Blood transfusion

Question 1

What blood groups are dominant and recessive?

Answer 1

A and B are dominant

O is recessive

Question 2

a patient is blood group A and requires blood due to haemorrhage.
what blood types can she receive blood from?

Answer 2

A and O

Question 3

a patient is blood group AB and requires blood due to haemorrhage.
what blood types can she receive blood from?

Answer 3

A, B, AB and O

Question 4

a patient is blood group O and requires blood due to haemorrhage.
what blood types can she receive red cells from?

Answer 4

group O

Question 5

a patient is at high risk of haemorrhage so you decide to give FFP.
their blood group is O. what type of donor can they receive FFP from?

Answer 5

A, B, AB and O

Question 6

a patient is at high risk of haemorrhage so you decide to give FFP.
their blood group is AB. what type of donor can they receive FFP from?

Answer 6

group AB

Question 7

a patient is at high risk of haemorrhage so you decide to give FFP.
their blood group is A. what type of donor can they receive FFP from?

Answer 7

A and AB

Question 8

what type of antibody is anti-A / anti-B in blood?

Answer 8

IgM

Question 9

what infections are blood donors screened for?

Answer 9

HIV
syphillis
hep B, C, E

Question 10

what are the 3 blood components?

Answer 10

plasma - clotting factors, albumin and antibodies

buffy coat - leukocytes (WC’s) and platelets

red blood cells

Question 11

what are some of the indications for a red cell transfusion?

Answer 11

severe anaemia which might otherwise cause organ damage

improve quality of life in someone with uncorrectable anaemia

prepare a patient for surgery or speed up recovery

reverse damage caused by the patients own cells i.e. sickle cell

Question 12

how much is unit of red blood cells?

Answer 12

5 g/l

Question 13

over how long is red blood cells transfused?

Answer 13

2-4 hours

Question 14

over how long is platelets transfused?

Answer 14

20 - 30 mins

Question 15

how much is 1 dose of platelets ?

Answer 15

20-40 x 10(9) /L

Question 16

what are the indications of a platelet transfusion?

Answer 16

massive haemorrhage

bone marrow failure

prophylaxis for surgery

if bleeding with cardiopulmonary bypass

Question 17

if a patient is blood group A+ and requires platelet transfusion due to bone marrow failure.
from what donor can she receive platelets from?

Answer 17

any blood group

you don’t require specific cross match for platelet transfusion as there are no antibodies/antigens in the buffy coat

Question 18

what test can be used as an indicator of a patient requiring FFP?

Answer 18

PT and APTT

measure of clotting of the blood

Question 19

when would a patient require FFP?

Answer 19

massive haemorrhage
DIC with bleeding
prophylactic

Question 20

what transfusion is given to correct fibrinogen deficiency?

Answer 20

cryoprecipitate

Question 21

how long does it take for FFP to thaw?

Answer 21

30 mins

Question 22

when donating blood, how long is the sample valid for?

Answer 22

samples kept for 7 days but only valid for 2 days if recent transfusion

Question 23

what happens when someone who is Rh-D negative becomes pregnant and the baby is Rh-D positive?

Answer 23

the mixi

Question 24

what are the indications of the direct and indirect Coombs test?

Answer 24

direct;

• alloiummune haemolysis (i.e. HDN)
• drug induced immune-mediated haemolysis (i.e. penicillin, methyldopa)
• autoimmune haemolysis (i.e. SLE)

indirect;

• cross matching for blood transfusions
• antenatal screening for IgG causing potential HDN

Question 25

in a massive haemorrhage, what immediate supply of blood products should you ask for?

Answer 25

6 units red cells 4 units FFP 1 unit platelets

Question 26

in an emergency situation what blood type should you give a patient whose blood type you don't know?

Answer 26

group O -ve

Question 27

what is TA-GvsHD

Answer 27

transfusion associated graft vs host disease a rare life threatening reaction in which the immunological competent donors T lymphocytes mount an immune response against the recipients lymphoid tissue

Question 28

shortly after receiving a blood transfusion, a patient becomes breathless. what are the possible complications that could account for this? how would you treat?

Answer 28

Transfusion associated circulatory overload (TACO) Anaphylaxis Transfusion related acute lung injury (TRALI) - 02 - diuretic - ventilation - adrenaline

Question 29

shortly after receiving a blood transfusion, urticaria develops on the patients arm. what are the possible complications that could account for this? how would you treat?

Answer 29

mild allergic reaction anaphylaxis - anti-histamine

Question 30

shortly after receiving a blood transfusion, a patient becomes pyrexic. what could be the cause of this? how would you treat?

Answer 30

febrile non-haemolytic transfusion reaction - anti-pyretic

Question 31

what are the 2 main complications that can arise if a baby is coombs test positive at birth?

Answer 31

anaemia | jaundice

Question 32

if a mother is Rh-D negative and the baby is Rh-D positive, what prophylaxis is given to prevent HDN?

Answer 32

the mother is given prophylactic anti-D at 28 weeks

Question 33

at birth the baby presents healthily but starts to show pupura on their skin and on a blood test shows low platelets. what is the diagnosis?

Answer 33

neonatal alloimmune thrombocytpenia (NAIT)

Question 34

what is the difference between direct and indirect Coombs test? (anti globulin test)

Answer 34

used to detect antibodies which are bound to RBC surface used to detect in vitro antibody-antigen reactions

Question 35

what does a positive direct Coombs test indicate?

Answer 35

an immune mechanism is attacking the patients own RBC

Question 36

what are the indications of cryoprecipitate?

Answer 36

bleeding due to thrombolytic therapy hypofibrinogen bleeding disorder i.e. von willibrands

Question 37

would you transfuse a 76 year old with Hb 54 g/L and blood film consistent with megaloblastic anaemia?

Answer 37

no because she has either folic acid or vitamin B12 deficiency so you would give folate supplements and vitamin B12 injections this will improve Hg within a week

Question 38

would you transfuse a 48 year old lady admitted for a planned hysterectomy with Hb of 95 g/L?

Answer 38

no because she is obviously bleeding from her uterus hence why she is probably receiving a hysterectomy e.g. menorrhagia therefore just give some iron supplements and it will improve

Question 39

what is the main way to determine clinically if a patient requires a blood transfusion?

Answer 39

if their blood volume is severely compromised check pulse and blood pressure they could lose a lot of blood but there Hg may still be normal therefore don't reply on Hg level to determine if they require a blood transfusion

Question 40

at what platelet level would you give platelet transfusion?

Answer 40

platelets < 15 x 10(9)

Question 41

how is FFP stored and why is this of clinical significance?

Answer 41

frozen at -22 degrees and takes 30 minutes to thaw so have to pre plan if you are going to use it

Question 42

would you transfuse a patient with DIC ?

Answer 42

only if they were bleeding

Question 43

would you transfuse a patient with FFP who is hypotensive with an albumin content of 16 g/L?

Answer 43

no you would give human albumin as a plasma expander

Question 44

would you give a patient FFP who is bleeding due to warfarin?

Answer 44

no you would give vitamin K + factor III and IV

Question 45

what coagulation factors does cryoprecipitate contain?

Answer 45

Factor VIII and XIII von willebrand factor fibrinogen fibronectin

Question 46

why may platelets and red cells be irradiated before transfusion?

Answer 46

to decrease the risk of graft vs host disease in patients who are at risk i.e. immunosuppressed