problems in transfusion - suhaib...
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C P bl iCommon Problems inBl d T n f i nBlood Transfusion
Maj Gen (R) Suhaib Ahmed, HI (M)MBBS; MCPS; FCPS; PhD (London)
Genetics Resource Centre (GRC)www.grcpk.com
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Antibodies of Blood Group Systemsp y
ABO SystemABO SystemNaturally Occurring (Pre-formed)Mostly IgM
Rh SystemAcquired (Take time to develop)Mostl IgGMostly IgG
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Compatibility TestingCompatibility Testing
Donor RecipientDonorRed CellsPlasma
RecipientRed Cells (Antigens)Plasma (Antibodies)Plasma Plasma (Antibodies)
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Compatibility TestingCompatibility Testing
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Blood ComponentsBlood Components
Whole BloodWhole BloodPacked CellsPlateletsFFPCryoprecipitatey p pOthers
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Blood Components
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Case-1
A patient developed chills and rigors afterA patient developed chills and rigors after the start of blood transfusion. The likely cause is:cause is:
Rapid administration of cold bloodNon Haemolytic Febrile Transfusion ReactionNon Haemolytic Febrile Transfusion ReactionAllergic reactionsMismatched blood transfusionMismatched blood transfusion
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Case-2
A multiply transfused patient developedA multiply transfused patient developed fever one hour after blood transfusion. The most likely cause is:most likely cause is:
Mismatched blood transfusionTransfusion of infected bloodTransfusion of infected bloodMalariaAnti-leukocyte antibodiesAnti leukocyte antibodies
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Case-3
A 62 years old patient developed dyspnoeaA 62 years old patient developed dyspnoea half way during a blood transfusion. The likely cause is:likely cause is:
Allergic reactionsMismatched blood transfusionMismatched blood transfusionTransfusion associated Acute Lung InjuryCirculatory overloadCirculatory overload
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Case-4
A patient developed fever anaemia and mildA patient developed fever, anaemia, and mild jaundice three days after a blood transfusion. She had also received a blood transfusion three months earlier. The most likely cause for her symptoms is:
Acute haemolytic blood transfusion reactionTransfusion of haemolysed bloodTransfusion of haemolysed bloodTransfusion of infected bloodPost transfusion hepatitisD l d h l ti t f i tiDelayed haemolytic transfusion reaction
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Case-5
A patient developed mild jaundice andA patient developed mild jaundice and abnormal liver function tests two months after a blood transfusion The most likelyafter a blood transfusion. The most likely cause for the symptoms is:
Delayed haemolytic transfusion reactionDelayed haemolytic transfusion reactionPost transfusion hepatitis
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Case-6
A known case of ITP failed to achieve aA known case of ITP failed to achieve a rise in platelet count following repeated platelet transfusions The most likelyplatelet transfusions. The most likely cause is:
Anti-platelet antibodiesAnti platelet antibodies
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Case-7
A 41 years old male presented with weakness y pand fatigability for 2½ months. Examination showed pallor and no other abnormality.
Bl d CP h dBlood CP showed:Hb: 6.8 g/dlTLC: 4.5 X 109/LMCV: 125 flPlatelets: 89 X 109/LRBC Morphology: Macrocytosis ++RBC Morphology: Macrocytosis ++ Reticulocytes: 0.5%
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Monthly Consumption of Blood at PNS Shifa
Surgical Gynae Medical Paeds
Total (270) 54 (20%) 81 (30%) 58(21%) 77 (29%)
p
Total (270) 54 (20%) 81 (30%) 58(21%) 77 (29%)
Routine67/270 (25%)
4/54 (7%) 9/81 (11%) 8/58 (14%) 46/77 (60%)
Urgent 50/54 (93%) 72/81 (89%) 50/58 (86%) 31/77 (40%)Urgent203/270 (75%)
50/54 (93%) 72/81 (89%) 50/58 (86%) 31/77 (40%)
Packed Cells163/270 (60%)
11/54 (20%) 35/81 (43%) 42/58 (72%) 75/77 (97%)( )
Whole Blood107/270 (40%)
43/54 (80%) 46/81 (57%) 16/58 (28%) 2/77 (3%)
Hb (Mean) 9.3 g/dl 8.3 g/dl 7.0 g/dl 7.3 g/dl(Range) (4.9-12.2) (4.4-11.1) (4.1-10.6) (2.6-9.6)
P value 0.660.02
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Monthly Consumption of Blood at PNS Shifa
50
60
20
30
40
0
10
20
0
>10g/dl 9-10g/dl 8-9g/dl 7-8g/dl <7g/dl
Surg & Gynae Med & Paeds