click below
click below
Normal Size Small Size show me how
Transfusion rxns
adverse effects of blood transfusion
Question | Answer |
---|---|
Most common cause of ABO-incompatibility-induced acute hemolysis | patient misidentification |
Drug-induced hemolysis is commonly caused by these drugs | cefotetan, ceftriaxone, and NSAIDs |
Mechanical hemolysis can occur in these settings | artificial heart valves, extracorporeal circulation, transfusion through a small bore catheter under high pressure |
What is done to mitigate the risk of a febrile non-hemolytic transfusion reaction (FNHTR)? | leukoreduction |
These common conditions are more common in patients who have allergic transfusion reactions | hay fever and food allergy |
What should you do if a patient with a history of anaphylactic transfusion reactions needs a RBC transfusion? | wash the cells |
second most common cause of transfusion-associated fatalities | TACO |
Definition of TRALI | acute lung injury with hypoxemia within 6 hours of transfusion. No prior risk factors for acute lung injury. |
The most common cause of TRALI | infusion of HLA antibodies that opsonize WBCs and get stuck in pulmonary capillaries. Contents of neutrophils released damaging lung. |
Typical donor implicated in a TRALI reaction | multiparous female |
Mortality rate for TRALI | 10% |
How long does TRALI usually last? | 48 to 72 hours |
Most common cause of transfusion-related mortality | TRALI (TACO in 2021) |
What causes a "hypotensive transfusion reaction?" | generation of bradykinin from activation of the kinin pathway caused by contact of plasma with artificial surfaces. |
Most common bacteria in a prospectively cultured blood unit | Skin flora (staphylococcus and propionibacteria) |
These bacteria which can grow at low temperature may proliferate in RBC units | yersinia and pseudomonas |
Why should calcium not be added to a unit of blood? | it could reverse the anticoagulant effect of citrate |
This condition is characterized by onset of profound thrombocytopenia 1 to 3 weeks after transfusion | post-transfusion purpura |
what blood products have been implicated in post-transfusion purpura? | all blood products |
What is the pathophysiology of post-transfusion purpura? | antibody to platelet antigen (HPA-1a) |
What is the treatment and clinical course of post-transfusion purpura? | resolves without treatment in 3 weeks if mild. IVIG if bad. |
What is the role of platelet transfusion in post-transfusion purpura? | emergency only. no role for prophylaxis |
How do you prevent transfusion associated graft-versus-host disease? | irradiation of cellular blood products |
This is the most common cause of post-transfusion hepatitis | Hepatitis B |
Current estimated window period for HIV | 9 days |
How do you reduce transfusion associated CMV? | leukoreduction and/or seronegative for CMV units |
These diseases are associated with HTLV-I | 1. adult T-cell leukemia-lymphoma 2. HTLV-associated myelopathy |
The most frequently implicated malaria species in a transfusion associated case of malaria | plasmodium falciparum |