Question 44

Question:

A 38-year-old woman with a history of Factor V Leiden deficiency, multiple deep venous thromboses, placement of IVC filter, and depression presents with syncope, severe pallor, and abdominal distention after overdosing on her warfarin in a suicide attempt. Due to the severe bleeding, the patient requires fresh frozen plasma (FFP) to reverse the anticoagulation, but her blood type is unknown. Which of the following FFP types can be safely given?

Correct Answer: B.  AB+

Fresh frozen plasma (FFP) is indicated in severe bleeding to reverse anticoagulation. The woman has signs of hypovolemic shock and probable intra-abdominal bleeding that requires rapid correction. FFP contains clotting factors that are deficient in patients on warfarin (namely II, VII, IX, X). Plasma also contains antibodies to A and B antigens on RBCs. A and B antigens are glycosphingolipids. People with type A blood will produce antibodies to B antigen, people with type B blood will produce A antibodies, and people with type O blood will produce both. Similarly, people with Rh- type blood will produce antibodies to Rh factor. All these antibodies will be present in the plasma; therefore AB+ is the universal donor for PLASMA because it does not contain any ANTIBODIES. You may remember that O- is the universal donor for RBC because it does not contain any ANTIGENS. Incidentally, transfusion is not required to incite production of antibodies. Many foods, viruses, and bacteria can trigger sensitization to AB and Rh factors, so it is important to protect patients with unknown blood types by giving the universal donors.