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BB LECT (finals) > transfusion > Flashcards

transfusion Flashcards

1
Q

a blood or blood component is donated to man because of? (5)

A
  • trauma (blood loss or surgery)
  • inadequate O2 carrying capacity
  • decrease coagulation proteins for hemostasis
  • donor could be autologous or allogenic
  • component therapy (specific component needed)
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2
Q

time limits of infusion

whole blood | packed RBCs

A

start after 30 mins of removal of storage and completed within 4 hours

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3
Q

time limits of infusion

platelets

A

infused ASAP after receiving, and completed within 20 minutes

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4
Q

time limits of infusion

fresh frozen plasma (FFP)

A

transfused ASAP after thawing and completed within 20 minutes

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5
Q

why FFP should be completed within 20 mins?

A

to avoid loss of labile clotting factors

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6
Q

identification is done during?

A

specimen collection or before infusion

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7
Q

one unit should be infused within?

A

1-2 hours
(if slow, within 4 hours)

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8
Q

emergency transfusion

need for emergency transfusion

A

group O RBCs

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9
Q

emergency transfusion

for child bearing females

A

Group O negative units

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10
Q

emergency transfusion

T or f: Rh-negative males can receive Rh-positive blood

for older patients

A

TRUE
if few units of Rh (-) is availanle

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11
Q

emergency transfusion

older females

A

can receive Rh nega or posi

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12
Q

the blood unit taken must not be returned unless? (3)

A
  • container closure is not disturbed
  • blood has not warmed at >10C or placed in cool temperature of <1C
  • sealed segment of integral donor tubig is still attached to the container
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13
Q

if the blood unit is returned, what should you note?

A

indicate reissue

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14
Q

acute/immediate hemolytic transfusion reaction is caused by — due to —

A

caused by ABO incompatibility due to IgM and complement activation

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15
Q

it is the most severe transfusion reaction and discontinue transfusion immediately if this happens.

A

acute/immediate hemolytic transfusion reaction

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16
Q

volume of incompatible blood that can cause acute/immediate hemolytic transfusion reaction

A

10 mL

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17
Q

enumerate the symptoms of acute/immediate hemolytic transfusion reaction (13)

symptoms appear —

A
  • abdominal, chest, flank, and/or back pain
  • fever, chills, dyspnea
  • tachycardia, pain at site of infusion
  • hemoglobinemia, hemoglobinuria
  • oliguria/anuria
  • hypotension

appears within 24 hours of transfusion

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18
Q

acute/immediate hemolytic transfusion reaction may result to? (4)

A
  • DIC (disseminated intravascular coagulation)
  • renal failure
  • shock
  • death
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19
Q

lab diagnosis of acute/immediate hemolytic transfusion reaction

A
  • increase free hemoglobin
  • increase bilirubin after 6 hours
  • decrease haptologin
  • DAT (+)
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20
Q

most commonly encountered transfusion reaction in which there is an increase temp (at about 1C) within 8-24 hours after transfusion

A

febrile non-hemolytic transfusion reaction

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21
Q

febrile non-hemolytic transfusion reaction is caused by?

what will you do to avoid this transfusion reaction?

A

Donor HLA present in WBC and platelets vs. recepient antibodies

use WBC filters or leukopoor RBCs

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22
Q

enumerate the symptoms of febrile non-hemolytic transfusion reaction (7)

A
  • fever, chills
  • nausea, vomiting
  • increase blood pressure
  • tachycardia and tachypnea
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23
Q

increase in body temp of a hypothermic patient to a normal temperature is not a?

A

febrile non-hemolytic transfusion reaction

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24
Q

the second most common acute, immune complications of transfusion presenting with variety of symptoms that vary according to the reaction’s degree

A

allergic transfusion reaction

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25
Q

allergic transfusion reaction occurs as a response of recipient antibodies to allergens from the donor blood due to?

A
  • activation of mast cells in the recipient against the allergen
  • binding of allergen and mast cells with IgE results to the release of histamine and other granule contents
  • anaphylactoid
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26
Q

what type of hypersensitivity that occurs during allergic transfusion reaction?

