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Hemology > Hematology 1.c.6 > Flashcards

Hematology 1.c.6 Flashcards

1
Q

formed elements of blood are

A
  • erythrocytes (red blood cells)
  • leukocytes (white blood cells)
  • thrombocytes (platelets)
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2
Q

____ + _____ = whole blood

A

formed elements + plasma = whole blood

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3
Q

what kind of tissue is blood considered to be and why?

A

connective tissue

because it contains:

  1. cells
  2. ground substance (fluid component)
  3. fibers
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4
Q

what is the definition of blood

A

connective tissue consisting of cells and cell components (formed elements) suspended in an intercellular matrix (plasma)

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5
Q

blood is the only ___ tissue in the body

A

liquid tissue in the body

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6
Q

how many liters and body weight does blood make up of the adult human body?

A

6-8 liters

8% body weight

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7
Q

cellular components is what percentage of blood volume?

A

45%

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8
Q

plasma is what percentage of blood volume?

A

55%

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9
Q

what is plasma?

A

viscous fluid the formed elements are suspended in

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10
Q

what is plasma made of?

A

90% water and 10% solid matter (protein, carbs, electrolytes, minerals, fats)

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11
Q

all blood cells develop from where?

A

stem cells that reside in bone marrow

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12
Q

what are stem cells

A

immature and undifferentiated cells

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13
Q

what is bone marrow

A

the soft, spongey center of bone

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14
Q

what is the production of blood cells called?

A

hematopoiesis or hemopoiesis

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15
Q

what are blasts

A

new immature blood cells

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16
Q

how many blood cels are generated each day

A

around 1 trillion blood cells

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17
Q

what kind of process is hematopoiesis considered?

A

ongoing process

blood cells are constantly regenerated

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18
Q

hemocytoblast to megakaryoblast to

A

megakaryocyte

to thrombocytes

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19
Q

hemocytoblast to monoblast to

A

monocyte to agranulocytes

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20
Q

hemocytoblast to lymphoblast to

A

lymphocyte to agranulocytes

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21
Q

hemocytoblast to myeloblast to

A

progranulocyte to

granulocyte to granulocytes

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22
Q

hemocytoblast to proerythroblast to

A

polychromatic erythroblast to

erythrocytes

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23
Q

what are the three kind of granulocytes

A

basophil
eosinophil
neutrophil

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24
Q

what are the two types of agranulocytes

A

lymphocyte to monocyte

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25
Q

what are the two types of leukocytes

A

granulocytes to agranulocytes

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26
Q

what are the most abundant type of cells

A

neutrophils

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27
Q

what are the least abundant type of cells

A

basophils

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28
Q

what are the 4 critical life supporting functions of blood

A
  1. delivers oxygen, hormones, and nutrients to body cells and picks up cell waste
  2. prevents blood loss by healing wounds
  3. acts as primary carrier of immunity
  4. helps control body temperature
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29
Q

what are the three mechanisms of blood

A
  1. transportation
  2. regulation
  3. protection
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30
Q

what are the three things does transportation of blood entail

A
  1. carting O2 and nutrients to cell
  2. removing CO2 and nitrogenous wastes from tissues to lungs and kidneys to be excreted
  3. carrying hormones from endocrine glands to target tissues
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31
Q

what three things does regulation of blood entail

A
  1. helping control body temp by removing heat from active areas
  2. fluid and electrolyte balance
  3. pH regulation via buffers in the blood, histidine
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32
Q

what three things does protection of blood entail

A
  1. prevents blood/fluid loss from hemorrhage when damaged
  2. protects against infections and diseases via cola with immune system
  3. protect from offending agents via antibodies in the plasma
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33
Q

composition of blood

A

top: plasma
middle: “Buffy coat” - WBCs and platelets
bottom: red blood cells

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34
Q

what are RBC also known as

A

erythrocytes

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35
Q

what is the most numerous of the formed elements?

