Blood Products

Question 1

All blood products carry the risk of HIV and hepatitis except which 2? Why?

Answer 1

Albumin and serum globulins do not carry this risk because they are heat treated

Question 2

All donated blood is screened for what diseases?

Answer 2

HIV, HepB, HepC, HTLV, syphilis, and West Nile Virus

Question 3

In what patients is CMV-negative blood used?

Answer 3

Low-birth weight infants, bone marrow transplant patients, and other transplant patients

Question 4

What type of blood is the universal donor and why?

Answer 4

Type O blood because it contains no antigens

Question 5

Who should receive Rh-negative blood?

Answer 5

Females of child bearing age

Question 6

What causes stored blood to have an increased affinity for oxygen?

Answer 6

Stored blood is low in 2,3-DPG which causes a left shift and increased affinity for O2

Question 7

What is the purpose of type and cross match?

Answer 7

To determine ABO compatibility

Question 8

What is the purpose of a type and screen?

Answer 8

Determines ABO compatibility and looks for preformed AB’s to minor antigens

Question 9

How much should one unit of pRBCs raise the Hgb? Hct?

Answer 9

Hgb should raise by 1 and Hct should raise between 3-5

Question 10

How much should one 6-pack of platelets raise the platelet count by?

Answer 10

50,000

Question 11

What causes acute hemolysis reaction?

Answer 11

ABO incompatibility

Question 12

What mediates acute hemolysis reaction?

Answer 12

Antibody mediated. Type II hypersensitivity

Question 13

What are signs of acute hemolysis reaction?

Answer 13

Back pain, chills, tachycardia, fever, hemoglobinuria

Question 14

What are some complications of acute hemolysis reaction?

Answer 14

ATN, DIC, shock

Question 15

What lab values are abnormal in acute hemolysis reaction?

Answer 15

Haptoglobin <50
Free Hgb >5
Increase in unconjugated bilirubin

Question 16

What is the treatment for acute hemolysis reaction?

Answer 16

Fluids, diuretics, HCO3-, pressors

Question 17

How may transfusion reactions present in anesthetize patients?

Answer 17

Diffuse bleeding

Question 18

What causes delayed hemolysis reaction?

Answer 18

Antibody-mediated against minor antigens from donor

Question 19

What sign is present in delayed hemolysis reaction?

Answer 19

Mild jaundice

Question 20

What is the treatment for delayed hemolysis reaction?

Answer 20

Observe if stable

Question 21

What causes non-immune hemolysis?

Answer 21

Squeezed blood

Question 22

What is the treatment for non-immune hemolysis?

Answer 22

Fluids and diuretics

Question 23

What is the most common transfusion reaction?

Answer 23

Febrile non-hemolytic transfusion reaction

Question 24

What is the usual cause of febrile non-hemolytic transfusion reaction?

Answer 24

Recipient antibody reaction against donor WBCs (cytokines release)

Question 25

What is the treatment for febrile non-hemolytic transfusion reaction?

Answer 25

Discontinue transfusion if patient had previous transfusions or if it occurs soon after transfusion has begun

Question 26

If patient has history of febrile non-hemolytic transfusion reaction, what should be done if they need a transfusion in the future?

Answer 26

Use WBC filters for subsequent transfusions

Question 27

What causes urticaria after transfusion?

Answer 27

Recipient antibodies against donor plasmas proteins or IgA in IgA-deficient patient Usually not hemolytic

Question 28

What is the treatment for urticaria after transfusion?

Answer 28

Histamine blockers (Benadryl), supportive

Question 29

What are the signs of anaphylaxis?

Answer 29

Hypotension, broncospasm, angioedema, urticaria

Question 30

What usually causes anaphylaxis after transfusion?

Answer 30

Recipient antibodies against donor IgA in IgA-deficient patient

Question 31

What is the treatment of anaphylaxis after transfusion?

Answer 31

Epinephrine, fluids, pressors, steroids, histamine blockers (Benadryl)

Question 32

What causes transfusion-related acute lung injury after transfusion?

Answer 32

Caused by donor antibodies to recipient’s WBCs, which causes clot in pulmonary capillaries RARE

Question 33

What is the complication of transfusion-related acute lung injury?

Answer 33

Noncardiogenic pulmonary edema in <6 hours (ARDS)

Question 34

What is the most common cause of death from transfusion reaction?

Answer 34

Transfusion-related acute lung injury

Question 35

What can occur with massive transfusion?

Answer 35

Dilutional thrombocytopenia and dilution of coagulation factors

Question 36

What electrolyte imbalance can occur with transfusions? What can it lead to?

Answer 36

Hypocalcemia | Can cause poor clotting because Ca is needed for the clotting cascade

Question 37

What vital sign may be altered in a patient with hypocalcemia?

Answer 37

Hypotension

Question 38

Why is infusing cold products or transfusing in a cold patient bad?

Answer 38

It can cause poor clotting due to slowing of enzyme reactions Must warm patient to restore clotting

Question 39

What often causes hypocalcemia after transfusion?

Answer 39

Citrate used in stored blood binds Ca

Question 40

What is the most common bacterial contaminant in stored blood products?

Answer 40

Gram negative rods (E coli)

Question 41

What is the most common blood product source of contamination and why?

Answer 41

Platelets- because they are not refrigerated

Question 42

What exotic disease can be transmitted through transfusions?

Answer 42

Chagas’ disease