Transfusion Medicine

Question 1

What are the 4 main components of blood?

Answer 1

RBC
Platelets
Plasma
Cyroprecipitate

Question 2

What is in the RBC transfusion bag after centifruge?

Answer 2

RBC packed at the bottom. Optimal added solution (OAS) added which contains components that benefit the RBC and allow them to live fro 28-30 days

Question 3

When are RBC transfusions used?

Answer 3

Anaemic (symptomatic or hit threshold)

Major blood loss/bleeding

Question 4

What is restrictive threshold?

Answer 4

Don’t always believe you have to hit a specific count. If the patient can tolerate lower Hb stick to this

Question 5

What is in the platelet bag?

Answer 5

Platelets and platelet additive solution

Question 6

What is FFP?

Answer 6

Fresh frozen plasma

Question 7

What is FFP indicated?

Answer 7

Deficiency for coagulation/clotting.

Bleeding

Question 8

What is aferesis platelets?

Answer 8

Donor uses a machine that only takes platelets = more platelets can be taken at one time

Question 9

When are platelets transfused?

Answer 9

When low platelet count and bleeding

Question 10

Special considerations for FFP?

Answer 10

Needs to be thawed

Volume considerations - therapeutic dose is 1l which is a-lot to take if patient doesn’t react well

Question 11

Whats in cryoprecipitate bag?

Answer 11

Concentrated fibrinogen

Question 12

When is cryoprecipitate indicated?

Answer 12

Clotting deficiency or major haemorrhage

Question 13

Special considerations for cryoprecipitate?

Answer 13

Needs to be thawed

Should be given early in major haemorrhage

Question 14

Why should cryoprecipitate be given earlier in major haemorrhage?

Answer 14

Fibrinogen is one of the last parts of the clotting cascade - if you don’t have this you cant form a clot no matter how much of the other stuff you have

Question 15

What is traceability?

Answer 15

Legal obligation to be able to trace blood from donor to recipient

Question 16

How to ensure right blood, right patient?

Answer 16

Postive patient identification
Bedside label of samples - done at bedside
2 sample rule - need 2 blood samples to ensure it was the right blood group
Final bedside check
Consent

Question 17

Which is most likely in blood transfusion?
Infection
Human error
Reaction

Answer 17

Human error

Question 18

List 4 immunological risks of blood transfusion?

Answer 18

Febrile event (fever)
Allergy
Alloimmunisation - antibodies against RBC given
TRALI = less frequent

Question 19

Name a circulatory risk of blood transfusion?

Answer 19

Transfusion - associated circulatory overload

Question 20

List 4 types of infection that can occur after blood transfusion?

Answer 20

Bacterial
Virus (from donor)
vCJD
The unknown

Question 21

When is alloimmunisation a problem?

Answer 21

In women of child-bearing age - if the antibodies produced pass through placenta into uterus and the baby carries this blood type then the antibodies will attack it

Question 22

What kinds of haematological patient are relevant to dentistry?

Answer 22

Bleeding disorder

Chemotherapy - cytopenia (low blood count)

Question 23

What impact does blood transfusion in thrombocytopenia patients before dental extraction have impact on bleeding?

a) Increase
b) Decrease
c) No impact

Answer 23

c - no impact

Question 24

What is thrombocytopenia?

Answer 24

Low platelet count