Unit 6 Flashcards
(138 cards)
1
Q
How should whole blood be matched
A
must be type specific
2
Q
What is the ratio of anticoagulant in WB
A
14:100
3
Q
What does washing RBCs do
A
washed with saline, removes almost all plasma proteins, microaggregates, plts and WBCs
4
Q
What patients need washed RBCs
A
hypersensitivity to plasma proteins
IgA deficient recipients
neonates
5
Q
Why are RBCs sometimes frozen, what preservative is used to do this
A
for rare blood types and autologous donors
glycerol
6
Q
What is the purpose of deglycerolizing RBCs after thawing them
A
washed with saline in decreasing concentrations until 0.9% isotonic. Can’t throw off blood osmo
7
Q
How long does it take to LR blood with a filter?
What is the purpose of LR
A
72 hrs
reduces TRALI
febrile reactions
alloimmunization if transplant HLA
Removes CMV
prevent GvHD
8
Q
What are the 4 ways RBCs can be leukoreduced
A
during donor collection
after donor collection, before storage
Right before transfusion
During transfusion
9
Q
What patients need LR blood?
A
immunodeficient
BM transplant
donated by family member
fetus
10
Q
What is the main WBC of concern in LR?
A
T lymphs
11
Q
What coagulation factor is higher when plasma is frozen withing 24hrs of collection
A
factor VIII
12
Q
What diseases are plasma donations NOT useful for
A
VWF disease- primary hemostasis, coag factors are all secondary
13
Q
What blood product is needed in:
Liver disease
Warfarin
MTP
DIC
A
transfuse FFP
14
Q
What is plasma that has never been frozen called
A
liquid plasma
15
Q
What is PF24 labelled as once thawed
A
thawed plasma
16
Q
What factors are in cryo
A
VIII, VWF, FBG, XIII fibronectin
17
Q
What blood product is needed in
Factor XIII deficiency
FBG deficiency
VWD
Fibrin glue
DIC
A
cryoprecipitate
18
Q
Hemophilia A is a deficiency of factor
A
VIII
19
Q
What is the difference between plasma and cryo
A
cryo is thawed plasma that has been spun and the plasma is taken off, it is the precipitate of plasma
20
Q
What does a soft spin and a hard spin do
A
soft- plt rich plasma
hard- removes/ express off plasma
21
Q
What should you do to plts after the are prepared before putting them on the agitator
A
let them sit 1 hr, to avoid activating them
22
Q
Why are plts pooled
A
usually before transfusion
23
Q
What blood product is needed in
thrombocytopenia
MTP
surgical patients
A
Random donor plts
24
Q
What patients should not receive random donor plts
A
TTP- abs directed against plts
ITP- idiopathic thrombocytopenia purpura
DIC- consume plts too fast
25
How to choose compatible plts
ABO and Rh compatible
most places don't care about Rh
26
IF a pt was transfused with plts 1 hour ago, but a CBC shows no rise in plts, what likely cause
Plts refractoriness
need special single donor HLA class 1 matched transfusion
27
What are plts collected by apheresis
very concentrated plts collected from a single donor
28
What QC is needed for plt products
testing for bacteria
min >3 x 10^11 plts
> 6.2 pH at expiration
no aspirin 72hrs before collection
29
What pts need granulocyte concentrates
BM transplant or certain cancers
30
How are granulocyte concentrates collected
apheresis
31
What requirements for granulocyte concentrates
>1 x 10^10 granulocytes
XM
IR
donor receives steroids
32
What blood product is needed if
Pt is unresponsive to antibiotic therapy, neonates especially
BM transplant
granulocytic dysfunction
Neutropenic chemo pts
granulocyte concentrates
33
What is PCC factor concentrate
prothrombin complex concentrate
34
What are NSA and PPF
volume expanders
Normal serum albumin
Plasma protein fraction
35
What coagulation factor concentrates are given
VIII, IX, VIIa
36
What are immune serum globulins that can be given
hep B
Rh
37
What activates the intrinsic pathway
contact activation from damaged blood vessel
38
What activates the extrinsic pathway
TF
39
What pathway is
12, 11, 9, 8
Intrinsic
40
What pathway is
7, TF
Extrinsic
41
What proteins are in the coagulation cascade and where in it are they
Proteins C, S in common pathway
42
What coagulation factors are vitamin K dependent
2, 7, 9, 10
43
Why are coag factor concentrates heated
reduces risk of HBV, HCV and HIV
44
What pts might need factor VIII concentrates
Hemophilia A
VWD
45
What should you give a pt that is forming factor VIII antibodies
five them factor VIIa- activates extrinsic pathway
46
What type of plasma gives
factor VIII concentrate
Faactor IX concentrate
VIII- derived or recombinant plasma
IX- pooled plasma or recombinant
47
What blood product should you give a pt with hemophilia B
factor IX concentrate
48
What blood product should give in
hemorrhagic pt
hemophilia A
to contradict coumadin or warfarin
bypass factor VIII antibodies
factor VII deficiency
traumas and MTPs
Liver transplant
Factor VIIa concentrate
49
What does PCC contain
factor 2, 7, 9 and 10, vitamin K dependents
50
Why would you give a pt PCC
factor VIII inhibitor
warfarin reversal
51
What are volume expanders for
maintain colloidal osmotic pressure in vascular system
during surgery
52
What are the 3 main goals of blood storage and preservation
maintain viability and function
prevent physical changes
minimize bacterial contamination
53
What anticoagulant/ preservative:
supports ATP generation by glycolytic pathway Ebden Meyerhof
Dextrose
54
What anticoagulant/ preservative:
is a substrate for RBC ATP synthesis in the Ebden Meyerhof pathway
Adenine
55
Which anticoagulant/ preservative extends an RBC lifespan from 21 to 31 days
Adenine
56
What preservative/ anticoagulant
chelates calcium and prevents clotting
citrate
57
What preservative/ anticoagulant
buffers pH and stabalizes 2,3 BPG so that it can bind to O2 in its tense state in the Rappaport pathway
monobasic sodium phosphate
58
What preservative/ anticoagulant
stabilizes RBC membrane and reduces hemolysis
Mannitol
59
What is in the AS additive system
Adsol, Optisol, Neutricel
Neutregena ad for eye cream
60
Adsol and Optisol both contain
mannitol
add has manny the mammothh
61
Neutricel contains
sodium phosphate
62
Adsol, neutricel, Optisol
AS #s
AS-1 Adsol
AS-3 Neutricel
AS-5 Optisol
63
What preservative extends RBC lifespan to 45 days
AS- Adsol Optisol and Neutricel
64
In what situations will heparin be added to RBCS
exchange transfusions, intrauterine, neonatal or sickle cell
65
How is RBC metabolism affected in storage
Increased: K, free HGB, lactic acid
Decreased: cell viability, Glucose, ATP, pH, 2,3DPG
66
What happens to the ODS curve when RBCs are stored for too long
left shift
67
List if increased or decreased
Free HGB
pH
lactic acid
ATP
Glucose
Cell viability
K
2,3 DPG
Free HGB- increased
pH- decreased
lactic acid- increased
ATP- decreased
Glucose- decreased
Cell viability- decreased
K- increased
2,3 DPG- decreased
68
In normal people, about ___% of HGB bind O2 at 28PO2
50
69
In an acidic environment, more __ is needed, affinity ____, O2 is ___ likely to let go of HGB
O2
decreases
more
70
Right shift ____ affinity
Left shit ____ affinity
reduces
increases
71
Why does pH decrease when RBCs are stored
anaerobic metabolism creates lactic acid, decreases pH to 7 or less
72
What is the pH of RBCs right when its collected
7.4 to 7.5
73
____ facilitates the transport of O2, from RBCs to tissues
2,3 DPG
74
_____ stabilizes tense HGB by allosteric binding
2,3 DPG
75
What will happen if there is a transfusion of 2,3 DPG depleted RBCs
body will regenerate 2,3 DPG in 3-8 hrs
returns to normal energy and HGB function
RBC shape may return to normal
76
How old should RBCs transfused to a baby be
no more than 5 days old
they cant regenerate 2,3 DPG very effectively
77
When ATP levels are low, RBCs become
more rigid, loose integrity, K passively leaves RBCs into plasma- could cause heart attack, Na enters RBCs, loss of gradient charge, zeta potential and membrane charge
78
In storage lesion how are these factors affected in RBCs
ammonia
membrane lipids
hemolysis
morphology
ammonia- increases
hemolysis- increases
membrane lipids- decrease
morphology- spiny projections
79
What occurs in platelet lesions
lactic acid
pH
platelet function
morphology
what do plts release
lactic acid- increases
pH- decreases
platelet function- decreases
morphology- become spherical instead of discoid
release cytoplasm and granule content
80
What can be used to rejuvenate RBCs, what is the window for it
pyruvate, inosine, adenine, phosphate
3 days after expiration
for cells with CPD, CPDA-1 and AS
81
Can the following RBC unit still be rejuvenated
expired 1 day ago
has no preservative
no, needs preservative
82
Can the following RBC unit still be rejuvenated
expired 1 week ago
has CPD preservative
no, can only be done up to 3 days after expiration
83
practice drawing figure in slide 22 Ch component prep and blood storage
How WB is converted into: RBCs, plt poor plasma, plt concentrate
pg 22
84
What organizations establish the guidlines for blood donation
FDA and AABB
85
What are the 3 steps of donor screening
registration
medical history questionnaire
partial physical exam
86
How much time do you have to wait between RBC donations
8 weeks or 56 days
if double donation 16 weeks
87
How much time do you have to wait between plasma, plt, or leukocyte donations
48 hrs
88
What is the max plt apheresis donations you can make in 1 year
