Brainscape's Knowledge GenomeTM

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


See full index

SBB > Transfusion Therapy > Flashcards

Transfusion Therapy Flashcards

1
Q

What % of donor cells die every day?

A

1%
EX) if Blood is transfused 10 day after collection in 30 days what % of donor cells remain? 10+30 = 40% lost; so 60% remain

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

1 Kg equals how many lbs?

A

2.2 lbs

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

How much will 1 unit of RBC’s increase the Hgb and Hct in an adult?

A 
Hgb = 1 g/dL
HCT = 3%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the formula to calculate how much blood to give to an infant?

A

10 ml/kg will increase HGB by 2-3 g/dL

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

How do you calculate TBV in females, males, and infants?

A

Females = 60 mL/kg
Males = 66 mL/kg
Preterm infant = 110 mL/kg
Term infant = 85 mL/kg

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

How do you calculate # of RHIG to give?

A

% fetal cells x TBV (AVG 5000) / 30

plus one vial

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

How do you calculate total plasma volume?

A

TBV x (1-HCT) = TPV

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

Calculate how much plasma to give to raise coagulation factors from 0 to 25%.

A

PV x % increase = ml of FFP

  • 1 FFP = 200-250 mL
  • 1 mL FFP = 100% coagulation factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How much fibrinogen is in cryo?

A

150 mg

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

How much factor VIII is in cryo?

A

80 IU

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

How many platelets are in an apheresis unit?

A

3.0 x 10*11

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

What is average volume and HCT of a unit of RBC’s with additives?

A

250-300 mL with 65% HCT
* CPDA HCT is 80%
+ 20-100 ml of plasma = 300-400 mL total volume

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

Leukocyte reduced blood must have less than how WBC?

A

less than 5.0 x 10*

and 85% of the original RBC volume

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

What is FFP vs FP24?

A

FFP is frozen within 8 hrs
FP24 is frozen with 24 hrs
FVIII is reduced in FP24

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

What is cryo poor plasma?

A

FFP thawed at 1-6C and centrifuge to remove precipitate
Has no F-VIII, F-XIII, vWF, or Fibrinogen
Only indicated in TTP when FFP is unsuccessful to remove vWF and replace ADAMTS-13

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

What is thawed plasma?

A

FFP thawed and stored at 1-6C for 5 days
F-V and F-VIII is reduced
Normal levels of F-II, F-VII, F-IX, F-X, Fibrinogen, ADAMTS-13

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

What is liquid plasma?

A 
Plasma that's never been frozen
Expires 5 days after WB unit
Reduced levels of F-V and F-VII
Used for MTP
Contains viable lymphocytes that may cause GVHD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the usual dose for FFP?

A

10-20 mL/kg will increase coag factors by 20-30%%

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

How do you calculate Cryo dose?

A

Fibrinogen increase x PV in dL (3000 mL = 30 dL)

divide by 250 mg = # of units

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How much will 1 cryo/ 10 kg of body weight raise fibrinogen levels by?

A

50 mg/dL

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

What is PCC?

A

Prothrombin complex concentrate
4 factor contains F-II, F-VII, F-IX, F-X PC and PS
3 factor lacks F-VII
Used to reverse Vit K antagonist such as warfarin or to replace Vit K dependent Coag factors when concentrates are not available
Can be used in hemophilia patients w/ inhibitors

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

What is normal serum albumin?

A

A sterile preparation of serum albumin obtained by fractionating blood plasma proteins from healthy donors

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

When is normal serum albumin used?

A

Used to maintain plasma colloid osmotic pressure in shock, burns, cardiopulmonary bypass, acute nephrosis, (not chronic nephrosis)
Replaces protein loss

24
Q

What is plasma protein fraction?

A

Volume expander used for replacement of human plasma in the acute treatment of shock

25
Q

What is salvage plasma?

A

Also called recovered plasma
Unlicensed component sold to fractionators to make albumin and immune globulins
No expiration date but records must be maintain indefinitely

26
Q

What is IVIG?

A

Used to treat many autoimmune disorders because it suppresses autoantibody production
Made from pooled human plasma

27
Q

How does IVIG work?

A

Blocks Fc receptors on macrophages and B cells and modulates complement activity
Suppresses inflammatory signals such as cytokines and chemokines

28
Q

What are the FDA approved uses of IVIG?

A 
Primary immunodeficiency
Auto immune thrombocytopenia
Kawaskai disease
HSCT in patients older that 20 yrs
Chronic B cell leukemia
Prevention of GVHD 
Pediatric HIV
29
Q

What are common off label use of IVIG?

A 
aplastic anemia
HDFN
AIHA
Clotting factor inhibitors
Multiple sclerosis
30
Q

What are the FDA guidelines for IVIG?

A

Prepared out of 1000 donors
All for IgG subclasses must be present
IgG should maintain biological activity for 21 days
Does not contain samples that are HIV, HEP C, or HEP B positive
Screened and treated in a manor that destroys viruses

31
Q

How much Hgb and Iron is in one unit of RBC’s?

A

50-80 g of hgb

about 250 mg of iron

32
Q

How platelets and plasma is in an apheresis platelet unit?

A

≥3.0 x 10*11 platelets

100-500 ml of plasma

33
Q

What are PAS plalelets?

A

Platelet additive solution that dilutes out the plasma

Studies show a reduce risk of allergic reaction

34
Q

How do you calculate the corrected count increment

A

Post-Pre PLT Ct x BSA / PLT transfused (10*11)

Platelet refractoriness is defined as a CCI ≤7,500 for at least 2 sequential platelet transfusions.

35
Q

What are causes of platelet refractoriness?

