Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IHO Week 2 > Transfusion Medicine - Krafts > Flashcards

Transfusion Medicine - Krafts Flashcards

1
Q

What determines a blood group?

A

Antigens on the red cell surface!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Red Cell antigens

A
  • Antigens are inherited from parents
  • REALLY important for transfusion
  • ABO and Rh systems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ABO system

A

A, B, AB, or O

  • A has A antigens
  • Type O= neither A or B antigens

** what you don’t have, you make antibodies to.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do make an antigen?

A
  1. Start with protein precursor
  2. Add fucose to make H antigen
  3. Add N-acetylgalactosamine to H Ag –> A Ag
  4. Add galactose to H Ag –> B Ag
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

H Gene

A

Everybody has this

Codes for an enzyme that makes H antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A, B, and O genes:

A
  • you have 2 genes
  • 6 possible genotypes: AA, BB, AB, AO, BO, OO
  • A and B code for enzymes that make A and B antigens
  • O has no gene product
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Whats the big deal with blood types?

A
  • We make antibodies to the antigens we DON’T have!!
  • Anti-A antibodies lyse type A RBCs.
  • Anti-B antibodies lyse type B RBCs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Universal Recipient?

A

AB! Yay, no antibodies made – bring on any blood type for transfusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Universal dOnor?

A

Type O

Type O can only get Type O blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

But WAIT, give type O to an A, the type O has anti A antibodies –Doesn’t that suck?

A

Nope, doesn’t matter :)

  • -Not many antibodies in a packed unit of RBCs
  • only concerned about the antibodies that the recipient has.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rh System:

What are the antigens?

A

D antigen! (=Rh factor)
Alleles: D and d

DD ==Rh+
Dd=Rh+
dd= Rh - (that’s me :] )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rh System: antibodies

A

These are acquired. You have to be exposed to the D antigen first.

Lack the D antigen +++ Get exposed to D + blood ==== make anti-D
-comes into play in pregnancy: give Rhogam if you have Rh- mom with Rh+ baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Other Systems:

A
  • antibodies to antigens are acquired
  • Only come into play if you have lots of transfusion or pregnancies.
  • These aren’t included in routine tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Blood Transfusion: blood products

A

Whole blood, red cells, platelets, granulocytes, cryoprecipitates, fresh frozen plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Apheresis donation

A

Take platelets or neutrophils and then return blood to the donor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications for WHOLE BLOOD transfusion

RBC, WBC, platelets, plasma

A

Massive Hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Indications for Red cell transfusion

RBC, and a little WBC, platelets, and plasma

A

Low hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Leukocyte-Reduced Red cell transfusion?

RBC, NO WBC, rare platelets, a little plasma

A

Decreased alloimmunization
Decreased allergic reaction
(patient is reacting to WBCs)

19
Q

Frozen Red Cell transfusion indications?

RBC, a few WBC

A

Storage of rare blood types

20
Q

Granulocyte transfusion indications?

neutrophils

A

Sepsis in neutropenic patients

-sometimes BMT patients or hard hitting chemo pts .

21
Q

Platelet transfusion indications?

A

Bleeding due to thrombocytopenia

22
Q

Fresh Frozen Plasma indications?

Plasma- including all coagulation factors

A

-Bleeding due to multiple factor deficiencies (DIC)

23
Q

Cryoprecipitates indications?

(fibrinogen, von Willebrand factor, VIII, XIII) –don’t need to know all that is in this

A

Low fibrinogen, vW disease, hemophilia A, XIII deficiency

24
Q

VIII indications?

A

Hemophilia A

25
Q

IX indications?

A

Hemophilia B

26
Q

Albumin indications?

A

Hypovolemia with hypoproteinemia

27
Q

IvIG indications?

intravenous

A

disease prophylaxis
autoimmune disease
Immune deficiency states

28
Q

Testing – Forward Type:

A

Look to see what antigens are on red cells:
1. Take pt’s red cells
2. + anti A antibodies
3 +anti human globulin (AHG)

Clumping === A antibodies coating red cells and red cells HAVE A antigens

No clumping == no A antigens

*Do this with Anti B Antibodies too!

