Transfusion Medicine

Question 1

What is the screening procedure for people who are donating their blood?

Answer 1

Questionnaire
Urged to call back if sick
Screening:
-Hct
-Platelet count

Question 2

This blood component is stored at 4-6 degrees Celsius for 35 days to optimize RBC recovery.

Answer 2

Whole blood

Question 3

This blood component is stored at 4-6 degrees Celsius for 35-42 days. The plasma is removed.

Answer 3

Packed RBC

Question 4

This acellular product is kept at -18 degrees Celsius for one year and contains >80% of all plasma procoagulant and anticoagulant proteins as well as complement factors.

Answer 4

Fresh frozen plasma

Question 5

This blood component is made from fresh plasma frozen quickly at -80 degrees Celsius and allowed to sit for 18 hours at 4 degrees Celsius. After further prep the bag consists of 80-100 U factor VIII/bag, fibrinogen, and increased levels of factor XIII. Caution for IgM

Answer 5

Cryopercipitate

Question 6

This blood component is stored at 22-24 degrees Celsius for 5-7 days in a gas permeable bag. There are two types Random donor unit (RDU) or apheresis platelet concentrates

Answer 6

Platelet Concentrates

Question 7

This blood component is collected by apheresis procedures and does not allow for storage. They must be kept at room temperature and transfused within 8-12 hours

Answer 7

Granulocyte (WBC) concentrates

Question 8

What are the two standard infectious disease screening tests?

Answer 8

1. Antibody against and/or antigen for each infectious agent
2. Nucleic acid amplification test (NAT) for:
   Hepatitis C
   HIV
   West Nile Virus

Question 9

Is there a functional difference between alloantigens?

Answer 9

No

Question 10

ABO are polysaccharides the the H being the basic sugar chain attached to the RBC. What determines the following:

• O antigen
• A antigen
• B antigen

Answer 10

O= addition of a fructose 
A= addition of a fructose and N-acetylgalactosamine 
B= addition of a fructose and D-galactose

Question 11

At what point do people start making agglutinins to blood types they do not express?

Answer 11

One year of age

Question 12

Do people normally express antibodies to Rh antigens?

Answer 12

No. In order to develop alloantibodies against an antigen you have to have a prior exposure

Question 13

Which of the Rh factors is the most immunogenic?

Answer 13

D

Question 14

If there is no time to cross match and do a Coombs test to determine the compatibility between a donor and recipient, what blood type should you give?

Answer 14

Give O, Rh(D) negative

Males or non-childbearing females: O, Rh(D)

Question 15

What does the Coomb’s test involve?

Answer 15

Add the donors cells to the recipients plasma. Then add florescently labeled antibody

Question 16

What is the indication for using whole blood?

Answer 16

Replace O2 carrying capacity AND blood volume when1 blood volume has been lost

Question 17

What is the indication for using packed RBC?

Answer 17

Transfused for oxygen carrying capacity. For chronic anemia

Question 18

What is the indication for using fresh frozen plasma?

Answer 18

Procoagulation deficiency (DIC, Liver failure, Vitamin K deficiency)

Deficiencies in Factors VIII, IX, VII

Question 19

What is the indication for using cyropercipitate?

Answer 19

Low or absent fibrinogen
Replacement for factor XIII deficiency
Factor VIII deficiency + von Willebrands Factor

Question 20

What is the indication for using platelet concentration?

Answer 20

Bleeding associated with thrombocytopenia or platelet dysfunction

Question 21

What is the indication for using granulocyte concentrations?

Answer 21

Severe fungal and bacterial infections

Question 22

What is the adverse reaction associated with > or equal to 1 degree Celsius rise in temperature from pre-transfusion events?

Answer 22

Febrile non-hemolytic transfusion reaction

Question 23

What adverse reaction is associated with hives after transfusion?

Answer 23

Mild allergic reaction

Question 24

What adverse reaction is associated with activation of complement and intravascular hemolysis which may lead to shock, acute renal failure and disseminated intravascular coagulation?

Answer 24

Immediate hemolytic transfusion reactions
TX with vigorous supportive care, diuretics and heparin
Incompatible ABO

Question 25

What adverse reaction is associated with slow destruction of the sensitizing red cells withvery few symptoms and signs?

Answer 25

Delayed hemolytic reaction

Question 26

What adverse reaction is associated with bronchospasm and/or large airway response and is treated with epinephrine, benadryl and steroids?

What patient population is particularly at risk?

Answer 26

Anaphylactic reaction

IgA deficient individuals

Question 27

What adverse reaction is associated with acute lung injury, infiltrates, problems breathing and difficulty maintaining peripheral oxygen saturation on room air. This occurs within 6 hours of transfusion

Answer 27

Transfusion related lung injury

TX: Vigorous ventilatory support

Question 28

What adverse reaction is associated with excessive amounts of products and/or cardiac dysfunction?

Answer 28

Transfusion associated circulatory overload (TACO)

TX: Diuretics