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Apheresis book 1
chapter 1
| Question | Answer |
|---|---|
| When a tube of blood is centrifuged, the components separate in order of increasing specific gravity: list top to bottom | plasma, platelets, lymphocytes and monocytes, granulocytes, RBCs |
| Typical preset ratio for anticoagulant solution in apheresis | 10-14 parts of whole blood to 1 part of citrate Anti-coagulant |
| Which is more commonly used for apheresis procedures: A. centrifugation B. filtration | A. centrifugation |
| The most commonly performed therapeutic apheresis procedure | TPE: therapeutic plasma exchange |
| What % of IgM is removed with a 1 volume TPE? | 70%; IgG is less |
| Increased muscle mass effects total blood volume in this way | increases |
| obesity effects total blood volume in this way | decreases |
| formula for estimating total blood volume | 70ml/kg in males; 65 ml/kg in females |
| The general standard of care is to limit the extracorporeal blood volume during an apheresis procedure to this % | 15% |
| for TPE, avoid using plasma unless: 1._ 2._ 3._ | 1. plasma is specifically indicated to treat disease(TTP) 2. plasma is required to correct a coagulation factor 3. plasma is needed to prevent dilutional coagulopathy in actively bleeding patient (pulmonary renal syndrome) |
| When a patient needs dialysis and apheresis the same day, which should be done first? Why? | apheresis because possible hypotension |
| anticoagulant of choice in apheresis | citrate |
| how does citrate work as an anticoagulant | binds calcium. blocks calcium dependent platelet activation and clotting factor reactions |
| Patients with dysfunction in this organ are more prone to citrate reactions in apheresis | liver |
| The single greatest risk factor for adverse events associated with therapeutic apheresis | central venous catheter |
| Apheresis effect on PT and PTT | increases |
| This coagulation protein should be assessed regularly in TPE patients | fibrinogen |
| The rate of adverse events during therapeutic apheresis is _% | 5% (up to 33% if you count mild perioral tingling,etc) |
| Most common symptoms of citrate reactions | perioral tingling and peripheral parethesias |
| treatments for citrate reactions | lower rate. Chewable calcium tabs IV calcium gluconate |
| The most common reaction seen with whole blood donation | vasovagal reaction |
| Treatment of air embolism | place patient on left side in Tredenlenberg position so air will go to apex of right ventricle. Then air will dissolve into bloodstream |
Created by:
jfshikle
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