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Terms in this set (102)What should be done in the transfusion process when the patient temperature spikes from 37.5^C to 38.5 ^C within 30 minutes of transfusion? Stop the transfusion and keep the intravenous line open A 41-year-old multiparous woman was rushed to the emergency room after being shot in the chest. She received 8 units of packed red blood cells and 5 units of platelets. The hemoglobin and hematocrit determinations stabilized after 6 hours in surgery, but the platelet counts remained less than 50,000 per µL. She had received additional units of platelets at 48-hour intervals with little efficacy. Her serum was tested for platelet antibodies. She was placed on corticosteroids to control chest wound bleeding. Anti-PLA1 was identified in the patient's serum. This case is representative of what type of transfusion reaction? Post-transfusion purpura A patient with 2 or more documented febrile nonhemolytic transfusion reactions(FNHTRs) should receive —————- blood components? Leukopoor What measure can be taken to prevent transfusion-associated hypothermia? Transfusion of product using a blood warmer Persons with a documented history of anaphylactic reactions should be transfused with —————— blood products. Washed A postpartum woman was crossmatched for 2 units of packed red blood cells. The first unit was issued at 3:15 a.m. At 3:45 a.m., the nurse called the blood bank and stated the patient was developing red hives and pruritus (itching). The transfusion was stopped and a post-transfusion specimen was drawn. The unit and identification tags were returned to the blood bank. The DAT on the specimen was negative, and hemolysis was absent. All visual and clerical checks were satisfactory. The pathologist ordered the treatment of diphenhydramine (Benadryl) for all subsequent transfusions. What type of transfusion reaction has occurred in this patient?
Allergic (urticarial) What premedication therapy is beneficial for thrombocytopenic patients with a known history of febrile nonhemolytic transfusion reaction (FNHTR) when leukopoor filters are not available? Acetaminophen Which of the following is a warning sign of an immediate hemolytic transfusion reaction (IHTR) in a anesthetized patient ? Hypotension In what circumstance would a direct antiglobulin test (DAT) be negative in the presence of a hemolytic process? Donor red cells have been completely destroyed. Which of the following is a possible etiology for an allergic (urticarial) transfusion reaction? The donor plasma has a foreign protein with which IgE or IgG in patient's plasma reacts A patient transfused with 2 units of packed cells spiked a fever of 99.5 degrees * F and complained of chills 3 days after transfusion. The DAT was positive with polyspecific antisera and anti-IgG, but negative with anti-C3d. Compatibility testing was performed on the pre- and post-transfusion specimens. The latter 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: Delayed hemolytic transfusion reaction (DHTR) caused by anamnestic response A 35-year-old woman was transfused with 1 unit of packed red blood cells. The nurse monitoring the transfusion noticed hives on the patients arm and an increase in body temperature. What is the choice of treatment for this patient? diphenhydramine( Benadryl) Which of the following results when large excess of free hemoglobin are released in the blood? Hemoglobinemia All of the following are symptoms of an allergic reaction except:
c.) anemia What treatment is recommended following a bacterial contamination reaction? Broad-spectrum antibodies What postanalytical measure is advocated in the prevention of sepsis? Transfusion of blood component within 4 hours Which of the following organisms is the most commonly implicated bacterial contamination in adverse reactions involving whole blood or red blood cells? Yersinia enterocolitica Which of the following represents the pathophysiologic mechanism of a febrile nonhemolytic transfusion reaction (FNHTR) ? HLA antibody in patient serum are directed against antigens present on monocytes, granulocytes, and lymphocytes A delayed hemolytic transfusion reaction is most often the result of an anamnestic response in a patient who has been previously sensitized by transfusion or pregnancy What is the most common preventable error occurring among the nursing and medical staff that results in a transfusion-related death? Improper patient identification A delta check was noted for potassium after a surgical patient was transfused with 2 units of packed red blood cells. The pretransfusion potassium was 3.1 mmol/L and the post-transfusion specimen was 6.2 mmol/L. What could be the reason for this sudden increase? Red blood cells spent maximum time in storage How could a potential alloimmunization due to anti-K be prevented? Matching of donor and recipient red blood cell phenotype What is the purpose of performing serial hemoglobin and hematocrit after a blood transfusion? To monitor the therapeutic or non-therapeutic response Upon investigation
