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House Hemat > Blood Transfusion Reactions > Flashcards

Blood Transfusion Reactions Flashcards

1
Q

Transfusion Reactions are _______ associated with the _________ and _________

A

adverse reactions

transfusion of blood and its components

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2
Q

ANY __________ is considered a transfusion reaction of blood treatment.

A

unfavorable consequence

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3
Q

The risks of transfusion must be weighed against the benefits

T/F

A

T

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4
Q

Transfusion reactions can either be _________ which occurs in _____ or ________ which occurs in _______

A

Acute ; less than 24 hours

Delayed; greater than 24 hours

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5
Q

Acute transfusion reactions can either be ———- or _________

A

Immunologic or non-immunologic

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6
Q

List the acute immunologic transfusion reactions

A

Hemolytic

Febrile non-hemolytic

Allergic

Anaphylactic

Transfusion reaction of acute lung injury

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7
Q

List the acute non- immunologic transfusion reactions

A

Hemolytic

Circulatory overload

Air embolus

Hypothermia

Hypocalcemia

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8
Q

List the delayed non- immunologic transfusion reactions

A

Iron overload

Infections

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9
Q

List the delayed immunologic transfusion reactions

A

Hemolytic

Post transfusion purpura

Graft VS host disease

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10
Q

Acute transfusion reaction

Occurs in the first ______ of first _____ of blood

A

10-15 mins

50cc

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11
Q

Acute Haemolytic Transfusion Reaction

Aetiology:

-_______________ : _______ jn recipient Lead to _____________ of donated Rbc

-occur within ________

A

Blood group incompatibility

Antibodies

intravascular destruction

minutes

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12
Q

Acute Haemolytic Transfusion Reaction

Prevention: ___________________

A

Give ABO compatible blood.

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13
Q

Acute Haemolytic Transfusion Reaction

Clinical features

-________ along infusion site
– ___________
– Abnormal _________/________/__________/_______
– Release of cytokines: ____,___________
– Renal failure/ _____uria, may progress
to…___uria

A

Pain

Shock

bleeding; DIC

Haemoglobinemia/uria

fever, hypotension

Olig; an

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14
Q

Febrile Non Haemolytic Transfusion Reaction

Definition:
– __________ during infusion of blood component
– Usually “(severe or mild?) & (benign or malignant?) ” = not life threatening

A

An INCREASE in temperature of 1OC

Mild and benign

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15
Q

Febrile Non Haemolytic Transfusion Reaction

Aetiology:

Recipient ______ to donor _______________ in the transfused blood component.

A

antibodies

WBCs & Cytokines

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16
Q

Febrile Non Haemolytic Transfusion Reaction

Seen in:

_________ patients

Multiple _______

– Previously __________

A

Multiply transfused

pregnancies

transplanted

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17
Q

Febrile Non Haemolytic Transfusion Reaction

Differentials:

__________ reaction

_____ contamination of unit

A

Haemolytic transfusion

Bacterial

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18
Q

Febrile Non Haemolytic Transfusion Reactionl

PREVENTION

__________ (____- storage reduction may be more effective than ____- storage reduction) or plasma removal is also helpful.

A

Leukocyte reduction

pre

Post

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19
Q

Allergic (Urticarial-Hives) Transfusion Reactions

Aetiology:

______ hypersensitivity triggered by _________ directed against:

– Donor _________ or
Other allergens (food, medicines) in donor plasma

A

Cutaneous

recipient antibodies

plasma proteins

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20
Q

Allergic (Urticarial-Hives) Transfusion Reactions

Begins within _______ of infusion

Characterized by _____,______, or ______

Common or Rare?

