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BB LEC > part 5 > Flashcards

part 5 Flashcards

1
Q

reasons why blood is being donated or transfused

A
  1. trauma
  2. inadequate of O2 carrying capacity
  3. decrease coagulation proteins for hemostasis
  4. autologous donor
  5. component therapy
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2
Q

whole blood and PRBC infusion starts after the removal of storage for how many mins.

A

30 mins

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3
Q

whole blood and PRBC infusion will be completed for how many hours

A

4 hours

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4
Q

platelet infusion will be completed for how many hours

A

20 mins

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5
Q

Free frozen plasma infusion will be completed for how many hours

A

20 mins

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6
Q

for PLT and FFP why there is a need to be completed ASAP

A

to avoid the loss of labile clotting factors

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7
Q

most important step during infusion

A

proper identification

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8
Q

when to perform proper identification

A

before and during collection

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9
Q

how many hours does a collection of 1 unit of blood bag happens

A

1-2hours

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10
Q

how many hours does a collection of 1 unit of blood bag happens but slow flow of blood

A

4 hours

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11
Q

If an emergency event happened what blood type should be infused

A

Group O rbc

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12
Q

If an emergency event happened what blood type should be infused for child bearing female

A

Group O negative

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13
Q

If an emergency event happened what blood type should be infused for rh(-) male and older women

A

Rh negative

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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

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15
Q

can you return blood?

A

yes, if it belongs to the exceptions

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16
Q

what are the exceptions of reissue of blood

A
  1. container closure is not disturbed
  2. Blood was not warmed at >10C
  3. Blood was not placed in a cool temp (<1C)
  4. sealed segment of integral donor tubing is still attached to the container
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17
Q

what to label of returned blood

A

Reissue

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18
Q

any transfusion related adverse effect that occurs during or after transfusion

A

transfusion reaction

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19
Q

the most severe reaction but not common

A

acute hemolytic transfusion reaction

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20
Q

what is the cause of acute HTR

A

ABO compatibility; where there is an IgG and complement activation

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21
Q

how many mL of incompatible blood can cause reaction

A

10mL

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22
Q

the symptoms of Acute HTR appears within?

A

24 hrs

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23
Q

what are the symptoms of acute HTR

A

Oliguria/Anuria
Hyotension
Tachycardia
Hemoglobinuria
fever, chills, dyspnea

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24
Q

Acute HTR may result to?

A

Disseminated intravascular coagulation
Renal failure
Shock
Death

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25
Q

What transfusion reaction:
Increase free hemoglobin
Increase bilirubin (after 6 hrs)
Decrease haptoglobin
(+)DAT

A

Acute HTR

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26
Q

Lab result for acute HTR

A

Increase free hemoglobin
Increase bilirubin (after 6 hrs)
Decrease haptoglobin
(+)DAT

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27
Q

why there is an increase of free hemoglobin during acute HTR

A

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

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28
Q

why there is an increase of bilirubin and why after 6 hours

A

the release of hemoglobin will be processed in the liver where it will be converted into bilirubin and released in the blood stream

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29
Q

why there is a decrease of haptoglobin in acute HTR

A

the haptoglobin binds to hemoglobin where the liver clears out these complex

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30
Q

what is the most common transfusion reaction

A

febrile non hemolytic transfusion reaction

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31
Q

these transfusion reaction is where there is an increase of temp at about 1C within 8-24 hours after transfusion

A

febrile non hemolytic transfusion reaction

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32
Q

what is the cause of febrile non hemolytic transfusion reaction

A

presence of HLA antigen in the donor WBC and PLT vs. recepient antibodies

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33
Q

how to avoid febrile non hemolytic transfusion reaction

A
  1. use WBC filter
  2. use leukopoor RBC
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34
Q

symptoms of febrile non-hemolytic transfusion reaction

A
  1. fever/chills
  2. vomitting
  3. increase blood pressure
  4. tachycardia and tachypnea
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35
Q

what is the second most common transfusion reaction

A

allergic transfusion reaction

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36
Q

the symptoms of allergic transfusion reaction vary according to?

A

reaction degree

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37
Q

cause of allergic transfusion reaction

A

due to the activation of mast cells in the patient against the allergen

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38
Q

what immunoglobulin cause allergic transfusion reaction

A

IgE, reagin

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39
Q

Allergen + mast cells + Mast cells will result to the release of?

