Transfusion Medicine 1

Question 1

What are the 2 reasons provided for transfusing blood components vs. whole blood?

Answer 1

• Conservation of blood resources

- Storage of each component at optimal conditions

Question 2

RBCs are stored in _ to extend their shelf life

Answer 2

Preservative solutions

Question 3

What is the major determinant of RBCs delf life?

Answer 3

The preservative solution chosen

Question 4

What is the optimal storage temperature for RBCs?

Answer 4

1-6 degrees C

Question 5

What is the indication for RBC transfusion?

Answer 5

Anemia with compromised clinical status

Question 6

True or false, RBC are frequently used as volume expanders, especially in immunocompromised patients

Answer 6

FALSE!! Use crystalloid or colloid instead

Question 7

One unit of RBC will increase an adults hemoglobin by _ g/dl. What about a child?

Answer 7

Adult (1g/dl) and pediatric (2g/dl)

Question 8

A patient with A blood can receive what type of blood (transfusion)?

Answer 8

A or O

Question 9

A person w/ B blood can receive what type of blood?

Answer 9

B or O

Question 10

A person w/ AB blood can receive what type of blood?

Answer 10

AB, A, B or O

Question 11

A person w/ O blood can receive what type of blood?

Answer 11

O

Question 12

What is the major reason for matching up blood during transfusion?

Answer 12

Prevents immune hemolysis

Question 13

For storage, platelets are suspended in _

Answer 13

Plasma

Question 14

Platelets can be obtained form either a single donor or pooled. What are the advantages of single donor platelets? (2)

Answer 14

Decreased risk of disease transmission and decreased risk of immunization with platelet antigens

Question 15

Platelets are pooled from how many blood donors to equal a single apheresis platelet donor?

Answer 15

Blood from 6-8 donors

Question 16

What is the shelf life of platelets and how are they stored?

Answer 16

5 day shelf life, stored at room temp (20-24 degrees)

Question 17

T/F. In cases of quantitative deficiencies, platelets are indicated to stop bleeding or to prevent bleeding before a proceedure

Answer 17

True

Question 18

T/F in cases of qualitative deficiencies, platelets are indicated for congenital platelet dysfunction syndromes or when a patient has been treated w/ a drug that inactivates platelets

Answer 18

True

Question 19

What are the 2 examples from this lecture of congenital platelet dysfunction diseases?

Answer 19

Bernard Soulier and Glanzmann’s thrombastenia

Question 20

I unit of platelets will Increase platelet counts by how much in a child? In an adult?

Answer 20

Child (140K/ul) and adult (30K/ul)

Question 21

T/F. Platelets are only transfused if they were obtained from a donor of the same blood type as the receipient

Answer 21

False. Matched blood types ideal but not essential

Question 22

Granulocytes for transfusion are usually contaminated w/ what 3 things?

Answer 22

RBCs, platelets and lymphocytes

Question 23

What is the shelf life for granulocytes? How are they stored?

Answer 23

24 hr shelf life, stored at room temp (20-24 degrees)

Question 24

What are the indications for granulocyte infusion?

Answer 24

Bacterial or fungal infection unresponsive toantibiotics AND
•Neutropenia (WBC <500/μL) or
•Hereditary neutrophil function defect

Question 25

What is the dosing regimen for granulocytes? What detemines when you stop administering granulocytes?

Answer 25

1 unit per day until infection resolves or WBC level recover.

Question 26

T/F granulocyte infusions must be blood type compatible. Why?

Answer 26

True, because granulocytes are contaminated with RBCs

Question 27

T/F granulocytes infusions significantly raise WBC counts

Answer 27

False, hard to substantially change WBC count

Question 28

The acellular blood component is referred to as _. What is its shelf life and how is it stored?

Answer 28

Plasma, stored frozen for up to 1 year

Question 29

How long is thawed plasma good for? How is thawed plasma stored?

Answer 29

Good for 5 days, stored at 1-6 degrees C

Question 30

When plasma is thawed, what 2 factors are degraded after 24 hrs

Answer 30

Factors V and VIII

Question 31

What are the 2 indications of plasma?

Answer 31

1) Multiple coagulation factor deficiencies AND current bleeding / planned proceedure 2) Congenital factor deficiency w/ our concentrate available (Factor 10)

Question 32

There is a logarithmic relationship between plasma coagulation factor concentration and INR. How does this affect infusion rates?

Answer 32

Need to infuse plasma fast, as a bolus

Question 33

What are the major components of cryoprecipitate?

Answer 33

Factor XIII, fibrinogen, VWF and Factor 8

Question 34

How is cryoprecipitate made?

Answer 34

Centrifuge thawed plasma, retain precipitate, redissolve and freeze

Question 35

What are the 2 current indications of cryoprecipitate?

Answer 35

1) Fibrinogen deficiency + bleeding or planned proceedure 2) Congenital deficiency of factor 13

Question 36

What are the 2 types of blood products that can undergo leukocyte reduction?

Answer 36

RBCs and platelets

Question 37

What are 3 reasons to for leukocyte reduction?

Answer 37

1) CMV infection, 2) Ab formation vs HLA Ag expressed on WBC3) Febrile reactions to transfusion (caused by cytokines in products)

Question 38

What are the 3 types of blood products that can undergo irradiation?

Answer 38

RBCs, granulocytes and platelets

Question 39

What is the indication of irradiation of blood products?

Answer 39

Prevention of transfusion associated graft vs. host disease (GVHD) by preventing lymphocyte proliferation

Question 40

Quality of what 2 blood products are adversely affected by washing?

Answer 40

Platelets and granulocytes

Question 41

What is the indication of washing of a blood product? (2)

Answer 41

Reduce risk of allergic reaction and to remove excess potassium from RBCs

Question 42

Under what circumstances would RBCs be frozen?

Answer 42

Performed for RBC lacking common RBC Ag (rare blood types), increases shelf life to 10 yrs