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Blood Groups And Blood Transfusion Flashcards

(61 cards)

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1
Q

What is a blood group

A

Classification of blood based on structures on surface of RBCs

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2
Q

What structures on the surface of RBCs act as antigens

A

Carbohydrates
Proteins
Glycolipids
Glycoproteins

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3
Q

What determines which antigens are present on an RBC

A

genes

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4
Q

What are the 2 most clinically important blood group systems

A

ABO
Rhesus

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5
Q

What are blood group antibodies

A

Immunoglobulins to RBC surface antigens

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6
Q

What are the 2 types of blood group antibodies

A

Acquired
Natural

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7
Q

Are natural blood group antibodies innate

A

No

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8
Q

When are acquired blood group antibodies formed

A

Immune response to exposure

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9
Q

How are neonates believed to gain natural blood group antibodies

A

Small amounts of antigens entering body through food, bacteria, and mosquito bites

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10
Q

What happens in the blood antibody- antigen reaction

A

Antibodies cross link to antigens causing RBC agglutination

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11
Q

What happens when an antibody antigen reaction occurs in vitro

A

RBC Clumping

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12
Q

What happens when an antibody antigen reaction occurs in vivo

A

RBC Haemolysis or phagocytosis

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13
Q

What defines a persons ABO blood group

A

A and B antigens on RBCs
Anti A and anti B antibodies in serum

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14
Q

When do patients have anti A or anti B antibodies in their plasma

A

When they don’t have the corresponding A or B antigen

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15
Q

How are ABO blood groups inherited

A

A and B Co dominant
O recessive

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16
Q

Which ABO blood type is the universal donor

A

Type O

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17
Q

Which ABO blood type is the universal recipient

A

AB

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18
Q

Which 3 proteins are the most important in the Rhesus system

A

C D and E

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19
Q

What protein determines rhesus +/- state

A

D protein

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20
Q

What does Rhesus positive mean

A

Express immunogenic D antigen

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21
Q

What does Rhesus dpnegative mean

A

No expression of D antigen

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22
Q

When d genotypes are Rhesus positive

A

DD or Dd

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23
Q

Which d genotype is Rhesus negative

A

dd

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24
Q

How does haemolytic disease of the newborn occur

A

Rh- mother carrying Rh+ baby -> Rh antigens from Cetus enter mothers blood -> mother produces anti Rh antibodies -> anti Rh antibodies attack RBCs of subsequent Rh+ foetus

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25
What blood type mothers and foetuses can haemolytic disease of the newborn occur in
RH- mother Rh+ feotus
26
How is haemolytic disease of the newborn prevented
Anti d immunoglobulin administered to mother
27
How does anti d immunoglobulin prevent haemolytic disease of the newborn
Neutralises RhD positive antigens so mother doesn’t produce antibodies
28
When is anti d immunoglobulin administered
Risk d antigens have crossed into blood Routine prophylaxis
29
Types of blood used for transfusion
Red cells Platelets Plasma - fresh frozen, cryoprecipitate, clotting factor concentrates
30
When are packed red cells used
Haemorrhage Bone marrow failure Haemolysis Inherited Hb disorders Anaemia
31
When are platelets used
surgery/invasive procedure w no active bleeding Stable, non bleeding
32
What is the most common cause of transfusion mismatch
Transfusion being given to wrong patient
33
How is blood typed
Plasma mixed with special detector RBCs expressing all common blood group antigens -> plasma antibodies bind to detector RBCs -> positive result = agglutination
34
What observations are monitored during transfusion
Pulse Blood pressure Temp
35
Which transusion complication is a NHS never event
Acute haemolytic reaction
36
What causes acute haemolytic reaction
Transfusion of wrong ABO blood type
37
acute haemolytic reaction
Massive intravascular haemolysis mediated through IgM due to incompatible ABO blood transfusion
38
Acute haemolytic reaction signs and symptoms
Fever Abdominal pain Hypotension
39
How quickly does acute haemolytic reaction occur
Minutes
40
Acute haemolytic reaction management
Stop transfusion Supportive care Fluid resuscitation Repeat blood typing, recheck patient and blood details
41
Non haemolytic febrile reaction
Antibodies react with white cell fragments in transfused blood product and cytokines that have leaked from blood cells during storage
42
Non haemolytic febrile reaction signs and symptoms
fever chills
43
Non haemolytic febrile reaction management
Slow down transfusion Paracetamol
44
Blood transfusion minor allergic reaction
Reaction to foreign plasma protein
45
Transfusion minor allergic reaction signs and symptoms
Pruritus Urticaria
46
Transfusion minor allergic reaction management
Temporarily stop transfusion Antihistamine Monitoring
47
Transfusion anaphylaxis cause
Patient with IgA deficiency who has anti IgA antibodies given blood with IgA
48
What deficiency mediates anaphylaxis from transfusion
IgA
49
Transfusion anaphylaxis symptoms
Hypotension Dyspnoea Wheezing Angioedema
50
Anaphylaxis management
IM adrenaline ABC support
51
Transfusion associated circulatory overload - TACO
Fluid overload caused by excessive rate of transfusion into pre existing heart failure
52
Which patients can get TACO
Heart failure patients
53
TACO signs and symptoms
Pulmonary oedema Hypertension
54
TACO management
Slow/stop transfusion IV Loop diuretic Oxygen
55
How does transfusion cause TACO in HF patients
Transfusion increases blood volume Electrolytes in transfusion cause kidneys to resorb more fluid
56
Transfusion related acute lung injury - TRALI
Non cardiogenic pulmonary oedema secondary to neutrophil activation
57
TRALI signs and symptoms
Hypoxia Pulmonary infiltrates in CXR Fever Hypotension
58
TRALI management
Stop transfusion Oxygen Supportive care
59
How does neutrophil activation cause TRALI
WBC degranulation increases vascular permeability causing inflammation and oedema
60
Infectious complications of transfusion
Bacterial contamination Bacterial transmission Viral transmission Parasites
61
Why are RBCs inspected before administration
Check for contamination

CR2 (33 decks)

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