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Haematology > Transfusion > Flashcards

Transfusion Flashcards

1
Q

State the criteria for blood donation

A

Hb 135g/l in males
Hb 125g/l in females
Weight >50kg

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2
Q

Describe the storage of each type of cell

A

Red cells - 4 degrees for 35 days
Platelets - room temp for 7 days with agitation
Plasma - - 30 degrees for 3 years

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3
Q

What microbiology tests are carried out on donor blood?

A

HIV, HBV, HCV, HEV, HTLV, Syphillis

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4
Q

What blood components are available for transfusion?

A

Red cells
FFP
Platelets
Cryoprecipitate

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5
Q

What blood products are available for transfusion?

A 
Anti-D immunoglobulin 
Prothrombin 
IV immunoglobulin 
Human albumin 
Specific Ig - zoster
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6
Q

What chromosome is the ABO gene on?

A

9

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7
Q

What do A and B genes do?

A

Code for transferases which modify precursor H substance on the red cell membrane

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8
Q

For each ABO phenotype give the possible genotype

A

Group O - OO
Group A - AA or AO
Group B - BB or BO
Group AB - AB

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9
Q

What is Landsteiner’s Law?

A

If an individual lacks the A or B antigen the corresponding antibody is produced by their plasma

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10
Q

Which antibodies are produced by each blood group?

A

A - anti-B
B - anti-A
O - anti A and anti B
AB - neither

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11
Q

Is rhesus positive or negative more common?

A

Positive

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12
Q

What is the problem with being rhesus negative?

A

If a patient is expose to D antigen they will mount an immune response and form an anti-D antibody which can cause a transfusion reaction or haemolytic disease of the new born

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13
Q

What two lab tests help to cross match the blood?

A

Antisera - specific antibody to identify antigen

Reagent red cells - specific antigen to identify antibody

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14
Q

What happens to IgM in the presence of antigen?

A

Agglutination

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15
Q

What colour are the antiseras?

A

Anti A - blue
Anti B yellow
Anti D clear

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16
Q

How is a patients plasma screened for antibodies?

A

Tested against reagent with known antigens and the additional of anti-human globulin

17
Q

State the clinical indications for red cells

A

Symptomatic anaemia Hb <70g/l

Major bleeding

18
Q

State the clinical indications for platelet

A

Prophylaxis in bone marrow failure
Bleeding in thrombocytopenia
Prophylaxis before surgery in thrombocytopenia

19
Q

State the clinical indications for FFP

A

Treatment of bleeding in patents with coagulopathy
Prophylaxis before surgery in coagulopathy
Massive haemorrhage
Early Trauma

20
Q

How soon will an acute transfusion reaction occur?

A

Within 24 hours

21
Q

What are the signs and symptoms of an acute transfusion reaction?

A

Symptoms - chills, rigours, rash, flushing, impending doom, collapse, loin pain, respiratory distress
Signs - fever, tachycardia, hypotension

22
Q

How should all transfusion reactions be managed?

A
  1. Stop transfusion
  2. ABCDE
  3. Re-check compatibility tag and pack
  4. Document in notes
23
Q

What is classed as a severe/life threatening reaction?

A

Shock - A, B, C compromise
Wrong component
Bacterial contamination

24
Q

Describe acute haemolytic reactions

A

Binding of IgM to the antigen on red cells leads to complement activation, lysis of transfused cells and release of inflammatory cytokines

25
Q

How is acute haemolytic reaction managed?

A

Stop transfusion and supportive measures

Send to lab to repeat tests

26
Q

What is TACO?

A

Transfusion associated circulatory overload

27
Q

Describe TACO

A

Within 6 hours of transfusion, presents with respiratory distress and signs of fluid overload

28
Q

How is TACO treated?

A

Oxygen, supportive and diuretics

29
Q

What are the risk factors for TACO?

A

Old age
Heart failure
Low albumin

30
Q

Describe mild transfusion reactions

A

Temp rise >38 or 1/2 degrees
Rash
Continue with transfusion but monitor regularly

31
Q

What can cause a mild transfusion reaction?

A

Allergic reaction - anti-histamine

Febrile non -haemolytic - paracetamol

32
Q

Describe delayed haemolytic reactions

A

Delayed IgG response to red cell antigen, extravascular haemolysis 5-10 days post transfusion

Haematology (18 decks)

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