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Clinical Pathology > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

Process by which WBCs are removed from a blood transfusion

A

Leucodepletion

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2
Q

Centrifuged FFP

A

Cyroprecipitate

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3
Q

Factor concentrates, albumin, immunoglobulins

A

Fractionation

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4
Q

Antibodies in one individual reacting to cells of another individual

A

Alloantibodies

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5
Q

A type of haemolysis caused by ABO incompatibility

A

Intravascular

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6
Q

A type of haemolysis caused by Rh incompatibility

A

Extravascular

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7
Q

1 unit RBCs is what volume

A

275ml

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8
Q

How are RBCs stored?

A

4 degresses for less than 35 days

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9
Q

Purpose of RBC transfusion

A

To prevent symptoms of anaemia and improve QofL and to prevent damage of end organs in anaemic patients, NOT to normalise the Hb in anaemic patients.

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10
Q

Transfusion threshold trigger

A

Invest the concentration of Hb that is not associated iwth symptoms of anaemia

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11
Q

Target Hb conc. for anaemic patients

A

80-100g/dL

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12
Q

Target Hb conc. for patients with inherited anaemias

A

Aim to suppress endogenous erythropoiesis. Target 100-120g/L

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13
Q

Treatment for anaemia in patients with renal disease

A

Erythropoietin

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14
Q

How are platelets stored?

A

room temp. 5 day shelf life.

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15
Q

Adult therapeutic dose of platelety

A

Platelets from 4 pooled donations or equivalent number from a sinlge apheresis (plasma separated from blood) donation

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16
Q

In what 4 causes would you transfuse platelets?

A

Severe thrombocytopenia
Massive haemorrhage
Bone marrow failure
Prophylaxis for surgery

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17
Q

Contraindications for platelet transfusion

A

Heparin induced thrombocytopenia and thrombosis

Thrombotic thrombocytopenic purpura

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18
Q

How is fresh frozen plasma stored?

A

-30 degrees, for up to 24 months. Thawing takes 20-30 minutes

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19
Q

In what 3 causes would you transfuse someone with FFP

A

Coagulopathy with bleeding/surgery
Massive haemorrhage
Thrombotic thrombocytopenic purpura

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20
Q

Contraindications for fresh frozen plasma infusion

A

Warfarin reversal

Replacement of single factor deficiency

21
Q

A blood transfusion product that contains all the vit. K dependent factors. Used to reverse warfarin over-anticoagulation

A

Prothrombin complex concentrate

22
Q

When would you require CMV negative blood transfusions

A

Children

23
Q

Why would you need to irradiate blood before transfusion

A

To prevent graft vs. host disease

24
Q

Group and Screen

A

Determines ABO and RH(D) group- plasma screened for antibodies against other clinically significant blood group antigens.

25
Q

Compatibility testing ‘crossmatching’

A

Patients plasma is mized with samples of donor RBCs to see if reaction (agglutination or haemolysis) occurs to identify risk of acute haemolysis.

26
Q

What time scale classes as an acute complication of transfusion

A
27
Q

Name 4 acute immunological complications of transfusion

A

Acute haemolytic transfusion reaction ‘ABO incompatibility’
Allergic reaction
Transfusion related acute lung injury (TRALI)
Febrile non-haemolytic transfusion reaction

28
Q

Describe the effects of an acute haemolytic reaction

A

Release of free Hb, deposits in renal tubule
Stimulation of coagulation results in microvascular thrombosis- stimulation of cytokine storm. Scavengers release NO resulting in generalised vasoconstriction

29
Q

Onset of ABO incompatibility/acute haemolytic reaction

A

During transfusion

30
Q

Signs of Acute haemolytic reaction

A

Fevers/chills, back pain, infusion pain, hypotension/shock, haemoglobinuria, increased bleeding (DIC), chest pain or feeling of impending death

31
Q

Prognosis for acute haemolytic reaction

A

fatal in 20-30%

32
Q

Cause of ABO incompatibility

A

Always human error

33
Q

When does a delayed haemolytic reaction occur

A

3-14 days after RBC transfusion

34
Q

Clinical features of delayed haemolytic reaction

A

Fatigue, jaundice and/or fever

35
Q

Pathological cause of delayed haemolytic reaction

A

IgG antibodies agains RBC antigens other than ABO. Antibodies are formed after the reaction

36
Q

Lab findings of delayed haemolytic reaction

A

low Hb
High LDH
high bilirubin

37
Q

Test used to confirm haemolysis is due to antibodies on RBCs

A

Anti-human globulin (Coomb’s test)

38
Q

Donor has antibodies to recipient’s leucocytes which results in activated WBCs which lodge in pulmonary capillaries and release substances that cause endothelial damage and capillary lead

A

Transfusion related acute lung injury

39
Q

Time of onset and prognosis for transfusion related acute lung injury

A

Occurs within 6 hrs

Majority recover in around 3 days

40
Q

Treatment for transfusion related acute lung injury

A

Supportive e.g. oxygen, mechinical ventilation

41
Q

Symptoms for transufion associated circulatory overload (TACO)

A

Sudden dyspnoea, orthopneoa, tachycardia, hypertension, hypoxemia

42
Q

Signs of TACO

A

increased BP

Increased JVP

43
Q

2 main types of allergic reactions in transfusion

A

Urticarial rash with or without wheeze

Anaphylaxis

44
Q

Acute complication of transfusions which is due to cytokines or biologically active molecules that accumulate during storage of blood components.

A

Febrile non haemolytic transfusion reactions

45
Q

Symptoms of febrile non haemolytic transfusion reactions

A

Fever, rise in temp, shakes/rigor

46
Q

RBCs broken down in the blood vessels

A

Intravascular haemolysis

47
Q

RBCs broken down by macrophages in the liver/spllen

A

Extravascular haemolysis

48
Q

Briefly outline the pathology behind thrombotic thrombocytopenic purpura

A

Don’t have enough of the enzyme required to break down von willebrand factor. Increased VWF in the blood results in the platelets adhering to the surface endothelium more easily, causing microthombi in the small vessels around the body.

Clinical Pathology (53 decks)

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