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Intro To AA > Exam 3- Blood Therapy/Blood Transfusion > Flashcards

Exam 3- Blood Therapy/Blood Transfusion Flashcards

1
Q

What are the 4 components of blood:

A

Plasma
RBCs
WBCs
Platelets

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2
Q

What makes up plasma?

A

Clotting factors

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3
Q

What makes up platelets?

A

Thrombocytes

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4
Q

What makes up the Buffy coat?

A

WBCs and Platelets

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5
Q

Lifetime of RBC

A

100-120days

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6
Q

Men WBC

A

5,000-10,000

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7
Q

Women WBC

A

4,500-11,000

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8
Q

Children WBC

A

5,500-15,500

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9
Q

Newborn WBC

A

9,000-35,000

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10
Q

Men Hb

A

14-18

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11
Q

Women Hb

A

12-16

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12
Q

Children Hb

A

9.5-15.5

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13
Q

Newborn Hb

A

14-24

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14
Q

Men Hct

A

42-52

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15
Q

Women Hct

A

37-47

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16
Q

Children Hct

A

32-44

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17
Q

Newborn Hct

A

44-64

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18
Q

Comparing Hb and Hct:

A

Hct is 3x Hb

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19
Q

Men PLT

A

140,000-450,000

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20
Q

Women PLT

A

140,000-450,000

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21
Q

Children PLT

A

150,000-45,000

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22
Q

Newborn PLT

A

150,000-450,000

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23
Q

3 primary phases to create clot:

A
  1. Vascular spasm
  2. Formation of platelet plug (vWF)
  3. Coagulation (fibrin mesh creation)
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24
Q

What is fibrinolysis?

A

Destroys the blood clot

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25
Q

What factors are NOT produced by liver:

A

8 and vWF

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26
Q

Genetic causes of hypo coagulation:

A

Hemophilia

vWF disease

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27
Q

Genetic causes for hyper coagulation:

A

Factor 5 Leiden

AT 3 deficiency

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28
Q

Platelet lifespan:

A

7-10 days

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29
Q

Dual Antiplatelet therapy (DAPT)

A

Aspirin + ADP/P2Y12 inhibitor

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30
Q

Prothrombin time (PT)

A

Reflects extrinsic pathway

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31
Q

Normal time for PT

A

11.5-14.5sec

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32
Q

What is INR?

A

Standardizes PT results

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33
Q

Normal INR time:

A

.8-1.2 sec

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34
Q

Partial Prothrombin Time (PTT)

A

Reflects intrinsic pathway

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35
Q

Normal time for PTT

A

24.5-35.2sec

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36
Q

Normal time for Thrombin time

A

22.1-31.2sec

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37
Q

Normal fibrinogen levels in plasma:

A

175-433 mg/dL

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38
Q

Normal time for activated clotting time:

A

70-180sec

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39
Q

Antibodies react against foreign antigens:

A

Compatibility test

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40
Q

Two main labs for compatibility testing:

A
  1. Type and screen

2. Type and cross match

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41
Q

ABO-Rh type + antibody screen:

A

Type and screen

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42
Q

ABO-Rh type + cross match (mimics transfusion)

A

Type and cross match

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43
Q

How long does type and screen take:

A

45min

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44
Q

How long does type and cross match take:

A

1hr

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45
Q

Phase 1 of type and cross match:

A

Immediate phase (1-5min)

  • ABO incompatibility
  • AB
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46
Q

Phase 2 of type and cross match:

A

Incubation phase (30-45min)

  • incomplete Ab that are bale to attach to Ag
  • Ab from Rh system
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47
Q

Phase 3 of type and cross match:

A 
Antiglobulin phase (60-90min)
-performed on blood with + Ab screen
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48
Q

EBV preterm neonate:

A

95ml/kg

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49
Q

EBV full-term neonate:

A

85ml/kg

50
Q

EBV infant (1-12month):

A

80mg/kg

51
Q

EBV men:

A

75ml/kg

52
Q

EBV women:

A

65ml/kg

53
Q

Allowable blood loss equation:

A

ABL= [EBV x (Hctinitial - Hcttarget)]/Hctinitial

-vise versa for Hgb

54
Q

What are the 5 blood products:

A
  1. Whole blood
  2. Packed RBCs
  3. Platelets
  4. Fresh Frozen Plasma
  5. Cryoprecipitate
55
Q

How much of PRBCs is in centrifuge:

A

250ml

56
Q

How much of PLTs in centrifuge:

A

50-70ml

57
Q

How long can PLTs be stored:

A

20-25*C for 5 days

58
Q

What is frozen to create FFP?

A

Plasma

59
Q

How is cryo created?

A

Slowly thaw FFP

60
Q

After donation anticoagulation: CPDA-1

A

Citrate binds Ca
Phosphate is a buffer
Dextrose gives RBCs energy
Adenosine is precursor for ATP synthesis

61
Q

Shelf life for whole blood:

A

35 days

62
Q

4 risks with PRBCs:

A
  1. Citrate toxicity
  2. Hypothermia
  3. Hyperkalemia
  4. Decreased 2,3-DPG
63
Q

When should RBCs be administered:

A

Hgb is < 6g/dL

Blood loss is acute

64
Q

What is FFP separated from ?

A

PRBCs/PLTs

65
Q

How much does 1 unit of FFP increase clotting factors?

A

2-3%

66
Q

Does FFP need ABO and Rh compatibility?

A

YES ABO

NO Rh

67
Q

4 indications for FFP:

A
  1. Factor deficiencies
  2. Reversal of warfarin therapy
  3. Coagulopathy due to liver disease
  4. Massive blood loss
68
Q

FFP should be given in doses calculated to achieve a minimum of what?

