Thrombosis and Transfusion Flashcards
Clotting factors reduced by Coumadin initiation
Protein C and S
in addition to II, VII, IX, and X
Clotting factors reduced by acute thrombosis
Protein C, Protein S, and ATIII
Clotting protein reduced by unfractionated heparin
ATIII
What does ATIII do
Inhibits thrombin from converting fibrinogen to fibrin
What are the 4T’s
What is a high score?
Thrombocytopenia- Fall by >50%, 2 points. 30-50%, 1 point
Timing of fall- between 5-10 days, 2 points, >10 or <1 days, 1 point
Thrombosis- New, 2 points, progressive/recurrent, 1 point
Other cause of TCP- None, 2 points. Possible, 1 point
6-8= High probability of HIT
What is Partial D in the Rh system
Rh d antigen that is slightly different than wild type. Can develop anti-d alloantibodies if transfused with Rh+ blood. Should be considered Rh negative and get Rh- blood and rhogam during pregnancy
When do you need rhogam?
Rh- mom and Rh+ baby. Given at 28 weeks and delivery
What abnormal RBC protein antigen is associated with chronic granulomatous disease and should be suspected if acanthocytes are seen on smear in CGD patient?
McLeod phenotype of Kell antigen (Kx). Weakened Kell expression
Cause of neonatal alloimmune thrombocytopenia and post transfusion purpura
HPA-1a/1b antibodies
Patient develops rash, jaundice, transaminitis, and diarrhea 2 weeks after blood transfusion. CBC shows pancytopenia. What is Diagnosis? What is pathophys?
Diagnosis: Transfusion induced GVH
Pathophys: immunocopetent donor lymphocytes mount an anti-host response in non-irradiated pRBC transfused blood
Common bacteria implicated in septic transfusion reactions (2)
Yersenia enterocolitica
borrelia burgdorferi
RBC antigen most associated with delayed hemolytic transfusion reaction
Kidd antigen (IgG mediated reaction)
Blood processing step to avoid FNHTR
leukoreduction
How do you prevent CMV transmission in blood transfusion?
Leukoreduction and irradiation (remove passenger lymphocytes)
What is in Cryoprecipitate?
Fibrinogen, FVIII, VWF, and FXIII
