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[Immunohematology] Lec > LESSON 2: HISTORICAL PERSPECTIVE AND OVERVIEW > Flashcards

LESSON 2: HISTORICAL PERSPECTIVE AND OVERVIEW Flashcards

1
Q

First time a blood transfusion was recorded in history.

A

Pope Innocent VII

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2
Q

Sodium phosphate

A

Braxton Hicks

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3
Q

ABO blood groups

A

Karl Landsteiner

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4
Q

Vein to vein transfusion

A

Edward E. Lindemann

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5
Q

Syringe-valve apparatus Sodium citrate

A

Unger

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6
Q

Sodium citrate

A

Hustin

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7
Q

Minimum amount of citrate needed for anticoagulation

A

Lewisohn

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8
Q

Citrate dextrose solution

A

Rous and Turner

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9
Q

Techniques in blood transfusion and blood preservation

A

Dr. Charles Drew

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10
Q

Introduced the formula for the preservative acid-citrate-dextrose

A

Loutit and Mollison

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11
Q

Introduced citrate-phosphate-dextrose

A

Gibson

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12
Q

The amount of whole blood in a unit has been

A

450 mL +/- 10% of blood

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13
Q

For a 110 lb donor, a maximum of (?) can be collected

A

525 mL

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14
Q

Total blood volume for most adults:

A

10 to 12 pints

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15
Q

Donors can replenish the fluid lost from the donation of

A

1 pint in 24 hours.

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16
Q

The donor’s red cells are replaced within (?) after donation.

A

1 to 2 months

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17
Q

A volunteer donor can donate blood every

A

8 weeks.

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18
Q

Units of the whole blood can be separated into three components:

A

Packed red blood cells, platelets, and plasma

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19
Q

The plasma can be converted by cryoprecipitation to a clotting factor concentrate that is rich in

A

antihemophilic factor.

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20
Q

A unit of whole blood-prepared RBCs may be stored for (?), depending on the anticoagulant-preservative solution.

A

21 to 42 days

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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

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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

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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)

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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

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25
Q

(?) 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.

A

Step 1: Educational Materials

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26
Q

designed to ask questions that protect the health of both the donor and the recipient, is given to every donor.

A

Step 2: The Donor Health History Questionnaire

uniform donor history questionnaire,

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27
Q

is used to identify donors who have been exposed to diseases that can be transmitted in blood.

A

Step 2: The Donor Health History Questionnaire

Health History Questionnaire

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28
Q

(?) for donors includes blood pressure, pulse, and temperature readings; hemoglobin or hematocrit level; and the inspection of the arms for skin lesions.

A

Step 3: The Abbreviated Physical Examination

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29
Q

1950’s

A

Syphilis

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30
Q

1971

A

Hepatitis B surface antigen (HBsAg)

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31
Q

1986

A

Hepatitis B core antibody (anti-HBc)

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32
Q

1990

A

Hepatitis C virus antibody (anti-HCV)

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33
Q

1992 1

A

Human immunodeficiency virus antibodies (anti- HIV-1/2)

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34
Q

1997 2

A

Human T cell lymphotropic virus antibody (anti-HTLV-I/II)

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35
Q

1999

A

Human immunodeficiency virus (HIV-1) (NAT) ** - Initially under IND

Hepatitis C Virus (HCV) (NAT) ** - Initially under IND

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36
Q

2004

A

West Nile Virus (NAT)

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37
Q

2007

A

Trypanosoma cruzi antibody (anti-T. cruzi)

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38
Q

2009

A

Hepatitis B virus (HBV) NAT

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39
Q

2012

A

Babesia microti antibody and NAT (recommended)

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40
Q

2016

A

Zika virus NAT

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41
Q

Three areas of RBC biology are crucial for normal erythrocyte survival function:

A
  1. Normal chemical composition and structure of the RBC membrane
  2. Hemoglobin structure and function
  3. RBC metabolism
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42
Q
  • main lipid component of the membrane
A

Phospholipids

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43
Q

arranged in a bilayer structure comprising the framework in which globular proteins traverse and move.

A

Phospholipids

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44
Q

The biochemical composition of the RBC membrane is approximately

A

52% protein, 40% lipid, and 8% carbohydrate.

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45
Q

: The loss of RBC membrane is exemplified by the formation of spherocytes and bite cells.

A

Deformability

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46
Q

: The RBC membrane is freely permeable to water and anions.

A

Permeability

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47
Q

The RBC membrane is relatively impermeable to cations such as

A

sodium and potassium

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48
Q

The erythrocyte intracellular-to- extracellular ratios for Na+ and K+ are (?), respectively

A

1:12 and 25:1

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49
Q

Goal of Blood preservation

To provide (?) for patients requiring blood transfusion.

A

viable and functional blood components

50
Q

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.

A

1oC and 6oC

51
Q

The loss of RBC viability has been correlated with the (?) which is associated with various biochemical changes.

A

“lesion of storage”

52
Q

% Viable Cells

A

Decreased

53
Q

Glucose

A

Decreased

54
Q

ATP

A

Decreased

55
Q

Lactic Acid

A

Increased

56
Q

pH

A

Decreased

57
Q

2,3-DPG

A

Decreased

58
Q

Oxygen Dissociation Curve

A

Shift to the Left

59
Q

Plasma K+

A

Increased

60
Q

Plasma hemoglobin

A

Increased

61
Q

Adenine supplemented blood can be stored at (?)

