A 26-yrs-old trauma victim is being resuscitated

Discussion in 'MRCS Forum' started by Lona., Oct 26, 2007.

  1. Lona.

    Lona. Guest

    A 26-yrs-old trauma victim is being resuscitated following an auto accident complicated by hypotension from a fractured pelvis and resultant hemorrhage. The patient becomes hypotensive with a normal CVP, oliguric and febrile and complains of flank pain. The most likely diagnosis is -
    a- Hypovolemic shock
    b- Acute adrenal insufficiency
    c- Gram-negative bacteremia
    d- Transfusion reaction
    e- Ureteral obstruction
  2. Lona.

    Lona. Guest

    Answer: d- Transfusion reaction. (Sabiston, 15/e, pp 124) Allergic and febrile reactions occur in about 1% of all transfusions. Hemolytic transfusion reactions are much less common (0.2%), with fatal reactions in 1 of 100,000 transfusions. Hemolytic transfusion reactions are due to the reaction of recipient antibodies against transfused antigens. These reactions can be both immediate and delayed. Symptoms of a hemolytic transfusion reaction include fever, chills, and pain heat at the infusion site, as well as respiratory distress, anxiety, hypotension and oliguria. During surgery a hemolytic transfusion reaction can manifest as abnormal bleeding.

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