Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BB Finals > BLOOD TRANSFUSION REACTIONS > Flashcards

BLOOD TRANSFUSION REACTIONS Flashcards

1
Q

Many of the ___ events seen with transfusion
are related to the fact that transfusion is the
introduction of ____ into the recipient.

A

adverse
foreign cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

___ and ___ involve the introduction of foreign proteins into the recipient that may cause a transfusion reaction

A

Non-cellular plasma and plasma-derived products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

It also carries the risk of ___

A

transfusion-transmitted infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

AABB Requirements for Laboratory Investigation of a Transfusion Reaction
1. ____ of the component bag, label, paperwork, and pre-transfusion patient specimen.
2. ____ ABO testing on the post-transfusion sample.
3. ____ of the pre- and post-transfusion
specimens for hemolysis.
4. ____ on the post-transfusion specimen.
5. ____ additional components prepared from the same donor collection.
6. ____ findings to transfusion service supervisor or medical director

A

Clerical check
Repeat
Visual check
Direct antiglobulin test (DAT)
Quarantine
Report

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Depends on the onset of signs and symptoms of the individual

A

Immediate or Delayed type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In Immediate or Delayed type
- Acute/Immediate: reaction is seen within ____
- Delayed Type: ____ before the
manifestation of transfusion reaction

A

24 hours
24 hours to 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Laboratory Tests Confirming Hemolysis in Hemolytic or Non-Hemolytic
1. ____ fibrinogen
2. ___ or ___ haptoglobin
3. ____ bilirubin
4. ____ lactate dehydrogenase
5. Hemoglobinemia/Hemoglobinuria
6. ____ of Spherocyte
7. ____ hemoglobin and hematocrit level on the post-transfusion blood

A

Decreased
Decreased or absent
Elevated
Elevated
Presence
Low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Serologic Evidence of Immune-Mediated HTR in Hemolytic or Non-Hemolytic
Cell mediator is present to trigger hemolysis
1. ___ DAT
2. ___ elution with identification of one or more alloantibodies

A

Positive
Positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nonimmune Hemolysis that is incompatible fluid alongside improper deglycerolization

A

Osmotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nonimmune Hemolysis that is a malfunction in the water bath or blood warmer; improper storage

A

Thermal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nonimmune Hemolysis that is a problem in blood bag, very small needle during transfusion, artificial heart valves

A

Mechanical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nonimmune Hemolysis that is a caused by sickle cell disease, and Hb C disease

A

Hemoglobinopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Nonimmune Hemolysis that is associated with G6PD, Hereditary spherocytosis

A

RBC Membrane and Enzyme Disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nonimmune Hemolysis is a associated with microangiopathic hemolytic anemia and Hemolytic uremic syndrome

A

Thrombotic Thrombocytopenic Purpura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nonimmune Hemolysis that cause sepsis (CMB)

A

Clostridium (B), Malaria (P), and Babesia (P)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  • Deglycerolization is important ____ transfusion.
  • Glycerol is just a cryoprotective agent to make sure that the blood won’t be ____ when storing in a low temperature.
A

before
damaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  • Most severe and most life threatening
  • A very small amount (at least 10cc) of an incompatible sample could lead to fatal (fetal??) sequelae
A

Acute, Immunologic Transfusion Reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The associated hemolysis is intravascular

A

Acute/Immediate Hemolytic Reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mediators for Immediate Immune Type: (IC)

A
  1. IgM antibodies (due to incompatible blood type)
  2. Complement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Signs and Symptoms Acute/Immediate Hemolytic Reactions: Onset of signs and symptoms happen within 24 hours (FCHDHSW)

A
  1. Fever
  2. Chills
  3. Hemoglobinuria
  4. Dyspnea
  5. Hypotension
  6. Systemic Vascular S/S
  7. Worst/Severe Complication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  • Increase temperature of greater than 1ºC after transfusion
  • Most common type of transfusion reactions
  • The patient develop fevers
A

Febrile Non-Hemolytic Transfusion Reaction (FNHTR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In FNHTR, ____ caused by interactions of recipient antibodies against the human leukocyte antigens on donor components (WBCs or Platelets)

A

Mild immunologic reactions

23
Q

Most common S/S of FNHTR

A

Fever accompanied by chills

24
Q

FNHTR Management/Prevention: (LLA)

A
  • Use of leukocyte filters
  • Use of leukocyte reduced components
  • Administer anti-pyretics
24
Q
  • Second most common type of transfusion
    reactions
  • IgE Mediated Transfusion Reaction
A

Allergic Transfusion Reaction

25
Q

Allergic Transfusion Reaction Signs and Symptoms: (HEA)

A
  • Presence of hives/urticarial
  • Erythema
  • Anaphylactic shock
26
Q

Allergic Transfusion Reaction Management/ Prevention:

A

Anti-histamine (administered before transfusion)

27
Q

Mediator: Plasma Proteins, and Antibodies to IgA antibodies

A

Anaphylactic Transfusion Reaction

28
Q

Anaphylactic Transfusion Reaction Management/ Prevention:

A

Transfuse IgA deficient components

29
Q
  • Caused by ENDOTOXIN-producing organisms particularly gram (-) organism
  • Cold-growing Yersinia enterocolotica
  • Associated with Pseudomonas, and Escherichia coli
  • Causes BACTERIAL SEPSIS - common with Yersinia spp.
  • Most frequent infection alongside FTHNR, but frequently under-recognized/not reported to the
    blood bank institution
A

Bacterial Contamination

30
Q

Bacterial Contamination S/S (FRHTNP)

A
  • High grade fever
  • Rigor
  • Hypotension
  • Tachycardia
  • Nausea and Vomiting
  • Pain and Respiratory complaints
31
Q

Transfusion-transmitted Bacterial Infection that is usually seen in RBC

A

Gram(-) organisms

32
Q

Transfusion-transmitted Bacterial Infection that is usually seen in platelet products

A

Gram (+)ve Staphyloccocus spp.

