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Blood Banking
Clinical Medicine II
| Question | Answer |
|---|---|
| What are the 4 components of blood | RBC, WBC, platelits, plasma |
| What are the 3 components of Plasma | coag factors, albumin, abs |
| What is albumin used for | transporting molecules throughout the body (usually lipid soluble) |
| How much donor blood is taken | 500ml and then separate into 4 parts, use each separately except WBC-discard |
| What is the MC blood product used for medical therapy | RBC’s |
| Why do they freeze it so rapidly, to what temp | to preserve the coag factors, 15 degrees below 0 |
| Indications for FFP | coag deficiencies d/t liver failure, DIC, vit K deficiency, warfarin tox, blood loss |
| Nl platelit count | 150-450,000/uL |
| Indications for platelet transfusions | thrombocytopenia (<50,000) <10,000 if asymptomatic for bleed. |
| What are causes of thrombocytopenia | chemo, increased destruction: DIC, massive blood loss |
| How much will a unit of platelet concentration increase the platelet count Donors? | 5000-10,000/uL 6 donors! |
| When would WBC transfusions be given | leukopenia because of chemotherapy with septic shock |
| Indications for RBC transfusion | ↑O2 carying, hypotension, ↓o2stats, dizziness, weakness, angina, altered mental status |
| What is the transfusion criteria for replacement | <8g/dl |
| What else depends on need for transfusion | rate of blood loss, rapid: body can’t compensate, need blood |
| When would we perfust albumin | need to ↑ osmotic pressure of intra-extra-vasbular back to nl usually d/t hypovolemia and hypoprotenimia |
| Other blood products available for transfusion | leukocyte reduced PRBCs irradiated leukocyte reduced PRBC’s, apheresis platelets, |
| Are there antigens on O blood | no, so have anti-a and anti-b abs |
| Are there antigens on A blood | yes, A surface antigens, and have anti-b Abs |
| When are ABO blood antibodies produced | by 3m after birth |
| What is the Rh antigen/antibodies | 70% born w/ Rh antigen |
| When are Rh antibodies produced | once exposed (don’t have them at birth, only have them once exposed to Rh + blood) |
| What happens to a Rh – pt with 1st and 2nd exposure to Rh+ blood | 1st, not much happens, builds Abs for it, 2nd, memory cells ↑ immune response, can be bad (kill a fetus) |
| What is a type and screen | type the pt’s blood for their type of blood, screen for atypical RBC’s for specific abs .5-1 hr |
| What is the screening more specifically for | an Rh like rxn to antigens in the donor blood→cause an immune response |
| What is a type and cross | type pts blood, crossmatch with a donors blood product actually in the blood blank with the intent to transfuse, add pt’s blood w/ donor blood in test tube looking for agglutination |
| What do we combine to crossmatch blood | pt’s WBC’s and the donor RBC blood looking for agglutination |
| Universial donor for RBC and FFP | O- for RBC and AB+/- for FFP |
| What happens w/ hemolytic transfusion rxns | RBCs burst, K+, Heme, Iron all released into the blood, usually toxic |
| Clinical presentation of hemolytic transfusion reactions | DIC, acute renal failure (↑proteins), shock, triads of fever fland and red/brown urine |
| What is the clinical triad of hemolytic transfusion reactions | fever, fland pain, red/brown urine |
| Tx hemolytic transfusion rxns | med emergency, stop transfusion, maintain airway, saline, notify BB, obtain blood and UAs, vasporessors for hypotension pts |
| What causes febrile nonhemolytic transfusion reactions | Interleukins and TNF alpha substance w/I blood products |
| Clinical presentation of febrile nonhemolytic transfusion rxns | fever, chills, rigors, mild dyspnea |
| Tx FNTR | usually stopping the transfusion, d/t what COULD happen, give tylonol and Benadryl for symptomatic relief |
| CP delayed hemolytic transfusion rxns | slight fever falling hematocrit, mild ↑ unjonjugated billrubin etc. no tx necessary |
| CP of anaphylaxis to transfusion rxns | shock, hypotension, angioedema, respiratory distress |
| Tx anaphylaxis trx rxns | stopi t, epi, IM, maintain airway, saline, vasopressor if necessary |
| What causes urticarial trx rxns | substance in blood prodcuts cause histamine release from mast cells and basophils causing hives |
| Tx of urticrial trs rxsn | stop trx benedrly 25-50mg, no other signs, trx can be resumed |
| What can cause severe thrombocytomenia lasting days to weeks post infusion | sensitivity to previous platelet antigen: HPA-1a called post transfusion purpura (PTP) |
| Tx PTP | high dose corticosteroids or exchange trx, give IVIG, furture trxs, give washed cells or HPA-1a – cells |
| What is TRALI | transfusion related acute lung injury unknown cause |
| CP of TRALI | sudden respiratory distress, INTUBATE! |
| Risks of transfusions | fluid overload, rxns, coag defects to massive trx, citrate tox, chelation of calcium, hyperkalemia, hypothermia, iron overload, air embolism |
| Shelf life of RBC, FFP, platelets | R: 45 days, spiked 4 rhs, F: 1 yrs, 12hrs thawed, Platelets: on shelf 5 days |
| What is hemolytic dz of newborn | mom Rh- baby Rh+ communication during birth, mom develops Rh abs, 2nd birth is Rh+ too, mom’s abs attack baby |
| How do we prevent hemolytic newborn dz | during 1st preggo, rhogam |
| What does rhogam do | kills the babies RBC in mom’s circulation, no Rh’s abs can be produced |
| Who do we give rhogam to? | all mom’s who are Rh – |
| When do we give Rhogam | 1 dose at 26-28 weeks of gestation and one dose w/I 72 hrs of delievery (more if trauma or ↑ amount of blood mixed |
Created by:
becker15
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