A

RBCs

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36
Q

what is the shape of RBC and what doe it help with

A
  • tiny biconcave disks that are thin in middle and thicker around the periphery
  • helps with flexibility for moving through capillaries with maximum surface area for diffusion of gases
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37
Q

what is the primary function of RBC and what must the do to carry out this function

A

to transport O2 (and CO2)

-must stay flexible and permeable to O2, CO2, nutrients and waste products

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38
Q

the flexibility in RBC are dependent on what?

A

ability to generate ATP

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39
Q

what happens to a RBC when ATP is lost

A

red cell becomes rigid and removed from circulation via the spleen

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40
Q

life span of RBC

A

approx 120 days

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41
Q

what do RBCs not contain once they are in circulation

A

nucleus

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42
Q

three reasons for absence of nucleus

A
  1. decease space available for O2 and CO2
  2. would increase blood’s weight and increase workload on heart about 20%
  3. do not require a nucleus to carry out function
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43
Q

low RBC indicates

A

anemia

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44
Q

high RBC indicates

A

erythrocytosis

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45
Q

what is polycythemia vera and what does it indicate

A

pathological increase in red cells

-indicates hematopoietic bone marrow

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46
Q

what defines anemia

A
  • hgb concentration <7 g/dL

- not enough red cells in circulation to transport sufficient amounts of O2

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47
Q

it is important to remember that anemia is not a disease of the ____, it is an indicator of…

A

not a disease of blood

indicator of disease process elsewhere in the body

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48
Q

what causes anemia

A
  • iron deficiency
  • vitamin/enzyme deficiencies
  • hemolysis
  • autoimmune
  • chemo/radiation
  • large amount of blood loss
  • ESRD
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49
Q

what is polycythemia vera

A
  • aka primary polycythemia
  • high RBC count of >18 g/dL
  • disorder of bone marrow that produces red cells independently of erethropoetin
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50
Q

what is the concern when it comes to primary polycythemia

A

high RBC = thick blood = increased viscosity = circulatory problems

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51
Q

what is oxygen transport made possible by

A

hgb

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52
Q

when blood circulates through the lungs, ___ becomes fully saturated with ___ and makes the blood bright red

A

hgb becomes fully saturated with O2 and makes the blood bright red

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53
Q

what happens to blood when red cells perfuse capillary beds of other organs

A

O2 is released to the tissues and blood becomes dark red

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54
Q

what does HgA consists of

A
  • 2 alpha and 2 beta chains = 4 polypeptide chains = 4 binding sites
  • heme molecule attached to each chain
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55
Q

what is the site where O2 binds to Hgb?

A

heme molecule

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56
Q

what is responsible for the red color of blood

A

heme molecule that contains iron atom

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57
Q

where does the production of heme occur?

A

mitochondria of immature RBCs

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58
Q

_____ enter circulation from bone marrow and lose what?

A

mature red cells enter circulation from bone marrow and lose mitochondria and nucleus

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59
Q

saturation in regards to hgb is what?

A

saturation = measure of O2 combined with Hgb

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60
Q

deoxyhemoglobin

A

Hgb that has released O2

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61
Q

each Hgb has what

A

4 heme sites, which means it is able to bind 4 O2 molecules

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62
Q

what is oxyhemoglobin

A

fully saturated hemoglobin

1.34 ml O2/gram of hbg

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63
Q

which has a higher affinity for O2? oxyhemoglobin or deoxyhemoglobin?

A

oxyhemoglobin

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64
Q

which has a higher affinity for CO2? oxyhemoglobin or deoxyhemoglobin?

A

deoxyhemoglobin

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65
Q

where does O2 bind to oxyhemoglobin at?

A

lungs

then transported via bloodstream to target tissues and eventually used for aerobic respiration

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66
Q

deoxyhemoglobin carries what?

A

CO2 back to lungs where its released via exhalation

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67
Q

the oxygen tissue receive depends on 3 conditions:

A
  1. blood flow to tissues
  2. hgb concentration in blood
  3. affinity of hgb for O2
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68
Q

what happens when an individual doesn’t have one of these conditions for optimal tissue perfusion?