of a delayed hemolytic transfusion reaction (DHTR), what should be included in the medical history? d.) all of the above All of the following comprise the immediate nonhemolytic transfusion reactions, except: b.) post- transfusion purpura (PTP) Physical or chemical damage of the transfused red blood cells can result in: Intravascular hemolyis An O positive patient transfused with A-positive red cells would experience what clinical manifestation? Acute hemolysis What is the primary mediator of an allergic response? Histamine Immediate transfusion reaction procedures consists of all of the following except: c.) serum haptoglobin Which of the following describes the etiology of graft-versus host disease (GVHD)? T lymphocytes from donor blood react with major and minor histocompatibility antigens in patient Which of the following therapies is not advocated in circulatory overload? Whole blood units Which of the following should be collected immediately from a patient exhibiting signs of a septic reaction to blood products ? Blood cultures Which of the following describes the initial event occurring in an immediate hemolytic transfusion reaction (IHTR) , triggering intravascular hemolysis? Binding of patient antibody to transfused incompatible red blood cell, forming an antigen- antibody complex on red cell surface Which of the following indicated a hemolytic process? Pretransfusion plasma is yellow; post-transfusion plasma is red What is a common finding in a delayed hemolytic transfusion reaction (DHTR)? Jaundice What type of hymolysis is implicated in delayed hemolytic transfusion reaction (DHTR) caused by primary alloimmunization? Intravascular Which of the following best describes a transfusion reaction? Any unfavorable transfusion-related event occurring in a patient during or after transfusion of blood components How is a febrile nonhemolytic transfusion reaction (FNHTR) best defined? a 1°C temperature rise associated with transfusion that has no medical explanation other than blood component transfusion (true/false) Anaphylactic and anaphylactoid reactions are of the immediate hypersensitivity type of immune system response . True A patient undergoing transfusion of packed red blood cells became hypotensive and cyanotic 30 minutes into the transfusion. The nurse also noted a 0.8°C increase in temperature. The transfusion was stopped and postblood specimens were sent down to the laboratory for a transfusion reaction investigation. The donor serum was tested against screening cells (3-vials) and was reactive at AHG in all vials. A panel was performed, and anti-Bga was identified. What special blood component should this patient now receive? leukopoor What is the pathophysiologic cause surrounding anaphylactic and anaphylactoid reactions? Patient is deficient is IgA develop IgA antibodies via sensitization from transfusion or pregnancy Which of the following best describes the principal of the Kleihauer-Betke test? Fetal hemoglobin is resistant to acid (alkali) and appear pink, where maternal red cells appear as ghost cells.
Which severe outcome can be caused by indirect bilirubin levels greater than 18mg / dL in the newbom infant? Kernicterus Why is reverse grouping omitted in neonate ABO grouping? Newborns do not produce isoagglutinins of their own A cord blood specimen from a jaundiced infant should be tested for which of the
following? d.) all of the above All of the following are characteristic of ABO hemolytic disease of the newborn (HDN) except: c.) the antibody is IgM What is the physiologic mechanism of Rhlg? attachment of fetal Rh-positive red cells in maternal circulation inhibiting production of anti-D Which of the following treatments use ultraviolet light to treat hyperbilirubinemia after the infant is delivered? Phototherapy A 300 ug dose of RHIg contains sufficient anti-D to protect against how much whole blood? 30 mL An O-positive mother gave birth to an A- negative baby. After 24 hours the newborn's bilirubin level rose to 18mg / d L. A DAT performed on the cord blood specimen was positive with polyspecific AHG and anti-IgG reagents. It is probable that —————- from matemal circulation is coating the newborn's red cells. Anti- A, B
Due to a short supply of O-negative packed cells, a Rh-negative patient was transfused with 1 unit of Rh-positive red cells. Calculate the number of RhIg vials needed to protect against 250 mL of Rh-positive packed cells. 18 In order for the mother to be considered for Rhlg, her Rh type must be and her newborn must be —————- Rh negative /Rh positive Which of the following red blood cells is appropriate for neonatal transfusions? Group O, CMV-negative The most important serologic test for the diagnosis of hemolytic disease of the newborn (HDN) is the —————- with anti-lg(G) reagents . DAT Why is the Rh-positive first-born of an Rh-negative mother unaffected by Rh hemolytic disease of the newborn (HDN)? The mother has not been immunized to the D antigen before placental separation. What effect does ABO incompatibility between mother and fetus have on maternal sensitization to Rh antigen? The chance of maternal sensitization to Rh antigen is decreased.
In the event of a clinically significant antibody found in the mother's serum, which of the following must be performed to determine its concentration? Antibody titer What is the cause of hemolytic disease of the newborn (HDN) ? Destruction of the RBCs of the fetus by antibody produced by the mother What immunoglobulin is capable of crossing the placenta? IgG Which of the following assays is used to "detect" fetomaternal hemorrhage in a postpartum specimen? Rosette test What life-threatening disorder is characterized by a severe anemia, effusions, and ascites from hepatomegaly and splenomegaly? Hydrops Fetalis Cannulation of the umbilical vein under ultrasound guidance is known as: cordocentesis Why are premature newborns more likely to require exchange transfusions, than full-term infants? Premature newborn livers are too underdeveloped to conjugate bilirubin Blood transfusions to the fetus and premature infants should be —————- to prevent graft-versus -host disease gamma irradiated Which of the following mother/infant blood types would be considered at risk for ABO hemolytic disease of the newborn (HDN)? a.) Mother is group O; baby is group B What is the timing interval (weeks gestation) that the antenatal dose of RHIg is given? 28 weeks Rhogam should be given within how many hours after delivery? 72 Which prenatal serologic tests are recommended during
the first trimester? d.) all of the above Anti-D in the serum of a third-trimester pregnant woman with a titer of 16 is indicative of: active immunization How are "reconsituted" units for exchange transfusion prepared? Group O red cells and group AB plasma Which of the following assays is used to "quantify" the amount of fetomaternal hemorrhage in postpartum specimen? Kleihauer-Betke test The indicator cells used to detect antibodies in a solid phase technology are: AHG-coated red cells Upon centrifugation of an antibody screen procedure done by the gel system, the red cell agglutinates are dispersed throughout the gel column with a few agglutinates at the bottom of the micro tubes. This reaction should be graded as a: 2 + reaction The FDA has approved the following tests for application of the gel technology: ABO, Rh, DAT, antibody screen and identification, and crossmatching When performing an antibody screen by gel technology, the following steps are eliminated: Saline wash, control check cells The gel system has all of the following advantages over the traditional tube procedure except: d.) different grading system In a gel-based technology, the solid band at the top of the gel indicates ————- whereas formation of a pellet at the bottom of the micro-tubes indicates ————- 4+ reaction/ negative reaction The washing procedure is applicable to which of the following serologic methods Solid phase and tube system A layer of red cell agglutinates at the top of the gel micro-tubes and a pellet of unagglutinated red cells at the bottom. These findings are comparable to which of the following reactions in the test tube? Mixed field In performing an antibody screen by solid phase technique, a monolayer of red cells is formed at the top of microplate wells following the addition of indicator cells. This result should be interpreted as: Positive What is the deferral period for a donor who has received a live attenuated vaccine for rubella? 4 weeks A potential donor diagnosed with West Nile Virus infection should be deferred until ——- days after the condition is resolved and at least ——— days from the onset of febrile illness or diagnosis of West Nile Virus, whichever date is later. 14/28 Persons who have had an acute case of SARS (Severe Acute Respiratory Syndrome) will be deferred from donating until ———— days after becoming asymptomatic and after any prescribed treatment is complete 28 What is the minimum hemoglobin level for a potential MALE allogeneic donor? 13.0 g/dL What is the minimum hemoglobin level for a potential FEMALE allogeneic blood donor? 12.5 g/dL Packed RBCs must have a final hematocrit of less than or equal to: 80% (True/false) Autologous units of blood may be crossed over into general inventory. False Giving a donor the option of declaring that their blood should not be used for transfusion is known as: Self-exclusion Which of the following must be obtained before donor phlebotomy is performed? Informed consent If a donor unit tests positive for one or more infections disease markers, which of the following must be done: e.) all of the above ( true/false) A person, who is a long distance marathon runner wishes to donate blood. During the physicial examination his pulse rate is determined to be 40. It is acceptable for this person to donate blood. True (True/false) During the physical examination of a donor, the blood pressure is determined to be 200/120 . This donor should be allowed to donate False An individual donating two units of red cells via automated collection method is not eligible to donate red cells again for how many days? 112 An individual donating a unit of whole blood cannot donate red cells again for how many days? 56 Which of the following would not be a condition for indefinite or
permanent deferral? d.) Past malarial infection Which of the following medications would not be acceptable for donation? d.) Bovine insulin What is the deferral period for a person receiving hepatitis B immunoglobulin after exposure to viral hepatitis? 1 year An individual who recently got a tatoo wants to donate blood. How long should they be deferred for? 1 year Taking which of the following medications would result in the permanent deferral for a donor? Tegison An individual that has had malaria is deferred from donating blood for how long? 3 years Compare and contrast ABO Rh HDN (be specific as to signs, symptoms, peripheral blood smear, appropriate lab tests, treatment) ... Compare and contrast Acute HTR and Delayed HTR (be specific as to signs & symptoms, peripheral blood smear appropriate lab tests and treatment) ... Sets found in the same folderTransfusions and Adverse Reactions29 terms a1b2t3y4 Chapter 16: Adverse Effects of Blood Transfusion89 terms Deandrean_Smith Chapters 18-1910 terms heidi_saavedra Other sets by this creatorExit exam review14 terms Grace_Vyukusenge Molecular Lab Exam I, II, and III AND Lecture Exam…187 terms Grace_Vyukusenge Lecture exam 1 (Quiz 1 -5)101 terms Grace_Vyukusenge Lab exam 1 (lab 1 - 5)26 terms
Grace_Vyukusenge Other Quizlet setsNR AST Defective Power Operated Points10 terms carys_hobden1 CPCU 500 Exam 820 terms john_schlosserrt Chapter 1 FO BOOK191 terms Medic332 Civ Pro Fall 202058 terms kperkinslaw What causes delayed hemolytic transfusion reaction?Delayed hemolytic transfusion reactions (DHTR) are caused by an anamnestic antibody response in the recipient precipitated by re-exposure to a non-ABO red cell antigen previously introduced by transfusion, transplantation or pregnancy.
What is the most common cause of hemolytic transfusion reactions?The most common cause for a major hemolytic transfusion reaction is a clerical error, such as a mislabelled specimen sent to the blood bank, or not properly identifying the patient to whom you are giving the blood.
Which antibody is most commonly associated with delayed hemolytic transfusion reaction?Duffy, Rh, Kidd, MNS, and Kell antigens are most often associated with delayed reactions. Kidd antibodies are notorious for an anamnestic response that can result in brisk intravascular hemolysis.
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A delayed hemolytic transfusion reaction is most often the result of: quizlet
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