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Phase 2 - General Surgery Placement > Blood Products and Transfusions > Flashcards

Blood Products and Transfusions Flashcards

1
Q

what is considered a ‘blood product’?

A

any part of the blood that is collected from a donor to use in a transfusion

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2
Q

what is the haemoglobin level at which transfusions can be given?

A

less than 70g/L hB

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3
Q

what is the target haemoglobin level post-transfusion?

A

70-90 g/L

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4
Q

what are the two different kinds of blood grouping?

A

ABO grouping and Rhesus D grouping

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5
Q

what does Rhesus D + refer to?

A

the patient’s blood group has Rhesus D surface antigens on their RBCs

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6
Q

how does Rhesus D group contribute to haemolytic disease of the newborn?

A

when a rhesus -ve mother first comes into contact with rhesus antigens, she will make the appropriate antibody but this will not affect her as she is rhesus -ve.
if she is pregnant with a rhesus +ve child, the antibody can cross the placenta and can affect the child leading to foetal anaemia.

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7
Q

what does the ABO group refer to?

A

it refers to the presence of A and B antigens on the RBCs

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8
Q

true or false: the universal donor O- has no surface antigens

A

true

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9
Q

true or false: type A blood will carry type A surface antigens

A

true

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10
Q

what are the two blood tests taken before a transfusion?

A

group and save (G&S) and cross match (X-match)

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11
Q

what does group and save blood test do?

A

determines the patients blood group and if there are any irregular antibodies present

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12
Q

what does cross match blood test do?

A

involves mixing the patient’s blood with donor blood to see if there is any immunological reaction

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13
Q

what are the different kinds of blood products?

A
  • packed red cells
  • platelets
  • fresh frozen plasma
  • cryoprecipitate
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14
Q

what do packed red cells contain?

A

red blood cells

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15
Q

what are the indications for giving someone packed red cells?

A
  • acute blood loss
  • chronic anaemia (hB <70g/L
  • symptomatic anaemia
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16
Q

what effect will packed red cells have on a patients blood levels?

A

1 unit of blood should increase the haemoglobin by 10g/L

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17
Q

what do platelet products contain?

A

platelets

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18
Q

what are the indications for giving someone a platelet transfusion?

A
  • haemorrhagic shock
  • thrombocytopenia (platelets <20 x10^9/L)
  • pre-operative platelet level <50 x10^9/L
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19
Q

what effect will the platelet have on a patients blood levels?

A

1 unit of platelets should increase the platelet levels by 20-40 x10^9/L

20
Q

what does fresh frozen plasma contain?

A

clotting factors

21
Q

what are the indications for giving someone fresh frozen plasma?

A
  • patient has DIC
  • any haemorrhage secondary to liver disease
  • given after 2nd unit of blood in all massive haemorrhages
22
Q

what does cryoprecipitate contain?

A
  • fibrinogen
  • von Willebrands Factor
  • factor VIII
  • fibronectin
23
Q

what are the indications for giving someone cryoprecipitate?

A
  • DIC with fibrinogen at < 1g/L

- von Willebrands Disease

24
Q

what are the different kinds of post-operative haemorrhage?

A
  • primary bleeding
  • reactive bleeding
    secondary bleeding
25
Q

what is ‘primary bleeding’?

A

bleeding that occurs within the intra-operative period

26
Q

when should primary bleeding be resolved?

A

during the operation

27
Q

what is ‘reactive bleeding’?

A

bleeding that occurs within 24 hours of the operation

28
Q

why does reactive bleeding occur?

A

it may be due to a missed blood vessel or failed ligature as during the operation the patient was vasoconstricted and had low BP
this normalised post-op causing the bleeding to occur

29
Q

what is ‘secondary bleeding’?

A

bleeding that occurs 7-10 days post-operatively

30
Q

why does secondary bleeding occur?

A

due to an erosion of the vessel because of an infection - it is most commonly seen in heavily contaminated wounds

31
Q

what are the features of haemorrhagic shock?

A

tachycardia, dizziness, agitation, visible bleeding, low urine output, tachypnoea

32
Q

true or false: hypotension is a common sign of haemorrhagic shock

A

false.

it is often a late sign of haemorrhagic shock

33
Q

what blood vessel is at most risk of damage during a laparoscopic surgery?

A

inferior epigastric artery

34
Q

what is the purpose of thromboprophylaxis?

A

it is given to patients to reduce the risk of developing a VTE

35
Q

what are the different kinds of thromboprophylaxis?

A

mechanical thromboprophylaxis

pharmacological thromboprophylaxis

36
Q

what is used in mechanical thromboprophylaxis?

A
  • antiembolic stockings

- intermittent pneumatic compression (used in theatre)

37
Q

what would be a contraindication to mechanical thromboprophylaxis?

A

should not be used in patients with peripheral arterial disease, peripheral oedema, or local skin conditions

38
Q

what is used in pharmacological thromboprophylaxis?

A

enoxaparin injections

39
Q

what is the classification of enoxaparin?

A

low molecular weight heparin

40
Q

true or false: patients with poor renal function should not be given LMWH

A

true.

they may be given unfractionated heparin instead

41
Q

what is the mechanism of action for LMWH?

A

inhibits clotting factors II and X

42
Q

what is the mechanism of action for unfractionated heparin?

A

inhibits clotting factors II, VII, IX, X

43
Q

what is the mechanism of action for warfarin?

A

inhibits clotting factors synthesised in the liver - II, VII, IX, X by inhibiting vitamin K

44
Q

why are patients who just start on warfarin are initially hypercoagulable?

A

because warfarin also inhibits synthesis of protein C, S, and Z which normally regulate clotting

45
Q

true or false: patients started on warfarin, only need warfarin

A

false.

they are also given LMWH as they are initially hypercoagulable

Phase 2 - General Surgery Placement (14 decks)

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