BB Transfusion Reactions Media lab
Which type of antibodies are known to cause transfusion-related acute lung injury (TRALI) reactions? Red cell antibodies Platelet antibodies HLA antibodies All of the above
HLA antibodies
Which of the following patients are at risk for transfusion-associated graft versus host disease (TA-GVHD) and would require cellular components prepared by a method known to prevent the disease? (Choose all that apply) Neonates less than 4 months of age Recipients of donor units known to be from a blood relative. Patients with chronic anemias. Patient receiving chemotherapy who are immunocompromised. Patients with a history of allergic reactions.
1. Neonates less than 4 months of age 2. Recipients of donor units known to be from a blood relative. 3. Patient receiving chemotherapy who are immunocompromised.
A patient transfused with two units of Red Blood Cells spiked a fever of 99.5oF and complained of chills five days after transfusion. The direct antiglobulin test (DAT) was positive with anti-IgG, but negative with anti-C3d. Compatibility testing was performed on the pre- and post-transfusion specimens. The post-transfusion specimen was incompatible with one of the donor units transfused. An antibody screen was done on both the pre- and post-transfusion specimens. An antibody was detected in the post-transfusion specimen only and identified by panel studies as anti-Jka. This transfusion reaction is most likely caused by: Post-transfusion purpura An anaphylactic response An acute hemolytic transfusion reaction A delayed hemolytic transfusion reaction
A delayed hemolytic transfusion reaction (Transfusion reactions that occurs more than 24 hours after the transfusion. Usually, the blood appears serologically compatible at initial testing. Delayed reactions are common in patients who have been immunized to a foreign antigen from a previous transfusion or pregnancy. The antibody titers decrease over time so that the antibody was not detectable during pre-transfusion testing. Exposure to antigen causes an anamnestic response. Antibodies become detectable in the serum at least 24 hours after transfusion.)
Which listed transfusion reaction is MOST OFTEN associated with transfused patients lacking IgA? Hemolytic Anaphylaxis Febrile Transfusion-associated circulatory overload (TACO)
Anaphylaxis Results from the recipients forming anti-IgA, which targets IgA proteins in the donor plasma. Recipients have a genetic IgA deficiency and have developed anti-IgA from sensitization during a previous transfusion or pregnancy.
Of the antibodies that are listed, which is most often implicated as a cause of delayed hemolytic transfusion reaction (DHTR)? Anti-S Anti-M Anti-Jka Anti-Lea
Anti-Jka (Of the antibodies that are listed, anti-Jka is most often reported as the cause of DHTR. Jkb is also well documented as a cause of DHTR. Antibodies that are also implicated in a DHTR include Kell, Rh, and Duffy system antibodies.)
What is a transfusion reaction? Any adverse event associated with the transfusion of blood components A fever associated with a transfusion The destruction of transfused red cells none of the above
Any adverse event associated with the transfusion of blood components (Adverse events can range from fever and hives to renal failure, shock, and death. Some adverse events can be prevented, but others cannot.)
Post-transfusion purpura (PTP) is characterized by which of the following? Appearance of purpura Platelet count of less than 10,000/µL Fever Mucosal membrane bleeding A very high incidence rate
Appearance of purpura Platelet count of less than 10,000/µL Mucosal membrane bleeding (PTP is characterized by thrombocytopenia. Patients typically present with purpura, bleeding of the mucosal membranes, and gastrointestinal and/or urinary tract bleeding. PTP is a very rare adverse event of transfusion.)
A patient experiences a mild allergic reaction to a transfusion, including urticaria, erythema (skin redness), and itching. What is the most likely source of the allergen? Donor plasma proteins Leukocyte antibodies Platelet antibodies
Donor plasma proteins (Mild allergic reactions result from a patient's hypersensitivity to soluble allergens in the plasma of the donor unit. The blood recipient forms antibodies to these allergens that are bound to IgE on mast cells and cause the release of histamines. Allergen substances may be drugs or food consumed by the blood donor.)
True or false. Delayed hemolytic transfusion reactions (DHTR) typically occur 3 hours after transfusion.
