Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Hematology, oncology > Transfusion Reactions > Flashcards

Transfusion Reactions Flashcards

1
Q

Presentation of febrile non-hemolytic transfusion reaction

A

Isolated fever, no systemic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

AHTR presentation

A

Fever, hypotension, chills, flank pain, hematuria, nausea/vomiting, and oozing from intravenous sites, “feeling of impending doom”.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does a urticarial transfusion reaction (UTR) present?

A

Hives but no other allergic findings (ie, no wheezing, angioedema, hypotension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definition of massive transfusion

A
  • 10 units of blood in 24 hours or less

- transfusion of 4 units in 1 hour or less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Transfusion goals with massive transfusion

A

Platelets greater than 50k

Fibrinogen greater than 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Transfusion goal with FFP

A

PT or PTT less than 1.5x mean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Complications of massive transfusion

A
  • hypothermia (blood products stored at cold temperatures)
  • hypocalcemia (large volume of citrate in blood components)
  • bleeding, coagulopathy (dilutional coagulopathy)
  • acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Evidence-based relative components of massive transfusion

A

1:1:2 (PRBC’s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pathophys + how AHTR typically happens

A

ABO mismatch (clerical error, nurse or someone else misidentifies blood sample and or misidentifies the patient)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most severe transfusion reaction

A
  • acute hemolytic transfusion reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

AHTR mechanism

A
  • PRBCs coated with antibody activate complement system, leading to hemolysis and active coagulation and fibrinolytic system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

AHTR management

A
  • stop transfusion
  • aggressive IV hydration w/ NS w/ added bicarb (renal protection)
  • Titrate to urine output >100cc/hr
  • alkalinize urine
  • Trend UA → goal urine pH > 7.5
  • Lasix
  • DIC labs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Febrile non hemolytic transfusion reaction mechanism

A
  • patient with anti-WBC antibodies

- OR cytokine accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Febrile non hemolytic transfusion reaction presentation

A

fever/chills, myalgias, tachycardia, headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

most common transfusion reactions

A
  • allergic

- febrile nonhemolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

mechanism of urticarial reaction

A

antibody in patient reacts with donor plasma proteins

OR antibod in donor plasma reacts with patient plasma proteins

17
Q

management of urticarial reaction + can you rechallenge?

A

Benadryl
+/- steroids
IF symptoms resolve → resume transfusion at slower rate

18
Q

mechanism of anaphylactic transfusion reactions

A

Antibodies to IgA in IgA deficient recipients

19
Q

TRALI mechanism

A
  • antibodies in donor plasma against patient WBC and or priming lipids
20
Q

TRALI natural course

A

Resolves in 24-48 but severe cases can be fatal

21
Q

TRALI diagnosis

A

Onset within 6 hours of transfusion + hypoxemia + bilateral infiltrates on CXR + no evidence of volume overload

22
Q

when delayed hemolytic transfusion reactions typically occur

A

1-2 weeks after pRBC transfusion

23
Q

RBC antigens most commonly responsible for DHTRs

A

kidd or Rh system

24
Q

Unique lab finding of delayed hemolytic transfusion reaction

A
  • reticulocytopenia (unknown why thought to be peripheral consumption?)
25
Q

Antigen on RBC’s that parvovirus binds to

A

P antigen

26
Q

pathophysiology of acute allergic reaction

A

antibody reacts with donor plasma proteins
- transfused blood contains IgE that binds to antigen from recipients blood or patient’s IgE binds to antigen in blood product, leading to histamine release from mast cells

27
Q

Febrile nonhemolytic transfusion reaction pathophys

A
  • antibodies directed against white blood cells HLA in donor blood
    OR cytokine release
28
Q

pathophys of TRALI

A
  • antibodies in donor plasma against a patients white blood cells
29
Q

Leading cause of transfusion-related mortality in the US

A

TRALI

30
Q

mechanism of delayed hemolytic transfusion reaction

A
  • low level antibody to RBC antigen (typically non-ABO)
31
Q

Cause of platelet refractoriness from alloimmunization

A
  • Antibodies to a donors antigens of the HLA system
32
Q

Antigen antibody is directed against in post-transfusion purpura

A

HPA-1a

33
Q

Most common alloantibody outside of the ABO and Rh group system

A

Anti-Kell

34
Q

pathophys of passenger lymphocyte syndrome

A

Minor mismatch between donor and recipient in ABO system

35
Q

Definition of major ABO incompatibility in transplant

A
  • naturally occurring antibody in the recipient (eg recipient 0, donor A or B OR recipient A, donor AB)
36
Q

Definition of minor ABO incompatibility in transplant

A
  • naturally occurring antibody in the donor (recipient A, donor O)
37
Q

Typical blood groups of mom and baby in hemolytic disease of the newborn

A
  • Group A or B neonates of group O mothers (group O individuals make predominantly IgG (rather than IgM) anti-A and anti-B isohemagglutinins, which can cross the placenta. IgM does not cross the placenta.
38
Q

Why patients on purine analogues need irradiated blood

A
  • purine analogues induce profound lymphopenia with low CD4 counts, which may persistent for several years after treatment
39
Q

What are the purine analogues

A
  • fludarabine, cladribine

Hematology, oncology (218 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions