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MDL 216 Blood Bank > Test 4 > Flashcards

Test 4 Flashcards

1
Q

Define transfusion reaction

A

physical reaction to TX of blood component

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2
Q

TX of incompatible RBC/whole blood: anti-A, Kell, JKa, Fya

A

Cause of immediate hemolytic reaction

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3
Q

fever, oliguria, anuria, death, nausea, back or chest

A

Intravascular symptoms of immediate hemolytic reaction

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4
Q

Follow all procedures/policies to ensure safe TX

A

Prevention of immediate hemolytic reaction

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5
Q

Secondary response to transfused RBC

A

Cause of delayed hemolytic reaction

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6
Q

Fever, chills, mild jaundice

A

Symptoms of delayed hemolytic reaction

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7
Q

Thorough medical history documenting any previous TX, pregnancies, transplants

A

Prevention of delayed hemolytic reaction

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8
Q

TX of pre-formed donor HLA Ab into Pt that cause respiratory compromised during or within 6 hours of TX

A

Cause of TRALI

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9
Q

Respiratory distress, acute pulmonary edema, hypotension, and fever. Typical “white-out” lung fields on chest x-rays classic signs

A

Symptoms of TRALI

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10
Q

Possibility of deferring multiparous women from future donations of blood products, definately stop TRALI donors from donating

A

Prevention of TRALI

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11
Q

Infusion of fluid volume beyond capacity of an individual’s cardiovascular system

A

Causes of TACO

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12
Q

Shortness of breath, coughing, decreased O2 saturation, wheezing, cyanosis, elevated BP, decreased pulse, and peripheral edema. Chest x-ray shows bilateral lung infiltrates & sometimes heart enlargement

A

Symptoms of TACO

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13
Q

Slow infusion rate TX = 100mL/hr; aliquot blood

A

Prevention of TACO

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14
Q

Antileukocytic antibodies in patient’s plasma

A

Cause of febrile reaction

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15
Q

1C rise in temperature associated with TX and having no medical explanation other than TX

A

Symptoms of febrile reaction

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16
Q

Anti-IgA in patient’s plasma

A

Cause of anaphylactic or anaphylactoid reaction

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17
Q

Occur after TX of only a few ml of plasma or plasma-containing components; coughing, breathing trouble, hives, chest pain, shock, death

A

Symptoms of anaphylactic or anaphylactoid reaction

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18
Q

Total plasma removal

A

Prevention of anaphylactic or anaphylactoid reaction

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19
Q

Allergen complexes = histamine release

A

Cause of allergic reaction

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20
Q

Redness, itching and hives

A

Symptoms of allergic reaction

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21
Q

pre-medicate with Benadryl

A

Prevention of allergic reaction

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22
Q

Endotoxins produced by bacteria capable of growing in cold; E. coli, Staphylococcus and Yersinia enterocolitica

A

Cause of bacterial contamination

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23
Q

“warm” reaction; dryness and flushing of skin

A

Symptoms of bacterial contamination

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24
Q

Strict adherence to component collection, storage, handling and preparation procedures, visual observation of units, TX within standard maximum allowable time limit = 4 hours. Now culture platelets after collection to ensure safer products.

A

Prevention of bacterial contamination

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25
Q

Attack from donor T-cell lymphocytes against the patient, and recipient becomes foreigner

A

Cause of transfusion associated graft vs. host disease

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26
Q

Rash, fever, nausea, vomiting, or diarrhea days to weeks following transfusion, and CBC reveals panctyopenia, with liver enzymes abnormal

A

Symptoms of transfusion associated graft vs. host disease

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27
Q

Irradiation of blood products, especially of family members, neonates, and transplant patients, to inactivate leukocytes

A

Prevention of transfusion associated graft vs. host disease

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28
Q

Pre-formed platelet specific alloantibodies present in patient’s plasma were induced from prior transfusion, pregnancy or tissue exposure (often PLA-A)

A

Causes of posttransfusion purpura

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29
Q

Sudden onset of red to purple discolorations on the skin the size of pencil eraser

