EXAM #2: BLOOD COMPONENT THERAPY Flashcards

1
Q

Why blood component therapy preferable to whole blood?

A

Aside from trauma, specific blood component defects require specific blood component therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the clinical indication for red cell transfusion?

A
  • Symptomatic patient with Hb less than 10

- Anemia w/ Hb less than ~7-8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the two methods of platelet product preparation?

A

1) Platelets

2) Cryoprecipitate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is alloimmunization?

A

This is an immune response to foreign antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the mechanism of alloimmunization in platelet therapy?

A

Patients that recieve platelets may make antibodies to the transfused platelets b/c:

  • Anti HLA (human luekocyte antigen)
  • Anti HPA (human platelet antigen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How can alloimmunization in platelet transfusion be prevented?

A

Find compatible platelets by:

1) Give random platelet units
2) Crossmatch
3) Find platelets without the antigen that causes the reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is CMV negative?

A
  • CMV is a virus that is carried in WBCs

- pRBCs that undergo Luekoreduction i.e. removal of WBCs are CMV negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the clinical indication of CMV negative blood products?

A

Transfusion of an immunocompromised patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does irradiated mean?

A

pRBC components are exposed to x-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the clinical indication for irradiated blood products?

A

This is done to prevent TRANSFUSION ASSOCIATED GRAFT VS. HOST DISEASE

This is indicated in patients that are IMMUNOCOMPORMISED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does filtered blood products mean?

A
  • Leukoreduction i.e. whole blood unit is hung and run through a filter
  • Filters OUT leukocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the clinical indication for filtered blood products?

A

Immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List the two indications for transfusing fresh frozen plasma.

A

1) Coagulation abnormalities in massive transfusions

2) Hemophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is cryoprecipitate? What the specific components of cryoprecipitate?

A

Precipitate that is formed when fresh frozen plasma is thawed, it contains:

  • Factor VIII
  • Fibrinogen
  • vWF
  • Factor XIII
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the clinical indication for cryoprecipitate?

A

Generally, the treatment of coagulation factor deficiencies involving fibrinogen and Factor VIII i.e.

1) Fibrinogen replacement in bleeding patient
2) Hemophilia A (Factor VIII)
3) vWF Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is prothrombin complex concentrate? What are the clinical indications for prothrombin complex concentrates?

A

Prothrombin complex concentrate is made via plasma fractionation and contains Vitamin K dependent coagulation factors; thus, it is indicated for patients with Hemophilia in the following situations:

  • Hemorrhage
  • Perioperative bleeding management
  • Prophylaxis of bleeding events
17
Q

What is the clinical indication for albumin?

A

1) Hypoalbuminemia

2) Volume replacement

18
Q

What is the indications for IVIG?

A

1) Primary humoral immunodeficiency e.g. SCID
2) Immune thrombocytopenia
3) Chronic inflammatory demyelinating polyneuropathy
4) Hypogammaglobulinemia
5) Post-exposure prophilaxis

19
Q

What are the main coagulation abnormalities that occur after massive transfusion?

A
  • Replacement of blood loss will lead to DILUATION of coagulation factors–>additional bleeding
  • Fibrinogen levels can drop
20
Q

Outline how the coagulation abnormalities seen following massive transfusion are treated.

A

1) FFP transfusions for coagulation factors

2) Cryoprecipitate for fibrinogen

21
Q

Is there a difference in clinical outcomes when old pRBCs are given vs. new?

A

NO

22
Q

What is pRBC volume reduction?

A
  • Centrifuge pRBC just prior to administration
  • Purpose: remove preservative RBCs are stored in

Indicated for patients with circulatory overload e.g. CHF and renal failure

23
Q

What are the general indications for plasma transfusion?

A

1) Coagulation factor replacement
2) Massive transfusion
3) ADAMSTS13

24
Q

What are the platelet thresholds for transfusion?

A

Generally, less than 100,000, EXCEPT:

  • Active bleed and major surgery= less than 50,000
  • Central line= less than 20,000
  • Prevent spontaneous bleeding= less than 5,000
25
Q

What is the definition of platelet refractoriness?

A

Patient that has an alloimmune response to donor platelets

26
Q

What are the ADVANTAGES of whole blood transfusion?

A

1) Best for TRAUMA
- Volume
- Hb
- Coagulation factors
- Replace platelets

27
Q

What are the indications for Recombinant Factor VIII?

A

Patients with Hemophilia A to:

  • Control and prevent bleeding
  • Perioperative bleeding management
28
Q

What blood component would you give a patient with anemia?

A

RBCs

29
Q

What blood component would you give a patient with DIC?

A

Plasma

30
Q

What blood component would you give a patient with thrombocytopenia?

A

Platelets

31
Q

What blood component would you give a patient with low fibrinogen?

A

Cryoprecipitate