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Classical Hematology > Transfusion Medicine > Flashcards

Transfusion Medicine Flashcards

1
Q

What blood type is universal RBC donor?

A

O-

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2
Q

What blood type is universal RBC recipient?

A

AB+

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3
Q

What is the second most immunogenic non-ABO antigen?

A

Kell

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4
Q

What is the purpose of leukocyte reduction? (4)

A

Reduce risk of:
Febrile nonhemolytic reaction
CMV transmission
HLA alloimmunization
Platelet refractoriness

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5
Q

What is the purpose of blood product irradiation?

A

Reduce risk of TA-GVHD

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6
Q

What is the purpose of washing blood products?

A

Severe or recurrent allergic or anaphylactic reactions
IgA deficiency
Intrauterine transfusions

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7
Q

Explain forward typing and reverse typing

A

Patient RBCs are mixed with sera that contain anti-A or anti-B IgM. Agglutination with either reagent indicates the presence of that Ag on RBC surface.
Reverse typing uses patient serum mixing with known RBCs

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8
Q

How does forward typing work with Rh antigen?

A

Only forward typing is needed. Unknown cells are tested against anti-D serum. If that patient is RhD-, there will be no reaction

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9
Q

What are some reasons why forward and reverse typing might not match?

A

If someone was recently transfused with type O blood
Newborns
Patients who received alloHCT from a different blood type
Some bacterial infections can cause a false B antigen to be detected on forward typing

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10
Q

What to do for patient with AIHA that needs transfusion?

A

Bloodbank testing will interpret the autoantibodies as there being no compatible blood.
Extended phenotypically matched cells may be needed, but don’t withhold transfusion

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11
Q

What transfusion reaction occurs within second/minutes of transfusion and is characterized by itching, hives?

A

Allergic/anaphylactic

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12
Q

Management of transfusion reaction where within second/minutes of transfusion and is characterized by itching, hives?

A

Stop transfusion
Antihistamines and steroids

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13
Q

What is the transfusion reaction where within seconds/minutes of transfusion you see fever, pain, hypotension, dark urine, and hemolysis

A

Acute hemolytic transfusion reaction

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14
Q

Management acute hemolytic transfusion reaction

A

Stop transfusion
hydrate
diuresis
maintain alkaline urine environment

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15
Q

What is the transfusion reaction that occurs within hours of transfusion and characterized by fever, rigors, chills, DAT negative

A

Febrile nonhemolytic transfusion reaction

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16
Q

Treatment for febrile nonhemolytic transfusion reaction

A

Antipyretics and meperidine for symptomatic treatment

17
Q

what can be used for prevention of febrile nonhemolytic transfusion risks

A

Leukoreduction

18
Q

Time frame for TACE?

A

Hours, up to 6 hours after

19
Q

Time period of TRALI

A

within 6 hours transfusion

20
Q

What is the mechanism of TRALI?

A

Anti-HLA or anti-neutrophil Abs present in donor plasma. Once transfused, these Abs bind to and active recipient leukocytes in pulmonary vascularture, causing noncardiogenic pulmonary edema

21
Q

What blood product has the highest risk of infection?

A

Platelets, because they are stored at room temperature

22
Q

Pathogenesis of delayed hemolytic transfusion reaction

A

Within 7-10 days of transfusion, patients have pre-existing antibodies to non-ABO group Abs. Once patient is transfused, an amnestic reaction occurs

23
Q

Pathogenesis of TA-GVHD

A

Within 7-10 days of transfusion, donor lymphocytes are transfused to immunocompromised patient. Donor lymphocytes engraft and cause diffuse maculopapular rash, jaundice, N/V/D

24
Q

Pathogenesis of post-transfusion purpura

A

5-10 days following transfusion. Anamnestic response to previously encountered foreign platelet antigen (most often against HPA-1a). Leads to increase in production of anti-platelet antibodies by the recipient, directed against donor platelet

25
Q

management of post transfusion purpura

A

IVIG x5 days
Steroids occasionally

26
Q

What is contained in FFP?

A

All coagulation factors

27
Q

What does cryoprecipitate contain?

A

Fibrinogen
Factor VIII
Factor XIII
Von Willebrand Factor
Fibronectin

28
Q

What is contained within activated PCC

A

Contains Factor II, VII, IX, X

Classical Hematology (15 decks)

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