Hem/Onc

Question 1

What are the clinical and laboratory features of acute hemolytic transfusion reaction?

Answer 1

onset w/in ONE HOUR of infusion
fever, chills, flank pain, infusion site discomfort, hemoglobinuria, DIC, renal failure
+ direct Coombs, pink plasma

Question 2

What causes acute hemolytic transfusion reaction?

Answer 2

ABO incompatibility

Question 3

What causes febrile nonhemolytic transfusion reaction?

Answer 3

Cytokines stored in the blood

Question 4

What are the clinical features of febrile nonhemolytic transfusion reaction?

Answer 4

fever, chills 1-6 after the onset of infusion (most common reaction)

Question 5

What causes an anaphylactic transfusion reaction?

Answer 5

recipient anti-IgA antibodies, occurs within seconds to minutes

Question 6

What causes urticarial/allergic transfusion reactions?

Answer 6

recipient IgE antibodies and mast cell degranulation, occurs within 2-3 hours

Question 7

What causes delayed hemolytic transusion reactions?

Answer 7

anamnestic (secondary) antibody response, so you get sensitized the first time, and you react the second time you see the antigen.

Question 8

Features of delayed hemolytic transfusion reaction

Answer 8

mild fever, hemolysis, + direct Coombs, new +antibody screen, onset 2-10 days after transfusion.

Question 9

What causes transfusion-related lung injury?

Answer 9

Donor anti-leukocyte antibodies.

Question 10

What is a possible hematologic sequel to infectious mononucleosis?

Answer 10

Autoimmune hemolytic anemia and thrombocytopenia.

Question 11

What causes the hematologic complication in infectious mononucleosis?

Answer 11

Cross-reactivity between anti-EBV Ab (cold agglutinins, anti-i antibodies) and red blood cells resulting in complement-mediated destruction. Usually Coombs+. Usually occurs 2-3 weeks after onset of symptoms.