Blood Transfusion

Question 1

List the blood components that make up one donation of blood

Answer 1

Red cells
Platelets
White cells
Plasma

Question 2

When is plasma deemed “fresh frozen plasma”?

Answer 2

If frozen within 8 hours of blood collection, containing the coagulation proteins in the same concn that was present in the patient’s blood

Question 3

List some blood products that can be acquired from batches of blood via manufacturing

Answer 3

Albumin
Immunoglobulin
Prothrombin complex concentrates

Question 4

Blood products are made from thousands of donors. True/False?

Answer 4

True

Giving one bottle of blood product to a patient exposes them to thousands of donors

Question 5

What must be done to donor blood to separate it into components?

Answer 5

Anticoagulation

Question 6

For standard blood donation, how often may someone donate blood?

Answer 6

Every 12 weeks

Max 5 a year

Question 7

List the basic criteria for a blood donor

Answer 7

Able to spare 465ml of blood
Minimum weight 50kg
Hb 13.5 (male)/12.5 (female)

Question 8

Who should avoid donating blood?

Answer 8

Infective risk
Transmitting disease (malignancy)
Drug addicts
Recent foreign travel to endemic areas

Question 9

Describe the order/position of blood components in a bag once blood has been centrifuged

Answer 9

Red cells at bottom (most dense)
Platelets + white cells in middle
Plasma at top (least dense)

Question 10

At what temperature must red cells be stored?

Answer 10

4’C +/- 2’C

Question 11

What is the shelf life of donated red cells? What happens if they are removed from storage for more than 30 mins?

Answer 11

35 days

If removed for more than 30 mins, must be transfused or discarded

Question 12

At what temperature must platelets be stored?

Answer 12

22’C

Question 13

What is the shelf life of donated platelets?

Answer 13

7 days if bacterial monitoring system applied

Question 14

At what temperature and for how long must fresh frozen plasma be stored?

Answer 14

-30’C for up to 3 years

Question 15

What are the possible blood groups a person can be?

Answer 15

A
B
AB
O

Question 16

Describe the red cell membranes of ABO blood groups

Answer 16

A: carry A-antigen
B: carry B-antigen
AB: carry A-antigen + B-antigen
O: no A or B antigen

Question 17

Order the blood groups from highest to lowest population frequency

Answer 17

O, A, B, AB

Question 18

Which of the ABO blood groups is the universal donor? Why?

Answer 18

O is universal donor because blood carries no antigen and therefore other blood groups won’t form antibody against it

Question 19

Which of the ABO blood groups is the universal recipient? Why?

Answer 19

AB is universal recipient because it carries both antigens and therefore won’t form antibody against any of the other blood groups

Question 20

Naturally occuring ABO antibodies are what - Ig?

Answer 20

IgM

Small proportion are IgG

Question 21

The genes that determine our ABO group are located on which chromosome?

Answer 21

Chromosome 9

Question 22

Which alleles for ABO group are dominant?

Answer 22

A and B are co-dominant

O is recessive

Question 23

The genes that determine Rhesus-D status are located on which chromosome?

Answer 23

Chromosome 1

Question 24

Inheritance of Rhesus-D follows what pattern?

Answer 24

Autosomal dominant

Question 25

How is blood group determined?

Answer 25

Agglutination

Giving antibody to individual of same blood type (e.g. anti-A to group A) will cause cells to stick together

Question 26

What must a doctor’s prescription for blood transfusion state?

Answer 26

Number of units
Special requirements
Rate of transfusion
Accompanying medication

Question 27

List possible indications for red cell transfusion in anaemia

Answer 27

Reduced exercise capacity
Medical/surgical issue
Heart or lung disease
“anaemic” symptoms

Question 28

List physiological response to acute blood loss

Answer 28

Increased heart rate + force of contraction
Vasoconstriction to protect organs
Fluid shift from ECF to ICF

Question 29

List indications for platelet transfusion

Answer 29

Low platelet count (duh!)
Bleeding symptoms
Underlying infection/fever
Surgical requirement/recovery
Platelet functional defects (myeloma)

Question 30

List indications for fresh frozen plasma transfusion

Answer 30

Liver disease (impaired coagulation)
Disseminated intravascular coagluation

Question 31

What does the acute haemolytic transfusion reaction involve?

Answer 31

Activation of complement, coagulation and kinin systems due to circulating antibody to donor blood

Question 32

What are the effects of complements C3a and C5a?

Answer 32

Increase vascular permeability
Dilate blood vessels
Release toxins and inflammatory markers (serotonin, histamine)

Question 33

What is the effect of bradykinin?

Answer 33

Arteriolar dilation
Increase vascular permeability
Leading to hypotension

Question 34

What action must be taken in an acute haemolytic transfusion reaction?

Answer 34

Stop blood transfusion
Give IV fluids
Obtain blood sample: transfusion, FBC, film, coagulation screen, biochemistry, blood culture, haptoglobin)

Question 35

What does haptoglobin do?

Answer 35

Binds free haemoglobin