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35 Cards in this Set
- Front
- Back
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What are agglutinins? |
Antibodies produced by immune system in response to presence of agglutinogens (antigen) |
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Why does agglutination occur? |
Agglutinins cross react w/ agglutinogens on foreign RBCs, which causes clumping Ultimately hemolysis of foreign RBC |
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Which Rh allele most commonly provokes immune reaction in non-carriers? |
RhD allele RhD carriers have Rh+ blood RhD non-carriers have Rh- blood |
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What is the function of Rh proteins? |
Erythrocyte ammonia transport Possibly O2/CO2 transport |
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What are the three main Rh alleles? |
RhAG RhCE RhD |
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When does immunity to A & B antigens start? Why? |
A few months after birth Due to cross-reactivity w/ bacterial antigens |
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In which situations would a strong, rapid RhD reaction occur? |
2nd blood transfusion of Rh+ blood to an Rh- patient 2nd pregnancy of Rh- mother carrying Rh+ fetuses |
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T/F RhD immunity is usually not acquired spontaneously? |
True |
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What is a name for the blood typing test? |
Coombs Test |
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What will cause A blood to clump? |
Mixing it w/ A antibodies B/c antibody will cause agglutination if the antigen is present |
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What will cause B blood to clump? |
Mixing it w/ B antibodies Antibody will cause agglutination if the antigen is present |
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What will cause Rh+ blood to clump? |
Mixing it w/ D antibodies Antibody will cause agglutination if the antigen is present |
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Which blood type is the universal donor? |
O- |
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Which blood type is the universal acceptor? |
AB+ |
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What can cause transfusion reaction even when blood is properly cross typed? |
Rare blood antigens Leukocyte or platelet reactions Cytokines or other substances in blood Pathogens |
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What causes an immune mediated acute hemolytic transfusion reaction? |
A/B mis-match Exposure of previously exposed Rh- person to Rh+ blood AGAIN |
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Which is more severe? Immune mediated or non-immune mediated acute hemolytic transfusion reaction? |
Immune mediated is much more severe |
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What causes a non-immune mediated acute hemolytic transfusion reaction? |
Thermal or mechanical damage to transfused blood |
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What causes symptoms of acute hemolytic transfusion reaction? |
Cytokines from immune rxns Products of blood lysis Reduced gas (O2/CO2) transport |
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What happens if a previously unexposed Rh- patient is exposed to Rh+ blood? |
Delayed transfusion rxn |
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What happens if a previously exposed Rh- person is exposed to Rh+ blood again? |
Acute Hemolytic Transfusion Reaction |
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Which has a milder course? Acute Hemolytic Transfusion Reaction or Delayed Transfusion Reaction? |
Delayed Transfusion Reaction |
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How long does it take for a delayed transfusion reaction to develop? |
2-4 weeks |
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What happens in transfusion related acute lung injury (TRALI)? (4) |
Neutrophils from transfused blood react w/ recipients lung capillary endothelial cells Rxn releases cytokines, which increase capillary permeability Albumin leaks from capillaries, nullifying the capillary colloid osmotic pressure Capillary blood pressure forces fluid into alveolar space, causing pulmonary edema (gas exchange reduced) |
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What type of transfusion is associated w/ anaphylactic reactions? |
Transfused leukocytes |
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In what type of patients are leukocyte-reduced blood products used? |
Patients at risk: Immune compromised (especially IgA-deficient) Congenital haptoglobin deficiency C1 inhibitor deficiency |
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T/F: Allergens transferred in blood will trigger allergic reactions |
True |
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What is a volume overload reaction, and what happens to the body? |
More blood than heart can pump out Pulmonary edema from increased capillary blood pressure Body corrects blood volume after a few days |
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What is the most common problem related to frequent transfusions? |
Iron overload |
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What causes sepsis or another pathogenic reaction? |
Pathogens in transfused blood (esp. viruses) Iatrogenic (failure to maintain sterile field, etc) |
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What is the pathophysiology of hemolytic disease of newborn (erythroblastosis fetalis)? |
Maternal exposure to D antigen & release of immunoglobulins (IgG crosses placenta) Antibodies cause aggregation and hemolysis Hepatomegaly, splenomegaly and constriction fetal circulation Kernicterus (bilirubin accumulates in brain) |
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What is the most feared chronic complication of hemolytic disease of the newborn? |
Kernicterus (bilirubin accumulates in brain): Severe jaundice Death/mental retardation May continue for months |
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Main symptoms of hemolytic disease of the newborn |
Jaundice (most common) Pallor Hepatomegaly w/ splenomegaly Hydrops (fluid accumulates in placenta and fetal liver/abdomen) |
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How to prevent hemolytic disease of the newborn |
Early identification and management RhoGam: anti-D antibody destroys Rh+ cells in maternal circulation to reduce immune response |
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Treatment of hemolytic disease of the newborn |
Fetal distress: early delivery, intrauterine exchange transfusion Post-partum: phototherapy for bilirubin, exchange transfusion in severe cases, treat imbalances (fluid, acid/base, electrolyte), oxygen to maximize blood saturation |
