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Rejuvenation to Quality Assurance - Statistics

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Topic Hint Answer % Correct
Transfusion Reactions After ____ red cell transfusions, excess iron is present in the liver, heart, and endocrine organs 10-15
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Blood substitute and components Transfusions for neonates are typically dosed at 10 to 15 mL/kg, therefore requiring only small volumes of blood products (_________) per dose. 10-25 mL
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HDFN The goal of intrauterine transfusion is to maintain fetal hemoglobin above ______ 10 g/dL
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Pre-transfusion Testing About ___ of blood is usually sufficient for all testing procedures if there are no known serologic problems. 10 mL
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HDFN The rosette screen will be positive if there is a FMH of _________ 10 mL or more
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Blood substitute and components An adult dose of cryoprecipitate is considered ___ 10 units of FFP
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Rejuvenation/ Freezing/ Deglycerolization Frozen RBC shelf life 10 years
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Pre-transfusion Testing The American College of Surgeons recommends transfusion of red blood cells, thawed plasma, and platelets in a ratio of ____ for effective blood component resuscitation. 1:1:1
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Rejuvenation/ Freezing/ Deglycerolization In deglycerolization with high glycerol, at what concentration should you wash the RBCs? Enumerate the steps. 12 NaCl; 1.6% NaCl; 0.9% NaCl with 0.2% dextrose
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Blood substitute and components For cryoprecipitate and cryo-poor plasma, how long does the thawing process of FFP take when using a refrigerator? And in what range of temperature in the water bath should you immerse that unit? 14-16 hours; 1-6 C
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Blood substitute and components Whole blood is collected in a ratio of ___ of anticoagulant preservative for every 100 mL of whole blood targeted for collection 14 mL
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Transfusion Reactions A post-transfusion to pretransfusion BNP ratio of ____, with a post-transfusion level equal or greater than 100 picograms per milliliter as a cutoff point, provides a sensitivity of 81% and a specificity of 89% for diagnosis of TACO. 1.5
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HDFN In determining the no. of Rhogam vials, what number should you use as the denominator if fetomaternal bleed is purely RBCs? 15
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Blood substitute and components A single unit of FFP or PF24, from whole blood collection, should contain ____ (200-375ml 7th edition of Harmening) of plasma, approximately ____ (300mg 7th ed of Harmening) of fibrinogen per 100 mL, and 1 unit of activity per mL of each of the stable clotting factors. FFP also contains the same level (1 unit/mL) of factors V and VIII. 150-250 mL; 400 mg
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HDFN The relative concentration of all antibodies capable of crossing the placenta and causing HDFN is determined by antibody titration. For the recommended method, ___ is considered the critical titer. 16
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Blood substitute and components RBC components typically have a final red cell volume of _____ mL (1) or _____ of hemoglobin suspended in the residual plasma and/or additive solution 160-275 mL
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Rejuvenation/ Freezing/ Deglycerolization Temperature in which deglycerolized units should be stored at 1-6C
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Blood substitute and components Once thawing is complete, the product may be stored at _____ for up to _____ 1-6 C; 24 hours
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Blood substitute and components Washed RBCs are stored at ________ for up to ____ hours. 1-6 C; 24 hours
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Rejuvenation/ Freezing/ Deglycerolization In deglycerolization, what should be omitted in the case of patient diagnosed with sickle cell trait as their RBCs would hemolyze upon solution in hypertonic solution? 1.6% NaCl
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Transfusion Reactions What cytokines are common? 16TNFa8
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Blood substitute and components red blood cells collected by apheresis must contain a mean of at least __ of hemoglobin or ____ (2) of RBC volume 180 mL
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Blood substitute and components CPP is deficient in 1813, vWF, cryoglobulin, fibronectin
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Blood substitute and components Both cryoprecipitate and CPP are stored at ___ or below for up to ___ from the whole blood collection date. -18 C; 1 year
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Blood substitute and components Frozen plasma is stored at ___ or colder for 1 year or at _____ or below for 7 years -18 C; -65 C
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Transfusion Reactions How much is the rise of temperature in FNHTR? 1C
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HDFN As little as ________ of fetal RBCs can immunize the mother 1 mL
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HDFN Which order of child affected by HDFN due to ABO? 1st
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HDFN Add ______ of RhIG to calculated dose to provide a safety margin 1 vial
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Pre-transfusion Testing Pretransfusion specimens, labels, and testing requests must contain at least _____ unique identifiers. 2
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HDFN The number of fetal cells (which take up the stain) are counted per total number of RBCs examined (which is usually ____), then multiplied by 100 (so that we can express it in percent). 2,000
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Blood substitute and components Spin conditions: Red blood cells + platelet-rich plasma 2,000 g x 3 minutes
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Blood substitute and components Whole blood to be used for RDP preparation must be maintained at ___ 20-24 C
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Blood substitute and components Platelets are stored at ____ with constant agitation 20-24 C
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Blood substitute and components Washed platelets are stored at _______ and must be transfused within ____ hours. 20-24 C; 4 hours
