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Blood Bank > Unit 6 > Flashcards

Unit 6 Flashcards

1
Q

How should whole blood be matched

A

must be type specific

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2
Q

What is the ratio of anticoagulant in WB

A

14:100

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3
Q

What does washing RBCs do

A

washed with saline, removes almost all plasma proteins, microaggregates, plts and WBCs

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4
Q

What patients need washed RBCs

A

hypersensitivity to plasma proteins
IgA deficient recipients
neonates

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5
Q

Why are RBCs sometimes frozen, what preservative is used to do this

A

for rare blood types and autologous donors
glycerol

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6
Q

What is the purpose of deglycerolizing RBCs after thawing them

A

washed with saline in decreasing concentrations until 0.9% isotonic. Can’t throw off blood osmo

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7
Q

How long does it take to LR blood with a filter?
What is the purpose of LR

A

72 hrs
reduces TRALI
febrile reactions
alloimmunization if transplant HLA
Removes CMV
prevent GvHD

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8
Q

What are the 4 ways RBCs can be leukoreduced

A

during donor collection
after donor collection, before storage
Right before transfusion
During transfusion

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9
Q

What patients need LR blood?

A

immunodeficient
BM transplant
donated by family member
fetus

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10
Q

What is the main WBC of concern in LR?

A

T lymphs

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11
Q

What coagulation factor is higher when plasma is frozen withing 24hrs of collection

A

factor VIII

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12
Q

What diseases are plasma donations NOT useful for

A

VWF disease- primary hemostasis, coag factors are all secondary

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13
Q

What blood product is needed in:
Liver disease
Warfarin
MTP
DIC

A

transfuse FFP

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14
Q

What is plasma that has never been frozen called

A

liquid plasma

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15
Q

What is PF24 labelled as once thawed

A

thawed plasma

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16
Q

What factors are in cryo

A

VIII, VWF, FBG, XIII fibronectin

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17
Q

What blood product is needed in
Factor XIII deficiency
FBG deficiency
VWD
Fibrin glue
DIC

A

cryoprecipitate

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18
Q

Hemophilia A is a deficiency of factor

A

VIII

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19
Q

What is the difference between plasma and cryo

A

cryo is thawed plasma that has been spun and the plasma is taken off, it is the precipitate of plasma

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20
Q

What does a soft spin and a hard spin do

A

soft- plt rich plasma
hard- removes/ express off plasma

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21
Q

What should you do to plts after the are prepared before putting them on the agitator

A

let them sit 1 hr, to avoid activating them

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22
Q

Why are plts pooled

A

usually before transfusion

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23
Q

What blood product is needed in
thrombocytopenia
MTP
surgical patients

A

Random donor plts

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24
Q

What patients should not receive random donor plts

A

TTP- abs directed against plts
ITP- idiopathic thrombocytopenia purpura
DIC- consume plts too fast

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25
Q

How to choose compatible plts

A

ABO and Rh compatible
most places don’t care about Rh

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26
Q

IF a pt was transfused with plts 1 hour ago, but a CBC shows no rise in plts, what likely cause

A

Plts refractoriness
need special single donor HLA class 1 matched transfusion

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27
Q

What are plts collected by apheresis

A

very concentrated plts collected from a single donor

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28
Q

What QC is needed for plt products

A

testing for bacteria
min >3 x 10^11 plts
> 6.2 pH at expiration
no aspirin 72hrs before collection

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29
Q

What pts need granulocyte concentrates

A

BM transplant or certain cancers

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30
Q

How are granulocyte concentrates collected

A

apheresis

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31
Q

What requirements for granulocyte concentrates

A

> 1 x 10^10 granulocytes
XM
IR
donor receives steroids

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32
Q

What blood product is needed if
Pt is unresponsive to antibiotic therapy, neonates especially
BM transplant
granulocytic dysfunction
Neutropenic chemo pts

