Deck 11: Adverse Complications of Transfusions

Question 1

What component is indicated for patients who receive directed donations from immediate family members to prevent graft-versus-host transfusion reactions?

A) Irradiated red blood cells
B) Packed red blood cells
C) Washed red blood cells
D) Cytomegalovirus-negative red blood cells

Answer 1

A
Irradiation of blood products prevents leukocytes from replicating,which causes graft-versus-host disease.

Question 2

What organ of the recipient's body is involved in a TRALI?

A) Heart
B) Lung
C) Liver
D) Brain

Answer 2

B
Transfusion-related acute lung injury (TRALI)is a complication caused by white cell antibodies in blood products that damage lung tissue.

Question 3

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 start of the first transfusion,she experiences erythema and hives.What type of transfusion reaction is occurring?

A) Urticarial
B) Febrile nonhemolytic
C) Delayed hemolytic
D) Acute hemolytic

Answer 3

A
Erythema and hives indicate an allergic reaction,which cannot be prevented by routine pretransfusion testing.

Question 4

Which one of the following transfusion reactions is associated with high fever,shock,hemoglobinuria,and DIC?

A) Anaphylactic
B) Sepsis
C) Circulatory overload
D) Allergic

Question 5

Which of the following transfusion reactions can be linked to the administration of whole blood to a patient with cardiac insufficiency?

A) Delayed hemolytic reaction
B) Transfusion-related acute lung injury (TRALI)
C) Circulatory overload (TACO)
D) Febrile nonhemolytic reaction

Question 6

A patient has a rise in temperature and chills during a transfusion.The transfusion is stopped,and a posttransfusion blood sample is carefully drawn.What should the transfusion service immediately perform upon receipt of this postreaction sample?

A)Perform a clerical check, observe the color of serum and perform an antibody screen
B) Perform a clerical check, observe the color of serum and perform a direct antiglobulin test
C) Perform an antibody screen and a direct antiglobulin test
D) Perform an antibody screen and a crossmatch

Question 7

Which of the following conditions can result from long-term red blood cell transfusions?

A) Citrate toxicity
B) Hemosiderosis
C) Graft-versus-host disease
D) Transfusion-related acute lung injury

Question 8

Under what circumstance would a direct antiglobulin test be negative in the presence of a hemolytic process?

A) Bacterial contamination of the unit
B) Medications administered with the unit
C) Red blood cell unit transfused quickly through a leukocyte reduction filter
D) All of the above

Question 9

A patient is diagnosed with cardiac insufficiency and needs a red blood cell transfusion.How should the transfusion be administered?

A) The red blood cell unit should be transfused slowly over a 4-hour period.
B) The unit should be transfused as whole blood.
C) Diuretics should be administered with the unit.
D) Transfusion should be avoided.

Question 10

What antibodies cause an anaphylactic transfusion reaction?

A) IgA
B) IgG
C) IgE
D) All of the above

Question 11

What is the cause of posttransfusion purpura?

A) Red cell antibodies
B) White cell antibodies
C) Platelet antibodies
D) Bacterial contamination

Question 12

Documentation of a transfusion reaction investigation should include all of the following except:

A) posttransfusion patient temperature.
B) human leukocyte antigen (HLA) typing.
C) re-identification of the patient and transfused component.
D) collection of a blood sample.

Question 13

Antibodies to which blood group system is often implicated in delayed transfusion reactions?

A) Kell
B) ABO
C) Duffy
D) Kidd

Question 14

Which of the following transfusion reactions has the highest incidence?

A) Hemolytic reactions due to ABO incompatibility
B) Urticarial
C) Graft-versus-host disease
D) Transfusion-related acute lung injury

Question 15

Select the clinical sign that is not associated with a hemolytic transfusion reaction.

A) Disseminated intravascular coagulation
B) Renal failure
C) Shock
D) Graft-versus-host disease

Question 16

Which of the following is necessary to prevent an anaphylactic reaction due to a known IgA antibody in a patient?

A) All red blood cell units should be irradiated.
B) Red blood cell units should be washed.
C) All blood components should be leukocyte-reduced.
D) Patient should be given antihistamine before transfusion.

Question 17

Which of the following nonimmune mechanisms can lead to a hemolytic reaction to red blood cells?

