Blood & Blood Products Flashcards
not yet done (99 cards)
1
Q
Year blood was taken from three young men & given to Pope Innocent VIII to cure
him
A
1492
2
Q
What was the significant breakthrough in 1883?
A
Creation of Ringer’s solution
2
Q
First successful human blood transfusion
A
1667
2
Q
In World War I, a gum-saline solution containing ____________ was used to extend
plasma -had some negative health effects
A
galactoso-gluconic acid
3
Q
What was the principle obstacle to overcome why success in blood transfusion took long?
A
Clotting
4
Q
Discovered Sodium Phosphate as a nontoxic anticoagulant
A
Braxton Hick in 1869
5
Q
Discovered the ABO blood group
A
Karl Landsteiner in 1901
6
Q
Around World War II, blood banks were established by the American Red Cross in?
A
1947
7
Q
Anticoagulant whose storage time is 21 days
A
- Acid–citrate–dextrose (ACD)
- Citrate-phosphate -dextrose (CPD)
- Citrate-phosphate -double dextrose (CP2D)
8
Q
Anticoagulant whose storage time is 35 days
A
- Citrate-phosphate -dextrose-adenine (CPDA-1)
9
Q
A constituent separated from
whole blood, by differential
centrifugation of one donor unit
or by aphaeresis
A
Blood Component
9
Q
Enumerate the specific gravity of RBC, Platelets, and Plasma
A
RBC –1.08 -1.09
Platelets -1.03 –1.04
Plasma - 1.02 -1.03
10
Q
Cite the different blood components
A
- Packed Red Cells
- Granulocyte Concentrate
- Cryoprecipitate
- Platelet concentrate
- Fresh frozen plasma
10
Q
Cite the different blood derivatives
A
- Factor VIII concentrate
- Factor IX concentrate
- Albumin
- Immunoglobulins
- Prothrombin complex concentrate
10
Q
Classifications of Blood Products
A
- Whole Blood
- Components (cellular, plasma)
- Plasma derivatives
10
Q
Cite the different plasma derivatives
A
- Albumin 5% & 25%
- Plasma Protein Fractions
- Factor VIII concentrate
- Immunoglobulins
- Fibrinogen
- Other coagulation factors
11
Q
Fresh blood is blood that is less than _____ hours old
A
24 hours
12
Q
What are the patients or conditions that would require one to be transfused with whole blood?
A
- Premature newborns with respiratory distress syndrome and
severely decreased 2,3–DPG levels. - Patients who are persistently hypotensive, poorly perfused, &
acidotic and who need large amount of blood.
13
Q
Whole blood in an approved container should contain ________ total volume and ______ anticoagulant
A
405 to 495 ml; 49 ml
14
Q
Whole blood in an approved container should contain:
A
- Hb approximately: 12 g/ml
- Haematocrit: 35%-45%.
- No functional platelets
- No labile coagulation factors (V & VII)
15
Q
Storage temperature for whole blood and PRBC
A
- 2C to 6C in approved blood bank refrigerator, with temperature chart and alarm
16
Q
1 unit of whole blood (350 ml) increases hemoglobin by about ______ g/dL, while 1 unite of whole blood (450 ml) increases hemoglobin by about ______ g/dL
A
0.75 g/dL; 1 g/dL
16
Q
You should never add ______ to a unit of blood
A
medication
16
Q
What are the changes which occur in stored Blood
A
- Loss of viability of RBCS
- Loss of ATP
- Depletion of 2-3 DPG
- Loss of granulocyte function
- Decrees in pH of blood
- Increase in plasma K+ Level
- Decrease in factor VII level
- Formation of microaggregates
16
In pediatric patients, 8ml/kg of Whole Blood increase hemoglobin by about ______ g/dL
1 g/dL
17
Blood components of Red Cells
- Packed Red Cells
- Red Cells in additive solution
- Leukocyte Poor red cells
- Washed red –Cells
- Frozen red Cells
- Irradiated red cells
18
Identify the need based on estimation of lost blood volume: Rapid volume replacement, including RBC transfusion is required
>40 percent loss (>2000 mL)
18
Identify the need based on estimation of lost blood volume: Need to transfuse crystalloids or synthetic colloids; need for RBC transfusion is unlikely unless the patient has pre-existing anemia, continuing blood loss, or reduced cardiovascular reserve
15 to 30 percent loss (800 to 1500 mL)
18
Identify the need based on estimation of lost blood volume: Rapid volume replacement with crystalloids or synthetic colloids is required, RBC transfusion will probably also be required
30 to 40 percent loss (1500 to 2000 mL)
19
Identify the need based on estimation of lost blood volume: No need for transfusion unless volume loss is superimposed on preexisting anemia, or when patient is unable to compensate due to severe cardiac or respiratory disease
Less than 15 percent blood loss (≤750 mL)
20
Identify the need based on hemoglobin concentration: Correct strategy unclear
Hgb 7-10 g/dL
21
Identify the need based on hemoglobin concentration: RBC transfusion not indicated
Hgb >10 g/dL
22
Identify the need based on hemoglobin concentration: RBC transfusion indicated, if the patient is otherwise stable, the patient should receive 2 units of packed RBC, following which the patient's clinical status and circulating Hgb should be reassessed
Hgb <7 g/dL
23
Identify the need based on hemoglobin concentration: Patients >65 and/or those with cardiovascular or respiratory disease may tolerate anemia poorly. Such patients may be transfused when Hgb <8 g/dL
High risk patients
24
What are the indications that a patient is needed to be transfused with red blood cells?