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Rejuvenation/ Freezing/ Deglycerolization Stored RBCs regain the ability to synthesize 2,3-DPG after transfusion, but levels necessary for optimal hemoglobinoxygen delivery are not reached immediately. Approximately ___________ are required to restore normal levels of 2,3-DPG after transfusion. 24 hours
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Rejuvenation/ Freezing/ Deglycerolization Shelf-life of deglycerolized unit 24 hours
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Blood substitute and components CPP is also thawed at 30° to 37°C, but it is stored at refrigerated temperatures and transfused within ____ unless relabeled as thawed plasma, cryoprecipitate reduced. 24 hours
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HDFN Aliquoted red cell is shelf life and temperature 24 hours; 1-6C
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Blood substitute and components For cryoprecipitate and cryo-poor plasma, how long does the thawing process of FFP take when using a circulating cryoprecipitate thaw bath? And in what range of temperature in the water bath should you immerse that unit? 2-4 hours; 4 C
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Pre-transfusion Testing A ___ saline suspension of RBCs is used for most serologic testing procedures 2-5%
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Transfusion Reactions unit of red blood cells contains approximately ___ mg of iron. 250 mg
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Blood substitute and components The expiration date of irradiated RBCs is __________ from the time of irradiation or the original outdate, whichever is sooner. 25 days
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Quality Assurance in Blood Bank All antisera should be stored at _____ when not in use 2-6C
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Pre-transfusion Testing Pretransfusion specimens and donor unit segments are typically stored at _____ and must be retained in the event that additional testing is warranted. 2-8 C
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HDFN The first dose is provided at ____________ (antepartum) since the majority of allosensitization appears to occur after this time. 28 weeks gestation
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Transfusion Reactions Level of rise in the temperature in sepsis 2C
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Blood substitute and components Shelf life: platelet stored at 1-6C 2 days
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General Blood Transfusion Practices It is desirable to complete a red cell transfusion within ____ 2 hours
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General Blood Transfusion Practices Blood components are infused slowly for the first 10 to 15 minutes (approximately ________) while the patient is observed closely for signs of a transfusion reaction. 2 mL for the 1st 15 minutes
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HDFN Which order of child affected by HDFN due to Rh? 2nd
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Tests Performed on Donor’s Blood How many bands in Western blot confirm the presence of HIV 2 out of 3
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HDFN Readings of MCA-PSV are typically done every____ to track the degree of fetal anemia; those that are greater than 1.5 multiples of the mean (MoM) are sensitive enough to predict significant fetal anemia in which intervention may be needed 2 weeks
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Blood substitute and components Shelf life: frozen platelet 2 years
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HDFN RhIg shelf-life 2 years
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Blood substitute and components Increase of platelet count in SDP 30,000-60,000 /uL
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Blood substitute and components Plasma volume in SDP 300 mL
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HDFN A full dose of __________ RhIG provides protection for up to ____ of D-positive red cells (approximately ____ of fetal whole blood). 300 ug; 15 mL; 30 mL
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Blood substitute and components Cryoprecipitate should be thawed before issuing. Cryoprecipitate should be thawed quickly at _____ and stored at room temperature (22° to 24°C) until transfused. 30-37 C
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Blood substitute and components FFP must be thawed before transfusion. Unit must be placed inside a plastic bag to prevent contamination. Both PF24 and FFP are thawed at temperatures between ______ or in an FDA-approved microwave device. 30-37 C
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General Blood Transfusion Practices Platelet or plasma transfusion within _____ 30-60 minutes
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Blood substitute and components Aliquot cannot be returned if ____ have passed 30 minutes
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Reissue of Unit Blood can be reissued after returning from the ward if the following conditions are met:- The closure must not have been entered in anyway - The blood must have been kept between 1-10oC on a continuous basis - The pilot tube or sealed segment of the donor tube must still be attached to the container - The blood should not be away from the blood bank for more than ____ - Records must be available that verify all inspections criteria. 30 minutes
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HDFN Minidose of _________ RhIg is sufficient for abortion, amniocentesis and ectopic rupture up to 12 weeks gestation. 30 ug
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Blood substitute and components Irradiated RBCs have been documented to have extracellular potassium levels as high as _____ as soon as 2 days after irradiation. 31 mEq/L
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Blood substitute and components Extracellular potassium levels increase over time in stored RBC units, which have been documented to contain as high as 60 mEq/L potassium after ______ 32 days
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Tests Performed on Donor’s Blood Spirochetes cannot thrive in blood stored for ____ days at ____ 3-4 days; 1-6 C
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General Blood Transfusion Practices Blood warmer such as water bath is set at _____ 37C
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Quality Assurance in Blood Bank Water baths and heat blocks are maintained at ___ 37C
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Rejuvenation/ Freezing/ Deglycerolization Rejuvenation is used primarily to salvage __________________ that are outdated or used with specific anticoagulant preservative solution up to ____ (2) past outdate. 3 days
