Transfusion Effects in Selected Patients Flashcards

1
Q

What are the two instances where transfusion of blood components may be used to support a patient?

A
  • Hematological problems
  • Rapid blood loss
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2
Q

What are the adverse side effects of mass transfusions?

A
  • Citrate toxicity
  • Hypothermia
  • Coagulation abnormalities such as consumption and dilutions
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3
Q

What three things that will be affected due to severe blood loss?

A
  • Electrolyte metabolism
  • Oxygen transportation
  • Stress on organs - increased heart rate
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4
Q

What is the goal of transfusing a patient who is experiencing severe blood loss?

A
  • Prevent hypovolemic shock
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5
Q

What risks might be seen due to hemorrhagic shock?

A
  • Organ failure
  • DIC
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6
Q

What is the method called, by which the patients blood is circulated outside of the body during cardiopulmonary bypass surgery.

A

Extracorporeal membrane oxygenation (ECMO)

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7
Q

What must a patient be on while undergoing a bypass surgery and why?

A

Heparin, because activation and thrombosis occurs in the ECMO process.

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8
Q

What is the risk of heparin excess?

A

Prolonged aPTT

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9
Q

How is heparin excess corrected?

A
  • Protamine treatment
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10
Q

When would we use frozen plasma for heparin excess?

A

Only when the patient has a serious bleed during surgery or shortly after to replace coagulation factors.

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11
Q

When is HgbF usually converted to adult Hgb?

A

32-34 weeks gestation

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12
Q

What is the biggest issue in premie’s and what is it?

A

Iatrogenic blood loss - caused by excessive blood collecting.

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13
Q

Where is EPO produced for newborns?

A

Liver

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14
Q

What are the symptoms of hypovolemia in newborns?

A
  • Cessation of breathing
  • Apnea
  • Metabolic rate
  • Hypoglycemia
  • Acidosis
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15
Q

What criteria have to be met in order to give newborn units of blood products?

A
  • Irradiated
  • Washed or fresh cells (<7 days)
  • ABO compatible
  • CMV negative
  • Leukoreduced
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16
Q

What is iatrogenic blood loss?

A

Over collecting blood from neonates resulting in anemia

17
Q

Which antigens are responsible for acute/chronic graft rejections?

A

ABO antigens

18
Q

What is the usefulness of hematopoietic progenitor cell transplants?

A
  • Aplastic anemia
  • Marrow failure
  • Leukemia
  • Lymphoma
  • Hodgkin’s disease
  • immunodeficiency syndrome
19
Q

Where are hematopoietic progenitor cell derived from?

A
  • bone marrow
  • Peripheral blood
  • umbilical cord blood
20
Q

what are the symptoms of GVHD?

A
  • rash
  • diarrhea
  • jaundice
  • fatal when untreated
21
Q

What is therapeutic apheresis?

A

Removal of abnormal cells, plasma or plasma constituents

22
Q

What is therapeutic plasma exchange? What purpose does it serve?

A

Plasma is removed from the PT and the blood cellular components are returned. To remove pathologic proteins

23
Q

In therapeutic plasma exchanges what is critical to ensuring the patient doesn’t go into hypovolemic shock?

A

Plasma that is removed should be replaced with albumin, donor plasma or 0.9% NaCl

24
Q

What are symptoms of citrate toxicity?

A
  • Numbness
  • Oral tingling
  • Nausea
  • Light headed
  • ECG changes
25
Q

What is therapeutic plasma exchange useful for?

A
  • Lupus
  • Waldenstrom’s macroglobinuria
  • Guillain-Barre Syndrome
  • TTP
26
Q

What is red cell exchange (Erythrocytapheresis)?

A

Removal of PT red cells and their plasma and PLT are returned.

27
Q

What purpose does red cell exchange serve?

A

Benefits patients with hemoglobinopathies

28
Q

What is photopheresis? What purpose does this procedure serve?

A

Collection of the buffy coat layer, to prevent leukocyte replication and induce programmed cell death.

29
Q

Following photophoresis what are patients infused with?

A

WBC’s

30
Q

What is expected to decrease in patients undergoing chemotherapy treatments, think CBC results.

A
  • PLT
  • WBC
  • Hgb
  • Hct
31
Q

What is the cause of PLT refractoriness?

A

HLA antigens in PLT

32
Q

What is the purpose of desmopressin?

A

Promote hemostasis by promotion the release of vWF.

33
Q

What are three primary hemostasis diseases?

A
  • vWD
  • Thrombocytopenia (allo and auto)
  • PLT function disorders
    (Glanzmann & bernard soulier)
34
Q
A