- Decrease bone marrow production (leukemia and aplastic anemia)
- Decrease RBC survival (hemolytic anemia, thalassemia)
- Excessive bleeding (caused by surgical with anticipated blood loss to be >1000 mL and traumatic cases)
- Anemia associated with incipient /established cardiac failure
- Full term pregnancy with Hb value
<7 gm/dl
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Red Cells from which most of Plasma removed
Red Cell Concentrate (Packed Red Cell or Plasma reduced blood)
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Volume of plasma removed in Red Cell Concentrate
230-330 ml total volume (with 20% plasma from total plasma volume from WB)
27
Used for replacement of red cells in anemic patients. Acute and massive blood loss (along with crystalloid or colloid)
Red Cell Concentrate (Packed Red Cell or Plasma reduced blood)
28
Difference in the haematocrit of a red cell concentrate and red cell suspension
Red cell Concentrate: 55%-75%
Red Cell Suspension: 50%-70%
29
Difference in the hemoglobin of a red cell concentrate and red cell suspension
Red cell Concentrate: 20g/100ml (Not less than 45 g\unit)
Red Cell Suspension: 15gm/100ml
30
What is the commonly used additive solution used for Red Cell suspension
SAGM (Saline, adenine, glucose & mannitol)
30
One of its advantages is that the flow of infusion (of this blood product) is improved due to reduction in viscosity
Red Cell suspension
31
Red cell suspension is contraindicated/strongly not used for?
exchange transfusion in neonate
32
A Red Cell suspension has improved viability obtained, its shelf life increases from 35 to ______
42 days
33
Volume of Red Cell suspension
150-200 ml red cells with minimal residual plasma
34
A red cell suspension containing less than 5x10^6 white cells/bag and prepared by filtration
Leukocyte–poor depleted red cells
34
These depend on whether the product is whole blood, red cell concentrate or red cell suspension
Hemoglobin and hematocrit
34
Leukocyte–poor depleted red cells is filterd through a?
leucocytes depleting filter
34
Significantly reduces the risk of transmission of CMV
Leukocyte–poor depleted red cells or leukocyte depletion
34
Red cell component used to avoid sensitization to HLA antigen in patients with severe aplastic anemia who are likely to receive allogenic bone marrow transplant
Leukocyte–poor depleted red cells
35
Packed red cells can be washed with normal saline to remove
___________
plasma proteins, white cells & platelets
35
Red cell component used for patients who have experienced two or more previous febrile reactions to red cell transfusion
Leukocyte–poor depleted red cells
36
Red cells can be stored frozen up to?
10 years
36
Use of such red cells is restricted for IgA–deficient individuals who have developed anti IgA antibodies
Washed red cells
37
To prevent hemolysis of red cells during freezing & thawing, a
cryoprotective agent such as _____ is added.
glycerol
38
Indicated for donor red cells with rare blood groups and autologous transfusion
Frozen red cells
39
When using frozen red cells, before it is transfused, red cells are ______ and ______ is removed gradually
thawed; glycerol
39
This inhibits the replication of donor lymphocytes
Gamma irradiation (25-30 Gy)
40
Such red cells are virtually free from leucocytes, platelets &
plasma & thus their use is associated with lower risk of non-haemolytic transfusion reactions
Frozen red cells
41
Indicated for
prevention of graft vs host disease in susceptible individuals like:
- Immunodeficient,
- Patients receiving blood from first degree relatives
Irradiated Red Cells
41
Gamma irradiation (25-30 Gy) is done with?