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Blood substitute and components Leukoreduction performed shortly after collection, usually within 3 days
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Pre-transfusion Testing ABO grouping, Rh typing, and screening for unexpected antibodies must be performed within____ prior to the scheduled transfusion. 3 days
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HDFN A second dose is given after delivery of Rh-D positive infant (it is recommended to give RhIG within______ after delivery) 3 days
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Rejuvenation/ Freezing/ Deglycerolization Rejuvenated RBCs may be prepared up to ______ when stored in CPD, CPDA-1, and AS-1 storage solutions. 3 days after expiration
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Blood substitute and components Minimum no. of platelets in RDPs 3 x 10^11
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Blood substitute and components Plasma volume in RDP 40-70 mL
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HDFN Exposure of newborns to fluorescent blue light in the __________ range can successfully treat physiologic jaundice and mild cases of HDFN, particularly ABO HDFN. 420-475 nm
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General Blood Transfusion Practices Blood warmer should have automatic temperature control with an alarm that will sound if the blood is warmed over ____ 42C
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Pre-transfusion Testing To be considered as massive transfusion, how many blood units is transfused in within 1 hour? 4-5
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Rejuvenation/ Freezing/ Deglycerolization For deglycerolization, how long does the thawing process take? And in what range of temperature in the water bath should you immerse that unit? 45 minutes; 30-37C
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Rejuvenation/ Freezing/ Deglycerolization In deglycerolization with low glycerol, at what concentration should you wash the RBCs? Enumerate the steps. 45% NaCl with 15% mannitol; 0.9% NaCl
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HDFN Exposure of newborns to fluorescent blue light in the __________ range can successfully treat physiologic jaundice and mild cases of HDFN, particularly ABO HDFN. (Harmening version) 460-490 nm
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Blood substitute and components Shelf life: pooled; in an open system; washed platelets 4 hours
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Blood substitute and components Cryoprecipitate pooled in the transfusion service laboratory using an open system must be transfused within ____ 4 hours
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General Blood Transfusion Practices Any transfusion must be completed within ____ of initiation. 4 hours
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HDFN In getting the maternal blood volume, if mother maternal blood volume and/or mothers weight is not given, use the average maternal volume of ______ 5,000
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Blood substitute and components Transfusion of platelet concentrates is indicated for neonates whose counts fall below _______ and who are experiencing bleeding 50,000 /mL
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Blood substitute and components Increase of platelet count in RDP 5,000-10,000 /uL
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Blood substitute and components Spin conditions: Red blood cells + plasma 5,000 g x 5 minutes
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Blood substitute and components Spin conditions: Harvesting platelets or cryoprecipitate from plasma 5,000 g x 7 minutes
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Blood substitute and components RBC components typically have a final red cell volume of _____ mL or _____ g (2) of hemoglobin suspended in the residual plasma and/or additive solution 50-80 g
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Blood substitute and components Whole blood can be modified by having ___ of plasma removed in the preparation of platelets, or ____ of plasma removed in the prepration of cryoprecipitate. 50 mL; 10-15 mL
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Rejuvenation/ Freezing/ Deglycerolization volume of rejuvenating solution, temperature, time 50 ml; 37C, 1 hour
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Transfusion Reactions PTP occurs ___ after transfusion 5-10 days
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Blood substitute and components If additive solutions (AS) are employed, as much of the plasma is removed as possible, and the AS must be added to the RBC component within 3 days of collection, resulting in a finished product with a hematocrit of ___ 55-65%
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Blood substitute and components Minimum no. of platelets in RDPs 5.5 x 10^10
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Blood substitute and components Shelf life: platelet at room temp with agitation 5 days
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Blood substitute and components If not transfused within the initial 24-hour period the thawed plasma may be stored for up to_____, but the product label must be changed to “______________” because it can not maintain therapeutic levels of the labile clotting Factor V and Factor VIII. 5 days; thawed plasma
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Blood substitute and components red blood cells collected by apheresis must contain a mean of at least __ (1) of hemoglobin or ____ of RBC volume 60 g
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Blood substitute and components 450 mL (±10%) of whole blood. how many mL of anticoagulant? 63 mL
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Blood substitute and components If an additive solution is not used, the volume of plasma removed is targeted such that the finished RBC product has a hematocrit of ___ 65-80%
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Blood substitute and components Whole blood to be used for RDP preparation must be process within ____ after collection (general) 6-8 hours
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Blood substitute and components Whole blood, with ACD as the anticoagulant, to be used for RDP preparation must be process within ____ after collection 6 hours
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Blood substitute and components Prestorage pooled cryoprecipitate and single units of cryoprecipitate must be transfused within ______ after thawing 6 hours
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Blood substitute and components 500 mL (±10%) of whole blood. how many mL of anticoagulant? 70 mL
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HDFN In getting the maternal blood volume, if mother’s weight is given multiply by ______ (constant; average blood volume per kg of body weight) 70 mL/kg