A) Incompatible intravenous solutions mixed with the unit
B) Improper storage of the unit
C) Bacterial contamination of the unit
D) All of the above

Question 18

Which of the following blood group systems has been implicated in transfusion reactions on the first exposure to incompatible red blood cells?

A) Rh
B) Kell
C) Kidd
D) ABO

Question 19

Which blood product is recommended for transfusions to individuals with a history of febrile nonhemolytic transfusion reactions?

A) Leukocyte-reduced red blood cells
B) Packed red blood cells
C) Frozen red blood cells
D) Whole blood

Question 20

Ten days after a 2-unit RBC transfusion,a patient experienced a 2 g/dL drop in hemoglobin and appeared slightly jaundiced.No evidence of bleeding was observed.What tests would be helpful in determining whether the patient is experiencing a delayed hemolytic transfusion reaction?

A) Culture the donor unit.
B) Compare pretransfusion and posttransfusion ABO and D typing.
C) Perform hepatitis B surface antigen test.
D) Perform an antibody screen and DAT on the current posttransfusion sample.

Question 21

The use of only male donors as a source of plasma for transfusion is a method to reduce the risk of:

A) allergic reactions
B) circulatory overload.
C) TRALI.
D) febrile reactions.

Question 22

MATCHING
Match the transfusion reaction with the description that best fits.
a.Prevented by leukocyte-reduced components
b.Prevented by irradiation of components
c.Symptoms include hives and itching
d.Associated with ABO incompatibilities
e.Caused by donor white cell antibodies
f.Alloantibodies to red cell antigens
g.Can be prevented by transfusion slowly
Transfusion-related acute lung injury

Question 23

MATCHING
Match the transfusion reaction with the description that best fits.
a.Prevented by leukocyte-reduced components
b.Prevented by irradiation of components
c.Symptoms include hives and itching
d.Associated with ABO incompatibilities
e.Caused by donor white cell antibodies
f.Alloantibodies to red cell antigens
g.Can be prevented by transfusion slowly
Circulatory overload (TACO)

Question 24

MATCHING
Match the transfusion reaction with the description that best fits.
a.Prevented by leukocyte-reduced components
b.Prevented by irradiation of components
c.Symptoms include hives and itching
d.Associated with ABO incompatibilities
e.Caused by donor white cell antibodies
f.Alloantibodies to red cell antigens
g.Can be prevented by transfusion slowly
Graft-versus-host disease

Question 25

MATCHING
Match the transfusion reaction with the description that best fits.
a.Prevented by leukocyte-reduced components
b.Prevented by irradiation of components
c.Symptoms include hives and itching
d.Associated with ABO incompatibilities
e.Caused by donor white cell antibodies
f.Alloantibodies to red cell antigens
g.Can be prevented by transfusion slowly
Urticarial

Question 26

MATCHING
Match the transfusion reaction with the description that best fits.
a.Prevented by leukocyte-reduced components
b.Prevented by irradiation of components
c.Symptoms include hives and itching
d.Associated with ABO incompatibilities
e.Caused by donor white cell antibodies
f.Alloantibodies to red cell antigens
g.Can be prevented by transfusion slowly
Febrile,nonhemolytic

Question 27

MATCHING
Match the transfusion reaction with the description that best fits.
a.Prevented by leukocyte-reduced components
b.Prevented by irradiation of components
c.Symptoms include hives and itching
d.Associated with ABO incompatibilities
e.Caused by donor white cell antibodies
f.Alloantibodies to red cell antigens
g.Can be prevented by transfusion slowly
Acute hemolytic

Question 28

In a delayed hemolytic transfusion reaction,what is a typical DAT result?

A) Negative
B) Positive due to C3
C) Mixed field positive
D) Very strongly positive

Question 29

Which of the following transfusion reactions demonstrates with coughing,cyanosis,and difficulty breathing?

A) Allergic
B) Febrile
C) Hemolytic
D) TRALI

Question 30

MATCHING
Match the transfusion reaction with the description that best fits.
a.Prevented by leukocyte-reduced components
b.Prevented by irradiation of components
c.Symptoms include hives and itching
d.Associated with ABO incompatibilities
e.Caused by donor white cell antibodies
f.Alloantibodies to red cell antigens
g.Can be prevented by transfusion slowly
Delayed hemolytic