EDAIC Coagulation and Transfusion Medicine 5

Question 1

A patient develops fever, rigors, and hypotension during a red cell transfusion. The direct antiglobulin test (DAT) is positive. What is the most likely diagnosis?

Accepted Answer

Acute hemolytic transfusion reaction

Answer

A positive DAT with hemolysis signs indicates acute hemolytic transfusion reaction from ABO incompatibility.

Question 2

What distinguishes TRALI from TACO in a patient who develops acute respiratory distress after transfusion?

Accepted Answer

TRALI presents with bilateral infiltrates and low/normal filling pressures; TACO presents with elevated filling pressures and responds to diuresis

Answer

TRALI is immune-mediated lung injury with non-cardiogenic pulmonary edema; TACO is hydrostatic pulmonary edema with elevated filling pressures.

Question 3

A patient with thrombocytopenia and a rising creatinine after heparin exposure has a 4Ts score of 6. What is the next step?

Accepted Answer

Stop all heparin and start a non-heparin anticoagulant

Answer

A 4Ts score ≥4 indicates intermediate-to-high probability of HIT; all heparin must be stopped and alternative anticoagulation started.

Question 4

Which factor deficiency is associated with a prolonged aPTT but no clinical bleeding tendency?

Accepted Answer

Factor XII deficiency

Answer

Factor XII (Hageman factor) deficiency prolongs aPTT but does not cause bleeding because it is not essential for in vivo hemostasis.

Question 5

In obstetric hemorrhage with suspected placental abruption, which specific coagulopathy should be anticipated?

Accepted Answer

Acute DIC with hypofibrinogenemia

Answer

Placental abruption releases large amounts of thromboplastin, triggering DIC with consumption of fibrinogen and other factors.

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC Coagulation and Transfusion Medicine 5