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
How is acute haemolytic reaction managed?
Stop transfusion and supportive measures | Send to lab to repeat tests
26
What is TACO?
Transfusion associated circulatory overload
27
Describe TACO
Within 6 hours of transfusion, presents with respiratory distress and signs of fluid overload
28
How is TACO treated?
Oxygen, supportive and diuretics
29
What are the risk factors for TACO?
Old age Heart failure Low albumin
30
Describe mild transfusion reactions
Temp rise >38 or 1/2 degrees Rash Continue with transfusion but monitor regularly
31
What can cause a mild transfusion reaction?
Allergic reaction - anti-histamine | Febrile non -haemolytic - paracetamol
32
Describe delayed haemolytic reactions
Delayed IgG response to red cell antigen, extravascular haemolysis 5-10 days post transfusion