A

automatically compensates by adjusting one or both of the other factors so optimal tissue perfusion in maintained

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69
Q

what is oxygen affinity

A

hemoglobin’s ability to bind or release O2

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70
Q

Bohr effect

A

influence of pH and CO2 on Hgb’s affinity to bind and release O2

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71
Q

in terms of affinity, when O2 is released in the tissues, what is the pH and CO2 levels

A

low pH (more H+)

high CO2 (metabolically active)

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72
Q

in terms of affinity, when Hgb picks up O2 more easily in the lungs, what are the pH and CO2

A

high pH

low CO2

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73
Q

oxygen affinity is regulated by what 3 factors in the blood

A
  1. hydrogen concentration (pH)
  2. partial pressure of CO2
  3. level of 2,3-DPG
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74
Q

2,3-DPG is a byproduct of the pathway of

A

glycolysis

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75
Q

why is 2,3-DPG present in the same concentration as Hgb

A

because it is bound to Hgb

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76
Q

what is the most important allosteric effector of positive cooperativity?

A

2,3-DPG

-one molecule is all that is required to change the affinity of an entire hub tetramer

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77
Q

the presence of 2,3-DPG stabilizes the ___ state of _______, decreasing the affinity for oxygen

A

T state of deoxyhemoglobin, which decreases its affinity for oxygen

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78
Q

what does fresher/older blood have to do with oxygen loading and unloading

A

the fresher the blood, the more response you are going to get for oxygen loading and unloading

older the blood, less it works for transport

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79
Q

what is the function of 2,3-DPG

A

lower hgb’s affinity for O2 so it realizes O2 to tissues more easily

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80
Q

what would happen if 2,3-DPG was not there?

A

O2 would remain bound to Hgb and could not be released to tissues

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81
Q

when does an increase in 2,3-DPG happen and what does it cause?

A
  • happens in response to hypoxia or erythropoietin

- shifts the curve to the right

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82
Q

when does a decrease in 2,3-DPG happen and what does it cause?

A
  • happens as a red cell storage lesion

- shifts the curve to the left

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83
Q

erythropoietin is dependent on what kind of system?

A

feedback system

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84
Q

Erythropoietin levels in the absence of anemia

A

Low

around 10 mU/mL

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85
Q

in hypoxic stress, what are EPO levels

A
  • EPO production may increase up to 1000 fold

- levels reaching 10,000 mU/mL of blood

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86
Q

in adults, where are EPO synthesized?

A

interstitial cells of the renal cortex

additional amounts being produced by liver and pericytes in brain

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87
Q

Since EPO relies on a feedback mechanism, what is the transcription factors for EPO

A

hypoxia-inducible factors are broken down in the presence of oxygen and iron

-made and released into circulation by the kidneys

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88
Q

what is hypoxia and what is a result from?

A

hypoxia is low levels of O2 in the tissues

results from low O2 concentration in the blood

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89
Q

what happens in the EPO cycle during hypoxia?

A

flow through kidneys stimulates an increased production of EPO

then stimulates stem cells in bone marrow to produce more red cells

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90
Q

if you are in a planned surgery, what might they put you on to control the production of red cells after surgery?

A

they put you on EPO at home so you can produce more red cells after the surgery

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91
Q

what does hematocrit measure

A

percentage of red cells in whole blood

also an indirect measure of O2 carrying capacity

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92
Q

what is the Hct for a normal adult?