29
Q

Reverse Typing:

*to double check your work

A

Looking for antibodies in serum

  1. take pt’s serum
    • reagent red cells Type B
    • AHG

clumping == pt has anti B antibodies
No clumping == pt does not have anti B antibodies –> they have Type B or AB blood.

30
Q

Crossmatch Test:

do this when you know you are putting red cells into patient.

A

Patient serum + donor RBC + AHG —->

If you get clumping DON’T put donor blood in patient.

*last double check

31
Q

Antibody Screen:

A
  • look for antibodies against weird blood group systems.
  • do if pt has has had multiple pregnancies/transfusions and they are starting to have transfusion rxns.

agglutination == + test (patient has antibodies against something in this sample)

32
Q

What goes wrong in transfusions?

A

Transfusion rxn: hemolytic (more serious) or non hemolytic

Infections
Circulatory overload
Iron overload
Graft-versus-host disease

33
Q

Acute Hemolytic Transfusion Reactions

A

-when pt has ABO antibodies against donor red cells

Usually a clerical error :(

34
Q

Acute Hemolytic Transfusion Reactions:
Symptoms:

Labs:

A

Symptoms: fever, chest pain, hypotension
-Hbg in serum & urine(pink)

Labs: decreased haptoglobin
increased bilirubin, DAT ++

Type and cross-match shows ABO mismatch

35
Q

Delayed Hemolytic Transfusion Reactions:

-occurs days after transfusion

A
  • caused by antibodies to non-ABO antigens
  • Hemolysis usually extravascular
  • presentation: falling Hgb after transfusion
  • usually NOT severe
36
Q

Febrile Transfusion Reactions: non hemolytic

symptoms?
Diagnosis? -rule out everything else
Tx?

A

-Recipient antibodies against donor WBC

Cytokines –> fever, headache, nausea, chest pain

Tx? Tylenol. Leukocyte-reduced components

37
Q

Allergic Transfusion Reaction?

  • most common complication
  • non hemolytic
A

-Probs a host reaction to donor plasma proteins

HIVES!
Tx? hmmm – Antihistamines

38
Q

Maybe my patient is having a transfusion reaction… what should I do?

A

STOP THE TRANSFUSION

  • check if right blood, right patient
  • monitor vitals
  • send blood, urine, and bag to blood bank
  • Lab will do DAT, ABO/Rh testing, look for hemoglobinuria
39
Q

Acute Hemolytic Transfusion rxn - What do we worry about?

A

Lysis of RBC and the release of the contents can cause kidney damage.

40
Q

Infection Danger of Transfusions?

symptoms and tx?

A
  • uncommon
  • Transfusion-related BACTERIAL infection (most common)
  • Sudden fever and shock
  • Test patient and blood unit!

tx: aggressive resuscitation and antibiotic therapy

41
Q

What infections do we test blood for?

A

HIV (very uncommon)
HTLV
Hepatitis B and C (B is more common to get than C)
Syphilis

*Mankato double checks all these!

Other possibilities: EBV, CMV, malaria, lyme’s

42
Q

Circulatory Overload:

A

–too much blood is given too quickly

symptoms: hypertension, congestive heart failure

Tx: stop transfusion, give diuretics

43
Q

Iron Overload

A

Hey, too much iron can damage heart and liver, remember?

Biggest risk: chronic anemia patients

Tx: iron-chelating agents

44
Q

Graft vs. Host disease:

Tell me about it…
symptoms?

Prevention?

A

Donor lymphocytes attack host (immunocomprimised pts or pts with blood relative donors (thanks mom))

Fever, rash, hepatitis, marrow failure
usually FATAL

-prevent by irradiating products

IHO Week 2 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions