ABPath Blood Banking and Transfusion 3 — Questions and Answers
Question 1: A patient develops sudden hypotension, back pain, and hemoglobinuria minutes after starting a transfusion. What is the most likely reaction?
- Acute hemolytic transfusion reaction (Correct answer)
- Allergic reaction
- TRALI
- Febrile nonhemolytic reaction
Correct answer: Acute hemolytic transfusion reaction
These signs indicate an acute intravascular hemolytic reaction, usually from ABO incompatibility.
Question 2: Transfusion-related acute lung injury (TRALI) is characterized by which finding?
- Non-cardiogenic pulmonary edema within 6 hours of transfusion (Correct answer)
- Volume overload with elevated BNP
- Delayed hemolysis at 7 days
- Isolated urticaria
Correct answer: Non-cardiogenic pulmonary edema within 6 hours of transfusion
TRALI presents as acute non-cardiogenic pulmonary edema within 6 hours of transfusion.
Question 3: Which patients require irradiated cellular blood products to prevent transfusion-associated graft-versus-host disease?
- Severely immunocompromised and intrauterine transfusion recipients (Correct answer)
- All group O recipients
- Patients with sickle cell trait
- Healthy adult trauma patients
Correct answer: Severely immunocompromised and intrauterine transfusion recipients
Irradiation prevents TA-GVHD in immunocompromised and fetal/neonatal recipients.
Question 4: A delayed hemolytic transfusion reaction most often results from an anamnestic response to which antibody type?
- Kidd (anti-Jka) antibodies (Correct answer)
- Anti-A
- Anti-Lewis
- Anti-P1
Correct answer: Kidd (anti-Jka) antibodies
Kidd antibodies notoriously drop below detection and cause delayed reactions on re-exposure.
Question 5: What is the expected corrected count increment purpose when transfusing platelets?
- To assess platelet transfusion response and detect refractoriness (Correct answer)
- To measure red cell survival
- To evaluate fibrinogen levels
- To check for ABO antibodies
Correct answer: To assess platelet transfusion response and detect refractoriness
The corrected count increment evaluates the platelet response and identifies refractoriness.
Question 6: Which anticoagulant-preservative allows RBC storage for up to 42 days?
- CPDA-1 with additive solution (AS) (Correct answer)
- CPD alone
- Heparin
- ACD-A
Correct answer: CPDA-1 with additive solution (AS)
Additive solutions extend RBC storage to 42 days.
Question 7: A patient with a history of anaphylactic transfusion reactions and undetectable IgA most likely needs which product?
- Washed or IgA-deficient components (Correct answer)
- Irradiated platelets
- Leukoreduced plasma only
- Fresh frozen plasma
Correct answer: Washed or IgA-deficient components
IgA-deficient patients with anti-IgA require washed or IgA-deficient components.
ABPath Blood Banking and Transfusion 3
A patient develops sudden hypotension, back pain, and hemoglobinuria minutes after starting a transfusion.
What is the most likely reaction?