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Hematology, oncology > Transfusion medicine > Flashcards

Transfusion medicine Flashcards

1
Q

How is cryo obtained

A

FFP is thawed and largest proteins precipitate out (vWF, factor XIII, fibrinogen)
- then centrifuged, expressing off cryo-poor plasma

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2
Q

What is aphaeresis?

A

Centrifugation of blood to separate into plasma and platelets

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3
Q

What is pathogen reduction technology

A
  • technology that inactivates broad spectrum of pathogens and T-cells (thus may reduce risk of GVHD) in blood products
  • not yet readily available in the US
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4
Q

Only indication for transfusion above 7

A

ACS NOT CAD

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5
Q

Platelet goal if bleeding

A

50K

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6
Q

Platelet goal for neurosurgery

A

100K

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7
Q

Platelet goal if septic

A

20k

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8
Q

platelet goal for bone marrow biopsy

A

20k

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9
Q

Per ASCO what is the indication for transfusion for thrombocytopenia patient

A

NO THRESHOLD to transfuse unless bleeding

- They can be walking around with platelets of 6

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10
Q

platelet threshold for central line placement

A

20k

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11
Q

General rule of thumb for increase in platelet count from 1 aphaeresis unit or 4-6 whole blood pooled

A

40K

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12
Q

When do you see a marked increase in GI bleeding in terms of platelet level + why

A

Platelet count less than 5k (the daily requirement for vascular endothelial maintenance is around 7k)

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13
Q

Indications for FFP

A

1) PT or PTT greater than 1.5x with active bleeding
2) Massive transfusion
3) MAHA (TTP or HUS)
4) reversal of nutritional vitamin k deficiency or warfarin overdose with active bleeding

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14
Q

Use of FFP for INR reversal in the absence of bleeding

A

Not well supported but common in practice

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15
Q

PCC is FDA approved for what?

A

Urgent reversal for supra therapeutic warfarin with active bleeding

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16
Q

PCC contains

A

vitamin-k dependent clotting factors

17
Q

what does cryo have

A
  • vWF
  • fibrinogen
  • Factor VIII, Factor XIII
18
Q

Common indications for cryo

A
  • think about what it contains
    1) hypofibrinogenemia (less than 100)
    2) factor XIII deficiency
    3) vWF if no DDAVP
    4) uremic platelet dysfunction
19
Q

Rule of thumb for how much cryo will increase fibrinogen

A

10 units to increase fibrinogen by 100 mg/dL

20
Q

Products that are leukoreduced

A

RBC and platelets (leukoreduction…)

21
Q

How leukoreduction works

A

Filters out WBC’s

22
Q

Indications for leukoreduction

A

1) transplant patients (Reduce HLA alloimmunization)
2) Hx of febrile transfusion reactions
3) Reduce CMV (immunocompromised, CMV seronegative pregnant women, transplant CMV-seronegative patients)

23
Q

How irradiation works + purpose

A
  • Gamma radiation blocks replication of donor T lymphocytes.
  • it is an additional step on top of leukoreduction which can help prevent transfusion-associated GVHD
24
Q

Indications for irradiation

A
  • basically anyone who’s severely immunocompromised
    1) stem cell transplant patients (Reduce HLA alloimmunization) + prevent transfusion-associated VHD
    2) congenital immunodeficiency
    3) Treatment with potent immunosuppressive therapies (purine analogs, ATG, monoclonal antibodies)
25
Q

Presentation of delayed hemolytic transfusion reaction

A
  • typically asymptomatic
26
Q

What to think when patients don’t respond to platelet transfusion

A

HLA alloimmunization (exposure to HLA antigens on donor WBC causes platelet refractoriness)

27
Q

Indications for plasmapheresis

A
  • TTP
  • HUS
  • myasthenia gravis
  • GBS
  • Goodpasture syndrome
  • CIDP
  • Paraproteinemic polyneuropathy
28
Q

Indications for red cell exchange

A

1) acute CVA
2) CVA prophylaxis in SSD
3) malaria

29
Q

Indications for leukopheresis

A

1) hyperleukocytosis in AML

30
Q

virus who’s transmission can be prevented by leukoreduction

A

CMV (leukocytes can contain CMV)

31
Q

Why transplant patients need irradiated blood

A
  • reduce transfusion-associated GVHD
  • TA-GVHD doesn’t occur after most transfusions because the donor lymphocytes are destroyed by the recipients immune system before they can mount a response against the host.
32
Q

Most common pathogen transmitted through blood transfusion

A

Hep b

Hematology, oncology (218 decks)

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