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Erez's HEM TEST notes 2024 > Tranfusion Facts > Flashcards

Tranfusion Facts Flashcards

1
Q

FNHTR

A

1st/2nd most common
Cytokines
Leukoreduction

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2
Q

Leukoreduction pre/post storage

A

Post storage less effective but cheaper

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3
Q

TACO

A

Common
Slower infusion and diuretics
Most common cause of death

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4
Q

TRALI

A

Less than 6 hours from transfusion
Activation of neutrophils in lung
Ab to HLA (HNA less common)
1st hit of priming to TRALI (infection, cancer)
Neutropenia (relative)
Plasma from multipara donors is a risk factor

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5
Q

AHTR

A

ABO incompatibility
30% mortality

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6
Q

Post transfusion purpura

A

Multiparous women that are HPA1A negative are suseptible
Ab against HPA1A
7-10 days post transfusion
Tx IVIG Steroids
Prevention- HPA1A negative platelets

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7
Q

Bacterial contamination type in PLT

A

Gram positive in platelets

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8
Q

Hypocalcemia post transfusion

A

Citrate
Massive transfusion

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9
Q

Delayed hemolytic reaction prevention methods

A

Rh Kell matched blood mainly in pts requiring many blood transfusions or AIHA
Leukoreduction to reduce APC
reduce possibility for future ab

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10
Q

Reasons of lack of natural antibodies to A,B

A

Neonates and elderly
Hypo/aglubolinemia

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11
Q

Reasons of excessive antibodies to A,B

A

Allo/auto-antibodies
Tx with non ABO matched plasma products
Paraprotein
Passenger Lymphocytes

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12
Q

Bombay phenotype blood

A

Lack of H antigen
Resembles O but can receive only transfusions from Bombay donors

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13
Q

Passenger lymphocyte syndrome

A

Lymphocytes of donor causing homolysis of pts RBCs

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14
Q

Acquired B antigen

A

pts with group A
During infection with GNR
Bacteria changes A to resmble B
But with no hemolysis
Causing ABO discrepancy
Cells will not react with Anti-B serum

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15
Q

Weak D antigen

A

Qunatitive defects in D
All epitopes exist
Donor and neonate must be Classified as D+ bcs they can Cause Ab developement in receipient
Blood receipient and pregnant women- considered D- bcs giving them D+ blood may cause Ab
Genentic tesiting available

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16
Q

Partial D variant

A

Loss of antigens on D (Qualititive)
common in blacks
Discovered when D+ pts develop Ab
No rutine way to diagnose

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17
Q

Ab development % to minor blood types depending on disease

A

30% in SCD, Thalasemia and AIHA
0% in ALL

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18
Q

Leukoreduction of blood products benefits

A

FNHTR
CMV
Alloimmunization to HLA (PLT refractoriness/Allo Ab)

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19
Q

Irradiation of blood product benefit

A

GVHD

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20
Q

Washing of blood product benefit

A

Allergic reactions

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21
Q

Enzyme effect on RBC antigens

A

Allows better determination of alloantibodies after antibody panel

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22
Q

Elution

A

Lysis of RBC covered with Ab allows isolating auto antibodies from the washed allo antibodies

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23
Q

How to deal with Dara interference

A

Phnotype
Genotype
DTT treated RBCs

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24
Q

Which minor blood groups are significant when allo antibodies are present

A

Kell
Kidd

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25
Q

HDFN

A

IgG of mother causing hemolysis in newborn
Usually, in 2nd pregnancy
Mother O, newborn A, B
mild jaundice

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26
Q

Maternal anti-D titer significance

A

Predicts HDFN

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27
Q

Maternal anti-kell titer significance

A

Titer>4 with very high risk of HDFN

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28
Q

Tx of severe HDFN

A

Intra uterine tansfusion- if signs of hydrops
IVIG
FU with MCA doppler

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29
Q

Tests for women with clinically relevant Ab during pregnancy

A

Paternal phenotype
FU every 2-4 weeks

30
Q

CPDA-1 vs SAG-M storage

A

CPDA1 35d. Hct 75-80%
SAG-M 42d, Hct 60%

C = concentrated
S = storage

31
Q

LTOWB vs PC

A

Improves 24h mortality and possibly long term survival in trauma pts

32
Q

Novel therpaies in transfusion medicine

A

Enzyme converted “O” cells (ECO)
Stelath cells (PEG covered cells that do not exhibit there antigens)

