Finals - transfusion reaction

Question 1

(T/F) Blood transfusion is a permanent treatment

Answer 1

false

temporary

Question 2

____ any adverse response by the recipient during or after transfusion of blood or blood products, some are preventable

Answer 2

transfusion reaction

Question 3

_____ classification of transfusion reactions

Answer 3

immune and non-immune (immediate or delayed)

Question 4

____ is when Signs and symptoms occur during the transfusion or within 24 hours after, by antibodies already present in the recipient’s circulation

Answer 4

Immediate/Acute non-immune TR

Question 5

____ what do the ff stand for: TRIALI, TACO

Answer 5

Transfusion Related Acute Lung Injury

Transfusion Associated Circulatory Overload

Question 6

which of the ff transfusion related fatalities is the most common occurrence in the past years?

a. HTR-ABO
b. HTR - non ABO
c. TRIALI
d. anaphylaxis

Answer 6

C

43% of fatalities in 2010
33% in 2011

Question 7

(T/F) HTR-ABO fatalities is the lowest among transfusion related fatalities

Answer 7

true

~ 3-11%

Question 8

____ when RBCs are rapidly destroyed and its products are released into the circulation

Answer 8

intravascular hemolysis (in IHTR)

Question 9

___ list the the signs of IHTR (7)

Answer 9

Hemoglobinuria
Abnormal bleeding at the surgical site
Hypotension
unconsciousness (?)
fever
pain
increased heart rate

more on pg 23, lec 10

Question 10

___ list the possible outcomes of IHTR (3)

Answer 10

Shock
Acute renal failure
Disseminated intravascular coagulation (DIC)

Question 11

____ list the antibodies (abs) most commonly implicated in IHTR

Answer 11

Anti-A
Anti-K
Anti-Jka
Anti-Fya

Question 12

(T/F) the abs involved in IHTR does not activate complement

Answer 12

false

it can!!!!

Question 13

which of the ff is the antibody that is the most common culprit in IHTRs?

a. Anti-A
b. Anti-K
c. Anti-Jka
d. Anti-Fya

Answer 13

A

42%

Question 14

(T/F)immune mediated hemolysis of RBCs are initiated by the primary exposure of patient to incompatible RBCs

Answer 14

false

2ndary - when Ag-Ab (incompatible rbc - patient ab) complexes form

Question 15

(T/F) in intravascular HTR, Complement is INcompletely activated and NO free hemoglobin, RBC enzymes or RBC stroma are released into the circulation

Answer 15

false

this is for extravascular

Question 16

___ these cells are involved in extravascular IHTR

Answer 16

macrophages

Question 17

____ the immediate action when signs of transfusion rxn is observed

Answer 17

STOP THE TRANSFUSION

Question 18

____ treatment for acute renal failure in IHTR to induce kidney function and diuresis

Answer 18

furosemide

Question 19

(T/F) treatments for extravascular IHTR are also needed

Answer 19

F

therapy not needed (kay wala may products na irelease sa plasma ?)

Question 20

___ list the sources of error for IHTR

Answer 20

incorrect:
Identification of recipient
Sample collection and labeling
Donor unit identification
Patient testing

Question 21

(T/F) intravascular hemolysis also usually occurs in DELAYED HTRs

Answer 21

false

usually extravascular

Question 22

(T/F) DHTR is usually because patient was sensitized before by transplant, transfusion, pregnancy

Answer 22

true

Question 23

which of the ff is false about DHTR?

a. mixed field agglutination is usually seen
b. Liver failure is involved
c. signs usually seen in anamnestic response
d. usually DAT neg

Answer 23

D

3 – 7 days after trans the direct antiglobulin test (DAT) is posi.ve with a mixed field pattern of agglutination

Question 24

(T/F) in DHTR,

Answer 24

true

Question 25

which of the ff is false about DHTR? a. c3d may be present on the RBCs b. typically do not bind complement c. is detected serologically d. symptoms are more severe than IHTR

Answer 25

D milder symptoms

Question 26

___ Anamnestic response in DHTR that does not result in | hemolysis

Answer 26

delayed serologic transfusion | reaction (DSTR)

Question 27

___ most common sign in DHTR

Answer 27

mild fever with/without chills

Question 28

__ list the ab involved in DHTR

Answer 28

``` Rh antibodies (mainly −c, −E & −C) Kidd abs (Jka most often implicated) Duffy abs (Fy) K abs ```

Question 29

___ list the signs of DHTR

Answer 29

DAT pos mild fever with/without chills Moderate jaundice

Question 30

__ a 1⁰C increase in temperature associated with transfusion, may involve chills and rigor

Answer 30

Febrile Nonhemolytic Transfusion Reaction (FNHTR)

Question 31

which of the ff is false about FNHTR? a. caused by HLA antibodies b. can be prevented by antipyretics c. can be stimulated by tissue transplantation d. pyrogens are involved

Answer 31

all are true :)

Question 32

(T/F) FNHTR involves C5a complement activation

Answer 32

true

Question 33

___ preventative measure for FNHTR

Answer 33

Leukocyte reduced blood | Pre-medicate the pa.ent with antipyretics

Question 34

___ an allergic transfusion reaction

Answer 34

Anaphylactic Transfusion Reactions

Question 35

which of the ff is false about Anaphylactic Transfusion Reactions? a. involves fever b. signs appear after exposure to few ml of plasma or blood products c. can cause shock and death d. associated with IgA

Answer 35

A no fever

Question 36

____ list the signs and symptoms of TRALI

Answer 36

*pulmonary edema *Chills, Fever *Hypotension Dyspnea Cyanosis Tachycardia Hypoxemia

Question 37

which of the ff about TRALI is false? a. main cause: passive transfer of HLA to recepient b. recipient has WBC abs that react with donor transfused WBC antigens c. Blood components containing plasma are always involved d. symptoms are immediate

Answer 37

all is true :)

Question 38

(T/F) male only plasma transfusion is used as a preventative measure for TRALI

Answer 38

true

Question 39

___ list the bacteria involved in transfusion reactions

Answer 39

- Yersinia enterocolitica – Serra-a liquefaciens – Psuedomonas fluorescens

Question 40

(T/F) gram positive bacteria involved in bacterial contamination of blood can survive in 4C

Answer 40

false first part G- only!

Question 41

(T/F) bacterial contamination in platelets are mostly by G+ organisms

Answer 41

true Staphylococcus spp. Bacillus cereus

Question 42

___ list other possible causes of TRs

Answer 42

``` Physically or Chemically Induced TRs Transfusion-Associated Circulatory Overload (TACO) Post-Transfusion Purpura (PTP) Transfusion-Associated Graft-versus Host Disease (TA-GVHD) Iron Overload ```