A

38-54%

males usually higher at 46-54%
females 38-44%

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93
Q

hematocrit levels are approx _____ the value of Hgb

A

ex

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94
Q

one unit of RBCs transfused elevates Hct by about ____%

A

3-4%

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95
Q

what is red cell hemolysis

A

destruction of red cell membrane

plasma free hgb can no longer transport O2

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96
Q

what does red cell hemolysis lead to

A

release and diffusion of hgb

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97
Q

what causes red cell hemolysis

A

immune/autoimmune reaction
admin wrong ABO blood unit
sepsis
high suction pressure

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98
Q

in the hemoglobin-oxygen dissociation curve, what causes a shift to left

A

O2 not released to tissues easily

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99
Q

in the hemoglobin-oxygen dissociation curve, what causes a shift to the righ

A

O2 readily released to tissues

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100
Q

what are the physiological factors that influence the affinity of hgb for oxygen

A 
CO2 
pH
2,3-DPG 
presence of unusual hemoglobin
temperature
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101
Q

how does the partial pressure of CO2 influence the affinity of hgb for oxygen

A

-increasing CO2 shifts the curve to the right

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102
Q

what does hyperventilation and hypocapnia shift the curve for affinity of hgb to oxygen

A

shifts the curve to the left

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103
Q

decreasing pH (acidosis) shifts the curve to the

A

right

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104
Q

alkalosis shifts the curve to the

A

left

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105
Q

increase 2,3-DPG in response to hypoxia or erythropoietin shifts the curve to the

A

right

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106
Q

decreased 2,3-DPG as a red cell storage lesion shifts the curve to the

A

left

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107
Q

Presence of methemoglobin, carboxyhemoglobin and fetal hemoglobin shifts the curve to the

A

left

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108
Q

Presence of sulfa hemoglobin shifts the curve to the

A

right

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109
Q

hyperthermia shifts the curve to the

A

right

110
Q

hypothermia shifts the curve to the

A

left

111
Q

the interaction of two competing actions results in a useful homeostatic mechanism for affinity of hgb for oxygen. what are the two competing actions

A
  • low pH by itself decreases the affinity of hgb for oxygen

- inhibiting the production of 2,3-DPG causes low pH increases the affinity of hgb for oxygen

112
Q

2,3-DPG opposes the ______

A

Bhor effect

  • acidosis shifts the curve to the right and decreases the oxygen affinity of hgb
  • this results in decrease in 2,3-DPG which shifts the curve to the left again
113
Q

fetal hemoglobin chains are

A

2 alpha chains and 2 y chains

114
Q

Hgb F is designed to _____ from maternal umbilical ___.

A

Hgb F is designed to extract O2 from maternal umbilical vein

115
Q

what is the p50 for Hgb F vs Hgb A

A

Hgb F P50 is 19 mmHg

Hgb A P50 is 26 mmHg

116
Q

at PaO2 of 30-25, what is the Hgb F saturation

A

80%

while Hgb A is only 50-60% saturated

117
Q

what is the normal fetal pH and what does it help with

A

7.25-7.35
lower than adults
helps with unloading oxygen from hgb at the tissues

118
Q

which has a greater affinity for O2, Hgb F or Hgb A

A

Hgb F

119
Q

why does fetal hemoglobin have a decreased affinity for 2,3-DPG and what does it result in

A

the absence of the histidine (replaced with serine) is the reason for decreased affinity

this results in an increased affinity for oxygen

120
Q

when is Hgb F replaced with Hgb A

A

between 3rd and 6th month following birth

121
Q

characteristics of methemoglobin

A
  • Fe2+ oxidized to Fe3+
  • brown color
  • cannot bind to O2
122
Q

characteristics of sulfa hemoglobin

A
  • irreversible

- decrease O2 carrying capacity

123
Q

characteristics of carboxyhemoglobin

A

-increase CO poisoning (smokers)

124
Q

characteristics of sickle cell anemia (Hgb S)

A
  • inherit a defective Hgb gene from each parent
  • always anemic and susceptible to infections
  • found in individuals with African, Middle Eastern, Indian, or Mediterranean
125
Q

when exposure to low O2 concentration, what happens to red cells

A

red cells take on sickle shape

126
Q

what do sickle cell block and what does it destroy

A

block microvasculature

destroys surrounding tissues and cause ischemia

127
Q

sickled cells are ____ and can ____ easily

A

fragile and can hemolyze easily

128
Q

what kind of transfusion is done on CPB and sickle cell patient

A

exchange transfusion

129
Q

what is exchange transfusion

A

sequestering the initial CPB venous drainage from the patient after priming the extracorporeal circuit with whole blood whole blood containing hemoglobin A

130
Q

what is the goal of exchange transfusion

A

hemoglobin A of 60-70%

131
Q

what are WBCs also known as

A

leukocytes

132
Q

WBC must be ____ ___ to carry out intended functions

A

high mobile

133
Q

leukocytes mostly work with

A

the immune system

134
Q

what do WBC use as transport and where do most of the work take place

A

use blood as a transport medium and do most of work in tissues

135
Q

diapedesis

A

property that allows white cells to squeeze through capillary pores and move into tissues

136
Q

what is the normal white cell count in adult

A

4.5-11 x 10^3/uL

137
Q

what is high WBC count known as

A

leukocytosis

138
Q

what is low WBC count known as

A

leukopenia

139
Q

generally leukocytes are ____ than erythrocytes but ____ in number

A

generally leukocytes are larger than erythrocytes but fewer in number

140
Q

how do leukocytes communicate among themselves

A

complex network of glycoproteins called cytokines

141
Q

how to cytokines work

A

communication among leukocytes

-alert other white cells to move to site of infection/invasion

142
Q

what are the three main groups of leukocytes

A

granulocytes
monocytes
lymphocytes

143
Q

what are the most numerous of all white cells

A

granulocytes

-neutrophils, basophils, eosinophils

144
Q

what do monocytes become

A

become macrophages once leave circulatory system and enter tissues

145
Q

what are the most complex leukocytes

A

lymphocytes

146
Q

what do lymphocytes differentiate into

A

B cells and T cells

147
Q

what is generally the first cell to enter infected/inflamed area

A

neutrophils

148
Q

what are the primary function of neutrophils

A

phagocytosis which is the ingestion of bacteria

149
Q

when you see swelling, pus, and inflammation, what is that an indication of?

A

presence of numerous neutrophils

150
Q

where do eosinophils resides and what are they highly involve din

A

reside in tissues

highly involved in combating allergic reactions

151
Q

basophils usually circulate in the blood, when they move into tissues, they are called

A

masts

152
Q

what is the main function of basophils

A

serene heparin and histamine

153
Q

what is the function of lymphocytes

A

specific immune response when foreign matter invades the body

154
Q

which cell plays a big role in body’s rejection of transplanted organs

A

lymphocytes

155
Q

thrombocytes are also known as

A

platelets

156
Q

what is the lifespan of thrombocytes

A

9-12 days once released from spleen into circulation

157
Q

what is the functions of thrombocytes

A

essential in maintaining hemostasis (preventing blood loss)

-involved in wound healing and inflammation

158
Q

what is the normal adult platelet count

A

150-450 x 10^3/uL

159
Q

what is thrombocytosis

A

high platelet count

160
Q

what is thrombocytopenia

A

low platelet count

161
Q

where are thrombocytes produced

A

in one marrow by megakaryocytes

162
Q

what are the 2 hemostatic functions of platelets

A
  1. form platelet plug over area of endothelial damage

2. provide platelet factor-3 which make it possible

163
Q

what is the main function for plasma

A

tranportation

164
Q

plasma accounts for ____ bw

A

about 4%

165
Q

plasma vs serum

A

plasma is fluid separated from unclothed blood

serum is fluid separated from clotted blood

166
Q

what is serum

A

plasma - fibrinogen

167
Q

where are plasma proteins produced

A

in the liver and remain in vascular space

168
Q

why are plasma proteins essential in helping maintain constant blood volume throughout the body

A

because they exert osmotic pressure in the vasculature

169
Q

what does plasma proteins consist of

A

albumin, clotting proteins, globulins (antibodies)