A

granulocyte concentrates

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33
Q

What is PCC factor concentrate

A

prothrombin complex concentrate

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34
Q

What are NSA and PPF

A

volume expanders
Normal serum albumin
Plasma protein fraction

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35
Q

What coagulation factor concentrates are given

A

VIII, IX, VIIa

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36
Q

What are immune serum globulins that can be given

A

hep B
Rh

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37
Q

What activates the intrinsic pathway

A

contact activation from damaged blood vessel

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38
Q

What activates the extrinsic pathway

A

TF

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39
Q

What pathway is
12, 11, 9, 8

A

Intrinsic

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40
Q

What pathway is
7, TF

A

Extrinsic

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41
Q

What proteins are in the coagulation cascade and where in it are they

A

Proteins C, S in common pathway

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42
Q

What coagulation factors are vitamin K dependent

A

2, 7, 9, 10

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43
Q

Why are coag factor concentrates heated

A

reduces risk of HBV, HCV and HIV

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44
Q

What pts might need factor VIII concentrates

A

Hemophilia A
VWD

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45
Q

What should you give a pt that is forming factor VIII antibodies

A

five them factor VIIa- activates extrinsic pathway

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46
Q

What type of plasma gives
factor VIII concentrate
Faactor IX concentrate

A

VIII- derived or recombinant plasma
IX- pooled plasma or recombinant

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47
Q

What blood product should you give a pt with hemophilia B

A

factor IX concentrate

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48
Q

What blood product should give in
hemorrhagic pt
hemophilia A
to contradict coumadin or warfarin
bypass factor VIII antibodies
factor VII deficiency
traumas and MTPs
Liver transplant

A

Factor VIIa concentrate

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49
Q

What does PCC contain

A

factor 2, 7, 9 and 10, vitamin K dependents

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50
Q

Why would you give a pt PCC

A

factor VIII inhibitor
warfarin reversal

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51
Q

What are volume expanders for

A

maintain colloidal osmotic pressure in vascular system
during surgery

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52
Q

What are the 3 main goals of blood storage and preservation

A

maintain viability and function
prevent physical changes
minimize bacterial contamination

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53
Q

What anticoagulant/ preservative:
supports ATP generation by glycolytic pathway Ebden Meyerhof

A

Dextrose

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54
Q

What anticoagulant/ preservative:
is a substrate for RBC ATP synthesis in the Ebden Meyerhof pathway

A

Adenine

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55
Q

Which anticoagulant/ preservative extends an RBC lifespan from 21 to 31 days

A

Adenine

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56
Q

What preservative/ anticoagulant
chelates calcium and prevents clotting

57
Q

What preservative/ anticoagulant
buffers pH and stabalizes 2,3 BPG so that it can bind to O2 in its tense state in the Rappaport pathway

A

monobasic sodium phosphate

58
Q

What preservative/ anticoagulant
stabilizes RBC membrane and reduces hemolysis

59
Q

What is in the AS additive system

A

Adsol, Optisol, Neutricel
Neutregena ad for eye cream

60
Q

Adsol and Optisol both contain

A

mannitol
add has manny the mammothh

61
Q

Neutricel contains

A

sodium phosphate

62
Q

Adsol, neutricel, Optisol
AS #s

A

AS-1 Adsol
AS-3 Neutricel
AS-5 Optisol

63
Q

What preservative extends RBC lifespan to 45 days

A

AS- Adsol Optisol and Neutricel

64
Q

In what situations will heparin be added to RBCS

A

exchange transfusions, intrauterine, neonatal or sickle cell

65
Q

How is RBC metabolism affected in storage

A

Increased: K, free HGB, lactic acid
Decreased: cell viability, Glucose, ATP, pH, 2,3DPG

66
Q

What happens to the ODS curve when RBCs are stored for too long

A

left shift

67
Q

List if increased or decreased
Free HGB
pH
lactic acid
ATP
Glucose
Cell viability
K
2,3 DPG

A

Free HGB- increased
pH- decreased
lactic acid- increased
ATP- decreased
Glucose- decreased
Cell viability- decreased
K- increased
2,3 DPG- decreased

