Chapter 14: Apheresis

_______ testing is performed on platelet apheresis products to make sure that HIV, WNV, and heptitic C are not present/

Nucleic acid

In plateletpheresis, which blood component is returned to the donor?

Options A and C Red blood cells White blood cells

Which of the following is an indication for therapeutic apheresis?

Options B and C A pathogenic substance exists in the blood that contributes to a disease process A substance can be more effectively removed by apheresis than by the body's own homeostatic mechanisms

All of the following constitute variable of apheresis procedures except:

blood type

The specific cell product used for testing sepsis is the:

granulocyte

A person participating in a serial apheresis program would not:

lose more than 25mL of red blood cells per week

Currently, the immunoaffinity column has FDA licensure for treating what disease state?

Idiopathic thrombocytopenic purpura (ITP)

Plasma exchange is most effective when _______ is considered the pathological substance.

IgM

The method in which a specific ligand is bound to an insoluble matrix in a column and plasma is perfused over the column with select removal of pathogenic substance and return of patient's plasma is known as

Immunoadsorption

What effect do steroids have on leukapheresis?

Increase the vascular pool fo granulocytes

Which of the following terms is defined as the removal of white blood cells with the return of red blood cells, plasma, and platelets?

Leukapheresis

Which patients are at the most risk for platelet refractoriness where they become alloimmunized to HLA antigens on platelets?

Leukemic patients

Erythrocytopheresis is successful in which of the following conditions?

Malaria

Which apheresis method carries the additional risk of returning red blood cells to the wrong individual and yielding the smallest volume of selected blood component?

Manual apheresis

What is the definition of apheresis?

Separation or removal of a blood component from whole blood

In what circumstance is a plasmapheresis donor rejected from donation?

Serum protein = 5.0 g/dL

A child undergoing apheresis at require CFC to minimize:

extracorporeal volume

All of the following statements are consistent with CFC except:

reinfusion to the patient ocmpletes one cycle

Compatibility testing is required for granulocyte concentration if the red blood cell contamination is greater than:

5mL

A donor's estimated total blood volume was determined to be 4,500 mL before a plasmapheresis procedure. the extracorporeal blood volume should not exceed:

675mL

The platelet count of the plateletpheresis donor must be _______ prior to the procedure.

>150 x 10^9 per L

The concentrate obtained from plateletpheresis via a closed system is stored for 5 days at room termperature. What must the pH be at the end of the storage?

>=6

What other technique is available for neonates with sepsis when apheresis is unavailable?

A buffy coat prepared from a whole blood unit less than 12 hours old

While undergoing plasmapheresis, the donor experienced numbness around his mouth, which is indicative of citrate toxicity. How can this be treated?

Administering exogenous calcium

What is a disadvantage of choosing fresh frozen plamsa for fluid replacement in persons undergoing therapeutic plasmapheresis?

All of the above Citrate toxicity Disease transmission ABO incompatibility

What variables are necessary to calculate the donor's total blood volume?

All of the above Height, Weight, Sex

Fresh frozen plasma (FFP) is not the optimal product for replacement fluids for the therapeutic plasma exchange procedure. For which patient is FFP the optimal product of choice?

All of the above Patient with liver disease Patient with thrombotic thrombocytopenic purpura (TTP) Patient scheduled to undergo an invasive procedure

When is isolation of PBSCs via apheresis equipment indicated?

All of the above The bone marrow contains malignant cells The bone marrow has be irradiated The patient cannot tolerate general anesthesia

How is HES used in apheresis procedures?

As a sedimenting agent to separate white blood cells from red blood cells

Which of the following conditions would necessitate a plasmapheresis procedure?

Barbiturate poisoning

What possible risk exists when hydroxyethyl starch (HES) concentration has exceeded the renal threshold and excretion is retarded?

Blockage of the reticuloendothelial system

Which of the following statements best describes the apheresis concept?

Blood is removed from an individual, anticoagulated, and separated, the desired component is retained, and the remaining portions are returned to the donor/patient

Wht is an example of a continuous flow centrifugation (CFC) instrument?

COBE Spectra

Fatalities that result from therapeutic apheresis have primarily been caused by:

Cardiac arrest and arrhythmia

What is the primary anticoagulant used in pheresis procedures?

Citrate

A normal healthy donor undergoes a procedure to obtain platelets that will be transfused to a patient is representative of:

Component apheresis collection

Photopheresis is effective against what malignant disorder?

Cutaneous T-cell lymphoma

Anitplatelet medications have differing deferral time periods. Which of the following does not match?

Feldene - 7 days

Which of the following incorporates membrane filtration technology with intermittent flow centrifugation (IFC) apheresis?

Fenwal Autopheresis-C

Which cell type is densest in the white blood cell layer when anticoagulated blood is centrifuged?

Granulocyte

Which immunoadsorbent has an affinity for IgG classes 1,2, and 4 and their immune complexes?

Staphylococcal protein A

What is the physiological cause of citrate toxicity in cytapheresis procedures?

The anticoagulant in plasma contains citrate, which binds calcium, lowering the body's ionized calcium

Which of the following factors influenced the need for apheresis technology?

The blood component needs of patients on chemotherapy

All of the following statements are consistent with photopheresis except:

The patient is given an oral dose of piroxicam, which binds to the RNA of all nucleated cells

What is therapeutic plasmapheresis?

The removal of large volumes of patient plasma

Which of the following is not an indication for plasmapheresis?

To decrease iron deposition in tissues in chronically transufsed patients

The removal of red blood cells in a hemapheresis procedure is called

erythrocytopheresis

Leukopheresis may be indicated when the white blood cell count exceeds _______.

100,000 per uL

During a plasmapheresis procedure, the red blood cells must be returned within how many hours of phlebotomy?

2 hours

One unit of apheresed platelets should increase the platelet count ________.

20,000 to 60,000 per uL

Whata does the hematocrit need to be (regardless of gender) for a double red blood cell collection?

40%

Plasmapheresis is synonymous with what term?

Plamsa exchange

What effect does aspirin have on platelets?

Prevents platelet aggregation

What can be done to prevent the development of HLA alloimmunization and platelet refractoriness?

Reduce the number of leukocytes in the platelet product

When a sample of whole blood is pun, distinct layers form. What cell line or lines make up the buffy coat?

White blood cells and platelets

Citrate used as an anticoagulant in apheresis procedures is removed from the body by:

being metabolized in the liver

The hematopoietic progenitor cells that eventually repopulate the bone marrow and also circulate in the blood are called

peripheral blood stem cells (PBSC)