Blood Bank

Question 1

Donor reactions-

Vasovagal reaction

Answer 1

Bradycardia with hypotension, syncope, incontinence

Question 2

Donor Reactions-

Hypovolemic shock

Answer 2

Tachycardia, hypotension, syncope, shock

Question 3

Donor reactions-

Hyperventilation

Answer 3

common in children’s and first timers. Shortness of breath, twitching

Question 4

Platelet donation time restrictions in donation

Answer 4

2-2-24.

At least 2 days between donations, no more then 2 donations per week, no more then 24 donations per year

Question 5

Weeks needed between whole blood donations?

Weeks needed between double whole blood donations?

Answer 5

8 weeks

16 weeks

Question 6

Needed Hgb and Hct for allogenic donors (donating to others)?

Needed Hgb and Hct for autogenic donors (donating to self)?

Answer 6

12.5/38%

11/33%

Question 7

infection risk for HIV in blood products?

HCV?

HBV?

Answer 7

1 in 1.5 million

1 in 1 million

1 in 350,000

Question 8

Donation deferral for 1-time anti-HBc (HepB core)?

Donation deferral for 2-time anti-HBc (HepB core)?

Donation deferral for confirmed HBsAG antigen?

Answer 8

None

indefinite

permanent

Question 9

Deferral for Hep C +Anti-HCV (unconfirmed)?

Deferral for Hep C +Anti-HCV (confirmed)?

Deferral for Hep C +NAT only?

Answer 9

indefinite, may try again in 6 months

Permanent

indefinite, may try again in 6 months

Question 10

Deferral for HIV +Anti-HIV (unconfirmed)?

Deferral for HIV +Anti-HIV (confirmed)?

Deferral for HIV +NAT only?

Answer 10

indefinite, may try again in 8 weeks

Permanent

indefinite, may try again in 8 weeks

Question 11

Name the three blood preservatives that provide 21 day storage?

Name the one preservative that provides 35 days storage?

Answer 11

ACD, CPD, CP2D

CPDA-1

Question 12

What preservative provides storage for 42 days for blood?

Answer 12

Adenine Saline, an “additive solution”. Several different types, AS-1, AS-3, AS-5, AS-7

Question 13

How many platelets should be contained in one dose of random (whole blood) platelets?

The pH should be at least what for platelets?

Answer 13

> or = 5.5 x 10^10

pH > or = 6.2

Question 14

How many platelets should be contained in one dose of apheresis platelets?

The pH should be at least what?

Answer 14

> or = 3.0 x 10^11 (more then the whole blood or “random” platelets

pH > or = 6.2

Question 15

Name the 4 counterindications/disease conditions to platelet transfusion?

Answer 15

TTP (Have large multimers of vWF that can bind with platelets and form more thrombi)

HIT (Increases risk of thrombosis)

ITP (platelet count doesn’t increase)

Post Transfusion Purpura (Antibody vs platelets, most transfused platelets have an antigen that can get attacked)

Question 16

What amount do you typically give a neonate of platelets, rbcs, etc….?

Answer 16

10-15 cc (mL/Kg)

Question 17

What is the maximum number of leukocytes that should be in leuko reduced apheresis platelets, RBCs, etc. ..?

How about in a unit of whole blood derived platelets?

Answer 17

5 million (5 X 10^6)

830,000 (8.3 X 10^5) Since it takes 6 doses of whole blood derived platelets to equal one dose of apheresis platelets, this number is just 5 million divided by 6

Question 18

What is the radiation dose for a bag of red cells?

Answer 18

At least 2500 cGy to the center of the bag, at least 1500 cGy to the periphery of the bag

Question 19

Name 5 indications for FFP?

Answer 19

Bleeding patients with a coagulopathy

Bleeding patients on warfarin

Trauma (1:1 with pRBCs)

Dilutional coagulopathy (Giving a patient a bunch of fluids)

TTP/HUS

Question 20

What is the problem with giving FFP to reverse Heparin?

Answer 20

It infuses Antithrombin which potentiates heparin!

Question 21

What is the coagulation factor that has the shortness halflife in the body? (In vivo)

Answer 21

Factor 7

Question 22

What are the factors that decreased the most rapidly in a bag of plasma?

Answer 22

Factor 5 and 8, especially 8

Question 23

What is the main indication of cryo reduced plasma? (The stuff left over after cryo)

Answer 23

For replenishment of ADAMTS13 in TTP

Question 24

Name the 4 important components of cryo?

Answer 24

Factor 8, factor 13, vWF, and fibrinogen

Question 25

Every unit of cryo has to have at least ___ mg of fibrinogen and ____ IUs of factor 8

Answer 25

150 80

Question 26

DDAVP causes release of ____ from the endothelial cells.

Answer 26

vWF

Question 27

What are the two main uses for NovoSeven?

Answer 27

Hemophilia A and B Congenital factor VII deficiency

Question 28

Granulocytes must be typed and crossmatched because........

Answer 28

It is hard to seperate the RBCs from WBCs completely as they have similar densities, therefore you should get some RBCs with each bag

Question 29

Should Granulocyte products be irradiated? Why or why not?

Answer 29

Yes, because they may contain T-lymphs that can cause GVHD. The radiation kills these cells but NOT the granulocytes.

Question 30

What is the number one cause of transfusion related mortality reported to the FDA?

Answer 30

TRALI

Question 31

What are the four acute transfusion reactions presenting with fever?

Answer 31

Acute hemolytic Febrile non-hemolytic Transfusion-related Sepsis TRALI

Question 32

What are the four acute transfusion reactions typically without fever?

Answer 32

Allergic Hypotensive Tx associated dyspnea TACO

Question 33

A febrile non-hemolytic transfusion reaction is an increase of temperature by __ C or ___ F. It is caused by ____

Answer 33

1 C, 2 F. Cytokines

Question 34

The most common type of bacteria to infect red cells are gram ___ ____, like ____ The most common organisms to infect skin are gram ___ ____ because they come from the ____

Answer 34

gram negative rods like Yersinia gram positive cocci, skin

Question 35

What is interesting about the blood pressure readings in TRALI?

Answer 35

It usually goes up, then down

Question 36

What are the two main theories of TRALI?

Answer 36

Transfused anti-HLA antibodies Transfused stored blood with breakdown products that activate neutrophils Either or both of these can stimulate the neutrophils in the lung to activation

Question 37

What is the most common cause of severe allergic reactions?

Answer 37

Patients with IgA deficiency (rare) Another is haptoglobin deficiency

Question 38

What are the three antibodies that typically caused delayed hemolytic transfusion reactions? What of these antibodies can sometimes fix complement and cause intravascular hemolysis?

Answer 38

Kidd, Duffy, Kell Kidd

Question 39

What is the difference between delayed hemolytic and delayed serologic transfusion reactions?

Answer 39

Hemolysis!

Question 40

What is post transfusion purpura? What is the pathophysiology? Treatment? Is this a contraindication to platelet transfusion?

Answer 40

Severe thrombocytopenia 10 days post transfusion Someone exposed to a common platelet antigen that they do not have (HPA-1a). Then they make an antibody. When it forms it also starts coating that persons platelets for an unknown reason as an auto antibody. IVIG Yes