Cesium-130 and Cobalt-60
41
Why are irradiated red cells indicated for patients receiving blood from first degree relatives?
Because the lymphocytes from the donor blood react against the tissue of the recipient or transfusion-associated graft-versus-host disease (TA-GVHD)
41
Temperature and storage of Platelet
Up to 72 hours at 20 –24c with constant agitation
*Max. period of storage is 3 to 5 days*
42
Patients with a platelet count of _______ will be transfused with PC regardless of clinical condition
<5000/µl
42
Why must platelet not be refrigerated?
Because if refrigerated, platelet function will be reduced
43
Patients with a platelet count of _______ will be transfused with PC if there is increased risk of bleeding
5000 -10000/µl
44
Patients with a platelet count of _______ will be transfused with PC
45
Patients with a platelet count of _______ will be transfused with PC if there is thrombocytopenic
bleeding
10,000 -20,000/µl
45
Patients with a platelet count of _______ will be transfused with PC if there is decreased production due to chemotherapy, or risk of bleeding (prophylactically)
≤20,000/µl
46
Patients with a platelet count of _______ will be transfused with PC if there is increase destruction (DIC), or platelet dilution (massive transfusion)
≤50,000/µl
47
Patients with a platelet count of _______ will be transfused with PC when undergoing major surgery
≤70-80,000/µl
47
_________ between donor & recipient is of minor importance in platelet transfusion
ABO compatibility
47
Dosage for Platelet concentrate
1 unit/10kg body weight (usual dose is 4-6 units) or
1.50 units/10kg body weight in cases of increased destruction of platelets
48
48
Rh (D) negative female patient of childbearing age should be given platelets from Rh (D) negative donor to prevent?
Alloimmunization
49
Each unit of P.C. will raise platelet count approximately by? (enumerate the raise in adults, child and infants)
- Adults: 5000-10,000/µl in 70 kg weight
- Child: 20,000/µl in 18 kg body weight.
- Infants: 75,000-100,000/µl
50
Effects of platelet transfusion of PC can be obtained after?
1 hour
51
Risk associated with platelet transfusion
- Alloimmunisation
- Platelet refractory state (less than 20 % of the expected increase)
- Infections
- Graft versus host disease
52
Indicated for congenital or acquired coagulation factor deficiency with active bleeding liver disease, DIC, coagulopathy in massive transfusion
Fresh frozen plasma
52
A portion of donor’s platelet and some plasma is removed with the return of donor’s RBCs, WBCs and remaining
plasma
Plateletpheresis
52
Plateletpheresis product is prepared in _______ and can be stored for?
closed system; 5 days
52
A routine Plateletpheresis procedure takes about
1 to 1.5 hours
53
Identify:
- Average: >3x10^11platelets
- Plasma volume: 200 ml
- Leucocytes: < 5.5 x 10^6, obviate the need of filtration
- Red cells: traces
- pH: 6.0 or more
- Exposes a patient to one donor
- Less exposure to infections
Plateletpheresis
54
Identify:
- Average: 5.5 x10^10platelet
- Plasma volume: 50-60 ml
- Leucocytes: 10^8 in each unit, filtration is
required
- Red cells: more
- pH: 6.0 or more
- Exposes a patient to multiple donors
- More exposure to infections
Random donor platelet
55
FFP is indicated for deficiency of factors such as?
Factors II, VII, IX & X
**Factors "1972"**
56
Indicated for Warfarin overdose reversal and
thrombotic thrombocytopenic purpura
Fresh frozen plasma
57
Albumin is prepared by _______ of pooled plasma
cold ethanol fractionation
58
Albumin is available in what solutions?
5%, 20%, 25% solutions
59
This is not necessary when transfusing FFP
compatibility testing
60
Albumin solutions are heat treated at _____ for ______
60c; 10 hours
61
Dosage for FFP
15ml/kg of body weight
62
FFP is thawed at?
30-37C
63
Effect of FFP is by?
APTT, PT & fibrinogen assay
64
Prepared by slowly thawing 1 unit of FFP at 4-6C & then resuspending it in 10-20 ml plasma
Cryoprecipitate
65
Cryoprecipitate is refrozen at _____or cooler & can be stored for ____ at this temp
-25C; 1 year
66
This contains:
- factor VIII (80 –100 iu/pack)
- Fibrinogen (150 –300 mg/pack)
- Factor XIII & fibronectin
Cryoprecipitate
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