Brainscape's Knowledge GenomeTM

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


See full index

Y3 - Haem > Transfusion Reactions > Flashcards

Transfusion Reactions Flashcards

1
Q

What is the main blood grouping system?

A

ABO

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

How does ABO system classify blood types?

A

Based on the antigen expressed and the IgM antibody present in the blood

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

In blood group O, what is the genotype, antigens, antibodies, and frequency?

A

Genotype - OO
Antigens - none
Antibodies - anti-A, anti-B
Frequency - 43%

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

In blood group A, what is the genotype, antigens, antibodies, and frequency?

A

Genotype - AO or AA
Antigens - A
Antibodies - anti-B
Frequency - 45%

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

In blood group B, what is the genotype, antigens, antibodies, and frequency?

A

Genotype - BO or BB
Antigens - B
Antibodies - anti-A
Frequency - 9%

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

In blood group AB, what is the genotype, antigens, antibodies, and frequency?

A

Genotype - AB
Antigens - A and B
Antibodies - none
Frequency - 3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is blood tested for ABO grouping?

A

Red cell testing - if there is agglutination between patient red cells and an antibody (e.g. anti-A), that means the antigen the antibody is against is expressed (e.g. A antigen)
Plasma testing - if there is agglutination between patient plasma cells and donor red cells of a group (e.g. group B) the patient has antibodies against that group (e.g. anti-B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What % of the population is rhesus positive?

A

85%

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

What does it mean to be rhesus positive or negative?

A

If you’re positive you express the rhesus antigen

If you’re negative you dont

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

How is blood tested for Rhesus grouping?

A

The patient’s blood is Rh-positive if it agglutinates when exposed to anti-D antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the significance of rhesus grouping for transplants?

A

Rh-positive blood cannot be given to Rh-negative patients
This is because rhesus antibodies are produced by Rh-negative people in response to exposure to Rh-positive blood
After sensitisation exposure to Rh-positive blood can result in haemolytic disease

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

How are Rh-negative pregnant women treated to prevent haemolytic disease?

A

Anti-D injection

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

What disorders are blood transfusions screened for?

A

Malignancy
HIV
Hepatitis
Syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What steps need to be taken when giving a transfusion?

A

Confirm patient details
Complete transfusion request with either G&S or crossmatch
Check the bag - is it the right patient, is it in date, are there any holes or clots
Double check patient ID and start transfusion

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

When are platelets given?

A

Thrombocytopenia

DIC

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

When is fresh frozen plasma given?

A

DIC

Warfarin overdose

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

When is cryoprecipitate given?

A

Same as FFP but contains factors VIII/IX, vWF so preferred if specific factors needed

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

When is prothrombin complex given?

A

Bleeding in vit K deficiency - warfarin, liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the symptoms of acute transfusion reactions?

A 
Chills
Rigors
Rash
Flushing
Feeling of impending doom
Collapse
Loin pain
Respiratory distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the signs of acute transfusion reactions?

A

Fever
Tachycardia
Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What actions should be taken in all transfusion reactions?

A

Stop the transfusion
ABCDE assessment
Re-check compatibility tag against patient details and inspect pack for evidence of contamination
Document event in medical notes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are signs of severe or life-threatening transfusion reaction?

A

Evidence of life-threatening airway, breathing or circulation problem
Evidence of wrong component transfused or bacterial contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the immediate management when a severe or life-threatening transfusion reaction is suspected?

A

Seek senior medical advice
Resuscitate patient
Return compartment to transfusion lab to allow further investigations

24
Q

What is an acute haemolytic transfusion reaction?

A

ABO mismatch transfusion

25
Q

What is the pathophysiology of acute haemolytic transfusion reaction?

A

IgM mediated reaction against transfused cells
Patient IgM anti-A or -B antibodies bind to the corresponding antigens in the donor bag resulting in complement activations and intravascular haemolysis of transfused cells
Release of inflammatory cytokines - complement, kinin, coagulation systems
Shock, increased vascular permeability, DIC, renal failure

26
Q

What is the presentation of an acute haemolytic transfusion reaction?

A 
Fever 
Flushing
Hypotension and tachycardia
Generalised severe pain - chest, abdomen
Oozing of blood out of cannulation site (DIC)
Onset as soon as transfusion starts
27
Q

What is the management of an acute haemolytic transfusion reaction?

A

Stop transfusion, return unit to lab, inform lab, check patient and bag identity
Supportive - oxygen, fluids
Repeat transfusion blood samples
Take bloods - FBC, coat screen, renal function, LDH, blood cultures

28
Q

Which type of unit is bacterial contamination more common with?

A

Platelets

29
Q

How can a bacterial contamination transfusion reaction be prevented?

A

Examination of the transfused unit for clots

30
Q

What is the presentation of a bacterial contamination transfusion reaction?

A

Fever
Rigors
Hypotension

31
Q

What is the management of a bacterial contamination transfusion reaction?

A

Culture patient and remains of unit
Treat supportively and with broad spectrum antibiotics
Inform transfusion lab for quarantine of other units

32
Q

What is an anaphylaxis transfusion reaction?

A

IgE mediated allergic reaction to plasma proteins in the transfuswion

33
Q

What is the presentation of an anaphylaxis transfusion reaction?

A

Hypotension
Mucosal swelling
Airway obstruction - stridor, desaturation

34
Q

When is an anaphylaxis transfusion reaction more common?

A

IgA desaturation

35
Q

What is the management of an anaphylaxis transfusion reaction?

A 
ABCDE guidelines - O2 and fluid challenge
Adrenaline 0.5mls IM
Hydrocortisone 200mg IV
Chlorphenamine 10mg IV
Get the anaesthetist
36
Q

What is transfusion associated circulatory overload?

A

A transfusion reaction that occurs due to a rapid transfusion of a large volume of blood
Results in cardiopulmonary oedema
Caused by an inability of the recipient to compensate fro the transfused volume

37
Q

What is the presentation of transfusion associated circulatory overload?

A

Respiratory distress within 6 hours of transfusion
Raised blood pressure
Raised JVP
Positive fluid balance

38
Q

What are the risk factors for transfusion associated circulatory overload?

A 
Elderly
Cardiac failure
Low albumin
Renal impairment
Fluid overload
39
Q

What is the management of transfusion associated circulatory overload?

A

Oxygen and supportive care as required
Diuretics
Consider slowing rate of further transfusions
Consider diuretics with future transfusion
Only transfuse minimum volume required

40
Q

How can transfusion associated circulatory overload be prevented?

A

Identify patients at risk before first transfusion

41
Q

What is transfusion related acute lung injury?

A

Acute respiratory distress syndrome that is caused by anti-leucocyte antibodies in the transfused plasma

42
Q

What is the presentation of transfusion related acute lung injury?

A 
Previously fit and well patient
Shortness of breath
Cough
Tachypnoea
Bilateral crepitations
43
Q

How is transfusion related acute lung injury diagnosed?

A

Clinical signs

Plus CXR - white out

44
Q

What is the management of transfusion related acute lung injury?

A

Oxygen
Admission to ITU
Source identified and removed from the register

45
Q

What is a mild transfusion reaction?

A

Isolated temperature rise to >38 and rise of 1-2 degrees or rash only

46
Q

What is the management of a mild transfusion reaction?

A

Continue transfusion - consider slowing rate
Close monitoring of patient in case condition worsens
Consider paracetamol/anti-histamine

47
Q

What is the presentation of a febrile non-haemolytic transfusion reaction?

A

Presents about 30 minutes after starting transfusion
Five
igors

48
Q

What is a mild allergic transfusion reaction?

A

IgE mediated reactions to plasma proteins in the transfusion

49
Q

What is the presentation of a mild allergic transfusion reaction?

A

Rash/itch but with normal observations

50
Q

What is the treatment of a mild allergic transfusion?

A

Anti-histamines (chloramphenamine)

51
Q

What is a delayed haemolytic transfusion reaction?

A

Patient mounts delayed immune response to red cell antigen - usually IgG
Extravascular haemolysis 5-10 days post-transfusion

52
Q

Who more commonly get a delayed haemolytic transfusion reaction?

A

Patients who have had previous transfusions

53
Q

What is the presentation of a delayed haemolytic transfusion reaction?

A

5-10 days after transfusion

Jaundice

54
Q

What do investigations show in a delayed haemolytic transfusion reaction?

A

Positive Coomb’s test
Sudden drop in Hb
Raised bilirubin, LDH
AKI

55
Q

What is the management of a delayed haemolytic transfusion reaction?

A

Slow or stop transfusion
Anti-pyretic - paracetamol
Close monitoring
If recurrent - whit cell depleted transfusions

Y3 - Haem (9 decks)

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