Usually involves release of _______

A

Minutes

rash, and/or hives and itching

Common

histamine

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21
Q

Allergic (Urticarial-Hives) Transfusion Reactions

MUST be sure that the only reaction is the development of ______

No:
•________
____________
___________

A

urticarial

angioneurotic edema

laryngeal edema

bronchial asthma

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22
Q

Allergic (Urticarial-Hives) Transfusion Reactions

Prevention: _________________ before transfusion

A

pre-treat recipient with anti- histamines

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23
Q

Anaphylaxis

Recipient is ________ & has _______ in serum

– Recipient _____ can react to even (small or large?) amounts of ______ in the plasma in any blood component

• Reaction may occur within _______ : Onset of symptoms is ______

A

IgA deficient; anti-IgA

anti-IgA; small; donor IgA

minutes; SUDDEN

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24
Q

Anaphylaxis

PREVENTION:

_____ cellular components or blood products from ________

A

Wash

IgA deficients

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25
Q

Anaphylaxis

Symptoms
–_______ sensation at infusion site
– Coughing, difficulty in breathing, and bronchospasms can lead to ________
– Nausea, vomiting, severe abdominal cramps, diarrhea
– _____tension which can lead to _____,_____, and _______
– (FEVER or NO FEVER ?)

A

Burning

cyanosis

Hypo

shock, loss of consciousness, & death

No fever

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26
Q

TRALI

A
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27
Q

TRALI

Acute onset of _____ and _______ on CX-RAY within ______ of transfusion without evidence of _______

A

hypoxemia and pulmonary edema

6 hrs

cardiac failure.

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28
Q

TRALI

Primary Suspect:____________ to _____________

Another cause:

________________ in the lungs causing _______

A

Donor antibodies to recipient WBCs

Biologically active lipids; edema

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29
Q

TRALI

Clinical features

Chills, _______, cough, cyanosis, ____tension, increased difficulty breathing

A

fever

Hypo

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30
Q

TRALI

Prevention:

– For recipients : give _____________

  • For donors: ________/_______
A

male products

watch/defer

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31
Q

Transfusion Associated Circulatory overload(TACO)

Aetiology

___________________

A

Rapid increases in blood volume to patient

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32
Q

Transfusion Associated Circulatory overload(TACO)

Risk factors:
– compromised _____________

– small _______________(elderly, young children),
– severe _____________

A

cardiovascular function,

intravascular volume

chronic anemia.

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33
Q

Transfusion Associated Circulatory overload(TACO)

Prevention:
– ______________

Treatment:

Stop infusion and ________________

A

Slow Transfusion

place patient in sitting position.

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34
Q

Transfusion Associated Circulatory overload(TACO)

Clinical features:
–______,________, severe headaches, _______tension or ____ (congestive heart failure).

A

Dyspnea, cyanosis

hyper

CHF

35
Q

Transfusion Associated Circulatory overload(TACO)

Chest X-Ray

__________,__________,_________________

A

pulmonary edema, distended pulmonary artery, cardiomegaly

36
Q

Transfusion Associated Circulatory overload(TACO)

Laboratory

elevated _____________ is 81% sensitive and 89% specific

A

B-natriuretic peptide (BNP)

37
Q

Physical or chemical induced red cell destruction

Etiology:

Destruction of red blood cells in the ————— and infusion of _____________

A

collection bag

free hemoglobin, etc

38
Q

Physical or chemical induced red cell destruction

Cause:

Improper __________
__________ haemolysis
__________ haemolysis

A

temperatures

Osmotic

Mechanical

39
Q

Physical or chemical induced red cell destruction

Prevention :

__________________ for all aspects of procuring, processing, issuing and administering red blood cell transfusions.

A

Adherence to procedures

40
Q

Hypocalcaemia

Excess _______: When infused at rate >_____ mL/minute or individuals with __________ function

A

citrate

100

impaired liver

41
Q

Hypocalcaemia

Citrate is broken down by _______.

Citrates chelates _______ leading to hypocalcaemia

Seen more in _____ and ______ patients

A

liver

calcium

pediatric and elderly

42
Q

Hypocalcaemia

Signs and Symptoms: _________, nausea, vomiting.

Prevention: ________ or __________ infusion.

