Blood and immunity: febrile transfusion reaction: practice question

A Physiology 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

Physiology · Blood and immunity: febrile transfusion reaction

Sample item

Thirty minutes into a red cell transfusion, a patient develops chills and a 1.5 degree C rise in temperature, with no haemolysis, hypotension or urticaria. Which cause is most likely?

ABacterial contamination of the unit with septic shockBABO incompatibility with intravascular haemolysisCRecipient antibodies reacting with donor leucocytes and cytokines released in stored bloodDAntibody to IgA in an IgA-deficient recipient

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

The answer and the reasoning

C. Recipient antibodies reacting with donor leucocytes and cytokines released in stored blood

Febrile non-haemolytic reactions result from recipient antibodies against donor leucocyte antigens and from cytokines accumulated in stored blood. They are self-limited, and leucodepletion lowers the risk. A haemolytic reaction brings red or dark urine and shock.

Option by option

A. Bacterial contamination of the unit with septic shock
A contaminated unit causes rigors with hypotension and septic shock.
B. ABO incompatibility with intravascular haemolysis
ABO incompatibility causes haemolysis, hypotension and haemoglobinuria.
C. Recipient antibodies reacting with donor leucocytes and cytokines released in stored blood (correct)
Correct. Leucocyte antibodies and stored cytokines cause a benign febrile reaction.
D. Antibody to IgA in an IgA-deficient recipient
Anti-IgA reactions cause anaphylaxis rather than 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.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is C, Recipient antibodies reacting with donor leucocytes and cytokines released in stored blood. Febrile non-haemolytic reactions result from recipient antibodies against donor leucocyte antigens and from cytokines accumulated in stored blood.

Why is "Bacterial contamination of the unit with septic shock" not the answer?

A contaminated unit causes rigors with hypotension and septic shock.

Why is "ABO incompatibility with intravascular haemolysis" not the answer?

ABO incompatibility causes haemolysis, hypotension and haemoglobinuria.

Why is "Antibody to IgA in an IgA-deficient recipient" not the answer?

Anti-IgA reactions cause anaphylaxis rather than isolated fever.

What concept does this question test?

It tests Blood and immunity: febrile transfusion reaction in Physiology. They are self-limited, and leucodepletion lowers the risk. A haemolytic reaction brings red or dark urine and shock.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Blood and immunity: febrile transfusion reaction?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.