33
Q

Acute immune mediated trasfusion reactions

A

AHTR (intravascular-ABO, extravascular- Rh)
Anaphlaxis, mild allergic reaction
TRALI
FNHTR

34
Q

Delayed immune mediated trasfusion reactions

A

Delayed hemolysis
TRIM
TA-GVHD
Post transfusion purpura

35
Q

Acute non-immune mediated trasfusion reactions

A

TACO
Metabolic

36
Q

Delayed non-immune mediated trasfusion reactions

A

Iron oveload

37
Q

Allergic transfusion reaction cause and prevention

A

Plasma proteins
Washing

38
Q

Top transfusion related mortality cause

A

TACO
Delay in transfusion

39
Q

TRALI moratlity %

A

5-10%

40
Q

TA-GVHD timing

A

8-10 post transfusion

41
Q

TA-GVHD clinial manifestations

A

Similar to acute GVHD + pancytiopenia

42
Q

TA-GVHD mortality %

A

90-95% !!

43
Q

Risk factors for TA-GVHD

A

Blood donation from realtives
HLA- matched PLT (bcs there is alot of plasma)
immundefficiecny

44
Q

TRALI prevention

A

Plasma from male donors

45
Q

Liberal vs restrictive blood transfusion after cardiac surgery

A

Liberal with less mortality at 90 days in one study and non-inferior in another study
TITRe2 vs TRICS III

46
Q

PLT transfusion thresholds before procedures

A

Surgery- 50K
Neurosurgery- 100K
Epidural- 80K

47
Q

PLT transfusion benefit before CVC placement- 50K

A

Less bleeding in non tunneled catheters

48
Q

PLT refractoriness definition

A

<5K increament

49
Q

Hemostatic levels of FXIII

A

5%

50
Q

Tx of FXIII def

A

Fibrogrammin 1/month

51
Q

How to measure plavix effectiveness levels

A

ADP<50%

52
Q

DOAC effects on PT/aPTT tests

A

Dabigatran- aPTT
Rivaroxaban- PT

53
Q

Liberal vs restrictive blood transfusion in MI pts with anemia

A

Numeral but not statistically significant benefit for liberal

54
Q

Factor deficiencies that occur together

A

FV
FVIII

55
Q

Blood type transfusion for IUD

A

O-
Fresh
Leukoreduction (prevent CMV)
Irradiated (GVHD)

56
Q

Workup in hemolysis of newborn

A

Blood type of mother and infant
Screen of mother- indirect coombs
DAT
If DAT + check eluate in order to phenotype the ab

57
Q

Anti kell hemolysis type in HDFN

A

Can cause lysis of eryrtoroid progenitor cells
+ hemolysis

58
Q

Ab titer that is important for HDFN (except kell)

A

1/32

59
Q

Screening of infant blood

A

With mother serum
Untill 4 months

60
Q

Restrictive vs liberal

A

Liberal- better in ACS and CVA
Restrictive- non inferior in the rest

61
Q

Ab not causing HDFN

A

p1, lewis, N

62
Q

PLT refractoriness workup

A

Transfuse- 2X SDP fresh and ABO matched
Increment less than < 5K
Send HLA and HPA ab
Find cross matched PLT (Crossing done in flow)

63
Q

Rh + in Israel

A

90%

64
Q

PPH blood product management

A

Give cryo early

65
Q

ECMO management of bleeding

A

Give PLT early due to thrombocytopenia

66
Q

Rh on blood products

A

Only on RBC
But also when trasfusing PLT there are some RBCs in the bag

67
Q

How to prevent alloimmunization after Rh+ PLT transfusion to Rh- pts

A

Anti D
Washing- to remove RBCs

Consider in young pts, especially in women of childbaring age

68
Q

Tests to screen blood products

A

HIV, HBV, HCV, TPHA, HTLV, WNV (seasonal)
CMV (in IUd and immunodeff.)

69
Q

Pts requiring leukoreduction

A

Pregnancy, IUD, multiple transfusions, planned transplant

70
Q

Indications to wash blood products

A

TRALI, anaphylaxis, incompatibility after allo transplant or solid transplant

71
Q

Tx of AHTR

A

Supportive care
Ecolizumab
Steroids/IVIG

72
Q

Tx of neonates with severe HDFN

A

Exchange transfusion

Erez's HEM TEST notes 2024 (35 decks)

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