. host disease

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20
Q

Component to use for hypovolemia

A

Crystalloid products (saline or electrolyte) solutions

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21
Q

Component to use for open heart surgery

A

Preoperative hemodilution and then reinfusion of the collected blood. Any additional units should be as fresh as possible to aid in the overall 2,3 DPG depletion recovery

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22
Q

Component to use for patients with repeated febrile transfusion reactions

A

Leukocyte-reduced red blood cells

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23
Q

Component to use for leukemia/ repeated transfusions of platelets necessary

A

Single-donor platelets prepared by pheresis

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24
Q

Component to use for hemophilia A

A

Factor VIII concentrate or cryoprecipitate antihemophilic factors

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25
Q

Component to use for hemophilia B

A

Factor IX concentrate

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26
Q

Component to use for disseminated intravascular coagulation

A

Fresh frozen plasma

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27
Q

Component to use for anemia

A

Packed RBC’s

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28
Q

Component to use for hypofibrinogenemia

A

Cryoprecipitate anti hemophilic factor

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29
Q

Component to use for acute blood loss

A

Packed RBCs

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30
Q

Component to use for severe burns with dehydration

A

NSA

5-25% (normal serum albumin)

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31
Q

Component to use for massive transfusion from trauma (more than 10 units needed)

A

Whole blood

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32
Q

What is the cryoprotective agent for frozen red blood cells and recommended storage temp?

A 
High glycerol (40% w/v) - 80 degrees C
Low glycerol (20% w/v) - 120 degrees C
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33
Q

How are frozen RBC prepared for transfusion?

A

1) equilibrate with 12% NaCl
2) wash 1.6% NaCl
3) final washing 0.9% NaCl and 0.2% dextrose

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34
Q

What are the advantages of frozen RBC over banked blood?

A

1) No plasma for people with PNH or anti-IgA

2) Extended shelf life for rare units

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35
Q

What is the optimum temp for shipping of blood?

A

1-10 degrees C

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36
Q

2,3 DPG is the most important factor in what RBC function

A

Hemoglobin affinity for oxygen

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37
Q

ATP is important for what RBC parameters?

A

RBC viability

Membrane integrity

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38
Q

How is refrigerator temp monitored?

A

Continuous recorder with alarm system

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39
Q

When inspecting blood each day, what do we look for?

A

Clot, discolorization

Bacterial contamination

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40
Q

Changes that occur in stored, anticoagulated blood

A

Decrease in 2,3 DPG
Increased plasma hemoglobin
Increased plasma K
Decrease in ATP

41
Q

What type of cooling system needs to be included with fresh frozen plasma?

A

Dry ice

42
Q

What type of cooling system needs to be included with frozen RBC’s?

A

Dry ice

43
Q

What type of cooling system needs to be included with whole/packed cells?

A

Ice to maintain 2-10 degree C window

44
Q

What type of cooling system needs to be included with platelets?

A

Maintain 20-24 degree C window

45
Q

How old of blood is allowed if a fresh whole blood transfusion is indicated?

A

<5 days

46
Q

What is the temp for units of blood during transport?

A

1-10 degree C

47
Q

As units of packed cells are stored, what happens to the pH and 2,3 DPG?

A

Both decrease

48
Q

What extra qualifications must a donor for platelet pheresis meet?

A

Apheresis platelet donor must not have taken aspirin-containing medication in last 3 days. Platelet count obtained on donor if donating more frequently than every 8 weeks

49
Q

What is the expiration limit for apheresed platelets?

A

5 days in a closed system

24 hours in open system

50
Q

Factors removed by plasmapheresis

A 
Immune complexes
Auto or alloantibodies
Inflammatory mediators
Protein-bound toxins
Lipoproteins
Platelet-aggregating factor
51
Q

What is the average number of platelets in each bag of random donor platelets?

A

5.5 x 10^10

52
Q

What is the average number of platelets in a single donor unit?

A

3.0 x 10^11

53
Q

What is the requirement for pH in a unit of platelets?

A

6.2 or greater

54
Q

A random donor pack of platelets is expected to increase the recipients platelet count by how much?

A

5,000-10,000 microliter

55
Q

What is the expected effect in the recipient after receiving 1 unit of packed cells?

A

Increased Hct by 3%

Increase Hgb 1 g/dL

56
Q

What is the expected effect in the recipient after receiving 1 unit of random donor platelets?

A

Increase 5,000-10,000 per unit

57
Q

What is the expected effect in the recipient after receiving 1 unit of platelets from a single donor by pheresis?

A

Increase 30,000-60,000 per unit

58
Q

What is the expected effect in the recipient after receiving 1 unit of whole blood?

A

Increase Hct 155

Increase Hgb 1 g/dL

59
Q

What would be the acceptable white blood count if you used a leukoreduced, pooled, random donor platelet component?

A

<5.0 x 10^6

60
Q

Why is the correct maintenance of the pH important for the storage of platelets?

A

Viability

61
Q

What is the probability of syphilis transmission via blood products?

