chapter 49. quiz 7. complications

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the defining factor of fresh whole blood according to some investigators?

  • Storage at 1°C to 6°C for less than 48 hours
  • Storage at 4°C for less than 6 hours
  • Storage at 2°C to 5°C within 48 hours after collection and used within 24 hours
  • Storage at 1°C to 6°C within 8 hours after collection and used within 24 hours (correct)

Which factor is directly related to the effectiveness of fresh whole blood?

  • The type of blood group
  • The temperature of storage
  • The length of storage (correct)
  • The age of the recipient

Why does blood stored for longer periods become less effective, especially in terms of coagulation?

  • Improved hemostasis
  • Increased platelet aggregability
  • Decreased platelet aggregability (correct)
  • Enhanced coagulation factors

What is the impact of storing whole blood for 24 hours at 4°C on its hemostatic effects compared to storing it for less than 6 hours?

<p>Decreased hemostatic effects (A)</p> Signup and view all the answers

What is retained in typed and crossmatched warm whole blood that has not been cooled?

<p>Most of the factors of normal in vivo blood (A)</p> Signup and view all the answers

Which event did the experience in Vietnam show warm whole blood to be extremely effective in treating?

<p><strong>Coagulopathy from massive transfusions</strong> (D)</p> Signup and view all the answers

What is the primary cause of consumptive coagulopathy in patients experiencing major trauma or blood loss?

<p>Crystalloid administration (C)</p> Signup and view all the answers

What is the key factor that differentiates patients who may tolerate multiple units of blood without developing a coagulopathy?

<p>Adequate perfusion (C)</p> Signup and view all the answers

Which condition does a patient develop when hypotensive and receiving many units of RBCs in the presence of bleeding?

<p>coagulopathy that resembles DIC. (A)</p> Signup and view all the answers

What are the common clinical signs indicating a coagulopathy due to excessive blood transfusion?

<p>oozing into the surgical field (A)</p> Signup and view all the answers

Which factor contributes significantly to dilutional thrombocytopenia in patients receiving massive blood transfusions?

<p>Dilution of platelets by volume administration (D)</p> Signup and view all the answers

What best describes the coagulopathy that develops in patients who are hypotensive and have received numerous units of RBCs?

<p>'DIC-like' syndrome (B)</p> Signup and view all the answers

At what platelet count do patients usually experience clinical bleeding during surgery?

<p>Less than 50 × 10^9/L (B)</p> Signup and view all the answers

What platelet count indicates a patient will develop a bleeding problem from dilutional thrombocytopenia according to Miller and colleagues?

<p>Less than 75 × 10^9/L (C)</p> Signup and view all the answers

At what platelet count does spontaneous bleeding usually occur?

<p>Less than 10 × 10^9/L (D)</p> Signup and view all the answers

What happens to platelets in whole blood stored at 4°C for more than 24 hours when infused for patient?

<p>They are absorbed by the reticuloendothelial system (C)</p> Signup and view all the answers

How many units of blood given to acutely wounded soldiers can decrease platelet counts to less than 100 × 10^9/L?

<p>10-15 units (A)</p> Signup and view all the answers

What platelet count is considered a guide for developing a hemorrhagic diathesis due to multiple units of bank blood transfusion?

<p>&lt;50 × 10^9/L (B)</p> Signup and view all the answers

What platelet count range is likely to impair coagulation due to a combination of dilutional thrombocytopenia and DIC?

<p>50 to 70 x 10^9/L (C)</p> Signup and view all the answers

Why do patients with acute induced thrombocytopenia develop a hemorrhagic diathesis at a higher platelet count than those with chronic thrombocytopenia?

<p>Platelets are poorly functioning in acute induced thrombocytopenia. (C)</p> Signup and view all the answers

In what scenario is giving platelets to treat laboratory evidence of thrombocytopenia NOT recommended?

<p>When there is no clinical coagulopathy present. (A)</p> Signup and view all the answers

Why is the efficacy of blood product administration often difficult to assess according to the text?

<p>Platelet function and impact on clinical bleeding can be unpredictable. (B)</p> Signup and view all the answers

Why are decreases in blood fibrinogen concentrations during blood loss and replacement considered significant?

<p>fibrinogen is critical for effective clot formation (D)</p> Signup and view all the answers

What is the impact of storage on Factors V and VIII in whole blood?

<p>They decrease to approximately 50% and 30% of normal after 21 days of storage. (D)</p> Signup and view all the answers

Why is administration of Fresh Frozen Plasma (FFP) recommended?

<p>It contains all clotting factors including Factors V and VIII. (C)</p> Signup and view all the answers

What role does fibrinogen supplementation play in the treatment of acquired bleeding?

<p>It is the most effective method of supplementation according to prospective studies. (A)</p> Signup and view all the answers

How do Factor V and Factor VIII levels change in whole blood after 35 days of storage?

<p>They fall further to approximately 20% activity of normal. (A)</p> Signup and view all the answers

What is the significance of fibrinogen supplementation in major bleeding?

<p>It should be recognized as critical for effective clot formation. (D)</p> Signup and view all the answers

What is the primary function of the clotting system in the coagulation process?

<p>To prevent excessive blood loss (A)</p> Signup and view all the answers

What leads to the development of disseminated intravascular coagulation (DIC)-like syndrome?

