Immunodeficiency: selective IgA deficiency: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Immunodeficiency: selective IgA deficiency

Sample item

A 30-year-old man with recurrent sinusitis and giardiasis develops urticaria, wheeze and hypotension within minutes of starting a red cell transfusion. Which blood product strategy is best for his future transfusions?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Washed red cells, or components from IgA-deficient donors

Selective IgA deficiency is the commonest primary immunodeficiency and some patients have anti-IgA antibodies that react with IgA in donor plasma, causing anaphylaxis. Future transfusions should use washed cellular components, which remove plasma, or blood from IgA-deficient donors. Leucodepletion removes white cells, not plasma proteins.

Option by option

  • A. Gamma-irradiated red cells

    Irradiation prevents transfusion-associated graft-versus-host disease and does not remove IgA.

  • B. Washed red cells, or components from IgA-deficient donors (correct)

    Correct. Washing removes the donor plasma IgA that triggers the reaction.

  • C. Leucodepleted red cells alone

    Leucodepletion removes leukocytes, but plasma IgA remains.

  • D. CMV-seronegative red cells

    CMV-negative components reduce CMV transmission and do not prevent anti-IgA reactions.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Washed red cells, or components from IgA-deficient donors. Selective IgA deficiency is the commonest primary immunodeficiency and some patients have anti-IgA antibodies that react with IgA in donor plasma, causing anaphylaxis.

Why is "Gamma-irradiated red cells" not the answer?

Irradiation prevents transfusion-associated graft-versus-host disease and does not remove IgA.

Why is "Leucodepleted red cells alone" not the answer?

Leucodepletion removes leukocytes, but plasma IgA remains.

Why is "CMV-seronegative red cells" not the answer?

CMV-negative components reduce CMV transmission and do not prevent anti-IgA reactions.

What concept does this question test?

It tests Immunodeficiency: selective IgA deficiency in Pathology. Future transfusions should use washed cellular components, which remove plasma, or blood from IgA-deficient donors. Leucodepletion removes white cells, not plasma proteins.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunodeficiency: selective IgA deficiency?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.