Adverse Effect of Blood transfusion (chpt 14) Flashcards
T/F. Blood transfusion is NOT, and likely NEVER will be, without risk
TRUE
it is an unintended and deleterious
occurrence associated with blood component transfusion. It
may occur before, during, or after a transfusion.
adverse event
what are the most common causes of deaths associated with transfusion recipients
TRALI (transfusion-related acute lung injury)
TACO (transfusion- associated bacterial infection)
TTBIs (transfusion-transmitted bacterial infections)
What component is most frequently involved with transfusion-associated sepsis?
Platelets
Fatal transfusion reactions are mostly caused by:
a. Serologic errors
b. Improper storage of blood
c. Clerical errors
d. Improper handling of the product
C. clerical errors
Early manifestation of an acute hemolytic transfusion reaction can be confused with: a. Allergic reaction b. Febrile nonhemolytic reaction c. Anaphylactic shock d. Sepsis
B. febrile nonhemolytic reaction
Pain at infusion site and hypotension are observed with
what type of reaction?
a. Delayed hemolytic transfusion reaction
b. Acute hemolytic transfusion reaction
c. Allergic reaction
d. Febrile nonhemolytic reaction
b. Acute hemolytic transfusion reaction
Irradiation of blood is performed to prevent:
a. Febrile nonhemolytic transfusion reaction
b. Delayed hemolytic transfusion reaction
c. Transfusion-associated graft-versus-host disease
d. Transfusion-associated circulatory overload
c. Transfusion-associated graft-versus-host disease
The only presenting sign most often accompanying a
delayed hemolytic transfusion reaction is:
a. Renal failure
b. Unexplained decrease in hemoglobin
c. Active bleeding
d. Hives
b. Unexplained decrease in hemoglobin
Which transfusion reaction presents with fever, maculopapular rash, watery diarrhea, abnormal liver function,
and pancytopenia?
a. Transfusion-associated sepsis
b. Transfusion-related acute lung injury
c. Transfusion-associated graft-versus-host disease
d. Transfusion-associated allergic reaction
c. Transfusion-associated graft-versus-host disease
A suspected transfusion-related death must be reported to:
a. AABB
b. Federal and Drug Administration (FDA)
c. College of American Pathologists (CAP)
d. The Joint Commission (TJC)
b. Federal and Drug Administration (FDA)
Nonimmune hemolysis can be caused during transfusion by:
a. Use of small bore size needle
b. Use of an infusion pump
c. Improper use of a blood warmer
d. All of the above
d. All of the above
. Transfusion reactions are classified according to:
a. Signs or symptoms presenting during or after
24 hours
b. Immune or nonimmune
c. Infectious or noninfectious
d. All of the above
d. All of the above
With febrile nonhemolytic transfusion reactions:
a. They are self-limited
b. Fever resolves within 2–3 hours
c. Treatment is required
d. a and b are correct
e. All of the above
d. a and b are correct
Absolute IgA deficiency is a classic example of a severe
allergic reaction. A result indicating an absolute IgA
deficiency is:
a. <0.05 mg/dL
b. <0.50 mg/dL
c. <0.50 gm/dL
d. <5 mg/dL
a. <0.05 mg/dL
How are mild allergic transfusion reactions with isolated
symptoms or hives and urticaria treated?
a. Transfusion is stopped and transfusion reaction
workup is initiated
b. Transfusion is stopped and antihistamines administrated; when symptoms improve, transfusion is
restarted
c. Stop transfusion and prepare washed red blood cells
d. Continue transfusion with a slower infusion rate
b. Transfusion is stopped and antihistamines administrated; when symptoms improve, transfusion is
restarted
TRALI presents with the following symptoms:
a. Respiratory distress
b. Severe hypoxemia and hypotension
c. Fever
d. All of the above
d. All of the above
Which of the following is characteristic of iron overload?
a. Delayed, nonimmune complication occurs
b. Chelating agents are used
c. Multiorgan damage may occur
d. All of the above
d. All of the above
These are constant leading causes of mortality associate with transfusion-related adverse reactions
TRALI and TACO
What is the first step you must do once a transfusion reaction is suspected
immediately stop the transfusion if the infusion is still in the process
What is the responsibilities of laboratory technologist in transfusion service
• Perform primary testing on postreaction sample
• Report findings to the transfusion service physician
• Perform additional testing as per transfusion service
physician orders
What are the signs and symptoms of Transfusion reaction
- fever
- Hypoxemia
- Tachycardia
- Tachypnea
- Hypertension
- Hypotension
What laboratory work up will help resolve Transfusion-Associated Sepsis? A. ruling out pancytopenia B. ruling out hemoglobinemia C. ruling out hemolysis D. ruling out clerical errors
C. ruling of hemolysis
It is the collection
of information on the complications of transfusion, analysis
of these data, and subsequent data-driven improvements in
transfusion practices.
Hemovigilance
It is the development of non-ABO anti -
bodies following RBC transfusion, pregnancy, or transplantation.
Alloimmunization
some individuals may be more susceptible than others to developing RBC alloantibodies. These persons, called
responders
is defined as
the combination of signs and symptoms associated with
hemolysis, biochemical evidence of hemolysis, and serologic
evidence of RBC incompatibility occurring during or within 24 hours after transfusion.
AHTR Acute hemolytic transfusion reaction
AHTR is due to
RBC transfusion (incompatible) - but they can occur with incompatible plasma-containing products
What is the most common symptoms in AHTRs
FEVER
What type of acute transfusion reaction, that upon testing will present a positive DAT? A. allergic severe B. acute immune hemolytic C. febrile non-hemolytic D. transfusion-associated sepsis
B. acute immune hemolytic
is a rare event associated with acute respiratory distress but a leading cause of mortality due to adverse reactions to transfusion.
TRALI
T/F “Possible
TRALI” is designated when the above criteria are present
but another cause of ALI is also identified, w
TRUE
T/F “delayed
TRALI” refers to when criteria for TRALI are present but the onset is 6–72 hours after transfusion.2
TRUE
What are the clinical presentation of TRALI
acute respiratory distress,
dyspnea
tachypnea, and hypoxemia.
Signs and symptoms may also include: fever rigors tachycardia hypothermia, and hypotension
is an adverse reaction characterized by acute respiratory distress from pulmonary edema caused by increased
intravascular volume due to excessive transfused fluid and/or
too rapid of an infusion rate and the inability of the patient
to accommodate the volume of transfused products due to
impaired pulmonary, cardiac, or renal function.
(TACO) transfusion- Associate Circulatory Overload
it is the second most common cause of transfusion related death reported to the FDA
TACO
T/ patients who developed TACO were more likely to require mechanical ventilation and have prolonged stays in the ICU
TRUE
What is the predominant symptom of transfusion-associated dyspnea (TAD)
Dyspnea
is a nonspecific sign that could be seen in a variety of other transfusion reactions or as part of the patient’s underlying condition
Hypotension
What is the cause of hypotensive transfusion reaction?
A. issoagglutinins present in the donor’s plasma
B. issoagglutinogens present in the donor’’s cells
C. increased bradykinins in stored donor’s plasma
D. Increased ferritin in stored donor’s cells
C. increased bradykinins in stored donor’s plasma
it is one of the most common adverse transfusion reactions. These reactions are generally mild and self limited
Febrile Nonhemolytic Transfusion Reaction
FNTR
T/F. FNHTRs mimic more serious and severe transfusion reactions, such as, AHTR, TRALI,
TACO, and transfusion-transmitted bacterial infection
True
Significant manifestation of FNTR ;
fever chills rigor mild dyspnea mild nausea/vomiting
Which is not a manifestation of Febrile non-hemolytic.
A. hemoglobinuria
B. chills
C. nausea
D. vomiting
A. hemoglobinuria
What is the most common reactions seen with platelet and
plasma transfusions, occurring in about 2% of transfused
platelets, and are second to FNHTRs in RBC transfusions.
Allergic Transfusion Reactions (ATRs)
Which is more severe? A. allergic reaction B. anaphylactoid reaction C. both D. none
B. anaphylactoid reaction
What is the clinical severity found with ATRs
mild skin reaction
What is the most common manifestation of ATRs
mucocutaneous reactions including;
urticaria
pruritus
generalized rash
What is the most commonly reported symptoms of Adverse Reaction to infusion of Plasma- Derived Products
Headache
is a rare but devastating event with a very high mortality rate
compared to other transfusion reactions as well as with
GVHD occurring in marrow/hematopoietic and solid organ
transplantation.
Transfusion-Associated Graft-Versus-Host Disease
TA-GVHD
the most common symptoms of TA-GVHD
rash fever increased liver enzymes pancytopenia diarrhea
is a rare transfusion reaction
in which there is a severe and sudden drop in the platelet
count, usually occurring 5 to 10 days after transfusion due
to alloimmunization to platelet-specific antibodies from
prior transfusion or pregnancy.
Post-Transfusion Purpura
PTP
What is the sever clinical manifestation of Post-transfusion purpura
Thrombocytopenia
