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IBI Test 3 > B3-050 Transfusion Reactions > Flashcards

B3-050 Transfusion Reactions Flashcards

1
Q

most life threatening transfusion reaction due to ABO mismatch

A

acute hemolytic transfusion reaction

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2
Q

symptoms:
fever and chills
back pain, nausea, flushing, dyspnea, DIC, acute renal failure

A

acute hemolytic transfusion reaction

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3
Q

symptoms:
fever
chill/rigor
dyspnea, wheezing
hypertension
flushing

A

febrile non hemolytic transfusion reaction

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4
Q

etiology: cytokin and WBC in bag

A

febrile non hemolytic transfusion reaction

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5
Q

treatment febrile non hemolytic transfusion reaction

A

r/o hemolytic reaction
tylenol, merperidine

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6
Q

prevention of febrile non hemolytic transfusion reaction

A

leukoreduction

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7
Q

symptoms:
fever
chills
hypotension

A

bacterial sepsis

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8
Q

symptoms:
fever
chills
hypotension

A

bacterial sepsis

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9
Q

etiology: bacterial contamination of unit

A

bacterial sepsis

usually G+ platelet

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10
Q

management of bacterial sepsis

A

draw cultures
send unit back to blood bank
IV antibiotics, pressors, fluids

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11
Q

prevention of bacterial sepsis

A

donor screening
cleansing of phelobotmy site
bacterial screening

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12
Q

symptoms:
urticaria, local erythema
pruritis, no fever

A

allergic reaction

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13
Q

allergic reaction to transfused plasma proteins

A

allergic reaction

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14
Q

management of allergic reaction

A

antihistamine

if symptoms subside, restart slowly

only TxRX that may not cause termination

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15
Q

prevention of allergic reaction

A

antihistamine 30 prior to starting trasfusion

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16
Q

symptoms:
hypotension/shock
wheezing, respiratory distress
larygeal edema

A

anaphylaxis

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17
Q

caused by anti-IgA antibodies in IgA deficient recipients

A

anaphylaxis

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18
Q

management anaphylaxis

A

treat hypotension
subq epi

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19
Q

prevention anaphylaxis

A

for known IgA deficienct patients:
-premedicate with antihistamines

for cellular components, used washed products
for plasma, IgA deficient donors are required

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20
Q

symptoms:
respiratory distress and severe hypoxemia
non-cardiogenic pulmonary edema
fever, chills
hypotension

A

TRALI

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21
Q

TRALI criteria

A

no evidence of ALI prior to transfusion
ALI onset within 6 hours
hypoxemia
bilateral infiltrates on CXR
no evidence of ciculatory overload

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22
Q

“two hit” mechanism

TRALI

A

inflammatory insult + transfusion

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23
Q

HLA or HNA antibodies in transfused blood

A

immune TRALI

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24
Q

management TRALI

A

oxygen and mechanical ventilation

reversible

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25
Q

management TRALI

A

oxygen and mechanical ventilation

reversible

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26
Q

TRALI risk factors

recipient related

A

massive transfusion
end stage liver disease
CABG
hematological malignancies
mechanical ventilation
sepsis
alcohol/smoking

27
Q

TRALI risk factors

donor related

A

HLA antibodies, related to number of pregnancies

28
Q

TRALI prevention from donor

A

plasma -male only
platelet- if female G2+, test for antibodies

29
Q

symptoms:
dyspnea, orthopnea
positive fluid balance
cardiogenic pulmonary edema on CXR
elevated central venous pressure
elevated serum BNP

A

TACO

30
Q

TACO is caused by

A

infusing too much, too fast
underlying cardiac or pulmonary disease

31
Q

albumin/plasma infusion may shift large volumes of extracellular fluid into vascular space

accutely expanding blood volume

A

TACO

(third-spacing)

32
Q

heart failure
transudate
significant diuretic response
elevated BNP

A

TACO

33
Q

exudate
decreased WBCs

A

TRALI

34
Q

TACO prevention

A

stopping or slowing transfusion
diuretics, oxygen
phelobtomy

35
Q

TA-GVHD does not occur in

A

AIDs Patients

36
Q

risk of TA-GVHD depends on

A

degree of HLA similarity between donor and recipient

37
Q

TA-GVHD prevention

A

irradiation

38
Q

engraftment and proliferation of donor T cells, attack recipient tissue

A

TV-GHD

39
Q

accelerated clearance/extravascular hemolysis of crossmatch compatible RBCS

A

delayed hemolytic transfusion response

40
Q

due to anamnestic antibody response (3-7 days) in previously senstitized recipient

A

delayed hemolytic transfusion reactions

41
Q

symptoms:
fever
jaundice
falling Hgb/Hct
oliguria
DIC

A

delayed hemolytic transfusion reaction

42
Q

DAT positive

A

delayed hemolytic transfusion reaction

43
Q

treatment delayed hemolytic transfusion reaction

A

IV fluids

44
Q

most common cause of acute hemolytic transfusion reaction

A

error in indentification of patient or blood product

45
Q

0 with anti-D indicates

A

Rh negative

46
Q

what blood product is given for urgent massive transfusion before workup can be finished

A

O neg RBC (uncrossmatched)
AB plasma

47
Q

exposure to Rh positive RBCs must be avoided in

A

Rh negative women of child bearing age

48
Q

uncrossmatched RBCs can be used

A

when massive transfusion is necessary before workup can be completed

49
Q

when the pretransfusion work up is finished,

A

crossmatched blood and plasma is given

50
Q

when platelets are below 50,000 transfusion should be considered prior to

A

invasive procedures associated with significant risk of bleeding

51
Q

risk of spontaneous intracerebral bleeding occurs at platelets counts

A

below 10,000

52
Q

acute hemolytic transfusion reactions are most often seen with transfusion of

A

RBCs

53
Q

for a mild allergic transfusion reaction

A

allow transfusions with no restrictions

consider premedication with antihistamin

54
Q

[T/F] IgM usually binds at body temperature and is unable to activate complement

A

false

IgM is cold antibody

55
Q

[T/F] circulating antibodies against RBC antigens can be detected by indirect antiglobulin test

A

true

56
Q

[T/F] IgG alloantibodies generally form after exposure to foreign antigens through transfusion or fetomaternal hemorrhage

A

true

57
Q

a patient’s RBCs show agglutination when mixed with anti A, but not when mixed with Anti-B. His blood type is

A

type A

58
Q

[T/F] a patient with type O has no antibodies against ABO antigens in his plasma

A

false

59
Q

[T/F] the primary indication for leukoreduction of blood products is to avoid GVHD

A

false

60
Q

what is likely to prevent future anaphylactic reactions in a known IgA deficienct patient

A

washed units

61
Q

[T/F] a liberal transfusion strategy results in lower overall mortality in younger patients

A

false

62
Q

prophylactic platelet transfusion are recommended when platelet counts are less than?

A

10,000

63
Q

the most common fatal complication of transfusion is

A

TRALI

IBI Test 3 (20 decks)

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