68
Q

In normal people, about ___% of HGB bind O2 at 28PO2

69
Q

In an acidic environment, more __ is needed, affinity ____, O2 is ___ likely to let go of HGB

A

O2
decreases
more

70
Q

Right shift ____ affinity
Left shit ____ affinity

A

reduces
increases

71
Q

Why does pH decrease when RBCs are stored

A

anaerobic metabolism creates lactic acid, decreases pH to 7 or less

72
Q

What is the pH of RBCs right when its collected

A

7.4 to 7.5

73
Q

____ facilitates the transport of O2, from RBCs to tissues

74
Q

_____ stabilizes tense HGB by allosteric binding

75
Q

What will happen if there is a transfusion of 2,3 DPG depleted RBCs

A

body will regenerate 2,3 DPG in 3-8 hrs
returns to normal energy and HGB function
RBC shape may return to normal

76
Q

How old should RBCs transfused to a baby be

A

no more than 5 days old
they cant regenerate 2,3 DPG very effectively

77
Q

When ATP levels are low, RBCs become

A

more rigid, loose integrity, K passively leaves RBCs into plasma- could cause heart attack, Na enters RBCs, loss of gradient charge, zeta potential and membrane charge

78
Q

In storage lesion how are these factors affected in RBCs
ammonia
membrane lipids
hemolysis
morphology

A

ammonia- increases
hemolysis- increases
membrane lipids- decrease
morphology- spiny projections

79
Q

What occurs in platelet lesions
lactic acid
pH
platelet function
morphology
what do plts release

A

lactic acid- increases
pH- decreases
platelet function- decreases
morphology- become spherical instead of discoid
release cytoplasm and granule content

80
Q

What can be used to rejuvenate RBCs, what is the window for it

A

pyruvate, inosine, adenine, phosphate
3 days after expiration
for cells with CPD, CPDA-1 and AS

81
Q

Can the following RBC unit still be rejuvenated
expired 1 day ago
has no preservative

A

no, needs preservative

82
Q

Can the following RBC unit still be rejuvenated
expired 1 week ago
has CPD preservative

A

no, can only be done up to 3 days after expiration

83
Q

practice drawing figure in slide 22 Ch component prep and blood storage
How WB is converted into: RBCs, plt poor plasma, plt concentrate

84
Q

What organizations establish the guidlines for blood donation

A

FDA and AABB

85
Q

What are the 3 steps of donor screening

A

registration
medical history questionnaire
partial physical exam

86
Q

How much time do you have to wait between RBC donations

A

8 weeks or 56 days
if double donation 16 weeks

87
Q

How much time do you have to wait between plasma, plt, or leukocyte donations

88
Q

What is the max plt apheresis donations you can make in 1 year

89
Q

What kind of donation can you make if you are taking aspirin, which one cant you

A

can- RBCs
cant plts

90
Q

What are the rules if you had a vaccine and want to donate blood

A

no deferral- if asymptomatic and standard/ synthetic vaccine
2 weeks- measles, rubeola by themselves
4 weeks- Rubeola, Mumps, polio, typhoid, german measles, MMR, chicken pox
12 months- unlicensed vaccine- rabies

91
Q

What are the physical requirements for blood donation

A

more than 17 or 16 with parent consent
>110 lbs
less than 180 systolic and 100 diastolic BP
50-100 bpm pulse
less than 37C or 99.5F temp
> 38% HCT

92
Q

What is the H&H requirement for autologous donors

93
Q

What is normal blood flow time

94
Q

What parts of the blood is apheresis done for

A

plts
plasma
WBCs
RBCs
Stem cells

95
Q

Therapeutic phlebotomy is used for

A

treatment for polycythemia- too much EPO
hemochromatosis- too much iron
cyanotic heart disease
ET- too many plts

96
Q

Autologous donation is used for

A

PACS
surgery
rare blood types

97
Q

What are the requirements for autologous donations

A

no age limit
no weight requirement
can donate if pregnant
HGB >11
HCT>33%
72hrs before surgery or more

98
Q

What are the requirements for directed donations to family members

A

must be IR

99
Q

Can you donate FFP if Ab screen is positive

A

no
must do 37C and AHG

100
Q

What diseases are donors tested for (10)

A

HBsAg
Anti-HBc
HBV DNA
Anti-HCV
HIV
Anti-HTLV
Syphilis
WNV RNA west nile virus
Chagas
CMV

101
Q

What organism causes syphilis, what test is used to ID it

A

Trepenoma pallidum
RPR

102
Q

What does indirect EIA detect? and sandwich EIA?