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Pre-transfusion Testing According to AABB Standards, a pretransfusion specimen for testing and red cell transfusion is valid for ____Hours. After ____ hours, a new sample must be drawn. 72 hours
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Pre-transfusion Testing The patient sample and a segment from the donor unit must be retained post-transfusion for at least ____. 7 days
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Rejuvenation/ Freezing/ Deglycerolization Deglycerolized blood product should ensure ___ RBC mass recovery 80%
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Blood substitute and components The volume of a unit of FFP or PF24 from apheresis may be as much as ______. 800 mL
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Blood substitute and components Cryoprecipitate contains at least ______ of AHF activity and at least ___ of fibrinogen. 80 units and 150 mg
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Pre-transfusion Testing To be considered as massive transfusion, how many blood units is transfused in less than 24 hours? 8-10
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Blood substitute and components Platelet percent component retention should be at least ______ 85%
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Blood substitute and components at least ___ of the original component must be recovered after leukoreduction. 85%
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Blood substitute and components Whole blood used to prepare platelet concentrates must be drawn by a single nontraumatic venipuncture, and the concentrate must be prepared within ____ of collection. 8 hours
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Blood substitute and components Whole blood, with CPDA1 as the anticoagulant, to be used for RDP preparation must be process within ____ after collection 8 hours
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Blood substitute and components Whole blood, with CPD as the anticoagulant, to be used for RDP preparation must be process within ____ after collection 8 hours
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Blood substitute and components Whole blood, with CP2D as the anticoagulant, to be used for RDP preparation must be process within ____ after collection 8 hours
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HDFN After a two-volume exchange transfusion, approximately ___ of the red blood cells have been replaced and ___ of the bilirubin has been removed 90%; 50%
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Pre-transfusion Testing The type and screen, coupled with an immediate spin crossmatch, is referred to as ________ abbreviated crossmatch
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HDFN Currently the most common cause of HDFN ABO
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Pre-transfusion Testing An Rh control is indicated when spontaneous agglutination of red blood cells is suspected, such as in patients typing as _______. AB Rh-positive
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Transfusion Reactions A transfusion reaction with signs or symptoms presenting during or within 24 hours of transfusion is defined as a ___________________ Acute transfusion reaction
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Blood substitute and components Prevent platelet aggregation and promote gas exchange agitation
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Blood substitute and components Component of cryoprecipitate AHF; fibrinogen; VwF; Factor XIII; Fibronectin
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Transfusion Reactions Cause: Incompatible blood transfused (commonly ABO) (abbreviation) AHTR
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Transfusion Reactions Among AHTR and FNHTR, which one results to hypotension? AHTR
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Transfusion Therapy To increase blood volume while maintaining colliodal oncotic pressure Albumin
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Blood substitute and components CPP contains albumin, 25791011, ADAMTS13
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Blood substitute and components are often transfused during the neonatal period or in infants younger than 4 months of age due to their small blood volume. aliquot
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HDFN The product most often transfused during the neonatal period or in infants younger than 4 months of age. It has a shelf life of 24hrs and should be stored at 1 to 6 C Aliquoted red cell
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Tests Performed on Donor’s Blood Surrogate tests used to screen for HCV are (2) ALT and anti-HCV
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Quality Assurance in Blood Bank Mercury thermometers Annually
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Pre-transfusion Testing Either __________________ are acceptable for pretransfusion testing. Anticoagulated specimens are often preferred due to ease of handling. Red blood cells from an anticoagulated sample are ideal for preparing a uniform cell suspension for testing. Clotted red blood cells may require additional washing steps to minimize interference in test interpretations. In addition, serum may contain small fibrin clots that can be difficult to distinguish from true agglutination. anticoagulated or clotted specimens
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Transfusion Reactions What is the cause of FNHTR? anti-leukocyte antibody
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Transfusion Transmitted Diseases HTLV is associated to ATLL
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Rejuvenation/ Freezing/ Deglycerolization Rejuvenation solutions are used to restore or regenerate ___ and ___ ATP and 2,3-DPG
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Pre-transfusion Testing Patient RBC + Patient serum; What is this called? Autocontrol
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Rejuvenation/ Freezing/ Deglycerolization RBC freezing is primarily used for autologous units and rare blood types
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Transfusion Transmitted Diseases cell in which EBV replicates B
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Transfusion Reactions Most frequently recovered from donated blood and contamination ofplatelet Bacillus cereus, Staphylococcus epidermidis
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Blood substitute and components Impetus for prestorage leukoreduction biological response modifier
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General Blood Transfusion Practices What vital signs are monitored periodically during the transfusion to detect signs of transfusion reaction? alphabetically blood pressure, pulse, respiration, temperature
