Pearls_06

Question 1

Blood Transfusions:

Patient received blood transfusion and develops fever, dyspnea, and hypoxia within 6 hours of transfusion -> XRAY showsdiffuse pulmonary infiltrates**

Dx?
MOA?
Tx?

Answer 1

TRALI
- transfusion related acute lung injury

MOA
- Ab’s in donor plasma directed against recipient neutrophil Ag’s

Tx
- supportive

Question 2

Ab’s in donor plasma directed against recipient neutrophil Ag’s

what is the blood transfusion rxn?

Answer 2

TRALI

- transfusion related acute lung injury

Question 3

TRALI
- this blood transfusion rxn presents with what si/Sx?

Xrays wouls show what?

Answer 3

fever, dyspnea, hypoxia within 6hrs of transfusion

Xray
- pulmonary infiltrates bc it is a lung injury

Question 4

blood transfusions:

Patient received blood transfusion and develops dyspnea, cough, tachycardia, and chest tightness during or within 1 to 2 hoursof a transfusion -> on exam also has jugular venous distention, an S3, and peripheral edema

Dx?
Tx?

Answer 4

TACO
- Transfusion associated circulatory overload

Tx

• O2
• IV diuresis

Question 5

TACO blood transfusion

Signs?
Symptoms?

Answer 5

Symptoms
-dyspnea, cough, tachycardia, chest tightness within 1-2 hrs of a transfusion

Signs

• JVP
• S3
• peripheral edema

Question 6

Summary for TRALI vs TACO

s/p 1-2 hrs of transfusion?
s/p 6 hrs of transfusion?

Answer 6

1-2 hrs
- TACO

6 hrs
- TRALI

Question 7

Summary for TRALI vs TACO

which one has JVP, S3, peripheral edema on physical exam?

Answer 7

TACO

Question 8

Summary for TRALI vs TACO

which has supportive tx?
which uses O2 + IV diuretics?

Answer 8

supportive
- TRALI

O2 + IV diuretics
- TACO

Question 9

Blood Transfusions:

s/p immediately of transfusion?
s/p 1-2 hrs of transfusion?
s/p 6 hrs of transfusion?
s/p 5-10 d of transfusion?

Answer 9

immediate
- Acute Hemolytic Transf Rxn

s/p 1-2 hrs
- TRALI

s/p 6 hrs
- TACO

s/p 5-10 days
- Delayed Hemolytic Trans Rxn

Question 10

Blood Transfusions:

- fever, HoTn, dark urine

Answer 10

Acute hemolytic transfusion rxn

Question 11

BLood transfusions:

• lab reveals kidney failure and DIC
• pt has fever, kidney failure, DIC

Answer 11

acute hemolytic rxn

Question 12

blood transfusions:
- acute hemolytic transf rxn has what type of presentation?

• labs reveal what two things?

Answer 12

fever
HoTn
dark urine

labs

• kidney failure
• DIC

Question 13

blood transfusions:
- ever, hypotension, dark urine -> labs reveal kidney failure and DIC ->

Dx?
Tx?

Answer 13

Acute Hemolytic Transfusion Rxn

Tx
- supportive

Question 14

blood transfusion:
- of the 4 types, which is the ONLY one that receives specific tx? what is it?

how are the other 3 treated?

Answer 14

TACO

• O2
• IV diuresis

TRALI, Acute Hemolytic, Delayed Hemolytic are supportive tx only

Question 15

blood transfusions:

- which is caused by ABO incompatiblity btw donor and recipient and why?

Answer 15

Acute hemolytic

- 2/2 clinical error

Question 16

blood transfusions:

MOA for acute hemolytic transfusion rxn

Answer 16

ABO incompatibliyt 2/2 clinical error

Question 17

blood transfuions MOA:

antibodies in donor plasma directed against recipient neutrophil antigen

Answer 17

TRALI

Question 18

blood transfuions MOA:

patient developed a new alloantibody

Answer 18

Delayed Hemolytic Transfusion Rxn

Question 19

blood transfusion MOA:

- fluid/circulatory overlaod

Answer 19

TACO

- transfusion associated circulatory overload

Question 20

blood transfusion:
- pt (often with sickle cell) 5-10days s/p transfusion

has fever, anemia, jaundice

Dx?
Tx?
MOA?

Answer 20

delayed hemolytic rxn

• supportive
• pt developed new alloantibody

Question 21

Summary of TACO vs TRALI

what is main difference btw the two?

Answer 21

lung (TRALI) vs systemic (TACO) overload