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

Whole blood:

3 cellular components?

Plasma derivatives?

Whole blood:

RBC, WBC, and platelets

Fresh frozen plasma, cryoprecipitate


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


Granulocytes (rarely given):

1. Must be ____ compatible

2. What are some complications?

3. Indications?


1. Must be ABO compatible

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

3. Indication: Severe sepsis



1. Indications?

Single donor platelets:

2. What is the benefit?

3. ____ is matched


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


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)



1. What is it prepared from?

2. What does it contain?

3. Uses?


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


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


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


Hemolytic transfusion reactions:

1. First response?

2. What is done to prevent renal failure?

3. How is HTR prevented?

Hemolytic transfusion reactions:


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

3. Prevented by following procedures and compatability testing


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


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


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


4. Epinepherine

5. Give washed RBCs that have no IgA


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


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)


What are 2 acute non-immunologic reactions?

Bacterial contamination and circulatory overload


Bacterial Contamination:

1. Symptoms?

2. Stop infusion immediately and treat with?

Bacterial contamination

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

2. Antibiotics


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


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


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


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


Delayed Non-immunologic reactions:


1. Who does this occur in?

2. Excess ____ in macrophages in what tissues?

Delayed Non-immunologic reactions:


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

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


Delayed Non-immunologic reactions:

What disease transmission can occur?

Delayed Non-immunologic reactions:

Hepatitis, HIV, HTLV, CMV, malaria