Hematologic Disorders 4

Question 1

What types of reactions can happen to blood and blood related products?

Answer 1

• Febrile non-hemolytic reaction
• Transfusion-related acute lung injury
• Adult hemolytic transfusion reaction
• Delayed hemolytic transfusion reaction
• Allergic reaction to donated plasma
• Anaphylaxis
• Septic reactions
• Circulatory overload

Question 2

What is the most common reaction to blood and blood products?

Answer 2

Febrile non-hemolytic reaction

less than 1% RB and 30# platelet transfusions

Question 3

What is a febrile non-hemolytic rxn?

Answer 3

Reaction of donor cytokines to antibodies of recipient

Question 4

What is done if there is a febrile non-hemolytic reaction?

Answer 4

• Stop the transfusion

- administer antipyretics or corticosteroids

Question 5

Febrile non-hemolytic reaction: timeframe

Answer 5

usually transient

Question 6

Prevalence of transfusion-related acute lung injury

Answer 6

1 in 2000 transfusions

Question 7

Transfusion-related acute lung injury is the most common cause of

Answer 7

transfusion-related death (5% mortality rate)

Question 8

What causes transfusion-related acute lung injury?

Answer 8

antibodies in donor plasma directed against recipient neutrophil antigens

Question 9

When antibodies of donor plasma are directed against recipient neutrophil antigens, this results in:

Answer 9

inflammation after ~ 6 hours

Question 10

sx of transfusion-related acute lung injury

Answer 10

Ranges from mild SOB to adult respiratory distress syndrome

Question 11

prevalence of adult hemolytic transfusion rxn

Answer 11

1 in 25,000

Question 12

Though adult hemolytic transfusion rxn is less common than some other conditions, it is most _____

Answer 12

most feared due to high mortality rate

Question 13

What causes adult hemolytic transfusion rxn?

Answer 13

• ABO incompatibility

- wrong blood givem

Question 14

Adult hemolytic transfusion rxn can be fatal or result in:

Answer 14

• disseminated intravascular coagulation
• renal failure
• severe hypotension

Question 15

When does a delayed hemolytic transfusion rxn occur?

Answer 15

5-10 days after transfusion

Question 16

What is the reason behind a delayed hemolytic transfusion rxn?

Answer 16

Donated erythrocytes quickly removed by recipients alloantibodies

Question 17

sx of delayed hemolyric transfusion rxn

Answer 17

• often asymptomatic

- just no boost from transfusion

Question 18

allergic reactions to donated plasma: What is it and who commonly gets it?

Answer 18

• variable allergic rxns

- often occurs in pts who have receive multiple transfusions

Question 19

treatment for allergic rxns to donated plasma

Answer 19

pre-treated by:

• antihistamines
• corticosteroids

Question 20

anaphylaxis: prevalence

Answer 20

• 1 in 20,000-50,000

- true cases are rare

Question 21

What is anaphylaxis usually caused by with blood products?

Answer 21

usually cause by:

• IgA deficiency
• anti-IgA antibodies

Question 22

anaphylaxis: sx timing and severity

Answer 22

Typically, the earlier sx occur, the more severe the rxn

Question 23

How is anaphylaxis treated?

Answer 23

treated as shock protocol

Question 24

Septic reactions with blood transfusions/products: causes

Answer 24

bacterial contamination of blood products

Question 25

bacterial contamination of blood products is a source of

Answer 25

• Hep B

- Hep C

Question 26

Septic rxns with blood products: prevalence

Answer 26

rare because of improved lab screening

Question 27

How is sepsis treated?

Answer 27

according to source of sepsis

Question 28

sx of circulatory overload (blood transfusions)

Answer 28

• SOB
• HA
• seizures