A Patient Transfused with 2 Units of Packed Cells Spiked

question 18

Multiple Choice

A patient transfused with 2 units of packed cells spiked a fever of 99.5°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-Jk^a. This transfusion reaction is most likely caused by:

• A) an anaphylactic response.
• B) delayed hemolytic transfusion reaction (DHTR) caused by anamnestic response.
• C) DHTR caused by primary alloimmunization.
• D) post-transfusion purpura.

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Definitions:

Atypical Neuroleptics

A class of medications primarily used to treat symptoms of schizophrenia and bipolar disorder, which tend to have fewer extrapyramidal side effects compared to older antipsychotics.

Aggressive Inpatient Children

Children admitted to a hospital or residential treatment who exhibit aggressive behavior towards themselves or others.

Risperidone

An “atypical” antipsychotic medication with fewer side effects than chlorpromazine. It was introduced in the 1990s and is believed to influence serotonin as well as dopamine.

Lithium

A chemical element used as a mood stabilizer in the pharmacological treatment of bipolar disorder and other mood disorders.