<p>Deposition of fibrin rendering blood unclottable (A)</p> Signup and view all the answers

What is a potential cause for the activation of the coagulation system in DIC syndrome?

<p>Hypoxic acidotic tissues releasing tissue thromboplastin (A)</p> Signup and view all the answers

Which factor contributes to the consumption of factors in DIC syndrome?

<p>Tumor necrosis factor (A)</p> Signup and view all the answers

What does activation of the fibrinolytic system aim to achieve in the presence of a hypercoagulable state?

<p>Counteract excessive fibrin by lysing it (B)</p> Signup and view all the answers

How does the release of thromboplastin into the circulating blood affect the coagulation system?

<p>Results in generalized activation of coagulation system (B)</p> Signup and view all the answers

What traditional approach for DIAGNOSIS AND TREATMENT OF A HEMORRHAGIC DIATHESIS ?

<p>obtain a blood sample for platelet count, PTT, and plasma fibrinogen level (D)</p> Signup and view all the answers

In diagnosing a bleeding problem, if the PTT is 1.5 times normal or more and other tests are normal, what factors are likely to be at very low levels?

<p>Factors V and VIII (D)</p> Signup and view all the answers

Which component can be used to treat a bleeding problem resulting from very low levels of factors V and VIII?

<p>Fresh Frozen Plasma (FFP) (A)</p> Signup and view all the answers

What determines whether platelets should be administered in the form of fresh blood, platelet-rich plasma, or platelet concentrates?

<p>Intravascular volume replacement requirements (D)</p> Signup and view all the answers

For treating very low levels of factors V and VIII, which of the following can be used besides Fresh Frozen Plasma (FFP)?

<p>Cryoprecipitate (D)</p> Signup and view all the answers

How many units of platelet concentrates are required in a 70-kg person to increase the platelet count by 10 × 10^9/L in the absence of a consumptive process?

<p>10 units (B)</p> Signup and view all the answers

What did Lavee and associates find regarding the effectiveness of fresh whole blood compared to platelet units?

<p>Fresh whole blood was superior to platelet units (C)</p> Signup and view all the answers

What is the volume of platelet-rich plasma compared to a unit of blood?

<p>half of the volume (D)</p> Signup and view all the answers

What is the approximate percentage of platelets that platelet concentrates provide in a unit of blood?

<p>70% (D)</p> Signup and view all the answers

Why is determining the plasma fibrinogen level useful in diagnosing coagulation disorders?

<p>It remains stable in whole blood. (C)</p> Signup and view all the answers

What is the significance of a low in vivo plasma fibrinogen level?

<p>strongly suggests DIC (B)</p> Signup and view all the answers

How does the plasma fibrinogen level behave in the presence of blood loss and replacement?

<p>It decreases significantly. (D)</p> Signup and view all the answers

How does a low plasma fibrinogen level aid in diagnosing coagulation disorders compared to other factors?

<p>It is more sensitive than platelet counts. (D)</p> Signup and view all the answers

What can lead to hypocalcemia, dysrhythmia, and hypotension due to blood transfusions?

<p>Citrate intoxication (B)</p> Signup and view all the answers

In which scenario is citrate intoxication more likely to occur?

<p>Pediatric populations (B)</p> Signup and view all the answers

What rate of blood infusion can lead to decreasing ionized Ca2+ levels?

<p>More than 1 unit every 10 minutes (B)</p> Signup and view all the answers

What is a common occurrence during apheresis for donation of blood components?

<p>Citrate intoxication reactions (D)</p> Signup and view all the answers

In what scenario is hyperkalemia as a result of transfusion relatively rare?

<p>With large amounts of blood transfusion (A)</p> Signup and view all the answers

When does clinically significant hyperkalemia from banked blood transfusion usually occur?

<p>From banked blood given at a rate of 120 mL/minute or more (D)</p> Signup and view all the answers

What is the recommended method to prevent decreases in body temperature when administering stored blood to a patient?

<p>Warming the blood to body temperature before transfusing (A)</p> Signup and view all the answers

What can happen if a patient's body temperature decreases to less than 30°C during blood transfusion?

<p>Ventricular irritability and cardiac arrest may occur (C)</p> Signup and view all the answers

Why is shivering from mild hypothermia considered counterproductive in patients receiving stored blood transfusions?

<p>It contributes to tissue ischemia (C)</p> Signup and view all the answers

How does hypothermia affect coagulation factors and platelet function?

<p>Significantly impairs coagulation factors and platelet function (D)</p> Signup and view all the answers

What temperature range is typically used for warming blood before transfusing it to a patient?

<p>37-38°C (A)</p> Signup and view all the answers

What is the primary reason for the decrease in pH of bank blood to approximately 6.9 after 21 days of storage?

<p>Accumulation of lactic and pyruvic acids by RBC metabolism (D)</p> Signup and view all the answers

What is the consequence of a high Pco2 in stored blood when adequate ventilation is provided to the recipient?

<p>Insignificant effect on the recipient (D)</p> Signup and view all the answers

Why is the administration of sodium bicarbonate not recommended is not indicated

<p>because of these unpredictable acid-base changes (B)</p> Signup and view all the answers

What should guide the administration of sodium bicarbonate during blood transfusions?

<p>Analysis of arterial blood gases (A)</p> Signup and view all the answers

Flashcards are hidden until you start studying

More Like This

Use Quizgecko on...
Browser
Browser