adverse transfusion reactions

Question 1

what is the case of acute hemolytic reaction ?

Answer 1

ABO incompatability

Question 2

what kind of haemolysis is associated with AHTR ?

Answer 2

intravascular haemolysis

Question 3

what is the clinical picture of AHTR ?

Answer 3

1- reaction develops within 1 hour off thee transfusion
2- abrupt onset
3- fever hypotension and anxiety

Question 4

what is the management of AHTR ?

Answer 4

stop the transfusion
notify blood bank
give saline

Question 5

what type of allergic reaction is associated with blood transfusion ?

Answer 5

type 1 hypersensitivity reaction IgE mediated

Question 6

what is the presentation of the allergic reaction associated with blood transfusion ?

Answer 6

uurticaria
fever

Question 7

what is the management of this allergic reaction ?

Answer 7

stop the transfusion
anti histamines

Question 8

what is the cause of severe allergic/anaphylactic reactions due to blood transfusion ?

Answer 8

IgA deficient donor receiving an IgA containing product

Question 9

what is the clinical presentation of the anaphylactic reaction ?

Answer 9

hypotension
cardiovascular instability
shock
airway compromise

Question 10

what is the management of the anaphylactic shock ?

Answer 10

immediately stop the transfusion
resuscitate
antihistamine and corticosteroids
adrenaline may be indicated

Question 11

what can be done as prevention of anaphylactic shock ?

Answer 11

washed cells
reduced IgA blood products

Question 12

what is the recommended transfusion time ?

Answer 12

4 hours

Question 13

what type of bacteria are likely to affect RBCs stored at 4C ?

Answer 13

gram negative bacteria

Question 14

what type of bacteria are more likely to affect platelets stored at room temperature ?

Answer 14

gram positive bacteria

Question 15

what is the clinical picture of transfusion related acute lung injury ?

Answer 15

presents with pulmonary oedema and can cause ARDS

Question 16

what type of blood component is associated with TRALI ?

Answer 16

plasma transfusion

Question 17

what is the pathogenesis of TRALI ?

Answer 17

associated with anti HLA antibodies

Question 18

what is the presentation of febrile non hemolytic transfusion reaction ?

Answer 18

fever up to 2 hours after thee transfusion but otherwise the patient is well

Question 19

what is the management of febrile non hemolytic transfusion reaction ?

Answer 19

slow down the transfusion and give paracetamol

Question 20

what can be done for prevention of febrile nonhemolytic transfusion reaction ?

Answer 20

leuko reduction

Question 21

what is the presentation of transfusion associated circulatory overload?

Answer 21

signs of heart failure
volume overload

Question 22

what is the management of TACO ?

Answer 22

slow the transfusion down and give furosemide

Question 23

what is the definition of massive blood transfusion ?

Answer 23

transfusion of 10 units of blood or complete replacement of circulating volume in 24 hours

Question 24

what are the criteria to trigger the activation of an MTP ?

Answer 24

one or more of thee following :

1- ABC score of two or more persistent hemodynamic instability

2- active bleeding requiring operation or angioembolization

3- blood transfusion in trauma bay

Question 25

what are the complications associated with massive transfusion ?

Answer 25

coagulopathy ((dilutional coagulpathy ) hypothermia acid base abnormalities electrolyte abnormalities

Question 26

why might there be acid base abnormalities ?

Answer 26

due to the presence of lactic acid and citric acid in the blood bag

Question 27

what is the ratio between RBC and plasma ?

Answer 27

1:1

Question 28

what is the cause of delayed hemolytic transfusion reaction ?

Answer 28

caused by an exaggerated response to a foreign red cell antigen

Question 29

what is the presentation of delayed hemolytic transfusion reaction ?

Answer 29

happens up to 5 days post op patient may be asymptomatic or have a slight fever

Question 30

what is the cause of transfusion associated graft versus host disease ?

Answer 30

thee donor's lymphocytes attack the recipients

Question 31

what is the onset of Ta-GHVD ?

Answer 31

from 8-10 days post transfusion

Question 32

how can Ta-GHVD be prevented ?

Answer 32

gamma irradiation of cellular blood products

Question 33

what is the cause of post transfusion purpra ?

Answer 33

1- the recipient always has a history of sensitization, mostly by pregnancy 2- HPA-1A negative patients with previous exposure to Anti-HPA-1A

Question 34

what is the clinical picture of post transfusion purpra ?

Answer 34

1- occurs 5-10 days after transfusion 2- severe sudden and self limiting thrombocytopenia 3-platelet count is less than 10