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Blood Bank > Test 5 > Flashcards

Test 5 Flashcards

1
Q

What is a major crossmatch?

A

donors cells and patient plasma

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2
Q

When is a major crossmatch performed?

A

patient has an unknown antibody

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3
Q

what is a antibody screen

A

patient plasma and known antigens

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4
Q

what is the most common thing done now for transfusions?

A

type and screen plus immediate spin crossmatch

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5
Q

what does the immediate spin detect?

A

ABO errors

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6
Q

What is the Type and screen?

A

ABO/RH and antibody screen

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7
Q

what is type and screen routinely used for?

A

patients who are not likely to actually need transfusions
during pregnancy to rule out antibodies
identify antibodies that might cause HDN
identify Rh negative mothers

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8
Q

how can the type and screen be tested to see if correct?

A

immediate spin of donors cells and patient plasma to rule out ABO errors

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9
Q

What type of blood do we transfuse in emergency transfusion?

A

Group O, Rh negative blood
must have doctors consent
if time is permitted give group and type of patient

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10
Q

what are some adverse complications of transfusion?

A 
hemolytic reactions due to antigen-antibody complexes
immediate or delayed hemolytic reactions
febrile reactions
allergic reactions- urticaria
transfusion related acute lung injury
bacterial contamination
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11
Q

what is the most severe reaction and what does it cause?

A

ABO incompatibility

intravascular and extravascular destruction

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12
Q

how long does it usually take a ABO reaction to take place?

A

within the first 100ml of blood

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13
Q

what are some causes for giving the wrong ABO blood?

A 
drawing the wrong patient
mixup of specimens
improper labeling of specimens
errors in paperwork
issuing the wrong unit of blood 
administering blood to the wrong patient
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14
Q

what are some symptoms of intravascular reactions?

A 
hemoglobinemia
hemoglobinuria
decreased haptoglobin levels
fever, chills, pain at infusion sites, back pain, headache
drop in blood pressure
shock
renal failure
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15
Q

what are some symptoms of extravascular reactions?

A

falling hemoglobin/hematocrit
fever, jaundice
bilirubinemia
bilirubinuria

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16
Q

what are some symptoms for febrile reactions?

A

fever and chills

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17
Q

what are febrile reactions caused by?

A

antibodies against leukocyte antigens

antibodies react with transfused donor white cells

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18
Q

what is a treatment of febrile reactions?

A

leukocyte-poor blood

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19
Q

most all donor units are now provided by blood banks is pre-filtered to remove what?

A

majority of leukocytes

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20
Q

what causes allergic reactions?

A

proteins in transfused plasma from blood unit

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21
Q

what is a symptom of allergic reaction?

A

urticaria (hives)

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22
Q

what do you treat a patient with a allergic reaction to proteins from a transfusion?

A

anti-histamine (Benadryl)

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23
Q

what is a very rare allergic reaction and what is it due to?

A

anaphylactic shock

IgA deficiency in patient

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24
Q

what is the usually cause of bacterial contamination of transfusions?

A

platelet transfusion because it is stored at room temp

but some bacteria can grow at refrigeration temps

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25
Q

what causes the reaction in bacterial contamination?

A

reaction to endotoxins

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26
Q

what causes circulatory overload?

A

rapid infusion of blood or given too much blood

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27
Q

what does circulatory overload cause?

A

congestive heart failure

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28
Q

what is the length of time the FDA recommends for giving blood?

A

two to four hour period

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29
Q

when is rapid infusion okay?

A

when the person is actively bleeding

30
Q

what does TRALI stand for?

A

Transfusion related acute lung injury

31
Q

what causes TRALI?

A

HLA antibodies from transfused plasma attacks lung tissue causing pulmonary edema

32
Q

when does TRALI happen?

A

happens during or within 6 hours of transfusion

33
Q

donors centers are now only making fresh frozen plasma from male donors, why?

A

females are more likely to have HLA antibodies due to exposure to fetal leukocytes during pregnancy

34
Q

what are the steps to take is there is a reaction?

A

check paperwork for errors
perform ABO/RH and antibody screen on pre and post transfusion patient blood samples
check donor unit ABO/RH
check urine for blood/hemoglobin
perform DAT to look for antibody attached to transfused RBC
culture donor blood bag

35
Q

what is the old name for HDN

A

erythroblastosis fetalis

36
Q

what can cause HDN?

A

ANY IgG antibody against fetal RBC antigen

37
Q

HDN is usually mild unless what antibody is involved?

