Andy Test - Bcsh Guideline On Massive Transfusion

12 Questions | Total Attempts: 111

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This quiz is to test how well you know the BCSH Guidelines on Massive Transfusion


Questions and Answers
  • 1. 
    Which of the following are accepted definitions of “massive blood loss”?
    • A. 

      One blood volume within a 24h period

    • B. 

      Transfusion rate of ≥ 6 units within a 24h period

    • C. 

      A haemoglobin level of less than 40g/l

    • D. 

      50% of the blood volume in a 3h period

    • E. 

      Blood loss of ≥ 150ml/min

  • 2. 
    The role of the Hospital Transfusion Committee include:
    • A. 

      Developing an Emergency Blood Management Plan

    • B. 

      Reviewing massive transfusion episodes critically

    • C. 

      Making decisions on when a patient should cease to receive energetic transfusion support

    • D. 

      The development of protocols for management of massive transfusions

    • E. 

      Providing guidance on clinical priorities for use of large volumes of blood components

  • 3. 
    According to the guideline, when should group O RhD negative blood be used in massive transfusions?
    • A. 

      In pre-menopausal women only

    • B. 

      Never

    • C. 

      Until bleeding in the patient slows sufficiently to make ABO and RhD matching the patient worthwhile

    • D. 

      In an extreme emergency only

    • E. 

      Until the ABO and RhD of the patient is known

  • 4. 
    Which of the following are therapeutic goals of managing massive blood loss?
    • A. 

      Use of blood component therapy to correct coagulopathy to arrest bleeding

    • B. 

      Treating any traumatic, surgical or obstetric source to arrest bleeding

    • C. 

      To prevent the patient being sensitised and making atypical red cell alloantibodies

    • D. 

      Maintenance of tissue perfusion and oxygenation

    • E. 

      To end an acute sickle crisis in patients suffering from sickle cell disease

  • 5. 
    Which of the following hazards of transfusion are cited in the guideline as particular problems associated with massive transfusion?
    • A. 

      Acute haemolytic transfusion reaction

    • B. 

      Delayed haemolytic transfusion reaction

    • C. 

      Transfusion-transmitted infections

    • D. 

      Transfusion-related acute lung injury

    • E. 

      Transfusion-associated graft versus host disease

  • 6. 
    The critical level of fibrinogen (1.0g/l) after which coagulopathy can occur is likely to be reached after about 150% blood volume loss.
    • A. 

      True

    • B. 

      False

  • 7. 
    The transfusion trigger for platelets in a patient who is actively bleeding is 50 x 109/l.
    • A. 

      True

    • B. 

      False

  • 8. 
    One of the most common metabolic consequences of massive transfusion is hypocalcaemia (reduced calcium levels) which may occur as a result of transfusing large volumes of plasma, especially in the presence of abnormal liver function. This can be corrected by intravenous infusion of gluconate.
    • A. 

      True

    • B. 

      False

  • 9. 
    The over-riding first requirement is maintenance of tissue perfusion and oxygenation.
    • A. 

      True

    • B. 

      False

  • 10. 
    Treatment of coagulation defects (using platelets, cryoprecipitate and FFP) should be done once all the test results are known to avoid making the defects worse
    • A. 

      True

    • B. 

      False

  • 11. 
    Coagulation factor deficiency (the primary cause of coagulopathy in massive transfusion) is often caused by dilution of the coagulation factors by volume replacement therapies (crystalloids and colloids) and transfusion of red cell products.
    • A. 

      True

    • B. 

      False

  • 12. 
    Recombinant factor VIIa (licensed for use in haemophiliacs to treat active bleeding or as prophylaxis before surgery) can be used off-licence to reduce blood loss in massive transfusion cases although the evidence for this is only anecdotal.
    • A. 

      True

    • B. 

      False

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