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Flashcards in Heme - Blood components and transfusion reactions Deck (22):
1

Whole blood:

3 cellular components?

Plasma derivatives?

Whole blood:

RBC, WBC, and platelets

Fresh frozen plasma, cryoprecipitate

2

Packed RBC:

1. What are packed RBCs?

2. Indications for packed RBCs?

3. Why should transfusions be minimized?

Packed RBC:

1. Packed RBCs have had plasma and platelets removed

2. Indications: anemia, sickle cell, thallasemia

3. Transfusions should be minimized to decrease Abs

3

Granulocytes (rarely given):

1. Must be ____ compatible

2. What are some complications?

3. Indications?

Granulocytes:

1. Must be ABO compatible

2. Complications: rigor, allergy, CMV, or GVHD

3. Indication: Severe sepsis

4

Platelets:

1. Indications?

Single donor platelets:

2. What is the benefit?

3. ____ is matched

Platelets:

1. Indication: count <10k, count <20k with bleeding, or for invasive procedures

Single donor platlets:

2. Benefit of a single donor is decreased #Ags exposed to

3. HLA is matched

5

Fresh frozen plasma:

1. What does it contain?

2. Indications?

Fresh frozen plasma:

1. Contains all coagulation factors and plasma proteins

2. Indications: coagulation factor deficiency, OD of coumadin, or coagulopathy (ex: liver disease)

6

Cryoprecipitate:

1. What is it prepared from?

2. What does it contain?

3. Uses?

Cryoprecipitate:

1. Prepared from fresh frozen plasma

2. Contains factors 8 and 13, vWF, and fibrinogen

3. Used mostly in critically ill patients, DIC, Hemophilia A, Afibrinogemia, and vWD

7

Transfusion reactions:

1. Acute intravascular - primary Ab? Example?

2. Acute extravascular - primary Ab? Example?

3. Delayed intravascular - primary Ab?

4. Delayed extravascular - primary Ab?

5. Which type is the most dangerous?

Transfusion reactions:

1. Acute intravascular - IgM: ABO

2. Acute extravascular - IgG: Rh

3. Delayed intravascular - IgG

4. Delayed extravascular - IgG

5. Most dangerous: acute intravascular

8

Hemolytic transfusion reactions:

1. Most common cause is ___ incompatibility.

2. Red cell destruction due to complement activation by __.

3. Causes _____ failure

Hemolytic transfusion reactions:

1. Most common cause is ABO incompatibility

2. RBC destruction due to complement activation by IgM

3. Causes multisystem failure

9

Hemolytic transfusion reactions:

1. First response?

2. What is done to prevent renal failure?

3. How is HTR prevented?

Hemolytic transfusion reactions:

1. STOP TRANSFUSION

2. Infuse fluids and diuretics to increase urine output and maintain BP/perfusion to kidney

3. Prevented by following procedures and compatability testing

10

Febrile nonhemolytic reactions:

1. Cause from ____ on the ___ of the donor that react with the recipient ____.

2. Symptoms? How to treat symptoms?

3. What is a good preventative measure?

Febrile nonhemolytic reactions:

1. Cause from HLA on the WBC of the donor that react with the recipient Abs.

2. Fever, chills, shaking; tylenol and benadryl

3. Give units with reduced leukocytes

11

Allergic transfusion reactions:

1. Cause?

2. Reaction?

3. Prophylaxis?

Allergic transfusion reactions:

1. Caused by Abs of the recipient to the proteins of the donor

2. hives, itching, erythema, dyspnea

3. Give antihistamine as prophylaxis

12

Anaphylactic Reactions:

1. Associated with?

2. Symptoms?

3. NO ____

4. Treat?

5. Prevent?

Anaphylactic reactions:

1. IgA antibodies in IgA deficient patients

2. flushing, nausea, diarrhea, hypotension, arrhythmia, arrest, and laryngeal edema

3. NO FEVER

4. Epinepherine

5. Give washed RBCs that have no IgA

13

Transfusion related lung injury:

1. Caused by what 2 things?

2. What occurs?

3. Patient displays acute ____ insufficiency with x-ray showing?

Transfusion related lung injury:

1. Donor Abs that react with recipient granulocytes or vice versa

2. Lungs fill with a high-protein fluid

3. Patient displays acute respiratory insufficiency with x-ray showing bilateral symmetric pulmonary edema

14

Transfusion related lung injury:

1. Symptoms?

2. Treatment?

3. Prevention?

Transfusion related lung injury:

1. dyspnea, cyanosis, tachycardia, and hypoxemia

2. Treat with steroids

3. Prevent: avoid donations from multiparous women and those who have reveived multiple transfusions (these people have more antibodies)

15

What are 2 acute non-immunologic reactions?

Bacterial contamination and circulatory overload

16

Bacterial Contamination:

1. Symptoms?

2. Stop infusion immediately and treat with?

Bacterial contamination

1. fever, shock, renal dysfunction, nausea, vomitting (appear rapidly)

2. Antibiotics

17

Circulatory overload:

1. When does this occur? What occurs?

2. Symptoms?

3. Prevention?

Circulatory overload:

1. patient is transfused too rapidly and this overloads the cardiopulmonary system (too much fluid at a time)

2. dyspnea, severe headache, CHF, swelling of feet

3. Give to patients in small aliquot of each unit over time, also, diuretics

18

Delayed hemolytic transfusion reactions:

1. When do these occur?

2. What is it mediated by?

Delayed hemolytic transfusion reactions:

1. Occurs AT LEAST 24 hours after transfusion

2. Mediated by IgG antibodies

19

GVH Disease:

1. When do symptoms appear?

2. May be caused by?

3. What occurs as a result of the immunologic response?

4. Prevention?

GVH Disease:

1. After 12 days symptoms appear

2. Caused by donor lymphocytes transfused to an immunocompromised patient

3. Pancytopenia

4. Any component with T-lymphocytes should be irradiated

20

Posttransfusion purpura:

1. Alloantibody directed against?

2. Who does this usually occur in?

3. When does this occur? What occurs?

4. Major concern? 

5. Treatment?

Posttransfusion purpura:

1. Directed against platelet antigen

2. Multiparous women who dont have the antigen

3. 5-10 days after transfusion; significant platelet count drop

4. Cerebral hemorrhage is a major concern

5. Treat by giving platelets

21

Delayed Non-immunologic reactions:

Hemosiderosis:

1. Who does this occur in?

2. Excess ____ in macrophages in what tissues?

Delayed Non-immunologic reactions:

Hemosiderosis

1. This occurs in individuals who receive multiple transfusions (or sickle cell patient)

2. Excess iron in macrophages in liver, heart, and endocrine glands

22

Delayed Non-immunologic reactions:

What disease transmission can occur?

Delayed Non-immunologic reactions:

Hepatitis, HIV, HTLV, CMV, malaria