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Intro to Anes > Blood > Flashcards

Blood Flashcards

1
Q

blood functions

A

O2/nutrient transport
clots
cells/antibodies to fight infection
brings waste to kidneys
supports water/electroly balance (pH mx)
regulated body temp/hormone circ

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2
Q

blood components

A

plasma - 55%
platelets
WBC
RBC - 44%

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3
Q

plasma function

A

coagulation
defense
mx of osmotic pressure
nutriction
acid/base regulation

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4
Q

normal osmotic pressure

A

25 mmHg

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5
Q

platelet function

A

hemostasis regulation
infmalattory process

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6
Q

RBC function

A

O2 delivery
CO2 removate

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7
Q

left shift curve

A

incr O2 affinity / decr perfusion
decr pCO2
decr H+
decr 2,3 DPG
decr temp
HbF

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8
Q

right shift curve

A

decr O2 affinity/incr perfusion
incr pCO2
incr H+
incr 2,3 DPG
incr temp

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9
Q

normal P50

A

26 mmHg

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10
Q

methemoglobinemia

A

iron is oxidize from Fe2+ to Fe 3+
“functional” anemia
unable to deliver O2 to tissue adquately
dyspnea or cyanosis
85% SpO2

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11
Q

methemoglobinemia curve shift

A

left shift

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12
Q

meth treatment

A

MB (1-2 mg/kg)

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13
Q

carboyhemoglobinemia

A

CO is bound to Hg instead of O2
normal SpO2
cherry red skin

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14
Q

carboxyhemogloin treatment

A

supplement O2
hyperbaric chamber

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15
Q

sickle cell anemia

A

substitution on beta subunit
hypoxia
autosomal recessive
hemolytic anemia

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16
Q

what to avoid in sickle cell pts

A

dehydration
acidosis
hypothermia
tourniquets

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17
Q

when do WBC increase

A

infections
inflammation
cancer

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18
Q

when do WBC decrease

A

meds
autoimmune

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19
Q

Hg/Hct increase

A

smoking
genetic polycythemia
altitude

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20
Q

Hg/Hct decrease

A

hemodilition
blood loss
low Fe/B12/folate
inherited blood condition
kidney disease
cancer

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21
Q

Plt increase

A

increased production

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22
Q

Plt decrease

A

low production
rapid destruction

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23
Q

primary hemostasis

A

plt activation/adhesion

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24
Q

primary hemostasis is promoted by

A

vWF

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25
Q

extrinsic patheay

A

response to external trauma

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26
Q

what is activated in extrinsic

A

Factor VII –> Factor X

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27
Q

intrinsic pathway

A

response to internal damage to endothelium

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28
Q

what is activated in intrinsic

A

Factor XII + Facot XI + Factor IX —> Factor X
vWF stabilized Factor VIII —> Factor X

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29
Q

common pathway

A

Factor I, II, V, X, XIII

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30
Q

Hgb lab values

A

12-17.5

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31
Q

Hct

A

34-52

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32
Q

Plt

A

150-450

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33
Q

WBC

A

4.5-11

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34
Q

PT

A

10-13

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35
Q

PTT

A

25-35

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36
Q

INR

A

0.8-1.2

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37
Q

PT/INR measures

A

extrinsic

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38
Q

PTT measures

A

intrinsic

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39
Q

ACT

A

time it takes for whole blood to clot in tube

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40
Q

normal ACT

A

70-120 seconds

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41
Q

unable to clot (hypocoagulable)

A

hemophilia
von willibrands

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42
Q

hpocoagulable values

A

thrombocytopenia
hypothermia
acidosis
anemia

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43
Q

what causes thrombocytopenia

A

drugs (heparin/NSAIDs)
alcohol
liver failure/cirrhosis

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44
Q

DIC

A

innapropriate acitivation of clotting cascade
uses up coags

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44
Q

excessive clotting (hypercoagulable)

A

factor V leiden
antithrombin III
protein C/S def
antphospholipid syndrome
drugs
cancer
pregnancy

45
Q

DIC labs

A

decr plt/fibrinogen
incr PT/PTT/INR
incr D dimer

46
Q

trauma triad aof death

A

hypothermia
acidosis
coagulopathy

47
Q

coumadin (warfarin)

A

extrinsic
PT

48
Q

warfarin reversal

A

PCC
vit K
FFP

49
Q

Heparin

A

intrinsic
PTT/ACT

50
Q

heparin reversal

A

protamine (1 mg/100 units heparin)

