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38 Cards in this Set
- Front
- Back
what percent of americans donate blood?
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5%
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how many pints of blood do men have? women?
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12 pints; 9 pints
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What are the general guidelines for donating blood
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- > 17 years old
- >110 lbs. - haven't donated in last 56 days - "healthy" (feel well and able to perform normal activities) - if chronically ill need to be on treatment and the condition needs to be undercontrol |
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Temporarily Deferred from Donation
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-heart attack or cardiac surgery in last 6-12 mon.
-malaria in last 3 yrs. or travel to an endemic area -blood transfusion w/in year -tattoo or piercing w/in year -household contact with a person who has hepatitis -not feeling well on the day of donation -antibiotics in the last 72 hrs. -low blood cell count |
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Permanently Deferred
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-Chemo or radiation to treat some types of cancers
-hepatitis at age 11 yrs. or older -high risk of having HIV due to IV drug use or sexual contact |
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What is the nucleic acid amplification testing (NAT) used for?
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detects genetics material of viruses for HIV-1 and HCV, WNV
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Autologous transfusions
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blood donor and recipient are the same
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Allogenic transfusions
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blood transferred to someone other than the donor
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preoperative donation
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Patients can make autologous donations up to 72 hrs. prior to surgery
44% are unused by the donor and are discarded |
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Blood Type A
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Antigens on RBC--> A
Antibodies in serum--> Anti-B Able to Receive--> A, O |
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Blood Type B
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Antigens on RBC--> B
Antibodies in serum--> Anti-A Able to Receive--> B, O |
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Blood Type AB
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Antigens on RBC--> A and B
Antibodies in serum--> none Able to Receive--> A, B, AB, O |
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Blood Type O
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Antigens on RBC--> none
Antibodies in serum--> Anti-A and Anti-B Able to Receive--> O |
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Rh Typing
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2 alleles, fully expressed on fetal RBCs by 30 days gestation
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Rh standard of care
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-Rh-Immune Globulin (RHIG, RhoGam)
-administered IM, should cover 15 mL of fetal RBCs -should be given w/in 72 hrs. of delivery of Rh+ infant -in case of abortion, assume Rh+ |
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Kleinhauer-Betke Test
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-quantitative measurement of fetal blood in maternal blood
-20 ug/RhoGam/1mL fetal RBCs |
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When is whole blood used
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Used for Rh complications (limited to exchange transfusions of neonates)
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what is the shelf life of blood?
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-35 days
-after storing 72 hrs. no viable platelets and negligible Factor VIII acitivity |
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Disadvantages of Whole blood transfusions
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-Volume overload
-Incr. K, NH3, H+ -Exposes patient to larger number of antigens and antibodies -Provides low level of clotting factors |
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Components of whole blood
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RBCs
Platelets Plasma Cryoprecipitated AHF (factor VIII) Granulocytes (transfused w/in 24 hrs. of collection) |
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How are packed RBCs obtained
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-obtained from centrifugation
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What is the shelf life of Packed RBCs
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storage up to 42 days, frozen up to 10 yrs.
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How much do packed RBCs help a patient
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one unit raises Hgb by 1 g/dL or HCT by 3%
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Are packed RBCs good for getting leukocytes
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no, they are poor; 70-85% removed by centrifugation, filters, or UV irradiation
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How are frozen packed RBCs used?
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cryoprotective agent is added, stored several years, thawed and washed prior to transfusion
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Deglycerolized RBCs
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-removes nearly all leukocytes and plasma
-most expensive |
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Washed RBCs
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-isotonic saline (IgA deficient patient)
-must be transfused within 24 hrs. -contamination risk during processing |
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Advantage of Washed RBCs
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-removes leukocytes--> febrile reaction
-Removes plasma--> allergic reactions -same increase in Hct as packed RBCs |
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Platelets
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-stored up to 5 days
-raises platelets by 50-60,000/uL in avg. size adult -transfused platelet survive 3-5 days -Use ABO compatible and Rh- for Rh- women of childbearing age |
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How many platelets do you need before surgery to avoid bleeding
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>50,000
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What type of platelets do you give to an immunocompromised pt.? to a pt. refractory to multiple transfusions?
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-Irradiated platelets
-HLA-matched platelets |
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Fresh Frozen Plasma
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-frozen w/in 6 hrs. of collection
-stored for up to 1 yr. -use ABO compatible |
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Isolated deficiencies of fibrinogen, factor 8, or factor 13 better treated by what?
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cryoprecipitate
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Cryoprecipitate
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-each bag exposes recipient to 10 donors
-Use ABO compatible |
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Compatibility Testing
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-review old blood bank records
-ABO, Rh of pt. and donor -Antibody screen of pt. and donor serums (ABO, Rh, Kell, Duffy, Kidd) -crossmatch |
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Crossmatch (2 types)
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Major--donor RBCs/Pt. serum
Minor--pt. RBCs/donor serum (less important) |
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Adverse Transfusion Reactions
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-Hemolytic-intravascular vs -extravascular
-Febrile -Allergic -Delayed -Hypothermia -Hypocalcemia -Hypo/hyper kalemia -Graft vs host -Disease transmission |
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If a transfusion reaction occurs what do you do?
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-discontinue transfusion
-determine type of reaction -check for hemolysis -CBC, creatinine, coag studies |