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BB Exam 4 - Diseases/Disorders Related to Transfusion Medic
Lecture 25
75
Biology
Undergraduate 3
03/14/2015

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Term
Acute and Chronic Blood Loss accounts for what percent of the anemia in the U.S.A.?
Definition
50%
Term
True or False:
The venous return determines the strength of the next heart beat
Definition
True
Term
True or False:
Without ATP to work the ion pumps, Na enters the cells
Definition
True
Term
When Na enters the cells, due to low ATP, what happens to the cells?
Definition
Swell and Be Destroyed
Term
Given % / mL of blood loss what are the symptoms:
10% / 500 mL
Definition
Usually none
Occasional lightheadedness
Term
Given % / mL of blood loss what are the symptoms:
20% / 1000 mL
Definition
Increased heart rate with exercise;
Hypotension when standing
Term
Given % / mL of blood loss what are the symptoms:
30-40% / >1500 mL
Definition
Decreased cardiac output and BP
Rapid pulse
Gasping for air
Cold Clammy Skin
Term
Given % / mL of blood loss what are the symptoms:
40-50% / 2500 mL
Definition
Compensatory mechanisms fail
Unconsciousness
Severe shock
Death
Term
5 Causes of Acute Bleeding
Definition
Trauma
Surgery
Aneurysm
Injured Spleen
OB problems
Term
If there is insufficient BP pushing on arteries, what happens?
Definition
Arteries collapse & blood cannot get back to the heart to initiate the next beat
Term
If there is a decrease in pressure, what will the release of epinephrine cause?
Definition
Vasocontriction, Increase Heart Rate, Improve Heart contraction strength
Term
When blood is diverted from skin, muscles, and other organs, where does it go to keep Oxygen?
Definition
Heart and Brain
Term
Extravascular fluid is drawn into the vessels by what?
Definition
Osmosis
Term
Extravascular fluid is drawn into the vessels by osmosis due to what?
Definition
Increased glucose released from the liver
Term
In an attempt to keep pressure up, the Kidney increases what?
Definition
Sodium
Water reabsorption
Term
What does Acidosis produced from lactic acid through anaerobic glycolysis cause?
Definition
Shift Oxygen dissociation curve to the right
Increase Breathing Rate
Term
True or False:
Trauma and/or acute blood loss - Volume often MORE Important than RBCs carrying O2
Definition
True
Term
What are the following examples of:
Crystalloids
Colloids
Definition
Volume Expanders
Term
What are the following examples of:
Saline
Ringers
Definition
Crystalloids
Term
What are the following examples of:
Albumin
Dextran Sulfate
Definition
Colloids
Term
If the patient has been previously screened and is found negative, there is a low chance of what?
Definition
Antibody
Term
True or False:
FFP is NOT recommended for volume because of risk of infectious diseases
Definition
True
Term
List 7 Adverse Physiologic Consequences of Massive Transfusion
Definition
Dilutional thrombocytopenia
Dilutional coagulopathy
Acid-base imbalance
Citrate toxicity
Hypothermia
Immunosuppression
Potassium overload
Term
If blood is over 7 days old, what blood components do not work well?
Definition
Platelets
Granulocytes
Term
If blood is over 7 days old, what factors will be decreased?
Definition
Factors V & VIII
Term
True or False:
Routinely giving FFP or Platelets is NOT justified because the bleeding is due to trauma or hypotension rather than dilution
Definition
True
Term
What can Citrate Toxicity cause?
Definition
Cardiac Arrest
Term
Citrate and Lactate in blood can lead to what?
Definition
Metabolic acidosis
Term
Generally levels of 2,3 DPG return to normal within how many hours after transfusion?
Definition
24 hours
Term
DIC is often observed in what type of patients?
Definition
OB patients
Trauma
Cancer
Infections
Term
What is used to treat DIC?
Definition
FFP
Platelets
Cryoprecipitate
Term
True or False:
FFP contains all of the coagulation factors
Definition
True
Term
True or False:
For Hemophilia A can use cryoprecipitate but now most often use Factor VIII concentrates
Definition
True
Term
What are VIII concentrates made from?
