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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
Q

What does whole blood contain and what is it used for?

A

RBC, WBC, platelets, plasma

Use: Massive Hemorrhage

26
Q

What does Red Cells contain and what is it used for?

A

RBC!!!
Few WBC, platelets, plasma
Use: Low Hemoglobin

27
Q

What does Leukocyte-Reduced Red Cells contain and what is it used for?

A

RBC!!!
NO WBC, Rare platelets, little plasma
Use: Low Alloimmunization
Low Allergic Reactions

28
Q

What does Frozen Red Cells contain and what is it used for?

A

RBC and few WBC

Use: Storage of rare blood types (good for 10 years)

29
Q

What does Granulocytes contain and what is it used for?

A

Neutrophils

Use: sepsis in neutropenic patients

30
Q

What are platelets used for?

A

Bleeding due to Thrombocytopenia

31
Q

What does Fresh Frozen Plasma contain and what is it used for?

A

Plasma (including ALL coagulation factors)

Use: Bleeding due to multiple factor deficiencies (Disseminated Intervascular Coagulation)

32
Q

What does Cyroprecipitate contain and what is it used for?

A

Fibrinogen, von Willebrand factor, VIII, XIII

Use: Low fibrinogen, vW disease, Hemophilia A, XIII deficiency

33
Q

What is VIII used for?

A

Hemophilia A

34
Q

What is IX used for?

A

Hemophilia B

35
Q

What is Albumin used for?

A

Hypovolemia with Hypoproteinemia

36
Q

What is IvIG used for?

A

Disease prophylaxis, autoimmune disease, immune deficiency states

37
Q

Forward Type

A

Add anti-A, anti-B, anti-D antibodies to red cells

DAT (Direct-Antiglobulin Test) using Anti-humanglobulin to cause agglutination if positive

38
Q

Reverse Type

A

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
Q

Crossmatch

A

Add donor RBCs to patient serum

DAT using AHG - if positive, do NOT give that blood to patient

40
Q

Antibody Screen

A

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
Q

Acute Hemolytic Transfusion Reactions

A

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
Q

Delayed Hemolytic Transfusion Reactions

A

Due to Rh antibody mismatch causing extravascular hemolysis occurring days after transfusion, with a falling hemoglobin
Labs: DAT positive, Antibody Screen

43
Q

Febrile Transfusion Reactions

A

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
Q

Allergic Transfusion Reactions

A

Host reaction to donor plasma proteins which results in hives
Treat with antihistamines
Rarely causes anaphylaxis

45
Q

What do you do if you suspect a transfusion reaction?

A

STOP THE TRANSFUSION
Check blood of patient and donor
Monitor vitals
Send blood, urine, and bag of blood to lab

46
Q

Transfusion-related bacterial infections

A

Symptoms: Fever, shock
Treatment: aggressive resuscitation and antibiotic therapy
Test: patient and blood unit

47
Q

Circulatory Overload

A

When too much blood is given too quickly
Symptoms: hypertension, CHF
Treatment: Stop transfusion, give diuretics

48
Q

Iron Overload

A

Too much iron can damage the heart and liver (High risk: chronic anemia)
Treatment: Iron-Chelating agents

49
Q

Graft vs. Host Disease

A

Donor lymphocytes attack host in immunocompromised patients or blood-relative donors
Symptoms: fever, rash, hepatitis, marrow failure, usually fatal

50
Q

What is the most common infection from a blood transfusion?

A

Bacterial Infection (more common in platelets = stored at room temperature, than in RBC transfusions = stored in fridge)

51
Q

What is the least common infection from a blood transfusion?

A

Hepatitis C and HIV

52
Q

What is the most common complication from a blood transfusion?

A

Allergic Reaction

53
Q

What is the least common complication from a blood transfusion?

A

Acute Hemolysis

IHO Week 2 (13 decks)

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