Fiser Chapter 3 BLOOD PRODUCTS

Question 1

Blood products that carry risk of HIV and hepatitis

Answer 1

All except albumin and serum globulins

Question 2

Donated blood is screened for what

Answer 2

HIV
HepB
HepC
HTLV
Syphilis
West Nile virus

Question 3

Who gets CMV negative blood

Answer 3

Low birth weight infants

BM transplant and other transplant patients

Question 4

MCC death from transfusion reaction

Answer 4

Clerical error leading to ABO incompatibility

Question 5

Type O blood

Answer 5

Universal donor, no Ag

Question 6

Type AB blood

Answer 6

Contains both A and B antigens

Question 7

Stored blood left shift due to

Answer 7

Low 2,3-DPG

Increased affinity for O2

Question 8

Hemolysis reactions

Answer 8

• Acute hemolysis
• Delayed hemolysis
• Nonimmune hemolysis

Question 9

Other reactions (non-hemolytic)

Answer 9

• Febrile nonhemolytic
• Anaphylaxis
• Urticaria
• TRALI

Question 10

ABO incompatibility causes what kind of reaction?

Answer 10

Acute hemolysis, Ab-mediated

• Back pain, chills, tachy, fever, hemoglobinuria
• Can lead to ATN, DIC, shock
• Haptoglobin <50, free Hgb >5, increased unconjugated bili
• Tx: fluids, diuretics, HCO3-, pressors, histamine blockers (Benadryl)
• In anesthetized patients, may present as diffused bleeding

Question 11

Tx of acute hemolytic transfusion rxn

Answer 11

(Caused by ABO incompatibility)

-Fluids, diuretics, HCO3-, pressors, benadryl

Question 12

Patient getting transfusion develops back pain, chills, tachycardia, fever, hemoglobinuria

Answer 12

Acute hemolysis from ABO incompatibility

-In anesthetized patient may present as diffuse bleeding

Question 13

Delayed hemolysis

Answer 13

Ab-mediated against minor antigens

Tx: observe if stable

Question 14

Nonimmune hemolysis

Answer 14

From squeezed blood

Tx: fluids and diuretics

Question 15

Febrile nonhemolytic transfusion reaction

Answer 15

• Most common transfusion reaction
• Usually recipient Ab against donor WBCs
• Tx: Stop transfusion if previous transfusions or if occurs soon after transfusion begun
• Use WBC filters for subsequent transfusions

Question 16

Most common transfusion reaction

Answer 16

Febrile nonhemolytic transfusion reaction (recipient Ab to donor WBCs)

Question 17

Anaphylaxis transfusion reaction

Answer 17

• Bronchospasm, hypotension, urticarial
• Usually recipient Ab against donor IgA in IgA-deficient recipient
• Tx: Fluids, Lasix, pressors, steroids, epinephrine, histamine blockers (Benadryl)

Question 18

Patient getting blood transfusion develops hypotension, bronchospasm, urticaria

Answer 18

Anaphylaxis

-IgA deficient recipient has Ab against donor IgA

Question 19

Uricaria transfusion reaction

Answer 19

• Usually nonhemolytic
• Usually recipient Ab against donor plasma proteins or IgA in IgA-deficient patient
• Tx: Histamin blockers (Benadryl), supportive

Question 20

TRALI

Answer 20

• Rare

- Donor Ab to recipient WBC (opposite of febrile nonhemolytic transfusion reaction) -> clot in pulmonary capillaries

Question 21

Recipient Ab against donor WBCs

Answer 21

Febrile nonhemolytic transfusion reaction

Question 22

Donor Ab against recipient WBCs

Answer 22

TRALI

Question 23

ABO incompatibility causes what

Answer 23

Acute hemolytic transfusion reaction

Question 24

Massive transfusion side effects

Answer 24

• Dilutional thrombocytopenia after 10 units pRBCs

- Hypocalcemia -> poor clotting

Question 25

Most common bacterial contaminate of blood

Answer 25

GNRs (e coli)

Question 26

Most common blood product source of contamination

Answer 26

Platelets (not refridgerated)