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IBI Test 3 > B3-050 Transfusion Reactions > Flashcards

B3-050 Transfusion Reactions Flashcards

(63 cards)

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1
Q

most life threatening transfusion reaction due to ABO mismatch

A

acute hemolytic transfusion reaction

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2
Q

symptoms:
fever and chills
back pain, nausea, flushing, dyspnea, DIC, acute renal failure

A

acute hemolytic transfusion reaction

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3
Q

symptoms:
fever
chill/rigor
dyspnea, wheezing
hypertension
flushing

A

febrile non hemolytic transfusion reaction

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4
Q

etiology: cytokin and WBC in bag

A

febrile non hemolytic transfusion reaction

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5
Q

treatment febrile non hemolytic transfusion reaction

A

r/o hemolytic reaction
tylenol, merperidine

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6
Q

prevention of febrile non hemolytic transfusion reaction

A

leukoreduction

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7
Q

symptoms:
fever
chills
hypotension

A

bacterial sepsis

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8
Q

symptoms:
fever
chills
hypotension

A

bacterial sepsis

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9
Q

etiology: bacterial contamination of unit

A

bacterial sepsis

usually G+ platelet

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10
Q

management of bacterial sepsis

A

draw cultures
send unit back to blood bank
IV antibiotics, pressors, fluids

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11
Q

prevention of bacterial sepsis

A

donor screening
cleansing of phelobotmy site
bacterial screening

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12
Q

symptoms:
urticaria, local erythema
pruritis, no fever

A

allergic reaction

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13
Q

allergic reaction to transfused plasma proteins

A

allergic reaction

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14
Q

management of allergic reaction

A

antihistamine

if symptoms subside, restart slowly

only TxRX that may not cause termination

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15
Q

prevention of allergic reaction

A

antihistamine 30 prior to starting trasfusion

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16
Q

symptoms:
hypotension/shock
wheezing, respiratory distress
larygeal edema

A

anaphylaxis

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17
Q

caused by anti-IgA antibodies in IgA deficient recipients

A

anaphylaxis

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18
Q

management anaphylaxis

A

treat hypotension
subq epi

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19
Q

prevention anaphylaxis

A

for known IgA deficienct patients:
-premedicate with antihistamines

for cellular components, used washed products
for plasma, IgA deficient donors are required

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20
Q

symptoms:
respiratory distress and severe hypoxemia
non-cardiogenic pulmonary edema
fever, chills
hypotension

A

TRALI

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21
Q

TRALI criteria

A

no evidence of ALI prior to transfusion
ALI onset within 6 hours
hypoxemia
bilateral infiltrates on CXR
no evidence of ciculatory overload

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22
Q

“two hit” mechanism

TRALI

A

inflammatory insult + transfusion

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23
Q

HLA or HNA antibodies in transfused blood

A

immune TRALI

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24
Q

management TRALI

A

oxygen and mechanical ventilation

reversible

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25
management TRALI
oxygen and mechanical ventilation | reversible
26
TRALI risk factors | recipient related
**massive transfusion** end stage liver disease CABG hematological malignancies mechanical ventilation sepsis alcohol/smoking
27
TRALI risk factors | donor related
HLA antibodies, related to number of pregnancies
28
TRALI prevention from donor
plasma -male only platelet- if female G2+, test for antibodies
29
symptoms: dyspnea, orthopnea positive fluid balance cardiogenic pulmonary edema on CXR elevated central venous pressure elevated serum BNP
TACO
30
TACO is caused by
infusing too much, too fast underlying cardiac or pulmonary disease
31
albumin/plasma infusion may shift large volumes of extracellular fluid into vascular space | accutely expanding blood volume
TACO | (third-spacing)
32
heart failure transudate significant diuretic response elevated BNP
TACO
33
exudate decreased WBCs
TRALI
34
TACO prevention
stopping or slowing transfusion diuretics, oxygen phelobtomy
35
TA-GVHD does not occur in
AIDs Patients
36
risk of TA-GVHD depends on
degree of HLA similarity between donor and recipient
37
TA-GVHD prevention
irradiation
38
engraftment and proliferation of donor T cells, attack recipient tissue
TV-GHD
39
accelerated clearance/extravascular hemolysis of crossmatch compatible RBCS
delayed hemolytic transfusion response
40
due to anamnestic antibody response (3-7 days) in previously senstitized recipient
delayed hemolytic transfusion reactions
41
symptoms: fever jaundice falling Hgb/Hct oliguria DIC
delayed hemolytic transfusion reaction
42
DAT positive
delayed hemolytic transfusion reaction
43
treatment delayed hemolytic transfusion reaction
IV fluids
44
most common cause of acute hemolytic transfusion reaction
error in indentification of patient or blood product
45
0 with anti-D indicates
Rh negative
46
what blood product is given for urgent massive transfusion before workup can be finished
O neg RBC (uncrossmatched) AB plasma
47
exposure to Rh positive RBCs must be avoided in
Rh negative women of child bearing age
48
uncrossmatched RBCs can be used
when massive transfusion is necessary before workup can be completed
49
when the pretransfusion work up is finished,
crossmatched blood and plasma is given
50
when platelets are below 50,000 transfusion should be considered prior to
invasive procedures associated with significant risk of bleeding
51
risk of spontaneous intracerebral bleeding occurs at platelets counts
below 10,000
52
acute hemolytic transfusion reactions are most often seen with transfusion of
RBCs
53
for a mild allergic transfusion reaction
allow transfusions with no restrictions | consider premedication with antihistamin
54
[T/F] IgM usually binds at body temperature and is unable to activate complement
false | IgM is cold antibody
55
[T/F] circulating antibodies against RBC antigens can be detected by indirect antiglobulin test
true
56
[T/F] IgG alloantibodies generally form after exposure to foreign antigens through transfusion or fetomaternal hemorrhage
true
57
a patient's RBCs show agglutination when mixed with anti A, but not when mixed with Anti-B. His blood type is
type A
58
[T/F] a patient with type O has no antibodies against ABO antigens in his plasma
false
59
[T/F] the primary indication for leukoreduction of blood products is to avoid GVHD
false
60
what is likely to prevent future anaphylactic reactions in a known IgA deficienct patient
washed units
61
[T/F] a liberal transfusion strategy results in lower overall mortality in younger patients
false
62
prophylactic platelet transfusion are recommended when platelet counts are less than?
10,000
63
the most common fatal complication of transfusion is
TRALI

IBI Test 3 (20 decks)

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