Deck 12: Adverse Reactions to Transfusion

Question 1

Over half the hypotensive transfusion reactions reported have been associated with which type of treatment?

A)ACE inhibitor
B)Angiotensin
C)Antihistamine
D)Antipyretic

Answer 1

ACE inhibitor

Question 2

Hypotensive transfusion reactions are identified as a drop in blood pressure of

A)>10 mm Hg
B)>20 mm Hg
C)>30 mm Hg
D)>40 mm Hg

Answer 2

>30 mm Hg

Question 3

Approximately how many milligrams of iron does a single red blood cell unit contain?

A)50
B)150
C)200
D)250

Answer 3

250

Question 4

All of the following are signs and symptoms of an acute hemolytic transfusion reaction except

A)Fever
B)Muscle cramps
C)Chest pain
D)Dyspnea

Question 5

Which of the following statements is true of delayed hemolytic reactions?

A)Are associated with complement-mediated intravascular hemolysis.
B)Are associated with extravascular hemolysis.
C)Are the most common reactions to occur during blood transfusion.
D)Occur immediately after exposure to a transfused component.

Question 6

Initial laboratory investigation of a suspected transfusion reaction includes all of the following except

A)ABO testing of post-transfusion blood specimen
B)Clerical check of label and tags on transfused component
C)Direct antiglobulin test on post-transfusion blood specimen
D)Inspection for visible hemolysis in pretransfusion urine specimen

Question 7

According to the 2005 UK SHOT data,the risk of a patient receiving an incorrect blood component is 1 in ____ blood components transfused.

A)100
B)5,000
C)15,000
D)100,000

Question 8

In the United States,transfusion-associated fatalities must be reported to which regulatory agency?

A)American Medical Association
B)Centre for Biologics EvaLuation and Research
C)Food and Drug Administration
D)Haemovigilance network

Question 9

Regarding febrile,nonhemolytic transfusion reactions (FNHTR),all of the following statements are true except

A)After an initial reaction,recurrence is uncommon.
B)Onset of symptoms occurs during or up to 4 hours after transfusion.
C)Prestorage filtration has been shown to be effective in reducing incidences.
D)Symptoms cause discomfort but are not life-threatening.

Question 10

Patients at a greater risk for transfusion-associated graft versus host disease (TA-GVHD)include all the following except

A)Fetuses
B)Older adults
C)Patients with Hodgkin's disease
D)Hematopoietic stem cell transplant recipients

Question 11

Hypothermia occurs when the body temperature drops below

A)92° F (33° C)
B)95° F (35° C)
C)98° F (37° C)
D)101° F (38° C)

Question 12

All of the following statements about anaphylactoid transfusion reactions are true except

A)They are serious and  life-threatening
B)They are triggered by IgE class antibodies that reLease mediators from mast cells
C)They can be caused by reaction between a protein allergen and its corresponding antibody
D)They can be caused by IgA in the transfused blood product reacting with anti-IgA in the patient's plasma

Question 13

Which of the following defines hyperhemoloysis?

A)The patient's red blood cells are destroyed in addition to transfused donor cells.
B)The patient's white blood cells are destroyed in addition to transfused donor cells.
C)The presence of hemoglobin in the patient's urine.
D)The presence of free hemoglobin in the patient's plasma.

Question 14

All of the following statements are true about transfusion-related immunomodulation (TRIM)except

A)Cause remains unproven.
B)First recognized in liver transplant recipients.
C)Possible deleterious effects include increased recurrence of cancer.
D)Refers to immune suppression following transfusion of allogeneic blood products.

Question 15

Which of the following is the most commonly reported complication associated with transfusion?

A)Acute hemolytic transfusion reaction
B)Delayed hemolytic transfusion reaction
C)Febrile nonhemolytic transfusion reaction
D)Immune-mediated hemolytic transfusion reaction

Question 16

What causes allergic transfusion reactions?

A)Patient antibodies that are directed against antigens present on the transfused red blood cells.
B)Patient antibodies to non-ABO red blood cell antigens.
C)Preformed plasma antibodies that react with protein-based allergens.
D)Pulmonary infiltrates caused by antibodies to HLA antigens.

Question 17

What can be done to prevent transfusion-associated circulatory overload (TACO)in at-risk patients?

A)Irradiate blood products before transfusion
B)Split a red blood cell product in half and transfuse each half over 4 hours
C)Transfuse only leukoreduced blood products
D)Wait several hours after medication is given before starting a transfusion

Question 18

Fever is a common symptom in which types of transfusion reactions?

A)Acute hemolytic,allergic,febrile nonhemolytic
B)Acute hemolytic,febrile nonhemolytic,transfusion-related acute lung injury
C)Allergic,febrile nonhemolytic,transfusion-associated circulatory overload
D)Anaphylactic,febrile nonhemolytic,transfusion-related immunomodulation

Question 19

Transfusion-associated graft versus host disease (TA-GVHD)is a rare complication of transfusion,but the mortality rate is approximately

A)75%
B)80%
C)85%
D)90%

Question 20

Signs and symptoms of transfusion-related acute lung injury (TRALI)include all of the following except

A)Acute onset of respiratory symptoms during or within 6 hours of transfusion
B)Bilateral infiltrates on chest radiography
C)Evidence of left atrial hypertension
D)Hypoxemia