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Flashcards in Blood & Blood Products Deck (54):
1

What is PT?

Prothrombin Time:
Tests extrinsic coagulation pathway

2

What is PTT?

Partial Thromboplastin Time:
Tests intrinsic coagulation pathway

3

What is INR?

International Normalized Ratio:
Reports PT results

4

What are packed RBCs?

One unit equals 300 mL.
No platelets or clotting factors, can be mixed with NS to infuse faster.

5

What is FFP?

Fresh Frozen Plasma:
Replaces clotting factors (no RBCs, WBCs, or platelets)

6

What is cryoprecipitate?

Replaces fibrinogen, von Willebrand factor, and some clotting factors

7

Which electrolyte is most likely to fall with the infusion of stored blood? Why?

Ionized calcium.
The citrate preservative used for the storage of blood binds serum calcium.

8

What changes occur in the storage of PRBCs?

Decreased Ca, 2,3-DPG, pH, PMNs.
Increased K, H.

9

What are general guidelines for blood transfusion?

Acute blood loss, Hgb < 10, and history of CAD/COPD, or
Healthy symptomatic patient with Hgb < 7.

10

What is the rough formula for converting Hgb to Hct?

Hgb X 3 = Hct

11

One unit of PRBC increases Hct by how much?

3-4%

12

Which blood type is the universal donor for PRBCs?

O negative

13

Which blood type is the universal donor for FFP?

AB

14

What is a type and screen?

Patient's blood type is determined and the blood is screened for antibodies.
A type and cross from that sample can then be ordered if needed later.

15

What is a type and cross?

Patient's blood is sent to the blood bank and cross-matched for specific donor units for possible blood transfusion

16

What is thrombocytopenia?

Low platelet count (< 100,000)

17

What are the common causes of thrombocytopenia in the surgical patient?

Sepsis, H2 blockers, heparin, massive transfusion, DIC, antibiotics, spurious lab value, Swann-Ganz catheter

18

What can be given to help correct platelet dysfunction from uremia, aspirin, or bypass?

DDAVP (desmopressin)

19

What common medication causes platelets to irreversibly malfunction?

Aspirin

20

What is Plavix?

Clopidogrel:
Irreversibly inhibits platelet P2Y12 ADP receptor (block fibrin cross-linking of platelets)

21

What platelet count is associated with spontaneous bleeding?

< 20,000

22

What should the platelet count be before surgery?

> 50,000

23

When should prophylactic platelet transfusion be given?

With platelets < 10,000

24

What is microcytic anemia, until proven otherwise, in a man or postmenopausal woman?

Colon cancer

25

Why not infuse PRBCs with lactated Ringer's?

Calcium in LR may result in coagulation within the IV line

26

For how long can PRBCs be stored?

About 6 weeks

27

What is the most common cause of transfusion hemolysis?

ABO incompatibility as a result of clerical error

28

What is the risk of receiving a unit of blood infected with HIV?

1/1,000,000

29

What are the symptoms of a transfusion reaction?

Fever, chills, nausea, hypotension, lumbar pain, chest pain, abnormal bleeding

30

What is the treatment for transfusion hemolysis?

Stop transfusion; provide fluids; perform diuresis to protect kidneys; alkalinize urine; give pressors as needed

31

What component of the blood transfusion can cause a fever?

WBCs

32

What is the transfusion trigger Hct in young healthy patients?

21%

33

What is the widely considered optimal Hct in a patient with a history of heart disease or stroke?

30%

34

When should aspirin administration be discontinued preoperatively?

At 1 week because platelets live 7-10 days

35

What can move the oxyhemoglobin dissociation curve to the right?

Acidosis, 2,3-DPG, fever, elevated PCO2,

36

What is the normal life of RBCs?

120 days

37

What is the normal life of platelets?

7-10 days

38

What factor is deficient in hemophilia A?

Factor VIII

39

How can the clotting factor for hemophilia A be remembered?

Eight sounds like A

40

What is the preoperative treatment of hemophilia A?

Factor VIII infusion to 100% normal preoperative levels

41

What coagulation study is elevated with hemophilia A?

PTT

42

How do you remember which coagulation study is affected by the hemophilias?

There are 2 major hemophilias and 2 T's in PTT

43

What factor is deficient in hemophilia B?

Factor IX

44

How are hemophilias A and B inherited?

X-linked recessive

45

What is von Willenbrand disease?

Deficiency of von Willenbrand factor (vWF) and factor VIII:C

46

How is von Willenbrand disease inherited?

AD

47

What is used to correct von Willenbrand disease?

DDAVP or cryoprecipitate

48

What coagulation study is elevated in von Willenbrand disease?

Bleeding time

49

What is the effect on the coagulation system if the patient has a deficiency in protein C, protein S, or antithrombin III?

A hypercoagulable state

50

What is a left shift on a CBC?

Juvenile polymorphonuclear leukocytes (bands).

51

What is the usual therapeutic PT?

With coumadin, usually shoot for an INR of 2.0-3.0

52

What is the acronym basis for the word "Warfarin"?

Wisconsin Alumni Research Foundation - ARIN

53

What is the most common inherited hypercoagulable state?

Factor V Leiden

54

What is Xigris?

Activated protein C, which is used in severe sepsis