Transfusions Flashcards
What must be added to fucose (H antigen) to make the A antigen?
N-acetylgalactosamine
What is the inheritance pattern of RBC antigens?
Mendelian
What must be added to fucose (H antigen) to make the B antigen?
galactose
Type A blood patients can receive what blood?
A and O
Type B blood can receive what blood?
B and O
Type AB blood can receive what blood?
ALL OF IT
Type O blood can receive what blood?
O
What is the antigen Rh genotype indicated as?
D or d
How many D antigens (as opposed to d) are needed to be Rh+?
Just one (heterozygous counts)
What is unique about antibodies to these receptors?
they are Acquired (you need exposure to have antibodies against them)
What are the indications for a complete (whole) blood transfusion?
A massive hemorrhage
What are the indications to use just RBC transfusion?
Low hemoglobin
What are the indications to use leukocyte reduced blood?
Decreased alloimmunization or to decrease allergic reaction
Why would you use frozen RBC’s?
Storage of rare blood types
Why would you use granulocyte transfusions?
Treat sepsis in neutropenic patients
Why would you use just platelets in a transfusion?
Treat bleeding due to thrombocytopenia
Why would you use just plasma?
bleeding due to multiple factor deficiency
What is contained in cryoprecipitate?
Fibrinogen
Von Willebrand factor
VIII
XIII
When would you use cryoprecipitate?
Low fibrinogen
vW disease
Hemophilia A
Factor XIII Deficiency
When would you use plasma with just factor VIII?
Hemophilia A
When would you use plasma with factor IX?
Hemophelia B
When would you use plasma with albumin?
Hypovolemia with hypoproteinemia
When would you use plasma with IvIG?
Disease prophylaxis
Autoimmune disease
Immunodeficiency states
Describe forward-type blood testing.
Vial of blood
Add antiA or antiB antibodies
Add AHG
Check for agglutination
Describe reverse type blood testing.
Take a vial of anti-a or anti-b antibodies from patients serum
Take reagent cells (RBC’s with type B)
Add AHG
Check for agglutination
What is happening in a crossmatch blood test?
Take patient serum (with antibodies)
Add donor RBC’s
Add AHG
Check for agglutination
Which is the most deadly complication of a blood transfusion?
Acute hemolytic transfusion reaction
What causes acute hemolytic transfer reactions?
When patient has anti ABO antibodies against donor RBC
What would labs for an acute hemolytic transfer reactions look like?
Decreased haptoglobin
Increased bilirubin
DAT +
Why is acute hemolytic transfusion reaction so detrimental?
Kidney damage from hemolysed cells
What causes delayed hemolytic transfusion reaction?
Host rejection of donor cells due to other antigens on RBC’s
Where does hemolysis usually occur for Delayed hemolytic transfusion reaction?
extracellularly
How does delayed hemolytic transfusion reaction usually present?
Dropping hemoglobin
DAT+
Usually can find antibody in serum
How does febrile transfusion reaction happen?
Reaction against donor WBC’s
How does febrile transfusion reaction present?
How is it treated?
All of the cytokine problems (fever, headache, chest pain, nausea)
Tylenol
What does allergic transfusion reaction look like and what causes it?
It presents as hives
Reaction against donor serum proteins
How does a bacterial infection due to transfusion usually present?
Sudden fever and shock
What happens when you give too much blood at once? How can you tell?
Circulatory Overload
Hypertension, CHF
What should you do to someone with circulatory overload?
Take them off transfusion
Give diuretics
How does iron overload present?
Who does it appear in most?
How do you treat it?
Liver/heart damage
Chronic anemia patients
Give iron chelating agents
What is wrong in graft-versus-host disease?
Donor lymphocytes attack host
How serious is graft versus host disease?
Usually fatal
