Transfusion Flashcards by Kimberly Camoro

Symptomatic anemia

<7g/dl

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Thrombocyte count when platelet concentrate should be administered

Less than 50,000/uL

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1 unit of whole blood or packed RBC can increase hematocrit by___

3% hematocrit or

1.0-1.5 g/dL hemoglobin

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Storage time of CP2D

21 days

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Additive solution content

Saline
Adenine
Glucose
Mannitol

SAGM /MAGS

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Purpose of Mannitol in additive solutions

Stabilizing agent

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Content of Rejuvenating Solutions

PIGPA OR PIPA

Phosphate
Inosine
Glucose
Pyruvate
Adenine

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light spin speed

End product

3200 xg for 2-3 mins
Or
2000 xg for 3 minutes

Product: platelet Rich Plasma
Temp: 22 deg Celsius

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Heavy spin speed
End product
Temperature

5000 xg for 5 minutes
Or 
3600 RPM for 5 minutes
Platelet poor plasma
4 deg Celsius

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Platelet concentrate should contain at least _____

And ph

5.5 x 10 ^10 platelets

pH: greater than or equal to 6.2

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Agitation of platelets purpose

Prevent aggregation and to promote gas exchange

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How many units can platelet concentrate be pooled

6-8

6-10 (Turgeon)

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How many mL of plasma should be left after removal of platelets

50 mL

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One RDP unit should increase px platelet count by

5,000 to 10,000 uL

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One SDP can increase px platelet count by

30,000 to 60,000/uL

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SDP unit should contain at least

3.0 x 10 ^11 platelets per unit

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Failure to yield an increase in recipient’a platelet count leas than 5,000/uL

Platelet refractoriness

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Cryoprecipitate contains (factors)

Factor VIII
Factor XIII
vWF Factor
Fibrinogen
Fibronectin

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Cryoprecipitate + Thrombin =

Fibrin glue

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How many mL of plasma removed in preparation of cryoprecipitate

10-15 mL

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Method used to irradiate blood components

Cesium ^137 source

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WBC products aka

And examples

BRMs - biologic response modifiers

Cytokines and complement fragments

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2 methods to reduce leukocytes

Pre-storage leuko-reduction

removed prior storage
prevent febrile transfusion caused by both WBCs and BRMs

Post-storage leuko-reduction

removed prior to issuing the unit
can prevent febrile transfusion by WBCs but not by BRMs (BRMs have accumulated during storage)

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Removal and storage of blood work or blood components before an elective procedure for reinfusion during or after the procedure

Preoperative Collection

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Blood collected before a surgical procedure and simultaneously replaces a comparable volume of crystalloid or colloid solution

Acute Normovolemic Hemodilution

Collection and reinfusion of blood lost by a px during surgery Device that utilize vacuum used to collect shed blood

Intraoperative Collection

Blood is collected from a drainage tube placed at the surgical site Used microaggregate filter to screen our debris

Postoperative Collection

General requirements for autologous donation

Age (no requirements) Hb (11g/dl) Hct (33%) 3 day intervals (3 day before surgery)

Most common anticoagulant for apheresis

Acid Citrate Dextrose (ACD)

Platelet count of donor for plateletpheresis

150 x10^3/uL

Requirements for erythracytopheresis Male Female

Male 5’1” 130 lbs hct 40% | Female 5’5” 150 lbs hct 40%

Mendel’s Law First Second Third

First Law: Law of Segregation Second Law: Law of Independent Assortment Third Law: Law of Dominance

Only blood group antigen that has been shown to be sex-linked

Mathematical formula that explains Mendelian Inheritance

Hardy-Weinberg Principle p+ q = 1 p^2 + 2pq + q^2 = 1

Trisomy 18

Edward’s Syndrome

Trisomy 13

Patau Syndrome

Anti-A1 Lectin

Dolichos biflorus

Anti-B Lectin

Griffonia (Bandeiraea) simplicifolia

Anti-H lectin

Ulex europaeus

Greatest amount of H Ag to Lowest amount of H ag

O > A2 > B > A2B > A1 > A1B

similar to Bombay except that there is normal ABH expression in secretions and body fluids

Para-Bombay phenotype | Genes: hh, Se

What microorganism associated with acquired B phenomenon

Proteus vulgaris (sometimes E.coli)

Bacterial enzyme associated with acquired B

Deacetylase

Treatment for RBCs with acquired B phenomenon

Acetic Anhydride

ISBT # of Rh

004

Immunogenicity of Rh antigens

D > c > E > C > e

Individuals do not possess the genes needed to synthesize Cc or Ee

D Deletion (D- -)

Antigen expressed when both c and e in the cis position or located in the same haplotype

f (ce)

Who developed Hybridoma technology

Kohler and Milstein

Antibody associated with Paroxysmal Cold Hemoglobinuria and demonstrated by Donath Landsteiner test

Autoanti-P

Second rated to D in terms of immunogenicity

Kell Ag

What phenotype has - an X linked inheritance - rbcs are acanthocytic in nature - wbcs are def of NADH-oxidase enzyme - associated with CGD - rbcs lack Kx and Km

McLeod phenotype

Confers to resistance against Plasmodium vivax infections

Duffy null phenotype (anti-Fy3)

Disappear rapidly both in vivo and in vitro thats why they are notoriously known for association with DHTR - demonstrate dosage - resist lysis in 2M Urea

Kidd Antibodies

Can produce mixed field agglutination

Anti-Lua

Incomplete antibody best demonstrated in AHG phase

Anti-Lub

Time for centrifugation in serofuge

20 seconds

Presence of two cell populations in a single individual

Chimerism ``` True chimerism (twins) Mosaicism (dispermy) - two sperm cells fertilized one egg ```

Gel Card centrifugation time

10 minutes

``` Sulfhydryl agents (2) And purpose ```

2-mercaptoethanol (2-ME) Dithiothreitol (DTT) - destroys pentameric structure of agglutinating IgM

Lectins is to plants as | Prolectin is to

Snails

Specific gravity of copper sulfate hemoglobin determination and equivalent hemoglobin Time for reading

1.053 (12.5 g/dL) 15 seconds

How many times blood bank is inspected each year

Once per year

Temperature of storage of antisera

2-6 deg Celsius

Indications of Exchange Transfusion

0.5 mg/dl/hr rise in bilirubin or | Rise of 10 mg/dl in the first 24 hours

Intrauterine transfusion is done by (2)

Intraperitineally | Cordocentesis

Indications of Intrauterine transfusion

- amniotic fluid A450 results are in high zone II or zone III - hb level < 10g/dl - fetal hydrops on ultrasound examination

Post thaw storage of FFP

1-6 deg C, transfuses within 24 hours

Purpose of plastic bag in thawing FFP

Prevent water contamination of the entry port

Examples of crystalloid

Ringer’s lactate solution | 7.5% normal saline