51
Q

antigens are found

A

on RBC

52
Q

antibodies are found

A

in plasma for antigen that they DO NOT HAVE

53
Q

group A

A

anti-B antibodies
A antigen

54
Q

group B

A

anti-A antibodies
B antigen

55
Q

Group AB

A

no antibodies
A and B antigen

56
Q

Group O

A

anti- A and anti-B antibodies
no antigens

57
Q

RH+ can receive

A

RH+ and Rh-

58
Q

Rh- can receive

A

Rh- only

59
Q

plasm universal recipient

A

type O

60
Q

plasma universal donor

A

type AB

61
Q

blood universal donor

A

O-

62
Q

blood universal receiver

A

AB+

63
Q

agglutination

A

occurs wehn antigen is mixed with corresponding antibody

64
Q

type and scree

A

<1% risk
45 mins

65
Q

type and cross

A

no risk
1 hr

66
Q

PRBC volume

A

250 mL

67
Q

PRBC Hct

A

70%

68
Q

PRBC shelf life

A

35 days frozen at 1-6 C

69
Q

PRBC uses

A

1 unit raises:
Hg 1 g/dL
Hct 3%

70
Q

PRBC risks

A

citrate toxicity
hypothermia
hyperkalemia
decr 2,3 DPG

71
Q

when do you need to consider PRBC transfusion

A

Hg 6-10 g/dL

72
Q

Plts volume

A

50-70 mL

73
Q

plt storage

A

20-24C for 5 days

74
Q

Plts uses

A

1 unit raises plt by 5-10000/mm3

75
Q

FFP

A

plasma proteins/clotting factorts
200-250 mL

76
Q

plts indictaion

A

thrombocytopenia
plt dysfunction

77
Q

is ABO compatibility needed for plts

A

no

78
Q

FFP uses

A

1 unit will raise clotting factor by 2-3%

79
Q

is abo compatibility neede for FFP

A

yes but not Rh

80
Q

FFP indications

A

tx of isolated factor deficiencies
warfarin reversal
coagulopathy
massive blood loss/transfusion

81
Q

cryo

A

precipoitate remaining after ffp is thawed slowly
10-15 mL
F VIII, FXII, vW, fibrinogen

82
Q

1 unit of cryo

A

increase fibrinoge 5-7 mg/dL

83
Q

cryo indiscations

A

FVII deficiency
hemophilia A
fibrinogen deficiency

84
Q

which blood products do you heat

A

RBC
FFP

85
Q

blood products must be

A

filtered (170 micron filter)

86
Q

blood product veriofication before administration

A

unit #
blood type
expiration date

2 staff members must verify

87
Q

blood consents

A

mandatory for every pt

88
Q

are there any mandatory transfusion triggers

A

NO

89
Q

allowable blood loss calculatiuon

A

ABL = EBV x [(Hct i - Hct f) / Hct i]

90
Q

EBV premature neonates

A

95 mL/kg

91
Q

EBV full term neonates

A

85 mL/kg

92
Q

EBV infants

A

80 mL/kg

93
Q

EBV adult men

A

75 mL/kg

94
Q

EBV adult women

A

65 mL/kg

95
Q

EBV morbid obese

A

55 mL/kg

96
Q

ermgency transfusion blood type known

A

abbvreviated cross match

97
Q

blood type unknown

A

give O- until correct type and cross is done

98
Q

MTP

A

need to transfuse 1-2x pt blood

99
Q

TRALI

A

leading cause of deth from transfusion

100
Q

TRALi occurs within

A

6 hrs

101
Q

TRALI is mnore common with

A

plt
FFP

102
Q

TRALI symptoms

A

dyspnea
cyanosis
chills/fever
decr BP

103
Q

TRALI presentation

A

acute hypocia
non cardiac pulmonary edema

104
Q

TRALI treatment

A

supplemental O2
vent support as needed (low TV, incr RR)

105
Q

TACO

A

transfusion associated circulatory overload

106
Q

TACO occurs when

A

blood products are administered too quickly

107
Q

TACO is more common in what pts

A

cardiac/renal dysfunction

108
Q

TACO symptoms

A

respiratory distress
PE
elevated BNP
elevated CVP

109
Q

TACO occurs within

A

12 hrs of the transfusion

110
Q

TACO treatment

A

stop transfusion
supp O2
ventilatory support
diuresis

111
Q
A

Intro to Anes (12 decks)

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