33
Q
  • Adverse reaction associated with acute respiratory distress
  • 2nd common cause of transfusion-related death
  • Common in patients with a condition that is cardiac and/or pulmonary related
  • May lead to Congestive Heart Failure and Pulmonary Edema
  • Associated with number of blood products
  • Both elderly and younger patients are affected
A

Transfusion-Associated Circulatory Overload (TACO)

34
Q
  • Usually caused by pulmonary edema due to increased intravascular volume due to excessive transfused fluid
  • Frequently seen 2 hours after the start of transfusion up to 6 hours
  • good example of iatrogenic (physician-caused) transfusion reaction
A

Transfusion-Associated Circulatory Overload (TACO)

35
Q
  • Dyspnea, occurring alone or as the predominant symptom, could be seen in allergic reactions, TACO, or TRALI, or could be related to the patient’s underlying condition.
  • Unknown pathophysiology
  • It is diagnosed when dyspnea occurs within 24 hours after transfusion and all other diagnoses are excluded
A

Transfusion-Associated Dyspnea (TAD)

36
Q
  • It is a nonspecific sign that could be seen in a variety of other transfusion reactions or as part of the patient’s underlying condition
  • It is defined by NHSN criteria in adults as a very low/ drop in systolic ≥30 mmHg, systolic BP of ≤ 80 mmHg
A

Hypotension

37
Q

This entity is diagnosed when hypotension is seen alone during or within 1 hour after the transfusion is finished.

A

Hypotensive Transfusion Reaction

38
Q

In children, it is defined as a ___ in the baseline of systolic BP

A

25%

39
Q

Hypotensive Transfusion Reaction Management: (LA)

A
  • Leukoreduction filters
  • Angiotensin Convertin Enzyme Inhibitors
40
Q
  • Happens in more than 24 hours
  • (+) DAT result for 24 hours to 28 days after transfusion
  • Either there is positive eluate or a newly identified alloantibody in the plasma/serum that indicates hemolysis
  • Associated hemolysis is generally EXTRAVASCULAR HEMOLYSIS
A

Delayed Hemolytic Transfusion Reaction (DHTR)

41
Q

Delayed Hemolytic Transfusion Reaction (DHTR) mediator (IKKD)

A

IgG Ab to Rh
Kell
Kidd
Duffy Ag

42
Q
  • Most cases appear 7-10 days after transfusion
  • Sometimes unsuspected to post-surgical patients because post-operative anemia is attributed to other causes.
  • Furthermore, there is often incomplete laboratory evaluation to substantiate the presence of hemolysis to diagnosis of anemia
  • The diagnosis for DHTR is left as probable/possible
A

Delayed Hemolytic Transfusion Reaction (DHTR)

43
Q

Happens when immunologic competent lymphocytes (donor’s T-lymphocyte) are being transfused to immunocompromised host with pancytopenia, skin rash, and liver dysfunction

A

Transfusion-Associated Graft vs. Host Disease (TA-GVHD)

44
Q

Transfusion-Associated Graft vs. Host Disease (TA-GVHD) S/S (FLRD)

A
  • Fever
  • Liver Problems
  • Rash
  • Diarrhea
45
Q

Transfusion-Associated Graft vs. Host Disease (TA-GVHD) Management/ Prevention

A

Transfusion of irradiated blood components

46
Q
  • TA-GVHD’s onset is ____ after transfusion
  • Associated with ____
  • Increased rate of _____
A

2 days to 6 weeks
transplantation
mortality

47
Q

Characterized by severe thrombocytopenia (very low platelet count) 1 week after transfusion due to antibody to platelet specific antigen

A

Post-Transfusion Purpura

48
Q

Post-Transfusion Purpura is seen in ____ patients that have been sensitized to platelets due to either pregnancy and/or transfusion

A

older female

49
Q

Post-Transfusion Purpura happens ____ after transfusion due to alloimmunization to platelet specific antibodies.

A

5 to 10 days

50
Q
  • Iron deposition in vital organs seen in patients who have RBC abnormalities: Thalassemia and who undergoes massive/chronic transfusion.
  • Associated with citrate toxicity (increased citrate)
A

Transfusion-Induced Hemosiderosis (Iron Overload)

51
Q
  • Late manifestation
  • Hepatitis B, NON-B Hepatitis (HCV), HIV, HTLV-1 (oncogenic retrovirus that causes adult T cell leukemia), CMV, EBV
A

Transmission of Diseases

52
Q

blood-borne transmissible diseases (Spirochetes – do not survive at ref temp for 72 hours)

A

Syphilis

53
Q

rare occurrence because it is transmitted through fecal-oral route

A

Hepatitis A

BB Finals (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions