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80 Cards in this Set

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Are the growing numbers of blood transfusions because we're being more liberal in doing them, or patients need them more?
Patients
How old do you have to be to donate blood?
17
How many weeks do you have to wait between blood donations?
8
How much blood is taken in a whole blood donation?
~500 mL
When were the first TA-AIDS cases reported, and what was the response?
1982; high risk donor deferrals were initiated.
Is there a zero % rate of HIV transmission now that HIV has been discovered and Anti-HIV screening is done?
no
Are blood donors compensated for donating?
no
What do you get from a whole blood donation?
-Red cells in additive solution
-Plasma
-platelets are thrown out
What are 3 things done in Blood processing?
-ABO/Rh typing
-Antibody screening
-Infectious disease testing
Why is CMV testing especially important?
Because CMV pos blood can still be transfused, just not to immunocompromised patients that are CMV neg
What 7 diseases do we screen blood products for?
-Hep B, Hep C
-HIV
-West nile virus
-Syphilis
-HTLV
-Chagas disease
What is CPDA?
Citrate
Phosphate
Dextrose
Adenine
What is the shelf life of blood with CPDA1?
35 days
What are the requirements for whether a blood product can be used?
70% of cells must remain viable at unit outdate or 24 hours after transfusion
Even if cells remain viable, what changes might we see that decrease the utility of a blood transfusion?
Decreased vasodilatory abilities and Nitric oxide metabolism
Are the growing numbers of blood transfusions because we're being more liberal in doing them, or patients need them more?
Patients
How old do you have to be to donate blood?
17
How many weeks do you have to wait between blood donations?
8
How much blood is taken in a whole blood donation?
~500 mL
When were the first TA-AIDS cases reported, and what was the response?
1982; high risk donor deferrals were initiated.
Is there a zero % rate of HIV transmission now that HIV has been discovered and Anti-HIV screening is done?
no
Are blood donors compensated for donating?
no
What do you get from a whole blood donation?
-Red cells in additive solution
-Plasma
-platelets are thrown out
What are 3 things done in Blood processing?
-ABO/Rh typing
-Antibody screening
-Infectious disease testing
Why is CMV testing especially important?
Because CMV pos blood can still be transfused, just not to immunocompromised patients that are CMV neg
What diseases do we screen blood products for?
-Hep B, Hep C
-HIV
-West nile virus
-Syphilis
-HTLV
-Chagas disease
What is CPDA?
Citrate
Phosphate
Dextrose
Adenine
What is the shelf life of blood with CPDA1?
35 days
What are the requirements for whether a blood product can be used?
70% of cells must remain viable at unit outdate or 24 hours after transfusion
Even if cells remain viable, what changes might we see that decrease the utility of a blood transfusion?
Decreased vasodilatory abilities and Nitric oxide metabolism
What are effects of storage of blood products?
Decreased 2,3 DPG
Decreased intracellular K+
Platelets/WBCs nonviable
Decreased labile coag Fxs
Increased cytokines
Bacterial contamination
What are the labile coag factors?
Fx 5 and 8
What are we mostly concerned with regarding cytokine concentrations increasing and bacterial contamination? Why?
Platelets - because they are kept at room temp
Where does the cytokine concentration increase occur?
Outside the cells, as the intracellular concentration is released.
What is the main blood group system we're worried about in transfusion reactions?
ABO
Why do ABO blood groups cause the worst Transfusion reactions?
-Their antibodies occur naturally
-They activate complement
-They're very potent
What is the universal donor when talking about packed RBCs?
Type O
What is the universal recipient when talking about packed RBCs?
Type AB - can give cells with A, B, or A/B
Which Rh antigen is most responsible for HDN? Why?
D; it is the most immunogenic
Are the Rh antibodies naturally occuring?
no
What does the DAT detect?
Antibodies that have coated the ANTIGENS ON RBCs in the body
What are 4 causes of a pos DAT?
-AIHA
-DIHA
-Hemolytic transfusion reaction
-HDN
What does the IAT detect?
ANTIBODIES in the patient's serum
What are the 3 situations that use the IAT?
-Antibody screen
-Red cell TYPING
-Compatibility testing
How do you do the DAT?
By washing/isolating the patient's RBCs, resuspending, and adding Coomb's reagent to detect hemolysis
What will a pos coomb's test show?
Agglutination - no hemolysis
How do you do an IAT?
By removing the RBCs from plasma, adding known phenotype RBCs to the plasma, and then using Coombs to see if there was a reaction.
What are the 3 things you have to do in Compatibility testing?
1. ABO/Rh type both patient and donor
2. Antibody screen the patient
3. Crossmatch the donor cells with patient serum
Why do you have to do the crossmatch of patient serum to donor cells?
In case the antibody screen failed to pick up a rare antibody to a rare antigen on the donor cells.
Is whole blood really a very useful transfusion? Why?
No; because the plasma is really pretty junky and useless. Why not just give packed RBCs
What is the main therapeutic use of a whole blood transfusion?
Increased oxygen carrying capacity, volume repletion
What is the shelf life of packed RBCs in Adsol?
42 days
How much will a packed RBC unit increase a patient's Hb level?
1 g/dl
What are 3 compensatory mechanisms in chronic anemia?
-Decreased blood viscosity
-Increased CO
-Increased 2,3 DPG
How low can you go in Hb concentration without causing inadequete O2 delivery in healthy volunteers?
5 mg/dl!!
What has a generally better outcome in the critical care setting; giving transfusions conservatively or liberally?
Conservatively
How much blood volume must be lost for shock to ensue usually?
30% or more
Would you give a patient with Vit B12 or folate deficiency anemia a transfusion?
No; you can treat them more effectively with other means
What Hemoglobin level would likely call for transfusing?
6-8 mg/dl, if asyptomatic
How is Plasma prepared?
1. Centrifuge out RBCs/WBCs
2. Centrifuge out platlets
How much plasma do you get out of a wb donation?
200-250 ml
What does fresh frozen plasma contain?
-All clotting factors
-Coag inhibitors - AT3, Protein S and C
How long can FFP be stored?
Up to 1 yr in -18
What is the universal PLASMA donor?
AB (has no antibodies)
Who can receive type O plasma?
Only type O
What is FFP indicated for?
Replacing coagulation plasma proteins
What are 3 situations in which you might need to replace plasma proteins for hemostasis?
-Multi factor deficiency
-Abnormal bleeding/coagulopathy
-Prophylaxis for surgery
What are 2 things FFP is NOT indicated for?
-Volume expansion
-Heparin reversal
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How is cryoprecipitate prepared?
by spinning down FFP
What is the main use of cryoprecipitate?
Replacing fibrinogen
What is the typical dose of cryo?
12 units
(1 unit/5 kg body weight)
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What are the 2 main types of platelet transfusions?
-Random donor platelets
-Single donor apheresis