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IHO Week 2 > Transfusion Medicine - Krafts > Flashcards

Transfusion Medicine - Krafts Flashcards

1
Q

What determines a blood group?

A

The antigens on the red cell surface.

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2
Q

Antigens are inherited how?

A

Mendelian pattern (everyone has 2 genes - one from mom and one from dad)

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3
Q

Type A Blood

A

Have A Antigen

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4
Q

Type B Blood

A

Have B Antigen

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5
Q

Type AB Blood

A

Have A and B Antigens

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6
Q

Type O Blood

A

Have neither A nor B Antigens

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7
Q

How do you make antigens?

A

Start with protein precursor
Add fucose to make H antigen
Add N-Acetylgalactosamine to H antigen to make the A antigen
Add Galactose to H antigen to make B antigen

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8
Q

If you don’t make then antigen, then what?

A

Then you naturally make antibodies against the antigen.

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9
Q

What gene does almost everyone have?

A

H Gene, codes for enzyme that makes H antigen

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10
Q

True/False: O has no gene product.

A

True

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11
Q

Bombay Phenotype

A

Do not have H antigen, therefore makes antibodies against H, A, and B.

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12
Q

Anti-A antibodies lyse what cells?

A

Type A Red Cells

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13
Q

Anti-B antibodies lyse what cells?

A

Type B Red Cells

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14
Q

What antigen is the most important in the Rh system?

A

D Antigen

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15
Q

Rh factor has 2 alleles: D and d. What antigen is considered Rh+?

A

D allele = D antigen = Rh+

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16
Q

Rh factor antibodies must be…

A

ACQUIRED

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17
Q

To make anti-D antibodies, you must:

A
  1. Lack the D-antigen on your red cells

2. Get exposed to D+ blood

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18
Q

Antibodies to antigens in the “other” systems are acquired, but how?

A
  1. Patient with multiple blood transfusions

2. Patient with multiple pregnancies

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19
Q

Why do we not have blood (components) products rather than whole blood?

A
  1. Don’t expose patients to excess antigens

2. Conserve the blood supply

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20
Q

What is apheresis and what is it used for?

A

Take blood out, take what cells you need, put blood back into patient
Used for platelets and granulocytes

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21
Q

Whole blood can be divided into what 3 blood products?

A

Red Cells
Granulocytes
Platelet-Rich Plasma

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22
Q

Red Cells can be divided into what 2 blood products?

A

Leukocyte-Reduced Red Cells

Frozen Red Cells

23
Q

Platelet-Rich Plasma can be divided into what 2 blood products?

A

Platelets

Fresh Frozen Plasma

24
Q

Fresh Frozen Plasma can be divided into?

A

Cryoprecipitate

VIII, IX, Albumin, IgG

25
What does whole blood contain and what is it used for?
RBC, WBC, platelets, plasma | Use: Massive Hemorrhage
26
What does Red Cells contain and what is it used for?
RBC!!! Few WBC, platelets, plasma Use: Low Hemoglobin
27
What does Leukocyte-Reduced Red Cells contain and what is it used for?
RBC!!! NO WBC, Rare platelets, little plasma Use: Low Alloimmunization Low Allergic Reactions
28
What does Frozen Red Cells contain and what is it used for?
RBC and few WBC | Use: Storage of rare blood types (good for 10 years)
29
What does Granulocytes contain and what is it used for?
Neutrophils | Use: sepsis in neutropenic patients
30
What are platelets used for?
Bleeding due to Thrombocytopenia
31
What does Fresh Frozen Plasma contain and what is it used for?
Plasma (including ALL coagulation factors) | Use: Bleeding due to multiple factor deficiencies (Disseminated Intervascular Coagulation)
32
What does Cyroprecipitate contain and what is it used for?
Fibrinogen, von Willebrand factor, VIII, XIII | Use: Low fibrinogen, vW disease, Hemophilia A, XIII deficiency
33
What is VIII used for?
Hemophilia A
34
What is IX used for?
Hemophilia B
35
What is Albumin used for?
Hypovolemia with Hypoproteinemia
36
What is IvIG used for?
Disease prophylaxis, autoimmune disease, immune deficiency states
37
Forward Type
Add anti-A, anti-B, anti-D antibodies to red cells | DAT (Direct-Antiglobulin Test) using Anti-humanglobulin to cause agglutination if positive
38
Reverse Type
Add B-Type RBCs to patient serum with anti-B antibody DAT using AHG to cause agglutination if positive Add A-Type RBCs to patient serum with anti-A antibody DAT using AHG to cause agglutination if positive
39
Crossmatch
Add donor RBCs to patient serum | DAT using AHG - if positive, do NOT give that blood to patient
40
Antibody Screen
Multiple Pregnancies or MultipleTransfusions Look for antibodies in the patient against weird blood groups Add "weird reagent" RBC to patient serum, perform DAT with AHG to cause agglutination if positive (looking for antibodies in the patient's serum)
41
Acute Hemolytic Transfusion Reactions
Due to ABO antibody mismatch against donor red cells Symptoms: fever, chest pain, hypotension, kidney pain Hemoglobin in serum and urine Labs: Decreased Haptoglobin, Increased Bilirubin, DAT positive
42
Delayed Hemolytic Transfusion Reactions
Due to Rh antibody mismatch causing extravascular hemolysis occurring days after transfusion, with a falling hemoglobin Labs: DAT positive, Antibody Screen
43
Febrile Transfusion Reactions
Commonly caused by recipient antibodies against WBC in donor blood which causes a febrile reaction with fever, headache, nausea, chest pain (all induced by cytokines) Treatment: Tylenol; Leukocyte-reduced components
44
Allergic Transfusion Reactions
Host reaction to donor plasma proteins which results in hives Treat with antihistamines Rarely causes anaphylaxis
45
What do you do if you suspect a transfusion reaction?
STOP THE TRANSFUSION Check blood of patient and donor Monitor vitals Send blood, urine, and bag of blood to lab
46
Transfusion-related bacterial infections
Symptoms: Fever, shock Treatment: aggressive resuscitation and antibiotic therapy Test: patient and blood unit
47
Circulatory Overload
When too much blood is given too quickly Symptoms: hypertension, CHF Treatment: Stop transfusion, give diuretics
48
Iron Overload
Too much iron can damage the heart and liver (High risk: chronic anemia) Treatment: Iron-Chelating agents
49
Graft vs. Host Disease
Donor lymphocytes attack host in immunocompromised patients or blood-relative donors Symptoms: fever, rash, hepatitis, marrow failure, usually fatal
50
What is the most common infection from a blood transfusion?
Bacterial Infection (more common in platelets = stored at room temperature, than in RBC transfusions = stored in fridge)
51
What is the least common infection from a blood transfusion?
Hepatitis C and HIV
52
What is the most common complication from a blood transfusion?
Allergic Reaction
53
What is the least common complication from a blood transfusion?
Acute Hemolysis

IHO Week 2 (13 decks)

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