170
Q

what is the function of plasma proteins

A 
nutrition
clot formation
act as a transport molecule
repair cellular damage
maintain blood volume 
form antibodies
contribute to buffering capacity of blood
171
Q

what is albumin used for

A

protein replacement and volume expansion

172
Q

albumin maintains ____ pressure between blood and body tissues

A

osmotic pressure

173
Q

how does albumin work as a volume expansion

A

increases oncotic pressure within vasculature when admin I.V., there increasing blood volume

174
Q

when you have albumin deficiency, that results in

A

edema

175
Q

what is the normal amount of albumin in the blood

A

3.5-5.5 g/dl

176
Q

with a little bottle of 25% of 100 mL of albumin, what does that do

A

raise oncotic pressure and balance fluid levels

177
Q

big 5% of 100 mL of albumin does what

A

no volume bc same oncotic pressure and add volume

178
Q

what is fibrinogen and what does it do

A

inactive form of fibrin

clotting protein used to stabilize platelet plug

179
Q

what do globulins refer to

A

general term for all proteins in plasma

except fibrinogen and albumin

180
Q

what are the 4 types of globulins

A

alpha 1
alpha 2
beta 1
immunoglobulins

181
Q

what is the function of globulins

A
  • act as enzymes in metabolic processes
  • humoral immunity
  • transport of heme to bone marrow which is recycled to produce new Hgb
  • transport of metals such as copper and iron
182
Q

what process immunoglobulins and what is their major role

A

produced by B cells (plasma cells)

major role in defending body from infection

183
Q

what is the most numerous immunoglobulins

A

IgG class

184
Q

when the blood is collected and stored, it can either be stored whole or it can be stored….

A

as packed red blood cells

185
Q

when the blood is stored as packed RBC, how much plasma has been removed and how do they remove it?

A

70% of the plasma has been removed

done by light centrifugation

186
Q

what can be done to the plasma that was removed from the packed RBC?

A

the plasma can be centrifuged heavily a second time to separate the platelet rich plasma

remaining plasma is used as a platelet pack

187
Q

the plasma that has been centrifuged twice can be stored into a third bag known as

A

fresh frozen plasma (FFP)

188
Q

each donated unit of blood is test for

A

ABO-Rh typ e

-hep B & C
-HIV I and II
HTLV-I/II (rare leukemia)
-Syphilis
-West Nile Virus

189
Q

what are platelets screened for

A

bacterial contamination

190
Q

what are the lab tests that must be completed before blood or blood products can be transfused

A

determination of blood type with a crossmatch

screening for antibodies

screening for possible infectious agents

191
Q

what are the MANDATORY tests that must be done on all units of blood

A
  • ABO group and Rh type
  • screening for blood-group antibodies
  • serologic test for syphilis
  • serologic test for human retroviruses (HIV 1, 2, p24 antigen, HTLV1 antibody)
  • serologic test for hepatitis (hep B surface antigen, Hep B core antibody, Hep C antibody)
192
Q

solutions placed in blood bags by manufacturer have 3 functions:

A
  1. prevent clots
  2. provide nutrients to maintain and preserve the viability of RBCs
  3. help maintain pH
193
Q

what are 4 solutions used to store whole blood

A
  1. ACD - acid citrate dextrose
  2. CPD - citrate phosphate dextrose
  3. CPDA-1 - citrate phosphate dextrose adenine
  4. heparin
194
Q

citrate is an

A

anticoagulant

chelates calcium (prevents clotting)

195
Q

phosphate and dextrose are

A

preservatives

196
Q

what does phosphate help prevent in storing solutions

A

prevents pH changes and maintain ATP levels

helps maintain 2,3-DPG

197
Q

what does dextrose do in storing solutions

A

maintain red cell viability

198
Q

how long does whole blood collected in CPD and ACD last?

A

21 days storage

199
Q

how long does blood collected in CPDA-1 last?

A

35 days storage

200
Q

how long does red cells stay in storage and what are the storage conditions?

