Rheumatology & Haematology — Flashcards

Flashcard 391: _____ is currently the leading cause of transfusion-related fatalities.

Answer: TRALI (Transfusion-Related Acute Lung Injury)

Extra: TRALI is characterized by non-cardiogenic pulmonary edema occurring within 6 hours of transfusion. It is usually caused by donor antileukocyte antibodies (anti-HLA or anti-HNA) reacting against recipient neutrophils in the lungs.

Flashcard 392: Which blood transfusion reaction is caused by donor anti-leukocyte antibodies against recipient neutrophils and pulmonary endothelial cells? _____

Answer: Transfusion-related acute lung injury (TRALI)

Flashcard 393: What is the management of minor allergic transfusion reaction (urticaria, no signs of anaphylaxis)? _____

Answer: Stop transfusion, antihistamines, resume transfusion if otherwise asymptomatic

Flashcard 394: What is the management of acute haemolytic transfusion reactions? _____

Answer: Stop transfusion, aggressive IV fluids

Flashcard 395: What are the initial investigations for myelofibrosis? _____

Answer: FBC & blood smear

Flashcard 396: What is the likely diagnosis in a patient that develops fever / chills, flank pain, haemoglobinuria, and DIC within 1 hour after starting RBC tranfusion? _____

Answer: Acute hemolytic transfusion reaction (AHTR)

Flashcard 397: What pathologic RBC is associated with myelofibrosis? _____

Answer: "Tear drop" cells (dacrocyte)

Flashcard 398: What condition is associated with increased risk for anaphylactic reaction when receiving blood transfusions? _____

Answer: Selective IgA deficiency

Flashcard 399: What is the most common blood transfusion reaction? _____

Answer: Febrile non-haemolytic transfusion reaction

Flashcard 400: What vital sign helps distinguish between TACO and TRALI? _____

Answer: BP (Hypertension vs Hypotension)

Extra: **TACO (Transfusion-Associated Circulatory Overload):** - Pathophysiology: Volume overload. - Key signs: Hypertension, distended neck veins, S3, responsive to diuretics. - BNP: Elevated. **TRALI (Transfusion-Related Acute Lung Injury):** - Pathophysiology: Neutrophil activation causing lung capillary leak (non-cardiogenic pulmonary edema). - Key signs: Hypotension, fever. - BNP: Normal.