Transfusion Medicine

Question 1

Cryoprecipitate components

Answer 1

• factor 8, fibrinogen, vWF

- used in DIC for fibrinogen

Question 2

Acute hemolytic transfusion reaction

Answer 2

• caused by ABO incompatibility
• findings: fever, chills, flank pain, abd pain, dyspnea, hypotension, tachycardia, free hgb in plasma. Coombs test is positive
• stop transfusion and notify blood bank
• maintain urine output at all costs

Question 3

Delayed hemolytic transfusion reaction

Answer 3

• delayed emergence of alloantibodies that causes rapid extravascular clearance of transfused erythrocytes 1-3 days after transfusion.
• findings: unexplained drop in hgb concentration, elevated serum bilirubin and LDH levels, increased retic count, decreased haptoglobin, presence of new alloantibody

Question 4

Post-transfusion purpura

Answer 4

• associated with thrombocytopenia >1 wk after transfusion
• reaction is most common in women who become sensitized to HPA-1a after pregnancy or an earlier transfusion. Subsequent transfusion may then cause immune-mediated thrombocytopenia
• diagnosis: antibodies to HPA-1a
• treat: IV Ig

Question 5

Febrile nonhemolytic transfusion reaction

Answer 5

• occurs at end of or after a transfusion and is caused by donor leukocyte cytokines or recipient alloantibodies directed against donor leukocytes
• treatment: stop transfusion, antipyretic agents and steroids are given

Question 6

Uses of FFP

Answer 6

-used to replace coagulation factors