LESSON 2: HISTORICAL PERSPECTIVE AND OVERVIEW Flashcards
(122 cards)
1
Q
First time a blood transfusion was recorded in history.
A
Pope Innocent VII
2
Q
Sodium phosphate
A
Braxton Hicks
3
Q
ABO blood groups
A
Karl Landsteiner
4
Q
Vein to vein transfusion
A
Edward E. Lindemann
5
Q
Syringe-valve apparatus Sodium citrate
A
Unger
6
Q
Sodium citrate
A
Hustin
7
Q
Minimum amount of citrate needed for anticoagulation
A
Lewisohn
8
Q
Citrate dextrose solution
A
Rous and Turner
9
Q
Techniques in blood transfusion and blood preservation
A
Dr. Charles Drew
10
Q
Introduced the formula for the preservative acid-citrate-dextrose
A
Loutit and Mollison
11
Q
Introduced citrate-phosphate-dextrose
A
Gibson
12
Q
The amount of whole blood in a unit has been
A
450 mL +/- 10% of blood
13
Q
For a 110 lb donor, a maximum of (?) can be collected
A
525 mL
14
Q
Total blood volume for most adults:
A
10 to 12 pints
15
Q
Donors can replenish the fluid lost from the donation of
A
1 pint in 24 hours.
16
Q
The donor’s red cells are replaced within (?) after donation.
A
1 to 2 months
17
Q
A volunteer donor can donate blood every
A
8 weeks.
18
Q
Units of the whole blood can be separated into three components:
A
Packed red blood cells, platelets, and plasma
19
Q
The plasma can be converted by cryoprecipitation to a clotting factor concentrate that is rich in
A
antihemophilic factor.
20
Q
A unit of whole blood-prepared RBCs may be stored for (?), depending on the anticoagulant-preservative solution.
A
21 to 42 days
21
Q
The donation process, especially (?), has been carefully modified over time to allow for the rejection of donors who may transmit transfusion-associated disease to recipients.
A
steps 1 and 2
22
Q
The (?) is safer than it has ever been because of the donation process and extensive laboratory screening (testing) of blood.
A
nation’s blood supply
23
Q
The use of (?), licensed by the Food and Drug Administration (FDA) since 2002, is one reason for the increased safety of the blood supply.
A
nucleic acid amplification testing (NAT)
24
Q
THE DONATION PROCESS 3 STEPS:
A
Step 1: Educational Materials
Step 2: The Donor Health History Questionnaire
Step 3: The Abbreviated Physical Examination
25
(?) that contains information on the risks of infectious diseases transmitted by blood transfusion, including the symptoms and sign of AIDS, is given to each prospective donor to read.
Step 1: Educational Materials
26
designed to ask questions that protect the health of both the donor and the recipient, is given to every donor.
Step 2: The Donor Health History Questionnaire
uniform donor history questionnaire,
27
is used to identify donors who have been exposed to diseases that can be transmitted in blood.
Step 2: The Donor Health History Questionnaire
Health History Questionnaire
28
(?) for donors includes blood pressure, pulse, and temperature readings; hemoglobin or hematocrit level; and the inspection of the arms for skin lesions.
Step 3: The Abbreviated Physical Examination
29
1950’s
Syphilis
30
1971
Hepatitis B surface antigen (HBsAg)
31
1986
Hepatitis B core antibody (anti-HBc)
32
1990
Hepatitis C virus antibody (anti-HCV)
33
1992 1
Human immunodeficiency virus antibodies (anti- HIV-1/2)
34
1997 2
Human T cell lymphotropic virus antibody (anti-HTLV-I/II)
35
1999
Human immunodeficiency virus (HIV-1) (NAT) ** - Initially under IND
Hepatitis C Virus (HCV) (NAT) ** - Initially under IND
36
2004
West Nile Virus (NAT)
37
2007
Trypanosoma cruzi antibody (anti-T. cruzi)
38
2009
Hepatitis B virus (HBV) NAT
39
2012
Babesia microti antibody and NAT (recommended)
40
2016
Zika virus NAT
41
Three areas of RBC biology are crucial for normal erythrocyte survival function:
1. Normal chemical composition and structure of the RBC membrane
2. Hemoglobin structure and function
3. RBC metabolism
42
- main lipid component of the membrane
Phospholipids
43
arranged in a bilayer structure comprising the framework in which globular proteins traverse and move.
Phospholipids
44
The biochemical composition of the RBC membrane is approximately
52% protein, 40% lipid, and 8% carbohydrate.
45
: The loss of RBC membrane is exemplified by the formation of spherocytes and bite cells.
Deformability
46
: The RBC membrane is freely permeable to water and anions.
Permeability
47
The RBC membrane is relatively impermeable to cations such as
sodium and potassium
48
The erythrocyte intracellular-to- extracellular ratios for Na+ and K+ are (?), respectively
1:12 and 25:1
49
Goal of Blood preservation
To provide (?) for patients requiring blood transfusion.
viable and functional blood components
50
To maintain optimum viability, blood is stored in the liquid state between (?) for a specific number of days, as determined by the preservative solution(s) used.
1oC and 6oC
51
The loss of RBC viability has been correlated with the (?) which is associated with various biochemical changes.
“lesion of storage”
52
% Viable Cells
Decreased
53
Glucose
Decreased
54
ATP
Decreased
55
Lactic Acid
Increased
56
pH
Decreased
57
2,3-DPG
Decreased
58
Oxygen Dissociation Curve
Shift to the Left
59
Plasma K+
Increased
60
Plasma hemoglobin
Increased
61
Adenine supplemented blood can be stored at (?)
