EXAM #2: BLOOD COMPONENT THERAPY Flashcards Preview

Hematology and Oncology > EXAM #2: BLOOD COMPONENT THERAPY > Flashcards

Flashcards in EXAM #2: BLOOD COMPONENT THERAPY Deck (31):
1

Why blood component therapy preferable to whole blood?

Aside from trauma, specific blood component defects require specific blood component therapy

2

What is the clinical indication for red cell transfusion?

- Symptomatic patient with Hb less than 10
- Anemia w/ Hb less than ~7-8

3

What are the two methods of platelet product preparation?

1) Platelets
2) Cryoprecipitate

4

What is alloimmunization?

This is an immune response to foreign antigen

5

What is the mechanism of alloimmunization in platelet therapy?

Patients that recieve platelets may make antibodies to the transfused platelets b/c:
- Anti HLA (human luekocyte antigen)
- Anti HPA (human platelet antigen)

6

How can alloimmunization in platelet transfusion be prevented?

Find compatible platelets by:
1) Give random platelet units
2) Crossmatch
3) Find platelets without the antigen that causes the reaction

7

What is CMV negative?

- CMV is a virus that is carried in WBCs
- pRBCs that undergo Luekoreduction i.e. removal of WBCs are CMV negative

8

What is the clinical indication of CMV negative blood products?

Transfusion of an immunocompromised patient

9

What does irradiated mean?

pRBC components are exposed to x-ray

10

What is the clinical indication for irradiated blood products?

This is done to prevent TRANSFUSION ASSOCIATED GRAFT VS. HOST DISEASE

*****This is indicated in patients that are IMMUNOCOMPORMISED*****

11

What does filtered blood products mean?

- Leukoreduction i.e. whole blood unit is hung and run through a filter
- Filters OUT leukocytes

12

What is the clinical indication for filtered blood products?

Immunosuppression

13

List the two indications for transfusing fresh frozen plasma.

1) Coagulation abnormalities in massive transfusions
2) Hemophilia

14

What is cryoprecipitate? What the specific components of cryoprecipitate?

Precipitate that is formed when fresh frozen plasma is thawed, it contains:
- Factor VIII
- Fibrinogen
- vWF
- Factor XIII

15

What is the clinical indication for cryoprecipitate?

Generally, the treatment of coagulation factor deficiencies involving fibrinogen and Factor VIII i.e.
1) Fibrinogen replacement in bleeding patient
2) Hemophilia A (Factor VIII)
3) vWF Disease

16

What is prothrombin complex concentrate? What are the clinical indications for prothrombin complex concentrates?

Prothrombin complex concentrate is made via plasma fractionation and contains Vitamin K dependent coagulation factors; thus, it is indicated for patients with Hemophilia in the following situations:
- Hemorrhage
- Perioperative bleeding management
- Prophylaxis of bleeding events

17

What is the clinical indication for albumin?

1) Hypoalbuminemia
2) Volume replacement

18

What is the indications for IVIG?

1) Primary humoral immunodeficiency e.g. SCID
2) Immune thrombocytopenia
3) Chronic inflammatory demyelinating polyneuropathy
4) Hypogammaglobulinemia
5) Post-exposure prophilaxis

19

What are the main coagulation abnormalities that occur after massive transfusion?

- Replacement of blood loss will lead to DILUATION of coagulation factors-->additional bleeding
- Fibrinogen levels can drop

20

Outline how the coagulation abnormalities seen following massive transfusion are treated.

1) FFP transfusions for coagulation factors
2) Cryoprecipitate for fibrinogen

21

Is there a difference in clinical outcomes when old pRBCs are given vs. new?

NO

22

What is pRBC volume reduction?

- Centrifuge pRBC just prior to administration
- Purpose: remove preservative RBCs are stored in

*****Indicated for patients with circulatory overload e.g. CHF and renal failure*****

23

What are the general indications for plasma transfusion?

1) Coagulation factor replacement
2) Massive transfusion
3) ADAMSTS13

24

What are the platelet thresholds for transfusion?

Generally, less than 100,000, EXCEPT:
- Active bleed and major surgery= less than 50,000
- Central line= less than 20,000
- Prevent spontaneous bleeding= less than 5,000

25

What is the definition of platelet refractoriness?

Patient that has an alloimmune response to donor platelets

26

What are the ADVANTAGES of whole blood transfusion?

1) Best for TRAUMA
- Volume
- Hb
- Coagulation factors
- Replace platelets

27

What are the indications for Recombinant Factor VIII?

Patients with Hemophilia A to:
- Control and prevent bleeding
- Perioperative bleeding management

28

What blood component would you give a patient with anemia?

RBCs

29

What blood component would you give a patient with DIC?

Plasma

30

What blood component would you give a patient with thrombocytopenia?

Platelets

31

What blood component would you give a patient with low fibrinogen?

Cryoprecipitate