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Year 5 😊✌🏼 > Blood Transfusion > Flashcards

Blood Transfusion Flashcards

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1
Q

Types of transfusion reaction

A

acute
chronic

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2
Q

What happens if you give an ABO incompatible blood transfusion?

A

massive intravascular haemolysis - can be fatal

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3
Q

What proportion of people have RhD +ve blood?

A

85%

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4
Q

What happens in an anti-D reaction?

A

delayed haemolytic transfusion rection

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5
Q

Other blood group markers than ABO and Rh

A

xxx

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6
Q

How many red cells anigens are there

A

100s

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7
Q

antibodies to red cells - what type?

A

IgG

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8
Q

Which patents are more likely to develop antibody against the other RBC antigens than ABO and RhD?

A

many transfusions

e.g. sickle cell disesae

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9
Q

How is blood grouped in hospitals?

A

automated blood grouping and antibody screening - safer and quicker than people doing it

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10
Q

IAT technique

A

???

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11
Q

G&S

A

group and save/screen

more info

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12
Q

Electronic crossmatch

A

selection and issue of red cell units where compatibility is determined by IR system without physical testing of donor cells against patient plasm,a

only for patient that had a negative antibody screen

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13
Q

How do you crossmatch blood if someone has antibodies?

A

serological crossmatch

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14
Q

types of crossmatch

A

electronic
serological

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15
Q

serological crossmatch - finding when not compatible

A

agglutination or haemolysis -> not crossmatch

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16
Q

What are donor RBCs labelled with?

A
  1. ABO nad D type
  2. Kell
  3. other Rh antigens
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17
Q

Pillars of patient blood management

A
  • optimise haemopoiesis
  • minimise blood loss and bleeding
  • harness and optimises physiological tolerance of anaemia e.g. optimise cardiac outer, restrictive transfusion threshold
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18
Q

When can you use cell salvage?

A
  • no cancer
  • clean surgery i.e. not bowel
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19
Q

how long are transfusion records of patients kept in the UK?

A

30 y

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20
Q

How long in advance should you let the lab know when you need large amounts of blood for a planned surgery?

A

at least 24-48 h

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21
Q

post transplant or immunosuppression - what special requirements for blood transfusion?

A

irradiated components

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22
Q

can people with sickle cell trait donate blood?

A

yes

but this blood cannot be given to someone with a sickle cell crisis because it will not help them.

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23
Q

why are bacterial infection concerns higher for platelets than red cells?

A

platelets are kept at room temp rather than 4C

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24
Q

pts with fever post transfusion - mx

A
  1. take blood cultures
  2. treat with blood spectrum abx
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25
FFP
need 20 mins to thaw out can be kept at 4 degrees for 24h transuse ....
26
trigger for blood transfusion in major blood loss
if >30% blood volume is lost
27
post chemo - trigger for transfusion
Hb <80 g/L
28
Indications to give platelets
Massive transfusion - aim puts > 75 x 10^9/L prevent bleeding post chemo 0 if < 10 x 10^9/L (<20 if sepsis) prevent bleeding (surgery - <50 x 10^9/L (<100 if critical site: eye, CNS, poly trauma)
29
when is platelet transfusion contraindicated?
HiTT (heparin induced thrombocytopenia thrombosis) TTP
30
by how much does a unit of platelets increase the platelet count?
30-40
31
what is octoplast?
???
32
Indications for FFP
33
dosage for FFP
34
What is cryoprecipitate
has more fibrinogen than FFP
35
Doses of fibrinogen
36
autologous vs allogenic blood donation
autologous - own allogenic - donor
37
is autologous blood donation e.g. prior to planned OP possible?
yes BUT not done in the uk
38
what is post op cell salvage?
collect blood lost post op into wound drain, filer and re-infuse mainly used in orthodox surgery does not have clotting faactors
39
When do you need CMV -ve blood?
intraunterine/ neonataal transfusions
40
irradiated blood
for highly uimmunsuppressed TAA_GvHD
41
When do we used washed red cells?
xxx
42
WBIT
wrong blood in tube can happen in labelling issues; can be detrimental/fatal for patient and career changing for healthcare professional
43
communists blood group in UK?
0 47%
44
how common is O, A, B and AB in
O - 47% A - 42% B - 8% AB - 3%
45
Why is a rather than AB the universal donor for plasma?
Because AB is rare in the population in the UK
46
O- how much of population?
7%
47
what is the % demand for O- blood?
13.3%
48
What are some specific/special requirements for all blood?
49
What is the universal donor for plasma?
A RhD +
50
What are acute and chronic transfusion reactions?
acute within 24 h chronic >24h
51
name some acute transfusion reactions
§xxx
52
name some chronic transfusion reactions/complicatosn
xxx
53
What is more common, TACO or TRALI?
TACO is 100x more common than TRALI
54
What is the name of a transfusion reaction affecting the lungs?
55
TACO
transfusion associated circulatory overload
56
what are the commonest causes of transfusion reaction
errors e.g. giving wrong group
57
How do you recognise an acute transfusion rct/
rise in pulse, temp fall in BO pain at side fever risgors flushing vomiting loin pain chest pain urticaria itching headache collapse
58
obs for transfusion
get baseline boss repeat 15 mins after start of transfusion repeat ...
59
FNHTR
febrile non-haemolytic transfusion reCTION 1 degree rise in temp chills rigorss common before leiucodelepted, now rare slow/ stop the transfusion and give practemaol
60
allergic transfusion reaction
common, especially with planma mild urticarial or itchy rash sometimes with a wheeze during or after transfusion treat with IV antihistamaiens
61
wrong blood reaction Sx
restlessness chest loin pain fever vomiting flushing collapse rise in HR fall in BP risse in temp haaemoglobinuria (later)
62
commonest respiratory related complication of transfusion
TACO
63
Sx of transfusion of blood with bacterial contaamination
BO fall HR and temp rise bacterial growth can cause endotoxin prosucion which causes immediate collapses
64
How do we prevent bacterial contamination in transfusion?
clean arm of donor ask if they had recent infections test first 20mls for bacteria look for abnormalities e.g. climbs, discolouration, debris store at 4 degrees celsius, can be out of fridge for 30 mins
65
shelf life of platelets
7 days
66
commonest blood product associated with bacterial infection
platelets
67
anaphylaxis to blood products
shock breathless wheeze often laryngeal &/or facial oedema
68
What are respiratory complications of transfusion?
TACO TRALI TAD
69
timeframe of TACO presentation
within 6h of transfision
70
how does TACO look clinically
like pulm oedema SOB ....
71
who is at risk of TACO?
weigh less than 50kg pulmonary oedema liver disease positive fluid balance/on IV fluid ...
72
What is TRALI?
SOB decreased O2 stats increased HR and BP
73
CXR finding in TRALI
74
infectons associated with transfusion
Hep B Hep C malaria HIV 1, 2 HEV, HTLV1+2, Parvovirus, CMV (reserved for pregnant women) WNV, Zika v-CJD
75
is there a test of v-CJD?
no
76
can you get COVID-19 from transfusion?
no
77
TTI
transfusion transmitted infectio
78
delayed haemolytic transfusion reactions
1-3% ... day 7 post raised bill, LDH, fall in Hb, +ve dat, Hb-uria and clears in subsequent days caan cause renal problems check if they developed a new antibody
79
TA-GvHD
rare, but always fatal (w-m post traaansfussion) donor's blood contains some lymphocytes (able to divide) prevented by irradiating blood components, leucodepletion and HLA matched blood if necessary
80
Which antibodies cross placenta?
IgG
81
when in pregnancy do G&S?
at booking at 28w
82
What to do if an antibody is present during pregnancy?
check father monitor level of antibody check ffDNA sample at around 28w
83
Where are intrauterine transfusions performed?
at highly specialised centres
84
What antibody most commonly causes HDFN?
Anti-D
85
when does anti-D have to be given in pregnancy?
within 72h of the sensitising event
86
sensitising vents during pregnancy
spontaneous miscarriage or surgical evacuation abdominal trauma in pregnancy delivery CVS/amnioi
87
Doses of Anti-D
ata leas 250 ui before 20w eat least 400 iu for any events after 20w, including delivery. Kleihauer teste used to determine how much?
88
What other antibodies can cause HDFN?
anti-c anti-Kell (stops erythropoiesis) usually less severe than anti-D

Year 5 😊✌🏼 (53 decks)

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