Blood Transfusion and Coagulation Quiz

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Questions and Answers

What is the maximum storage duration for CPDA-1 anticoagulated whole blood, and what temperature must it be kept?

CPDA-1 anticoagulated whole blood can be stored for a maximum of 35 days at 1-6 degrees Celsius.

Explain the consequences of diluting coagulation products in a 1:1:1 transfusion ratio.

Diluting coagulation products in a 1:1:1 transfusion ratio leads to a less concentrated product, potentially compromising hemostatic effectiveness.

What are the primary components found in Fresh Frozen Plasma (FFP)?

FFP contains all coagulation factors except platelets, as well as albumin, immunoglobulins, and plasma protease inhibitors.

In what circumstances might low titer O positive blood be administered, and why is it particularly useful in trauma cases?

Low titer O positive blood is administered to non-group O recipients in trauma situations due to its universal donor capability, especially when O negative is in short supply. Signup and view all the answers

What is the normal fibrinogen level range in mg/dL, and why is fibrinogen important in coagulation?

The normal fibrinogen level ranges from 200-400 mg/dL, and fibrinogen is crucial as it is a key factor in the coagulation cascade that helps form blood clots. Signup and view all the answers

What is the significance of cryoprecipitate in relation to fibrinogen and what components does it contain?

Cryoprecipitate is significant for replenishing fibrinogen, and it contains fibrinogen, Factor VIII, Factor XIII, and von Willebrand factor. Signup and view all the answers

What causes hypovolemic shock and how is it typically treated?

Hypovolemic shock is caused by inadequate circulating volume due to hemorrhage or excessive fluid loss. Treatment includes volume resuscitation and addressing the source of fluid loss. Signup and view all the answers

Describe the primary mechanism behind septic shock.

Septic shock occurs due to systemic inflammation leading to vasodilation and decreased afterload. This results in impaired tissue perfusion despite adequate blood volume. Signup and view all the answers

What are the common treatments for cardiogenic shock?

Common treatments for cardiogenic shock include inotropic support with medications like dobutamine and dopamine, and the use of temporary mechanical devices like the intra-aortic balloon pump. These therapies aim to optimize cardiac output and reduce myocardial workload. Signup and view all the answers

How does neurogenic shock differ in its presentation compared to other forms of shock?

Neurogenic shock typically presents with bradycardia, hypotension, and vasodilation due to unopposed parasympathetic stimulation following a spinal cord injury. Unlike other shocks, it often does not exhibit compensatory tachycardia. Signup and view all the answers

What role do sympathomimetics play in the treatment of neurogenic shock?

Sympathomimetics are used to counteract the effects of vagal overactivity in neurogenic shock, increasing heart rate and vascular tone. This helps in managing hypotension encountered in the condition. Signup and view all the answers

What is the significance of the intra-aortic balloon pump in managing cardiogenic shock?

The intra-aortic balloon pump provides mechanical assistance by augmenting diastolic pressure and reducing afterload, improving coronary blood flow and cardiac output in cardiogenic shock patients. This intervention is vital to stabilize severely compromised cardiac function. Signup and view all the answers

Explain how obstructive shock differs from other types of shock.

Obstructive shock is characterized by an obstruction in blood flow that prevents adequate circulation, unlike other shocks which are primarily due to decreased blood volume or impaired pump function. Treatment focuses on relieving the obstruction. Signup and view all the answers

What is the role of epinephrine in the treatment of anaphylactic shock?

Epinephrine acts as a potent vasoconstrictor and bronchodilator, reversing the life-threatening effects of anaphylactic shock such as vasodilation and bronchoconstriction. Immediate administration is crucial for survival. Signup and view all the answers

Study Notes

Hematological Concepts

Whole Blood Transfusion: Low titer O positive is preferable for non-type O recipients. O negative is limited, used primarily in trauma.
Stored Whole Blood:
- CPD can be stored for 21 days at 1-6°C.
- CPDA-1 extends storage to 35 days.
- After 2 weeks, hemostatic function may decrease.
Platelet Repletion: Requires care to maintain adequate platelet levels.
Fresh Whole Blood: Must be used within 24 hours at room temperature. Can be refrigerated for up to 8 hours.

Trauma Indications

Transfusion Ratios: Fresh Frozen Plasma (FFP), Red Blood Cells (RBC), and Platelets (PLT) should be given in a physiological ratio to avoid product dilution.
Volume Efficiency: Smaller volumes of anticoagulant needed, decreasing workload on medical staff during trauma situations.

Coagulation Concepts

Normal Fibrinogen Levels: Ranges from 200-400 mg/dL.
Cryoprecipitate: Obtained by thawing FFP; contains fibrinogen, Factor VIII, Factor XIII, and Von Willebrand factor.

Fresh Frozen Plasma (FFP)

Components: Contains all clotting factors except platelets, along with albumin, immunoglobulins, and plasma protease inhibitors.
Indications:
- Used during trauma, Acquired fibrinogen deficiency, Disseminated Intravascular Coagulation (DIC).
- Recommended FFP standard; Cryoprecipitate used if low fibrinogen persists after multiple FFP transfusions.

Shock Concepts

Impaired Tissue Perfusion: Can lead to multiple shock types.

Hypovolemic Shock

Caused by inadequate circulating volume leading to decreased preload, often due to hemorrhage or excessive fluid loss.

Distributive Shock

Septic Shock: Characterized by systemic inflammation causing vasodilation and decreased afterload.
- Treatment includes volume resuscitation and vasoactive medications like norepinephrine, vasopressin, epinephrine, and Giapreza.
Neurogenic Shock: Results from spinal cord injury, leading to unopposed parasympathetic stimulation, causing vasodilation, bradycardia, and hypotension.
- Treatment: Sympathomimetics are used to manage symptoms.
Anaphylactic Shock: Triggered by allergens leading to a systemic inflammatory response causing vasodilation and bronchoconstriction.
- Treatment: Epinephrine and albuterol, along with antihistamines.

Cardiogenic Shock

Description: Heart's inability to produce adequate cardiac output; causes include myocardial infarction and heart failure.
- Treatment: Inotropic support (dobutamine, dopamine, milrinone) and mechanical cardiac devices to reduce heart workload and optimize oxygen supply.
- Temporary Mechanical Devices:
  - Intra-aortic balloon pump enhances coronary blood flow; contraindicated in aortic valve insufficiency and aneurysm.
  - Impella device offloads the left ventricle.

Obstructive Shock

Goal is to relieve obstruction and provide supportive therapy; causes include cardiac tamponade, tension pneumothorax, and pulmonary embolism.

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Description

Test your knowledge on key concepts related to blood transfusions and coagulation factors. This quiz covers topics such as storage duration for anticoagulated blood, components of Fresh Frozen Plasma, and the significance of fibrinogen. Dive into the specifics and enhance your understanding of these crucial medical practices.