Fiser.03.BloodProducts

Question 1

Which two blood products do not carry risk of HIV or hepatitis transmission and why?

Answer 1

Albumin and serum globulins because these are heat treated

Question 2

Name 6 conditions donated blood is screened for

Answer 2

HIV, HepB, HepC, HTLV, syphilis, and West Nile Virus

Question 3

Name three indications for CMV-negative blood

Answer 3

LBW infants; BM transplant patients; Other transplant patients;

Question 4

What is the MCC of death s/p blood transfusion?

Answer 4

Clerical error leading to ABO incompatibility

Question 5

Which blood type is the universal donor and contains no antigens?

Answer 5

Type O derp

Question 6

What happens to 2,3-DPG levels in stored blood and how does this affect O2 affinity?

Answer 6

Low in 2,3-DPG causes left shift and increased O2 affinity

Question 7

What is the MOA of ABO incompatibility acute hemolysis

Answer 7

Ab-mediated

Question 8

What are the 5 S/Sx a/w acute hemolysis 2/2 ABO incompatibility?

Answer 8

Back pain, chills, tachycardia, fever, hemoglobinuria

Question 9

What are the three complications of acute hemolysis 2/2 ABO incompatibility?

Answer 9

ATN, DIC, shock

Question 10

Name 3 lab findings a/w acute hemolysis 2/2 ABO incompatibility

Answer 10

Haptoglobin < 50 mg/dL (binds to free hemoglobin and then gets degraded); Free Hb > 5; Increased uncongugated bilirubin

Question 11

What is the treatment for acute hemolysis 2/2 ABO incompatibility (5)?

Answer 11

IVF, diuretics, bicarb, pressors, histamine blockers

Question 12

How do transfusion reactions present in the anesthetized patient?

Answer 12

Diffuse bleeding

Question 13

What is the MOA of delayed hemolysis s/p transfusion?

Answer 13

Ab-mediated reaction against minor Ag

Question 14

What is the MOA of and treatment for nonimmune hemolysis?

Answer 14

From squeezed blood, treat with IVF and diuretics

Question 15

What is the most common transfusion reaction?

Answer 15

Febrile nonhemolytic transfusion reaction

Question 16

What is the underlying pathophysiology of febrile nonhemolytic transfusion reaction?

Answer 16

Recipient antibody reaction against donor WBCs

Question 17

How do you treat febrile nonhemolytic transfusion reaction?

Answer 17

Discontinue transfusion

Question 18

How do you prevent febrile nonhemolytic transfusion reaction in the future?

Answer 18

Use WBC filters for subsequent transfusions

Question 19

Name three symptoms a/w anaphylaxis 2/2 transfusion

Answer 19

Bronchospasm, hypotension, urticaria

Question 20

What is the underlying pathophysiology of anaphylaxis 2/2 transfusion (2 possible)?

Answer 20

Recipient antibodies against donor plasma proteins OR recipient antibodies against donor IgA when recipient is IgA deficient

Question 21

How do you treat anaphylaxis 2/2 transfusion (6)?

Answer 21

IVF, Lasix, pressors, steroids, epinephrine, histamine blockers (benadryl)

Question 22

Is urticaria after transfusion 2/2 hemolysis?

Answer 22

Usually not

Question 23

What is the underlying pathophysiology of urticaria 2/2 transfusion (2 possible)

Answer 23

Recipient antibodies against donor plasma proteins OR recipient antibodies against donor IgA when recipient is IgA deficient

Question 24

How do you treat urticaria s/p transfusion?

Answer 24

Histamine blockers (Benadryl), supportive care

Question 25

What is the underlying pathophysiology of transfusion-related acute lung injury (TRALI)?

Answer 25

Donor antibodies to recipient WBCs

Question 26

How does TRALI present?

Answer 26

Blood clot in pulmonary capillaries

Question 27

How do cold products or cold patients affect blood transfusions?

Answer 27

Cause coagulopathy, patients need to be warm to clot correctly

Question 28

How many PRBCs until you get dilutional thrombocytopenia?

Answer 28

10U PRBCs

Question 29

When do you see hypocalcemia with blood transfusions and how does it affect clotting?

Answer 29

See it with massive transfusion; Ca2+ is required for coagulation cascade, causes poor clotting

Question 30

What is the MC bacterial contaminant for blood products?

Answer 30

GNRs, E. coli

Question 31

Which blood products is most frequently contaminated and why?

Answer 31

Platelets, not refrigerated

Question 32

Can Chagas disease be transmitted with blood products?

Answer 32

Yes