A

The syphilis microbe will not be viable after 3 days. Most likely transmission would be from platelets but has not been documented. Testing appears to continue as a general screen for at-risk sexual activity

62
Q

What is the international coding system used for component labeling?

A

International Society for Blood Transfusion (ISBT)

Code 128

63
Q

Why may we test a donor’s ALT?

A

Elevated liver enzymes to screen for Hepatitis

64
Q

How many units of FVIII should be in each bag of cyro?

A

80-150 IU (minimum of 80 IU per plasma collection)

65
Q

What is Rh immune globulin?

A

Rh immune globulin is anti-D prepared from humans. It is given to an Rh-neg unsensitized mother of an Rh pos baby within 72 hours post-partum or about 28 weeks antenatal. Mini doses are given antenata

66
Q

Is there a risk of disease transmission with this product?

A

Low risk of HIV, Hepatitis A & B, and Hepatitis C antibodies have been identified

67
Q

How long do RBC’s survive normally?

A

120 days

68
Q

What percentage of RBCs in a unit of blood should be viable in the patient 24 hours after transfusion?

A

75% of donor blood should be viable in patient after 24 hours

69
Q

What is HBIG and when is it used?

A

Hepatitis B immunoglobulin. It is used when there is exposure to hepatitis B with no immunity

70
Q

How can RBCs be rejuvenated after expiration date and for how long?

A

Within 3 days after expiration, add PIPA - shelf life then becomes 24 hours

71
Q

Why are units irradiated?

A

To make T cells nonviable to eliminate GVHD caused by transfused WBCs

72
Q

What is the range of radiated in Gy’s for inactivation of WBC’s in prevention of GVHD?

A

25-35 gy’s

73
Q

How long are records maintained for both the donor and recipient?

A

10 years

74
Q

Describe what bacterial contamination may look like in a packed unit of cells

A

Purplish, white flecks throughout when mixed

75
Q

What is the expiration time and storage temp for PPF and NSA?

A

5 years at 2-10 degrees C

76
Q

How long can fresh frozen plasma be thawed before the labile coagulation factors are nonviable?

A

24 hours

77
Q

How many mL of plasma is in a unit of fresh frozen plasma?

A

150-250 mL

78
Q

What is the difference between FFP and single donor plasma (SDP)?

A

FFP still has labile coagulation factors that are viable (< 1 yr) and SDP does not (1-5 yrs)

79
Q

What are the labile coagulation factors that are non-viable in single donor plasma?

A

Factors V and VIII

80
Q

How fast should RBCs be infused?

A

Within 4 hours

81
Q

When should blood be warmed?

A

Rapid or exchange transfusion

Patients with PCH or cold agglutinins reactive at 37 degree C

82
Q

What is a transfusion reaction?

A

Adverse response to a transfusion

83
Q

Advantages of autologous transfusion

A

Reduced risk of transfusion reaction

Reduced risk of transmission of infectious disease

84
Q

What diseases are routinely tested by molecular methods on donor units?

A

West Nile, HIV, HBV, St. Louis Encephalitis, Zika

85
Q

Purpose of solutions infused

A

Only 0.9% saline or 5% albumin should be used to dilute blood components

86
Q

Purpose of warmers

A

Blood warmer with automatic temp control set for 37 degree C with an alarm if temp is exceeded

87
Q

Speed of transfusion

A

Within 4 hours

88
Q

How long must blood samples be kept for both the donor unit and recipient past transfusion?

A

At least 7 days

89
Q

Symptoms of mild donor reactions

A

Pallor, sweating, hyperventilation, decreased blood pressure, nausea.
Treatment: stop donation, loosen tight clothing and elevate feet. Apply cold towel to forehead, neck

90
Q

Symptoms of moderate donor reactions

A

Periods of unconsciousness, decreased pulse, decreased blood pressure, hyperventilation.
Treatment: check blood pressure, pulse and temp until normal again. Administer O2

91
Q

Symptoms of sever donor reactions

A

Convolutions or seizure, hyperventilation, tetany

Treatment: summon help immediately, ensure adequate airway, give 95% O2

92
Q

What is intraoperative blood salvage?

A

Blood is collected by drainage tubes at surgical site. Used most frequently in cardiopulmonary bypass surgery and total knee replacements

93
Q

How long before intraoperative blood salvage must be re-infused or discarded?

A

Must be used within 6 hours

94
Q

What is preoperative hemodilution?

A

Usually used in cardiopulmonary bypass surgery where 1-3 units of blood are removed from the patient before surgery and re-infused back post surgery. The blood can be store at 1-6 degrees C for 24 hours or at room temp for four hours

95
Q

What are the coagulation factors in cryoprecipitate?

A

FVIII
VWF
FXIII
Fibrinogen

96
Q

When preparing cryoprecipitate, how long do you have before the plasma needs to be frozen?

A

8 hours

97
Q

When preparing cryoprecipitate for freezing, what is the maximum amount of time allowed between the initiation of the freeing to being frozen solid?

A

1 hour

98
Q

If cryoprecipitate is being pooled, how many hours is the maximum allowed between pooling and transfusion?

A

4 hours

Immunohematology 480 (8 decks)

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