A

1 to 6 degrees Celsius for 35 days

62
Q

other anticoagulants are approved for

A

21 days

63
Q

Chemicals in Anticoagulant solutions:

A
  1. Citrate
  2. Monobasic sodium phosphate
  3. Dextrose
  4. Adenine
64
Q
  • chelates calcium
A
  1. Citrate prevents clotting
65
Q

prevents clotting

A
  1. Citrate
66
Q
  • maintains pH during storage
A
  1. Monobasic sodium phosphate
67
Q
  • Substrate for ATP production
A
  1. Dextrose
68
Q
  • Production of ATP
A
  1. Adenine
69
Q

ACD-A

A

Acid Citrate-Dextrose (formula A)

70
Q

21 DAYS STORAGE TIME

A

ACD-A

CPD

CP2D

71
Q

35 DAYS STORAGE TIME

A

CPDA-1

72
Q

is used for apheresis components

A

Acid Citrate-Dextrose (formula A)

73
Q

CPD

A

Citrate-phosphate dextrose

74
Q

CP2D

A

Citrate-phosphate-double dextrose

75
Q

CPDA-1

A

Citrate-phosphate-dextrose-adenine

76
Q

Preserving solutions that are added to the RBCs after removal of the plasma with or without platelets.

A

ADDITIVE SOLUTIONS

77
Q

reduce hematocrits from around 70% to 85% to around 50% to 60%.

A

ADDITIVE SOLUTIONS

78
Q

The additive solution is contained in a (?) and is added to the RBCs after most of the plasma has been expressed.

A

satellite bag

79
Q

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
A

42 days

plasma and platelets

lower viscosity

80
Q

42 DAYS STORAGE TIME

A

AS-1

AS-3

AS-5

AS-7

81
Q

AS-1

A

Adsol (Fenwal Inc.)

82
Q

AS-3

A

Nutricel (Haemonetics Corporation)

83
Q

AS-5

A

Optisol (Terumo Corporation)

84
Q

AS-7

A

SOLX (Haemonetics)

85
Q

Used for autologous units and storage of rare blood types.

A

RBC FREEZING

86
Q

It involves the addition of a cryoprotective agent to RBCs that are less than 6 days old

A

RBC FREEZING

87
Q

Currently, the FDA licenses frozen RBCs for a period of (?) from the date of freezing

A

10 years

88
Q

frozen RBCs may be stored up to (?) before thawing and transfusion.

A

10 years

89
Q

is used most commonly and is added to the RBCs slowly with vigorous shaking, thereby enabling the it to permeate the RBCs.

A

Glycerol

90
Q

The cells are then rapidly frozen and stored in a

A

freezer

91
Q

The usual storage temperature is below (?)

A

–65°C

92
Q

depends on the concentration of glycerol used.

A

storage (and freezing) temperature

93
Q

HIGH GLYCEROL

Initial freezing temperature

A

-80oC

94
Q

LOW GLYCEROL

Initial freezing temperature

A

-196oC

95
Q

HIGH GLYCEROL

Need to control freezing rate

A

No

96
Q

LOW GLYCEROL

Need to control freezing rate

A

Yes

97
Q

HIGH GLYCEROL

Type of freezer

A

Mechanical

98
Q

LOW GLYCEROL

Type of freezer

A

Liquid nitrogen

99
Q

HIGH GLYCEROL

Maximum storage temperature

A

-65oC

100
Q

LOW GLYCEROL

Maximum storage temperature

A

-120oC

101
Q

HIGH GLYCEROL

Shipping requirements

A

Dry ice

102
Q

LOW GLYCEROL

Shipping requirements

A

Liquid nitrogen

103
Q

HIGH GLYCEROL

Effects of changes in storage temperature

A

Can be thawed and refrozen

104
Q

LOW GLYCEROL

Effects of changes in storage temperature

A

Critical

105
Q

Advantages of RBC Freezing

A

Long-term storage
Maintenance of RBC viability and function
Low residual leukocytes and platelets
Removal of significant amounts of plasma proteins

106
Q

Disadvantages of RBC Freezing

A

A time-consuming process
Higher cost of equipment and materials
Storage requirements
Higher cost of the product

107
Q

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 (?)

A

additive solutions

RBC units

O type RBCs

bioengineering (blood pharming)

RBC substitutes

108
Q

are involved in the blood coagulation process

A

Platelets

109
Q

are given to treat or prevent bleeding.

A

Platelets

110
Q

They are given either therapeutically to stop bleeding or prophylactically to prevent bleeding.

A

Platelets

111
Q

Platelets are intimately involved in

A

primary hemostasis

112
Q

which is the interaction of platelets and the vascular endothelium in halting and preventing bleeding following vascular injury.

A

primary hemostasis

113
Q

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 (?)

A

platelet plug formation

fibrin formation

vascular integrity

114
Q

Platelets are stored at (?) with maintaining continuous gentle agitation throughout the storage period of (?)

A

20°C to 24°C

5 days

115
Q

The loss of platelet quality during storage is known as the

A

platelet storage lesion.

116
Q

Lactate

A

Increased

117
Q

pH

A

Decreased

118
Q

ATP

A

Decreased

119
Q

Morphology scores change from discoid to spherical (loss of swirling effect

A

Decreased

120
Q

Degranulation (β-thromboglobulin, platelet factor 4)

A

Increased

121
Q

Platelet activation markers (P-selectin [CD62P] or CD63)

A

Increased

122
Q

Platelet aggregation

A

Drop in responses to some agonists

[Immunohematology] Lec (35 decks)

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