Adverse Effect of Blood transfusion (chpt 14)

Question 1

T/F. Blood transfusion is NOT, and likely NEVER will be, without risk

Answer 1

TRUE

Question 2

it is an unintended and deleterious
occurrence associated with blood component transfusion. It
may occur before, during, or after a transfusion.

Answer 2

adverse event

Question 3

what are the most common causes of deaths associated with transfusion recipients

Answer 3

TRALI (transfusion-related acute lung injury)
TACO (transfusion- associated bacterial infection)
TTBIs (transfusion-transmitted bacterial infections)

Question 4

What component is most frequently involved with transfusion-associated sepsis?

Answer 4

Platelets

Question 5

Fatal transfusion reactions are mostly caused by:

a. Serologic errors
b. Improper storage of blood
c. Clerical errors
d. Improper handling of the product

Answer 5

C. clerical errors

Question 6

Early manifestation of an acute hemolytic transfusion 
reaction can be confused with:
a. Allergic reaction
b. Febrile nonhemolytic reaction
c. Anaphylactic shock
d. Sepsis

Answer 6

B. febrile nonhemolytic reaction

Question 7

Pain at infusion site and hypotension are observed with
what type of reaction?
a. Delayed hemolytic transfusion reaction
b. Acute hemolytic transfusion reaction
c. Allergic reaction
d. Febrile nonhemolytic reaction

Answer 7

b. Acute hemolytic transfusion reaction

Question 8

Irradiation of blood is performed to prevent:

a. Febrile nonhemolytic transfusion reaction
b. Delayed hemolytic transfusion reaction
c. Transfusion-associated graft-versus-host disease
d. Transfusion-associated circulatory overload

Answer 8

c. Transfusion-associated graft-versus-host disease

Question 9

The only presenting sign most often accompanying a
delayed hemolytic transfusion reaction is:
a. Renal failure
b. Unexplained decrease in hemoglobin
c. Active bleeding
d. Hives

Answer 9

b. Unexplained decrease in hemoglobin

Question 10

Which transfusion reaction presents with fever, maculopapular rash, watery diarrhea, abnormal liver function,
and pancytopenia?
a. Transfusion-associated sepsis
b. Transfusion-related acute lung injury
c. Transfusion-associated graft-versus-host disease
d. Transfusion-associated allergic reaction

Answer 10

c. Transfusion-associated graft-versus-host disease

Question 11

A suspected transfusion-related death must be reported to:

a. AABB
b. Federal and Drug Administration (FDA)
c. College of American Pathologists (CAP)
d. The Joint Commission (TJC)

Answer 11

b. Federal and Drug Administration (FDA)

Question 12

Nonimmune hemolysis can be caused during transfusion by:

a. Use of small bore size needle
b. Use of an infusion pump
c. Improper use of a blood warmer
d. All of the above

Answer 12

d. All of the above

Question 13

. Transfusion reactions are classified according to:
a. Signs or symptoms presenting during or after
24 hours
b. Immune or nonimmune
c. Infectious or noninfectious
d. All of the above

Answer 13

d. All of the above

Question 14

With febrile nonhemolytic transfusion reactions:

a. They are self-limited
b. Fever resolves within 2–3 hours
c. Treatment is required
d. a and b are correct
e. All of the above

Answer 14

d. a and b are correct

Question 15

Absolute IgA deficiency is a classic example of a severe
allergic reaction. A result indicating an absolute IgA
deficiency is:
a. <0.05 mg/dL
b. <0.50 mg/dL
c. <0.50 gm/dL
d. <5 mg/dL

Answer 15

a. <0.05 mg/dL

Question 16

How are mild allergic transfusion reactions with isolated
symptoms or hives and urticaria treated?
a. Transfusion is stopped and transfusion reaction
workup is initiated
b. Transfusion is stopped and antihistamines administrated; when symptoms improve, transfusion is
restarted
c. Stop transfusion and prepare washed red blood cells
d. Continue transfusion with a slower infusion rate

Answer 16

b. Transfusion is stopped and antihistamines administrated; when symptoms improve, transfusion is
restarted

Question 17

TRALI presents with the following symptoms:

a. Respiratory distress
b. Severe hypoxemia and hypotension
c. Fever
d. All of the above

Answer 17

d. All of the above

Question 18

Which of the following is characteristic of iron overload?

a. Delayed, nonimmune complication occurs
b. Chelating agents are used
c. Multiorgan damage may occur
d. All of the above

Answer 18

d. All of the above

Question 19

These are constant leading causes of mortality associate with transfusion-related adverse reactions

Answer 19

TRALI and TACO

Question 20

What is the first step you must do once a transfusion reaction is suspected

Answer 20

immediately stop the transfusion if the infusion is still in the process

Question 21

What is the responsibilities of laboratory technologist in transfusion service

Answer 21

• Perform primary testing on postreaction sample
• Report findings to the transfusion service physician
• Perform additional testing as per transfusion service
physician orders

Question 22

What are the signs and symptoms of Transfusion reaction

Answer 22

1. fever
2. Hypoxemia
3. Tachycardia
4. Tachypnea
5. Hypertension
6. Hypotension

Question 23

What laboratory work up will help resolve Transfusion-Associated
Sepsis? 
A. ruling out pancytopenia
B. ruling out hemoglobinemia
C. ruling out hemolysis
D. ruling out clerical errors

Answer 23

C. ruling of hemolysis

Question 24

It is the collection
of information on the complications of transfusion, analysis
of these data, and subsequent data-driven improvements in
transfusion practices.

