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+--- Thread: nbme - miss_ismail_79 (/showthread.php?tid=106797)
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nbme - miss_ismail_79 - ArchivalUser - 08-02-2006
27 yr old woman--b/l femoral shft #--20 mins after blood transfusion of 1 unit packed red blood cells--she develops flank pain--haematuria---101.F---
most likely cause
abo incompatability
contamination of transfused blood
fat embolism synndrome
reaaction to leukocye antigens in thansfused blood
retroperitoneal bleed
0 - ArchivalUser - 08-02-2006
reaaction to leukocye antigens in thansfused blood ?????????????????
0 - ArchivalUser - 08-02-2006
reteroperitoneal bleed
0 - ArchivalUser - 08-02-2006
it is classical abo incompatibility leading to hemolysis
pt has hematuria and flank pain plus temp .
only contamination of blood would give rise to temp
only retroperitoneal bleed. why and would not give rise to hematuria and flank pain both sides
reaction to leucocyte antigen would be allergic type and would not start around in 20 min unless she has been exposed to same donor before.
fat embolism does not present this early and would present with respy distress
3 - ArchivalUser - 08-02-2006
i think i go with ajeet , he gave us the explanation yesterday which i think is coorrect. u have hematuria meaning rbcs in urine not hemoglobinuris brought about by lysis as in the other choices
0 - ArchivalUser - 08-02-2006
how do u explain hematuria in the urine
and why after 20 min of the bt
and why temp. temp should rise only if clot forms
and we do refer any red color urine as hematuria. then investigate that it has rbc or not.
so why does ajeet says its retroperitoneal bleed what is the explanation.
i go with transfusion reaction because it is classically . saw few pt with those symptoms
0 - ArchivalUser - 08-04-2006
My answer is retroperitoneal bleed, but I am not sure.
Retroperitoneal bleed because of injury to renal tracts. And I think you can get a temperature with even uneventful blood transfusion.
0 - ArchivalUser - 08-04-2006
why not lecocyte....or ab incompatibility?
0 - ArchivalUser - 08-04-2006
i go with abo incompatibility. massive haemoglobinuria can lead to pigment induced tubular necrosis that will lead to haematuria. hla reaction should take longer than 20 mins. retoperitoneal bleed can only cause haematuria if there is an associated renal or urinary tract injury. nothing in the stem is suggestive of this and rather the symptoms are tied in time to bld transfussion.
0 - ArchivalUser - 08-04-2006
this Q has been rehashed....and each of those times the Q stem keeps getting shorter and shorter, and the info in it lesser!