Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

M2 Heme/Lymph > Transfusion Cases > Flashcards

Transfusion Cases Flashcards

1
Q

What are the two main sources of vitamin K?

A

Diet

Production by gut bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is the source of vitamin K important clinically?

A

Anything that disturbs dietary or bacterial vitamin K can affect bleeding risk.

Gut infection
Antibiotic use
Gut resection
Disease
Diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Just a reminder, what factors are vitamin K dependent?

A

2, 7, 9, 10, c, s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is present in cryoprecipitate?

A

Fibrinogen, von Willebrand Factor, Factor 13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If giving multiple blood products, which should be administered first?

A

Cryoprecipitate

Without replacing fibrinogen, clots will not form.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should be done on patients taking warfarin with an increased INR?

A

Conservative treatment first

  • Hold/ decrease warfarin
  • replace vitamin K
  • replace coagulation factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should be used to temporarily reverse warfarin?

What should be used to reverse warfarin long-term?

A

FFP or PCC

Vitamin K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is PCC?

A

A combination of vitamin K dependent clotting factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A patient has petechiae, low platelets, increased INR, and low fibrinogen. What is the most likely diagnosis?

A

DIC

Low fibrinogen is a give-away for this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is DIC treated?

A

DIC is a reactive disease; you must treat the underlying cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the criteria for massive blood loss?

A

One of the following:

  • loss of 5L in less than 24 hours
  • loss of half blood volume in less than 3 hours
  • loss of more than 150ml/min with hemodynamic instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the criteria for a massive transfusion?

A

One of the following:

  • more than 20 units blood in less than 24 hours
  • more than 10 units RBCs in less than 24 hours
  • more than 50 units blood products in less than 24 hours
  • more than 4 units RBCs in one hour, with ongoing need
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When might a massive transfusion be necessary?

A 
Trauma
Childbirth
Surgery
GI hemorrhage
Aortic aneurysm rupture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If giving blood products to replace blood volume, what ratio of products should be used?

A

2 RBCs : 1 FFP : 1 platelet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the best transfusion?

A

No transfusion

whoa….so deep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the three most common reactions to transfusions?

A
  • allergy/hives
  • febrile nonhemolytic reaction
  • TACO
17
Q

What is the ddx for transfusion related fever?

A
  • Febrile non-hemolytic transfusion reaction
  • Hemolytic transfusion reaction
  • Septic transfusion reaction
  • Transfusion related acute lung injury
  • Allergic reaction
18
Q

What are the symptoms of febrile non-hemolytic transfusion reaction?

Who is most likely to get it?

A

Chills, rigors, fever over 100.4 up to 4 hours following transfusion

multiparous women or multi-transfused patients

19
Q

What is believed to cause febrile non-hemolytic transfusion reaction?

How is it treated?

A

Recipient antibodies against donor WBCs
OR
Passive infusion of cytokines

Treat with tylenol

20
Q

What is the universal RBC donor?

What is the universal plasma donor?

A

O negative

AB positive

21
Q

Who should ALWAYS be given Rh negative blood?

The answer is not Rh negative people

A

Rh negatives with Anti-Rh IgG
Rh negative fertile females

All other Rh groups can be given Rh positive blood in an emergency

22
Q

What is the difference between the direct coombs test and the indirect coombs test?

A

Direct tests whether antibodies are binding to the RBCs and indirects tests whether there are anti-RBC antibodies in the serum

23
Q

Following hemolysis, in what order are byproducts cleared?

A 
Haptoglobin
Urine hemoglobin
Plasma hemoglobin
Serum Bilirubin
LDH
24
Q

What is important following acute hemolytic transfusion reaction?

A

Keep urine output VERY high to prevent clogging kidneys

25
Q

What is the most common cause of acute hemolytic transfusion reaction?

A

Human error

-usually patient misidentification

26
Q

What is the ddx for a patient presenting with transfusion related dyspnea?

A

TACO
TRALI
Anaphylaxsis

27
Q

Transfusion patient presents with dyspnea, bilateral infiltrates, and large heart. What is the dx?

A

TACO

28
Q

Transfusion patient presents with dyspnea, bilateral infilatrates, and normal sized heart. What is the dx?

A

TRALI

29
Q

Transfusion patient presents with dyspnea that improves with diuretics. What is the dx?

A

TACO

30
Q

What is the treatment for TTP?

A

plasma transfusion to replace ADAMTS13

31
Q

What are the recommendations for RBC transfusion in:

Hgb > 10
Hgb 10-8
Hgb 6-8
Hgb <6

A

Don’t transfuse
Don’t transfuse; consider trial
transfuse if symptomatic
transfuse

32
Q

What conditions should RBC transfusion be avoided?

A

Endocrine/Renal Insufficiency
Nutritional deficiency anemia
Compensated hemolytic anemias

33
Q

When should a patient receive platelet transfusions?

A

Marrow failure with counts <100K

34
Q

When should platelet transfusions be avoided?

A

Heparin induced thrombocytopenia
Thrombotic thrombocytopenic purpura
Immune thrombocytopenia (w/o bleeding)

35
Q

When should a patient receive a plasma transfusion?

A

documented coagulopathy
multiple factor deficiency
-liver disease, vitamin K, DIC, or Factor 11
surgery prophylaxis

36
Q

What is ADAMTS13?

What disease is caused by an ADAMTS13 deficiency?

A

enzyme responsible for cleaving VWF

TTP

37
Q

When should a plasma transfusion be avoided?

A

Volume expansion
Single factor defects
Vitamin K deficiency
Liver disease patient (not bleeding)

M2 Heme/Lymph (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions