Blood Flashcards
(71 cards)
1
Q
What’s in blood?
A
RBCs WBCs Platelets Coagulation factors Plasma
2
Q
What’s in blood?
A
RBCs WBCs Platelets Coagulation factors Plasma
3
Q
Blood Type A
A
A antigen on the RBC, Anti-B in the plasma
4
Q
Blood Type B
A
B antigen on the RBC, Anti-A in the plasma
5
Q
Blood Type AB
A
AB antigen on the RBC, No antibodies in the plasma
6
Q
Blood Type O
A
No antigen on the RBC, Anti-A and Anti-B in the plasma
7
Q
Where does coagulation occur?
A
Surface of endothelial cells, subendothelial cells, and platelets.
8
Q
What do we use to evaluate coagulation?
A
Platelet Count ACT PTT PT INR
9
Q
What is the platelet count?
A
The actual number of platelets per cubic ml of blood.
10
Q
Normal Adult/elderly children lab value for platelet?
A
150,000-400,000/mm3
11
Q
Thrombocytopenia
A
Less than 100,000/mm3
12
Q
Thrombocytosis
A
> 400,000/mm3
13
Q
What is the activated clotting time? (ACT)
A
Measures the amount of time required for whole blood to clot in a test tube. Used to monitor heparin therapy.
14
Q
What activated clotting time is sufficient for Cardiopulmonary Bypass?
A
> 400 seconds
15
Q
What activated clotting time is sufficient for Cardiopulmonary Bypass?
A
> 400 seconds
16
Q
Blood Type A
A
A antigen on the RBC, Anti-B in the plasma
17
Q
Blood Type B
A
B antigen on the RBC, Anti-A in the plasma
18
Q
Blood Type AB
A
AB antigen on the RBC, No antibodies in the plasma
19
Q
Blood Type O
A
No antigen on the RBC, Anti-A and Anti-B in the plasma
20
Q
Where does coagulation occur?
A
Surface of endothelial cells, subendothelial cells, and platelets.
21
Q
What do we use to evaluate coagulation?
A
Platelet Count ACT PTT PT INR
22
Q
What is the platelet count?
A
The actual number of platelets per cubic ml of blood.
23
Q
What is the universal donor blood type of platelets, FFP, and cryoprecipitate?
A
Type AB platelets because they contain neither Anti-A nor Anti-B antibodies
24
Q
Thrombocytopenia
A
> 100,000/mm3
25
Thrombocytosis
> 400,000/mm3
26
What is the activated clotting time? (ACT)
Measures the amount of time required for whole blood to clot in a test tube. Used to monitor heparin therapy.
27
What is a normal ACT time?
70-180 seconds
28
What is the percentage of hematocrit in PRBCs?
70-80%
29
What is a normal Prothrombin Time?
10-14 secs or 30-40 secs
30
What is the International Normalized Ratio?
Developed to standardize PT values to better monitor oral anticoagulation therapy
31
When does Therapeutic (warfarin) dosing occur?
When INR= 2.0-3.0
32
What is PTT?
Partial Thromboplastin Time can be used to monitor anticoagulation therapy. Normal 25-38 secs
33
Leukocyte-reduced PRBCs
The RBCs are centrifuged, washed, or filtered to avoid nonhemolytic febrile reactions, minimize transmission of HIV or CMV.
34
Irradiated PRBCs
Cells are exposed to a standard dose of ionizing radiation.
| Used for people not capable of mounting counterattack and neutralizing transfused lymphocytes.
35
What type of patient would need Irradiated PRBCs?
```
Stem cell transplant
Chemotherapy
Hodgkin's Disease
Congential cellular immunity deficits
Premature neonates
```
36
What is the universal donor blood type and why?
Type O because it contains neither A or B antigens
37
What is the universal donor blood type of platelets, FFP, and cryoprecipitate?
Type AB platelets because they contain neither Anti-A nor Anti-B antibodies
38
How are platelets prepared?
Centrifuging individual units from multiple whole blood donors or a single donor apheresis
39
What do you need to check before giving blood?
Blood must be checked in the OR by two licensed providers.
| Verify patient's medical record number, blood unit number, and blood type
40
What are some specific components of blood that can be given for therapy?
```
PRBCs
Cell Saver
Platelets
FFP
Cryoprecipitate
```
41
How much is in a unit of blood?
