Coagulopathy
This is the most common inherited coagulopathy
What is von Willebrand disease?
What is the most common transfusion complication?
what is febrile transfusion reaction
This is the leading cause of death in sickle cell disease
What is infection?
This is the therapeutic range for PTT on heparin
What is 60-100
(varies by institution)
In heparin induced thrombocytopenia, antibodies form against this complex
what is heparin - platelet factor 4?
In massive transfusion, this ratio of blood products is recommended to prevent dilutional coagulopathy.
1:1:1 PRBCs:plasma:platelets
A 57-year-old man with a history of peptic ulcer disease presents to the emergency department with large-volume black stools. The patient has a history of diabetes and heart failure. Point-of-care laboratory studies reveal a hemoglobin of 4.7 g/dL. The patient is given 4 units of packed red blood cells. While receiving the fourth unit of blood, he becomes dyspneic. His temperature is 97°F (36.1°C), blood pressure is 174/94 mm Hg, heart rate is 90 bpm, respirations are 22/min, and oxygen saturation is 90% on room air. Physical exam reveals jugular venous distension and pulmonary crackles and wheezes that were not present on initial exam. Which of the following is the most likely diagnosis?
What is transfusion-associated circulatory overload?
In a child with sickle cell disease who presents with lethargy, tachycardia, and a rapidly enlarging spleen, this is the most important immediate management step.
What is rbc transfusion?
A patient is on warfarin after having an aortic valve replacement. They have an elevated INR to 7. There is no active bleeding. What is the appropriate management?
What is hold warfarin?
In DIC with active bleeding and a fibrinogen level <100 mg/dL, this is the most appropriate blood product to administer.
What is cryoprecipitate?
A patient develops flank pain, fever, hypotension, and dark urine shortly after starting a transfusion
What is acute hemolytic transfusion reaction?
A 27-year-old man with a medical history of sickle cell disease presents to the emergency department with shortness of breath and chest discomfort with exertion. The patient is requesting pain management. His temperature is 100°F (37.8°C), blood pressure is 102/68 mm Hg, heart rate is 120 bpm, respiratory rate is 20/min, and oxygen saturation is 99% on room air. Physical exam is notable for an uncomfortable-appearing, pale young man who vomits during his exam. His lungs are clear to auscultation. Laboratory values are notable for a hemoglobin of 5.5 g/dL and a reticulocyte count of 0.5%. An initial ECG shows sinus tachycardia and his chest X-ray is unremarkable. Which of the following is the best next step in care?
What is tranfuse packed red blood cells?
A 55-year-old man with a history of hypertension, smoking, and multiple myeloma presents to the hospital with 3 days of headache, dizziness, and intermittent nose bleeding, and now he also has trouble walking. Vital signs show a heart rate of 102 bpm, blood pressure of 168/82 mm Hg, respiratory rate of 20/min, and temperature of 36.7°C. Remarkable examination findings include bilateral nystagmus and difficulty with tandem gait and finger-to-nose testing on the right. Laboratory work shows a hemoglobin of 6.5 g/dL, white blood cell count of 6,500/µL, and platelets of 72,000/µL. Potassium is 4.9 mEq/L, and creatinine is 2.1 mg/dL. What is the most appropriate treatment for this patient?
What is plasmapheresis?
A 49-year-old woman presents for evaluation of epistaxis. She reports 4 days of mild intermittent bleeding. Review of systems is significant for several weeks of fatigue and dyspnea on exertion. Her temperature is 98°F (36.7°C), heart rate is 115 bpm, respiratory rate is 20/min, blood pressure is 100/50 mm Hg, and oxygen saturation is 98% on room air. Her exam is significant for petechiae and scattered bruising. She is not actively bleeding. Blood work reveals white blood cell count of 32,500/µL, hemoglobin of 6 g/dL, platelet count of 34,000/µL, prolonged prothrombin time, fibrinogen of 20 mg/dL, and D-dimer of 14,500 ng/mL. Which of the following is the most effective treatment?
What is all-trans retinoic acid?
What electrolyte abnormality should you look out for in the setting of massive transfusion?
What is hypocalcemia?
A patient with SCD develops acute neurologic deficits; this intervention should be initiated emergently to prevent permanent injury.
What is exchange transfusion?
This is the gold standard for the diagnosis of heparin induced thrombocytopenia.
What is a serotonin release assay?
What is the name for a severe thrombotic cutaneous complication of disseminated intravascular coagulation?
What is Purpura fulminans
A 45-year-old G3P3 woman is transfused 1 unit of packed red blood cells for symptomatic anemia. Approximately 1 hour after the completion of the transfusion, she develops a fever of 100.7°F (38.2°C), but reports no myalgias, shortness of breath, headache, or urticaria. On examination, she has clear breath sounds bilaterally and no rash or ecchymosis. Which of the following interventions could have helped to prevent this reaction?
What is use of leukocyte-reduced packed red blood cells?
This infection is the most common cause of aplastic crisis in sickle cell disease
What is parvovirus?
What might be seen on funduscopic exam in patients with hyperviscosity syndrome and vision changes?
What is Sausage-link or boxcar segmentation