sandra wrote:
isnt the 2nd one d?
I believe that to.
The patient has hematuria, which is not expected in ABO-incompatibility reactions. The urine would be red-brown, due to hemoglobinuria, not hematuria. If this patient was suffering from that, then we would expecting hemolytic anemia with increased bilirubin, and maybe jaundice according to degree of severity. But this patient presents with a nonhemolytic febrile transfusion reactions usually caused by cytokines from leukocytes in transfused red cell or platelet components, causing fever, chills, or rigors. In the setting of transfusion administration, a fever is defined as a temperature elevation of 1 degree Celsius or 2 degrees Fahrenheit. A nonhemolytic transfusion reaction is a diagnosis of exclusion, since hemolytic and septic reactions can present similarly.
If they ask you how to prevent these kind of readtions, then the answer is some kind of "washing" of the RBC prior to transfusion. Don't pick "whole blood" since this contains the greatest amounts of white blood cells. Whole blood isn't centrifugated and thus contains lots of WBC.
But indeed she has flank pain, most commonly associated with ABO-incompatibility. Anyway non-hemolytic febrile reaction is more common... Confusing.
Someone please explain, thx!
Edited by romano on 01/07/08 - 12:27 AM
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