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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
allergic transfusion reaction occurs as a response of recipient antibodies to allergens from the donor blood due to?
- 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
26
what type of hypersensitivity that occurs during allergic transfusion reaction?
type I
27
this refers to allergic transfusion reaction from non-IgE mediated release of mast cell mediators
anaphylactoid
28
allergic transfusion reaction is caused by --- due to that the donor has?
caused by **IgE** due to that the donor has **reagin**
29
# what will you do if allergic transfusion reaction occurs? if mild? if severe?
- if **mild**: temporary discontinue transfusion - if **severe**: discontinue
30
what will u do to avoid allergic transfusion reaction?
- administer **antihistamines** before transfusion - use **washed RBCs**
31
what will u do to avoid allergic transfusion reaction? if SEVERE
give: - aminophylline - epinephrine - corticosteroid
32
enumerate the symptoms of allergic transfusion reaction (5)
- urticaria - erythema - hives - itching (pruritus) - anaphylaxis
33
anaphylactic transfusion reaction is due to --- | this can cause?
- plasma proteins - IgA or anti-IgA | **mild urticarial** BUT NO FEVER
34
what will u do to avoid anaphylactic transfusion reaction?
transfuse **IgA deficient components**
35
acute reaction with respiratory distress, severe hypoxemia during or within 6 hours of transfusion, this refers to? | this is due to?
transfusion reaction associated lung injury | **HLA problems** of donor/patient
36
transfusion reaction associated lung injury is also known as?
- non-cardiogenic pulmonary edema - transfusion reaction associated lung injury - transfusion releated acute lung injury
37
# transfusion reaction associated lung injury the HLA problems cause a reaction of **recipient's WBCs** causing --- that occlude the ---
causing **aggregates** that occlude the **pulmonary circulation**
38
transfusion reaction associated lung injury is the leading cause of? | HLA problems may be with ---
**Transfusion-associated fatalities** | fever or hypotension
39
pulmonary hypersensitivity edema and allergic pulmonary edema. this is associated to?
transfusion reaction associated lung injury
40
what will u do to avoid transfusion reaction associated lung injury?
use **leukopoor blood**
41
transfusion-associated sepsis is caused by? | bacterial contamination: immunologic or non-immunologic?
endotoxins of gram (-) bacteria
42
temperature of 2C or more above normal and can be accompanied by hypotension. this refers to?
transfusion-associated sepsis
43
enumerate the cold-growing bacterias (5)
- Yersinia enterocolitica - E. coli - Pseudomonas - Propionibacterium acnes - B. cereus
44
enumerate the symptoms of transfusion-associated sepsis
dryness and flushing of patient's skin
45
# transfusion-associated sepsis always check the blood properly. what u will check?
check for: - color change - clots - cloudiness - hemolysis | you may perform **GS/C**
46
# true or false contamination usually occurs during transfusion.
FALSE. occurs during **phlebotomy or thawing** or from **contaminated platelet units**
47
this is when the cardiovascular system's ability to handle additional workload is exceeded. this refers to? | non-immunologic or immunologic?
transfusion-associated **circulatory overload** | non-immunologic
48
circulatory overload is an --- transfusion reaction | this is common in patient with?
**Iatrogenic** (physician-caused) transfusion reaction | common in patient with **cardiac and pulmonary disease**
49
# transfusion-associated **circulatory overload** hypervolemia may lead to? (4)
- CHF - pulmonary edema - cardiomegaly - distended pulmonary artery
50
# transfusion-associated **circulatory overload** enumerate the symptoms (5) | this can be used for diagnosis
- headache - dyspnea - coughing - chest tightness - hypertension | Pro-BNP
51
what will u do to avoid transfusion-associated **circulatory overload**?
- patient should **sit upright** - administer **supplemental oxygenation** - start diueresis - donor blood should be aliquoted - therapeutic phlebotomy - slow down transfusion
52
enumerate the delayed transfusion reactions (4)
- delayed hemolytic transfusion reaction - transfusion associated graft-versus-host disease - post-transfusion purpura - transfusion-induced hemosiderosis
53
delayed hemolytic transfusion reaction may heppen? | what is the most common sign?
14 days later after transfusion | **decreased hgb and hct**
54
delayed hemolytic transfusion reaction may be due to? | increased ---
IgG antibodies to **Rh, MNSs, Kell, Kidd, and Duffy antigens** | destroyed transfused RBCs
55
detection of new red cell antibodies and associated with secondary response also may be due to primary response. this refers to?
delayed hemolytic transfusion reaction
56
5-7 days post transfusion fever and mild jaundice, this refers to?
delayed hemolytic transfusion reaction
57
this is due to proliferation of competent lymphocytes which leads to profound **marrow aplasia** with a mortality rate >90% | death occurs?
transfusion asosciated **graft-versus-host disease** | **1-3 weeks** after first symptoms appear
58
enumerate the causes of reaction in transfusion asosciated **graft-versus-host disease** (5) | this occurs ---
- fever - liver problems - rash - diarrhea - pancytopenia (may lead to sepsis and hemorrhage) | occurs **3-30 days after transfusion**
59
what are the reactions that might occur of transfusion-associated graft-versus-host disease
**maculopapular rash** starts at the center then to the extremeties
60
high risk of transfusion-associated graft-versus-host disease | what will u use to avoid these?
- infants - cancer patients - immunocompromised patients | use **IRRADIATED BLOOD COMPONENTS**
61
number of lymphocytes in a bag is determined by?
age of blood component | fresher blood components contain **MORE VIABLE T-LYMPHOCYTES**
62
diagnostic testing for transfusion-associated graft-versus-host disease
- skin biopsy - bone marrow examination - liver biopsy - molecular studies
63
post transfusion purpura is rare, common in? | what is the treatment?
older women | **infuse intravenous immunoglobulin**
64
this happens when a person previously sensitized to platelets due to transfusion or previous pregnancy is re exposed via transfusion
post transfusion purpura
65
why post transfusion purpura is considered as self-limiting? | post transfusion purpura happens --- after transfusion.
platelet counts return to normal **within 2 weeks** | **1-24 days**
66
most commonly implicated in post transfusion purpura | what happens when u this kind of transfusion reaction?
Human platelet antigen 1a | severe thrombocytopenia with bleeding
67
post transfusion purpura reaction destorys
reaction destroys both **transfused** and **autologous platelets**
68
presence of iron deposits in vital organs which is the multiorgan damage secondary to **excessive iron accumulation**
transfusion-induced hemosiderosis (non-immunologic)
69
**transfusion-induced hemosiderosis** is presence of iron deposits in vital organs which is common in | these vital organs are?
thalassemias and chronic transfusion patients | **liver and spleen**
70
treatment for transfusion-induced hemosiderosis (non-immunologic) | what is the alternative to transfusion therapy?
iron chelation therapy | **red cell exchange transfusion**
71
chelating agents bind to iron in the tissues removing them via?
urine and/or feces
72
73
enumerate the chelating agents (3)
- Deferoxamine - Oral deferiprone - Deferasirox
74
# transmission of disease what is the most common hepatitis? | enumerate the other disease
hepatitis B and C | HIV, Malaria, Syphilis
75
define iatrogenic | what transfusion reaction is associated with iatrogenic?
it is a physician-caused transfusion reaction | transfusion associated **circulatory overload**

BB LECT (finals) (6 decks)

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