Complications and emergencies: febrile non-haemolytic 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: febrile non-haemolytic transfusion reaction

Sample item

Thirty minutes into a platelet transfusion a patient develops chills and a 1.5 degree C rise in temperature. Blood pressure and oxygen saturation are normal, there is no urticaria or haemoglobinuria, and the crossmatch and Gram stain of the pack are normal. The fever settles with paracetamol. What is the reaction?

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

The answer and the reasoning

C. Febrile non-haemolytic reaction

A febrile non-haemolytic reaction is the most common transfusion reaction. It produces fever and chills from recipient antibodies to donor leucocytes or from cytokines released in stored components, and it is a diagnosis of exclusion once haemolysis, sepsis and lung injury are ruled out. Pre-storage leucodepletion reduces its frequency.

Option by option

  • A. Acute haemolytic transfusion reaction from ABO mismatch

    Acute haemolysis would cause hypotension, flank pain, haemoglobinuria and a positive direct antiglobulin test, none of which are present.

  • B. Transfusion-related acute lung injury from donor antibodies

    Lung injury would produce hypoxia and bilateral infiltrates, but oxygen saturation is normal.

  • C. Febrile non-haemolytic reaction (correct)

    Correct. Isolated fever and chills with normal haemodynamics, normal crossmatch and a sterile pack that settle with an antipyretic fit this reaction.

  • D. Allergic urticarial reaction to plasma proteins

    An allergic reaction presents with urticaria, itching or wheeze, not isolated fever.

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, Febrile non-haemolytic reaction. A febrile non-haemolytic reaction is the most common transfusion reaction.

Why is "Acute haemolytic transfusion reaction from ABO mismatch" not the answer?

Acute haemolysis would cause hypotension, flank pain, haemoglobinuria and a positive direct antiglobulin test, none of which are present.

Why is "Transfusion-related acute lung injury from donor antibodies" not the answer?

Lung injury would produce hypoxia and bilateral infiltrates, but oxygen saturation is normal.

Why is "Allergic urticarial reaction to plasma proteins" not the answer?

An allergic reaction presents with urticaria, itching or wheeze, not isolated fever.

What concept does this question test?

It tests Complications and emergencies: febrile non-haemolytic transfusion reaction in Anaesthesia. It produces fever and chills from recipient antibodies to donor leucocytes or from cytokines released in stored components, and it is a diagnosis of exclusion once haemolysis, sepsis and lung injury are ruled out. Pre-storage leucodepletion reduces its frequency.

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: febrile non-haemolytic 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.