Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MS2 Unit2 > Tranfusion Lectures - Sheet2 > Flashcards

Tranfusion Lectures - Sheet2 Flashcards

(79 cards)

Start Studying
1
Q

Mixing pt RBCs w. anti A/B/D(Rh) is what type of basic testing

A

Froward Testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mixing pt plasma w. A and B RBCs is what type of basic testing

A

Reverse testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mixing pt plasma w. screening O cells s what type of basic testing

A

Antibody Screen for non ABO Abs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What blood type is the universal donor for RBC? for Plasma?

A
  • O;

- AB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

tranfusions reactions present what sx (4)? and result in?

A
  • fever, chills, SIRS, flank pin

- kidney damage, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hemolytic dz in fetus and newborns results in (4)

A

hemolysis
anemia
hyrdops fatalis
death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

whole blood can be fractionated via pharesis into what volumes of RBCs, plasma, and plt

A

350 mL RBC
200 mL plasma
350 mL plt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

RBC admin is pt specific, and given primarily to____

A

↑ O2 carrying capacity (correct anemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

5 factors affecting target Hgb?

A
  1. PMH of cardiac dz/stoke
  2. chronic anemia (leukema, chemo, renal failure, ∆Hb)
  3. Active bleeding/coagulopathy
  4. Cardiac hypoxia (angina)
  5. Neural hypoxia (SYncope/TIA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A problem of stored blood is ____

A

hyperviscocsity (↓ pliability + tissue perfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

plts undergo a conformation change in GPIIb-IIIA to bind to

A

fibrinogen (–> plt crossbridging)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

after activation, content release from ____ in plts –> cytoskeletal changes

A

𝛂 granules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are plt’s stored?

A

5 days at RT with gentle agitation (afterward ↑ microbial growth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If plt are cold they are considered

A

activated (cold = activated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are RBCs stored?

A

21-42 days at 4C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

plt cut off to avoid spontanous bleeding

A

6K (10K is prophylactic std)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the transfusion guidlines for prophx; active bleeding/surgical hemostasis; neurosurgery?

A

prophx <10K
active bleeding/surgical hemostasis <50K
neurosurgery <100K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ITP, TTP, HIT, HUS (hemolytic uremic syndrome), bleeding due to coagulopahty, and prophylactic transfusion without bleeding are common mistakes made with what blood component?

A

plt (plt transfusion increases risk for thrombosis)

TTP + HIT = contraindication (Hypercoag states w/ plt consumption + risk for stroke)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when should you replace coag or anticoag factors? (2)

A

when pt is bleeding or at risk for bleeding (invasive procedure)

PT > 20
INR > 1.8
PTT > 44

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

should you give plasma if: prophx tx of severe liver dz

A

if no bleeding, no!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

should you give plasma if: nurittional support or oncotic/fluid support

A

no!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

should you give plasma if: heparin reversal

A

no, give protamine sulfate!!! (heparin potenztions ATIII –> ↑ PTT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

should you give plasma if: single factor defc’s

A

no!; factor concentrates available for PCC, rVIIa, VIII, IX, vWF, ATIII, C1inh (=hereditary angiodema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cryoppt (7-15 mL/U) usually containts ___ firbrinogen and ____ of FVIII; how much should be given to adults?

A

250 mg fibrinogen
80-120 U FVIII (+ vWF + FXIII)
5-10 pooled units for adults (prepooled cropppt = 5 U)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
For Hypofibrinogenemia (<100 mg/dL) or dysfribrinogenemia (asympto) what do you give?
Cryoppt (less common for vWF dz or VIII defc)
26
Warfarin blocks the enzyme ____
vit K reductase (-/-> vitK regeneration to carboxylate 2,7,9,10 C and S)
27
What 3 types of inactive factor concentrates are there ?
1. Prothrombin complex conc (Kcentra, Profilnine, 2-7-9-10-C+S) 2. Single factor concentrate (FVIII) 3. vWF (w/ø FVIII)
28
Profilnine is composed of what 3 factors
2-9-10
29
K centra has how many factors?
4 factors in Kcentra
30
Factor VIII defc (ø synth) is also known as ____ and is mild, sever, and critical at what percentages of FVIII expression?
Hemophilia A (A-ght) asympto > 30% expression mild = 5-30% severe = 1-5% Critical <1%
31
What 2 types of active factor concentrates are there ?
Coagulation factors Novo7 (FVIIa) + FEIBA (Factor 8 Inh Bypassing Activity)
32
What is FEIBA? how does it work
non active 2-9-10 + active F7 --> coagulation via extrinsic + common pathways
33
whats the major risk of FEIBA
thrombotic potential! (use for critical bleeding)
34
who is FEIBA best for?
designed for pts with anti F8 Abs
35
after a procedure, pt presents w/Fever, chills, rigors, impending sense of doom. Exam shows flank pain and SIR. Tests show ↑ free Hb (serum and urine) and kidney tubule damage; ↓haptoglobin, ↑LDH + bili; ⊕DAT(direct combs). CBC shows poor ↑Hgb/Hct. Dx? Tx?
Hemolytic Transfusion Rxn (↑hb + ↓haptoglobin + ↑LDH/bili = RBC damage) Tw hydration (flush kidneys) + supportive care (most likely clerical error)
36
in Hemolytic Transfusion Rxn, ↑ free Hb binds with _____ which forms methemoglobin --> cytokine release (IL8 IL6) --> fever chills, SIRS. Decrease in this compound also leads to what phenomenon?
NO (nitric oxide); ↓NO --> hypercoagulability (+ ↑vasc tone)
37
Acute HTR sx onset is due to ____ vs a delayed HTR onset due to _____
high Ab titer (acute); | low Ab titer (delayed)
38
Plasma transfused with cytokines (IL1, IL6, TNF𝛂), which causes a hypothalamic response in the pt (shivering, VasoC, fever). What is the Dx? Tx?
Febrile non-hemolytic transfusion (ø free Hb) Tw with antipyretics/tylenol (± self-limited)
39
Pt with PMH of CHF, COPD is in for another infusion; after procedure exhibits profuse pulmonary edema after a spike in BP (volume overload). The infusion seemed to have lead to ↑ BNP (atrial pressure) and cardiac failure. Dx ?
TACO (Transfusion-assc circulatory overoad; tw LASIX = diuretics + hydration) run transfusions slower in the future
40
After a procedure, pt presents with acute + severe hypoxia, shortness of breath reactive htn, and a sudden drop in BP. CXR shows diffuse consolidation (white out). The medical team intubates to avoid death and AVOIDS plasma rich units! Dx?
TRALI (Transfusion-related acute lung injury; ↓BP dt hypovolemia; diuretics would worsen)
41
Tranfusion of room tempt plt results in ↑temp (fever) and dramatic tachycardia (HR > 120)
Bacterial Contamination (looks like SIRS/sepsis) | 4C RBCs = cold growing bact,Yersinia enterocolotica
42
This transfusion reaction can result in hives (trunk and head involvment) or anaphylactice shock + organ dysfunction. Tx?
Allergic Transfusion rxn Tw supportive care, Benadryl, corticosteroids
43
How should you tx a pt with IgA defc or a pt with repeated allergic rxns?
- give IgA⊖ blood products (most common immunodefc) | - premedicate w. Benedryl
44
2 causes of allergic transfusion rxn
1. rcp IgE Ab recognize allergen --> amst cells release histamine 2. Donor histamine --> vasoD + vasc permb in rcp endoth cells
45
Post transfusion purpura results bc of Abs mouned against _____ on donor plt
HPA-1a (aka PLA-1 or CD61) Ab response --> immune destruction of donor AND pt plts
46
After a procedure, pt has very low plt count, and diffuse purpura and some eccymoses on skin. to avoid bleeding thiasis how should you treat the pt? (2)
IVIG or plasmapharesis
47
HPA-1a is an antigentc site on ____
GPIIIa rcp on plt
48
anti HPA-1a Abs cross the placenta and causes
neonatal alloimmune thrombocytopenia
49
Pt presents with severe chest hip and lower back pain shortly after a procedure. The pain stopped shortly after transfusion; and the pt was given supportive care? Dx?
Pain Tranfusion (unknown mechanism, comes and goes within an hour)
50
vWF forms multimers (plt aggregation/binding/F8 stabzn) and is cut by _____ into smaller, functional multimers
ADAMTS13 (results in TTP)
51
Explain the mechanism for ADAMTS13 defc TTP
Anti-ADAMTS13 Ab/congenital defect --> ↓ ADAMTS13 --> HMW vWF multimers + wide spread thromboses --> (thrombocytopenia) plt consumption + RBC destruction + deformation (shistocytes)
52
The process of removing blood, centrifuging components --> removing selected components --> and returnign blood to the pt via continue cycle (1.5-4 hrs)
Apharesis (= take away; sequential depletion ) maximum removal of bad factor with min SEs (series of 5 works best)
53
For what condition is Apharesis not ideal
Guillon Barre (treat underlying sx)
54
Anticoag that binds ATIII and potientiates its activiey on X and II
heparin (HIGH bleeding risk)
55
Anticoag that chelates ionized Ca (= required for 8-9a and 10-5a activity)
Citrate
56
benefit of citrate as an anticoag
spontaneous reversal
57
con of citrate as an anticoag (2)
1. hypocalcemia (∆membrane potential --> parasthesia/twiching/cardiac defects/GI) 2. metabolic alkalosis (contra for kidney failure)
58
toa void thick (jello) consistency blood use
plasma exchange with door plasma
59
the intent of TTP treatment
removal of HMW vWF, anti ADAMTS13 Ab; replace w/ functional ADAMTS13 ↓chance of clotting, hemolysis, ↑plt count
60
ET usually usually has what mutations?
JAK2, CALR, MRL otw isolated high plt (>400K) = reactive thromocytosis or p/splenectomy
61
Differential of high Hb (3)
1. 2˚ plycythemia (COPD, CO poisoning form smoking, ∆Hb) 2. P.vera (∆Jak2 or BFU form (ø EPO) 3. p/splenectomy
62
CML mutations are ____ (2)
acquired + somatic (not germline)
63
Myeloproliferative disorders can lead to _____ (2)
Acute leukemia or marrow failure (↑ plt--> myelofibrosis = reactive endpt)
64
Post hot shower pruritis?
p.vera
65
painful red hands or feet with normal pulses
erythromelaliga (ET dt ↑ plt count)
66
Carefully palpate for spleen in _____ position if suspecting MPN
right lateral decubitis
67
This drug provides folate rescue when fiven with methotrexate
Leucovorin
68
Methotrexate inhibits what enzyme
DHFR (dihydrofolate reductase)
69
GEfitinib, CEtuximab and ERlotinib both do what?
inhibit EGFR tyrosine kinase (EGFR+ cancer)
70
Imatinib and Nilotinib both inh ___?
ABL kinase (tx CML)
71
Bevacizumab is a monoclonal Ab against ___?
VEGF
72
This drug inh Ribonucletoide reductase (key enzyme for DNA precursors)
Hydroxyurea (hydRRRoxyurea)
73
give ____ with ATRA to abate leukocyte activation syndrome (30% of cases)
Prednisone (corticosteroids for immunosuppression)
74
↑glutathione production may cause resistance to what class of cancer drugs?
alkylators
75
VemuRAFenib and DabRAFenin are both known to inhibit
BRAF+ cancers
76
Ipilimumab is a known ___ inh
CTLA4 inh
77
Trametinib is a ____ inh
MEK inh
78
A known side effect of Vemurafenib is
QT interval prolongation (ventricular arrythmia [fatal]; contraindicated in long QT syndrome, electrolyte abnormalities, and other QT prolongation drugs)
79
Temozolomide and methotrexate are not prodrugs that require enzymatic conversion (T/F)
true

MS2 Unit2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions