Blood Components

Question 1

when are antigens formed on RBCs and platelets?

Answer 1

early in fetal life

Question 1

what condition are ABO mismatches associated with?

Answer 1

acute hemolytic transfusion reactions

Question 2

when are antibodies in the system formed? how are they stimulated?

Answer 2

after birth
non-immune stimulated

Question 3

what is the most important blood group?

Answer 3

ABO

Question 4

what is the second most important blood group?

Answer 4

Rh type

Question 5

reflects the presence or absence of a single D antigen and is present only on RBCs

Answer 5

Rh

Question 6

exposure to as little as 1 ml of Rh type cells can stimulate what?

Answer 6

antibody production

Question 7

what are 4 things all donor blood must be tested for?

Answer 7

ABO group
Rh type
unexpected antibodies
infectious disease

Question 8

test that detects immune coating of RBCs, used in transfusion reaction workup, autoimmune hemolytic anemia workup, and HDFN

Answer 8

direct antiglobulin test (DAT)

Question 9

what should be assessed in pregnant women?

Answer 9

risk of HDFN (hemolytic disease of the fetus and newborn)

Question 10

type and screen + units crossed/held for a specific patient in case they need it

Answer 10

type & cross

Question 11

what is the transfusion threshold/hemoglobin in a adult that is hemodynamically stable?

Answer 11

7 gm/dl

Question 12

what is the transfusion threshold/hemoglobin in a adult that is undergoing orthopedic, cardiac surgery, or with pre-existing CV disease?

Answer 12

8 gm/dl

Question 13

whole blood that is spinned down, removing most of the plasma in the unit

Answer 13

packed RBCs

Question 14

what do PRBCs not have? (3)

Answer 14

platelets
WBCs
coagulation factors

Question 15

maximizes O2 delivery without increasing volume, used for acute blood loss, trauma, surgery, intrauterine and exchange transfusion

Answer 15

PRBCs

Question 16

which condition can be treated with PRBCs if it is not responding to other treatment?

Answer 16

symptomatic anemia

Question 17

RBCs are only given with what?

Answer 17

normal saline

Question 18

what must be compatible when using PRBCs?

Answer 18

ABO and Rh match

Question 19

in using PRBCs, in which patients is Rh match especially important? (2)

Answer 19

children
women of child-bearing years

Question 20

in an average sized individual, how does 1 unit of PRBCs increase HCT and Hgb?

Answer 20

increases HCT by 3%
increases Hgb by 1 gm/dl

Question 21

decreases risk of sensitization to human leukocyte antigen, febrile non-hemolytic transfusion reactions, and cytomegalovirus transmission

Answer 21

leukoreduced units

Question 22

removes most of plasma in PRBCs

Answer 22

washed PRBCs

Question 23

when do washed PRBCs become outdated?

Answer 23

24 hours once washed

Question 24

neonates, intrauterine transfusions, IgA deficient patients, and patients with repeated allergic reactions should use which transfusion product?

Answer 24

washed PRBCs

Question 25

what are the uses of frozen RBCs? (2)

Answer 25

store rare blood types military stockpile

Question 26

how long can frozen RBCs be stored? when do they become outdated?

Answer 26

stored up to 10 yrs outdate 24 hours-14 days after being thawed

Question 27

decreases risk of transfusion-associated graft-vs-host disease, used for immunocompromised patients

Answer 27

irradiated units

Question 28

exchange transfusion in neonates, often used in severe HDFN

Answer 28

pediatric aliquots

Question 29

contains all labile and stable coagulation factors, protein C and protein S - great for patients who need coagulation

Answer 29

fresh frozen plasma (FFP)

Question 30

in fresh frozen plasma, it must be _____ compatible, but _____ is not considered since it is only present on RBCs

Answer 30

ABO Rh

Question 31

what is the shelf life of fresh frozen plasma once thawed?

Answer 31

24 hours

Question 32

frozen fresh plasma can reduce the effects of what medication?

Answer 32

warfarin

Question 33

made from FFP, contains fibrinogen, factor VIII, VW factor, and factor XIII

Answer 33

CRYO (cryoprecipitated anti-hemophilic factor)

Question 34

what is the shelf life of CRYO?

Answer 34

4 hours

Question 35

CRYO does not have to be _____ or ___ matched

Answer 35

ABO Rh

Question 36

what is the primary use for CRYO?

Answer 36

hypofibrinogenemia (fibrinogen less than 100) treats bleeding

Question 37

how long does CRYO work in a patient?

Answer 37

12 hours

Question 38

do platelets need to be ABO and Rh compatible?

Answer 38

yes

Question 39

what is the shelf life of platelets? how is it stored?

Answer 39

5 days room temp

Question 40

all units of platelets are tested for what? this decreases the risk of what?

Answer 40

bacterial contamination decreases the risk of septic shock

Question 41

in which 2 cases are platelets NOT used?

Answer 41

immune thrombocytopenic purpura thrombotic thrombocytopenic purpura

Question 42

what occurs in a patient if they do not get the expected platelet increase? SAF-D

Answer 42

sepsis active bleeding fever DIC

Question 43

antibody-mediated destruction that occurs when a patient becomes immune to the use of products

Answer 43

refractory

Question 44

what is required in a refractory situation?

Answer 44

HLA-matched platelets for future transfusions

Question 45

removes specific components and returns the remainder to the donor

Answer 45

apheresis

Question 46

how long does apheresis collection take?

Answer 46

1.5-3 hours

Question 47

when is apheresis used?

Answer 47

when we want to pick a specific product from the donor

Question 48

what are 3 situations when we would want cell depletions via apheresis?

Answer 48

leukemia with high WBCs polycythemia vera sickle cell complications

Question 49

what are 2 situations when we would want therapeutic plasma exchange?

Answer 49

remove autoantibodies remove alloantibodies

Question 50

when is leukapheresis done? (2)

Answer 50

septic + not responding to antimicrobials WBCs > 500,000

Question 51

used in place of manual bone marrow collections to obtain cells for transplant

Answer 51

peripheral blood stem cells

Question 52

what are peripheral blood stem cells used to treat? (2)

Answer 52

leukemia or lymphoma inherited immune deficiencies

Question 53

what kind of blood products should patients receive, if they are getting peripheral blood stem cells?

Answer 53

irradiated blood

Question 54

colloid volume expander that draws extravascular fluid into intravascular flow

Answer 54

serum albumin

Question 55

is ABO and Rh match required for serum albumin?

Answer 55

no

Question 56

what product should be used in a shock, burn patient, early in massive transfusion, or replacement of fluid in therapeutic plasma exchanges?

Answer 56

serum albumin

Question 57

pooled human plasma that provides antibodies in congenital immunodeficiency, immune cytopenia, post-transplant, and graft vs host disease

Answer 57

intravenous immunoglobulin

Question 58

in which patients is intravenous immunoglobulin NOT indicated?

Answer 58

DIC patients

Question 59

given to pregnant Rh negative women with Rh positive fetus

Answer 59

Rh immune globulin

Question 60

what does Rh immune globulin prevent?

Answer 60

sensitization from fetal Rh positive cells

Question 61

at what point in time is Rh immune globulin given?

Answer 61

at week 28 postnatal within 72 hours

Question 62

in which 2 patients are Rh immune globulins given?

Answer 62

Rh negative women children who are given Rh positive blood

Question 63

used for hemophilia A

Answer 63

factor VIII

Question 64

used in severe bleeding and counteracts warfarin effects

Answer 64

recombinant factor VII

Question 65

contains factor II, VII, IX, and X; is vitamin K dependent

Answer 65

factor IX concentrate (prothrombin complex)