A

type I

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27
Q

this refers to allergic transfusion reaction from non-IgE mediated release of mast cell mediators

A

anaphylactoid

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28
Q

allergic transfusion reaction is caused by — due to that the donor has?

A

caused by IgE due to that the donor has reagin

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29
Q

what will you do if allergic transfusion reaction occurs?

if mild?
if severe?

A
  • if mild: temporary discontinue transfusion
  • if severe: discontinue
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30
Q

what will u do to avoid allergic transfusion reaction?

A
  • administer antihistamines before transfusion
  • use washed RBCs
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31
Q

what will u do to avoid allergic transfusion reaction? if SEVERE

A

give:
- aminophylline
- epinephrine
- corticosteroid

32
Q

enumerate the symptoms of allergic transfusion reaction (5)

A
  • urticaria
  • erythema
  • hives
  • itching (pruritus)
  • anaphylaxis
33
Q

anaphylactic transfusion reaction is due to —

this can cause?

A
  • plasma proteins
  • IgA or anti-IgA

mild urticarial BUT NO FEVER

34
Q

what will u do to avoid anaphylactic transfusion reaction?

A

transfuse IgA deficient components

35
Q

acute reaction with respiratory distress, severe hypoxemia during or within 6 hours of transfusion, this refers to?

this is due to?

A

transfusion reaction associated lung injury

HLA problems of donor/patient

36
Q

transfusion reaction associated lung injury is also known as?

A
  • non-cardiogenic pulmonary edema
  • transfusion reaction associated lung injury
  • transfusion releated acute lung injury
37
Q

transfusion reaction associated lung injury

the HLA problems cause a reaction of recipient’s WBCs causing — that occlude the —

A

causing aggregates that occlude the pulmonary circulation

38
Q

transfusion reaction associated lung injury is the leading cause of?

HLA problems may be with —

A

Transfusion-associated fatalities

fever or hypotension

39
Q

pulmonary hypersensitivity edema and allergic pulmonary edema. this is associated to?

A

transfusion reaction associated lung injury

40
Q

what will u do to avoid transfusion reaction associated lung injury?

A

use leukopoor blood

41
Q

transfusion-associated sepsis is caused by?

bacterial contamination: immunologic or non-immunologic?

A

endotoxins of gram (-) bacteria

42
Q

temperature of 2C or more above normal and can be accompanied by hypotension. this refers to?

A

transfusion-associated sepsis

43
Q

enumerate the cold-growing bacterias (5)

A
  • Yersinia enterocolitica
  • E. coli
  • Pseudomonas
  • Propionibacterium acnes
  • B. cereus
44
Q

enumerate the symptoms of transfusion-associated sepsis

A

dryness and flushing of patient’s skin

45
Q

transfusion-associated sepsis

always check the blood properly.
what u will check?

A

check for:
- color change
- clots
- cloudiness
- hemolysis

you may perform GS/C

46
Q

true or false

contamination usually occurs during transfusion.

A

FALSE.
occurs during phlebotomy or thawing or from contaminated platelet units

47
Q

this is when the cardiovascular system’s ability to handle additional workload is exceeded. this refers to?

non-immunologic or immunologic?

A

transfusion-associated circulatory overload

non-immunologic

48
Q

circulatory overload is an — transfusion reaction

this is common in patient with?

A

Iatrogenic (physician-caused) transfusion reaction

common in patient with cardiac and pulmonary disease

49
Q

transfusion-associated circulatory overload

hypervolemia may lead to? (4)

A
  • CHF
  • pulmonary edema
  • cardiomegaly
  • distended pulmonary artery
50
Q

transfusion-associated circulatory overload

enumerate the symptoms (5)

this can be used for diagnosis

A
  • headache
  • dyspnea
  • coughing
  • chest tightness
  • hypertension

Pro-BNP

51
Q

what will u do to avoid transfusion-associated circulatory overload?

