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Study Stuff > NONINFECTIOUS TX COMPLICATIONS > Flashcards

NONINFECTIOUS TX COMPLICATIONS Flashcards

1
Q

Which of the ff is the best prevention method for febrile nonhemolytic transfusion reaction (FNHTR)?
A. Prestorage leukocyte reduction
B. Limiting the amount of administration of minor ABO incompatible platelets
C. Collection and administration of plasma from male donors only
D. Transfusion of antigen negative RBCs

A

A. Prestorage leukocyte reduction

B - prevention for AHTR
C - Prevention of TRALI
D - prevention for DHTR/DSTRs

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2
Q

Which of the ff is the best prevention method for DHTR/DSTR?
A. Prestorage leukocyte reduction
B. Limiting the amount of administration of minor ABO incompatible platelets
C. Collection and administration of plasma from male donors only
D. Transfusion of antigen negative RBCs

A

D. Transfusion of antigen negative RBCs

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3
Q

Which of the ff is the best prevention method for TRALI?
A. Prestorage leukocyte reduction
B. Limiting the amount of administration of minor ABO incompatible platelets
C. Collection and administration of plasma from male donors only
D. Transfusion of antigen negative RBCs

A

C. Collection and administration of plasma from male donors only

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4
Q

Which of the ff is the best prevention method for AHTR?
A. Prestorage leukocyte reduction
B. Limiting the amount of administration of minor ABO incompatible platelets
C. Collection and administration of plasma from male donors only
D. Transfusion of antigen negative RBCs

A

B. Limiting the amount of administration of minor ABO incompatible platelets

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5
Q

Which of the ff symptoms is NOT a prominent feature of anaphylactic transfusion reaction?
A. Dyspnea (labored breathing)
B. Angioedema (painless swelling under the skin)
C. Fever
D. Pruritis (severe itching of skin)

A

C. Fever

Fever is a prominent symptom for HTR and bacterial contamination, but not for anaphylaxis

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6
Q

A patient is observed to develop hives after 15 mins of starting a platelet transfusion. What should be the best next course of action?
A. Stop the transfusion and contact the blood bank; a transfusion reaction investigation should be done
B. Pause the transfusion, administer antihistamine then resume transfusion once symptom has dissipated
C. Stop the transfusion, administer antipyretics, report the reaction to BB for a transfusion reaction investigation
D. Stop the transfusion, contact BB, monitor the patient and provide supportive care

A

B. Pause the transfusion, administer antihistamine then resume transfusion once symptom has dissipated

  • urticaria is the only transfusion reaction in which transfusion of component can be resumed after treatment
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7
Q

What is the best prevention method for patients with severe or recurring urticarial reactions to blood components?
A. Routine pre medication before administration of blood component
B. Collection and administration of blood component from male donors only
C. Consider giving washed RBCs/platelets/PAS platelets/ pooled SD plasma
D. Administer components slowly, at a rate of 2 to 4ml / min and 1 ml/kg of body weight per hour

A

C. Consider giving washed RBCs/platelets/PAS platelets/ pooled SD plasma

A - does not support prevention of ATR
D - prevention for TRALI

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8
Q

________ involves the collection of information on the complications of transfusion, analysis of data, and subsequent improvement in transfusion practices for the purpose of improving the reporting of transfusion related adverse events

A

Hemovigilance

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9
Q

Which of the ff can cause severe acute hemolytic transfusion reaction (AHTR)?
A. Components collected from pregnant females
B. Gram negative bacteria - tx related sepsis
C. IVIG infusion
D. Primed neutrophils

A

C. IVIG infusion

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10
Q

Which of the ff is the primary cause of TRALI?
A. Components collected from pregnant females
B. Gram negative bacteria
C. IVIG infusion
D. Primed neutrophils

A

D. Primed neutrophils

  • may be activated by HLA ab or by biologically active compounds

A - - must be avoided, for TRALI prevention
B - tx related sepsis

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11
Q

true/ false - volume overload is often associated with TRALI, therefore, diuretics is indicated for treatment.

A

False

not associated, no need for diuretics

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12
Q

Which of the ff is a distinguishing symptom of TACO from TRALI?
A. Volume overload, patient responsive to diuretics
B. Pulmonary edema, non responsive to diuretics
C. Respiratory distress, responsive to diuretics
D. Hypotension, non responsive to diuretics

A

A. Volume overload, patient responsive to diuretics

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13
Q

Which of the ff is a distinguishing symptom of hypotensive transfusion reaction from other types of transfusion reaction?
A. Hypotension, lasting for 2 hr
B. hypotension , with uticaria
C. Hypotension with fever
D. Hypotension, resolving shortly after transfusion is stopped

A

D. Hypotension, resolving shortly after transfusion is stopped

B - anaphylactic shock
C - septic shock

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14
Q 
Which of the ff may be the primary cause of hypotensive transfusion reaction?
A. IVIG infusion
B. Idiopathic
C. Bradykinins
D. Primed neutrophils
A

C. Bradykinins

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15
Q

Which of the ff are better predictors of hemostatic failures(with microvascular bleeding) in patients undergoing/ has undergone massive transfusion?
A. Platelet count below ~50,000/uL
B. The length of time the patient was hypotensive
C. Low fibrinogen and plt counts
D. Elevated PT and PTT

A

C. Low fibrinogen and plt counts

A - correlates with increase in microvascular bleeding
B - correlates with degree of plt and clotting abnormalities

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16
Q

Which of the ff is a prominent symptom of Delayed hemolytic/serologic transfusion reaction?
A. Fever with hemolysis
B. Fever and anemia occurring days to weeks after transfusion
C. Acute renal failure and DIC within days after transfusion
D. Fever without hemolysis

A

B. Fever and anemia occurring days to weeks after transfusion

A - may also occur after contamination of parasites such as babesia and malaria
C - not generally present since hemolysis in DHTR is mostly extravascular
D - indication of GVHD

17
Q

Which of the ff is the primary cause for DHTRs/ DSTRs?
A. Contaminated components with intracellular red cell parasites (eg malaria, babesia)
B. Presence of gram negative bacteria in transfused components
C. Administration of components collected from male donors
D. primary immunization to transfused red cell antigens and subsequent transfusions

A

D. primary immunization to transfused red cell antigens and subsequent transfusions

18
Q

________ is the phenomenon where antibody titers slowly decrease after the initial immune response

A

Evanescence

19
Q 
Which antibody to the ff red cell antigen groups exhibit evanescence?
A. Kell
B. Rh
C. Kidd
D. MNS
A

C. Kidd

20
Q

What method is the best prevention for transfusion associated graft vs host disease?
A. Administration of cellular components collected from males only
B. Administration of irradiated cellular components
C. Administration of antigen negative red cell components
D. Administration of stem cell component from a homozygous HLA haplotype donor

A

B. Administration of irradiated cellular components

D - usually causes GVHD is recipient is heterozygous pg 590

21
Q 
What is the current treatment of choice for post transfusion purpura?
A. IVIG
B. Antigen matched donor components
C. HLA matched donor components
D. Steriods
A

A. IVIG

22
Q

Approximately how much iron does a unit of RBC unit contain?

A

200 - 250 mg

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