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106 Cards in this Set
- Front
- Back
What is the Fisher Race nomenclature for Rh antigens?
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D, C/c, E/c
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What is the corresp. Weiner symbol for each fisher race?
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D = Rho
C = rh' c = rh'' E = hr' e = hr'' |
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What is the most common Rh antigen for whites?
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e
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What are the top 4 Rh antigens for whites in order?
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e > D > c > C
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What is the most common Rh antigen for blacks?
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e
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What are the top 4 Rh antigens for blacks in order?
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e > c > D > C > E
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What antigens are present for the genotype Ro?
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Dce
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What antigens are present for the genotype R1?
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DCe
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What antigens are present for the genotype R2?
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DcE
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What antigens are present for the genotype Rz?
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DCE
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What antigens are present for the genotype r?
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dce
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What antigens are present for the genotype r'?
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dCe
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What antigens are present for the genotype r''?
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dcE
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What antigens are present for the genotype ry?
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dCE
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What is the most common genotype in whites?
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R1 - DCe
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What is the most common genotype in blacks?
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R0 - Dce
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What is the least common genotype of all?
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Rz
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What is the 2nd most common genotype for both black/whites?
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r - cde
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what are the naturally occurring antibodies?
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ABO MN Lewis Lua P1
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what are the clinically significant antibodies?
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ABO, Rh, Kell, Kidd, Duffy, SsU
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What are the warm antibodies?
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Rh Kell Duffy Kidd
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What are the Cold antibodies?
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M N P1
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What antibodies usually only react in the AHG's phase?
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Kell Duffy and Kidd
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What antibody can react in any phase?
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Lewis
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What antibodies are not detected by enzyme treatment of cells?
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M N Duffy
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Detection of what antibodies are enhanced by enzymes?
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Rh, Kidd, Lewis, P1
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What antibody is enhanced by acidification?
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M
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What antibodies show dosage?
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Rh (except D)
MNS Duffy Kidd |
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Which antibodies bind complement?
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I, Kidd, Lewis
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What antibodies cause in vitro hemolysis?
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ABO, Lewis, Kidd, Vell, some P1
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What What antibody is labile in vivo and in vitro, and commonly causes an anamnestic response?
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Kidd
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What antibody is associated with PNH?
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Anti-P
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What antibody is associated with cold agglutinins disease and mycoplasma pneumoniae?
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Anti-I
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What antibody is associated with infectious mono?
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Anti-i
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What is required for a 95% confidence in antibody id?
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3 pos and 3 neg reactions
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What will agglutinate cord cells? What will not?
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Will: Anti-i
Will not: Anti-I, Anti-H, Anti-IH |
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For compatibility testing, what is the patient specimen requirement?
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-Must have been collected within 3 days of transfusion if the patient has been pregnant/transfused in past 3 months.
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What must be done for a complete Compatibility Testing?
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1. Repeat ABO on donor (Rh if labeled as Rh neg)
2. ABO/Rh type recipient. 3. Crossmatch. Retain patient specimen, unit segment for 1 week. |
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When doing a crossmatch you find one Ab screen is pos, and one donor is positive in AHG. What should you suspect?
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An alloantibody; identify it and crossmatch compatible units.
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When doing a crosmatch you find that all Ab screen cells, all donors, and the autocontrol are neg except one donor in the AHG. What should you suspect?
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A positive DAT in the donor. Return it to the bloodcenter.
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When doing a crossmatch you find aht all Ab screen cells, donors, and the autocontrol are positive - only in AHG. What should you suspect?
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A Warm autoantibody; it's best to not transfuse but if you must find a least incompatible unit.
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When doing a crossmatch you find that all Ab screen cells, donors, and the autocontrol are positive - in 37 And AHG. What should you suspect?
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Rouleaux; do a saline replacement technique.
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What is standard protocol for newborn testing?
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1. ABO/Rh Fwd type the infant cord capillary or venous blood.
2. Ab screen baby or mom. 3. If Ab screen pos, crossmatch compatible units. |
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How soon do red cells at room temp "go bad"? why?
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30 min - reach 10'C that fast!
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What are the conditions for reissuing blood?
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1. Maintain at 1-10'C
2. Closure unbroken 3. At least 1 segment left 4. Inspect 5. Record reissuing |
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How can you differentiate intra and extravascular hemolysis?
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-Both have decreased haptoglobin
-Intra shows hburia/hbemia, DIC -Extra shows jaundice, increased bilirubin, takes 2 days longer. |
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What usually causes intravascular HTR?
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-ABO incompatibility
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What usually causes extravascular HTR?
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KIDD
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Which is fatal, intra or extra?
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intra
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What causes febrile reactions?
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Anti-leukocyte antibodies.
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What is the clinical sign of a febrile transf rxn?
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Increased temp within 24 hrs.
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What is the sign of an allergic reaction?
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Hives (urticaria)
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What causes an allergic response?