Definition
Pooled plasma and are virus inactivated either by heat or solvent detergents
Term
True or False:
You can also use recombinant DNA to treat Factor Deficiencies
Definition
True
Term
Both Recombinant DNA & VIII concentrates are ______ and can be given at home
Definition
Lyophilized
Term
What factor do you give to a patient who has Hemophilia B?
Definition
IX
Term
Mild cases of vonWillibrands treated with ______ which causes a release of endogenous stores of Factor VIII and vWF?
Definition
DDAVP (desmopressin)
Term
Other than DDAVP, what else can you treat mild cases of vonWillibrands with?
Definition
FFP
Cryoprecipitate
Term
Factor I deficiency is treated with what?
Definition
Cryoprecipitate
Term
True or False:
Platelets are very important for hemostasis
Definition
True
Term
Platelet disorders are related to what?
Definition
Number and/or Function
Term
Decreased # of Platelets is related to a large variety of conditions resulting from what?
Definition
Decreased Production
Increased Destruction
Term
What do the following cause:
Drugs, sepsis, liver disease, bypass surgery, primary bone marrow disorders
Definition
Decreased Number of Platelets
Term
If patient is refractory for platelets, then what needs to be done?
Definition
HLA or crossmatched instead of pooled
Term
Previously, you were transfused with platelets if the number of platelets was at or below what?
Definition
20,000 / microliter
Term
What does chemo therapy damage?
Definition
Stem cells
Term
What do most patients of chemo therapy develop?
Definition
Low RBC, WBC, & Plt Counts
Term
What do most patients of chemo therapy need?
Definition
Frequent Transfusions
Term
What type of blood do BM & Other Tissue Transplant patients need?
Definition
WBC-Reduced Blood Products
Term
Liver Disease-
Decreased Platelets due to what?
Definition
Splenomegaly
Term
Liver Disease-
_____ synthesis of ALL clotting factors
Definition
Decreased
Term
Liver Disease -
____ blood loss from esophageal varices
Definition
Acute
Term
Liver Disease -
Nutritional problems such as ... (2)
Definition
Iron or Folate Deficiency
Term
What do you use mostly for Liver Disease?
Definition
FFP
Platelets
Term
For liver transplant how many units are you likely to use during and immediately after the surgery?
Definition
15-30
Term
True or False:
Liver biopsy also usually requires blood
Definition
True
Term
What do Burns cause that allow fluid and protein to escape?
Definition
Increased vascular permeability
Term
Burns -
Fluid loss produces symptoms that are similar to what condition?
Definition
Acute blood loss
Term
Burn patients are prone to what type of imbalances?
Definition
Electrolyte
Infections
Term
First priority is to replace volume lost with what for burn patients?
Definition
Crystalloids
Term
True or False:
Later the burn patient will often need RBCs
Definition
True
Term
Some institutions will give burn patients what to fight sepsis?
Definition
Granulocytes
Term
True or False:
With AIHA patients you should try NOT to transfuse
Definition
True
Term
What do you need to make sure of before possibly transfusing a AIHA patient?
Definition
That there are no underlying alloantibodies
Term
True or False:
You should phenotype AIHA patients BEFORE the transfusion so that you can later work-up suspected alloantibodies
Definition
True
Term
What is the following consistent with:
Platelets destroyed by pump or stick to walls of pump
Definition
Cardiopulmonary Bypass
Term
What type of patients need regular transfusions with iron chelation agents?
Definition
Thalassemia
Term
What are the problems associated with Thalassemia?
Definition
Alloimmunization
Exposure
Iron Overload
Term
What would you do if you have a sickle cell patient requiring surgery in order to keep HS S at 30%
Definition
Hypertransfusion
Term
What type of transfusion do donors go through for Sickle Cell and Thalassemia patients?
Definition
Neocyte apheresis
Term
True or False:
Thalassemia & Sickle Cell
Try to give fresh blood and REMOVE WBC to prevent HLA
Definition
True
Term
Thalassemia & Sickle Cell
Try to give fresh blood and Remove what?
Definition
WBC
Term
Thalassemia & Sickle Cell
Try to give fresh blood and REMOVE WBC to prevent what?
Definition
HLA
Term
True or False:
Thalassemia & Sickle Cell
Try to phenotype and give AGN compatible whenever possible
Definition
True
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