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Preformed antibodies
76%
91/120
Deposition of immune complexes
7%
8/120
T lymphocyte reaction
8%
9/120
IgE mediated reaction
5%
6/120
Production of leukotrienes
2%
2/120
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This patient with fever, hypotension, and tachycardia several minutes after red blood cell transfusion is having an acute hemolytic transfusion reaction due to preformed antibodies. Acute hemolytic reactions occur most often due to clerical errors and ABO incompatibility. Patients will present fever, hypotension, tachycardia, jaundice, hemoglobinuria, and oozing from venipuncture sites. Acute hemolytic tranfusion reactions are a type II hypersensitivity reaction due to preformed antibodies. Incorrect Answers: Answer 2: Deposition of immune complexes is seen in type III hypersensitivity reactions, such a serum sickness. Answer 3: T lymphocyte reactions are responsible for acute and chronic transplant rejection and are a type IV (delayed) hypersensitivity reaction. Answer 4: IgE-mediated reactions are seen in type I hypersensitivity reactions due to cross-linking of IgE molecules by antigens. They are responsible for allergic and anaphylactic reactions which occur rapidly and present with urticarial, pruritis, wheezing, and fever. Answer 5: Production of leukotrienes causes a delayed response in type I hypersensitivity reactions. Bullet Summary: Acute hemolytic reactions occur due to ABO incompatibility and present with hypotension, fever, tachycardia, and oozing from venipuncture sites.
4.6
(5)
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