Transfusion Medicine

Question 1

What infectious diseases are tested for with blood donation?

Answer 1

Hep B, Hep c, HIV, HTLV, Syphilis, West Nile, Trypanosoma cruzi

Question 2

What does the indirect antiglobulin test detect?

Answer 2

Antibodies in the patient’s serum

Question 3

Function of cell preservatives – citrate

Answer 3

Anticoagulant, binds Ca2+

Question 4

Function of cell preservatives–phosphate

Answer 4

Maintains 2,3 DPG levels

Question 5

Function of cell preservatives–dextrose

Answer 5

For cell metabolism

Question 6

Function of cell preservatives–adenine

Answer 6

For ADP/ATP production

Question 7

How much does 1 unit of pRBC’s raise the hemoglobin?

Answer 7

1 g/dL in an average sized adult

Question 8

When is transfusion for anemia supported?

Answer 8

<6 g/dL – but must take into consideration the patients entire presentation

Question 9

When giving pRBC’s which ABO type is the universal donor? universal acceptor?

Answer 9

Universal donor–O

Universal acceptor–AB

Question 10

What does 1 unit of Fresh Frozen Plasma do for a patient?

Answer 10

10-15 mL raises all clotting factors by 20-30% in average sized adult

Question 11

When giving FFP which ABO type is the universal donor? universal acceptor?

Answer 11

Universal Donor–AB (no antibodies)

Universal Acceptor–O (Both antibodies)

Question 12

How much does 1 unit of platelets raise the platelet count?

Answer 12

30,000-60,000 for the average sized adult

Question 13

What is the first thing to use for DIC?

Answer 13

Cryoprecipitate – it contains fibrinogen (and factors VIII, XIII, vWF)

Question 14

What is Febrile Non-hemolytic transfusion reaction (FNHTR)? How do you differentiate between that and Hemolytic transfusion reaction?

Answer 14

Antibodies in recipient against donor WBC’s

Patients may have similar symptoms (Chills/backpain/fever_ but hemolytic reaction will show +DAT, hemoglobinuria, increased bilirubin, decreased haptoglobin and increase LDH

Question 15

What can be given for rigors?

Answer 15

Demerol (IV)

Question 16

What is especially important in a case of hemolytic transfusion reaction?

Answer 16

Promote adequate renal blood flow (keep urine output >100 mL/hour with IVF and IV diuretics)

Question 17

What is the #1 cause of death with transfusion?

Answer 17

TRALI = Transfusion related acute lung injury

Patients are SOB, have pulmonary edema, hypotension, fever, tachycardia

Question 18

What are the three reactions to transfusion that may cause SOB?

Answer 18

TRALI
Allergic reaction
TACO = Transfusion associated circulatory overload

Question 19

Is a person hypertensive or hypotensive with TACO?

Answer 19

Hypertensive

Will also have an enlarged heart on CXR?

Question 20

What is the treatment for TACO?

Answer 20

Lasix