part 5 Flashcards
1
Q
reasons why blood is being donated or transfused
A
- trauma
- inadequate of O2 carrying capacity
- decrease coagulation proteins for hemostasis
- autologous donor
- component therapy
2
Q
whole blood and PRBC infusion starts after the removal of storage for how many mins.
A
30 mins
3
Q
whole blood and PRBC infusion will be completed for how many hours
A
4 hours
4
Q
platelet infusion will be completed for how many hours
A
20 mins
5
Q
Free frozen plasma infusion will be completed for how many hours
A
20 mins
6
Q
for PLT and FFP why there is a need to be completed ASAP
A
to avoid the loss of labile clotting factors
7
Q
most important step during infusion
A
proper identification
8
Q
when to perform proper identification
A
before and during collection
9
Q
how many hours does a collection of 1 unit of blood bag happens
A
1-2hours
10
Q
how many hours does a collection of 1 unit of blood bag happens but slow flow of blood
A
4 hours
11
Q
If an emergency event happened what blood type should be infused
A
Group O rbc
12
Q
If an emergency event happened what blood type should be infused for child bearing female
A
Group O negative
13
Q
If an emergency event happened what blood type should be infused for rh(-) male and older women
A
Rh negative
14
Q
If an emergency event happened what blood type should be infused for rh(-) male and older women
BUT
there is only few units of rh(-) left
A
Rh positive blood
15
Q
can you return blood?
A
yes, if it belongs to the exceptions
16
Q
what are the exceptions of reissue of blood
A
- container closure is not disturbed
- Blood was not warmed at >10C
- Blood was not placed in a cool temp (<1C)
- sealed segment of integral donor tubing is still attached to the container
17
Q
what to label of returned blood
A
Reissue
18
Q
any transfusion related adverse effect that occurs during or after transfusion
A
transfusion reaction
19
Q
the most severe reaction but not common
A
acute hemolytic transfusion reaction
20
Q
what is the cause of acute HTR
A
ABO compatibility; where there is an IgG and complement activation
21
Q
how many mL of incompatible blood can cause reaction
A
10mL
22
Q
the symptoms of Acute HTR appears within?
A
24 hrs
23
Q
what are the symptoms of acute HTR
A
Oliguria/Anuria
Hyotension
Tachycardia
Hemoglobinuria
fever, chills, dyspnea
24
Q
Acute HTR may result to?
A
Disseminated intravascular coagulation
Renal failure
Shock
Death
25
What transfusion reaction:
Increase free hemoglobin
Increase bilirubin (after 6 hrs)
Decrease haptoglobin
(+)DAT
Acute HTR
26
Lab result for acute HTR
Increase free hemoglobin
Increase bilirubin (after 6 hrs)
Decrease haptoglobin
(+)DAT
27
why there is an increase of free hemoglobin during acute HTR
The antibody attached to the foreign rbc resulting to the activation of complement system, this will result to the formation of MAC causing the rupture of rbc releasing hemoglobin in the plasma
28
why there is an increase of bilirubin and why after 6 hours
the release of hemoglobin will be processed in the liver where it will be converted into bilirubin and released in the blood stream
29
why there is a decrease of haptoglobin in acute HTR
the haptoglobin binds to hemoglobin where the liver clears out these complex
30
what is the most common transfusion reaction
febrile non hemolytic transfusion reaction
31
these transfusion reaction is where there is an increase of temp at about 1C within 8-24 hours after transfusion
febrile non hemolytic transfusion reaction
32
what is the cause of febrile non hemolytic transfusion reaction
presence of HLA antigen in the donor WBC and PLT vs. recepient antibodies
33
how to avoid febrile non hemolytic transfusion reaction
1. use WBC filter
2. use leukopoor RBC
34
symptoms of febrile non-hemolytic transfusion reaction
1. fever/chills
2. vomitting
3. increase blood pressure
4. tachycardia and tachypnea
35
what is the second most common transfusion reaction
allergic transfusion reaction
36
the symptoms of allergic transfusion reaction vary according to?
