Name: Alison Carter

Theme: Blood transfusion (adverse events/reactions)

OPTION LIST

A	Immunological haemolytic reaction	I	Air embolism
B	Non-haemolytic reaction	J	Post-transfusion purpura (PTP)
C	Reaction to massive transfusion	K	CMV infection
D	Transfusion-related acute lung injury (TRALI)	L	Clostridium perfringens infection
E	Delayed haemolytic transfusion reaction (DHTR)	M	B19 parvovirus infection
F	Transfusion-related fluid overload	N	Yersinia enterocolitica infection
G	Iron overload	O	Graft vs. Host disease (GvHD)
H	Allergic reaction to transfusion	P

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. An 18 year old African girl known to suffer from sickle cell anaemia develops a fever, sudden lethargy, pallor and arthralgia two months post-transfusion. Investigations reveal bone marrow red cell aplasia and a positive Paul-Bunnell test.

2. A 32 year old Irish man was noted to have a temperature of 36.9ºC and blood electrolyte results of: urea = 5.2 mmol/L, sodium = 144 mmol/L, potassium = 5.5 mmol/L, calcium = 2.5 mmol/L after receiving 10 units of blood over a 24 hour period.

3. A 55 year old British female developed an itchy, diffuse erythematous rash on both arms fifteen minutes after receiving a blood transfusion. This rash responded well to acrivastine.

4. A 36 year old Italian gentleman presented with severe bruising across the dorsal aspect of his left arm one week post-transfusion. FBC results included: Hb = 15g/dL, platelets = 8x10⁹/L and WBC = 5.5x10⁹/L.

5. A 72 year old Australian man developed a fever and jaundice five days post-transfusion. FBC revealed Hb = 9g/dL and MCV = 105fL with haemoglobinuria noted on urine dipstick testing.

ANSWERS

1. M

2. C

3. H

4. J

5. E