Haemtology

Question 1

PRBC storage

Answer 1

42d at 1-6deg

Question 2

FFP’s/cryo storage

Answer 2

Frozen - 1y

Thawed - 5d at 1-6deg

Question 3

Platelets storage

Answer 3

5d at 22-24deg

Question 4

What changes occur in stored blood

Answer 4

Inc K
Inc lactate
Increased haemolysis - RC’s swell, spherical
Dec 2,3 DPG
Dec viable plt 
Dec factor 7,8,9

Question 5

Types of reactions post transfusion

Answer 5

Acute haemolytic - ABO incompatibility. SIRS type response
Febrile non-haemolytic - anti-leukocyte antibodies against donor blood
Hypersensitivity - plasma protein sensitisation from previous transfusion
TRALI - antileukocyte antibodies against recipient blood
Nosocomial infection

Question 6

Define massive transfusion

Answer 6

Entire blood volume <24h
30% blood volume in 4h
4u in 1h with continued blood loss

Question 7

Transfusion triggers - platelets

Answer 7

<10
<50 and massive bleed or pre-op
<100 and microscopic bleed or TBI

Question 8

Transfusion triggers FFP

Answer 8

INR >1.5

Question 9

Transfusion triggers cryo

Answer 9

Fibrinogen <1

VWD

Question 10

TXA indication

Answer 10

<3h post injury with significant bleed

Question 11

Normal R-time, what to give if abnormal

Answer 11

4-8 min

FFP’s - clotting factors

Question 12

Normal K- time, what to give if abnormal

Answer 12

1-3min

Cryo

Question 13

Normal alpha angle, what to give if abnormal

Answer 13

34-47

Cryo

Question 14

Normal MA, what to give if abnormal

Answer 14

50-70mm

Platelets

Question 15

Normal Ly30, what to give if abnormal

Answer 15

<3%

TXA

Question 16

Exceptions to restrictive transfusion strategy

Answer 16

TBI
Septic shock with CVO2 <70%
AMI, unstable angina, ACS

Question 17

HIIT diagnosis and treatment

Answer 17

Platelet factor 4 Eliza

Argatroban

Question 18

DIC inticing event

Answer 18

Tissue factor release

Question 19

TTP mechanism

Answer 19

Platelets bind to abnormal VWF

Clotting factors not depleted

Question 20

TTP pentad

Answer 20

Fever
AMS
ARF
low plt
Microangiopathic haemolytic anaemia

Question 21

HELLP vs DIC

Answer 21

INR and PTT are normal

Question 22

Haemophilia inheritance pattern

Answer 22

A, B - X-linked

C - AR

Question 23

VWD inheritance pattern

Answer 23

AD

Question 24

Heparin reversal

Answer 24

Protamine sulphate

Question 25

UFH works on

Answer 25

2a (via AT3)

10a

Question 26

Oral 10a inhibitors

Answer 26

Rivaroxaban
Abixaban
Endoxaban

Question 27

Oral thrombin inhibitors

Answer 27

Dabigatran

Argatraban

Question 28

Prerequisits before administration of recombinant factor 7

Answer 28

PH >7.2
Plt >50 (?100)
T normal - at least >35
Fibrinogen >1
Hct >24%

Also
- massive transfusion received

Question 29

What increases PT

Answer 29

Warfarin, liver dysfunction, DIC

Normal 10-12s

Question 30

What increases PTT

Answer 30

Heparin, haemophillia, DIC

Normal 30-40s

Question 31

What decreases fibrinogen

Answer 31

DIC, envenomation

Normal 200-400