A

35 days

stored at 1-6 degree C to decrease glycolysis

201
Q

under 2 degrees C for storage of red cells causes

A

freezing injury to cells

202
Q

over 8 degrees for storage of red cells causes

A

bacterial overgrowth

203
Q

how long can FFP stay in storage and what are the storage conditions?

A

1 year
stored at -18 C or colder
factors V and VII retain most of their effectiveness

204
Q

if storage is colder than -20 degrees C for FFP, what happens?

A

factors V and VII lose some effect

205
Q

how long and at what conditions can platelets stay stored?

A

5 days

20-24 C

206
Q

what will storing platelets at a degree below 22 C cause?

A

increase in large aggregates

207
Q

what is the shelf life and at what conditions for cryoprecipitate?

A

shelf life of 1 year at -18 C

208
Q

what are the blood components of bank blood?

A

packed red cells for anemia and improving O2 carrying capacity

platelets treat thrombocytopenia/dysfunction

plasma (FFP) treats coagulation defects/deficiencies

209
Q

what does cryoprecipitate treat?

A

fibrinogen deficiency
hemophilia A
von Willebrand’s disease

210
Q

where do you cryoprecipitate from?

A

when FFP is thawed, white precipitate called cryoprecipitate remains

211
Q

cryoprecipitate is rich in ___, especially ___ and ____

A

rich in coagulation protein

especially FVII and fibrinogen

212
Q

what must be done before any recipient receives blood

A

ABO/Rh identification

213
Q

what is blood grouping

A

ABO/Rh identification

214
Q

what is crossmatching

A

determining compatibility b/w donor and recipient

215
Q

what is the final step of pretransfusion testing

A

crossmatching

a portion of donor blood is combined with patient plasma or serum and checked for agglutination

216
Q

once a properly labelled specimen from recipient received at the blood bank, what happens

A

ABO/Rh typing and antibody screening

217
Q

what happens when an antibody screen is negative

A

proceed with computer crossmatch and issue RBCs

218
Q

what happens when an antibody screen is positive

A

identify antibody

if clinically significant, locate antigen-negative, ABO-compatible RBCs

219
Q

what are the four groups Karl Landsteiner determined that all blood belongs to

A

A
B
AB
O

220
Q

There are two antigens and two antibodies that are mostly responsible for the ABO types

A

A antigen
B antigen
anti-A antibody
anti-B antibody

221
Q

antigen is on the

A

RBC

222
Q

antibody is in the

A

plasma

223
Q

Type A characteristics

A

Antigen A
Anti-B antibody

can’t have B or AB blood
can have A or O blood

224
Q

Type B characteristics

A

Antigen B
anti-A antibody

can’t have A or AB blood
can have B or O blood

225
Q

Type AB characteristics

A

Antigens A+B
neither antibody

can have any type of blood
universal recipient

226
Q

Type O characteristics

A

Neither A or B antigen
both antibodies

can have only O blood
is the universal donor

227
Q

Rh typing is also called

A

D antigen

228
Q

Rh+ means

A

presence of antigen on cell

229
Q

Rh-means

A

absence of antigen

230
Q

___% population is Rh+

A

85%

231
Q

what are the most common distribution of blood types in the US

A

O Rh+

2nd place: A rh+

232
Q

what is the least common distribution of blood types in the US

A

AB Rh-

233
Q

what is the term for transfusion reactions with adverse event due to non immune

A

transfusion complication

ie circulatory overload

234
Q

what is the most serious transfusion reaction

A

anaphylaxis

can kill in minutes

235
Q

when a transfusion reaction is acute, when do the events occur

A

shortly after transfusion

236
Q

when the transfusion reaction is delayed, when do the events occur

A

over 24 hours after transfusion

237
Q

what does it mean when a transfusion reaction is localized

A

remain at site of antigen entry such as a rash

238
Q

what does it mean when a transfusion reaction is systemic

A

reaction takes place throughout body such as hypotension

239
Q

what does it mean when a transfusion reaction is hemolytic

A

involves rupture of red cells (Ag-Ab complex)