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Tests Performed on Donor’s Blood Both screening tests are based on antibody directed toward ____ particles cardiolipin
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Blood substitute and components Irradiation may be achieved by using either a radioactive source (________________) or x-ray Cesium 137 or cobalt
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Pre-transfusion Testing A major cause of transfusion-associated fatalities is _____ resulting in incorrect ABO groupings and transfusion of ABO incompatible blood. Clerical error is the greatest threat to safe transfusion therapy. The most common cause of error is misidentification of the recipient clerical error
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Blood substitute and components Red blood cell aliquots maintain the outdate of the original RBC component. closed system
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Transfusion Transmitted Diseases most frequently transmitted virus from mother to fetus. CMV
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Pre-transfusion Testing This crossmatching eliminates the need for a serologic crossmatch, which reduces sample volume requirements and testing time. What is this? Computer crossmatch
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HDFN Using high-resolution ultrasound with color Doppler enhancement of blood flow, the umbilical vein is,visualized at the level of the cord insertion into the placenta. A spinal needle is inserted into the umbilical vein, and a sample of the fetal blood is obtained The fetal blood sample can then be tested for hemoglobin, hematocrit, bilirubin, blood type, direct,antiglobulin test (DAT), and antigen phenotype and genotype. Cordocentesis or PUBS
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HDFN The anticoagulant of aliquoted red cell most often used for neonatal transfusions is ___ CPDA-1
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Pre-transfusion Testing final step of pretransfusion compatibility testing crossmatching
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Pre-transfusion Testing determining the recipient’s ABO group and Rh type, screening for any unexpected antibodies, and crossmatching the donor unit with the recipient’s plasma. crossmatching tests
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Transfusion Therapy Hypofibrinogenemia; Factor XIII deficiency (Second line therapy for von Willebrand’s disease,hemophilia A, and uremic bleeding); DIC Cryoprecipitate
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Blood substitute and components Fibrin glue is composed of cryoprecipitate and topical thrombin
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Transfusion Reactions Endogenous pyrogen is also known as cytokines
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Quality Assurance in Blood Bank Heating blocks, Water Baths, Donor unit agitators, Scales, Balances, Hemoglobinometer, Microhematocrit centrifuges, Refrigerator and Freezers (continuous monitoring) Daily when in use
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HDFN The most important serologic test for diagnosing HDFN in the Newborn or infant’s sample is the _____ with anti-IgG reagent. A positive test result indicates that the antibody is coating the infant’s RBCs; however, the strength of the reaction does not correlate well with the severity of the HDFN DAT
0%
HDFN Fetal cells remain intact because of high concentrations of Hgb F and would appear __________ after staining deep pink
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Transfusion Reactions A transfusion reaction with signs or symptoms presenting after 24 hours of transfusion is defined as _____________ Delayed transfusion reaction
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Transfusion Reactions Cause: Incompatible blood transfusion especially KIDD BGS (most common) DHTR
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Blood substitute and components Platelets are collected by apheresis, the cryopreservative _____ (1) is added, and the platelets are frozen at ____ (2). The frozen platelets can be stored for up to _________ (3). Prior to transfusion, the platelets are thawed and centrifuged to remove the DMSO. DMSO; -80C; 2 years
0%
HDFN The measurement of the fetal middle cerebral artery peak systolic velocity (MCA-PSV) with color _____ ultrasonography can reliably predict anemia in the fetus. Doppler
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Transfusion Transmitted Diseases Alphabetically, who has resistance to malaria? Duffy negative blood, G6PD deficiency, sickle cell anemnia
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Tests Performed on Donor’s Blood If HIV screening test is positive, how many times should you repeat the test? duplicate
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Tests Performed on Donor’s Blood Screening tests for HCV include (2) EIA and ChLIA
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Tests Performed on Donor’s Blood Screening test for HIV include (3) EIA, ChLIA, NAT
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Transfusion Reactions level of BP in TACO elevated
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Tests Performed on Donor’s Blood Most commonly employed method for detection of hepatitis infection ELISA
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Transfusion Reactions In FNHTR, what do the WBCs release when the antibodies attack them? endogenous pyrogens
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Quality Assurance in Blood Bank Platelet incubators (enclosed, monitored chambers) Every 4 hours
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HDFN ________ is the use of whole blood or equivalent to replace the neonate’s circulating blood and simultaneously remove maternal antibodies and bilirubin (unconjugated). exchange transfusiom
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HDFN Cases of hyperbilirubinemia that fail to respond to phototherapy require ____ exchange transfusion
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Transfusion Therapy Prevent or control bleeding in patients with hemophilia B or with specific factor deficiencies Factor IX concentrate
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Transfusion Therapy Prevent or control bleeding in hemophilia A patients. Factor VIII concentrate
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Blood substitute and components Cryoprecipitate is indicated in the treatment of ______ deficiency, as a source of fibrinogen for hypofibrinogenemia, and as a secondary line of treatment for classic hemophilia (hemophilia A) and von Willebrand’s disease Factor XIII
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HDFN Rosette test may be _____________ if the mother is weak-D positive and may be ____________ if the baby is weak-D positive false positive; false negative