Answer 24

Hemovigilance

Question 25

It is the development of non-ABO anti - | bodies following RBC transfusion, pregnancy, or transplantation.

Answer 25

Alloimmunization

Question 26

some individuals may be more susceptible than others to developing RBC alloantibodies. These persons, called

Answer 26

responders

Question 27

is defined as the combination of signs and symptoms associated with hemolysis, biochemical evidence of hemolysis, and serologic evidence of RBC incompatibility occurring during or within 24 hours after transfusion.

Answer 27

AHTR Acute hemolytic transfusion reaction

Question 28

AHTR is due to

Answer 28

``` RBC transfusion (incompatible) - but they can occur with incompatible plasma-containing products ```

Question 29

What is the most common symptoms in AHTRs

Answer 29

FEVER

Question 30

``` What type of acute transfusion reaction, that upon testing will present a positive DAT? A. allergic severe B. acute immune hemolytic C. febrile non-hemolytic D. transfusion-associated sepsis ```

Answer 30

B. acute immune hemolytic

Question 31

is a rare event associated with acute respiratory distress but a leading cause of mortality due to adverse reactions to transfusion.

Answer 31

TRALI

Question 32

T/F “Possible TRALI” is designated when the above criteria are present but another cause of ALI is also identified, w

Answer 32

TRUE

Question 33

T/F “delayed | TRALI” refers to when criteria for TRALI are present but the onset is 6–72 hours after transfusion.2

Answer 33

TRUE

Question 34

What are the clinical presentation of TRALI

Answer 34

acute respiratory distress, dyspnea tachypnea, and hypoxemia. ``` Signs and symptoms may also include: fever rigors tachycardia hypothermia, and hypotension ```

Question 35

is an adverse reaction characterized by acute respiratory distress from pulmonary edema caused by increased intravascular volume due to excessive transfused fluid and/or too rapid of an infusion rate and the inability of the patient to accommodate the volume of transfused products due to impaired pulmonary, cardiac, or renal function.

Answer 35

(TACO) transfusion- Associate Circulatory Overload

Question 36

it is the second most common cause of transfusion related death reported to the FDA

Answer 36

TACO

Question 37

T/ patients who developed TACO were more likely to require mechanical ventilation and have prolonged stays in the ICU

Answer 37

TRUE

Question 38

What is the predominant symptom of transfusion-associated dyspnea (TAD)

Answer 38

Dyspnea

Question 39

is a nonspecific sign that could be seen in a variety of other transfusion reactions or as part of the patient’s underlying condition

Answer 39

Hypotension

Question 40

What is the cause of hypotensive transfusion reaction? A. issoagglutinins present in the donor's plasma B. issoagglutinogens present in the donor''s cells C. increased bradykinins in stored donor's plasma D. Increased ferritin in stored donor's cells

Answer 40

C. increased bradykinins in stored donor's plasma

Question 41

it is one of the most common adverse transfusion reactions. These reactions are generally mild and self limited

Answer 41

Febrile Nonhemolytic Transfusion Reaction | FNTR

Question 42

T/F. FNHTRs mimic more serious and severe transfusion reactions, such as, AHTR, TRALI, TACO, and transfusion-transmitted bacterial infection

Answer 42

True

Question 43

Significant manifestation of FNTR ;

Answer 43

``` fever chills rigor mild dyspnea mild nausea/vomiting ```

Question 44

Which is not a manifestation of Febrile non-hemolytic. A. hemoglobinuria B. chills C. nausea D. vomiting

Answer 44

A. hemoglobinuria

Question 45

What is the most common reactions seen with platelet and plasma transfusions, occurring in about 2% of transfused platelets, and are second to FNHTRs in RBC transfusions.

Answer 45

Allergic Transfusion Reactions (ATRs)

Question 46

``` Which is more severe? A. allergic reaction B. anaphylactoid reaction C. both D. none ```

Answer 46

B. anaphylactoid reaction

Question 47

What is the clinical severity found with ATRs

Answer 47

mild skin reaction

Question 48

What is the most common manifestation of ATRs

Answer 48

mucocutaneous reactions including; urticaria pruritus generalized rash

Question 49

What is the most commonly reported symptoms of Adverse Reaction to infusion of Plasma- Derived Products

Answer 49

Headache

Question 50

is a rare but devastating event with a very high mortality rate compared to other transfusion reactions as well as with GVHD occurring in marrow/hematopoietic and solid organ transplantation.

Answer 50

Transfusion-Associated Graft-Versus-Host Disease | TA-GVHD

Question 51

the most common symptoms of TA-GVHD

Answer 51

``` rash fever increased liver enzymes pancytopenia diarrhea ```

Question 52

is a rare transfusion reaction in which there is a severe and sudden drop in the platelet count, usually occurring 5 to 10 days after transfusion due to alloimmunization to platelet-specific antibodies from prior transfusion or pregnancy.

Answer 52

Post-Transfusion Purpura | PTP

Question 53

What is the sever clinical manifestation of Post-transfusion purpura

Answer 53

Thrombocytopenia