7 (Blood Bank C)

Front 1

Symptoms:

- fever, chills, dyspnea, DIC

- flank pain, hypotension

TREATMENT:

- Reduce diuresis & treat shock

- Manage DIC

Back 1

Immediate Transfusion Reactions

Front 2

The most common reaction

Symptoms: chills, fever

Treament:

Give leukocyte reduced cells

Back 2

Febrile Non-hemolytic Transfusion Reaction

Front 3

Symptoms: Hives w/ itching

Treatment:

antihistamine while flow is slowed/stopped

Back 3

Urticaria

Front 4

Symptoms:

- occurs after a few mL

- Flushing of skin; no fever

- coughing, resp.distress

- Cramps, nausea, diarrhea

Treatment:

Washed cells or plasma components from IgA deficient donors

Back 4

Anaphylactic shock

Front 5

Symptoms:

- Chills, fever, cough

- Bilateral pulmonary edema

- Hypoxemia, hypotension

Treatment:

- Respiratory support, steroids diuretics

Back 5

Transfusion Related Acute Lung Injury (TRALI)

Front 6

Symptoms:

- Fever, chills, tachycardia

- Warm type shock, renal failure

- DIC, hgbnemia, hmgbinuria

Treatment:

- IV antibiotics, fluids

- vasopression to maintain BP

Back 6

Bacterial Contamination

Front 7

Symptoms:

- Anxiety, restlessness, tachycardia, cyanosis

- Dyspnea, severe headache

- Signs of congestive heart failure

Treatment:

- Diuretics and place in patient in upright position

- Identify & transfuse most concentrated form slowly

Back 7

Circulatory Overload

Front 8

Symptoms:

asymptomatic hemoglobinuria

Treatment:

None; adhere proper protocol

Back 8

Physical or Chemical Hemolysis

Front 9

Symptoms:

- Fever, decreased hgb, jaundice

- positive DAT *

Treatment:

None; Check previous record;

- administer antigen (-) blood for all subsequent transfusions

Back 9

Hemolytic Delayed Transusion Reaction

Front 10

Symptoms:

- Fever, diarrhea, infection

- Abnormal liver function

- Cytopenia; usually fatal

Treatment:

- Corticortisoids, cyclosporine

- Methotrexate, azothioprine

- Antithymocyte globulin

- Irradiated blood components containing lymphocytes w/ 25Gy before transfusion

Back 10

Acute Transfusion Assoc. Graft vs Host Disease

Front 11

Symptoms:

- scleroderma-like disease

- sicca syndrome

- interstitial pneumonitis

- malabsorption

Back 11

Chronic Transfusion Assoc. Graft vs Host Disease

Front 12

Symptoms:

- Self-limiting thrombocytopenia

- Purpura; difficult to prevent

Treatment:

- Corticosteroids

- Therapeutic plasma exchange

- High doses IV immunoglobulin

Back 12

Post-transfusion Purpura

Front 13

Symptoms:

- Muscle weakness, weight loss, jaundice

- Fatigue, arrythmias, diabetes

- Growth retardation in children

Back 13

Transfusion Induced Hemosiderosis

Front 14

Symptoms:

- Fever, fatigue, malaise, icterus

- Arthralgia, hemolysis (malaria)

Treatment:

- Quarantine components from unit; use volunteer blood supply and perform serologic tets

-Give Hepa B vaccine to workers

- Admi. Hepa Prophylaxis after HBsAg exposure

Back 14

Disease Transmission

Front 15

What should you do during a Transfusion Reaction Investigation?

Back 15

1. Stop transfusion

2. IV line must be kept open w/crystalloids in case immediate treatment is necessary to overcome hypotension

3. Notify attending physician and blood bank

Front 16

Transfusion Reaction Causes:

- antibody to RBC antigens

- antibody to wbc/plt/cytokines

- Ab soluble to Ag in plasma

- anti IgA

Back 16

Types:

- hemolytic

- febrile

- urticarial

- anaphylactic

Front 17

- routine anti sera and red cells tested:

- special anti sera tested:

Back 17

Daily

When used

Front 18

Antiglobulin reagent control testing:

Negative tests imply:

-

-

-

Back 18

- insufficient removal of serum prior to addition if AHG

- omission of AHG from procedure

- must repeat test

Front 19

- inheritance of antigen from father; mother has corresp. IgG

- Ab crosses placenta coating fetal cells = removal from circulation causing anemia and hyperbilirubinemia

- bilirubin (neurotoxin) causes brain damage (kernicterus)

Back 19

HDN

Front 20

Cause of HDN:

- inc. spherocytes

- DAT weak/negative

- delayed jaundice

- bilirubin rarely >15mg%

Back 20

ABO

Front 21

Cause of HDN:

- inc. retuculocytes

- DAT positive

- immediate jaundice

- bilirubin if ten >20mg%

- exchange transfusion likely needed

Back 21

Rh

Front 22

- supplies antigen (-) blood

- group O, D, hgb S negative

- must be irradiated

- fresh less than 3 days old

Back 22

Intrauterine transfusion

Front 23

- reduces Ab and bilirubin levels by removing Ab coated cells

Accepted specimen:

- maternal sample (best)

- eluate from infant cells

- infant serum

Back 23

Exchange transfusion

Front 24

Unit selection for exchange transfusion:

Group O if -

D negative if -

Back 24

- ABO HDN

- Rh HDN

Front 25

- given at 28 weeks to D (-) women and within 72hrs of delivery with D (+) infants

- 300ug covers 30mL whole blood fetal maternal hemorrhage

Back 25

Rh immune globulin

Front 26

- screening test for Rh immune globulin

- if (+) , Kleinhauer-Betke quantitates fetal maternal bleeding

- fetal cells resist (pink)

- adult cells are ghost cells

Back 26

Rosette test

Front 27

- polymorphic system of antigens present on all nucleated cells

- genes located on chromosome 6

- typed using microlymphocytotoxicity

Back 27

HLA system

Front 28

Immunodominant structure of

H antigen:

B antigen:

A antigen:

Back 28

L-fucose

D-galactose

N-acetylgalactosamine

Front 29

A₁ and A₂ are sub-groups of A

What are some of their differences?

Back 29

A₁ cells are agglutinated while A₂ are not

Front 30

A₁ are anti a ____

A₂ and A₃ are anti a ____

Back 30

(+)

(-)