A

Symptoms of posttransfusion purpura

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30
Q

HLA negative platelets in future

A

Prevention of posttransfusion purpura

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31
Q

Formation of HLA antibodies following exposure to Ags from transfusion, pregnancies or transplants. Common in multiparous women

A

Causes of alloimmunization to HLA antigens

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32
Q

Platelet refractoriness - no increase in counts following transfusion of platelets

A

Symptoms of alloimmunization to HLA antigens

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33
Q

Irradiated HLA matched platelets and ABO-matched leukoreduced platelets

A

Prevention of Alloimmunization to HLA antigens

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34
Q

Name three reactions considered to be delayed non-hemolytic reactions

A

Post-transfusion purpura
TX-associated graft-versus-host disease
Iron overload

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35
Q

Name some of the diseases transmitted by blood

A 
Hepatitis
CMV
Chagas
Dengue
Syphilis
Toxoplasmosis
EBV
Parvovirus
HIV
West Nile
Malaria
Lyme Disease
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36
Q

Compare the 5 types of Hepatitis regarding transfusion:

Vaccine

A

Hep B

37
Q

Compare the 5 types of Hepatitis regarding transfusion:

Bloodborne

A

Hep B, C, and D

38
Q

Compare the 5 types of Hepatitis regarding transfusion:

Fecal-oral

A

Hep A and E

39
Q

Compare the 5 types of Hepatitis regarding transfusion:

Chronic states

A

Hep B, C, D

40
Q

Compare the 5 types of Hepatitis regarding transfusion:

Long incubation

A

Hep B & C

41
Q

Describe the procedure for a transfusion work up:

Step 1

A

Check for any discrepancies in patient/donor ID; label and record checks

42
Q

Describe the procedure for a transfusion work up:

Step 2

A

Observe patient’s pre and post TX samples for hemolysis

43
Q

Describe the procedure for a transfusion work up:

Step 3

A

DAT on post-TX sample

44
Q

Describe the procedure for a transfusion work up:

Step 4

A

ABO/Rh typing on patient’s pre- and post- TX samples and donor segments

45
Q

Describe the procedure for a transfusion work up:

Step 5

A

Compatibility test on patient’s pre- and post- TX samples with donor segments

46
Q

Describe the procedure for a transfusion work up:

Step 6

A

Ab screen and Ab ID on patient’s pre- and post-TX samples and donor segments

47
Q

Describe the procedure for a transfusion work up:

Step 7

A

Test urine for free Hgb

48
Q

Describe the procedure for a transfusion work up:

Step 8

A

Bilirubin test

49
Q

Describe the procedure for a transfusion work up:

Step 9

A

Hgb and Hct levels

50
Q

List the fluids from which HIV has been isolated

A 
Blood
Semen
Vaginal secreations
Tears
Sweat
Breast milk
51
Q

List the individuals at risk for infection with HIV

A 
Homosexuals
Bisexuals
Prostitutes
IV drug users
Recipients of transfusions
Sexual partners of above
Health care workers
Infants born to infected mothers
52
Q

Toxic levels of bilirubin in a newborn’s brain that causes permanent brain damage

A

Kernicterus

53
Q

Destruction of RBC of the fetus and neonate by antibodies produced by the mother

A

HDN Step 1

54
Q

Mother is stimulated to form the Abs by previous pregnancy or TX

A

HDN Step 2

55
Q

IgG Abs, cross the placenta, directed against antigens the baby has inherited from the father

A

HDN Step 3

56
Q

During gestation, and particularly during delivery when the placenta separates from the uterus, variable numbers of fetal RBC enter the maternal circulation

A

HDN Step 4

57
Q

These fetal cells carry antigens that stimulate antibody production in the mother

A

HDN Step 5

58
Q

What is TACO?

