The composition of blood transfused to a hemophilia patient is?

Appeared in: AIIMS Nagpur NO - 2018

Explanation

Hemophilia is a bleeding disorder caused by a deficiency of clotting factors, most commonly Factor VIII (Hemophilia A) or Factor IX (Hemophilia B).
The primary treatment involves replacing the deficient clotting factor to enable normal blood coagulation and stop bleeding.
Cryoprecipitate is a blood product derived from plasma that contains a high concentration of Factor VIII, fibrinogen, and von Willebrand factor.
Therefore, it is the most suitable component among the choices for treating bleeding in a patient with Hemophilia A.

Option A: While plasma contains all clotting factors, they are in a much lower concentration than in cryoprecipitate. A large volume of plasma would be needed to provide the same amount of Factor VIII, increasing the risk of fluid overload.
Option B: Packed red blood cells (RBCs) are primarily for restoring oxygen-carrying capacity due to blood loss. They contain negligible amounts of clotting factors and do not address the underlying cause of bleeding in hemophilia.
Option D: Hemophilia is a disorder of the clotting cascade (secondary hemostasis), not a problem with platelets (primary hemostasis). Platelet transfusions are ineffective for treating factor deficiencies.

Clinical Relevance

Nursing practice connection: Use the key finding related to Blood component therapy for hemophilia to guide bedside assessment, documentation, and the next nursing action.
Nurses must understand specific blood component therapy to ensure the right product is given for the right indication, minimizing risks like volume overload and transfusion reactions.
Administering cryoprecipitate requires careful monitoring for signs of allergic reaction and ensuring it is thawed and infused according to protocol, typically within a short timeframe.
What if the patient had Hemophilia B (Factor IX deficiency)? Then, cryoprecipitate would be ineffective, as it contains very little Factor IX. The treatment would be Factor IX concentrate or Fresh Frozen Plasma (FFP).

How to Approach the Question

First, identify the core pathophysiology of the disease in the question stem. 'Hemophilia' is a clotting factor deficiency.
Next, analyze the question's requirement: 'composition of blood transfused'. This asks for the specific treatment.
Evaluate each option based on its contents and function. The goal is to replace the missing clotting factor.
Plasma has factors but is dilute. Packed cells have no factors. Platelets are for a different bleeding problem.
Cryoprecipitate is a concentrated source of Factor VIII, the factor missing in the most common type of hemophilia, making it the best fit among the choices.

Concept Tested & Keywords

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E6 PATHOLOGY QUICK REVIEWBased on Harsh Mohan Textbook of PATHOLOGY p. 138-140

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