A

Facial tingling

Slowing or discontinuing

43
Q

Hypothermia

Etiology: Drop in core body temperature due to ____________________________

A

rapid infusion of large volumes of cold blood.

44
Q

Hypothermia

Symptoms: ——-eased body temperature and _____ ______

Seen in small ______ or massive _______

A

Decr

ventricular arrhythmias.

infants; transfusion

45
Q

Hypothermia

Prevention: Reduce rate of infusion or use ___________

A

blood warmers.

46
Q

Air embolism

Etiology: If blood in an open system is ____________ or if air enters the system while __________________ are being changed.

A

infused under pressure

container or blood administration sets

47
Q

Air embolism

Treatment: Place patient on (left or right?) side with _________ to displace air bubble from _______________
•

A

Left

Head down

pulmonic valve.

48
Q

Delayed (>24 Hours) Transfusion Reaction -

Immunologic
__________,_______,____________

Nonimmunologic
______________

A

Haemolytic ; Graft vs. Host Disease; Posttransfusion Purpura

Iron Overload

49
Q

Delayed Haemolytic Transfusion Reaction (red blood cell alloimmunization)

Onset within _____ (>________)

Associated with _______ Haemolysis

A

days; 24 hours

Extravascular

50
Q

Delayed Haemolytic Transfusion Reaction (red blood cell alloimmunization)

Etiology: Antibodies that ______________ : ____,_____ etc

Prevention: Give _________________

A

usually do NOT

activate Complements

Rh, Kell,

antigen negative blood.

51
Q

Delayed Haemolytic Transfusion Reaction

Signs & Symptoms
______________
_________
Unexpected _______

A

Fever or fever & chills

Jaundice; anemia

52
Q

Delayed Haemolytic Transfusion Reaction

Some may present as ________ of an anticipated increase in ________ and _________

A

an ABSENCE

Hemoglobin and hematocrit.

53
Q

Graft VS host disease

Etiology:_________________ attack ___________.

Very rare in blood stored _____ days due to __________

A

Donor CD8+ T-Lymphocytes

recipient (host) tissues

4+

WBC inactivation

54
Q

Graft VS host disease

Groups at risk:
–______________ patients (Cancer, fetus, neonatal, bone marrow transplant).

A

Immunocompromised

55
Q

Graft VS host disease

•Signs: ________,________, or erythroderma, ______, diarrhea, pancytopenia, etc.

Prevention: _______ of blood products.

A

Fever, dermatitis

hepatitis

Irradiation

56
Q

Post- Transfusion Purpura

Etiology:————- to _________ causes abrupt ___________ of ____________

(platelet count < ________/l) 5-10 days following transfusion.

A

Antibodies to platelet antigens (HP1a )

onset of severe thrombocytopenia

10,000

57
Q

Post- Transfusion Purpura Usually affects _______ women .

A

multiparous

58
Q

Post- Transfusion Purpura

Signs: _______,__________, _____ in platelet count

A

Purpura, bleeding

fall

59
Q

Post- Transfusion Purpura

treatment: _______,___________ or ___________

_________ are usually NOT recommended

A

IVIG, plasmapheresis or corticosteroids

platelet transfusions

60
Q

Iron overload

Etiology: Excess iron resulting from __________________ such as those suffering from ___________,_________, etc.

A

chronically transfused patients

hemoglobinopathies, chronic renal failure

61
Q

Iron overload

Signs: Muscle _______, fatigue, weight loss, mild ________, anemia, etc

Treatment: Infusion of _________ - an ________________ agent has been useful.

A

weakness

jaundice

deferoxamine

Iron chelating

62
Q

Bacterial Contamination

Aetiology

At time of collection: either from ________ or __________.

• During _________________, etc.

A

the donor or the venipuncture site

component preparation

63
Q

Bacterial Contamination

Usually involves endotoxins

T/F

64
Q

Bacterial Contamination

Components:
– Most often from ______ components (______ temp).

