Module 1-Blood Components Flashcards
(114 cards)
1
Q
State the donation intervals for Whole Blood
A
Once every 56 days
2
Q
State the donation interval for Plateletpheresis
A
Every 7 days
3
Q
State the donation interval for Double Red Apheresis
A
112 days
4
Q
State the minimum age requirement to donate blood
A
16 years (w/ parental consent)
5
Q
What is the specific gravity of copper sulfate that corresponds to a hemoglobin concentrate of 12.5 g/dL
A
1.053
If hemoglobin is 12.5 or greater, blood drop should sink within 15 seconds
6
Q
Units requiring more than 15 minutes to draw many not be suitable for preparation of which components?
A
Platelets, FFP or Cryoprecpitated AHF
7
Q
What is considered a successful % of recovery for deglycerolized red blood cells stored in AS-1 or AS-3
A
> 80%
8
Q
What are three methods for determining that adequacy of glycerol removal from thawed red blood cells
A
- Hue check-comparing the color of the final wash with a color comparator
- Hand held refractometer-small amount of supernatant is transferred to a measuring prism and held against a light source; the refraction value should be less than 30 to ensure that the glycerol level is <1%.
- Osmolality-a small amount of supernatant is transferred to an osmometer curette; the value should not exceed 400mOsm/Kg H20 to ensure the glycerol level is <1%.
9
Q
Plasma separated from cellular blood elements must be frozen in what amount of time to preserve the activity of labeled coagulations factors and be labeled as FFP?
A
Within 8 hours
10
Q
FFP prepared from whole blood anticoagulated with ACD must be frozen at _____C within ____hours?
A
-18 C /6 hours
11
Q
FFP collected from units other than ACD must be collected and stored at ______ C within _____hours.
A
-18 C/8 hours
12
Q
Plasma frozen >8 hours of collection but within 24 hours must be labeled as ________
A
PF24
13
Q
Which coagulation factors are found in Cryoprecipitated AHF?
A
Fibrinogen, Factor VIII, Factor XIII, vWF and fibromectin
14
Q
How is Cryoprecipiataed AHF made?
A
FFP is thawed at 1-6 C must be refrozen within 1 hour
15
Q
Pooled Cryoprecipated AHF must contain a minimum of ________mg of fibrinogen and ______IU of Factor VIII X__________
A
150 mg of fibrinogen and 80 IU of Factor VIII x the number of components in the pool
16
Q
AABB Standards for Blood Banks and Transfusion Services required that sufficient plasma remain with the platelet concentrate to maintain the pH at ______ or higher for the entire storage period.
This pH level usually requires a minimum of 35 ml of plasma, but 50 to 70 ml is preferable.
A
6.2
17
Q
Which vaccines use live, attenuated virus?
A
Measles, mumps, Rubella, yellow fever and some influenza, smallpox
18
Q
What is the deferral period for a person who has received an allogeneic transfusion?
A
3 months
19
Q
What is the deferral period for smallpox?
A
8 weeks
20
Q
What is the deferral period for donating a double red (apheresis)?
A
112 days or 16 weeks
21
Q
What is the deferral period for someone who is incarcerated for >3 consecutive days?
A
12 months
22
Q
Residents of malaria-endemic countries are deferred for_______after departure from the country of residence
A
3 years
23
Q
Prior residents of malaria-endemic countries who live in non-endemic countries for more than 3 consecutive years without traveling to a malaria-endemic country, will then be deferred for _________ after subsequent travel to a malaria-endemic country.
A
3 months
24
Q
A person who is not a prior resident of a malaria-endemic country and travels to a malaria-endemic area is deferred for _______after departure from that area.
A
3 months
25
True or False
In the April 2020 Malaria Guidance from the FDA, it states you may collect platelet and/or plasma components from a donor who is a resident of a non-endemic country and who has traveled to or through a malaria endemic area without a deferral period, provided the blood component are pathogen reduced using an FDA approved pathogen reduction device effective against Plasmodium falciparum (and the donor meets all other eligibility criteria).
True
26
vCJD
A person who spent more than______in the UK between the years of _____ and ______ is deferred for how long?
3 months/1980-1996/indefinitely
27
What is the difference between the guidance for vCJD for UK and the April 2020 Guidance for France and Ireland?
The previous guidance include the UK and Northern Ireland, but not Ireland and France.
The time frame is 1980-2001.
If a person spent cumulative time adding up to 5 years or more. The UK guidance is 3 months or more.
The deferral is indefinite.
28
What is the deferral period for pregnancy?
A female that is pregnant now or has been pregnant in the past 6 weeks is deferred for the safety of the donor.