A

histamine
other granule content that belongs to the type 1 hypersensitivity

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40
Q

a reaction from non IgE mediated release of mast cell mediators

A

anaphylactoid

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41
Q

what is anaphylactoid

A

a reaction from non IgE mediated release of mast cell mediators

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42
Q

symptoms of allergic transfusion reaction

A

urticaria
erythema
hives
itching (pruritus)
anaphylaxis

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43
Q

what to do if there is an allergic transfusion reaction

A

give histamine
used washed rbc

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44
Q

what drugs to give if there is a severe allergic transfusion reaction

A

Aminophylline
Epinephrine
Corticosteroid

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45
Q

what is the cause of anaphylactic transfusion reaction

A
  1. plasma protein
  2. IgA deficient
  3. Anti-IgA
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46
Q

these transfusion reaction has a symptoms of mild urticarial but no fever

A

anaphylactic transfusion reaction

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47
Q

symptoms of anaphylactic transfusion reaction

A

mild urticarial but no fever

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48
Q

how to avoid urticarial transfusion reaction

A

transfuse IgA deficient components

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49
Q

non cardiogenic pulmonary edema is also known as

A

transfusion reaction associated lung injury
transfusion related acute lung injury

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50
Q

these transfusion is an acute reaction with respiratory distress, severe hypoxia during 6 hrs. of transfusion

A

non cardiogenic pulmonary edema

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51
Q

cause of non cardiogenic pulmonary edema

A

HLA problems of donor or patient

52
Q

symptoms of non cardiogenic pulmonary edema

A

fever
hypotension

53
Q

these is the leading cause of transfusion associated fatalities

A

non cardiogenic pulmonary edema

54
Q

non cardiogenic pulmonary edema is the leading cause of

A

transfusion related fatalities

55
Q

non cardiogenic pulmonary edema is associated with

A
  1. pulmonary hypersensitivity edema
  2. allergic pulmonary edema
56
Q

how to avoid non cardiogenic pulmonary edema

A

use leukopoor blood

57
Q

what are the non immunogenic transfusion reaction

A
  1. bacterial contamination
  2. transfusion associated circulatory overload
  3. transfusion induced hemosiderosis
58
Q

transfusion associated sepsis

A

bacterial contamination

59
Q

these transfusion has a temp of 2C or more above normal and can be accompanied by hypotension

A

bacterial contamination

60
Q

cause of bacterial contamination

A

endotoxin of gram neg bacteria (grows in cold temp)

61
Q

what are the cold growing bacteria

A
  1. Yersinia enterolitica
  2. Escherichia coli
  3. Pseudomonas
  4. Propionibacterium acnes
  5. Bacillus cercus
62
Q

how does the bacteria enter the blood bag

A
  1. during preparation
  2. accidental open of unit
63
Q

symptoms of bacterial contamination

A

dryness
flushing of skin

64
Q

what to check in the blood bag always

A

color change
clots
cloudiness
hemolysis

perform grams staining and culture

65
Q

bacterial contamination occurs during

A

phlebotomy
thawing
from contaminated platelet units

66
Q

these transfusion reaction is when the cardiovascular sytems ability to handle additional workload is exceeded

A

transfusion associated circulatory overload

67
Q

transfusion associated cirrculatory overload is also known as

A

Iatrogenic transfusion reaction

68
Q

transfusion associated circulatory overload is mostly caused by

A

physician

69
Q

common patient of transfusion associated circulatry overload

A

cardiac and pulmonary patient

70
Q

hypervolemia or the fluid overload may lead to

A
  1. Congestive heart failure
  2. pulmonary edema
  3. cardiomegaly
  4. distended pulmonary artery
71
Q

symptoms of transfusion associated circulatory overload

A

headache
dyspnea
coughing
chest tightness
hypertension

72
Q

what to do if the patient has transfused associated circulatory overload

A
  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
Q

why we need to start diuresis in transfusion associated circulatory overload

A

to reduce excess body fluid, reducing the overall blood volume

74
Q

diagnosis for transfusion associated circulatory overload

A

PRO-BNP (Brain natriuretic peptide)

75
Q

what transfusion reaction happens after 14 days

A

delayed hemolytic transfusion reaction

76
Q

delayed HTR happens after?