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Plasma proteins that are foreign to the system.
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What is a clinical sign of anaphylatic transf rxn?
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bronchospasms
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What causes an anaphylactic response to transfusion?
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Anti-IgA in an IgA deficient recipient.
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Who do you commonly see circulatory overload in?
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Children, cardiac/pulmonary patients, elderly
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What causes circulatory overload?
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Transfusion of too high volume
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What are the signs of circ overload?
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coughing/cyanosis/problems breathing.
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What causes septicemia from a transf reaction?
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septic blood
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What are some signs of contaminated blood transfusion?
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Renal failure, DIC, fever, cramps, diarrhea, everything.
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What ABO type mothers are most at risk for causing HDN?
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O
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What type of elution is used for investigating ABO HDN?
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Heat or freeze-thaw
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What type of elution is used for investigating Rh HDN?
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Acid
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When is RhIg given to mothers?
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-28 wks gestation
-within 72 hrs of birth if baby is Rh pos |
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What is standard protocol for when an Rh pos baby is born to a neg mom?
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-Draw mom's blood w/in 1 hr.
-Do rosette test to screen for fetal bleed |
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If the rosette test is positive postpartum, what should you do?
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Klei=hauer Betke acid elution to quantiate the fetal bleed.
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What is the principle of the Kleihauer-Betke test?
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Fetal cells resist acid elution and stain pink.
Momma cells appear as ghosts. You count the baby cells to see how bad the bleeding was. |
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How much Rhogam should be dosed after a fetal maternal bleed?
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1 dose per 15 ml Baby CELLS or 30 ml fetal whole blood.
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how long is the deferral for taking aspirin?
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3 days if only giving plt
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how long is the deferral for measles, mumps, polio, or yellow fever vaccines?
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2 wks
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how long is the deferral for rubella vaccine?
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4 wks.
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how long is the deferral for pregnancy?
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6 wks.
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how long is the deferral for having travelled to an endemic area for malaria?
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1 yr
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how long is the deferral for having lived in a malaria area?
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3 yrs
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What is the anticoagulant volume for blood collection?
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63 ml
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What is the blood volume collected for transfusions?
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450 +/- 45 mL
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How low of a volume can be collected for a unit before adjusting the anticoag?
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Down to 300
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How fast should blood be collected?
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4-10 min
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Name 3 anticoag/preservatives
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-ACD acid citrate dextrose
-CPD citrate phosphate dextrose -CPDA1 - w/ adenine |
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Which preservatives have 21-day shelf lives?
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ACD and CPD
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whats the shelf life of CPDA1?
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35 days
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what are 3 additives?
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adsol
nutricel AS-2 nutricel AS-3 |
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what are the best addtives? why?
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adsol and nutrisel as-3; increase shelf life to 42 days
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How much should one unit of blood increase a person's hct?
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3%
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how long are frozen rbcs good for?
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10 yrs from drawing; 24hrs after thawing
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how soon should RBCs be prepared for freezing?
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within 6 days
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what temp should frozen RBCs be stored at?
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20% glycerol -120
40% glycerol -65 |
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What are washed RBCs given for? (condition)
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PNH patients or IgA deficient but prefer frozen for the latter
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what is the max amt of WBCs that can remain in leuko reduced units?
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no mroe than 5 x 10'6
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what is used to rejuvenate rbcs?
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PIPA
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what is the new shelf life of RBCs if rejuvenated?
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24 hrs, or else freeze them.
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when are RBCs rejuvenated?
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up to 3 days after outdate; restores their 2,3-DPG and ATP
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whats the exception for rejuvenating?
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can't do it to cells in additive solution (adsol/nutricel)
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what are RBCs irradiated for?
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Transfusing immunocompromised or intrauterine patients, to prevent GVHD
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What is the indication for FFP?
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Coag factor deficiency - EXCEPT factors 1, 8 and 13
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What is the indication for Cryo?
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-Hemophilia A
-Von willebrand's -Hypofibrinogenemia -Factor XIII defic. |
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What temp should FFP be stored at? What is its shelf life?
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Store at <18, for 12 months
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What are the storage conditions of cryo?
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Same as FFP
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What are the conditions to be met by cryo?
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Should contain at least 80 IU Factor VIII and 150 mg fibrinogen.
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How soon should cryo be transfused after thawing?
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6 hrs, or 4 if pooled.
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How much plasma is in a pile of platelets?
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Enough to keep the pH at 6
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What is the storage temp for platelets and granulocytes?
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24'C - room temp!!!
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what is the shelf life of plts and grans?
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plt: 6 days if agitating
Grans: 24 hrs |
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do WBCs need to be crossmatched?
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you betcha - they contain RBCs too
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What should a plt transfusion do for the patient?
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Raise the plt count by 5-10,000/uL in a 75 kg patient
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How long can units be usable if they've been stored at room temp?
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4 hrs
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