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Question | Answer |
---|---|
What types of RBCs should be issued with massive transfusion protocol? | O negative for young women. For males and postmenopausal females, it’s reasonable to BEGIN by using O-positive blood in emergencies |
List causes of warm autoimmune hemolytic anemia | 1) Idiopathic (~ 50%) 2) Malignancies (CLL, NHL) (~25%) 3) Autoimmune disease (SLE) 4) Drugs (α-methyldopa) |
Triggers for Neonatal RBC Transfusions (Birth to 4 months) | Generally higher RBC transfusion thresholds than in adults; common thresholds follow: 1) No symptoms: 8 g/dL 2) Cardiopulmonary disease, major surgery: 10 g/dL 3) Severe cardiopulmonary disease: 12-13 g/dL |
Why is ABO compatibility more of a concern in neonatal platelet transfusions? | 1) Minor ABO mismatch that is ok in adult PLT transfusions may be disastrous in neonates 2) Remember incompatible plasma and smaller baby volumes; keep ABO compatible if at all possible |
Describe the ASFA categories for therapeutic apheresis | a. Category I: TA accepted, proven for primary therapy b. Category II: TA accepted, useful for 2 nd -line therapy c. Category III: TA not proven but might be helpful d. Category IV: TA not helpful and may be harmful |
Most common type of HDFN | ABO HDFN |
Why are ABO HDFN generally mild or undiagnosed? | 1) Weak ABO antigen expression in utero 2) Soluble plasma ABO antigens neutralize antibodies |
Describe blood types of ABO HDFN | Group O moms, group A or B babies |
Obstetric indications for Rhogam | a) D-neg female at about 28 weeks gestation b) D-neg female < 72 hours of D+ infant’s birth c) D-neg female with pregnancy complications or invasive procedures (amnio, cordocentesis) |
How much blood does a full dose of Rhogam cover? | One full dose vial (300 g or 1500 IU) per 30 ml of D+ whole blood (15 ml D+ RBCs) |
Why is HDFN particularly severe with anti-K? | Anti-K attaches to K antigen on early RBC precursors and causes severe fetal anemia |