Red cell units will look ______

A

platelet

room

dark

65
Q

Bacterial Contamination

Symptoms: (slow or rapid ?) onset

________ , _____tension, shaking chills, muscle pain, Vomiting, abdominal cramps, ________ , _______uria, ___, renal failure, & _____.

A

Rapid

Fever; hypo

bloody diarrhea

hemoglobin; shock

DIC

66
Q

Bacterial Contamination

Transfusion must be stopped immediately

_________ and _______ should be done on the _________,_______, and _________ .

__________ antibiotics should be given immediately intravenously

A

Gram stain & blood cultures

unit, patient and all infusion sets

Broad-spectrum

67
Q

Bacterial contamination

Prevention: Maintain _______ of donor selection, blood collection and proper maintenance of collected blood components.

68
Q

Other Infectious Complication

___________
________
___________
______

A

VIRAL
PARASITE
Bacterial
Prion diseases

69
Q

Other Infectious Complication
VIRAL:
•______,_______,_________,______

PARASITE:
•______,_______,__________

Bacterial: –_________*

Prion diseases:____________ Disease

A

HIV,Hepatitis B and C*, HTLV West nile

Babesia microti, Malaria, Trpanosoma cruzi

Syphilis

Creutzfeldt-Jacob

70
Q

Massive transfusion

____ body volume in ________

“_________” coagulopathy

A

One ; 24 hours

Dilutional

71
Q

Massive transfusion

“Dilutional” ___________

– depleted __________
– thrombocyt_________
– ____ perfusion
– confounding conditions: ____,_____

A

coagulopathy

coagulation factors

openia

Hypo

DIC, sepsis

72
Q

In Summery: when shit happens

1- _______ immediately and ___________ with ________
2-______,_________,________
3- ______ the clinician
4-Check vital signs every _________
5-Check labels,forms,and Ids
6-Send bags &patient’s blood to BB
7-Minor(______,______________) VS Serious (___________)

A

Stop transfusion; keep an IV open with normal Saline

Corticosteroid, antihistamine, antipyretic

Contact; clinician

15 minutes

allergic-febrile non-hemolytic

hemolytic &febrile

73
Q

ACUTE RESPIRATORY DISTRESS

_______
____________
________________
________________

A

Anaphylactic
TACO
Transfusion-Related Acute Lung Injury (TRALI)
Acute hemolytic transfusion reactions - Immune
- Non-immune

74
Q

PULMONARY OEDEMA

_____________
________________

A

Transfusion-Related Acute Lung Injury (TRALI (non-cardiogenic)
Circulatory overload (cardiogenic)

75
Q

Fever /CHILLS

_________________

_________________

_________________

_________________

_________________

A

Non-hemolytic febrile transfusion reactions
Acute Immune hemolytic transfusion reactions
Bacterial sepsis
Delayed Hemolytic Transfusion Reactions (DHTR)
Transfusion-Related Acute Lung Injury (TRALI)

76
Q

HYPOTENSION/SHOCK

_______
__________
_________
_________

A

Acute hemolytic transfusion reactions Bacterial sepsis
Anaphylactic
Transfusion-Related Acute Lung Injury (TRALI)

77
Q

HAEMOGLOBINAEMIA/HAEMO GLOBINURIA

_________
___________

A

Immune hemolytic transfusion reactions Bacterial sepsis

78
Q

Transfusion reactions are mostly due to ————- and can range from ———— to _________

A

clerical errors

benign reactions to life threatening emergencies

79
Q

Transfusion reactions

____________,_____________ and instituting supportive care are key to management.
.

A

Early detection, discontinuation of transfusion

80
Q

Reporting of only some reactions helps to improve standard practices and reduce future occurrences

T/F

81
Q

Anaphylaxis

Life threatening or benign reaction

A

Life threatening emergency

82
Q

Acute Haemolytic Transfusion Reaction

Life threatening or benign reaction

A

Life threatening

83
Q

Febrile Non Haemolytic Transfusion Reaction

Life threatening or benign reaction

House Hemat (29 decks)

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