A client who received a blood transfusion 4 weeks ago now exhibits symptoms including fever, rash, diarrhea, and pancytopenia.
What complication might be responsible for these symptoms?
Delayed hemolytic reaction.
Graft-versus-host disease.
Transfusion-associated graft-versus-host disease (TA-GVHD)
Post-transfusion purpura.
The Correct Answer is C
Choice A rationale:
Delayed hemolytic reaction occurs more than 24 hours after a blood transfusion and is characterized by a drop in hemoglobin levels, jaundice, and a positive direct antiglobulin test (Coombs test)
It does not typically present with fever, rash, and pancytopenia, so it is not the best choice for the given symptoms.
Choice B rationale:
Graft-versus-host disease (GVHD) is a condition where donor T lymphocytes attack the recipient's tissues, often seen in bone marrow or stem cell transplant recipients.
While it can cause pancytopenia, it typically occurs within a few weeks of transplantation, not four weeks after a blood transfusion.
Therefore, it is less likely to be the cause in this scenario.
Choice C rationale:
Transfusion-associated graft-versus-host disease (TA-GVHD) occurs when viable T lymphocytes in the transfused blood attack the recipient's tissues.
Symptoms can include fever, rash, diarrhea, and pancytopenia.
TA-GVHD is a delayed complication of transfusion that typically presents about 1 to 6 weeks post-transfusion, making it the most likely cause of the symptoms described in the scenario.
Choice D rationale:
Post-transfusion purpura is a rare condition that occurs 5 to 12 days after a transfusion and is characterized by sudden severe thrombocytopenia (low platelet count) and bleeding, often in the form of purpura.
It does not typically present with fever, rash, and pancytopenia, so it is not the best choice for the given symptoms.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Whole blood.
Rationale: Whole blood contains red blood cells, plasma, platelets, and other components.
It is typically used for patients with significant blood loss or when multiple blood components need to be replaced.
However, in this case, the patient is specifically experiencing thrombocytopenia, which means a low platelet count.
Administering whole blood would not be the most appropriate choice because it does not provide a concentrated dose of platelets, which is what the patient needs.
Choice B rationale:
Packed red blood cells (PRBCs)
Rationale: Packed red blood cells are primarily used to increase oxygen-carrying capacity in patients with anemia or significant blood loss.
They do not contain a sufficient quantity of platelets to address thrombocytopenia, so this is not the correct choice for the patient in question.
Choice C rationale:
Fresh frozen plasma (FFP)
Rationale: Fresh frozen plasma is rich in clotting factors and is used to treat bleeding disorders or clotting factor deficiencies.
While it can be a valuable component in some cases, it does not directly increase platelet counts.
Therefore, it is not the most appropriate choice for a patient with thrombocytopenia.
Choice D rationale:
Platelets.
Rationale: Platelets are the correct choice for a patient with thrombocytopenia.
Platelet transfusion provides a concentrated dose of platelets, which can help increase the patient's platelet count and improve clotting ability.
It directly addresses the underlying issue in thrombocytopenia, making it the most suitable option.
Correct Answer is B
Explanation
Choice A rationale:
Transfusion-related acute lung injury (TRALI) is characterized by acute respiratory distress and is usually not associated with abdominal symptoms.
TRALI is more common in patients receiving plasma-containing blood products.
Choice B rationale:
Transfusion-associated circulatory overload (TACO) occurs when a patient receives a volume of blood or blood products that exceeds their circulatory system's capacity.
Symptoms include dyspnea, orthopnea, tachypnea, and crackles on lung auscultation, which match the symptoms described in the question.
This condition is more likely when blood products are transfused too rapidly or in excessive volume.
Choice C rationale:
Allergic reactions to blood transfusions typically present with symptoms like itching, hives, and flushing, rather than the respiratory symptoms and crackles on lung auscultation described in the question.
Choice D rationale:
Febrile nonhemolytic reactions are characterized by fever and chills and do not typically manifest as dyspnea, orthopnea, tachypnea, or crackles on lung auscultation.
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