A

30% of plasma clotting factor concentration

-10-15ml/kg

69
Q

3 indications for FFP:

A
  1. Antithrombin III deficiency
  2. Treat immunodeficiency’s
  3. Treat thrombotic thrombocytopenia purpura
70
Q

What is PLTs centrifuged from:

A

PRBCs/plasma

71
Q

One unit of PLT increases PLTs by:

A

5,000-10,000/mm3

72
Q

Is ABO compatibility needed for PLTs:

A

NO

73
Q

2 indications for PLTs:

A
  1. Thrombocytopenia

2. Dysfunctional PLTs

74
Q

How is cryoprecipitate received?

A

After FFP is thawed slowly

75
Q

Volume approx of cryo:

A

10-20ml

76
Q

What does cryo have:

A

Factors 8,13, vWF, fibrinogen

77
Q

One unit of cryo increases fibrinogen by:

A

5-7mg/dL

78
Q

3 indications for cryo:

A
  1. Factor 8 deficiency
  2. Hemophilia A
  3. Fibrinogen deficiencies
79
Q

When is cryo indicated because of fibrinogen concentration:

A

Less than 80-100mg/dL

80
Q

What 5 things are checked before blood administration:

A
  1. Name
  2. Hospital ID number
  3. Blood type
  4. Expiration date
  5. Product number
81
Q

What type of fluid is used for blood administration:

A

Normal saline

82
Q

Why not LR for blood administration:

A

Ca binds citrate leading to blood clotting

83
Q

What guage is used for adults and peds in blood administration:

A

Adult: 20ga
Peds: 24ga

84
Q

If blood type is unknown and is emergency transfusion what should be given until cross match complete:

A

O- PRBCs

85
Q

What labs show DIC (3):

A
  1. Decreased PLTs/fibrinogen
  2. Prolonged PT/PTT/INR
  3. Increased D-dimer
86
Q

How to begin treating DIC:

A

1st treat underlying disease process

87
Q

Most concerned hepatitis viral infections:

A

Hep b

Hep c

88
Q

Hep B exposure:

A

1 in 200,000

89
Q

Hep C exposure:

A

1 in 1,900,000

90
Q

HIV exposure:

A

1 in 1,900,000

91
Q

HTLV exposure:

A

1 in 2,900,000

92
Q

Bacterial rxns from RBC exposure:

A

1 in 250,000

93
Q

Bacterial rnx from PLTs exposure:

A

1 in 25,000

94
Q

What is acute destruction of tranfused RBCs (3):

A
  1. Occur within 24 hr
  2. Intravascular
  3. ABO incompatibility
95
Q

What is delayed destruction of tranfused RBCs (3):

A
  1. Occur after 24 hrs
  2. Extra vascular
  3. Rh incompatibility
96
Q

What does acute hemolytic rxns lead to (3)

A
  1. Renal damage
  2. DIC
  3. Death
97
Q

5 signs in acute hemolytic rxns anesthetize pt:

A
  1. Tachycardia
  2. Hypotension
  3. Increased temp
  4. Hemoglobinuria
  5. Diffuse oozing
98
Q

4 symptoms for delayed hemolytic rxn:

A
  1. Malaise
  2. Jaundice
  3. Fever
  4. Decreased Hgb
99
Q

How is delayed hemolytic rxn diagnosed?

A

Coombs test

100
Q

Febrile rxn characterized by:

A

Increase of >1*C within 4 hrs

101
Q

Anaphylactic rxn cause by:

A

Typically in IgA-deficient pts with anti-IgA Abs

102
Q

5 symptoms for anaphylactic rxns:

A
  1. Hypotension
  2. Tachycardia
  3. Bronchospasm
  4. Swelling
  5. Hives
103
Q

3 treatments for anaphylactic rxn:

A
  1. Epi
  2. Fluids
  3. Steroids
104
Q

What presents as non cardiac pulmonary edema similar to ARDS:

A

TRALI

105
Q

Leading cause of transfusion-related mortality:

A

TACO

106
Q

Blood products administered faster than CO

-occur when source of bleeding controlled and provider continues to give blood products

A

TACO

107
Q

Class 1 hemorrhage:

A

Loss of 5% of blood volume or less

108
Q

Class 2 hemorrhage

A

15-30% blood volume loss

-sympathetic; HR and DBP increase

109
Q

Class 3 hemorrhage

A

30-40% loss of blood volume

110
Q

Class 4 hemorrhage

A

> 40% loss

-needs blood now or will die

111
Q

How much blood loss needs a massive transfusion:

A

> 150ml/hr

112
Q

4 variables for assessment of blood consumption score:

A

HR >120 BPM
SBP <90mmHg
Positive FAST (fast assessment with sonography)
Penetrating injury

113
Q

How many pt scores is need to have massive blood transfusion:

A

Two or greater

114
Q

When does tranexamic acid need to be given:

A

Early, within 3hrs of injury

115
Q

Goals for SBP:

A

80-100

116
Q

Goals for temp:

A

> 35*C

117
Q

Goals for Hb:

A

> 7

118
Q

Goals for pH:

A

> 7.2

119
Q

Goals for BE:

A

> -6

120
Q

Point of care test that can assess whole blood coagulation time:

A

Thromboelastography (TEG)

121
Q

5 complications of massive transfusion:

A
  1. Hyperkalemia
  2. Coagulopathy
  3. Citrate toxicity
  4. Hypothermia
  5. Acid-base balance
122
Q

Pt donates own blood prior to surgery

A

Autologous transfusion

Intro To AA (8 decks)

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