Adverse Effects of Transfusion

Question 1

1. True or false? Two of the biologic systems that may be
   activated by an immediate hemolytic reaction are complement and coagulation.

Answer 1

True

Question 2

2. True or false? When an ABO-mediated hemolytic reaction occurs a testing error in the blood bank is the most
   common cause.

Answer 2

False

Question 3

3. True or false? A reaction due to ABO incompatibility results in extravascular hemolysis.

Answer 3

False

Question 4

4. True or false? ABO antibodies are generally IgG.

Answer 4

False

Question 5

5. True or false? An anamnestic response of antibody may
   result in a delayed transfusion reaction.

Answer 5

True

Question 6

6. True or false? Pulmonary edema that occurs in TRALI is
   due to cardiac failure

Answer 6

False

Question 7

7. True or false? Febrile nonhemolytic reactions are the
   most frequent in occurrence, but least life threatening.

Answer 7

True

Question 8

8. True or false? Among the most severe and life threatening of reactions is the extremely rare anaphylactic
   reaction in patients who have selective IgA deficiency.

Answer 8

True

Question 9

9. If a hemolytic reaction is suspected the evaluation must
   include:
   a. visual check for hemolysis in the pre- and posttransfusion samples
   b. repeat ABO group determination on the posttransfusion sample
   c. direct antiglobulin test (DAT) posttransfusion samples
   and if positive, a DAT on the most recent pretransfusion sample
   d. all of the above

Answer 9

d. all of the above

Question 10

10. Administration of multiple units of red cells and FFP to
    a patient with cardiac insufficiency would most likely result in which of the following?
    a. extravascular hemolytic
    b. allergic
    c. anaphylactic
    d. circulatory overload

Answer 10

d. circulatory overload

Question 11

11. Allergic reactions may be prevented or reduced by:
    a. washing
    b. filtration
    c. irradiation
    d. a and b

Answer 11

a. washing

Question 12

12. Which combination of the following can be seen if a patient is experiencing an intravascular transfusion reaction?
    a. hemoglobinuria, increased haptoglobin, decreased
    bilirubin, hemoglobinemia
    b. decreased haptoglobin, hemoglobinuria, hemoglobinemia, increased bilirubin
    c. decreased haptoglobin, hemoglobinuria, hemoglobinemia, decreased bilirubin
    d. none of the above

Answer 12

b. decreased haptoglobin, hemoglobinuria, hemoglobinemia, increased bilirubin

Question 13

13. Which of the following involves hemolysis of RBCs
    through removal by the reticuloendothelial system?
    a. extravascular hemolysis
    b. intravascular hemolysis
    c. anaphylaxis
    d. none of the above

Answer 13

a. extravascular hemolysis

Question 14

14. Which of the following does NOT occur days to weeks
    following transfusion?
    a. transfusion-associated graft-versus-host disease
    b. hemolytic transfusion reaction
    c. transfusion-related acute lung injury
    d. posttransfusion purpura

Answer 14

c. transfusion-related acute lung injury

Question 15

15. Which of the following is most effective at reducing the
    risk of transfusion-related graft-versus-host disease?
    a. irradiate components at 15 Gy for susceptible patients
    b. universal leukoreduction
    c. provision of fresh units for immunosuppressed
    patients
    d. use of an approved irradiator on red cell components for newborn babies

Answer 15

a. irradiate components at 15 Gy for susceptible patients

Question 16

16. All fatal transfusion reactions need to be reported
    within 24 hours to which agency?
    a. Center for Biologics Evaluation and Research
    b. Center for Drug Evaluation and Research
    c. Center for Disease Control
    d. Serious Hazards of Transfusion Agency

Answer 16

a. Center for Biologics Evaluation and Research

Question 17

17. The red cell component storage lesion may show
    changes with all of the following except
    a. changes in the shape of the red cell
    b. decrease in extracellular potassium
    c. changes in oxygen-carrying capacity
    d. possible changes in clinical outcome in some patients

Answer 17

b. decrease in extracellular potassium

Question 18

18. What is the first step when a transfusion reaction is
    suspected?
    a. contact the blood bank and attending physician
    b. assess for symptoms of acute hemolytic transfusion reaction
    c. immediately collect a blood sample for crossmatch verification
    d. stop the transfusion

Answer 18

d. stop the transfusion

Question 19

19. True or false? Transfusion-related immunomodulation
    is associated with improved outcomes from kidney transplantation.

Answer 19

True

Question 20

20. True or false? Meticulous attention to procedure is away to prevent transfusion reactions.

Answer 20

True