A

14 days

77
Q

cause of delayed HTR

A
  1. new red cell antibodies detection
  2. due to a secondary response
  3. due to IgG antibodies to Rh, kell, kidd, duffy antigens
78
Q

lab diagnosis of delayed HTR

A

decrease both hemoglobin and hematocrit

79
Q

signs of delayed HTR (5-7 days)

A

fever
mild jaundice

80
Q

cause of transfusion associated graft-versus-host

A

the donor lymphocyte attack the transfusion recepient

81
Q

what will happen when the donor lymphocyte attacks the transfusion recipient

A

profound marrow aplasia occurs

82
Q

mortality rate of profound marrow aplasia

A

> 90%

83
Q

when does profound marrow aplasia happens

A

after 1st symptoms appears

84
Q

transfusion associated graft-versus-host is associated with?

A

maculopapular rash

85
Q

signs of transfusion associated graft-versus-host

A

fever
liver problem
rash
diarrhea
pancytopenia

86
Q

severe transfusion associated graft-versus-host may lead to

A

sepsis
hemorrhage

87
Q

the signs of transfusion associated graft-versus-host will shows after

A

3-30 days after transfusion

88
Q

who are the high risk patients for transfusion associated graft-versus-host

A

infants
cancer patients
immunocompromised patients

89
Q

for transfusion associated graft-versus-host what blood must be used

A

irradiated blood component

90
Q

the number of lymphocyte in bag is determined by

A

age of blood component

91
Q

diagnostic tests of transfusion associated graft-versus-host

A

skin biopsy
bone marrow examination
liver biopsy
molecular studies

92
Q

disease is commonly transferred during?

A

transfusion

93
Q

what is the most common blood borne disease

A

heap B and C

94
Q

what are the blood borne diseases

A

hepatitis
hiv
malaria
syphilis

95
Q

these transfusion reaction is common on older women

A

post transfusion reaction

96
Q

post transfusion reaction is associated with

A

severe thrombocytopenia
bleeding

97
Q

when does post transfusion reaction usually happens

A

after 1-24 days of transfusion

98
Q

what is the cause of post transfusion reaction

A

patient previously sensitized to platelets due to transfusion of prev. pregnancy

99
Q

the post transfusion reaction destroys

A

transfused PLT
autologous PLT

100
Q

what is the most implicated in the post transfusion reaction

A

Human platelet antigen 1a

101
Q

true or false:
post transfusion reaction is self-limiting

A

true

102
Q

why does post transfusion reaction called self limiting

A

the PLT number turn back to normal within 2 wks

103
Q

post transfusion reaction treatment

A

infused intravenous immunoglobulin

104
Q

excessive accumulation of iron deposits

A

hemosiderosish

105
Q

how does hemosiderosis related to transfusion

A

if there is an rbc transfused there is a build up of iron

106
Q

cause of transfusion induced hemosiderosis

A

presence of iron deposits in vital organ such as liver and spleen

107
Q

what organs does iron usually present

A

liver and spleen

108
Q

how are the high risk for transfusion induced hemosiderosis

A

thalassemia
chronic transfusion patient

109
Q

what therapy is the most important for transfusion induced hemosiderosis

A

iron chelating therapy

110
Q

iron is being removed in a form of

A

urine
feces

111
Q

where does chelating agents bind with iron

A

in the tissues

112
Q

what are the chelating agents

A

deferoxamine
oral deferiprone
defecation

113
Q

what is the alternative for transfusion therapy

A

red cell exchange transfusion

114
Q

two types of blood donor

A

autologous
allogenic

115
Q

most dangerous blood type

A

abo

116
Q

what are the cause of the most dangerous blood type

A

acute htr

117
Q

what is the testing of acute htr

A

positive for DAT

118
Q

how to identify bacterial contamination

A

check for color, cloudiness, clot, hemolysis,

perform gram staining and culture

119
Q

what does iatrogenic means

A

error of illness caused by physician

120
Q

proliferation of component lymphocyte

A

transfusion associated graft versus host

121
Q

donor lymphocytes attack the transfusion recepient

A

transfusion associated graft versus disease

122
Q

what is the reaction of transfusion associated graft versus host

A

maculopapular rash

123
Q

explain what is fnhtr

A

where there is an increase of temperature (1C) within 8-24 hrs)

124
Q

viability of FFP

A

20 mins

125
Q

treatment for PTP

A

infuse intravenous immunoglobulin

BB LEC (1 decks)

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