A

indirect- antibodies
sandwich- antigens apple and gems in sandwich

103
Q

What is NAT testing and what is it for

A

Nucleic acid testing
find HIV, HCV, WNV, HBV

104
Q

What are the specificity and sensitivity calculations?

A

sensitivity: TP/TP+ FN
Specificity: TN/TN+ FP

105
Q

What hepatitis viruses can only cause disease if RNA is present

A

A, C, D, E

106
Q

What hepatitis viruses can only cause disease if DNA is present

107
Q

What hepatitis viruses are blood born

108
Q

What does the presence of HBsAG indicate? and anti-HBc

A

HBsAG- surface antigen- individual is currently infected
anti-HBc- individual has had it in the past

109
Q

What is HTLV-I and HTLV-II

A

I- adult T leukemia
II- large granular lymphocytic leukemia

110
Q

What type of virus is WNV and what transmits it

A

mosquito
flavivirus

111
Q

What disease is the CMV associated with

A

mononucleosis

112
Q

What organism causes chagas disease

A

Trypanosoma cruzi

113
Q

What bacteria is often in plts

A

staph epidermidis

114
Q

What bacteria is often in RBCs

A

yersinia enterocolitica

115
Q

What is the purpose of apeheresis

A

for pts with bleeding, anemia, hypoxemia

116
Q

What blood cells can apheresis separate

A

plasma
plts
lymphs
granulocytes
erythrocytes

117
Q

What does plasmapheresis remove

A

immune complexes
alloabs
autoabs
immunoglobulins
protein bound drugs
lipoproteins
phytanic acid

118
Q

What is phytanic acid and why do we want to get rid of it

A

if there are too many lipids in blood- Refsums disease

119
Q

Why do we want to remove immune complexes

120
Q

Why do we want to remove auto abs

A

guillian barre and goodpasture

121
Q

Why do we want to remove immunoglobulins

A

hyperviscosity
Waldenstroms- IgM

122
Q

How often can you donate plts if
frequent
infrequent
single apheresis
double + apheresis

A

frequent- 2 days
single- 2 days
infrequent-4 weeks
double + 7 days

fanny sings in duets

123
Q

How often can you donate granulocytes

124
Q

What is photopheresis for

A

collect buffy coat with UV light, kills DNA in WBCs

125
Q

What diseases make us want to do therapeutic apheresis

A

waldenstroms
multiple myeloma
sickle cell
myasthenia gravis
guillain barre
TTP

126
Q

What is the most common immediate complication of apheresis

A

citrate toxicity

127
Q

What is the difference between high concentration glycerol and low concetration glycerol

A

high- slow thaw
low- fast thaw, lower temp

128
Q

What are RDP plts vs SDP plts

A

random donor
single donor

129
Q

What plasma product has a higher yield of coag factors

130
Q

____ ensures safe and healthful working conditions

131
Q

___ is involved in assessing medical waste

132
Q

What organizations must the BB be compliant with

A

FDA
JC
CAP
AABB

133
Q

A rule or requirement imposed by government

A

regulation

134
Q

A government permission to operate or engage in practice

135
Q

Laboratories/ institutions are _____, people are ___, companies are

A

accredited
certified
regulated

136
Q

Consent of donors is kept for, recipient consent is kept for

A

10 years
5 years

137
Q

Software or hardware databases are kept for

138
Q

What is in the CPDA perservative

A

citrate phosphate dextrose adenine

Blood Bank (8 decks)

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