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72 Cards in this Set
- Front
- Back
- 3rd side (hint)
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what is CDP and what is it used for?
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Citrate dextrose phosphate is a red blood cell additive that extends shelf life to 21 days. It has anticoagulant and perservative
CD2P has twice as much sugarbut still 21d shelf life. Rarely used as sole additive |
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how is CPDA-1 different from CPD?
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Citrate phosphate destrose adenine-1 has a little more sugar and has adenine which extends the shelf life to 35 days. widely used in the 90's.
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What is the best predictor of post transfusion red blood cell survival?
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Stored ATP level in RBCs
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How much additive solution is added after rbcs are separated?
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separated via centrifuge. 100ml is added
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Compare and contrast AS-1, AS-5, and AS-3
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AS-1=Adsol
AS-5=Opitisol AS-3=Nutricell |
All extend shelf life to 45 days
AS-1 and AS-5 have CPD AS-1 and AS-5 have mannitol AS-3 has CP2D AS-3 doesn't have manitol |
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T/F manitol present in additive red cell soultions is there to promote diuresis.
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False. The purpose is to enhance viability.
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a 65 kg person can safely donate how much blood?
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Can give 10.5 ml per kg body weight
10.5(65)=683 ml though the sandard draw is 450ml +/-10% |
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List some reasons for blood donation deferals to protect donors.
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-must be 8 weeks between whole blood donation or 2 days between apheresis donation
-poor health -pregancy -previous donation complications -pulse <50 or >100 -BP>180/100 |
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T/F people less than 105 lbs cannot donate blood.
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False. There is no longer a minimum weight requirement
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All of the following are reasons for permanent blood donor defereals except
a. Risk of CJD b. Malaria c. Hepatitis after age 11 d. Babesiosis/Chaga's e. Evidence of viral disease |
b. Malria results in a 3 year deferal
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a. Risk of CJD family hx, corneal translant, human GH injection
e. +HBsAg, more than one +HBc, HIV Ab, HTLV Ab, any hx of HCV regardless of age Other permanent deferal reasons include receiving money for sex or drugs, high risk HIV, leukemia or lymphoma |
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List some reasons for 1 year blood donation deferal
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incarcaration >72hours, rape, needle/scalple injuries, paying for sex or having STI, syphillis/ghonorea, travelto malaria area, intranasal cocain,
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How long after taking aspirin can one donate platelets?
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36 hours
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These vaccines result in a 4 week deferal for blood donation
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Variella, Rubella
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Which vaccines result in a two week deferal of blood donations?
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Measles, (rubeola) oral polio, mumps, typoid, yellow fever
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T/F the requirements for allogenic and autlogous blood donations are the same.
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Fasle.
Allogenic Autologous 8 wks 72 hrs 12.5/38% 11/33% screen 4 dz no unless> |
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What are the criteria for platelet donation?
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Same physical requirements as whole blood, no aspirin in 36 hours, can donate in 48 hours, bu not more than twoce a week or 24 times a year
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What affect can adenine and or manitol have in transfused neonates?
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I massive transfusion needed, raises the concern for renal toxicity, but not a concern in routine transfusions
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All of the following are indications for prbc except
a. loss of >15% patients total blood volume b. lack of rbc production c. red cell destruction d. symptomatic cronic anemias e. Hb<10/hct<30% d. cardiopulmonary disorders in association with other diseases |
a. loss of blood volume>20%
b. Hb<6 |
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3 units f prbc's should raise the Hb/hct by what?
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each unit raises themby 1g/dl and 3% respectively; therefore, 3 units should raise the hb by 3 and the hct by 9%
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How are platelet concentrates prepared?
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whole blood soft spin to separate cells from plasma and platelets. Hard spin to separate plt from plasma then 50 ml of donor plasma added back.
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What is the self life of platelets?
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5 days gently aggitated at 20-24 celsius (room temp)
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What is the standard plt dosage for adults and neonates?
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For adults, 1 bag per 10kg body weight. For neonates 10-15ml per kg body weight.
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What are the indications for platelet transfusion?
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-10 to 15th if no risk factors
-20th if risk factors are present -for surgery or ongoing bleeding 50th |
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In the perfect scenario, by how much will one bag of platets increase the platelets of a 70 kg person?
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5-10th
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This platelet disorder is inherited in an AR pattern, has a deficiency of gp1b, associated with giant platelets, increased production in marrow, and decreased survival time.
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Bernard Soulier. gp1b is the vwb factor receptor that links blatelets to endothelium and to one another
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This platelet disorder is characterized by AR inheritence or can be autoimmune, and lack gpIIbIIIa receptor.
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Glanzmann's thrombasthenia. Platelets cannot link to one another via lack of fibrin receptor.
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What is ristocetin and what is it used for in the lab?
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It is an antiobiotic that causes agllutination by causing vwbf to bind to gp1b on platelets. Distinguishes Bernard Soulier from vwb dz. BSS will not agglutinate with ristocetin or addition of normal plasma as the defect is in gp1b
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This disorder is the most common inherited coagulation abnormality, but can also be aquired through other medical conditions.
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vwb dz. A qualitative or quantitative defect.
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1. have to mesaure the level of vwf in an antigen assay
2. check effectiveness via ristocetin |
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T/F vwb dz is inherited in an AR pattern.
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Partially true.
AD=type I deceased level type II nl level but defective AR=Type III no dectable vwf platelet type (pseudo vwb dz) and rarely also type II |
Note: type III also has decreased factor VIII as vwf slows degradation of VIII. May present similarly to factor VIII deficiency i.e. hemarthrosis which is usually unusual for vwb dz.
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describe the mechanism of action of DDAVP
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releases ones native vwb factor found in Wable Palade bodies of endothelial cells. Used to treat
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List some contraindications for plt transfusion
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TTP: will worsen thrombosis
HIT: will worsen thrombosis ITP: relative contraindication cans give if life threatening bleeding. |
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T/F apheresis platelets do not reduce the posibility HLA antigen alloimmunization like leukoreduced platelets.
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True. Apheresis even though only one donor as aposed to pooled (6 to 10 donors) is used does not significantly decrease ones risk of HLA antigen alloimmunization.
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What are benefits of leukoreduced products?
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deceased risk of HLA antigen allimmunization, risk of CMV, and febrile nonhemolytic reactions.
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Waht patients are at increased risk of TA-GVHD and how is it avoided?
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- Tcell deficiency (DiGeroge, CVIDS)
-bone marrow or stem cell transplant -lymphopenia (500/uL) -premies *Gamma irradiation at 25Gy incapacitates wbc |
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True/False Leukoreduction of RBC and/or platelets can be done with the same filter.
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False. The filers are not interchangable
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What are some methods for leukoreduction?
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1. best is 4th generation filters
2. microaggregates and washing 3. freezing red cells |
1. removes 99.99% of wbc. 2 and 3 are often done together
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What types of products should an IgA deficient recipient get?
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1. Washed
2. frozen rbc's 3. products from another IgA deficient donor |
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What product is used to freeze blood products?
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Glycerol
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What is the shelf life of frozen rbc'S
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10 years.
after glycerol removed (thawed), must be used within 24 hours (stored at 1 to 6 celcius) |
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What does "washing" esential do and for what would this be most useful?
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1. Removes plasma from the product
2. Useful to give to patients with plasma protein hypersensitivity (i.e. IgA deficiency), people who have repeated febrile non-hemolytic reactions, neonatal alloimmune TTP (caused by maternal anti-PL) |
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1. What disease does irradiation not reduce?
2. T/F washing prevents TA-GVHD. |
1. Crutzfeld-Jakob
2. False |
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What is the shelf life of washed platelets?
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4 hours at 20 to 24 celceus
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How are red cells rejuvenated and what must be done before usage?
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Can rejuvenate up to 3 days after they expire. Does so by adding 2-3 DPG and ATP. Must be washed to remove excess inosine which can be toxic.
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How is FFP prepaired and what is in it?
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1. a. hard spin whole blood>PRBCs and FFP
b. soft spin>PRP and RBCs then hard spin to sep plt and FFP 2. All coagulation factors and fibrinogen |
200 ml yeilded means 200IU of each factor per bag and 400 mg of fibrinogen per bag
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What is FFP used for?
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-deficencies of multiple factors (liver failure or hemodilution)
-single factor deficeny when none available -emergency reversal of warfarin -exchange transfusion |
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T/F FFP has utility in treatment of heparin reversal
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False. That is what protamine is for. No utility in mild PT/PTT elevations either
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What are some disadvantages of SDP?
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Not kill non enveloped viruses. Very expensive.
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What is an alternate to SDP?
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DRP (donor retested plasma). A single donor is used. The product is shelved for 16 weeks then rthe donor is etested at next donation. if negative can be used etc.
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How is cryoprecipitate made?
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from FFP. FFP usually stored at -18 c and then thawed at 30 to 37 c. When making Cryo, FFP is thawed at 1 to 6 c. Cryo sticks to the bag, most liquid is removed then it is refrozen at -18 c.
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What is in cryo?
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Cryo
stored at -18 thawed at 30 to 37 c good for 24 hrs at room temp (20 to 24 c) fibrinogen factor VIII, factor XIII vWF fiibronectin |
FFP
stored at -18 thawed at 30 to 37 c good for 4 hrs (pooled) or 6hrs (non pooled) at room temp fibrinogen all clotting factors vWF fibronectin |
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What is cryo used for?
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fibrinogen deficiency
uremic thrombocytopathy ltopical local bleeding control |
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A 100 kg hemopheliac pesents with an acute abdomen and factor IX (Christmas disease) activity of 40%. He is diagnosed with appendicities and surgery is scheduled. HIs hematocrit is 20%. How many vials of factor IX will he need before surgery?
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1. calculate blood volume
100kgx70ml/kg=7000ml 2. calculate plasma volume 7000ml (1-.2)=5600ml 3. calculate factor units need 100% for surgery so 100%-40%=60% (0.6) 4. calculate number of vials 500IU per vial 0.6x5600=3360IU needed 3360/500=6.72 rather 14 vials because only 50% of factor willhave an effect secondary to redistribution. For all other factors, no need to double amount |
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How would one calculate the number of Rh vials needed for maternal fetal hemorrhage?
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1. calculate maternal blood volume (wtx70).
Multiply this by % fetal cells(decimal form) then devide by 30 2. mutlply the percent of fetal cells (whole number ie 4% is 4) by 50 then devide by 30 |
if number ends in a decimal <5 round up once. If it ends in a decimal >5 rund up twice
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Which antibodies are good at fixing compliment?
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IgM and IgG1 and IgG3
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What class antibodies are warm antibodies?
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Usually IgG except ABO which are IgM. IgG aka aquired
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What class are cold antibodies?
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IgM with exception of ABO antibodies which are warm.
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Which group of antibodies is naturally occuring?
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IgM
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The most common cold antibodies are against what?
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ABO, P, I/i, Lewis
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Which blood group antigens are decreased by enzymes?
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MNSs
Duffy |
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1. What is the basic backbone of blood group antigen?
2. The H antigen? |
1. Glu-Gal-Nag-Gal
2. Glu-Gal-Nag-Gal Fru |
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What does Ulex europaeus agglutinate?
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Cells that carry the H antigen
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Dloichos biflorus agglutinates what?
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Agglutinates A1. A1 accouns for 80% of type A.Does not agglutinate A2
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Gal
GL-Gal-Nag-Gal Fru |
B antigen
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What is the structure of the Lea antigen?
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Glu-Gal-Nag-Gal
Fru |
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What is the structure of the Leb antigen?
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Gl-Gal-Nag-Gal
Fru Fru |
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What is the mechanism of aquired B phenotype?
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Gram neg bacteria exposure via interstinal pathology. Some of these bacteria have enzymes that alter the terminal Nag on A antigen. Now the Nag resembles the terminal Gal of the B antigen.
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shows weak B on forward type and strong B on back type. Acidifying the serum that has anti B resolves this (doesn't recognize it)
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What is the Bombay phenotype?
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Person lacks the H gene therfor no fructose addes to the terminal Gal of the antigen back bone. Types as an O, but makes antiboidies against everything, H, A, and B.
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Can only receive blood from other Bomaby donors.
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What type of Ig are Lewis antibodies and are they clinically significant?
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IgM. They are cold reacting and clinically nonsignificant.
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Hydatid cyst fluid or pigeon egg fluid neutorlizes what antibody?
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Anti-P1 which is the most common P antigen. This test helps identify it.
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Most P antiboddies are anti IgM and cold reacting. What is the acception?
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Paroxysmal Cold Hemoglobinuria from anti-P IgG antibodies (Donath-Landsteiner). Bind at cold and hemolyze after warmed up
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What virus gains access to the RBC via the P antigen?
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Parvo virus B19
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How many Rh antigens are there and of those, how many are major?
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There are over 50 with only 5 major ones D, C, c, E, e
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