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Pre-transfusion Testing Intrauterine transfusions (IUT) are indicated in severe cases of _____ fetal anemia
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HDFN FMH formula % fetal cells/100 x MBV
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HDFN FMH formula shortcut % fetal cells x 50
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Blood substitute and components If the plasma unit has been prepared within 6 hours after collection (if ACD is used) or within 8 hours after collection (if CP2D, CPD, or CPDA1 is used). What is this component? abbreviation only FFP
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Transfusion Therapy Correct multiple coagulation factor deficiency occurring in patients with liver failure, DIC, vitamin K deficiency, warfarin overdose, or massive transfusionTTP Replace isolated factor deficiencies when specific component is not available Reverse effects of warfarin anticoagulant drug FFP
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Transfusion Reactions In AHTR, what symptom was highlighted in the trans? flank pain
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HDFN No. of Rhogam vials formula; constant and whole blood bleeding FMH/30
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Blood substitute and components Cryoprecipitate and cryo-poor plasma units are prepared from ____ Fresh frozen plasma
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Transfusion Therapy Storage of rare blood and autologous units Frozen RBC
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Tests Performed on Donor’s Blood Confirmatory test for syphilis FTA-ABS
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Blood substitute and components Both the FDA and AABB recommend a minimum dose of ____ of _____ to the central portion of the blood unit, with no less than _____ delivered to any part of the blood unit gamma irradiation; 25 gy; 15 gy
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Rejuvenation/ Freezing/ Deglycerolization RBC freezing commonly uses ______ as a freezing agent glycerol
0%
Transfusion Therapy Neutropenia with infection unresponsive to appropriate antibiotics Granulocytes
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Blood substitute and components Platelet product pH should be ___________ greater than or equal to 6.2
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HDFN Round the calculated dose up if _____ 0.5 following decimal point or down if _____ 0.5 greater than or equal to; <
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Pre-transfusion Testing For emergent transfusions, issuing ________ to traumatically injured patients where ABO grouping is unknown is becoming widespread practice group A thawed plasma
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Tests Performed on Donor’s Blood What are to be detected when testing for hepatitis infection? HBsAg and anti-HBc
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Blood substitute and components 5,000 g x 5 minutes and 7 minutes. what is this called? heavy/hard spin
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HDFN Based on the principle that _______ (found in baby’s RBCs) are resistant to acid elution (that means, they’re not removed by acid), whereas adult hemoglobin (found in mother’s RBCs) are eluted (or removed) by acid Hemoglobin F
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Transfusion Reactions Cause: Iron overload is a delayed, nonimmune complication of transfusion, presenting with multiorgan (i.e., liver, heart, endocrine organs) damage secondary to excessive iron accumulation Hemosiderosis
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Rejuvenation/ Freezing/ Deglycerolization Slow, uncontrolled freezing; 40% w/v final concentration High glycerol method
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Rejuvenation/ Freezing/ Deglycerolization more commonly used RBC freezing method High glycerol method
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Tests Performed on Donor’s Blood What presence should be detected when screening for HIV? HIV-1/2
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Transfusion Reactions Characteristic symptom of ALTR Hives and wheals
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Blood substitute and components FFP is initially stored _________, but once frozen, should be shifted to _______ position horizontally; vertically
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Transfusion Transmitted Diseases first retrovirus to be associated with a human disease. HTLV-1
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Transfusion Transmitted Diseases fifth disease Human Parvovirus B19
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Rejuvenation/ Freezing/ Deglycerolization A blood unit is exposed to decreasing osmolarity, from _________________________________ hypertonic to isotonic
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Transfusion Reactions Cause of TACO iatrogenic
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Pre-transfusion Testing Pretransfusion testing begins and ends with the proper _______ of the patient sample Identification and collection
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Transfusion Reactions Anaphylactic Transfusion Reaction is attributed to the condition of the patient IgA deficiency
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HDFN RhIG is a concentrate of ________ prepared from pools of human plasma. IgG anti-D
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Transfusion Therapy used for patients with congenital hypogammaglobulinemia and for patients exposed to diseases such as hepatitis A or measles. immune globulin
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Rejuvenation/ Freezing/ Deglycerolization Rejuvenated RBCs must be washed before infusion to remove the _____ (which may be toxic) and transfused within 24 hours or frozen for long-term storage. Inosine
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Blood substitute and components Two platelet additive solutions, _____ and _______, have been approved for use in the United States. Intersol; Isoplate
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Transfusion Therapy Inactivate T lymphocyte; patients who are receiving a bone marrow or stem cell transplant and fetuses undergoing an intrauterine transfusion. Also indicated for recipients of components collected from a blood relative or HLA-matched donors (prevention of GVHD) Irradiated blood component
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General Blood Transfusion Practices Should be used as intravenous solutions to dilute blood components Isotonic saline or 5% albumin
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HDFN Of the non–Rh system antibodies, _____ is considered the most clinically significant in its ability to cause HDFN. Kell
