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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
Attack from donor T-cell lymphocytes against the patient, and recipient becomes foreigner
Cause of transfusion associated graft vs. host disease
26
Rash, fever, nausea, vomiting, or diarrhea days to weeks following transfusion, and CBC reveals panctyopenia, with liver enzymes abnormal
Symptoms of transfusion associated graft vs. host disease
27
Irradiation of blood products, especially of family members, neonates, and transplant patients, to inactivate leukocytes
Prevention of transfusion associated graft vs. host disease
28
Pre-formed platelet specific alloantibodies present in patient's plasma were induced from prior transfusion, pregnancy or tissue exposure (often PLA-A)
Causes of posttransfusion purpura
29
Sudden onset of red to purple discolorations on the skin the size of pencil eraser
Symptoms of posttransfusion purpura
30
HLA negative platelets in future
Prevention of posttransfusion purpura
31
Formation of HLA antibodies following exposure to Ags from transfusion, pregnancies or transplants. Common in multiparous women
Causes of alloimmunization to HLA antigens
32
Platelet refractoriness - no increase in counts following transfusion of platelets
Symptoms of alloimmunization to HLA antigens
33
Irradiated HLA matched platelets and ABO-matched leukoreduced platelets
Prevention of Alloimmunization to HLA antigens
34
Name three reactions considered to be delayed non-hemolytic reactions
Post-transfusion purpura TX-associated graft-versus-host disease Iron overload
35
Name some of the diseases transmitted by blood
``` Hepatitis CMV Chagas Dengue Syphilis Toxoplasmosis EBV Parvovirus HIV West Nile Malaria Lyme Disease ```
36
Compare the 5 types of Hepatitis regarding transfusion: | Vaccine
Hep B
37
Compare the 5 types of Hepatitis regarding transfusion: | Bloodborne
Hep B, C, and D
38
Compare the 5 types of Hepatitis regarding transfusion: | Fecal-oral
Hep A and E
39
Compare the 5 types of Hepatitis regarding transfusion: | Chronic states
Hep B, C, D
40
Compare the 5 types of Hepatitis regarding transfusion: | Long incubation
Hep B & C
41
Describe the procedure for a transfusion work up: | Step 1
Check for any discrepancies in patient/donor ID; label and record checks
42
Describe the procedure for a transfusion work up: | Step 2
Observe patient's pre and post TX samples for hemolysis
43
Describe the procedure for a transfusion work up: | Step 3
DAT on post-TX sample
44
Describe the procedure for a transfusion work up: | Step 4
ABO/Rh typing on patient's pre- and post- TX samples and donor segments
45
Describe the procedure for a transfusion work up: | Step 5
Compatibility test on patient's pre- and post- TX samples with donor segments
46
Describe the procedure for a transfusion work up: | Step 6
Ab screen and Ab ID on patient's pre- and post-TX samples and donor segments
47
Describe the procedure for a transfusion work up: | Step 7
Test urine for free Hgb
48
Describe the procedure for a transfusion work up: | Step 8
Bilirubin test
49
Describe the procedure for a transfusion work up: | Step 9
Hgb and Hct levels
50
List the fluids from which HIV has been isolated
``` Blood Semen Vaginal secreations Tears Sweat Breast milk ```
51
List the individuals at risk for infection with HIV
``` Homosexuals Bisexuals Prostitutes IV drug users Recipients of transfusions Sexual partners of above Health care workers Infants born to infected mothers ```
52
Toxic levels of bilirubin in a newborn's brain that causes permanent brain damage
Kernicterus
53
Destruction of RBC of the fetus and neonate by antibodies produced by the mother
HDN Step 1
54
Mother is stimulated to form the Abs by previous pregnancy or TX
HDN Step 2
55
IgG Abs, cross the placenta, directed against antigens the baby has inherited from the father
HDN Step 3
56
During gestation, and particularly during delivery when the placenta separates from the uterus, variable numbers of fetal RBC enter the maternal circulation
HDN Step 4
57
These fetal cells carry antigens that stimulate antibody production in the mother
HDN Step 5
58
What is TACO?
Transfusion Associated Circulatory Overload
59
Transplacental hemmorrhage of fetal RBC into the maternal circulation occurs in up to 7% of pregnancies
Exposure factor HDN
60
Amniocentesis, chorionic villus sampling, trauma to abdomen
Exposure factor HDN
61
A little as 0.1 mL of fetal RBC can stimulate immune response in mother
Exposure factor HDN
62
Depends on complex genetic factors
Host Factor HDN
63
In Rh-neg individuals, transfused with one unit of Rh+ blood, about 80% will form anti-D
Host Factor HDN
64
Rh-Negative mother after an Rh+ pregnancy = 10 % will form anti-D
Host Factor HDN
65
IgG, crosses the placenta
IgG Class HDN
66
Subclasses of IgG = IgG1 and IgG3 are most efficient at crossing the placenta
IgG Class HDN
67
Subclasses in mother affect severity of HDN
IgG Class HDN
68
Rh [D] is the most immunogenic
Antibody Specificity HDN
69
C, E and c are also potent immunogens; moderate to severe HDN
Antibody Specificity HDN
70
After Rh, anti-Kell is most clinically significant in HDN
Antibody Specificity HDN
71
Clinical symptoms of HDN
Hemolysis, anemia and erythropoiesis
72
Severe anemia, cardiac failure, edema, effusions and ascites = may develop at 18 to 20 weeks gestation = used to be fatal = may now be treated
Hydrops fetalis
73
maternal IgG Abs attach to specific Ags on fetal RBC
Clinical symptom of HDN: | Hemolysis, anemia and erythropoiesis
74
Ab-coated cells are then removed from circulation by macrophages of spleen
Clinical symptom of HDN: | Hemolysis, anemia and erythropoiesis
75
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 =
erythroblastosis fetalis Clinical symptom of HDN: Hemolysis, anemia and erythropoiesis
76
The bone marrow fails to produce enough RBC to keep up with the rate of destruction; spleen and liver become enlarged
Hypertension and damage Clinical symptom of HDN: Hemolysis, anemia and erythropoiesis
77
RBC destruction releases Hgb
metabolized to bilirubin [indirect]
78
Newborn liver is unable to metabolize bilirubin
Clinical symptom of HDN: | Bilirubin
79
Can reach toxic levels in the brain; >18 mg/dL = brain damage = kernicterus
Clinical symptom of HDN: | Bilirubin
80
ABO/Rh typing and Ab screen at first prenatal visit during first trimester; medical history
Clinical symptom of HDN: | Serologic Testing
81
If Ab screen is positive, Ab ID must be performed
Clinical symptom of HDN: | Serologic Testing
82
If mother has an Ab, a sample of the father's blood should be tested for the corresponding antigen
Clinical symptom of HDN: | Serologic Testing
83
Amniocentesis can be done on fetus to test for antigen
Clinical symptom of HDN: | Serologic Testing
84
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
Clinical symptom of HDN: | Serologic Testing
85
Monitors concentration of bilirubion pigment in the amniotic fluid
degree of fetal anemia
86
Best formula for RholG Admin
``` # of fetal cells/# of adult cells x 5000/30 = # vials Round up if >5, then +1 Round down if < 5, then +1 ```
87
Secondary formula for RholG Admin
(# fetal cells x mom | s blood volume/30)# adult cells = # vials
88
Management of HDN
Intrauterine TX Early delivery Phototherapy with UV light TX of newborn

MDL 216 Blood Bank (5 decks)

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