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Donor Selection & Pleb.
Testing of Donor Blood
Blood Component Preparation
Blood Component Therapy
Transfusion Therapy in Select Pts.
100
The acceptable limits for random blood donors for the physical examination: General appearance H&H Temperature (F&C) Blood Pressure Pulse Weight Age
General appearance: General good health, no alcohol or drug use, no needle tracks in the arms Hct:>/=38% Hgb: >/=12.5g/dL Temp: </= 37.5C or 99.5F BP: </= 180/100 mmHg Pulse: No specific requirements (b/w 50-100 beats ok) Weight: Minimum of 110lb Age: >16years
100
What test method is used to confirm a positive Anti-HIV1/2 screen?
The Western blot
100
Irradiation of blood products prevents what condition?
Grafts versus host disease
100
How much should 1 unit of platelets increase the platelet count? What term is used to describe a lack response to platelet transfusions?
5,000 to 10,000/microliter Platelet refractory or refractoriness
100
State 3 reasons for transfusions in premature neonates and the criteria for selection of blood products for neonates.
1. Iatrogenic blood loss 2. Insufficient erythropoeisis 3. Conversion of Hgb F to Hgb A Blood products should be O neg or type specific, cross matched with maternal serum, CMV and Hgb S neg, Irradiated, leukoreduced and < 7days old
200
State the 3 main phases of donor screening and describe the processes occurring in each phase.
Donor Registration- full identification of donor and review of educational materials which describe the donation process and donor eligibility. Health History Interview- A donor history questionnaire designed to protect the donor and recipient. Donors may be deferred permanently, indefinitely or temporarily based on the answers provided. Physical Exam- A physical exam of donor to ensure physical exam limits are within range. (temp, H&H, general appearance, BP, Weight and Age)
200
Draw the following immunoassays on the board. Indirect ELISA Sandwich ELISA Competitive ELISA
See page 290
200
State the indication of use for Frozen RBCs. What must occur before the units are frozen? What must occur when the units are thawed for use?
Prolonged storage for rare blood units or autologous storage. A cryoprotective such as glycerol must be added before freezing to prevent cell dehydration and ice crystal formation. Deglycerolization by washing the RBCs with saline must occur upon thawing.
200
Which single blood product can be used to treat von Willebrand's disease (vWD), fibrinogen deficiency and Hemophilia A?
What is Cryoprecipitate.
200
State the proper blood component used for the 3 main complications arising in patients receiving chemotherapy. Anemia Bleeding Infection
Anemia- PRBCs Bleeding- FFP and platelets Infection- Granulocytes
300
State 2 reasons someone would be permanently deferred from blood donation.
History of viral hepatitis (B or C) Past or present clinical or lab evidence of Hepatitis B, C, HTLV or HIV. History of babesiosis or Chagas disease Family history of CJD Recipient of dura mater or human pituitary growth hormone Risk of vCJD (living in UK for extended period of time) Use of a needle to administer non-prescription drugs
300
NAT for HIV has decreased the window period for HIV detection to...
7-9 days
300
This is defined as the biochemical changes that occur when blood is stored at 1-6C. State 2 changes that occur.
The storage lesion. > in plasma Hgb and potassium < in viable cells, ph, Na, ATP and 2,3 DPG
300
After 1 unit of RBCs, what would you expect the H&H to be in a pt. with an initial H&H of: 7 g/dL & 21%
Hemoglobin is increased 1 g/dL w/ each unit. Hematocrit is increased 3% w/ each unit. H&H should be approximately 8 g/dL & 24% after 1 unit of RBCs.
300
What is the ideal component for treatment of Hemophilia A?
Factor VIII concentrate
400
State the 5 intended uses for donations. Briefly explain each.
Allogeneic- donation for use by the general patient population. Autologous- donation by a donor reserved for the donor's later use Directed Donation- donation reserved for use by a specific patient. Apheresis-donation of a specific component of the blood; parts of the whole blood that are not retained are returned to donor Therapeutic phlebotomy-donation performed to withdraw blood from a patient for medical reasons such as PV or Hemochromatosis
400
State 2 diseases that are not screened for in the laboratory but only through the health history interview.
Malaria Babesiosis Chagas disease (1 time test) Leishmaniasis vCJD CJD
400
List the whole blood component preparation in the order it occurs to make RBCs, Platelets, FFP and Cryo. 1. Express 2. Freeze 3. Centrifuge 4. Thaw
3, 1, 3, 1, 2, 4, 1 Centrifuge, express (RBCs) Centrifuge, express (Platelets) Freeze, thaw, express (Cryo and FFP)
400
A massive transfusion is defined as the exchange of 1 volume of blood in a 24 hour period. Approximately how many units of RBCs is this in the average adult?
10-12 units
400
Long term transfusions are at risk for which condition? What type of therapy treats this condition? State 2 populations at risk for this condition.
Hemachromatosis. Iron chelation therapy. Sickle cells and patients with thalassemias
500
Which of the following is NOT a cause for temporary deferment of a whole blood donor? Hepatitis B immunoglobulin taken 4 weeks previously Oral polio vaccine taken 1 week previously Rubella injection 1 week previously Aspirin ingestion 12 hours previously
Aspirin ingestion 12 hours previously
500
Provide all the routine tests performed on donor blood. Both immunohematologic and infection disease testing (there are 7 diseases)
ABO/Rh including Weak D Antibody screen Hepatitis: HBsAg, Anti-HBc, Anti-HCV, NAT for HCV HIV: Anti-HIV 1/2 and NAT for HIV HTLV: Anti-HTLV 1/2 Syphilis: RPR or Hemagglutination WNV: NAT for WNV Trypanosoma cruzi (Chagas disease): IgG antibody to T. cruzi one time screen
500
Provide the storage temperature and expiration limits for each product: RBCs Irradiated RBCs Deglycerized RBCs FFP Thawed FFP Platelets Cryo Pooled Cryo
RBCs-(1-6C) for 42 days with CPDA1 and an AS Irradiated RBCs- (1-6C) for 28days or the original exp. Deglycerized RBCs- (1-6C) for 24hr FFP- (<-18C) for 1yr or (<-65C) for 7yrs Thawed FFP- (1-6C) for 24 hrs Platelets- (20-24C) for 5 days Cryo- (<-18C) for 1yr Pooled Cryo- (20-24C) for 4hrs
500
State the indication for use for the following blood products: RBCs Platelets FFP Granulocytes
Pg 325 Ch. Summary RBCs- increase oxygen carrying capacity in anemia, trauma and surgery Platelets- Bleeding caused by thrombocytopenia or thrombocytopathy (irregular platelet function) FFP- Replace coagulation factors (both stable and labile) Granulocytes- Neutropenia with infection, unresponsive to antibiotics
500
CMV is dangerous for which type of patient? Name at least 2.
Neonatal Immunocompromised or suppressed patients: HIV, or Bone marrow transplant recipients