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Blood Bank Chapter 10
Terms in this set (57)
Coughing, cyanosis, and difficulty breathing are symptoms of which of the transfusion reactions
Reaction to donors HLA Ab to the granulocytes in the recipients
The use of only male donors as a source of plasma for transfusion is a method to reduce the risk of
In a delayed hemolytic transfusion reaction, the DAT is typically
Which of the transfusion reactions is associated with high fever, shock, hemoglobinuria, and DIC
Sepsis - Bacterial Contamination
A patient was identified as having cardiac insufficiency that needed a red blood cell transfusion. How should the transfusion be administered
at a slow rate in small volume aliquots. 4-6 hour process
In what circumstance would a DAT be negative in the presence of a hemolytic process
1Bacterial contamination of the unit
2Medications that were administered with the unit
3Red blood cell unit transfused quickly through a leukocyte reduction filter
Which of the following is necessary to prevent an anaphylactic reaction due to a known IgA antibody in a patient
Red blood cell units should be washed
An anaphylactic transfusion reaction is caused by __________ antibodies
Long-term red blood cell transfusion can result in what of the conditions
Posttransfusion purpura is caused by
A hemolytic reaction to red blood cells can be caused by which of the following nonimmune mechanisms
-Incompatible intravenous solutions mixed with the unit, -Improper storage of the unit, and -bacterial contamination of the unit
Which of the following transfusion reactions has the highest incidence
What organ of the recipient's body is involved in a TRALI
What component is indicated for patients who receive directed donations from immediate family members to prevent graft-versus-host transfusion reactions
Irradiated Red Blood Cells
Administration of whole blood to a patient with cardiac insufficiency could result in what type of transfusion reaction
TACO (Circulatory Overload )
Which blood product is recommended for transfusions to individuals with a history of febrile nonhemolytic transfusion reactions
Leukocyte-reduced Red Blood Cells
What is a common cause of febrile non hemolytic reaction?
Recipient has HLA Ab to the donors hla ag
Ten days after the transfusion of 2 units, a patient had a 2 g/dL drop in hemoglobin and was slightly jaundiced. No evidence of bleeding was found. What tests would be helpful in determining whether the patient is experiencing a delayed hemolytic transfusion reaction
Perform an antibody screen on the current posttransfustion sample
A 44-year-old woman has a hemoglobin level of 6.1 g/dL. White blood cell and platelet counts are within normal levels. The patient is group O D-negative with a negative antibody screen. Crossmatches are compatible. However, 15 minutes after the first transfusion is started, she experiences erythema and hives. What type of transfusion reaction is occurring?
Urticarial -Allergic reaction
A patient is observed to have a rise in temperature and chills during a transfusion. The transfusion is stopped, and a posttransfusion blood sample is carefully drawn. On receipt of this postreaction sample, the transfusion service should immediately
Observe the color of the serum and perform a DAT
What are the top blood group systems have been implicated in transfusion reactions on the first exposure to incompatible red blood cells
What is the first thing you do when you receive a call that a patient is having a transfusion reaction
Stop the transfusion, keep line open with saline.
What pt are at risk for circulatory overload
Patients over 70 and infants
Name three differences between an Acute vs a Delayed transfusion reaction
-Acute signs within 24 hours
-Delayed after 24 hours
-Acute usually due to ABO incompatibility
-Delayed usually due to IgG Ab
-Acute high severity than Delayed
List 5 common symptoms of an adverse transfusion reaction
Fever/Chills, Pain, Dyspnea/respiratory distress,Bleeding, Hypotension/Hypertension
The Clinical Sequelae of a hemolytic transfusion reaction may include all of the following EXCEPT
The Clinical Sequelae of a hemolytic transfusion reaction may include the following
DIC, Renal Failure, Shock
Cause of Bacterial Transfusion reactions
Bacteremia in the donor
Improper cleansing of the donor skin during collection
Symptoms of Bacterial Transfusion reactions
Prevented by leukocyte-reduced components
Prevented by irradiation of components
Symptoms include hives and itching
Urticarial (Allergy reactions)
Caused by donor HLA antibodies
Transfustion-realted acute lung injury (TRALI)
Alloantibodies to red cell antigens
Usually due to ABO incompatibility
Complement is activated (mostly by immunoglobulin M [IgM]),which causes intravascular hemolysis
Phagocytes are activated and release cytokines
Coagulation is activated (e.g., disseminated intravascular coagulation [DIC])
Shock and renal failure occur
Can be prevented by transfusion slowly
TACO (Circulatory Overload)
Which of the following transfusion reactions has the highest FATALITY
What plasma protein functions to BIND hemoglobin following intravascular hemolysis?
Which of the following pt hx might suggest future transfusion with saline-washed RBC?
IgA-negative recipient with anti-IgA ab
What microorganism grows well at 4C and may result in a transfusion-transmitted sepsis?
What is the expected therapeutic effect in the recipients hematocrit after the transfusion of 1 unit of RBc?
increase of 3%
Posttransfusion purpura following transfusion of a platelet or RBC unit is usually caused by:
anti-HLA-1a made by the recipient
How to treat TACO?
oxygen therapy and diuretic medications
-Donor blood is stronger to recipients.
-Transfusing immunocompetent T-Lymphocytes
If suspect adverse reaction during transfusion how do you proceed
STOP the transfusion
Keep IV open with saline
Perform clerical check
Monitor/ records vital signs
Contact transfusion service
Collect post-tx sample, return with blood bag, and attached IV fluid to the lab
A 65-year-old woman experienced shaking, chills and fever of 103 degrees F approximately 40 minutes following the transfusion of a second unit of red blood cells. The most likely explanation of the patient's symptoms is:
severe febrile transfusion reaction
A patient has a hemolytic reaction to blood transfused 8 days ago. What is the most likely cause?
Delayed; immunologic; probably due to an antibody such as Jka
A trauma patient had a severe hemolytic reaction just minutes after receiving a blood transfusion. What is the most likely cause?
Immediate, immunologic probably due to clerical error, ABO incompatibility
All of the following are part of the preliminary evaluation of a transfusion reaction EXCEPT:
Panel on pre and posttransfusion sample
An unexplained fall in hemoglobin and mild jaundice in a patient transfused with red blood cells 1 week ago would most likely indicate:
delayed hemolytic transfusion reaction
During initial investigation of a suspected hemolytic transfusion reaction, it was observed that the posttransfusion serum was yellow in color and the direct antiglobulin test was negative. What is the next step in the investigation?
No further serologic testing is necessary.
Which of the following transfusion reactions occurs after infusion of only a few milliliters of blood and gives no history of fever?
Delayed transfusion reaction
-Less severe than acute hemolytic reactions
-Usually due to IgG antibodies formed from prior exposure to RBCs through previous transfusion or pregnancy
-Antibodies may be undetected during pretransfusion testing due to low titers
-Common antibodies: Kidd, Duffy, Kell, MNS
Acute, Immune reaction
Hemosiderosis- iron overload
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