Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

random > random facts about transfusion medicine- Martin > Flashcards

random facts about transfusion medicine- Martin Flashcards

1
Q

what diseases will result in an altered A Ag

A

leukemia = dec Ag on each RBC

gastric/pancreatic carcinoma= increased serum BGSS–> neutralize any Anti-A Ab –>makes the blood look like “O type” on forward and backward testing

intestinal obstructions: acquired B Ag on previously A cells
–> forward typing shows AB, back typing shows only anti-B Ab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

forward vs backwards typing of ABO

A

forward: put commerical anti-sera Ab into pt’s RBC –> will it bind pt?

bach/reverse: add pts sera into type of known At (A/B/anti-D) –> will pt attack?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

is Rh Ab naturally occurring

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

McLeod Phenotype

A

abn Kell Ag –> acanthocytes (spur cell) with chronic compensated hemolytic anemia

chronic granulomatous ds of childhood (x NADH-oxidase on Nø)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Kell vs Kidd vs Duffy vs MNS vs Lewis systems

A

Kells= K and k Ags= IgG
–> HDN +hemolytic transfusion rxn

Kidd= Jk(a) and jk(b)
NO Ab detected bc its so transient and weak binding, but then causes rapid hemolysis post transfusion
dosage phenomenon= stronger rxn to homozygous cells

Duffy: Fya and Fyb
IgG Ab, cause HDN and hemolytic transfusion rxn
Fy(a-,b-) seen in AA, resistance to P. xivax

MNS system: M, N, S, s
anti-M IgM, NON HEMOLYTIC usually
dosage phenomenon

Lewis system
IgM warm Abs, naturally occuring
Le Ag –> lewis lives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

shelf life of RBC
plts
plasma

A 
RBC= 42 days
plt= 5 days
plasma= 1 yr frozen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

antibody screen, direct vs indirect Coomb’s test

A

DAT= detect autoimmune hemolytic anemia
pt’s washed RBCs incubated w Ab against self Af
use RBCs

IAT= for pretransfusion ad pre-natal preg tests
recipient Ig target donor Ab= complex
use serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

bombay phenotype is what

A

Oh/ h/h phenotype

no H, anti-H Ab need transfusion with another of the same phenotype

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

given autoimmune hermolytiv anemia, which type is most problematic for Ab screening

A

cold can give a false (+) ABO, but if you just warm up the serum you can avoid it
oft= auto-anti-I

warm= more problematic for Rh, Kell, Kidd, Duff, no affect ABO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what infections are associated with causing cold agglutinin ds

A 
mycoplasma pnuemoniae
infectious mono (EBV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

steps of IAT

A
  1. room temp = detect cold IgM
  2. 37C= detect warm Ab= IgG, Rh, Kell, Kidd, Duffy
  3. AHG= detect warm, IgG that coat RBC
  4. CC: verify the AHG findigns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

acute hemolytic transfusion reaction

etiology
sx
trx
prevention

A

preformed IgM Ab, induce complement and intravasc hemolysis

sx= HYPOtension, Hgb-emia+uria, DIC, flank pain, dyspnea, fever, –>late=renal failure

trx= discontinue and verify
Na-bicard to maintain pH

prevent: proper ID pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

delayed hemolytic transfusion reaction

etiology
sx
trx
prevention

A

> 24 hrs post, = IgG
(DAT), common causes= Rh, Kell, Kidd
extravasc hemolysis

labs= inc LDH+bili, dec haptoglobin

trx= IVIG, prevent renal/sickle crisis w fluids

prevention: serologic detection of RBC Ab is key!! (abo, etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

febrile hemolytic transfusion reaction

etiology
sx
trx
prevention

A

MOST COMMON RXN
can be delayed up to an hour post transfusion

sx= fever, chills, HYPERtension,

trx= r/u lifethreatning ds, fever self resolve in 2-3 hrs
antipyretic (acetominophen), meperidine
NO ASA

p: prophylactic antipyretic, pre-storage leukocytes and plasma reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

