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Blood Bank II Summer > Transfusion Rxns Clinical > Flashcards

Transfusion Rxns Clinical Flashcards

1
Q

TFRXN

workup path?
who IDs/Works up….etc

A

Unfavorable response to infusion of blood or blood products

first ID’s by infusionist
worked up by blood banker
classified by pathologist
treated by doctor

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2
Q

Workup

A

ABO/Rh both pre and post

post can have mixed field

DAT on post IgG + C3B
look for hemolysis

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3
Q

Hemolytic
destruction of?
related?

A

destruction of rbcs
product related

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4
Q

Non hemolytic

A

other organs affected

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5
Q

Acute

A

adverse immediately upon transfusion
product related

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6
Q

Delayed

A

> 24hr after transfusion, Anti Kidd common

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7
Q

Signs and symtoms of Transfusion rxn

A

hemolysis
increased temp
bp change
shortness of breath
pain
limited survival of product

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8
Q

Hemolysis
hemogl
hemogl
what doesnt rise?
what is POS?
what on slide?

A

hemoglobinuria
hemoglobinemia
Hgb level doesnt rise
DAT POS
Agglutination on slide

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9
Q

Raise in temp

A

fevers, chills, nausea, vomit

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10
Q

Bp
types

A

hypotension - down - shock

Hypertention: Up - jugular vein dissention

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11
Q

Shortness of breath

A

wheezing anaphylaxis hypoxemia, angioedema

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12
Q

Pain

A

back pain
at infusion site
impending doom
uticaria

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13
Q

Non immune causes of hemolysis
improper
incomplete
rapid
improper bl
hypo
anything

A

improper shipping temp
incomplete deglycerolized rbcs
rapid pressure infuser
improper blood warmer
hypotonic solutions
anything other than saline

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14
Q

Acute hemolytic
what happens? what is activated? casues?

immunoglobulins? groups?

A

hemolyzed, compliment,DIC renal failure

IgM > IgG
ABO Rh kell

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15
Q

Delayed hemolytic
causes?
what drops?
D?
mild?
immunoglobulin?
what immunoglobulin groups?

A

fever, DAT, H/H drop, mild jaundice

IgG
Kidd, duffy, kell, MNS

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16
Q

FN HTR
febrile non hemolytic rxn
prevent?
causes what symptoms?

caused by?

lab results?
treatment?

A

prevent w leukoreduced products

fever, nausea, tachycardia, BP increased

Caused by wbc derrived HLA abs in PLTs

NEG DAT, no visible hemolysis

treat w tylenol

17
Q

Allergic rxns
prevention?

symptoms?

all….what in donor product? (what immunoglobulin in which product?)

DAT? hemolysis?

Treatment

A

prevention: use diff donor products

symtpoms urticaria, itching

allergens, proteins in donor products (IgA in plasma)

NEG DAT, no visible hemolysis

Antihistamine

18
Q

TA GVHD
prevent by irr….to
key feature? mortality? symptom?

why?

causes p/l

treatment? sc/im

A

prevent by irradiating cellular products to inactivate donor lymphs

Macropapular rash, 90% mortality, diarrhea

recipient doesnt recogn donor lymphs as foregin, causes immune response

pancytopenia, lymph infiltrates
SC transplant/immunosuppressants

19
Q

TRALI
transfusion associated lung injury
increase donor deferrals for….

causes severe,s,h

from? in what product?

stop? suppliment?

A

prevent: increase donor deff for females who have been pregnant and males who have been transfused

Severe respiratory distress, shortness of breath, hypotension

WBC ab (HLA) plasma products

stop transusion, 02 suppliment

20
Q

TACO
prevent by?

causes d,c,h

underlying?

elevated? no?

A

prevent: check lab val before transf

dyspenea, coughing, hypertension

underlying cardiopulmonary path overload

elevated BNP no hemolysis

21
Q

Who is at risk from reciveing plasma from a multiparous female?

A

TRALI

22
Q

Who is at risk from low circ/heart output?

A

TACO

23
Q

Who is at risk for immune compromised

A

GVMD

24
Q

Sepsis
caused by what product?

causes …symptoms?

blood..

body temp?

ID/Ab

A

PLTs/storage (RT)

rigors + hypertension
blood culture

body temp >2 degrees of normal

ID contam/antibiotics

25
Q

iron overload (Hemosiderosis)

prevent by?

causes..y/m

accumulation of

increased
theraputic?

A

prevent: <20 rbcs a yr or washed cells

yellowing skin, multiorgan failure

Accumulation of iron in tissues

increased ferritin

theraputic phleb

26
Q

Citrate toxicity

what sensation
inability?

A

prevent: ingestion of calcium

tingling/prickling sensation
inability of liver to metabolize

27
Q

PTT post transfusion purpura
what crossmatch? what matched transfusion?

causes?

pt has? usually?

what products administered?

A

PLT crossmatch/HLA matched plt transfusion

thrombocytopenia

pt has plt ab, usually Anti-HPA1

IVIG pooled products

28
Q

Report to FDA

A

Sepsis, TRALI, hemolytic

Blood Bank II Summer (9 decks)

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