Hematology

Question 1

Which blood product is given to increase O2 carrying capacity?

Answer 1

PRBC’s

Question 2

One unit of PRBC’s should increase H/H by __ and __.

Answer 2

1

3

Question 3

Due to antigens on RBC’s, watch for ___________.

Answer 3

Acute Hemolytic reaction (increased temp)

Question 4

Multiple units of PRBC’s (4 units <20 min) can cause?

Answer 4

Citrate toxicity (Give calcium)

Question 5

Administration of PRBC’s

Answer 5

Warm blood
Add equal volume of NS
Watch for HyperK, Citrate toxicity, and Left shift of OHDC

Question 6

Hemolytic Reaction

Answer 6

Fever, back pain, dyspnea
Short onset
Stop transfusion

Question 7

True or False: If patient develops a fever 30 -90 minutes post infusion, they are having a hemolytic reaction.

Answer 7

False, Hemolytic reactions occur almost immediately. Febrile reactions occur slowly and are due to antibody reactions.

Question 8

Acute hemolytic reactions

Answer 8

30-50% of acute hemolytic reactions will develop DIC and die.
Support with fluids, pressers, diuretics, and oxygenation

Question 9

Fresh frozen plasma indications

Answer 9

Replaces exhausted coagulation factors

Coumadin therapy reversal, DIC, Antithrombin III deficiency, Dilutional coagulopathy

Question 10

Platelet indications

Answer 10

Platelet deficiency (<50k)

Question 11

Cryoprecipitate indications

Answer 11

High level of fibrinogen and separate factors not in FFP

DIC, Hemophilia A, TPA induced bleeding, Von Willebrand disease

Question 12

Normal RBC

Answer 12

5

Question 13

Normal Hgb

Answer 13

15

Question 14

Normal Hct

Answer 14

45

Question 15

Normal Plt

Answer 15

150k-400k

Question 16

What is primary hemostasis?

Answer 16

Platelet plug development

Question 17

What is secondary hemostasis?

Answer 17

Clot formation occurs

Question 18

Intrinsic clotting pathway

Answer 18

Triggered by endothelial damage with collagen exposure which activated platelets, initiates clotting cascade

Question 19

Extrinsic clotting pathway

Answer 19

Triggered by tissue damage with tissue thromboplastin release which activates platelets and initiates clotting cascade

Question 20

Which electrolyte is essential at numerous steps of clotting cascade?

Answer 20

Calcium

Question 21

Fluid replacement should be ___ of crystalloid to ___ of blood loss

Answer 21

3 liters

1 liter

Question 22

Define Disseminated Intravascular Coagulopathy

Answer 22

Systemic activation of clotting cascade by overwhelming release of tissue thromboplastin

Question 23

Causes of DIC

Answer 23

Sepsis
Massive trauma
Hypoxia

Question 24

S/S of DIC

Answer 24

History of recent trauma
Positive D-Dimer
Low clotting factors (fibrinogen / platelets)
High PT, aPTT, INR

Question 25

Treatment of DIC

Answer 25

Focus on correcting underlying pathology

Replace clotting factors using FFP, Cryo, Platelets

Question 26

Highest quantities of tissue thromboplastin is in the ___ and ____.

Answer 26

Brain

Placenta

Question 27

Normal WBC

Answer 27

5-10k

Question 28

Normal PT

Answer 28

Prothrombin time: 11 seconds

Question 29

Normal PTT

Answer 29

Partial thromboplastin time: 21-35 seconds

Question 30

Normal INR

Answer 30

International Normalized Ratio : 1.0> (clot less)

Question 31

What labs are drawn in a Chem 7 (basic metabolic panel)

Answer 31

Na+
K+
Cl-
Hco3-
BUN
CR
Glucose