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HDFN A __________________________- should be performed to quantitate the FMH Kleihauer-Betke or flow cytometry
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Rejuvenation/ Freezing/ Deglycerolization It involves the addition of a cryoprotective agent to RBCs that are less than 6 days old
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Transfusion Therapy Symptomatic anemia; Febrile reactions due to leukocyte antibodies; Reduction of CMV transmission and HLA Alloimmunization; TRALI Leukoreduced RBC
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Blood substitute and components Process of removal of white blood cells (WBCs) from blood or blood components prior to transfusion Leukoreduction
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Blood substitute and components 2,000 g x 3 minutes. what is this called? light/soft spin
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Blood substitute and components Plasma from whole blood donations may also remain in a liquid state, stored at 1° to 6°C, and be labeled as ________. It expires ______ after the whole blood shelf life from which it was collected. liquid plasma; 5 days
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Rejuvenation/ Freezing/ Deglycerolization Rapid, more controlled freezing; 20% w/v final concentration Low glycerol method
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Transfusion Reactions Level of IgA to be considered absolute IgA deficiency? <0.05 mg/dL
0%
Rejuvenation/ Freezing/ Deglycerolization Glycerol must be removed to a level of ______ residual. <1%
0%
Blood substitute and components leukoreduced blood components were to contain ______ residual white blood cells per each whole blood, red blood cells, or apheresis platelet <5 x 10^6
0%
Blood substitute and components each platelets derived from whole blood should contain _____ residual WBCs <8 x10^5
0%
Blood substitute and components Irradiation is performed to inactivate the ____________, which can cause graft-vs-host disease. lymphocytes (T)
0%
Tests Performed on Donor’s Blood ____ detects for HRP-2 (Histidine-rich protein-2) produced by Plasmodium falciparum MalaQuick Standby Malaria Test
0%
Pre-transfusion Testing In what conditions can be a Rh-negative patient receive Rh-positive blood? male and post-menopausal women with no preformed anti-D
0%
HDFN _____________ and _____________________ in the infant are characteristic of ABO HDFN, but not of Rh HDFN Microspherocytes and increased RBC fragility
0%
Quality Assurance in Blood Bank Alarm activation (freezers and refrigerators), centrifuge temperature (refrigerated) Monthly
0%
Blood substitute and components specialized hemocytometer which is designed to count WBCs at exceptionally low levels Nagoette chamber
0%
Transfusion Therapy Sickle cell anemia, thalassemia Neocyte-enriched RBC
0%
Pre-transfusion Testing Can we give a different blood group of platelet to patient? No
0%
Pre-transfusion Testing Is compatibility testing required for the transfusion of platelets, thawed plasma, and cryoprecipitate? No
0%
Tests Performed on Donor’s Blood Hepatitis C was initially referred to as Non-A, Non-B hepatitis
0%
Rejuvenation/ Freezing/ Deglycerolization Large molecules; does not enter the cells; forms a shell around the cells, thereby preventing loss of water Non-penetrating agent
0%
HDFN % fetal cells formula no. of RBCs with fetal F/total RBCs examined x 100
0%
Rejuvenation/ Freezing/ Deglycerolization Removal of glycerol from a unit of red blood cells after thawing has been performed; it is required to return the cells to a ________ normal osmolality
0%
Pre-transfusion Testing For emergent transfusions, if patient blood type is unknown, what can be required to transfuse? O
0%
Rejuvenation/ Freezing/ Deglycerolization Rejuvenation is used primarily to salvage __________________ (1) that are outdated or used with specific anticoagulant preservative solution up to ____ past outdate. O and rare RBC units
0%
Blood substitute and components RBC aliquot must be transfused within 24 hours. open system
0%
Tests Performed on Donor’s Blood _____ detects parasitic lactate dehydrogenase (p-LDH) produced by variable malaria parasite OptiMal assay
0%
Pre-transfusion Testing extreme emergencies, when there is no time to obtain and test a pretransfusion sample, group __ can be used O Rh-negative
0%
Pre-transfusion Testing For neonatal transfusions, what blood type is selected? O Rh-negative
0%
Pre-transfusion Testing For IUT, what blood type is selected? O Rh-negative
0%
Tests Performed on Donor’s Blood Bands in the western blot include p24, gp41, gp120/160
0%
Transfusion Therapy Restore/Increases oxygen carrying capacity, Symptomatic anemia; red blood cell exchange transfusion Packed RBC
0%
Blood substitute and components Component collected: 5000g for 7 minutes packed red blood cells and cell-free plasma
0%
Blood substitute and components Component collected: 5000g for 5 minutes packed red blood cells and platelet concentrate
0%
HDFN Hemoglobin A is eluted from the maternal cells; and thus the maternal cells would appear as _____________. pale ghost cell
0%
Pre-transfusion Testing When should be the final clerical check? Patient bedside
0%
Rejuvenation/ Freezing/ Deglycerolization Small molecules enter the cells and prevents cell dehydration as the ice forms Penetrating agent
0%
Blood substitute and components synthetic hydrocarbon structures in which all hydrogen atoms have been replaced with fluorine perfluorocarbons
0%
Transfusion Reactions Causes of TRAEDMTAPANHDT period
0%
HDFN Mechanism of RhIg Period
0%
Blood substitute and components If the plasma unit has been prepared within 8-24 hours after collection. What is this component? abbreviation only PF24
0%
HDFN _____ is performed as an initial treatment for hyperbilirubinemia in infants. Phototherapy
0%
Rejuvenation/ Freezing/ Deglycerolization Mnemonics of the component of rejuvenation solution PIGPA
0%
Transfusion Reactions What has ALA, Anti-HLA class 1, and ANA? plasma of donor
0%
Tests Performed on Donor’s Blood Component capable of transmitting spirochete infections platelet
0%
Blood substitute and components Component collected: 2000g for 3 minutes platelet-rich plasma
0%
Blood substitute and components What is not impacted by irradiation? platelets and granulocytes
0%
Pre-transfusion Testing Provides an excess of cations that neutralize the repulsive force between red cells, producing nonspecific aggregation and antibody- mediated lattice work formation. What potentiator is this? polybrene or protamine
0%
Blood substitute and components Can prevent febrile trasfusion reactions caused by WBCs but not the BRMs post-storage leukoreduction
0%
Transfusion Reactions EKG abnormality in potassium toxicity prolongedPR interval
0%
Transfusion Reactions EKG abnormality in citrate toxicity prolonged QT interval
0%
Transfusion Reactions Common isolate of human skin, was the most common bacterial contaminants in RBC Propionibacterium spp.
