SAQ 836 – Haematology – microcytic anaemia and transfusion reaction

A 68-year-old woman presents to your tertiary ED with lethargy, shortness of breath and a presyncopal episode. Her full blood examination is shown below.

Test	Result	Reference range
Hb	68 g/L	130-170
Hct	0.33 L/L	0.36-0.50
RCC	3.6 x 10^12/L	4.2-5.9
MCV	68 fL	80-99
MCH	24 pg	26-34
MCHC	304 g/L	315-365
Platelets	163 x 10^9/L	150-400
WCC	4 x 10^9/L	4-12

List four (4) possible causes for this result.

(Marked out of 4.0)

/ 4

A decision is made to transfuse 1 unit of packed red blood cells. Complete the table by listing four (4) possible complications of blood product transfusion and a clinical feature expected with each.

(Marked out of 8.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Transfusion reaction</th> <th>Clinical feature</th> </tr> </thead> <tbody> <tr> <td>1</td> <td></td> </tr> <tr> <td>2</td> <td></td> </tr> <tr> <td>3</td> <td></td> </tr> <tr> <td>4</td> <td></td> </tr> </tbody> </table> <p>

/ 8

Shortly after the blood transfusion starts, she feels sweaty, nauseated and lightheaded. State six (6) next steps in managing this patient.

(Marked out of 6.0)

Observation	Value
HR	125 bpm
BP	80/60 mmHg
Temperature	39 C
RR	18/min
SaO2	97% room air

/ 6

Total Score: 0 / 18

Percentage: 0%