240
Q

what is acute HTR

A

acute hemolytic transfusion reaction

-serious and life threatening caused by Ag-Ab response to ABO incompatibility

241
Q

acute HTR immune response leads to

A

intravascular lysis of donor red cells

242
Q

what are signs of acute HTR

A

anaphylactic shock, DIC, renal failure

243
Q

what is delayed HTR

A

delayed hemolytic transfusion reaction

-usually non life threatning and occurs about 2 weeks after transfusion

244
Q

what are the signs of delayed HTR

A

drop in H/H

245
Q

when does febrile transfusion reaction occur

A

usually in patients who have received multiple transfusions

246
Q

what is the most common transfusion reaction

A

febrile transfusion reaction

generally non hemolytic

247
Q

what are symptoms of febrile transfusion reaction

A

temp increase of 1 degree C

chills

248
Q

characteristics of transfusion related acute injury (TRALI)

A
  • pulmonary edema unrelated to cardiac problems or volume overload
  • occurs 1-6 hrs following admin of blood products with plasma
249
Q

what causes TRALI

A

when plasma containing HLA or granulocyte specific antibodies that correspond to antigens found on donor WBCs

-granulocyte enzymes are released and increase capillary permeability leading to pulmonary edema

250
Q

what are symptoms of TRALI

A 
respiratory distres
fever 
cyanosis 
tachycardia
hypotension
hypovolemia
251
Q

what is the most common type of incidence of transfusion reactions

A

allergic

252
Q

what is the least common type of incidence of transfusion reactions

A

hemolytic,fatal

253
Q

how is Hep B transmitted

A

blood transfusion
sexual contact
contaminated needles
occupational or prenatal exposure to contaminated blood

254
Q

what is the diagnosis and incubation period of Hep B

A

incubation period: 2 months - 6 months

diagnosis: symptoms and presence of HBsAg or HBcAg

255
Q

what will the Hep H vaccine have

A

surface antibody present

not HBsAg or HBcAg

256
Q

what is the risk of transmission (RT) for Hep B

A

1/66,000 - 1/200,000

257
Q

what is the most widespread and deadliest type of hepatitis

A

hep C

258
Q

how is Hep C spread

A

contaminated IV needles
sexual contact w infected person
contaminated blood transfusion

259
Q

what test is available for Hep C

A

detect HCV antibodies

260
Q

what is the mean incubation time and risk of transmission for Hep C

A

mean incubation time: 6-8 weeks

RT = 1/121,000

261
Q

what can human immunodeficiency virus (HIV) cause

A

AIDS

262
Q

how is HIV transmitted

A

through sharing of contaminated IV needles or contact with infected person’s body fluids

263
Q

what does the HIV-1 antigen test

A

presence of p24 antigen of HIV vs presence of antibodies produced in response to HIV

264
Q

RT for HIV

A

1/563,000 - 1/825,000

265
Q

what is the human T-lympocytotrophic virus (HTLV-1)

A

retrovirus that is endemic to Caribbean and Japan

266
Q

how is HTLV-1 transmitted

A

through blood cell component transfusion

NOT PLASMA TRANSFUSION

267
Q

HRLV-1 is also involved with

A

leukemia
lymphoma
neurological disease

268
Q

what is CMV

A

cytomegalovirus

in herpes daily

269
Q

what can CMV do and who is at risk

A

can infect kidney, lung, liver, leukocytes, epithelial cells

at risk is people with incompetent immune system

270
Q

how to prevent potential problems of CMV

A

transfusing CMV negative blood or frozen deglycerolized RBCs

271
Q

donors traveling to high risk malaria areas are excluded from donating blood for

A

six months

272
Q

other disease that are rarely transmitted by RBC

A

malaria
babesiosis
lyme disease
Chagas’ disease

Hemology (2 decks)

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