ITE CA2 Heme Flashcards
The gold standard laboratory analysis of platelet function is
The gold standard laboratory analysis of platelet function is optical aggregometry, though viscoelastic monitoring of coagulation is a reasonable surrogate if the appropriate assays are utilized.
shortest half-life of the vitamin K dependent factors
Factor VII has the shortest half-life of the vitamin K dependent factors and is an early and reliable measure of potentially severe liver dysfunction.
factors made outside the liver
III, VIII, XIII (also liver)
Simple febrile reactions to blood product administration are usually due
Simple febrile reactions to blood product administration are usually due to antibodies that the host has formed against human leukocyte antigens (HLAs) present on donor leukocytes. The febrile period is usually mild, short-lived, and can be treated with acetaminophen.
Signs and symptoms of hemolytic transfusion reactions may include
Signs and symptoms of hemolytic transfusion reactions may include fever, chills, nausea, vomiting, diarrhea, chest and back pain, acute renal failure (ARF) and disseminated intravascular coagulation (DIC).
Anaphylactic reactions to blood product transfusions
Anaphylactic reactions (IgE-mediated) to blood product transfusions classically occur in patients with hereditary IgA deficiency. These patients have been sensitized by previous transfusions or by pregnancy with subsequent exposure to blood with foreign IgA protein. Signs and symptoms of anaphylaxis may include bronchospasm, dyspnea, hypotension, tachycardia, and angioedema
what electrolyte change from MTP
mechanism
EKG changes
Citrate is added to most blood products as a preservative and to prevent clotting. Administering blood products at a rapid rate and in large amounts can result in decreased plasma levels of ionized calcium due to chelation by citrate. Most of the citrate administered during massive transfusions is in fresh frozen plasma and not in packed red blood cells (PRBCs). Hypotension, narrow pulse pressure, prolonged QT interval, widening of the QRS complexes, and flattened T waves can occur as a result of hypocalcemia.
bacterial contamination of blood products
Bacterial contamination of blood products occurs at a much higher frequency than most other infections associated with transfusions. There is a substantially higher risk of contamination of platelets compared to PRBCs as platelets are stored at room temperature. A patient who has received blood products contaminated with bacteria will rapidly experience a variety of symptoms, including fever, chills, tachycardia, dyspnea, emesis, and shock. They may also develop DIC and ARF.
Normal values for TEG R time Alpha angle Max amplitude LY30
Normal values for thromboelastography can be remembered by the rule of 6’s:
- R time around 6 minutes
- Alpha angle around 60 degrees
- Maximal amplitude around 60 mm
- LY30 of around 6%
what does plasmin do
plasmin generation, the mechanism of action of which is a proteolytic degradation of fibrin and fibrinogen.
The most common adverse reaction to transfusions is a _____ reaction, which is caused by
The most common adverse reaction to transfusions is a febrile reaction, which is caused by the release of cytokines by donor leukocytes. Therefore, using leukoreduced blood can reduce the incidence of febrile reactions.
Even can happen with platelets
TRALI mechanism
Transfusion-related acute lung injury (TRALI) is an immune-mediated reaction that involves antibodies directed toward human leukocyte antigens (HLA), with the release of cytokines and vasoactive mediators that cause non-cardiac pulmonary edema.
Anaphylactoid reactions in blood transfusion
Anaphylactoid reactions are clinically similar to anaphylaxis but are not IgE-mediated. They are caused by a release of mediators from mast cells and basophils, with activation of the complement system.
What is in cryo?
Cryoprecipitate (cryo) contains a concentrated subset of FFP components including fibrinogen, factor VIII coagulant, vonWillebrand factor, and factor XIII.
blood transfusion increased risk from first degree relative
and how to reduce risk
Graft versus host disease (GVHD) can occur when a directed blood donation from a blood relative is used, especially a first-degree relative. Similarities in human leukocyte antigen (HLA) between close relatives increases the risk of GVHD. The number and viability of donor T lymphocytes affects the risk as well. To reduce this risk, directed donor blood is irradiated to eliminate donor lymphocytes. Even though directed donors are typically relatives, the blood is subject to the same rigorous screening and there is no evidence that directed blood donation is any safer.