29
True or False
A person who has had malaria is deferred for three years after becoming asymptomatic while residing in a malaria-endemic country.
False; they are deferred for three years after becoming asymptomatic and living in a non-endemic country.
30
Give one example of a permanent deferral.
Donor received a human cadaver (allogeneic) dura mater transplant
[xenotransplantation is indefinitely]
Donor is on Tegison
Donor had or has Hepatitis B
Donor has a family member with vCJD
31
Babesia
A person who has had a positive test for Babesia is deferred_______
Indefinitely or at least 2 years from the date of the most recent reactive test result. In states where Babesia is not required, the donor is permitted only if testing is performed on the donation as a part of requalification (May 2019 Babesia Guidance)
32
What is the deferral period for a donor that has been treated for syphilis or gonorrhea?
3 month after completion of treatment
33
What is the deferral period for a donor that received the Hep B vaccine?
21 days (per ARC website?)
34
What are the indications for Washed Red Blood Cells
Prevent severe allergic reactions
For IgA deificient patients
For haptoglobin deficient patients
35
List three contraindication for platelet therapy
ITP (Idiopathic thrombocytopenia purpura)
DIC (Disseminated intravascular coagulation)
TTP (Thrombotic thrombocytopenia purpura)
HIT (Heparin induced thrombocytopenia)
36
What is the dosing for platelets?
I unit/10kg of body weight
1 pool is 4-6 units
I unit will raise account approx 5000/microliter
37
What is the volume of a platelet apheresis?
What is the concentration?
200-400 ml
3.0x10*11
38
What is the calculation for a corrected count increment (CCI)
(Plt increment) (BSA)/Plt transfused x 10*11; if no BSA given, assume 2m*2
Successful transfusion: CCI> or =7500
39
What is the usual dose of plasma? FFP PF24 or Thawed Plasma
10-20 mL/kg
40
What is the dosing for Cryoprecipitated AHF?
Each cryo increase fibrinogen by 5-20 mg/dL
-reasonable target=100 mg/dL
41
What is the concentration of granulocytes in a granulocyte apheresis?
What is the volume of granulocytes collected in an apheresis unit?
1.0 x 10*10
260-600 ml
42
What are the FDA recommendations for residual WBCs in a leukoreduced product?
< or = to 5.0 x 10*6 residual WBCs/product
43
What are 3 benefits of leukoreduction?
1. Decreased febrile non-hemolytic reactions
2. Reduced risk of CMV transmission
3. Reduced risk of HLA alloimmunization
44
What biochemical changes do RBCs go through during storage?
Plasma HgB increases
Plasma K+ increases
-pH decreases
-ATP viability decreases
-2,3-DPG function decreases
45
What are the acceptable pulse for donor selection?
50-100 bpm
46
What is the acceptable body temperature for donation
< or = 37.5 C or 99.5 F
47
What is the donation frequency for whole blood?
Once every 56 days
48
What is the shelf life of CPD and CP2D red blood cells?
21 days
49
What is the shelf life of CPDA-1 red blood cells?
35 days
50
What is the shelf life of CPD or CP2D red cells to which additive solutions (AS-1 or AS-3) have been added?
42 days
51
What are the indications for CPDA-1 units?
CPDA-1 units are used for collecting pediatric patients
Additional adenine increase shelf life without adding mannitol which cannot be tolerated by infants and children
52
What is the dose for irradiating a cellular component?
At least 25 Gy in the center of the unit, but no more than 50 Gy; all areas must receive at least 15 Gy
53
True or False
All donors must undergo NAT testing for Zika virus in the U.S.
False as of 2021, Zika virus is no longer considered a relevant TTI.
54
What is the estimated risk of Hepatitis B?
1:843, 000-1:1.2 million
55
What is the risk of Hepatitis C in blood donation?
1:1.1 million
56
What is the risk of HIV?
1:1.5 million
57
What is the estimated risk of HCV transmission by transfusion?
1 in 1.1 million
58
When should FFP be frozen after manufacturing?
Store the plasma at –18 C or colder within 8 hours of phlebotomy; within 6 hours of phlebotomy if anticoagulated with ACD; or as specified by the applicable regulatory authority.
59
What are the storage requirements for thawed cryo?
Thawed Cryoprecipitated AHF prepared for transfusion must be stored at room temperature. If pooled for immediate transfusion, it must be administered within 4 hours. Thawed single units, if not entered, must be administered within 6 hours of thawing if intended for replacement of Factor VIII. Pools of thawed individual units may not be refrozen.
60
What is the intended minimum dose of irradiation for the central portion of the blood container?
The intended dose of irradiation shall be a minimum of 25 Gy (2500 cGy) delivered to the central portion of the container. The minimum dose at any point in the components shall be 15 Gy (1500 cGy).
61
Deferral for live attenuated vaccines for measles, Mumps, Polio, Typhoid or Yellow Fever
2 weeks
62
Receipt of live attenuated viral and bacterial vaccines [German measles (rubella), chicken pox/shingles (varicella zoster)]
4 weeks
63
SARS – CoV-2
-Individuals who received a nonreplicating, inactivated, or mRNA-based vaccine
-Individuals who received a live-attenuated viral COVID- 19 vaccine
-Individuals who are uncertain about which COVID-19 vaccine was administered
2 weeks
64
Deferral
• Reactive test for Babesia spp.
2 years
65
Deferral
Confirmed positive test for HBsAg4
Permanent
66
Deferral
Repeatedly reactive test for anti-HBc on more than one occasion or Positive HBV NAT result
Indefinite
67
Deferral
Present or past clinical or laboratory evidence of infection with HIV, HCV,8 HTLV, or T. cruzi 9
Indefinite
68
Deferral
Incarceration in a correctional institution (including juvenile detention, lockup, jail, or prison) for 72 or more consecutive hours
12 months
69
Deferral
Syphilis or gonorrhea
- Following the diagnosis of syphilis or gonorrhea; must have completed treatment
3 months
70
Deferral
Donor who has a reactive screening test for syphilis
Indefinite
Reentry is possible
71
Leukocyte Reduction expected yields
Leukocyte-reduced blood and blood components shall be prepared by a method known to reduce the leukocyte number to <5 × 10*6 for Red Blood Cells and Apheresis or Pooled Platelets
and to <8.3 × 10*5 for whole-blood-derived Platelets. Validation and quality control shall demonstrate that >95% of units sampled meet this criterion.
72
Labeling requirements for pooled components
For pooled components, the preparing facility shall maintain records of the ABO/Rh, donation identification number, and collecting facility for each unit in the pool.
Standards 5.1.6.5.1, 5.1.6.5.2, and Reference Standard 5.1.6A, Requirements for Labeling Blood and Blood Components, apply.
73
What are low volume red blood cells?
When 300 to 404 mL of whole blood is collected into an anticoagulant volume calculated for 450 ± 45 mL
or
when 333 to 449 mL of whole blood is collected into an anticoagulant volume calculated for 500 ± 50 mL, red cells prepared from the resulting unit shall be labeled Red Blood Cells Low Volume. No other components shall be made from a low- volume collection.
74
Apheresis Red Blood Cells weight/volume requirements?
Apheresis Red Blood Cells shall be prepared by a method known to ensure a mean collection of greater than equal to 60 g of hemoglobin (or 180 mL red cell volume) per unit.
At least 95% of the units sampled shall have >50 g of hemoglobin (or 150 mL red cell volume) per unit. Validation and quality control shall demonstrate that these criteria or the criteria specified in the operator’s manual are met
75
Apheresis Red Blood Cells Leukocytes Reduced hemoglobin/volume requirements?
Apheresis Red Blood Cells Leukocytes Reduced shall be prepared by a method known to ensure a final component containing a mean hemoglobin of greater than or equal to 51g (or 153 mL cell volume).
The sampling plan shall confirm with 95% confidence that more than 95% of units contain <5 × 10*6 leukocytes.
At least 95% of units sampled shall have >42.5 g of hemoglobin (or 128 mL red cell volume).
76
Cryoprecipitated AHF fibrinogen/factor VIII requirements?
Cryoprecipitated AHF shall be prepared by a method known to separate the cold insoluble portion from Fresh Frozen Plasma and result in an average content of at least 150 mg of fibrinogen and 80 IU of coagulation Factor VIII per container or unit.
In tests performed on prestorage pooled components, the pool shall contain at least 150 mg of fibrinogen and 80 IU of coagulation Factor VIII per component in the pool.*
77
QC requirements: Platelets prepared from Whole Blood
Validation and quality control of Platelets prepared from Whole Blood shall demonstrate that at least 90% of units sampled contain greater than or equal to 5.5 × 10*10 platelets and have a pH greater than or equal to 6.2 at the end of allowable storage. FDA criteria apply.*
78
Apheresis Platelets
QC criteria
Validation and quality control of Apheresis Platelets shall demonstrate with 95% confidence that greater than 75% of units contain greater than or equal to 3.0 × 1011 platelets and shall demonstrate with 95% confidence that greater than 95% of units have a pH greater than or equal to 6.2 at the time of issue or within 12 hours after expiration. FDA criteria apply.*
79
Apheresis Granulocytes
Unless prepared for neonates, Apheresis Granulocytes shall be prepared by a method known to yield a minimum of 1.0 × 1010 granulocytes in at least 75% of the units tested. Product requirements for neonates shall be defined by the medical director.
80
Red Cell Antigen Testing Other than ABO—HISTORICAL TYPING
Units may be labeled as antigen negative, without testing the current donation, if units from two previous separate donations were tested by the collection facility and found to be concordant.
81
PF24
Labile Factors V, VIII/Protein C may be reduced (over FFP)
ADAMTS 13, Fibrinogen II, VII, IX, X, XI levels similar to FFP
82
Fresh Frozen Plasma (FFP)
Contains all plasma proteins
Normal levels of label factors V and VIII
83
PF24RT24
Not indicated for treatment of deficiencies of labile coagulation factors including: V, VIII and Protein S
84
Cryoprecipitated AHF
Fibrinogen, Factor VIII, XIII, vWF
85
What blood products are priority labeled?
CPDA-1
LTOWB
Platelets
All labeled Day 1
Non-priority labeling occurs on Day 3
86
What is the order and concentration of saline used for deglycerolization of frozen red blood cells?
12%
1.6%
0.9%
87
What is the dosing for neonatal RBC transfusion?
1–15mL/kg in additive solution with a hematocrit of 60% will increase Hgb by 3 g/dL
88
What is the formula for the CCI?
CCI=CI (body surface area in m2)/number of platelets transfused X10*11
CI=postransfusion count minus pre-transfusion platelet count
89
What is the CCI for a person with a BSA of 1.8m2 and CI of 15,000/microliters who was transfused 3x10*11 platelets?
9000
Goal>7500 10-60 minutes reflects 20-30% platelet recovery
90
FDA requires the average 24-hour post-transfusion RBC survival be at least _____%.
75%
91
What is the deferral period for a donor who has received a live attenuated vaccine for rubella (German measles)?
4 weeks
92
A patient who recently stopped taking clopidogril (Plavix) needs to donate platelets. How long must the patient defer donation after completing the medication?
14 days
93
What is the donation interval for frequent plasmapheresis?
Every 2 days; no more than twice in a week
94
What are the blood pressure requirements for donation?
90-180 mm Hg systolic; 50-100 mm Hg diastolic
95
What is the pulse requirement for donation?
50-100 beats/min (bpm)
96
What are the hemoglobin/hematocrit requirements for women?
> or = 12.5 g/dL & > or = 38%
97
What are the hemoglobin/hematocrit requirements for men?
> or = 13.0 g/dL
> or = 39%
98
What is the deferral for measles, mumps, polio, typhoid and yellow fever vaccination?
2 weeks
99
What is the maximum whole blood collection volume per kg of body weight?
10.5 mL/Kg
100
What are the whole blood collection volumes in two different bag sizes?
1. 400 +/- 45 mL
2. 500 +/- 50 mL
101
True or False: The replenishment of 2,3-DPG in children younger than 4 months is less efficient and one of the reasons red cell components for transfusion are usually <5-7 a days old
True
102
Pathogen reduction technologies inactive white cells and the risk of ____________, negating the need for irradiation.
TA-GVHD
103
Treatment of plasma product and platelets with _______+_______is currently FDA approved for pathogen reduction.
amotosalen (psoralen) + UV light phototherapy
104
What is the maximum time without agitation allowed for platelets?
30 hours during transport
105
What is the expiration date of irradiated products?
28 days from the date of irradiation or the original expiration date, whichever is sooner
106
What is the dosing for pooled platelets?
One platelet increases the count by 5000/microliter (5x10*9/L) for a 70kg adult (155 pounds); multiple 5000 x number of units in the pool.
107
What is the dosing for apheresis platelets?
Increase the count in a 70Kg adult (155 lbs) by 30,000-50,000/microliter
108
What is the dosing for cryoprecipitate AHF?
Each unit will increase fibrinogen by 5-10 mg/dL in an average sized adult
109
RBC without additive solution shall have a final hematocrit of ________
80%
110
Additives to extend storage of rbcs must be added within________hours.
72 hours
111
Red blood Cells Leukocyte Reduced must contain at least _______ of the original red cells and contain less than________residual leukocytes per unit.
85%
5 x 10*6
112
List three criteria required to diagnose TRALI
1. Acute onset within 1-6 hours of completing transfusion
2. Bilateral infiltrates on frontal chest x-ray
3. Hypoxemia
113
Approximately how many grams of iron in a unit of blood?
250 mg. (Primarily in the form of hemoglobin)
114
What is the average level of fibrinogen in a single unit of cryoprecipitate? What is the minimum level?
250 mg/unit; minimum-150 mg/single unit
10 units=approx 2500 mg=2.5 g