250-300mL
42
What is FFP
Fresh frozen plasma is the fluid portion obtained from a single unit of whole blood that is frozen within 6 hours of collection.
43
Increase in hemoglobin by PRBCs administration
1 g/dL
44
Increase in hematocrit by PRBCs administration
3%
45
Contraindications of PRBC therapy
Warm the blood
Don't use Lactated Ringer's
Use at least a 150 micron fliter
46
What are washed RBCs?
Centrifuged in saline to remove plasma and cytokines in order to remove excess potassium from older units. Washed PRBCs can only be stored for 24hrs
47
Leukocyte-reduced PRBCs
The blood is centrifuged, washed, or filtered to avoid nonhemolytic febrile reactions and to minimize the transmission of HIV or CMV. It's also used to prevent sensitization of patients with aplastic anemia
48
Irradiated PRBCs
Cells are exposed to a standard dose of ionizing radiation.
| Used for people not capable of mounting counterattack and neutralizing transfused lymphocytes.
49
What type of patient would need Irradiated PRBCs?
```
Stem cell transplant
Chemotherapy
Hodgkin's Disease
Congential cellular immunity deficits
Premature neonates
```
50
What is the purpose of cell saver?
To salvage blood from the surgical field and return it to the patient. The blood contains 65-70% hematocrit.
51
Contraindications of Cell Saver administration
Do not warm
Use a 40 micron filter
Do not pressurize a cell saver bag
Never clamp the delivery line.
52
How are platelets prepared?
Centrifuging individual units from multiple whole blood donors
53
What is the platelet count for multiple donor platelet units?
5 x 10^10 platelets in 50-77cc of plasma per unit
54
What is the rule of thumb for platelet transfusion?
1 unit pack of apheresis will raise the platelet count by 30-50 x 10^9/ L
55
Contraindication of Platelet Transfusion
Do not warm or cool platelets
Use a 150 micron filter
Do not use microaggregate filters (20-40 micron) because it will remove the platelets
56
What is FFP
Fresh frozen plasma is the fluid portion obtained from a single unit of whole blood that is frozen within 6 hours of collection.
57
How much FFP should you give?
10 to 15 ml/kg will raise coagulation proteins by 25-30%
58
True or False: FPP can be used for primary therapy for coagulation defect deficiency? (Hemophilia A, hemophilia B, Factor VII or XIII?
False
59
What is cryprecipitate?
Fraction of plasma that precipitates when FFP is thawed.
60
What are the contents of cryprecipitate?
200mg of Fibrinogen and 100 units of Factor VIII
61
When should you use cryoprecipitate?
Patients with congenital fibrinogen of factor VIII deficiency, loss of fibrinogen from massive hemorrhage
62
What is the treatment for Anaphylactic Reactions?
1. Stop the transfusion
2. Epiniphrine Bolus
3. Airway maintenance, Oxygenation
4. Volume Maintenance with Saline
5. Vasopressors if necessary
63
What are some clinical manifestations of anaphylactic reaction?
1. Rapid onset
2. Shock
3. Hypotension
4. Angioedema
5. Respiratory Distress
64
What are some complications of Blood Transfusion?
1. Febrile Reaction
2. Allergic Reaction
3. Hemolytic Reaction
4. Transmission of Disease
5. Transfusion-Related Acute Lung Injury
6. Suppression of cell-mediated immunity
7. Metabolic derangements
65
Febrile Reactions
(FNHTR)
This occurs in 0.5-1% of transfusions due to the immune reaction of between cytokines or platelets with the recipients antibodies.
66
What are some clinical manifestations of Febrile reactions?
Fever
Chills
Mild Dyspnea
67
Mild Allergic Reaction
Increase in body temperature and pruritis. Treat with IV antihistamine and stop the transfusion
68
Hemolytic Reaction
Medical emergency that results from the administration of the ABO incompatible blood.
Hemolytic reactions lead to rapid destruction of donor erythrocytes by the recipient antibodies.
69
What are clinical manifestations of Hemolytic Reaction?
```
Hypotension
Fever
Chills
Lumbar/Substernal Pain
Dyspnea
Skin Flushing
```
70
Which pathogen has the highest risk of transmission of disease through blood transfusion?
Hepatitis B 1 in 31,000 to 220,0000
71
Which pathogen has the least risk of transmission of disease through blood transfusion?
HIV
| 1 in 1.5 million to 4.7 million
