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yr 5 haem > transfusion > Flashcards

transfusion Flashcards

1
Q

what electrolyte abnormality ca you get with blood transfusions

A

hyperkalaemia (risk is higher when receiving multiple units)

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2
Q

what are the components of cryoprecipitate

A

FIBRINOGEN, factor VIII, vWF

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3
Q

what are the uses for cryoprecipitate

A

DIC, liver disease, major haemorrhage, bleeding related to haemophilia A

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4
Q

storage of cryoprecipitate

A

same as FFP

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5
Q

what is the use of prothrombin complex

A

it is used in the emergency reversal of anticoagulation in patients with fatal bleeding like intracranial haemorrhage or vatical bleed

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6
Q

what must prothrombin complex be administered with

A

IV vit K (as prothrombin has a short half life and will wear off after 6 hours, which is when vit K starts to work)

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7
Q

what is the universal donor of FFP

A

AB

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8
Q

what is the storage of FFP

A

has to be stored at -18. has a one year shelf life and needs 45 mins to thaw

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9
Q

what level of platelets do you transfuse at if someone has clinically significant bleeding

A

<30 x 10(9)

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10
Q

if there is no active bleeding, at what level do you transfuse platelets

A

10x10(9)

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11
Q

2 conditions where you would not transfuse platelets

A

thrombotic thrombocytopenia purport and chronic bone marrow failure

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12
Q

shelf life of platelets

A

5 days

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13
Q

when is a pregnant mum tested for her rhesus status

A

at booking appointment

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14
Q

if a mum is rh -, when is anti D given in pregnancy

A

there are two regimes - one dose at 28 weeks or two doses, one at 28 weeks and one at 34 (if there is a sensitising event - do kleihauer test and then give anti D)

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15
Q

how long does it take blood to be crossmatched in an emergency situation

A

45 mins

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16
Q

what is electronic issue and when is it appropriate

A

when blood is issues without a crossmatch. It is appropriate only if antibody negative and if patients current blood group matches the one on the system.

17
Q

what kind of antibody causes ABO incompatibility reaction

A

IgM (hence why it cannot cross the placenta)

18
Q

when are observations done in a blood transfusion

A

at the start of a transfusion, within 15 mins and then on completion

19
Q

who needs CMV neg blood

A

pregnant women and neonates up to 28 days

20
Q

how does a TAGVHD present

A

10 days post transfusion, rash, fever, diarrhoea

21
Q

what happens in TAGVHD (why certain people need irradiated blood products)

A

the donor cells can engrafted into the host as they cannot be recognised as non self and then they react to the host

22
Q

4 alternatives to transfusion

A

intraoperative cell salvage, iron transfusion, EPO, tranexamic acid

23
Q

how long should blood products be traceable for

A

30 years

24
Q

Storage of red blood cells

A

-stored at 4 degrees and transfusion needs to be started within 30 minutes of removal from fridge
-usually transferred over 90-120 minutes
-shelf life 35 days from collection
-can be stored in a blood bank validated cooler for 6 hours
-in practise should use one unit and then recheck Hb

25
Q

what is the limit for platelets in surgery

A

<50 x 10(9)

26
Q

what is the coagulopathy you get in liver disease

A

reduced production of platelets, fibrinogen and clotting factors

27
Q

what is the coagulopathy you get in ESRF

A

get high uraemia which promotes platelet abnormalities (increased bleeding time)

28
Q

what is a major haemorrhage defined as

A

loss of more than one blood volume in 24 hours, 50% of total blood volume lost in 3 hours, bleeding in excess of 150ml/min but in practise its based on signs : systolic < 90 and HR > 110

29
Q

what do blood bank prepare when major haemorrhage protocol is activate

A

2FBC,2FFP, 1 platelet

30
Q

what is the lethal triad in major haemorrhage

A

hypothermia, acidosis and coagulopathy

31
Q

what is TIBC like in an iron deficiency anaemia

A

high

32
Q

when might ferritin be falsely elevated in an iron deficienecy anaemia

A

it is an acute phase protein so may be elevated in inflammatory conditions

33
Q

how often do you need the pneumococcal vaccine in hyposplenism

A

5 yearly

34
Q

how often do you need pneumococcal in diabetes or chronic respiratory

A

once

35
Q

contraindications to a platelet transfusion

A

chronic bone marrow failure, heparin induced thrombocytopenia, autoimmune thrombocytopenia

yr 5 haem (5 decks)

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