Transfusion Medicine

Question 1

When platelet counts drop below what level is platelet transfusion recommended?

Answer 1

100,000

Question 2

What is dilutional coagulopathy?

Answer 2

Dilution of coagulation factors due to massive blood transfusion that are often deficient in clotting factors and platelets

Question 3

What is the universal blood donor?

Answer 3

O-

Question 4

What characterizes transfusion associated circulatory overload?

Answer 4

Respiratory distress secondary to cardiogenic pulmonary edema due to fluid overload

Question 5

What electrolyte abnormalities may present with large volume transfusions?

Answer 5

Hypocalcemia - due to citrate as an anticoagulant

Hyperkalemia - release of potassium while cells are stored

Question 6

What patients are most at risk for transfusion associated circulatory overload?

Answer 6

Patients with congestive heart failure or acute renal failure

Question 7

What blood components are available for transfusion?

Answer 7

Packed RBCs, platelets, fresh frozen plasma, cryoprecipitate, granulocytes

Question 8

In adults, how much will Hb increase with administration of one unit of packed RBCs?

Answer 8

1 g/dL per unit of pRBCs

Question 9

What blood component is administered in cases of severe bleeding to replace lost coagulation factors?

Answer 9

Fresh frozen plasma

Question 10

Approximately how much will platelet count increase with transfusion of one unit of platelets?

Answer 10

25,000 - 50,000/uL

Question 11

What is the universal blood recipient?

Answer 11

AB+

Question 12

This is administered to Rh - mothers with a Rh+ fetus to prevent loss of pregnancy.

Answer 12

RhoGAM - prevents hemolytic disease of the newborn

Question 13

What is the clinical indication for cryoprecipitate transfusion?

Answer 13

Fibrinogen deficiency

Question 14

True/False. As compared to pRBCS, fresh frozen plasma does not need to be ABO or Rh compatible.

Answer 14

False - Fresh frozen plasma must be ABO compatible, but does not need to be Rh compatible

Question 15

What are possible complications of blood transfusions?

Answer 15

Infection, hemolysis, allergic reaction, febrile reactions, transfusion-related lung injury

Question 16

While still very low risk, which virus is most likely to infect via blood transfusion?

Answer 16

Hepatits B

Question 17

How can febrile reactions due to transfusion be prevented?

Answer 17

By administering leukocyte-reduced blood products

Question 18

What is the clinical presentation of transfusion related lung injury (TRALI)?

Answer 18

Approximately 2-4hrs after transfusion, acute hypoxemic respiratory distress with pulmonary edema and patch lung infiltrates, but normal venous pressure

Question 19

What is the most common complication of blood transfusions?

Answer 19

Febrile reactions

Question 20

Allergic reactions of transfusion often present with hives and itching. What is the pathophysiology?

Answer 20

Exposure to donor IgA

Question 21

At what hemoglobin level is blood cell transfusion standardly recommended?

Answer 21

7 g/dL

Question 22

What is the cause of acute hemolytic transfusion reactions?

Answer 22

Incompatible RBCs (usually ABO incompatible)