24
89
What kind of donation can you make if you are taking aspirin, which one cant you
can- RBCs
cant plts
90
What are the rules if you had a vaccine and want to donate blood
no deferral- if asymptomatic and standard/ synthetic vaccine
2 weeks- measles, rubeola by themselves
4 weeks- Rubeola, Mumps, polio, typhoid, german measles, MMR, chicken pox
12 months- unlicensed vaccine- rabies
91
What are the physical requirements for blood donation
more than 17 or 16 with parent consent
>110 lbs
less than 180 systolic and 100 diastolic BP
50-100 bpm pulse
less than 37C or 99.5F temp
> 38% HCT
92
What is the H&H requirement for autologous donors
33%
93
What is normal blood flow time
5-8 min
94
What parts of the blood is apheresis done for
plts
plasma
WBCs
RBCs
Stem cells
95
Therapeutic phlebotomy is used for
treatment for polycythemia- too much EPO
hemochromatosis- too much iron
cyanotic heart disease
ET- too many plts
96
Autologous donation is used for
PACS
surgery
rare blood types
97
What are the requirements for autologous donations
no age limit
no weight requirement
can donate if pregnant
HGB >11
HCT>33%
72hrs before surgery or more
98
What are the requirements for directed donations to family members
must be IR
99
Can you donate FFP if Ab screen is positive
no
must do 37C and AHG
100
What diseases are donors tested for (10)
HBsAg
Anti-HBc
HBV DNA
Anti-HCV
HIV
Anti-HTLV
Syphilis
WNV RNA west nile virus
Chagas
CMV
101
What organism causes syphilis, what test is used to ID it
Trepenoma pallidum
RPR
102
What does indirect EIA detect? and sandwich EIA?
indirect- antibodies
sandwich- antigens apple and gems in sandwich
103
What is NAT testing and what is it for
Nucleic acid testing
find HIV, HCV, WNV, HBV
104
What are the specificity and sensitivity calculations?
sensitivity: TP/TP+ FN
Specificity: TN/TN+ FP
105
What hepatitis viruses can only cause disease if RNA is present
A, C, D, E
106
What hepatitis viruses can only cause disease if DNA is present
B
107
What hepatitis viruses are blood born
B and C
108
What does the presence of HBsAG indicate? and anti-HBc
HBsAG- surface antigen- individual is currently infected
anti-HBc- individual has had it in the past
109
What is HTLV-I and HTLV-II
I- adult T leukemia
II- large granular lymphocytic leukemia
110
What type of virus is WNV and what transmits it
mosquito
flavivirus
111
What disease is the CMV associated with
mononucleosis
112
What organism causes chagas disease
Trypanosoma cruzi
113
What bacteria is often in plts
staph epidermidis
114
What bacteria is often in RBCs
yersinia enterocolitica
115
What is the purpose of apeheresis
for pts with bleeding, anemia, hypoxemia
116
What blood cells can apheresis separate
plasma
plts
lymphs
granulocytes
erythrocytes
117
What does plasmapheresis remove
immune complexes
alloabs
autoabs
immunoglobulins
protein bound drugs
lipoproteins
phytanic acid
118
What is phytanic acid and why do we want to get rid of it
if there are too many lipids in blood- Refsums disease
119
Why do we want to remove immune complexes
lupus
120
Why do we want to remove auto abs
guillian barre and goodpasture
121
Why do we want to remove immunoglobulins
hyperviscosity
Waldenstroms- IgM
122
How often can you donate plts if
frequent
infrequent
single apheresis
double + apheresis
frequent- 2 days
single- 2 days
infrequent-4 weeks
double + 7 days
fanny sings in duets
123
How often can you donate granulocytes
2 days
124
What is photopheresis for
collect buffy coat with UV light, kills DNA in WBCs
125
What diseases make us want to do therapeutic apheresis
waldenstroms
multiple myeloma
sickle cell
myasthenia gravis
guillain barre
TTP
126
What is the most common immediate complication of apheresis
citrate toxicity
127
What is the difference between high concentration glycerol and low concetration glycerol
high- slow thaw
low- fast thaw, lower temp
128
What are RDP plts vs SDP plts
random donor
single donor
129
What plasma product has a higher yield of coag factors
FFP
130
____ ensures safe and healthful working conditions
OSHA
131
___ is involved in assessing medical waste
EPA
132
What organizations must the BB be compliant with
FDA
JC
CAP
AABB
133
A rule or requirement imposed by government
regulation
134
A government permission to operate or engage in practice
Licensure
135
Laboratories/ institutions are _____, people are ___, companies are
accredited
certified
regulated
136
Consent of donors is kept for, recipient consent is kept for
10 years
5 years
137
Software or hardware databases are kept for
2 years
138
What is in the CPDA perservative
citrate phosphate dextrose adenine
