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eMCD - Hae > Haematology 10: Blood Transfusion > Flashcards

Haematology 10: Blood Transfusion Flashcards

1
Q

List major blood groups

A
  • ABO Blood Groups
    (common stem = H antigen)

A gene + common stem
B- GAL + common stem

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2
Q

What is the shelf life of blood?

A

5 weeks

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3
Q

On the RBC cell membranes, we all have a common __________

A

H stem

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4
Q

In blood group O:
Common stem Y/N
A antigens Y/N
B antigens Y/N

A

In blood group O:
Common stem =Y
A antigens = N
B antigens = N

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5
Q

In blood group A:
Common stem Y/N
A antigens Y/N
B antigens Y/N

A

In blood group O:
Common stem =Y
A antigens = Y
B antigens = N

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6
Q

In blood group B:
Common stem Y/N
A antigens Y/N
B antigens Y/N

A

In blood group O:
Common stem =Y
A antigens = N
B antigens = Y

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7
Q

How are A + B antigens formed?

A
  • add 1+ sugar residues onto common glycoprotein + fructose stem on RBC membrane
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8
Q

What does A gene code for?

A

A gene:
- codes for enzyme that adds N-acetyl galactosamine

–> onto common glycoprotein + fructose stem

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9
Q

What does B gene code for?

A

B gene:
- codes for enzyme that adds galactose

–> onto common glycoprotein + fructose stem

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10
Q

A + B genes are

Dominant / Recessive / Codominant

A

A + B genes are

Codominant

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11
Q

A + B genes are

Dominant / Recessive / Codominant

A

A + B genes are

Codominant

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12
Q

O gene is

Dominant / Recessive / Codominant

A

O gene is

Recessive

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13
Q

Blood group A
Antigens on RBC =
Antibodies in plasma =

A

Blood group A
Antigens on RBC = A
Antibodies in plasma = Anti B

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14
Q

Blood group B
Antigens on RBC =
Antibodies in plasma =

A

Blood group B
Antigens on RBC = B
Antibodies in plasma = Anti A

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15
Q

Blood group O
Antigens on RBC =
Antibodies in plasma =

A

Blood group O
Antigens on RBC = Nil
Antibodies in plasma = Anti A + Anti B

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16
Q

Blood group AB
Antigens on RBC =
Antibodies in plasma =

A

Blood group AB
Antigens on RBC = A + B
Antibodies in plasma = Nil

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17
Q

How do you test blood groups?

A
  1. Blood sample taken from patient
  2. ABO group determined
  3. select donor unit of the same group
  4. carry out X match
18
Q

What is X match

A

patient’s serum = mixed with donor RBC

  • if it reacts –> shows that it is incompatible
  • shouldn’t react
19
Q

How does O -ve and AB +ve differ

A

O -ve = safe for everyone

AB +ve = can only be given to other AB +ve

20
Q

How does RhD +ve and RhD

-ve differ?

A

RhD +ve:

  • you have D antigen
  • no antibodies

RhD -ve:

  • you don’t have D antigen
  • can make anti-D antibodies if sensitized
21
Q

Note

A

Anti-D antibodies = IgG antibodies

22
Q

What are some implications of Anti-D antibodies?

A
  • when needed, RhD -ve blood individuals need to get RhD -ve or else anti-D will reacts with RHD pos blood
  • -> causing anaemia, high BR, Jaundice
  • HDN
  • HAEMOLYTIC DISEASE of the newborn
  • if RHD -ve mother has antiD, in next pregnancy –> so fetus i post RhD possible causes haemolysis of fetal red cells
  • avoid RhD -ve patients making anti-D
  • you need to transfuse blood of the same RhD blood group
  • O -ve = used as emergency blood when patient’s blood group is not know
23
Q

Why is whole blood no longer given to patients?

A
  • it is more efficient to give parts because patients may not need all the components
  • some components degenerate quickly if stored as whole blood (e.g blood in fridge = not good for coagulation factors)
  • prevent fluid overload
24
Q

How do you collect blood?

A
  • 1 pint of blood = collected into bag with anticoagulant
  • RBC = concentrated
  • Plasma = removed (allows you to avoid fluid overloading patients)
  • split 1 unit of blood by centrifuging the bag
  • Blood splits up into components
  • each layer = squeezed into satellite bags –> cut free
  • entire system = closed
25
Q

what are indications of FFP (Fresh Frozen Plasma) ?

A
  • if bleeding –> DUE TO abnormal coagulation test results (PT, APTT)
  • reversal of warfarin (but its not the best)

note: for plasma, you only need to know blood group
(not detrimental - NO CROSS MATCH NEEDED)

26
Q

How is FFP stored

A

stored at NEGATIVE -30 deg cel

  • thawed at room temp 20-30 mins before use
27
Q

What does cryoprecipitate contain?

A
  • Fibrinogen

- Factor 8

28
Q

what are indication of need for cryoprecipitate?

A
  • massive bleeding + low fibrinogen

- hypofibrinogenaemia (but rarely)

29
Q

How are platelets stored?

A
  • stored at room temp
  • needs to be constantly agitated –> avoid aggregating
  • shelf life = 5 days
    Note: Need to know blood group

note: 1 pool from 4 donors
or from 1 donor by aphaeresis.

30
Q

Do you need to cross match to give platelets ?

A

No cross matching required
but
you need to give the same blood group
wrong group –> RhD sensitization

31
Q

When would you give platelets?

A
  • bone marrow failure
  • massive bleeding
  • DIC
32
Q

give examples of some fractionated products

A
  • factor 8 + 9
  • immunoglobulins
  • albumin
33
Q

note: 1 donor gives approx 1 pint of blood

every 4 months

A

-

34
Q

what is the significance of IgM?

A

IgM = complete antibody that fully activates complement cascade to cause hemolysis of red cells

35
Q

How would you test for compatibility of donor blood sample?

A
  • take patient blood sample
  • ABO group (test w known anti and anti B reagents)
  • select donor unit
  • cross match patient’s serum with donor RBCS –> shouldn’t react.
    (if reacts = incompatible)
36
Q

How do you know if patient will need antigen neg blood

A

so before you test patients blood sample with EBC antibodies

so before transfusing patient, you ned to do a antibody screen FIRST

37
Q

note: B positive individuals:
- B antigens
- Anti- A antbodies

A

-

38
Q

NOTE: warfarin interferes with coagulation factors 2,7,9 and 10

A

-

39
Q

What is the use of platelets indicated?

A
  • mostly for those with bone marrow failure
  • sometimes doe massive bleeding / acute DIC
  • if undergoing cardiac bty pass and patient i son anti platelet drugs
40
Q

Fractionated products include:

A
  • factor 8 + 9
  • Immunoglobulin
  • Albumin
41
Q

Note: all blood must be tested for

  • hep B
  • hep C
  • HIV
  • Syphiliis
  • HEP E
A

Be careful of window period of infections

  • exclude high risk donors
  • use voluntary unpairednvolunteers

eMCD - Hae (11 decks)

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