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Hematology Exam 2 > Lec 16 - Blood Components Therapy > Flashcards

Lec 16 - Blood Components Therapy Flashcards

1
Q

Why is blood component therapy preferable to whole blood therapy?

A
  • allows for more compatible options

- more precise

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2
Q

platelet indications

A

-prophylaxis: stable patients with platelet counts <100K/uL

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3
Q

clinical presentation of TTP

A

THINK “MNRFT”

  • M-microangiopathic hemolytic anemia
  • N-neurologic changes
  • R-renal impairment
  • F-fever
  • T-thrombocytopenia

physiology: decreased ADAMTS-13 level

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4
Q

treatment of TTP

A

-give plasma to replenish ADAMTS-13 enzyme

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5
Q

mechanism of alloimmunization

A
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6
Q

significance of alloimmunization

A

-can get hemolytic reaction in patient if they have antibody to something in the blood you are about to give them

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7
Q

how to decrease chances of alloimmunization

A

need to test and match blood very well before giving it to patient

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8
Q

indications for massive transfusion

A

-someone is bleeding out - order MTP

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9
Q

factor 8 concentrate

  • what is it?
  • what is it used for?
A

plasma derivative: used for hemophelia A patients (DONT USE CRYO if F8 concentrate is available)

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10
Q

CMV negative indications

A

Uses:

  • Fetuses (IUT-intra uterine)
  • LBW (low birth weight) preemies bron to CMV neg moms
  • solid organ or allogeneic hematopoetic transplant patients from CMV seronegative donors
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11
Q

washed indications

A
  • give to:
  • –neonates undergoing large volume transfusion
  • –IgA deficient patients with anti IgA IgE
  • –history of severe, progressive allergic transfusion reaction
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12
Q

irradiated indications

A

give to patient with aplastic anemia

ONLY REASON TO GIVE is to prevent TA-GVHD (transplant associated-graft v host disease

-IT INACTIVATES WHITE BLOOD CELLS TO PREVENT GVHD

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13
Q

Why give red blood cells?

A

Only to increase O2 carrying capacity

NOT to inc plasma osmolality or for anemias that can be corrected wtih B12, folate, etc

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14
Q

two type of platelet products:

A

1) single donor apheresis platelets (pull out everything from blood except what you want and give the patient the rest back)
2) whole blood derived pooled platelets - typically from 6-units of whole blood

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15
Q

plasma indications

A
  • bleeding patients with INR>1.8
  • emergency coumadin reversal
  • bleeding with dilutional coagulopathy
  • bleeding with severe liver failure
  • TTP treatment
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16
Q

What is ADAMTS-13?

A

enzyme that cleaves vWF multimers so that that they dont accumulate and impede flow of stuff in the vasculature (schistocytes stuff)

usually an antibody interferes with function of ADAMTS-13

17
Q

apheresis of component important to help treat what problem

  • red cells
  • leukocytes
  • platelets
  • plasma
A
  • RBC ==> sickle cell
  • leukocytes ==> acute leukemia
  • platelets ==> thrombocytosis
  • plasma ==> neurologic diseases and TTP
18
Q

primary use for cryoprecipitate?

A

someone with low fibrinogen (usually DIC)

19
Q

mnemonic for which RBC antigens matter?

A

Kell Kills
Duffy Dies
Lewis Lives

20
Q

Massive transfusion considerations:

A

1-potassium toxicity -(K leaks out of cells with storage) esp in infants and cardiac toxicity
2-citrate toxicity - (citrate bind Ca) hypocalcemia, hypomagnesemia, cardiac dysrythmia
3-hypothermia (significantly cool core body temp if give colder blood)- inc Hb-O2 affinity
4-coagulopathy

21
Q

Do NOT give irradiated products to:

A

sickle cell
thallasemia patients

-also not required for solid organ transplant; HIV/AIDS; cardiovasc surgery patients

22
Q

IV albumin:

  • what is it?
  • what is it used for?
A

-plasma derivative:

made from pooled plasma. can be used to maintain oncotic pressure of intravascular space in burn and cirrhotic patients

23
Q

intavenous immune globulin (IVIG):

  • what is it?
  • what is it used for?
A

-plasma derivative: from pooled plasma. Uses: maintenance treatment of immune deficiencies and ITP

24
Q

prothrombin complex concentrate:

  • what is it?
  • what is it used for?
A

-plasma derivative:from pooled human plasma

25
Q

Kcentra:

  • what is it?
  • what is it used for?
A

-plasma derivative: for warfarin reversal - contains all the Vit K dependent clotting factors

Hematology Exam 2 (10 decks)

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