Hematology II

Question 1

What is major reason for transfusion of PRBCs in the OR?

Answer 1

improve oxygen caring capacity

Question 2

Hgb 7-8 do you tranfuse?

Answer 2

1. If undergoing ortho or cardiac surgery
2. if have stable cardiovascular disease, after doing clinical evaluation

Question 3

When do we transfuse pt with Hgb 8-10?

Answer 3

symptomatic anemia
ongoign bleeding
ACS with ischemia
hematology/oncology pt with severe thrombocytopenia

Question 4

What is type and screen?

Answer 4

test patients blood for Rh factor, and wha antibodies they have

Question 5

What is type and cross?

Answer 5

type and screen and then you cross match it with blood > tag it and set aside for patient

Question 6

O type blood has what antigens? and what antibodies?

Answer 6

No antigens
Anti-a & anti-b antibodies

Question 7

What blood can someone with O type receive?

Answer 7

O blood

Question 8

Type A blood has?

Answer 8

A antigen
anti-B antibody

Question 9

What blood can someone with type A receive?

Answer 9

Type O
Type A

Question 10

Type B blood has?

Answer 10

B antigen
anti-a antibody

Question 11

What blood can someone with type B receive?

Answer 11

type b
type O

Question 12

What blood can someone with type AB receive?

Answer 12

O
A
B
AB

Question 13

T/F Rh+ can receive Rh- but not the other way around?

Answer 13

true

Question 14

AB type blood has what antibodies?

Answer 14

none. no antibodies

Question 15

Universal Donor?

Answer 15

O-

Question 16

Universal recepient?

Answer 16

AB+

Question 17

antigen

Answer 17

marks the blood cell

Question 18

antibodies

Answer 18

attack and destroy other blood cells

Question 19

sx of acute hemolytic transfusion reaction

Answer 19

fever, chills, flushing
chest/flank/back pain
hypotn
oliguria or anuria or hemoglobinuria
diffuse bleeding out of IVs and tubes

Question 20

tx for acute hemolytic transfusion rxn

Answer 20

1. stop transfusion
2. keep uop 75-100 ml/hr
3. assay urine and plasma for hgb [ ]
4. return unused blood to the blood bank
5. prevent hypotension
6. recheck labelling

Question 21

your patient is under anesthesia and you gave blood, what are some signs that your patient is having an acute hemolytic transfusion rxn

Answer 21

increased T
unexplained tachycardia
hypotension
hemoglobinuria
bronchospasm
diffuse oozing in surgical field

Question 22

what are hemolytic transfusion rxns due to

Answer 22

ABO incompatability

Question 23

_________ is a transfusion reaction with a mild reaction, typically with re-exposure d/t Ab to non-D antigens

Answer 23

hemolytic

Question 24

sx of hemolytic transfusion reaction

Answer 24

1. clinical low grade fever
2. mild jaundice
3. unexpected drop in hgb

Question 25

how do you manage transfusion reaction?

Answer 25

supportive therapy: 1. monitor hgb 2.hydration 3. tranfuse if hgb too low

Question 26

what causes febrile non hemolytic transfusion reaction?

Answer 26

typically due to multiple transfusions which leads to the development of alloantibodies on donated blood WBC

Question 27

most common transfusion reaction?

Answer 27

febrile non hemolytic transfusion reaction

Question 28

sx of febrile non-hemolytic transfusion reaction

Answer 28

1. fever.chills 2. respiratory depression 3. anxiety 4.headache 5. myalgia

Question 29

what is the treatment for a febrile non-hemolytic transfusion reaction?

Answer 29

tylenol

Question 30

RALi within 6 hours of tranfusion you will have what sx?

Answer 30

dyspnea chills/fever bilateral pulmonary edema significant pulmonary compromise > intubation hypotension in cardiac patients

Question 31

TRALI treatment?

Answer 31

stop transfusion O2/ventilation > low Tidal Volume

Question 32

indications to transfuse PRBC?

Answer 32

symptomatic anemai Hbg<6 if healthy massive hemorrhage decreased O2 carrying capacity

Question 33

how long to platlets last normally? if donated?

Answer 33

7-10 days 4-5 days

Question 34

I unit of platelets should increase plt count by

Answer 34

30,000-60,000

Question 35

home many plateletpheresis packs per 10kg of weight?

Answer 35

one

Question 36

T/F plt have to be ABO compatible?

Answer 36

false, preferred but not required

Question 37

contents in plts?

Answer 37

plts and clotting factors

Question 38

plt transfusion triggers

Answer 38

1. active bleeding with bleedign time 2x normal 2. active bleeding with plt < 20,000 3. active bleeding with bleeding time < 60,000 for surgical pts 4. active bleeding after complete heparin neutralization (post ECC bypass)

Question 39

For CNS procedure give plts if they are < ?

Answer 39

100,000

Question 40

FFP must be ABO compatible?

Answer 40

True

Question 41

contents in FFP?

Answer 41

all coagulation factors (especially II, VII, IX, and X) protein C protein S antithrombin III

Question 42

for every 3 UPRBC you should give how many FFP?

Answer 42

one

Question 43

for every 3 UPRBC you should give how many FFP?

Answer 43

one

Question 44

if massive tranfusion protocol, normally you give __ FFP for every ___ PRBC?

Answer 44

1:1

Question 45

Indications to give FFP

Answer 45

bleeding from warfarin therapy massive transfusion/coagulopathy coagulation factor deficiency Antithrombin III deficiency correction of multiple coagulation deficits correction of microvascular bleeding w/ abn coags give if entire blood volume has been tx

Question 46

10 - 15 ml/kg of FFP should increase clotting factors by ______________%

Answer 46

20-30

Question 47

FFP in NOT indicated for

Answer 47

PT, INR, or aPTT that is normal solely for augmentation of blood volume or albumin [ ]

Question 48

1 "pool" of cryoprecipitate will increase fibrinogen ______________

Answer 48

45 mg/dL

Question 49

____________________ is a concentrated version of FFP

Answer 49

cryoprecepitate

Question 50

T/F: cryoprecipitate must be ABO compatible

Answer 50

false, preferred but not required

Question 51

cryoprecipitate product content

Answer 51

fibrinogen factors V, VIII, and XIII and vWF

Question 52

when do you transfuse cryo

Answer 52

hypofibrinogenemia (<80-100) massive hemorrhage bleeding pts with vWD, unresponsive to DDAVP tx of microvascular bleeding with fibrin deficicency