allergic urticarial transfusion reaction

etiology
sx
trx
prevention

A

recipient IgE against donor Ag
in IgA deficient recipeint= anti-IgA IgGs

can look like TRALI if have dyspnea = pruritis, urticaria, cut flushing, laryngeal edema and bronchoconstrictions (wheeze, CP)

trx: antihistamine (diphenhydramine)
intubate, O2 prn

p: check for IgA deficiency, prophylactic antihistamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

severe allergic (anaphylactic) transfusion reaction

sx
trx
prevention

A

sx= CV instbaility, HYPOtension, tachy, LOC, arrhythmia/cardiac arrest

trx= intubate, O2 prn,
IV diphenhydramine + epinephrine
aminophylline for bronchospasms

p: check for IgA deficiency, prophylactic antihistamine

17
Q

TRALI transfusion reaction

etiology
sx
trx
prevention

A

= w/in hours, Ab bind MHC 1 Ag on Nøs (2 hit hypothesis)
associated w multiparous Fs
w transfusion of FFP and pls

sx= NONCARDIOGENINC PULM EDEMA- dyspnea, hypoxia, tachy, fever and HYPOtension, normal breath sounds

dx w n level of pulm A wedge P

trx= self-resolve within 48-96 hrs- support w antipyretics, lfuids, O2…

18
Q

infection associated w transfusion reaction

etiology
sx
trx
prevention

A

associated with transfusion of platelets and plasma cell

most common = skin flora from the donor, contaminated unit

Septic bacteria infections:
Yersinia enterocoitica, pseudomonas ~ packed RBC

strep+staph, salmonella, Escherichia, serratia
~ plts

less common are viral infections
HIV, HepC+B mostly

19
Q

indications and expected results of transfusion w packed RBC

contra?

storage?

A

i: symptomatic anemia

e: Hgb inc ~1 for every unit in 24 hrs
inc Hct 3% per unit in 24 hrs

contra= volume expansion, coag deficiency, drug treatable anemia

35-42 days storage

20
Q

indications and storage of transfusion w frozen/deglyced RBC

A

i: hypersensitivity to plasma particles

store for 10 yrs, 24 hrs post thawing

21
Q

indications and storage of transfusion w washed RBCs

A

i: severe allergic rxn to unwashed RBCs
storage: 24 hrs

22
Q

indications and storage of transfusion w irradiated RBC

A

i: risk of GVHD
storage: 35-42 days

23
Q

indications and storage of transfusion w leukocyte reduced RBCs

A

i: febrile rxns secondary to leukocyte Ab
store: 35-42 days

24
Q

the minimum threshold of plts in @ risk populations: keep plts above this number

in pts w no bleeding, just prophylactic

in pts w sign hemorrhage

in pts w risk of CNS bleeding

A 
in pts w no bleeding, just prophylactic
 10k
in pts w sign hemorrhage
50k
in pts w risk of CNS bleeding
100k
25
Q

do you need to check compatibility if you are only transfusing platelets

A

yes still need ABO, may be need to get Rh (risk of RBC contamination)

26
Q

indications and storage of transfusion w fresh frozen plasma

A

indicated in pts w

  • deficit of coag factors
  • emergent warfarin reversal needed
  • trx TTP

storage: 18c for 1 yr

27
Q

indications and storage of transfusion w cryoprecipitate

A

provides fibrinogen in the setting of F8/vWF replacement needed

storage: 18c for 1 yr

28
Q

RhoGAM

what is the Kleihauer Betke test:
when do you give RhoGAM

A

kleihauer betke test: measure fetal Hbg in mom’s circulation

give on dose at 26-28 wks gestation OR w/on 72 hrs of delivery of Rh+ infant

29
Q

when giving massive transfusions, what is the rule of thumb of the amount of units you are giving

A

give 1 unit FFp per every 2-3 units of RBCs

30
Q

indication for the following types of apheresis trxs

plasma exchange
therapeutic plasmapharesis
therapeutic RBC exchange
autologous

A 
plasma exchange
   TTP + HUS
therapeutic plasmapharesis
   hematologic / neuro ds
therapeutic RBC exchange
    sickle cell crisis prevention,  HDN
autologous
    save own components for use in a crisis

random (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions