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Heme Onc Royal College > Transfusion Medicine > Flashcards

Transfusion Medicine Flashcards

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1
Q

what factor has the shortest half life?

A

factor VII

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2
Q

half life of factor VII?

A

6 hrs

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3
Q

how to reverse warfarin

A

PCC (FEIBA)
vitamin K (IV faster than PO)
plasma can be given if other options are not available

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4
Q

what is in PCCs

A

human-derived coagulation factor concentrates - contains factor 2, 7, 9 and 10, protein C and S

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5
Q

volume of one unit of cryo

A

10-15 mL

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6
Q

infusion time of cryo

A

15-30mins for total dose

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7
Q

sepsis occurs most frequently with which blood product and why

A

platelets, because they are stored at RT

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8
Q

what is TRALI

A

acute respiratory distress with hypoxia and bilateral chest infiltrates on x-ray - occurs within 6 hrs of transfusion

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9
Q

when can transfusion associated GVHD occur?

A
  • immunocompromised recipient

- immunocompetent recipient transfused a haplo identical product

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10
Q

who should receive irradiated blood?

A
  • Congenital immunodeficiency states
  • Intrauterine and neonatal exchange transfusions
  • Pre-term infants
  • Patients with lymphoma
  • Post-transplant (bone marrow or stem cell)
  • Treatment with purine analogues (e.g. fludarabine)
  • Directed donations from family members
  • HLA-matched platelets
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11
Q

most common antigen causing anti-platelet antibodies post transfusion?

A

HPA-1a

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12
Q

most common viral infection transmitted by blood product in canada

A

west nile virus (< 1 in 1 million)
hepatitis B (1 in 1.7 million)
chagas (1 in 4 million)

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13
Q

components of cryoprecipitate

A

fibrinogen
factor 8
factor 13
vWF

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14
Q

what is the correlation between ABO antigen expression and VWF

A

people with blood type O have approx 25% less factor 8 and VWF

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15
Q

dosing of pRBCs and how much hemoglobin should increase

A

10-20 cc/kg (15 cc/kg) should increase hemoglobin by 10

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16
Q

dosing of platelets and how much count should increase

A

10 cc/kg should increase platelets by 50-100

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17
Q

FFP dosing and how much coagulation factors should increase

A

10-15 cc/kg should increase coagulation factors 15-20%

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18
Q

dosing of cryo and how much fibrinogen should increase

A

1 unit/10kg should increase fibrinogen by 0.5

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19
Q

which viruses are destroyed by viral inactivation?

A

encapsulated viruses (inactivation affects lipid membrane) such as HIV, hep B/C, HTLV, EBV, CMV

20
Q

at what age do isohemagglutinins develop?

A

usually between 4-8 months

altho small amounts can be detected at birth

21
Q

what is a type and screen

A

determines the person’s ABO blood group, Rh status and screens for antibodies against minor antigens

22
Q

what is a cross match

A

mixing of the person’s serum with the washed RBCs that they were matched with to ensure they do not agglutinate

23
Q

most common blood type?

A

O (approx 46% in canada)

24
Q

least common blood type?

A

bombay (no AB or H antigen, <1%)

followed by AB (approx 3%)

25
Q

common clinical scenarios that can have a positive DAT (name 3)

A

delayed hemolytic transfusion reaction
AIHA
HDFN

26
Q

what is the indirect antiglobulin test?

A

the patient’s serum is incubated with RBCs that are known to express a certain antigen on their cell surface, then incubated with anti-human globulin - observed to see if they agglutinate (used to screen pregnant women for antibodies that can cause HDFN)

27
Q

patient has anaphylaxis to blood products. how do you investigate IgA deficiency?

A

IgA level

anti-IgA antibodies

28
Q

special prep for platelets in patient with anaphylaxis related to IgA deficiency

A

apheresis platelets from IgA deficient donor

29
Q

special prep for RBCs in patient with anaphylaxis related to IgA deficiency

A

wash to reduce IgA levels significantly

30
Q

two uses of PCC

A
  • to reverse warfarin-related bleeding

- to treat bleeding in hemophilia B if purified factor is not available

31
Q

when would you use activated PCC (FEIBA)

A

in patient with hemophilia A and inhibitor who is bleeding

32
Q

how common is selective IgA deficiency?

A

range from 1/100 to 1/1000 (in canada, less common in asians)

33
Q

components of whole blood

A

RBC
plasma
buffy coat (which contains platelets)

34
Q

storage limit of platelets

A

5 days

35
Q

which antigens are important in SCD population

A

Rh and Kell

36
Q

what is the formula used to identify patients who are refractory to platelet transfusions

A

Correct count increments = platelet count increase x BSA x 10^11 / total platelet transfused

37
Q

how can you prevent platelet refractoriness?

A

use ABO compatible platelets

38
Q

treatment of platelet refractoriness

A

try using HLA matched platelets, crossmatch the platelets, give fresh platelets, ABO matched platelets

39
Q

cause of febrile transfusion reaction

A

cytokines that are generated / accumulated during storage of blood products

40
Q

three benefits of leukoreduction

A
  1. transmission of CMV
  2. alloimmunization of HLA antigens
  3. prevent febrile transfusion reactions
41
Q

what products are leukoreduced?

A

RBC and platelets

42
Q

why is blood irradiated?

A

to prevent transfusion associated GVHD

43
Q

what products are irradiated?

A

RBCs
platelets
granulocytes
non-frozen fresh plasma

44
Q

indication for CMV negative blood

A

patients receiving intrauterine transfusion

45
Q

indications for cryopreservation of RBCs

A

rare blood types (ie bombay phenotype)

46
Q

when evaluating an antibody panel, which antibodies have a dosage effect? (ie, if the antigen is heterozygous, it may be a false negative)

A 
Rh (other than D)
Kidd
Duffy
MNS 
("R you KidDing Me?")

Heme Onc Royal College (30 decks)

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