A
  • patient should sit upright
  • administer supplemental oxygenation
  • start diueresis
  • donor blood should be aliquoted
  • therapeutic phlebotomy
  • slow down transfusion
52
Q

enumerate the delayed transfusion reactions (4)

A
  • delayed hemolytic transfusion reaction
  • transfusion associated graft-versus-host disease
  • post-transfusion purpura
  • transfusion-induced hemosiderosis
53
Q

delayed hemolytic transfusion reaction may heppen?

what is the most common sign?

A

14 days later after transfusion

decreased hgb and hct

54
Q

delayed hemolytic transfusion reaction may be due to?

increased —

A

IgG antibodies to Rh, MNSs, Kell, Kidd, and Duffy antigens

destroyed transfused RBCs

55
Q

detection of new red cell antibodies and associated with secondary response also may be due to primary response. this refers to?

A

delayed hemolytic transfusion reaction

56
Q

5-7 days post transfusion fever and mild jaundice, this refers to?

A

delayed hemolytic transfusion reaction

57
Q

this is due to proliferation of competent lymphocytes which leads to profound marrow aplasia with a mortality rate >90%

death occurs?

A

transfusion asosciated graft-versus-host disease

1-3 weeks after first symptoms appear

58
Q

enumerate the causes of reaction in transfusion asosciated graft-versus-host disease (5)

this occurs —

A
  • fever
  • liver problems
  • rash
  • diarrhea
  • pancytopenia (may lead to sepsis and hemorrhage)

occurs 3-30 days after transfusion

59
Q

what are the reactions that might occur of transfusion-associated graft-versus-host disease

A

maculopapular rash starts at the center then to the extremeties

60
Q

high risk of transfusion-associated graft-versus-host disease

what will u use to avoid these?

A
  • infants
  • cancer patients
  • immunocompromised patients

use IRRADIATED BLOOD COMPONENTS

61
Q

number of lymphocytes in a bag is determined by?

A

age of blood component

fresher blood components contain MORE VIABLE T-LYMPHOCYTES

62
Q

diagnostic testing for transfusion-associated graft-versus-host disease

A
  • skin biopsy
  • bone marrow examination
  • liver biopsy
  • molecular studies
63
Q

post transfusion purpura is rare, common in?

what is the treatment?

A

older women

infuse intravenous immunoglobulin

64
Q

this happens when a person previously sensitized to platelets due to transfusion or previous pregnancy is re exposed via transfusion

A

post transfusion purpura

65
Q

why post transfusion purpura is considered as self-limiting?

post transfusion purpura happens — after transfusion.

A

platelet counts return to normal within 2 weeks

1-24 days

66
Q

most commonly implicated in post transfusion purpura

what happens when u this kind of transfusion reaction?

A

Human platelet antigen 1a

severe thrombocytopenia with bleeding

67
Q

post transfusion purpura reaction destorys

A

reaction destroys both transfused and autologous platelets

68
Q

presence of iron deposits in vital organs which is the multiorgan damage secondary to excessive iron accumulation

A

transfusion-induced hemosiderosis
(non-immunologic)

69
Q

transfusion-induced hemosiderosis is presence of iron deposits in vital organs which is common in

these vital organs are?

A

thalassemias and chronic transfusion patients

liver and spleen

70
Q

treatment for transfusion-induced hemosiderosis (non-immunologic)

what is the alternative to transfusion therapy?

A

iron chelation therapy

red cell exchange transfusion

71
Q

chelating agents bind to iron in the tissues removing them via?

A

urine and/or feces

72
Q
A
73
Q

enumerate the chelating agents (3)

A
  • Deferoxamine
  • Oral deferiprone
  • Deferasirox
74
Q

transmission of disease

what is the most common hepatitis?

enumerate the other disease

A

hepatitis B and C

HIV, Malaria, Syphilis

75
Q

define iatrogenic

what transfusion reaction is associated with iatrogenic?

A

it is a physician-caused transfusion reaction

transfusion associated circulatory overload

BB LECT (finals) (6 decks)

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