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Haematology SB > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

1
Q

what blood product is given to a severe burn patient

A

albumin

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2
Q

what must be included from blood donors blood

A

infective risk
- bacterial, viral, protozoal infection

risk of transmitting disease
- malignancy, neurological conditions (MS)

HIV
HEP C
HEP B
Syphillis

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3
Q

what are the 4 blood groups and what differentiates them

A

A - RBC membrane carries A antigen

B - RBC membrane carries B antigen

AB - RBC membrane carries A and B antigen

O - RBC membrane does not carry A or B antigen

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4
Q

what blood can be given to any recipient

A

group O

i.e. universal donor

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5
Q

what blood group can receive blood from any other donor ABO group

A

AB recipient

i.e. universal recipient

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6
Q

if the body was to launch an autoimmune attack against a wrong ABO transfusion, what antibodies would be seen

A

IgG

IgM - majority

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7
Q

what chromosome codes for our blood group

A

chr 9

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8
Q

what are the phenotype of the blood groups

A

O gene = silent
A gene = dominant
B gene = dominant

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9
Q

what would you need to be an O blood group

A

OO

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10
Q

what would you need to be an A blood group

A

AA or AO

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11
Q

what would you need to be a B blood group

A

BB or BO

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12
Q

what would you need to be a AB blood group

A

AB

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13
Q

what is chromosome is responsible for Rh(D) grouping

A

Chromosome 1

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14
Q

what determines your Rh(D) status

A

The presence or absence of the Rh(D) protein on the surface of one’s red cells determines whether one is Rh(D) positive or Rh(D) negative

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15
Q

what is the phenotype of Rh(D) and what are the combinations of this

A

D - dominant
d - recessive

DD = Rh(D) positive 
Dd = Rh(D) positive 
dd = Rh(D) negative
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16
Q

what reaction in the lab do we rely on to determine blood group

A

agglutination

17
Q

what blood group is the following patient:

red cells + Anti-A = no agglutination

red cells + Anti-B = no agglutination

red cells + Anti-AB = no agglutination

red cells + Anti-D = agglutination

A

Group O

RhD positive

18
Q

what colour is anti A and what colour is anti B

A

anti A = blue

anti B = yellow

19
Q

what are indications for red cell transfusion

A

1 - anaemia (severe)

2 - acute blood loss

20
Q

what are indications for fresh frozen plasma

A

1 - bleeding or surgery in liver disease with impaired coagulation

2 - coagulopathy following massive transfusion

3 - DIC

21
Q

what are potential side effects of blood transfusion

A

1 - immediate haemolytic transfusion reaction
2 - delayed haemolytic transfusion reactions
3 - febrile non-haemolytic transfusion reaction
4 - urticarial reactions
5 - circulatory overload
6 - bacterial infection
7 - viral infection

22
Q

what happens in immediate haemolytic transfusion reaction

A

i.e. say A blood is transfused to a group O recipient

1 - group A red cells reach the recipient’s circulation
2 - IgM anti-A binds to the cells
3- activates complement cascade
4 - formation of membrane-attack complex (MAC)
5 - release of C3a and C5a
6 - act on blood vessels to cause leakage and dilatation
7 - fluid leaks into circulation
8 - BP drops

23
Q

what are the net effects of immediate haemolytic transfusion reaction

A 
systemic hypotension
DIC
renal vasoconstriction
formation of renal intravascular thrombi
shock
renal failure
- OFTEN FATAL
24
Q

what are Sx a patient will complain of in immediate haemolytic transfusion reaction

A 
pyrexia / rigors
faintness / dizziness
tachycardia / tachypnoea / hypotension
pallor / sweating
headaches / chest or lumbar pain
local pain at infusion site
cyanosis
patient may say “something is wrong”
25
Q

what is the Mx of immediate haemolytic transfusion reaction

A

stop transfusion

start iv fluids to maintain BP and urine output

obtain blood samples

  • for transfusion lab - FBC and blood film - coagulation screen
  • biochemistry
  • blood cultures
  • serum haptoglobin
26
Q

what are features of delayed haemolytic transfusion reactions

A

symptoms / signs similar to, but less acute than, a IHTR

unexplained fall in Hb value as transfused red cells are destroyed

appearance of jaundice, renal failure or biochemical

features associated with IHTRs

27
Q

what are lab features of a delayed haemolytic transfusion reactions

A

anaemia, spherocytic red cells on blood film

elevated bilirubin and LDH

positive DAGT and/or appearance of red cell allo-antibody
+/- a degree of renal failure

28
Q

what are features of a febrile non-haemolytic transfusion reaction

A

rapid temp rise 1-2 degrees
chills
rigors

29
Q

what causes a febrile non-haemolytic transfusion reaction

A

recipient has anti-HLA antibodies that bind to residual white cells within the component being transfused

or as a result of vasoactive and pyrogenic substances being released from white blood cells during storage of blood components

30
Q

what causes a urticarial reaction in a blood transfusion reaction

A

mast cells releasing IgE in response to infused plasma proteins

31
Q

Sx of a urticarial reaction

A

Rash / weals within few minutes of starting transfusion

32
Q

Tx of a urticarial reaction

A

Slow the transfusion

Consider anti-histamines

33
Q

who is at risk of circulatory overload from a blood transfusion

A

people with circulatory impairment

- elderly, CCF

34
Q

what is the main Sx of circulatory overload

A

pulmonary oedema

35
Q

what are Sx of a bacterial infection caused by blood transfusion

A

fever
immediate collapse
shock
DIC

Fever, chills, vomiting, tachycardia, hypotension

36
Q

how should an acute bacterial infection caused by blood transfusion be treated

A

same as immediate-type haemolytic transfusion reaction

once lab shows patient has not had an ABO-incompatible transfusion then broad spectrum antibiotics should be started

Haematology SB (19 decks)

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