A

Transfusion Associated Circulatory Overload

59
Q

Transplacental hemmorrhage of fetal RBC into the maternal circulation occurs in up to 7% of pregnancies

A

Exposure factor HDN

60
Q

Amniocentesis, chorionic villus sampling, trauma to abdomen

A

Exposure factor HDN

61
Q

A little as 0.1 mL of fetal RBC can stimulate immune response in mother

A

Exposure factor HDN

62
Q

Depends on complex genetic factors

A

Host Factor HDN

63
Q

In Rh-neg individuals, transfused with one unit of Rh+ blood, about 80% will form anti-D

A

Host Factor HDN

64
Q

Rh-Negative mother after an Rh+ pregnancy = 10 % will form anti-D

A

Host Factor HDN

65
Q

IgG, crosses the placenta

A

IgG Class HDN

66
Q

Subclasses of IgG = IgG1 and IgG3 are most efficient at crossing the placenta

A

IgG Class HDN

67
Q

Subclasses in mother affect severity of HDN

A

IgG Class HDN

68
Q

Rh [D] is the most immunogenic

A

Antibody Specificity HDN

69
Q

C, E and c are also potent immunogens; moderate to severe HDN

A

Antibody Specificity HDN

70
Q

After Rh, anti-Kell is most clinically significant in HDN

A

Antibody Specificity HDN

71
Q

Clinical symptoms of HDN

A

Hemolysis, anemia and erythropoiesis

72
Q

Severe anemia, cardiac failure, edema, effusions and ascites = may develop at 18 to 20 weeks gestation = used to be fatal = may now be treated

A

Hydrops fetalis

73
Q

maternal IgG Abs attach to specific Ags on fetal RBC

A

Clinical symptom of HDN:

Hemolysis, anemia and erythropoiesis

74
Q

Ab-coated cells are then removed from circulation by macrophages of spleen

A

Clinical symptom of HDN:

Hemolysis, anemia and erythropoiesis

75
Q

Destruction of fetal RBC and resulting anemia stimulate the fetal bone marrow to produce RBC at an accelerated rate = erythroblasts are released into the circulation =

A

erythroblastosis fetalis

Clinical symptom of HDN:
Hemolysis, anemia and erythropoiesis

76
Q

The bone marrow fails to produce enough RBC to keep up with the rate of destruction; spleen and liver become enlarged

A

Hypertension and damage

Clinical symptom of HDN:
Hemolysis, anemia and erythropoiesis

77
Q

RBC destruction releases Hgb

A

metabolized to bilirubin [indirect]

78
Q

Newborn liver is unable to metabolize bilirubin

A

Clinical symptom of HDN:

Bilirubin

79
Q

Can reach toxic levels in the brain; >18 mg/dL = brain damage = kernicterus

A

Clinical symptom of HDN:

Bilirubin

80
Q

ABO/Rh typing and Ab screen at first prenatal visit during first trimester; medical history

A

Clinical symptom of HDN:

Serologic Testing

81
Q

If Ab screen is positive, Ab ID must be performed

A

Clinical symptom of HDN:

Serologic Testing

82
Q

If mother has an Ab, a sample of the father’s blood should be tested for the corresponding antigen

A

Clinical symptom of HDN:

Serologic Testing

83
Q

Amniocentesis can be done on fetus to test for antigen

A

Clinical symptom of HDN:

Serologic Testing

84
Q

AB titer = testing for relative concentration of the Ab; patient serum is diluted and tested against appropriate RBC to determine the highest dilution at which RX occurs; in general a titer of 32 is considered significant; second titer should be done at 18 to 20 weeks gestation to look for increase in AB production

A

Clinical symptom of HDN:

Serologic Testing

85
Q

Monitors concentration of bilirubion pigment in the amniotic fluid

A

degree of fetal anemia

86
Q

Best formula for RholG Admin

A 
# of fetal cells/# of adult cells x 5000/30 = # vials
Round up if >5, then +1
Round down if < 5, then +1
87
Q

Secondary formula for RholG Admin

A

(# fetal cells x mom

s blood volume/30)# adult cells = # vials

88
Q

Management of HDN

A

Intrauterine TX
Early delivery
Phototherapy with UV light
TX of newborn

MDL 216 Blood Bank (5 decks)

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