Transfusion Therapy

Question 1

What blood type is the universal recipient?

Answer 1

AB+

Question 2

What blood type is the universal donor?

Answer 2

O-

Question 3

What are the reasons to give a blood transfusion of a Hgb < 8

Answer 3

Surgical patient - orthopedic or cardiac surgery
Pre-existing CVD
Actively bleeding

Question 4

One unit of PRBC’s will increase Hgb levels by how much (g/dL)

Answer 4

1.0

Question 5

Is consent required in an emergent situation?

Answer 5

No

Question 6

What must be done before a transfusion?

Answer 6

Type and Screen

Question 7

How long is a type and screen good for?

Answer 7

72 hours

Question 8

What are the components of whole blood?

Answer 8

Includes RBC’s, plasma, and platelets

Question 9

When is whole blood transfusions indicated?

Answer 9

Massive transfusion to maintain ratio of blood components (10+ units in 24 hours)

Question 10

What are the components of packed red blood cells?

Answer 10

Includes RBC’s, platelets, some residual plasma, some WBC

Question 11

How long can frozen PRBC’s be stored for?

Answer 11

10 years

Question 12

Why are PRBC’s given?

Answer 12

To raise hemoglobin/blood volume

Question 13

What are irradiated red blood cells?

Answer 13

PRBC’s subjected to radiation

Question 14

Who needs irritated RBC’s?

Answer 14

Immunosuppressed patients
Stem cell or bone marrow transplants
Intrauterine transfusions
Premature infants
First degree relative donors (HLA heterozygous getting HLA homozygous)

Question 15

How long are platelets good for?

Answer 15

5 days

Question 16

How can transfusion reactions be defined?

Answer 16

Non-hemolytic reactions and Hemolytic reactions

Question 17

What is the typical presentation of transfusion allergic reactions?

Answer 17

Hives (wheels), rash, and itching

Question 18

What are the typical presenting symptoms of a transfusion bacterial contamination?

Answer 18

Fever
Chills
Tachycardia
Hypotension
GI symptoms (nausea, vomiting, abdominal cramps)

Question 19

What is acute hemolytic reaction in response to?

Answer 19

Result of transfusing ABO incompatible blood

Question 20

What are the symptoms of hemolytic reactions?

Answer 20

Pain at infusion site
Facial flushing
Back and chest pain

Question 21

What is the onset of delayed hemolytic reactions?

Answer 21

2-10 days after transfusion

Question 22

What are the symptoms of Transfusion Related Acute Lung Injury (TRALI)?

Answer 22

Dyspnea
Hypoxemia
Fever
Rigors
Bilateral diffuse pulmonary infiltrates on CXR

Question 23

What is the treatment for TRALI?

Answer 23

Stop transfusion and provide pulmonary support (O2 or ventilation)

Question 24

What is Transfusion Associated Cardiac Overload (TACO) related too?

Answer 24

Rapid transfusion, especially with pre-existing cardiac disease

Question 25

What are the symptoms of TACO?

Answer 25

Hypertension Dyspnea and respiratory distress Cough Rales on auscultation (pulm edema)

Question 26

What is the treatment for TACO?

Answer 26

Diureses Reduce rate of transfusion or stop it Mechanical ventilation if needed **Reduce amount of IV fluids being administered during transfusion of blood products

Question 27

What is the cause of transfusion-associated graft-versus-host-disease

Answer 27

Immune reaction produced by discordant HLA types

Question 28

When can transfusion-associated graft-versus-host-disease present?

Answer 28

2-30 days

Question 29

What are the possible presenting symptoms of transfusion-associated graft-versus-host-disease?

Answer 29

Fever Rash Diarrhea Hepatitis Lymphadenopathy Pancytopenia