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Pathology - Blood Module > Complications of Transfusion > Flashcards

Complications of Transfusion Flashcards

1
Q

What is the most common type of complication that occurs in transfusion reaction?

A

Febrile nonhemolytic reaction

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2
Q

Describe Febrile nonhemolytic reaction.

A

Fever, chills, and mild dyspnea after 6 hours of transfusion of red cells or platelets.

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3
Q

How is Febrile nonhemolytic reaction mediated?

A

Inflammatory mediators produced by the donor leukocytes

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4
Q

What factor exacerbates Febrile nonhemolytic reaction?

A

The frequency of these reactions increases with the storage age of the product.

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5
Q

What factor decreases Febrile nonhemolytic reaction?

A

Taking measures the limit donor leukocyte contamination

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6
Q

What is the treatment of Febrile nonhemolytic reaction?

A

Antipyretics

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7
Q

The symptoms of Febrile nonhemolytic reaction are ____________ (short lived/long lasting)

A

short-lived (transient and minor)

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8
Q

What are the two causes of allergic reactions due to transfusion?

A

IgA is absent in the recipient body but the donor has got IgA
Any allergen present in the donor’s blood and IgE of the recipient recognize it.

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9
Q

Allergen induced reaction is called ___________ allergic reaction.

A

Urticarial allergic reaction

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10
Q

What is the treatment given in allergic-induced transfusion reactions?

A

Antihistamines

Transfusion should NOT be discontinued

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11
Q

Hemolytic reactions are divided into two types. Name them.

A

Acute hemolytic reaction

Delayed hemolytic reaction

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12
Q

The acute hemolytic reaction is ______ (IgG/IgM) mediated.

A

IgM

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13
Q

The delayed hemolytic reaction is ______ (IgG/IgM) mediated.

A

IgG

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14
Q

_____ (ABO/Rh) incompatibility is an example of acute hemolytic reaction.

A

ABO

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15
Q

_____ (ABO/Rh) incompatibility is an example of delayed hemolytic reaction.

A

Rh

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16
Q

What are the other blood groups that can mediate the hemolytic reaction?

A

Kidd and Kell

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17
Q

How does hemolysis occur in both types of hemolytic reactions?

A

It is complement-mediated hemolysis

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18
Q

Type of hemolysis that occurs in acute hemolytic reaction is __________ (intravascular/extravascular)

A

intravascular

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19
Q

On urine analysis, there _____ (is/is’nt) hemoglobinuria in hemolytic reaction

A

is

20
Q

Other lab findings include in hemolytic reaction
_________ (high/low) LDH
_________ (high/low) haptoglobin

A

high LDH

low haptoglobin

21
Q

________ hemolytic reactions are usually caused by preformed antibodies against donor red cells that fix complement.

A

Acute

22
Q

________ hemolytic reactions are caused by antibodies that recognize red cell antigens that the recipient was sensitized to previously

A

Delayed

23
Q

Give an example of a condition in which an acute hemolytic reaction can occur.

A

The patient receives ABO incompatible unit of blood by mistake

24
Q

Give an example of a condition in which a delayed hemolytic reaction can occur.

A

A prior blood transfusion and patient becomes sensitized to the antigen

25
Q

Direct Coombs test is _________ (positive/negative) in both hemolytic reactions.

A

positive

26
Q

What are the symptoms of hemolytic reaction?

A

Fever
Chills
Shaking
Flank pain

27
Q

What can happen in severe cases of hemolytic reaction?

A

DIC
Shock
Acute renal failure
Death

28
Q

Some antibodies do not fix complement in hemolytic reactions. Then, how does hemolysis occur in this type?

A

Red cell opsonization
Extravascular hemolysis
Spherocytosis
(Minor signs and symptoms)

29
Q

What is TRALI acronym for?

A

Transfusion-Related Acute Lung Injury

30
Q

TRALI is a severe and frequently fatal complication in which factors in transfused blood trigger the activation of ____________ in the lung microvasculature.

A

neutrophils

31
Q

TRALI occurs _________ (more frequently/equally) in patients with preexisting lung disease.

A

more frequently

32
Q

Explain the two-hit hypothesis of TRALI.

A

The first hit is due to the priming event of neutrophils

The second hit is due to transfused blood

33
Q

What is the priming event of neutrophils in TRALI?

A

Increased sequestration and sensitization of neutrophils in the microvasculature of lungs. Inflammatory mediators may cause activation of the endothelium.

34
Q

How does transfused blood act as a second hit in TRALI?

A

The antibodies in the donor’s blood recognize class I MHC molecules (antigens) on the recipient’s neutrophils.

35
Q

On whom, the antibodies against neutrophils are most likely to be found in TRALI?

A

Multiparous women (because these women generate antibodies against the fetus)

36
Q

What kind of blood products have high levels of antibodies against neutrophils in TRALI?

A

Fresh frozen plasma and platelets

37
Q

What are the symptoms of TRALI?

A

Sudden respiratory failure
Fever
Hypotension
Hypoxemia

38
Q

What are the treatment options and methods of prevention in TRALI?

A

Supportive treatment

Exclude multiparous women from plasma donation

39
Q

Most bacterial infections are caused by _____ flora in transfusion reactions.

A

skin

40
Q

Significant bacterial contamination is much more common in _________ (platelet/red cell) preparations

A

platelet

41
Q

Why is significant bacterial contamination much more common in platelet preparations?

A

Platelets must be stored at room temperature. That is also favorable for bacterial growth.

42
Q

What are the symptoms of infection-mediated transfusion reaction?

A

Fever
Chills
Hypotension

43
Q

What is the treatment of infection-mediated transfusion reaction?

A

Broad-spectrum antibiotics

44
Q

What are some examples of infection-mediated transfusion reaction?

A 
HIV
Hepatitis B and C
West Nile virus
Trypanosomiasis
Babesiosis
45
Q

What are the rate of transmission of
HIV
Hepatitis C
Hepatitis B

A

HIV - 1 in 2 million
Hepatitis C 1 in 1 million
Hepatitis B 1 in 500,000

Pathology - Blood Module (20 decks)

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