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FHMP > FHMP 030 Blood components and blood groups > Flashcards

FHMP 030 Blood components and blood groups Flashcards

1
Q

what is haemopoieses?

A
  • the process by which blood cells are produced
  • all made from multi-potent cells in the bone marrow (haemopoietic stem cells HSC)
  • HSC initially divide to produce multi-lineage progenitor cells, which then further divide and produce more mature progenitor cells until we have multiple lineages of different blood cell types
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2
Q

where does haemopoiesis occur in foetus’ and adults?

A
  • foetus = liver
  • adult = bone marrow
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3
Q

what factors regulate haemopoiesis?

A
  • growth factor = granulocyte-colony-stimulating factor (G-CSF) acts on the progenitor and precursor cells in the bone marrow which give rise to neutrophils
  • accessory cells = adipocytes, fibroblasts, osteoblasts, osteoclasts and endothelial cells
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4
Q

what are erythrocytes/what do they do?

A
  • red blood cells
  • transport oxygen from lungs to tissues and carries away carbon dioxide to the lungs to expire
  • contain haemoglobin which oxygen binds to
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5
Q

what are immature red blood cells called?

A
  • reticulocytes
  • comprise of 1% of erythrocyte count
  • through erythropoiesis, reticulocytes develop and mature in the bone marrow and then circulate for about a day in the blood stream before developing into erythrocytes
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6
Q

how are red blood cells stored?

A
  • as reticulocytes
  • 280ml in a unit
  • 3ml/kg increases the Hb by 10g/L
  • stored at 4 degrees for up to 35 days
  • Red cells are suspended in a fluid medium called additive solution
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7
Q

what are leukocytes and what are the 5 types of leukocytes?

A
  • white blood cells
  • neutrophils
  • basophils
  • eosinophils
  • monocytes
  • lymphocytes
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8
Q

what are the 3 granulocytes?

A
  • neutrophils, basophils, eosinophils
  • because they contain granules in their cytoplasm
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9
Q

what are basophils and what is their function?

A
  • white blood cell, leukocyte, granulocyte
  • least common of the granulocytes
  • responsible for inflammatory reactions and allergic responses
  • undergo phagocytosis
  • produce histamine, serotonin and heparin
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10
Q

what are neutrophils and what is their function?

A
  • most abundant type of granulocyte and leukocyte
  • short lived and highly motile
  • part of innate immune response
  • undergo phagocytosis of the pathogens/microorgansims
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11
Q

what are lymphocytes and what is their function?

A
  • main cell type found in lymph
  • comprised of B and T lymphocytes
  • recognise foreign cells/ infected cells and kill them
  • help antigen presentation and produce antibodies and memory cells
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12
Q

what are monocytes and what is their function?

A
  • largest type of leukocyte
  • differentiates/matures into macrophages which can phagocytose
  • present antigens
  • in blood stream but macrophages found in tissues
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13
Q

what are eosinophils and what is their function?

A
  • type of granulocyte
  • responsible for combating multicellular parasites and certain infections
  • also respond to allergy
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14
Q

what are thrombocytes and what is their function?

A
  • platelets
  • help stop bleeding by clumping and clotting blood vessel injuries
  • have no cell nucleus
  • are fragments of cytoplasm that are derived from the megakaryocytes of the bone marrow and then enter the circulation
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15
Q

how are thrombocytes stored?

A
  • stored at 22 degrees and constantly agitated so dont clump
  • store for 7 days (risk of bacteria infection)
  • need to know blood group but crossmatch is not needed
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16
Q

what is plasma, what is it made up of and its function?

A
  • largely made in the liver
  • makes up 55% of blood volume
  • contains plasma proteins like fibrinogen, albumin, immunoglobulins and clotting factors
  • fibrinogen = helps with clotting
  • albumin = helps regulate oncotic pressure of the blood
  • immunoglobulins = antibodies, kills pathogens
  • clotting factors = help speed up the clotting process
17
Q

what are the 2 ways to store plasma?

A
  • fresh frozen plasma (FFP)
  • cryoprecipitate
18
Q

what is fresh frozen plasma and how is it stored?

A
  • frozen and preserved plasma after a blood donation
  • 1 unit = 300ml
  • stored at -30 degrees for 1 year
  • must use within 1 hour of thawing
  • need to know blood group but dont need to crossmatch
19
Q

what is cryoprecipitate and how is it stored?

A
  • when fresh frozen plasma is centrifuged and the precipitate is collected
  • stored at -30 degrees for a year
  • contains fibrinogen and factor VIII
20
Q

what are the 4 main blood groups?

A
  • A, B, AB, O
  • based on red blood cell surface antigens
21
Q

describe the inheritance of ABO blood groups

A
  • A and B are co-dominant
  • O is recessive
22
Q

describe the differences in the blood group antigens and antibodies

A
  • group A = A antigen and anti-B
  • group B = B antigen and anti-A
  • group AB = A and B antigen and no antibodies
  • group O = no antigens and anti-A and anti-B
23
Q

what is the Rhesus (Rh) blood group?

A
  • 2 genes code for the RhD groups
  • D is dominant coding for D antigen
  • d is recessive coding for antigen
  • So RhD positive = with antigen and RhD negative = no antigen
  • 85% of people are RhD Positive
24
Q

Name 5 blood group related clinical scenarios

A
  1. haemolytic disease of the newborn
  2. acute haemolytic transfusion reaction
  3. delayed haemolytic transfusion reaction
  4. non-immune transfusion reactions (not blood group related)
  5. major haemorrhage
25
Q

what is haemolytic disease of the newborn?

A
  • when a mother is RhD- and the baby is RhD+
  • first child/birth is fine but during birth, the transfer of foetal blood to maternal blood sensitises mother’s blood and produces anti-D antibodies
  • the following pregnancies will cause the anti-D antibodies to attack the foetus’ erythrocytes, causing HDN
  • leads to bilirubin release, causing neonatal jaundice and can lead to permanent brain damage (kernicterus) if bilirubin is deposited there
26
Q

how is haemolytic disease of the newborn treated?

A
  • RhIG (Rh immunoglobulin, antibodies to Anti-D) is given to the mother at 28 week and 34 weeks and 48 hours after delivery to prevent sensitisation of the mothers blood to RhD+ antigens (in first pregnancy and everyone after)
27
Q

what is acute haemolytic transfusion reaction?

A
  • most serious and life-threatening
  • usually ABO incompatibility
  • very rare and lethal
  • causes anaphylaxis, like an allergic reaction
28
Q

what is delayed haemolytic transfusion reaction?

A
  • incompatibility with blood groups other than ABO e.g. Rhesus
  • causes anemia and jaundice
  • less severe usually
29
Q

give 3 examples of non immune transfusion reactions ( not blood group related)

A
  • infection e.g. bacteria
  • iron overload = a major cause of morbidity and mortality in people with transfusion-dependent diseases due to iron deposits in the liver
  • errors = human error when administrating the transfusion - need to have name, DOB, hospital number and signed by the patient to be correct and label patient
30
Q

what are some special considerations to take into account when doing transfusion?

A
  • age of blood, younger blood lasts longer, less cation leak
  • specific phenotype requests e.g. for sickle and thalassemia
  • irradiated - may have depressed lymphocyte function e.g. due to certain drugs or condition e.g. di George syndrome
  • haemoglobin count, plasma depleted
31
Q

what is a major haemorrhage?

A
  • when someone has a haemorrhage that becomes hypotensive
  • loss of more than 1 blood volume in 24 hours (70ml/kg)
  • 50% of total blood volume lost in less than 3 hours
  • bleeding in excess of 150ml/min
32
Q

what is the major haemorrhage protocal?

A
  • call haematology register/ consultant, blood bank, and courier to get blood as soon as possible
  • patient is given fresh red blood cells and fresh frozen plasma otherwise just red cells the patient would become coagulopathic (cannot clot blood)
  • full cross match takes too long (45 minutes), so whilst waiting, give universal O Rh- blood (no antigens to react to)
33
Q

what are the 2 antiglobulin tests?

A
  • direct antiglobulin test (DAT)
  • indirect antiglobulin test
34
Q

what is the direct antiglobulin test and what does it test for?

A
  • testing if there are any antibodies on the patient’s erythrocytes
  • detects the cause of haemolytic anaemia, investigates transfusion reaction and diagnoses haemolytic disease of the newborn
  • also known as the Coombs test
  • adds anti-globulin to patients red blood cells
  • if present the red blood cells will clump together (agglutination)
35
Q

what is the indirect antiglobulin test and what does it test for?

A
  • tests for antibodies in the patients serum
  • detects antibodies against red blood cell antigens, in preparation of a transfusion or during pregnancy/birth
  • o

FHMP (18 decks)

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