A

anti-D

38
Q

is HDN is caused by any antibody besides anti-D what can be done to treat?

A

phototherapy

39
Q

how is HDN caused by anti-D treated?

A

exchange transfusion of the infant

40
Q

which HDN is not predictable, not preventable, can occur in first pregnancy?

A

ABO HDN

41
Q

how is ABO HDN treated?

A

phototherapy

42
Q

which mothers and Babies does ABO HDN usually happen in?

A

group O mothers and Group A babies

43
Q

Which HDN is very serious?

how is it predictable and preventable?

A

RH HDN
predictable by antibody titers on mother’s plasma
preventable by administering anti-D antibody to destroy rbcs in mothers circulation before she can build anti-D antibody

44
Q

what is given to mothers with a chance of RH HDN?

A

ortho diagnostics

45
Q

what is the brand name for ortho diagnostics

A

Rhogam

46
Q

300 ug will destroy how much RBCs?

A

15 ml RBCs (30 ml whole blood)

47
Q

when is Rhogam administered?

A

at 28 weeks and again within 3 days after delivery of a RH positive infant

48
Q

when is another time Rhogam is administered?

A

in spontaneous abortion in RH negative mothers

49
Q

what is the rosette test?

A

a screening test to determine if the fetal bleed into mother’s circulation exceeds 30ml of blood

50
Q

what is a rosette test called?

A

fetal screen and fetaldex

51
Q

what do you do if the rosette test is positive?

A

a semi-quantitative test is performed called Kleihauer-Betke

52
Q

what prenatal tests are ran for RH RDN?

A

abo/rh test
antibody screen for anti-D antibody
weak D testing if D negative on initial test

53
Q

what are post-pardum tests ran?

A

ABO/RH on cord blood
DAT on cord blood
elution of antibody from baby’s cells to identify antibody
identification of antibody

54
Q

what are Rhogam criteria?

A

mother must be D negative, weak D negative
infant must be D positive or weak D positive
mother must not already have anti-D from previous pregnancies

55
Q

what is used for the exchange transfusion of infant?

A

Group O negative red cells reconstituted with group AB plasma

56
Q

what does the exchange transfusion of infant do?

A
  1. removes rbcs coated with antibody
  2. lowers bilirubin level
  3. corrects anemia
  4. lowers circulating antibody level
57
Q

what does donor selection do?

A

it is to protect donor and blood recipient

58
Q

How much time should lapse between donations?

A

8 weeks

59
Q

What are some requirements for donors?

A 
appear in good health
hemoglobin 12.5 gm/dL or greater
hematocrit of 38% or greater
minimum of 110 lbs
blood pressure better than 180/100
pulse between 50 and 100
temperature cannot exceed 99.5
60
Q

what should the temp not exceed for a donor?

A

99.5

61
Q

what should the hemoglobin be for a donor?

A

12.5 gm/dL or greater

62
Q

what is the minimum weight for a donor?

A

110

63
Q

what should the blood pressure be for a donor?

A

180/100 or better

64
Q

what should the pulse be for a donor?

A

between 50 and 100

65
Q

what are some reasons for permanent deferrals?

A

history of hepatitis
previous positive test for hepatitis, HIV or HTLV
history of babesiosis or chagas disease
family history of CID
recipient of Dure mater or pituitary growth hormone
use of needle to inject non-prescription drugs

66
Q

what are some reasons for temporary deferrals?

A

Immunizations- 2 weeks for measles, mumps, polio, typhoid, yellow fever
4 weeks for rubella, varicella, hepatitis B vaccine
pregnancy- 6 months
one year- tattoos, needle stick, sex with high risk HIV person, syphilis therapy, transfusion of blood products, rabies vaccine.

67
Q

in donors. how long do you need to wait after getting immunizations for measles, mumps, polio, typhoid, yellow fever?

A

2 weeks

68
Q

in donors, how long do you need to wait after getting immunizations for rubella, varicella, hepatitis B vaccine?

A

4 weeks

69
Q

in donors, what are the immunizations that you need to wait 4 weeks?

A

rubella, varicella, hepatitis B vaccine

70
Q

in donors, What are the immunizations that you need to wait 2 weeks?

A

measles, mumps, polio, typhoid, yellow fever

71
Q

in donors, what do you need to wait 1 year after getting to donate blood?

A

tattoos, needle stick, sex with high risk HIV person, syphilis therapy, transfusion of blood products, rabies vaccine.

72
Q

how long should a person wait after having a baby to donate blood?

A

6 months

Blood Bank (6 decks)

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