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hematology > adverse transfusion reactions > Flashcards

adverse transfusion reactions Flashcards

1
Q

what is the case of acute hemolytic reaction ?

A

ABO incompatability

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2
Q

what kind of haemolysis is associated with AHTR ?

A

intravascular haemolysis

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3
Q

what is the clinical picture of AHTR ?

A

1- reaction develops within 1 hour off thee transfusion
2- abrupt onset
3- fever hypotension and anxiety

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4
Q

what is the management of AHTR ?

A

stop the transfusion
notify blood bank
give saline

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5
Q

what type of allergic reaction is associated with blood transfusion ?

A

type 1 hypersensitivity reaction IgE mediated

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6
Q

what is the presentation of the allergic reaction associated with blood transfusion ?

A

uurticaria
fever

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7
Q

what is the management of this allergic reaction ?

A

stop the transfusion
anti histamines

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8
Q

what is the cause of severe allergic/anaphylactic reactions due to blood transfusion ?

A

IgA deficient donor receiving an IgA containing product

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9
Q

what is the clinical presentation of the anaphylactic reaction ?

A

hypotension
cardiovascular instability
shock
airway compromise

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10
Q

what is the management of the anaphylactic shock ?

A

immediately stop the transfusion
resuscitate
antihistamine and corticosteroids
adrenaline may be indicated

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11
Q

what can be done as prevention of anaphylactic shock ?

A

washed cells
reduced IgA blood products

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12
Q

what is the recommended transfusion time ?

A

4 hours

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13
Q

what type of bacteria are likely to affect RBCs stored at 4C ?

A

gram negative bacteria

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14
Q

what type of bacteria are more likely to affect platelets stored at room temperature ?

A

gram positive bacteria

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15
Q

what is the clinical picture of transfusion related acute lung injury ?

A

presents with pulmonary oedema and can cause ARDS

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16
Q

what type of blood component is associated with TRALI ?

A

plasma transfusion

17
Q

what is the pathogenesis of TRALI ?

A

associated with anti HLA antibodies

18
Q

what is the presentation of febrile non hemolytic transfusion reaction ?

A

fever up to 2 hours after thee transfusion but otherwise the patient is well

19
Q

what is the management of febrile non hemolytic transfusion reaction ?

A

slow down the transfusion and give paracetamol

20
Q

what can be done for prevention of febrile nonhemolytic transfusion reaction ?

A

leuko reduction

21
Q

what is the presentation of transfusion associated circulatory overload?

A

signs of heart failure
volume overload

22
Q

what is the management of TACO ?

A

slow the transfusion down and give furosemide

23
Q

what is the definition of massive blood transfusion ?

A

transfusion of 10 units of blood or complete replacement of circulating volume in 24 hours

24
Q

what are the criteria to trigger the activation of an MTP ?

A

one or more of thee following :

1- ABC score of two or more persistent hemodynamic instability

2- active bleeding requiring operation or angioembolization

3- blood transfusion in trauma bay

25
Q

what are the complications associated with massive transfusion ?

A

coagulopathy ((dilutional coagulpathy )
hypothermia
acid base abnormalities
electrolyte abnormalities

26
Q

why might there be acid base abnormalities ?

A

due to the presence of lactic acid and citric acid in the blood bag

27
Q

what is the ratio between RBC and plasma ?

A

1:1

28
Q

what is the cause of delayed hemolytic transfusion reaction ?

A

caused by an exaggerated response to a foreign red cell antigen

29
Q

what is the presentation of delayed hemolytic transfusion reaction ?

A

happens up to 5 days post op
patient may be asymptomatic or have a slight fever

30
Q

what is the cause of transfusion associated graft versus host disease ?

A

thee donor’s lymphocytes attack the recipients

31
Q

what is the onset of Ta-GHVD ?

A

from 8-10 days post transfusion

32
Q

how can Ta-GHVD be prevented ?

A

gamma irradiation of cellular blood products

33
Q

what is the cause of post transfusion purpra ?

A

1- the recipient always has a history of sensitization, mostly by pregnancy
2- HPA-1A negative patients with previous exposure to Anti-HPA-1A

34
Q

what is the clinical picture of post transfusion purpra ?

A

1- occurs 5-10 days after transfusion
2- severe sudden and self limiting thrombocytopenia
3-platelet count is less than 10

hematology (15 decks)

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