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T2: Theme 2: Blood > Lecture 8: Blood transfusions > Flashcards

Lecture 8: Blood transfusions Flashcards

1
Q

What are agglutinins?

A

Naturally occurring pentameric IgM antibodies

Link RBCs together

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2
Q

What shape are ABO antibodies

A

IgM pentameric Abs

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3
Q

What is the main consequence of a transfusion with incompatible blood?

A

Intravascular lysis

Can lead to - shock, HT, tachycardia, renal failure, loin pain, DIC and death

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4
Q

Describe the ABO blood grouping system

A

A: A Ag, anti-B Abs

B: B Ag, anti-A Abs

AB: A and B Ags, no Abs

O: no Ags, anti-A and anti-B Abs

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5
Q

What is forward grouping?

A

Test the Ag on RBC surface

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6
Q

What is reverse grouping?

A

Test Ab in plasma

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7
Q

Who can AB give blood to and receive blood from?

A

Give to AB

Receive from AB, A, B and O

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8
Q

Who can A give blood to and receive blood from?

A

Give to A and AB

Receive from A and O

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9
Q

Who can B give blood to and receive blood from?

A

Give to B and AB

Receive from B and O

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10
Q

Who can O give blood to and receive blood from?

A

Give to AB, A, B and O

Receive from O

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11
Q

What are the frequencies of each blood group?

A

O - 46%
A - 42%
B - 9%
AB - 3%

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12
Q

What does coagulation at the top of a blood grouping card mean?

A

Positive reaction

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13
Q

What are atypical Abs?

A

Arise due to sensitisation with foreign red cell Ags caused either by previous blood transfusion or pregnancy

Can cause transfusion reaction if the patient is transfused with incompatible blood in the future

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14
Q

What is the direct anti-globin test (Coombes)?

A

Tells you if the RBCs are coated with an Ab

Positive after a transfusion reaction and in HDN

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15
Q

What is the indirect anti-globin test (Coombes)?

A

Tells you in the patient is positive for Rhesus and other blood groups

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16
Q

What % of people are rhesus negative?

A

15%

17
Q

What Ab is generated during rhesus sensitisation?

A

IgG

18
Q

Which is the most important Ag in rhesus?

A

RhD

19
Q

What is HDN?

A

Caused by Rh sensitisation

If a mother, who is Rh neg is pregnant with a Rh positive foetus, she may produce Abs that can cross the placenta and harm the baby

20
Q

What can result from HDN?

A

Anaemia, jaundice and kernicterus (brain damage)

21
Q

How is HDN prevented?

A

Rh +ve women receive antiD Ab IM injection at 28 and 34 weeks to prevent sensitisation

If baby is Rh +ve after birth the mother receives further anti-D until foetal cells become negative

If already sensitised the foetus is monitored by transcranial doppler and may receive intra-uterine transfusions

22
Q

What is in the buffy coat?

A

White blood cells and platelets

23
Q

What is in plasma?

A

Albumin, gamma globulins, coagulation factors

24
Q

What is the name for the process where blood is taken from one arm, a single blood component is removed and then the blood is returned to the patient via their other arm?

A

Apheresis

25
Q

When do you give a transfusion?

A

Severe acute blood loss: RTA, GI blood loss, obstetric blood loss

Elective surgery associated with significant blood loss

Medical transfusions: cancer, chemotherapy, renal failure

26
Q

What blood components can be given during a transfusion?

A

Red cells, platelets, FFP, cryoprecipitate

Plasma derivatives: pooled products - Its, coagulation factors, albumin

Autologous blood

27
Q

What is the difference between FFP and cryoprecipitate?

A

Cryoprecipitate is enriched with fibrinogen

28
Q

What reactions can occur as a result of a blood transfusion?

A

Major ABO incompatibilities (acute renal failure, DIC, death)

Anaphylaxis and severe allergic reaction

Minor allergic reactions

Late transfusion reactions

Fluid overload

29
Q

How do you treat iron overload?

A

Iron chelation

30
Q

How do you treat fluid overload?

A

Diuretics

31
Q

What bacterial infections may be transmitted by transfusion?

A

Syphylis

Pyogenic infections

Contamination infections (pseudomonas)

32
Q

What viral infections may be transmitted by transfusion?

A

Hepatitis (B and C)

HIV

CML

T2: Theme 2: Blood (8 decks)

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