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CP > Transfusion medicine > Flashcards

Transfusion medicine Flashcards

1
Q

What is the usual transfer time of 1 unit RBC?

A

1.30-3h - 4h limit from removal from cold storage to end of transfusion

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2
Q

How is RBC kept healthy during storage?

A

plasma is removed to leave concentrated red blood cells

replaced by a solution of electrolytes, glucose and adenine

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3
Q

Why are patients transfused with RBC?

A

To prevent symptoms of anaemia
To improve quality of life of anaemic patients
To prevent ischemic damage of end organs in anaemic patients

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4
Q

What is the transfusion threshold (trigger)?

A

lowest concentration of Hb that is not associated with symptoms
varies between different subgroups of patients

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5
Q

How long is the shelf life of platelets?

A

5 days from collection

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6
Q

What is the adult therapeutic dose of platelets?

A

platelets from 4 pooled donations

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7
Q

When do you transfuse platelets?

A

bleeding due to severe thrombocytopenia (low platelets)
platelet dysfunction
prevention of bleeding

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8
Q

When you transfer fresh frozen plasma?

A

coagulopathy with bleeding/surgery
massive haemorrhage
thrombotic throbocytopenic purpura

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9
Q

What are the contraindications of plasma?

A

warfarin reversal.

replacement of single factor deficiency

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10
Q

What is used for emergency reversal of life-threatening warfarin over-anticoagulation?

A

Prothrombin Complex Concentrate (PCC) - Plasma-derived Vit K dependent factors: II VII IX X

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11
Q

What is the group and screen test?

A

determination of ABO and Rh(D) group

patients plasma screened for antibodies against other clinically significant blood group antigens

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12
Q

What is an anti-globulin test?

A

testing the patient’s plasma against a panel of red cells containing all the clinically significant blood groups

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13
Q

What is a crossmatching compatibility test?

A

correct ABO and Rh donor selected

Patients plasma is mixed with aliquots of donor red cells to see if agglutination or haemolysis occurs

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14
Q

What are the immunological acute transfusion

reaction complications/ adverse effects of transfusion?

A

Acute haemolytic transfusion reaction
ABO incompatibility
Allergic /anaphylactic reaction
TRALI (Transfusion-related acute lung injury)

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15
Q

What are the non immunological acute transfusion

reaction complications/ adverse effects of transfusion?

A

Bacterial contamination
TACO (transfusion associated circulatory overload)
Febrile non-haemolytic transfusion reaction

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16
Q

What are the immunological delayed transfusion

reaction complications/ adverse effects of transfusion?

A

Transfusion-associated graft-versus-host disease (TA-GvHD)

Post transfusion purpura

17
Q

What are the non immunological delayed transfusion

reaction complications/ adverse effects of transfusion?

A

Transfusion Transmitted Infection (TTI) –viral/prion

18
Q

Before what time period after transfusion is a acute reaction?

A

24 hours

19
Q

After what time period after transfusion is a delayed reaction?

A

24 hours

20
Q

What infections come under infective risk of blood transfusions?

A

Hepatitis B
HIV
Hep C

21
Q

What is a sign of a transfusion reaction when giving a transfusion?

A

Oozing from venepuncture sites

22
Q

What blood group can only receive itself but donate to anyone?

A

O

23
Q

What blood group can receive from anyone but donate only to themselves?

A

AB

24
Q

What is acute haemolytic reaction?

A

caused by ABO incompatibility
release of free Bh
deposition of Hb in the distal renal tubule = acute renal failure.
stimulation of coagulation results = microvascular thrombosis
stimulation of cytokine storm

25
Q

What are the signs and symptoms of acute haemolytic reaction?

A 
Fever and chills 
Back pain 
Infusion pain
Hypotension /shock
Hemoglobinuria (may be the first sign in anesthetized patients)
Increased bleeding (DIC)
Chest pain
Sense of “impending death"
26
Q

When does acute haemolytic reaction first present?

A 
severe = within the first 15 mins
milder = later but usually before the end of transfusion
27
Q

What are the signs and symptoms of delayed haemolytic reaction?

A 
fatigue,
jaundice, 
and/or fever
Drop in Hb
Increased LDH
Increased indirect bilirubin
Positive direct antiglobulin test
28
Q

When does delayed haemolytic reaction first present?

A

Onset 3-14 days following a transfusion of RBC

29
Q

What is delayed haemolytic reaction?

A

due to immune IgG antibodies against RBC antigens other than ABO after the transfusion

30
Q

What is transfusion related acute lung injury?

A

Donor has antibodies to recipient’s leucocytes
Activated WBC lodge in pulmonary capillaries
Release substances that cause endothelial damage and capillary leak

31
Q

When does transfusion related acute lung injury present?

A

within 6 hours of transfusion

32
Q

What are the signs and symptoms of transfusion related acute lung injury?

A

Hypoxemia
New bilateral chest X-ray infiltrates
No evidence of volume overload

33
Q

What is the treatment for transfusion related acute lung injury?

A

Mild forms may respond to supplemental oxygen therapy.

evere forms may require mechanical ventilation and ICU support

34
Q

What are the signs and symptoms of transfusion-associated circulatory overload (TACO)?

A 
sudden dyspnea
orthopnoea - shortness of breath which occurs when lying flat
tachycardia 
hypertension 
hypoxemia
Raised BP
elevated jugular venous pulse
35
Q

What are the risk factors of transfusion-associated circulatory overload (TACO)?

A 
elderly patients 
small children
patients with compromised left ventricular function
increased volume of transfusion
increased rate of transfusion
36
Q

What presents in an allergic reaction after a transfusion?

A

Urticarial Rash

wheeze

37
Q

What are the symptoms of anaphylaxis after a transfusion?

A 
Severe, life-threatening
soon after transfusion started
Wheeze/ asthma
raised pulse
low BP (shock)
Laryngeal oedema/ facial oedema
38
Q

What is febrile non-haemolytic transfusion reactions (FNHTR)?

A

cytokines or other biologically active molecules that accumulate during storage of blood components

39
Q

What are the signs and symptoms of febrile non-haemolytic transfusion reactions (FNHTR)?

A

Fever
shakes/rigors
raised pulse

CP (50 decks)

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