Complications and emergencies: septic transfusion reaction: practice question

A Anaesthesia 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.

Try it

Anaesthesia · Complications and emergencies: septic transfusion reaction

Sample item

A patient receiving a platelet pool stored for five days develops rigors, a temperature of 39.5 degrees C and a fall in blood pressure to 80/50 mmHg within 15 minutes. What is the immediate management?

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

The answer and the reasoning

C. Stop it, culture pack and patient, start antibiotics

Platelets are stored at room temperature and are the component most often contaminated by bacteria. Rapid fever, rigors and hypotension suggest bacterial contamination: stop the transfusion, keep intravenous access, send blood cultures from the patient and the pack for culture and Gram stain, and start broad-spectrum antibiotics with supportive care.

Option by option

  • A. Stop the transfusion and give furosemide for overload

    Hypotension with fever is not circulatory overload, and a diuretic would worsen shock.

  • B. Slow the infusion, give paracetamol and chlorphenamine

    Slowing the infusion and giving antipyretics is the response to a mild febrile reaction and would delay treatment of sepsis.

  • C. Stop it, culture pack and patient, start antibiotics (correct)

    Correct. Fever with hypotension during a stored platelet transfusion needs the product stopped, cultured and empirical antibiotics started.

  • D. Continue the transfusion under hydrocortisone cover

    Continuing the transfusion delivers more bacteria and steroids do not treat sepsis.

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 Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Stop it, culture pack and patient, start antibiotics. Platelets are stored at room temperature and are the component most often contaminated by bacteria.

Why is "Stop the transfusion and give furosemide for overload" not the answer?

Hypotension with fever is not circulatory overload, and a diuretic would worsen shock.

Why is "Slow the infusion, give paracetamol and chlorphenamine" not the answer?

Slowing the infusion and giving antipyretics is the response to a mild febrile reaction and would delay treatment of sepsis.

Why is "Continue the transfusion under hydrocortisone cover" not the answer?

Continuing the transfusion delivers more bacteria and steroids do not treat sepsis.

What concept does this question test?

It tests Complications and emergencies: septic transfusion reaction in Anaesthesia. Rapid fever, rigors and hypotension suggest bacterial contamination: stop the transfusion, keep intravenous access, send blood cultures from the patient and the pack for culture and Gram stain, and start broad-spectrum antibiotics with supportive care.

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 Complications and emergencies: septic transfusion reaction?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.