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case 14: anemia > haematology: blood groups & transfusions > Flashcards

haematology: blood groups & transfusions Flashcards

1
Q

How is blood products obtained

A

5-10minutes of donation procedure giving one unit of donated whole blood then centrifugation & separate blood constituents

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2
Q

What is the 3 constituents of blood

A
  1. Plasma
  2. Buffy coat
  3. Red cells
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3
Q

What does plasma contain

A

Mostly water
Proteins (clotting factors, immunoglobulins & albumin)

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4
Q

What is the 2 forms of plasma

A
  1. Plasma: fresh frozen plasma, cryoprecipitate & cryosupernatant
  2. Fractionated plasma products: factor concentrates, albumin & IV immunoglobin
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5
Q

What does the buffy coat contain

A

White cells
Platelets that contain clotting factors that prevent bleeding

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6
Q

What does the red cells contain

A

Hemoglobin (given to traumas or obstetrics)

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7
Q

What are the 2 types of plasma donations for platelets

A
  1. Pooled patient products
  2. Single donor patient collection for immunocompromised patients
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8
Q

What are the two main criteria’s for blood groups

A
  1. ABO groups
  2. Rhesus group
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9
Q

What does the Mendelian inheritance state

A

A & B are co-expressive but dominant over O

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10
Q

What is the significance of H antigen

A

Different sugars can attach to H antigen to form A & B blood groups
O does not contain a sugar only H antigen

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11
Q

What is the Bombay phenotype

A

Lack of H antigen

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12
Q

What does the rhesus group mean

A

Presence of antigen on surface of red blood cells
Rh D antigen most clinically significant

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13
Q

What is the genotype of rhesus group

A

Rh +: present & Rh+/Rh+ or Rh+/Rh-
Rh -: absent & Rh-/Rh-

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14
Q

ABO groups diagram

A

antibodies & blood type

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15
Q

Who is the universal donor

A

Group O

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16
Q

Who is the universal recepient

17
Q

What is the two instances of antibody present

A
  1. Naturally occurring: anti-A or -B via IgM that develops at 3-6 months due to exposure to A & B like antigen (develop antibodies unless found in blood)
  2. Immune developed: Rh anti-D develops when exposed to non-self antigen during blood transfusion or pregnancy
18
Q

What is the golden standard for blood transfusions in women

A

Rh – women of child bearing age should not receive Rh + blood

19
Q

When does hemolysis occur

A

Due to incorrect blood transfusion or pregnancy

20
Q

How does hemolysis work

A

IgG/IgM antibodies attach to specific RBC antigens that agglutination & can lead to hemolysis (intra-/extravascular) that cause RBC to rupture, release hemoglobin & activate cytokines & severe acute inflammatory cascade

21
Q

What is the four consequences of hemolysis

A

Acute renal failure, shock, DIC & potential death

22
Q

What is hemolytic disease of fetus & newborn

A

Results from maternal IgG antibodies crossing placenta & bind to fetal RBC leading to hemolysis in fetus & harmful to baby

23
Q

What is the most frequent case of HDN

A

ABO antibodies

24
Q

What is the most severe case of HDN

A

Rh antibodies

25
How is RDN managed
Pregnant women test for blood group & Rh status Rh – women have regular Rh (D) antibody level checks Main aim is to prevent Rh antibodies formation & RhoGAM that removes fetal Rh + RBC that cross over into maternal circulation
26
What is the 3 risks of blood transfusions
1. Incompatible blood transfusions due to human error & life-threating consequences 2. Transmission of infection from donor to patient: window period risk & blood only test for HIV, Hepatitis B & C & syphilis 3. Adverse transfusion reactions due to WBC
27
What is the steps to order for a blood transfusions
Risk vs benefit Blood sample in cross-match tube Blood ordering request form
28
How is blood transfusions administered
Given in specialized IV sets containing filters Special set for platelets No fluids/drugs can be added to blood products After blood is collected from blood bank requires 2 people confirm patient detail Patient sign consent form
29
What is the rate of administration of blood transfusions
Dependent on the products
30
At what rate is red cell units given
Stored in refrigerator & transfused slowly 1-2 hours If rapid transfusion required, blood should be warmed (if not leads to cardiac arrythmias)
31
At what rate is platelet units given
Stored at room temperature & transfused quickly
32
At what rate is plasma products given
Frozen & thawed before use to body temperate then transfused quickly
33
What is the monitoring of a patient receiving blood transfusions
Vitals signs are recorded at the start Patient is monitored for first 30 minutes for adverse symptoms

case 14: anemia (12 decks)

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