Shared Flashcard Set

Details

HemeOnc
Blood Banking & Component Therapy
16
Accounting
Pre-School
01/09/2011

Additional Accounting Flashcards

 


 

Cards

Term
Donation types
Definition
o Allogenic – standard; go to Red Cross, give blood, goes to someone else
o Autologous – give blood to yourself; for a transfusion later during surgery (never proven useful)…
o Directed – choose your own donor
Term
Methods of blood collection
Definition
o Whole blood – go to Red Cross, give 500cc of your blood
o Apheresis – hook up to dialysis, take only specific desired components of blood (platelets, etc)
Term
• Blood Donor Qualification
Definition
very strict, FDA regulated; screen for health risks (diseases, medications, cancer, pregnancy)
o Infectious Diseases Screened – syphilis, HepBSurfAg, HepBCore, HIV, HTLV, HCV, West Nile, Typanosoma cruzi (Chagas), Hep B nuclear antigen
o Adverse Effects of Donation – iron def., hematoma, syncope, hyperventilation, arterial puncture, nerve injury
o Autologous Donation – less strict, since you’re giving to yourself
Term
Blood components
Definition
RBCs, plasma, platelet concentration, granulocytes, mononuclear cells, hematopoietic cells, FFP, cryoprecipitate
Term
RBC storage changes
Definition
slight hemolysis (more if stronger anticoagulant used), K+ leakage (usually insignificant, unless transfusing large volume), decreased 2,3-DPG (thus cells hold on to O2 more), and senescence (RBCs filtered @ spleen), loss of SNO-Hb
Term
plasma and platelet storage changes
Definition
• Plasma – clotting Factors V & VIII are somewhat decreased, but totally adequate
• Platelets – some will become activated, releasing granules, and Gp1b aggregation (store max 5d)
o Room temperature storage – if you store in cold, Gp1b aggregates & macrophages engulf & liver removes
Term
RBC Ab screening: direct agglutination, indirect antiglobulin, DAT
Definition
• Direct Agglutination – mix plasma with RBCs known to have antigens  look for IgM agglutination
• Indirect Antiglobulin – patient serum mixed w/ RBCs known phenotype, add anti-IgG & assess binding
o Use – assess blood type, look for RBC surface antigens
• Direct Antiglobulin (DAT) – patient RBCs mixed with anti-IgG/C3; assess binding
o Use – assess for AIHA, transfusion reactions, drug-induced hemolysis, cold agglutinin disease
o Transfusion reaction – see if transfused blood is covered with IgG…
Term
RBC Pretransfusion Tests
Definition
• ABO Typing – test for A and B antigens, double-check by assessing for anti-A/B Ig’s
o Type A – has A antigen, no B; thus has antibodies to B, but not A  can’t give to B or O
o Type O negative – has antibodies for A & B, and Rh (2o exposure, no Rh antigen)
• Rh Typing – do an Rh(D) antigen test
• RBC Antibody screening – described above (DAT, Indirect, etc)
Term
Emergency Transfusions considerations
Definition
o RBCs – should be Type O (have no antigens = universal donor)
o Plasma – should be Type AB (has no antibodies)
o Rh – negative preferable, especially in women of child-bearing age (avoid newborn hemolytic)
o Pretransfusion sample – obtain a cross match ASAP
Term
Indications for transfusion
Definition
o Symptomatic anemia – is patient showing elevated HR, low BP, fatigue, etc.?
o Bleeding >15% Blood Volume – is patient volume depleted?
o Chronic anemia – due to drugs, disease, etc  eventually need x-fusion
o Hemolytic anemia – sickle cell, other congenital
o Uremic bleeding – keep hematocrit > 30%, helps push platelets to peripheral vasculature & clot
Term
transfusion should be given to hemat 25% in px with AI hemolytic anemia?
Definition
NO! . PX MUST BE SYMPTOMATIC!!!!!!!!!!
Term
CIs to platelet transfusions
Definition
o Immune Thombocytopenic Purpura – platelets taken out of circulation within minutes
o TTP – platelet thrombi, risk of embolism
o Heparin-induced thrombocytopenia – risk of thrombosis high
Term
indications for platelet transfusion
Definition
• Hemorrhage – due to thrombocytopenia or platelet dysfunction, should give more platelets!
• Hemorrhage Risk – thrombocytopenia < 10,000
• Surgery Risk – thrombocytopenia < 50,000, invasive surgical procedure

• Example of Not Indicated – patient with ITP, 20,000 count, no surgery
Term
platelet transfusion success depends on the following factors (5)
Definition
• Body Size/Transfusion Rate –needs to be an adequate titration for patient transfused
• Antibodies – platelet specific antibodies must not react (HPA, HLA class I, ABO)
• Splenomegaly – greater proportion of transfused platelets will be stored in spleen, less successful
• Consumption/DIC, Sepsis – consume platelets!
• Drugs – can cause platelet consumption or deactivate platelets
Term
plasma transfusion indications
Definition
• Coagulation Factor Deficiency – although may consider a single factor concentrate as better choice
• Disseminated Intravascular Coagulation – all plasma components consumed, need to re-stock
• Reversal of Warfarin Anticoagulation – need to re-stock free plasma components
• Dilutional Coagulopathy – receiving massive transfusions  too much anticoagulant, need to correct
• Hemorrhage in Liver Disease – very complex coagulopathies
• TTP – replace enzyme which breaks down vWF (ADAMS 13)
• Trauma – studies have shown early and aggressive FFP + RBCs leads to increased survival
Term
Indications for cryoprecipitate transfusion
Definition
• Cryoprecipitate Contents – contains Factor VIII, vWF, fibrin, Factor XII… thus replace these deficiency:
o Factor VIII Deficiency – although Factor VIII concentrate may be better choice
o Von Willebrand’s Disease – although vWF concentrate may be better choice
o Hypofibrinogenemia – only fibrinogen concentrate
o Factor XIII deficiency – rare, will help here
• Uremic Bleeding – high molecular weight vWF in high concentration likely what helps
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