trans med Flashcards
(107 cards)
1
Q
TRANSFUSION MEDICINE IS used primarily to treat two conditions:
A
inadequate oxygen-carrying capacity
because of anemia or blood loss and
insufficient coagulation proteins or platelets to
provide adequate hemostasis.
2
Q
Done to prevent circulatory overload and
adverse reaction
A
COMPONENT THERAPY
3
Q
RBC CONTAINING
A
● Whole blood
● Packed RBC
● Leukocyte reduced rbc
● Washed rbc
● Deglycerolized RBC
4
Q
Contains all blood plasma and cellular
elements
A
WHOLE BLOOD
5
Q
Increases RBC and plasma volume
A
WHOLE BLOOD
6
Q
DO NOT GIVE to patients with severe
chronic anemia
A
WHOLE BLOOD
7
Q
RBC with no plasma
A
PACKED RBC (PRBC)
8
Q
GIVEN to patients who needs increased o2
carrying capacity
A
PACKED RBC (PRBC)
8
Q
prbc is given to individuals with
○ Increased Respiratory rate
○ Increased Pulse rate
A
○ Increased Respiratory rate >30/min
○ Increased Pulse rate >100/min
9
Q
how is plasma separated in PRBC
A
via centrifugation and sedimentation
10
Q
transfure prbc
disease state -
healthy
A
Low hgb
■ Disease state = 8g/dl
■ Intact compensatory
mechanism = 6g/dl
11
Q
to prevent
○ viral infection
○ conditions triggered by leukocytes and
cytokines
A
LEUKOCYTE REDUCED RBC
12
Q
average unit of leukocyte-reduced
RBCs contains
A
less than 5 × 10^6
leukocytes
13
Q
how much leukocyte toprevents febrile
non-hemolytic reactions
A
○ 5 x 10^8
14
Q
leukocytes are inactivated by
A
irradiation or
removed via leukocyte depletion filters
15
Q
PRBCs washed with isotonic saline solution
to remove all traces of plasma
A
WASHED RBC
16
Q
Prevents allergic response due to plasma
proteins due to washing process
A
WASHED RBC
17
Q
Also indicated for patients with Anti-IgA due
to IgA deficiency
A
WASHED RBC
18
Q
TRANSFUSE IF
Acute blood loss of
A
< 15% of estimated blood
volume
19
Q
To get blood volume,
A
weight times
70
○ 70 is the average blood factor
20
Q
TRANSFUSE IF Preoperative Hb ?? g/dL with expected blood loss OF mL
A
Preoperative Hb < 9.0 g/dL with expected
blood loss > 500 mL
21
Q
TRANSFUSE IF
● Hb < 7.0 g/dL in a
A
critically ill patient
22
Q
TRANSFUSE IF
● Hb < 8.0 g/dL in a patient with
A
an acute
coronary syndrome
23
Q
TRANSFUSE IF
● Hb < 10.0 g/dL with
A
uremic or
thrombocytopenic bleeding
24
non rbc containing
● Platelets (RD/SD)
○ Rd = random donor
○ Sd = single donot.
● Granulocyte concentrate
● FFP
● Cryoprecipitate
25
From one unit of whole blood how many platelets
= 5.5 X
10^10/uL platelets
26
--
● Plateletpheresis or pools of 4 to 6 units =
3
X 10^11/uL
27
indicated for patients whose platelet
count is
less than 5,000 to 10,000/uL.
28
a 4-hour expiration in open system
PLATELET CONCENTRATE
29
Indicated in cases of neutropenia (WBC ct. <
500/uL) with infection and poor response to
antibiotics. As well as reversible bone
marrow hypoplasia, and a reasonable chance
for survival
GRANULOCYTE CONCENTRATE
30
Granulocyte components usually contain
____________ granulocytes as well
as platelets and __________ of
erythrocytes.
Granulocyte components usually contain
greater than 1.0 × 1010 granulocytes as well
as platelets and 20 to 50 mL of
erythrocytes.
31
the neutrophil count will increase to
______ in response to infusion of
granulocyte colony-stimulating factor
(GCSF)–mobilized granulocytepheresis.
he neutrophil count will increase to
1,000/µL or more in response to infusion of
granulocyte
colony-stimulating
factor
(GCSF)–mobilized granulocytepheresis.
32
Recommended dose of granulocyte concentrate
● One unit daily for 4 or more days in
adults
● Administered once or twice in
neonates.
33
GRANULOCYTE CONCENTRATE administer within
Should be administered within 24 hours of
collection to maintain viability of cells
34
HOW IS GRANULOCYTE CONCENTRATE STORED
stored at 20° to
24°C without agitation.
35
● Contains all clotting factors
FRESH FROZEN PLASMA
36
ffp vs fp254
○ FFP - frozen within 8 hrs of
collection
○ PF24 - plasma frozen within 24 hrs
after phleb
37
ffp treats what
○ factor XI
○ multiple coagulation deficiencies
38
Used as replacement fluid during
plasmapheresis
FRESH FROZEN PLASMA
39
FFP's thawed at 1 to 6 ℃ can be used to
prepare
liquid plasma and cryoprecipitate
40
Usually_____ will effectively
control hemostasis.
Usually 4 to 6 units of plasma will effectively
control hemostasis.
41
CRYOPRECIPITATE contains
Contains fibrinogen, von willebrand factor
and fibrin stabilizing factor
42
cryo pool and not pool how long
● If using single units (not pooled):
○ Must be transfused within 6 hours of
thawing, if kept at room temperature
and not pooled.
● If pooled (manually or prepooled):
○ Must be transfused within 4 hours of
pooling (because sterility is
compromised during pooling).
43
for treating hemophilia a
cryoprecipitate
44
how many fibrinogen is in a single pool of cryoprecipitate
750 to 1,250 mg of
fibrinogen
45
Each unit of cryoprecipitate must
contain at least _____ of factor VIII
Each unit of cryoprecipitate must
contain at least 80 units of factor VIII
46
factor viii is for
hemophilia a and von willebrand disease
47
factor ix is
for hemophilia b
48
factor viia
- inhibitor in hemophilia a and b
- factor vii deficiency
- warfarin overdose and liver damage
- massive hemorrhage
49
how to prepare factor viii
Preparation is by fractionation and
lyophilization of pooled plasma
50
final products of factor viii are sterilized Final products are sterilized using
pasteurization or solvent-detergent treatment.
51
animal vs human source of factor viii concentrate
animal source is from pigs. further usage can lead to the production of antibodies against it
human source needs to undergo pasteurization of plasma and detergents in order to separate factor viii concentrate
52
factor ix complex is aka
prothrombin complex/concentrate
53
factor ix complex contains
vitamin k dependent factors ii,vii,ix,x
54
human vs animal source of factor ix complex
human souce is from monoclonal antibodies while recombinant sourve isfrom chinese hamster ovary
55
Recombinant human factor IX is effective
only in the
management of factor IX
deficiency (hemophilia B).
56
Protease inhibitor that inhibits clot formation
ANTITHROMBIN III
57
Antithrombin III activity is enhanced by
,
heparin
57
indicated for patients with
hereditary antithrombin III deficiency and
disseminated intravascular coagulation (DIC).
antithrombin iii
58
Serine protease inhibitor that inactivates
factor V and VIII thus preventing thrombus
formation.
PROTEIN C
59
Important for hemostasis or regulation of
coagulation factors
PROTEIN C
60
human plasma derived protein vs recominant human activated protein c differntiate
● Human plasma–derived protein c are
approved for use in hereditary deficiency
states.
● Recombinant human activated protein C
has been used for DIC and sepsis
61
Heat treated product used for patients with alpha1-antitrypsin
deficiency
ALPHA1-PROTEASE INHIBITOR
62
alpha1-antitrypsin
deficiency
deactivates elasticity of lungs
ALPHA1-PROTEASE INHIBITOR
63
how is alpha 1 antitrpysin activated
Prepared using albumin purification via
fractioning of plasma by ultracentrifugation or
detergent reagents
64
Prepared from chemical and physical
fractionation of pooled plasma
ALBUMIN (5-25% SOLN)
65
heat treated, Used for volume replacement
ALBUMIN (5-25% SOLN)
66
exposure to
diseases such as hepatitis A or measles.
IMMUNE GLOBULIN
67
Half-life of immune globulin in the
bloodstream is
22 days.
68
infused immune globulin blocks the
reticuloendothelial system or mononuclear
phagocytic system.
69
_________must be given 30 minutes
before transfusion
○ To prevent febrile hemolytic
transfusion reactions
Oral Prophylactic must be given 30 minutes
before transfusion
○ To prevent febrile hemolytic
transfusion reactions
70
unless otherwise indicated by the patient's
clinical condition, rate shall be_________ for the ________ and must be infused______
nless otherwise indicated by the patient's
clinical
condition, rate shall be 5-10
ml/minute for the first 15 minutes and must
be infused within 4 hours --
71
tagvhd
IRRADIATED BLOOD COMPONENTS
72
expiration of irradiated
28 days
73
decreases or eliminates the
mitogenic (blastogenic) capacity of the
transfused T cells, rendering the donor T cells
immunoincompetent.
Irradiation
74
To irradiate blood component, administer
cesium 137 or cobalt 60
75
cesium 137 or cobalt 60 - DOSE
Dose: 25gy (grays) OR 2,500 cGy
(centigray) on central part of unit. On
periphery no more than 15gy should
be distributed
76
All blood units undergoing irradiation should
be irradiated__________, expiration would
be ________from collection no matter the
anticoagulanT
All blood units undergoing irradiation should
be irradiated within 14 days, expiration would
be 28 days from collection no matter the
anticoagulan
77
types of AUTOLOGOUS TRANSFUSION
○ Predeposit
■ Predeposit blood tas during
procedure transfuse the same
predeposited blood
■ Within 3 days of surgery
○ Acute normovolemic hemodilution
■ Before surgery kuha dugo then
replace using colloid or saline
solutions tas transfuse after
surgery
○ Intraoperative hemodilution
■ collection of 1 or 2 units of
blood from the patient just
before a surgical procedure,
replacing the removed blood
volume with crystalloid or
colloid solution.
■ Same sa acute
○ Postoperative salvage
■ Lahat ng natanggal na dugo
during suction. Huagsan yon
tas separate debris tas pwede
na itransfuse sa patient
78
when is emergebcy transfusion done
For Rapid or uncontrollable bleeding or
patient that lost 20% of Blood Volume
79
platelets are required if the platelet count is
less than 50,000/µL,
80
transfuse cryoprecipitate if fibrinogen level is
less
than 100 mg/dL
81
dosage for neonatal tranfusion
10ml per kg of b
82
in neonatal transfusion how should units be prepared
Units should be CMV negative and
Leukoreduced/ irradiated
83
FOR IgA negative persons PNH
WASHED RBC
84
DOSAGE FOR RBC ALIQUOTS
30ML/KG AND INCREAES OF HCT BY 3%
ETO LANG NAIIBA HALOS LAGHAT NG RBC CONTAINING INCREASES HGB BY 1-1.5MG/DL WHILE HCT INCREASE UB 3%
85
STORAGE TEMPERATURE OF RBC CONTAINING
1-6C EXCEPT KAY FROZEN RBC NA -65c
86
DOSAGW FOR PLATELETS SD AND IRRADIATED
INCREASE 30-60,OOO/UL
87
DOSAGE OF PLATELETS LEUKOREDUCED
RD: INC 5-10K
SD: INC30-60K
88
PLATELETS STORAGE TEMPERATURWE
20-24C
89
FFP STORAGE RTEMP
-18/-65
90
CRYOPRECIPITATE STORAGE TEMP
-18C/20-24C
91
VOLUME OF PLATELETS
200-400ML
92
PH OF LEUKOREDUCED PLATELETS
>6.2
93
FFP VOLUME
200-250ML
94
CRYOPRECIPITATE
10-25ML;
95
USE OF PLATELETS
PLATELET REFRACTORINESS
96
THROMBOCYTOPENIA, DIC AND BLEEDING
PLATELETS POOLED
97
FOR COAGULATION DEFICIENCUES, LIVER DISEASE, DIC AND MASSIVE TRX
FFP
98
FFP DOSAGE
INC FACTOR 20-50%
10-20ML/KG
99
CRYOPRECIPITATE DOSAGE
5-10MG/DL
99
VOLUME FOR WHOLE BLOOD
450-500ML
100
VOLUME FOR RBC EXCEPT WASHED RBC AND DEGLYCEROLIZED
250-300ML
101
VOLUME FOR WASHED RBC
180ML
102
RBC DEGLYCEROLIZED VOLUME
180 ML
103
RECOMBINANT HUMAN PRODUCTS
FACTOR VIII
FACTOR IX
PROTEIN C
ANTITHROMBIN III
ALPHA1 PROTEASE INHIBITOR
ALBUMIN (5-25% SOLN)
IMMUNE GLOBULIN
104