0%
Transfusion Reactions Second most common isolate found of RBC units Pseudomonas spp.
0%
Transfusion Reactions Cause of bacterial contamination transfusion-associated sepsis psychrophilic bacteria
0%
Transfusion Reactions Cause: Anti-platelet antibodies / anti-HPA1 (human platelet antigen1) antibodies PTP
0%
Quality Assurance in Blood Bank Blood warmers, Cell washers (speed, timer), Centrifuge speed timer Quarterly
0%
Blood substitute and components To confirm a product was irradiated, a________________ is affixed to the component before it is placed into the metal canister of the irradiator. Darkening of the film confirms irradiation requirements. radiochromic film label
0%
Blood substitute and components platelets derived from whole blood are typically called ________ random-donor platelet
0%
Transfusion Therapy Bleeding due to quantitative or qaulitative platelet defect RDP
0%
Rejuvenation/ Freezing/ Deglycerolization only FDA approved rejuvenation solution Rejuvesol
0%
Transfusion Reactions Cause of ALTR response of recipient antibody to allergen in donor’s blood component
0%
HDFN is considered as the most severe cause of HDFN. Rh
0%
Tests Performed on Donor’s Blood Confirmatory tests for HCV are (2) RIBA and HCV RNA
0%
General Blood Transfusion Practices Solution that causes shocking of RBCs Ringers solution
0%
HDFN Qualitative screening test for FMH that detects fetal D+ red cells in maternal Rh negative blood Rosette test
0%
Tests Performed on Donor’s Blood Screening tests for syphilis (2) RPR and VDRL
0%
Transfusion Therapy Bleeding due to quantitative or qaulitative platelet defect; generally indicated for patients who are unresponsive to random platelets due to HLA alloimmunization or to limit the platelet exposure from multiple donors; Prevention of bleeding from marrow hypoplasia SDP
0%
Transfusion Reactions For ANTR to occur, what is the requirement? Sensitization from transfusion or pregnancy
0%
HDFN Destruction of fetal RBCs leading to ______ is extremely rare severe anemia
0%
Pre-transfusion Testing What does the enzyme potentiator cleave? sialic acid
0%
Blood substitute and components platelet product obtained from an apheresis donation is referred to as _______ because each component contains one adult dose from a single donor. single-donor platelet
0%
Transfusion Transmitted Diseases fifth disease mild rash on the face is described as slapped cheek
0%
Blood substitute and components Endpoint of thawing FFP to produce CPP is when plasma becomes slushy
0%
General Blood Transfusion Practices About 200ml blood /hrInfusion must be completed within 4 hours speed of infusion
0%
Quality Assurance in Blood Bank Timing of the centrifuge and serofuges must be checked periodically with a ____. stopwatch
0%
Quality Assurance in Blood Bank Speed of centrifuge must be checked with a _______ at least every 6 months tachometer
0%
Transfusion Reactions second most common cause of transfusion related deaths reported to the FDA TACO
0%
Blood substitute and components Irradiation of cellular blood components (red blood cells, platelets, and granulocytes) is indicated to prevent the development of ___________ (abbreviation) TA-GVHD
0%
Transfusion Reactions Cause: delayed immune transfusion reaction due to an immunologic attack by viable donor lymphocytes (T cells) contained in the transfused blood component against the transfusion recipient. TA-GVHD
0%
Transfusion Reactions ALA, Anti-HLA class 1, ANA TRALI
0%
Transfusion Reactions leading cause of transfusion-associated fatalities TRALI
0%
HDFN Exchange transfusions are used primarily to remove high levels of _________________ and thus prevent kernicterus. unconjugated bilirubin
0%
Transfusion Therapy To removes plasma proteins; IgA deficiency with anaphylactoid/ anaphylactic reaction; Severe allergic reactions, rare donors, symptomatic anemia; red blood cell exchange transfusion Washed RBC
0%
Tests Performed on Donor’s Blood Confirmatory test for HIV include (2) Western blot and IFA
0%
Blood substitute and components Causes of febrile transfusion reactions White blood cells and biological response modifiers
0%
Transfusion Therapy To restore blood volume and oxygen-carryimng capacity; Symptomatic anemia with large-volume deficit Whole blood
0%
Transfusion Reactions When does a patient with PTP normally go back to normal? within 2 weeks
0%
Pre-transfusion Testing For emergent transfusion, Rh-negative red blood cell units are preferred but may be limited to________ in order to conserve inventory. women of childbearing age
0%
Quality Assurance in Blood Bank Blood banks are inspected yearly
0%
Transfusion Reactions According to CDC, it is the Most common cause of death by bacterial contaminated blood components Yersinia enterocolitica
0%
Pre-transfusion Testing Is the transfusing facility required to confirm the ABO grouping on all units and the Rh typing on all Rh-negative units upon receipt from the supplier? Yes
0%
Pre-transfusion Testing For neonatal transfusions, can you perform antibody screening and any required for compatibility to the specimen of mother? Yes
0%
HDFN Can you still give RhIg even if 72 hours has already elapsed? Yes
0%
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