reaction degree
37
cause of allergic transfusion reaction
due to the activation of mast cells in the patient against the allergen
38
what immunoglobulin cause allergic transfusion reaction
IgE, reagin
39
Allergen + mast cells + Mast cells will result to the release of?
histamine
other granule content that belongs to the type 1 hypersensitivity
40
a reaction from non IgE mediated release of mast cell mediators
anaphylactoid
41
what is anaphylactoid
a reaction from non IgE mediated release of mast cell mediators
42
symptoms of allergic transfusion reaction
urticaria
erythema
hives
itching (pruritus)
anaphylaxis
43
what to do if there is an allergic transfusion reaction
give histamine
used washed rbc
44
what drugs to give if there is a severe allergic transfusion reaction
Aminophylline
Epinephrine
Corticosteroid
45
what is the cause of anaphylactic transfusion reaction
1. plasma protein
2. IgA deficient
3. Anti-IgA
46
these transfusion reaction has a symptoms of mild urticarial but no fever
anaphylactic transfusion reaction
47
symptoms of anaphylactic transfusion reaction
mild urticarial but no fever
48
how to avoid urticarial transfusion reaction
transfuse IgA deficient components
49
non cardiogenic pulmonary edema is also known as
transfusion reaction associated lung injury
transfusion related acute lung injury
50
these transfusion is an acute reaction with respiratory distress, severe hypoxia during 6 hrs. of transfusion
non cardiogenic pulmonary edema
51
cause of non cardiogenic pulmonary edema
HLA problems of donor or patient
52
symptoms of non cardiogenic pulmonary edema
fever
hypotension
53
these is the leading cause of transfusion associated fatalities
non cardiogenic pulmonary edema
54
non cardiogenic pulmonary edema is the leading cause of
transfusion related fatalities
55
non cardiogenic pulmonary edema is associated with
1. pulmonary hypersensitivity edema
2. allergic pulmonary edema
56
how to avoid non cardiogenic pulmonary edema
use leukopoor blood
57
what are the non immunogenic transfusion reaction
1. bacterial contamination
2. transfusion associated circulatory overload
3. transfusion induced hemosiderosis
58
transfusion associated sepsis
bacterial contamination
59
these transfusion has a temp of 2C or more above normal and can be accompanied by hypotension
bacterial contamination
60
cause of bacterial contamination
endotoxin of gram neg bacteria (grows in cold temp)
61
what are the cold growing bacteria
1. Yersinia enterolitica
2. Escherichia coli
3. Pseudomonas
4. Propionibacterium acnes
5. Bacillus cercus
62
how does the bacteria enter the blood bag
1. during preparation
2. accidental open of unit
63
symptoms of bacterial contamination
dryness
flushing of skin
64
what to check in the blood bag always
color change
clots
cloudiness
hemolysis
perform grams staining and culture
65
bacterial contamination occurs during
phlebotomy
thawing
from contaminated platelet units
66
these transfusion reaction is when the cardiovascular sytems ability to handle additional workload is exceeded
transfusion associated circulatory overload
67
transfusion associated cirrculatory overload is also known as
Iatrogenic transfusion reaction
68
transfusion associated circulatory overload is mostly caused by
physician
69
common patient of transfusion associated circulatry overload
cardiac and pulmonary patient
70
hypervolemia or the fluid overload may lead to
1. Congestive heart failure
2. pulmonary edema
3. cardiomegaly
4. distended pulmonary artery
71
symptoms of transfusion associated circulatory overload
headache
dyspnea
coughing
chest tightness
hypertension
72
what to do if the patient has transfused associated circulatory overload
1. patient sit up straight
2. give supplemental oxygenation
3. start diuresis
4. donor blood should be aliquoted
5. therapeutic phlebotomy
6. slow down transfusion
73
why we need to start diuresis in transfusion associated circulatory overload
to reduce excess body fluid, reducing the overall blood volume
74
diagnosis for transfusion associated circulatory overload
PRO-BNP (Brain natriuretic peptide)
75
what transfusion reaction happens after 14 days
delayed hemolytic transfusion reaction
76
delayed HTR happens after?