False DHTR occurs 3-7 days after transfusion. Reaction is caused my secondary immune response, requiring enough time for antibodies to be produced by the patient to exhibit signs and symptoms of extravascular hemolysis)
True or false. Leukocyte-reduced blood components are associated with the development of febrile nonhemolytic transfusion reactions (FNHTR).
False FNHTR can actually be reduced/eliminated by using pre-storage leukocyte reduced blood components
A febrile nonhemolytic transfusion reaction (FNHTR) is characterized by which of the following symptoms? Increase in temperature of >1°C above the baseline during transfusion or up to two hours following transfusion An increase in temperature of >5°C above the baseline immediately following transfusion Fever above the baseline, which develops 24 hours after the transfusion is completed Appearance of rash
Increase in temperature of >1°C above the baseline during transfusion or up to two hours following transfusion
Delayed transfusion reactions occur at what time post cessation of transfusion? 3 or more hours after transfusion 8 or more hours after transfusion More than 24 hours after transfusion 12 months after transfusion
More than 24 hours after transfusion
Transfusion-associated graft-versus-host disease (TA-GVHD) may be prevented by which of the following? Washing blood components Leukoreduction of blood components Irradiation of cellular products None of the above
Irradiation of cellular products (known to inactivate residual leukocytes)
A patient with two or more documented febrile nonhemolytic transfusion reactions (FNHTRs) should receive __________ blood components. Leukoreduced Irradiated Cytomegalovirus (CMV) negative Hemoglobin S negative
Leukoreduced (Pre-storage leukocyte reduction prevents febrile non-hemolytic transfusion reactions that occur due to cytokine accumulation during storage.)
Which type of blood component is MOST often implicated in bacterial contamination? Platelets Red Blood Cells Fresh Frozen Plasma (FFP) Cryoprecipitate (CRYO)
Platelets ( the room temperature storage requirements provides an adequate growth for bacteria)
A 40-year-old female receives two units of Red Blood Cells during a surgical procedure. The patient has no prior history of transfusions. Seven days later, she presents with extensive bruising of the extremities and bleeding of the gums, with no additional symptoms. Her platelet count is 5 x 109/L ( reference interval 150 - 400 x 109/L). What is the most likely diagnosis? Please select the single best answer Post transfusion purpura (PTP) Acute hemolytic transfusion reaction (AHTR) Disseminated intravascular coagulation (DIC) Allergic reaction
Post transfusion purpura (PTP) (PTP is caused by platelet-specific antibodies in a patient who has been previously exposed to platelet antigens through pregnancy or transfusion. The most frequently identified antibody is Anti-PLA1, which reacts with platelet antigen HPA-1a. The platelet antibody binds to the platelet surface, which allows for extravascular removal through the liver or the spleen. The patient's own platelets are destroyed as well, thus aggravating the thrombocytopenia.)
An acute hemolytic transfusion reaction (AHTR) may be caused by which of the following? (Choose all that apply) Transfusion of ABO incompatible blood Failure to irradiate cellular products Exposure to a red cell antigen when the corresponding antibody is present Leukocyte antibodies
Transfusion of ABO incompatible blood and Exposure to a red cell antigen when the corresponding antibody is present
True or false. Evaluating B-type natriuretic peptide (BNP) levels can be helpful in distinguishing transfusion-related acute lung injuries (TRALI) from transfusion-associated circulatory overload (TACO).
True It is important to rule out cardiac causes of pulmonary edema. One way of differentiating is evaluating the BNP level, which is known to be elevated in TACO and not TRALI.
True or false. Patients with diseases that require chronic transfusions are at risk for iron overload.
True (Patient's with diseases such as congenital hemolytic anemia and aplastic anemia require frequent transfusions. Each unit of Red Blood Cells contains 225 mg of iron, which puts these patients at risk for iron overload.)
True or False. Premedication with antihistamines may prevent an allergic reaction in patients with a history of multiple urticarial transfusion reactions.
True (administration of antihistamines 30 mins before transfusion can help prevent an allergic reaction in patients with a history of transfusion reactions)