A

Refractory platelet transfusions can be due to a number of non-immune causes, including fever, infection, bleeding, DIC, extensive surgery, splenomegaly, irradiation, and concurrent amphotericin B therapy

36
Q

When is platelet transfusion not indicated?

A

Use of platelets in patients with autoimmune thrombocytopenia, thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS), idiopathic thrombocytopenic purpura (ITP), or heparin-induced thrombocytopenia with thrombosis (HITT) should be avoided except for life-threatening hemorrhage

37
Q

What is solvent-Detergent Plasma?

A

Pooled plasma that is treated and filtered to remove HMW vWF. Solvent removes lipid virus such as HIV, HCV, and HBV but not HAV or B19
Product is deficient in VIII, vWF and Protein S
Thrombotic complications in liver surgery may be due to lack of Protein S

38
Q

What are not indicators for FFP transfusion?

A

Volume expansion
Nutritional support
Bleeding with no evidence of factor deficiency
Mildly increased PT/PTT alone
Prophylactical TRN to increase INR for surgery (Poor predictor of bleeding risk)
Heparin reversal
- can used for coumadin reversal if emergency and no time for Vitamin K

39
Q

What are indicators for FFP transfusion

A

Patients with multiple coagulation factor deficiencies
massive transfusion
Factor deficiency when specific therapy (recombinant or
virally-inactivated) is not available (factors II, V, X, and XI,
c1-esterase deficiency, AT-III deficiency)
Patients requiring emergency reversal of coumadin (NOT heparin)
Patients with TTP
Patients with protein C or protein S deficiency associated with a hypercoaguable state

40
Q

How much fibrinogen is 1 unit of FPP?

A

Approx. 400 mg

41
Q

What are some diseases TPE is indicated for?

A

Thrombotic thrombocytopenic purpura (TTP)
Gullain-Barré syndrome
Myasthenia gravis
Cryoglobulinaemia (severe)
Hyperviscosity (Waldenström’s macroglobulinemia)
Antibody-mediated renal rejection

42
Q

What are the common anti-platelet drugs?

A 
Aspirin inactivate cyclooxygenase and inhibits platelet thromboxane production.  
Thienopyridines (e.g., ticlopidine [Ticlid] and clopidogrel [Plavix]) inhibit platelet adenosine diphosphate (ADP) receptor. 
Glycoprotein inhibitors (e.g., abciximab [ReoPro], eptifibatide [Integrilin], and tirofiban [Aggrastat]) are potent inhibitors of platelet aggregation that block a receptor for fibrinogen and vWF
43
Q

What are the “triggers” for platelet transfusion?

A
  • 5000/μL: stable patients
  • 10,000/μL: patients with fever or recent hemorrhage
  • 20,000/μL: patients with coagulopathy, on heparin, or with anatomic lesions likely to bleed.
  • 50,000/μL: bleeding patients, patients about to undergo a hemostatic challenge such as surgery
  • 100,000/μL: patients with intracerebral, pulmonary, and ophthalmic hemorrhage
44
Q

What diseases are platelet transfusions not indicated in?

A

ITP, TTP, HIT, HUS, or DIC

Unless the patient has a life-threatening hemorrhage

45
Q

What are the disadvantages to a BMT ABO mismatch?

A

Delayed engraftment
Increased risk of GVHD
May have decreased survival

46
Q

What is the advantage and disadvantage of using G-CSF mobilized peripheral SCT?

A

may engraft quicker but may have increased risk of GVHD

Benefit of donor lymph’s causing an anti-tumor effect is unclear

47
Q

What are the transfusion threshold for BMT patients?

A

Hgb 8-10 g/dL

PLT 10,000-20,000

48
Q

What is passenger lymphocyte syndrome?

A

Donor lymph produce antibodies that may cause acute hemolysis of recipient RBC’s
Can be ABO, Kidd, Kel, Duffy, or Rh antibodies.
Usually occurs during the 1st or 2nd week after transplant

49
Q

What does a major ABO Mismatched BMT result in?

A

Donor RBC’s are incompatible with recipient
Can result in immediate hemolysis
Ongoing production of ABO antibodies directed against donor RBC may last for 3-4 months.

50
Q

What does a minor ABO mismatched BMT result in?

A

Donor plasma is incompatible with recipient

Can result in delayed hemolysis from donor antibodies

51
Q

What can cause pure red cell aplasia in BMT patients?

A

Occurs if there is a major ABO mismatch and recipients lymphocytes survive the myeloablation and produce antibodies against donor RBC’s.

52
Q

What are signs of hemorrhagic shock?

A 
Tachycardia
Hypotension
increased respirations
Mental status changes
Occurs with blood loss of 20-30%
53
Q

What does transexamic acid do?

A

Anti-fibrinolytic > binds to plasminogen to prevent plasmin from breaking down fibrin
Prevents fibrinolysis, promotes clot stability, and may lower inflammation
Can lead to thrombosis

54
Q

What is ECMO?

A

Extracorporeal Membrane Oxygenation
Pumps the blood and oxygenates to give the heart and lungs a rest. Requires blood to prime machine.
Platelets are consumed so goal of 100,000-150,000
Hgb maintained at 10-12 g/dL

55
Q

What are the complications of Massive transfusion?

A 
Coagulopathy 
Hemodilution of Coag factors and PLT's if colloids used
Hypocalcemia (citrate toxicity)
Hyperkalcemia
Acidemia due to shock and poor perfusion
Hypothermia
Immune hemolysis
56
Q

Why should additives in RBC’s be removed in large volume transfusions for neonates?

A

Adenine - renal toxic
Mannitol - potential diuretic
Dextrose - high blood glucose > brain injury
High potassium - cardiac risk (use fresh blood)

SBB (37 decks)

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