Blood components

Question 1

are older RBC units better or worse than newer units?

Answer 1

no differences in clinical outcome

Question 2

are restrictive or liberal transfusion strategies better for Hb transfusion?

Answer 2

restrictive

Question 3

what is the Hb transfusion threshold for symptomatic patients with an MI?

Answer 3

10 g/dL or less

Question 4

what is the Hb transfusion threshold for hospitalized patients?

Answer 4

7-8 g/dL

Question 5

what virus is carried in WBCs?

Answer 5

CMV

Question 6

leukoreduced units are considered free of what disease?

Answer 6

CMV

Question 7

what is done to prevent transfusion associated graft-vs-host disease?

Answer 7

irradiation

Question 8

which population is indicated for receiving irradiation of cellular blood components for prevention of GVHD?

Answer 8

immunocompromised HSC recipients or organ transplant recipients

Question 9

when is RBC volume reduction performed?

Answer 9

when circulatory overload is a concern (CHF, renal failure)

Question 10

what are the indications for giving plasma?

Answer 10

1. coagulation factor replacement
2. massive transfusions
3. ADAMTS13

Question 11

what is platelet refractoriness?

Answer 11

when patients who have received platelets make antibodies to the transfused platelets

Question 12

how are compatible platelets found for patients with platelet refractoriness?

Answer 12

1. give random platelet units
2. cross match
3. find platelets that do not have the antigen that the antibody is directed toward

Question 13

what is in cryoprecipitate?

Answer 13

1. factor VIII
2. fibrinogen
3. vWF
4. factor XIII

Question 14

when is cryoprecipitate used?

Answer 14

1. fibrinogen replacement in bleeding patient

2. when normal treatment medications are not available (hemophilia A, factor XIII, vWF disease)

Question 15

what is included in the prothrombin complex concentrate? when is it given?

Answer 15

1. vitamin K factors (10, 9, 7, 2)

2. patients with hemophilia during hemorrhage, perioperative bleeding management, routine prophylaxis of bleeding events

Question 16

when is recombinant factor VIII given?

Answer 16

patients with hemophilia A

Question 17

when are IV Igs given?

Answer 17

1. primary humoral immunodeficiencies
2. immune thrombocytopenia
3. chronic inflammatory demyelinating polyneuropathy
4. hypogammaglobulinemia
5. post exposure prophylaxis

Question 18

when is albumin given?

Answer 18

1. hypoalbuminemia

2. volume replacement

Question 19

what is the reason for coagulation abnormalities following a massive transfusion?

Answer 19

replacement of blood loss with pRBCs and crystalloids and colloids will lead to a dilution of coagulation factors

Question 20

how do coagulation abnormalities manifest in test values following a massive transfusion?

Answer 20

1. increased PT and aPTT

2. fibrinogen levels drop - give cryoprecipitate

Question 21

what is a directed donation?

Answer 21

1. donation of a component for a specific patient

2. risky for both donor and patient (donor may be untruthful)

Question 22

giving whole blood is best in what situation?

Answer 22

trauma