14 days
77
cause of delayed HTR
1. new red cell antibodies detection
2. due to a secondary response
3. due to IgG antibodies to Rh, kell, kidd, duffy antigens
78
lab diagnosis of delayed HTR
decrease both hemoglobin and hematocrit
79
signs of delayed HTR (5-7 days)
fever
mild jaundice
80
cause of transfusion associated graft-versus-host
the donor lymphocyte attack the transfusion recepient
81
what will happen when the donor lymphocyte attacks the transfusion recipient
profound marrow aplasia occurs
82
mortality rate of profound marrow aplasia
>90%
83
when does profound marrow aplasia happens
after 1st symptoms appears
84
transfusion associated graft-versus-host is associated with?
maculopapular rash
85
signs of transfusion associated graft-versus-host
fever
liver problem
rash
diarrhea
pancytopenia
86
severe transfusion associated graft-versus-host may lead to
sepsis
hemorrhage
87
the signs of transfusion associated graft-versus-host will shows after
3-30 days after transfusion
88
who are the high risk patients for transfusion associated graft-versus-host
infants
cancer patients
immunocompromised patients
89
for transfusion associated graft-versus-host what blood must be used
irradiated blood component
90
the number of lymphocyte in bag is determined by
age of blood component
91
diagnostic tests of transfusion associated graft-versus-host
skin biopsy
bone marrow examination
liver biopsy
molecular studies
92
disease is commonly transferred during?
transfusion
93
what is the most common blood borne disease
heap B and C
94
what are the blood borne diseases
hepatitis
hiv
malaria
syphilis
95
these transfusion reaction is common on older women
post transfusion reaction
96
post transfusion reaction is associated with
severe thrombocytopenia
bleeding
97
when does post transfusion reaction usually happens
after 1-24 days of transfusion
98
what is the cause of post transfusion reaction
patient previously sensitized to platelets due to transfusion of prev. pregnancy
99
the post transfusion reaction destroys
transfused PLT
autologous PLT
100
what is the most implicated in the post transfusion reaction
Human platelet antigen 1a
101
true or false:
post transfusion reaction is self-limiting
true
102
why does post transfusion reaction called self limiting
the PLT number turn back to normal within 2 wks
103
post transfusion reaction treatment
infused intravenous immunoglobulin
104
excessive accumulation of iron deposits
hemosiderosish
105
how does hemosiderosis related to transfusion
if there is an rbc transfused there is a build up of iron
106
cause of transfusion induced hemosiderosis
presence of iron deposits in vital organ such as liver and spleen
107
what organs does iron usually present
liver and spleen
108
how are the high risk for transfusion induced hemosiderosis
thalassemia
chronic transfusion patient
109
what therapy is the most important for transfusion induced hemosiderosis
iron chelating therapy
110
iron is being removed in a form of
urine
feces
111
where does chelating agents bind with iron
in the tissues
112
what are the chelating agents
deferoxamine
oral deferiprone
defecation
113
what is the alternative for transfusion therapy
red cell exchange transfusion
114
two types of blood donor
autologous
allogenic
115
most dangerous blood type
abo
116
what are the cause of the most dangerous blood type
acute htr
117
what is the testing of acute htr
positive for DAT
118
how to identify bacterial contamination
check for color, cloudiness, clot, hemolysis,
perform gram staining and culture
119
what does iatrogenic means
error of illness caused by physician
120
proliferation of component lymphocyte
transfusion associated graft versus host
121
donor lymphocytes attack the transfusion recepient
transfusion associated graft versus disease
122
what is the reaction of transfusion associated graft versus host
maculopapular rash
123
explain what is fnhtr
where there is an increase of temperature (1C) within 8-24 hrs)
124
viability of FFP
20 mins
125
treatment for PTP
infuse intravenous immunoglobulin