1 to 6 degrees Celsius for 35 days
62
other anticoagulants are approved for
21 days
63
Chemicals in Anticoagulant solutions:
1. Citrate
2. Monobasic sodium phosphate
3. Dextrose
4. Adenine
64
- chelates calcium
1. Citrate prevents clotting
65
prevents clotting
1. Citrate
66
- maintains pH during storage
2. Monobasic sodium phosphate
67
- Substrate for ATP production
3. Dextrose
68
- Production of ATP
4. Adenine
69
ACD-A
Acid Citrate-Dextrose (formula A)
70
21 DAYS STORAGE TIME
ACD-A
CPD
CP2D
71
35 DAYS STORAGE TIME
CPDA-1
72
is used for apheresis components
Acid Citrate-Dextrose (formula A)
73
CPD
Citrate-phosphate dextrose
74
CP2D
Citrate-phosphate-double dextrose
75
CPDA-1
Citrate-phosphate-dextrose-adenine
76
Preserving solutions that are added to the RBCs after removal of the plasma with or without platelets.
ADDITIVE SOLUTIONS
77
reduce hematocrits from around 70% to 85% to around 50% to 60%.
ADDITIVE SOLUTIONS
78
The additive solution is contained in a (?) and is added to the RBCs after most of the plasma has been expressed.
satellite bag
79
Benefits of RBC Additive Solutions:
1. Extends the shelf-life of RBCs to (?) by adding nutrients
2. Allows for the harvesting of more (?) from the unit
3. Produces an RBC concentrate of (?) that is easier to infuse
42 days
plasma and platelets
lower viscosity
80
42 DAYS STORAGE TIME
AS-1
AS-3
AS-5
AS-7
81
AS-1
Adsol (Fenwal Inc.)
82
AS-3
Nutricel (Haemonetics Corporation)
83
AS-5
Optisol (Terumo Corporation)
84
AS-7
SOLX (Haemonetics)
85
Used for autologous units and storage of rare blood types.
RBC FREEZING
86
It involves the addition of a cryoprotective agent to RBCs that are less than 6 days old
RBC FREEZING
87
Currently, the FDA licenses frozen RBCs for a period of (?) from the date of freezing
10 years
88
frozen RBCs may be stored up to (?) before thawing and transfusion.
10 years
89
is used most commonly and is added to the RBCs slowly with vigorous shaking, thereby enabling the it to permeate the RBCs.
Glycerol
90
The cells are then rapidly frozen and stored in a
freezer
91
The usual storage temperature is below (?)
–65°C
92
depends on the concentration of glycerol used.
storage (and freezing) temperature
93
HIGH GLYCEROL
Initial freezing temperature
-80oC
94
LOW GLYCEROL
Initial freezing temperature
-196oC
95
HIGH GLYCEROL
Need to control freezing rate
No
96
LOW GLYCEROL
Need to control freezing rate
Yes
97
HIGH GLYCEROL
Type of freezer
Mechanical
98
LOW GLYCEROL
Type of freezer
Liquid nitrogen
99
HIGH GLYCEROL
Maximum storage temperature
-65oC
100
LOW GLYCEROL
Maximum storage temperature
-120oC
101
HIGH GLYCEROL
Shipping requirements
Dry ice
102
LOW GLYCEROL
Shipping requirements
Liquid nitrogen
103
HIGH GLYCEROL
Effects of changes in storage temperature
Can be thawed and refrozen
104
LOW GLYCEROL
Effects of changes in storage temperature
Critical
105
Advantages of RBC Freezing
Long-term storage
Maintenance of RBC viability and function
Low residual leukocytes and platelets
Removal of significant amounts of plasma proteins
106
Disadvantages of RBC Freezing
A time-consuming process
Higher cost of equipment and materials
Storage requirements
Higher cost of the product
107
Research and development in RBC preparation and preservation is being pursued in 5 areas:
1. Development of improved (?)
2. Development of procedures to reduce and inactivate the level of pathogens that may be in (?)
3. Development of procedures to convert A, B, and AB type RBCs to (?)
4. Development of methods to produce RBCs through (?)
5. Development of (?)
additive solutions
RBC units
O type RBCs
bioengineering (blood pharming)
RBC substitutes
108
are involved in the blood coagulation process
Platelets
109
are given to treat or prevent bleeding.
Platelets
110
They are given either therapeutically to stop bleeding or prophylactically to prevent bleeding.
Platelets
111
Platelets are intimately involved in
primary hemostasis
112
which is the interaction of platelets and the vascular endothelium in halting and preventing bleeding following vascular injury.
primary hemostasis
113
The role of platelets in hemostasis includes
1. initial arrest of bleeding by (?)
2. stabilization of the hemostatic plug by contributing to the process of (?)
3. maintenance of (?)
platelet plug formation
fibrin formation
vascular integrity
114
Platelets are stored at (?) with maintaining continuous gentle agitation throughout the storage period of (?)
20°C to 24°C
5 days
115
The loss of platelet quality during storage is known as the
platelet storage lesion.
116
Lactate
Increased
117
pH
Decreased
118
ATP
Decreased
119
Morphology scores change from discoid to spherical (loss of swirling effect
Decreased
120
Degranulation (β-thromboglobulin, platelet factor 4)
Increased
121
Platelet activation markers (P-selectin [CD62P] or CD63)
Increased
122
Platelet aggregation
Drop in responses to some agonists
