chapter 1
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| 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
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| Typical preset ratio for anticoagulant solution in apheresis | 10-14 parts of whole blood to 1 part of citrate Anti-coagulant
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| Which is more commonly used for apheresis procedures: A. centrifugation B. filtration | A. centrifugation
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| The most commonly performed therapeutic apheresis procedure | TPE: therapeutic plasma exchange
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| What % of IgM is removed with a 1 volume TPE? | 70%; IgG is less
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| Increased muscle mass effects total blood volume in this way | increases
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| obesity effects total blood volume in this way | decreases
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| formula for estimating total blood volume | 70ml/kg in males; 65 ml/kg in females
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| The general standard of care is to limit the extracorporeal blood volume during an apheresis procedure to this % | 15%
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| 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)
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| When a patient needs dialysis and apheresis the same day, which should be done first? Why? | apheresis because possible hypotension
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| anticoagulant of choice in apheresis | citrate
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| how does citrate work as an anticoagulant | binds calcium. blocks calcium dependent platelet activation and clotting factor reactions
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| Patients with dysfunction in this organ are more prone to citrate reactions in apheresis | liver
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| The single greatest risk factor for adverse events associated with therapeutic apheresis | central venous catheter
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| Apheresis effect on PT and PTT | increases
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| This coagulation protein should be assessed regularly in TPE patients | fibrinogen
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| The rate of adverse events during therapeutic apheresis is _% | 5% (up to 33% if you count mild perioral tingling,etc)
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| Most common symptoms of citrate reactions | perioral tingling and peripheral parethesias
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| treatments for citrate reactions | lower rate.
Chewable calcium tabs
IV calcium gluconate
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| The most common reaction seen with whole blood donation | vasovagal reaction
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| 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
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