TRALI
Quiz by Sadeq K. Ali Al-Salait
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- Q1
What is the primary pathophysiological mechanism proposed for TRALI development?
Direct organ damage
Immune suppression
Single-hit mechanism
Two-hit theory
Genetic predisposition
30s - Q2
What characterizes the "priming step" in the pathogenesis of TRALI?
Activation of alveolar macrophages
Activation of pulmonary endothelial cells (ECs) and polymorphonuclear neutrophils (PMNs)
Activation of macrophages in the spleen
Release of histamine from mast cells
Release of cytokines from T-cells
30s - Q3
Which donor-related factor has been most implicated in the reduction of TRALI cases?
Use of male plasma donors
Plasma pooled from multiple donors
Pathogen reduction technology
Leukoreduction of all blood products
Exclusion of ABO-incompatible donors
30s - Q4
Which phase of TRALI is characterized by damage to the pulmonary vascular endothelial barrier?
Effector phase
Priming step
Hemostasis phase
Coagulation phase
Pulmonary reaction phase
30s - Q5
Which type of TRALI is associated with the presence of acute respiratory distress syndrome (ARDS) risk factors?
Type II TRALI
Sepsis-induced TRALI
Type I TRALI
Immune-mediated TRALI
Antibody-independent TRALI
30s - Q6
Which antibody is most commonly identified in TRALI cases?
Anti-HLA class I
Anti-B
Anti-A
Anti-RhD
Anti-ABO
30s - Q7
In non-immune TRALI, which of the following biologic response modifiers (BRMs) is involved?
Histamine
Transforming growth factor-β (TGF-β)
C-reactive protein
Soluble CD40 ligand (sCD40L)
Cytokine IL-10
30s - Q8
What is the typical time frame for TRALI onset following transfusion?
Immediately after transfusion
6-12 hours after transfusion
Within 1-2 hours after transfusion
48 hours after transfusion
24 hours after transfusion
30s - Q9
Which of the following is considered a major risk factor for TRALI?
Multiparous female donors
Cryoprecipitate transfusion
Blood group incompatibility
Use of male-only donors
Use of pathogen-reduced plasma
30s - Q10
Which strategy has been shown to reduce the incidence of TRALI associated with platelet transfusion?
Use of leukoreduced platelets
Use of platelet additive solution (PAS)
Use of irradiated platelets
Pathogen reduction technology (PRT)
Use of solvent/detergent-treated pooled plasma
30s - Q11
Which condition is most frequently included in the differential diagnosis of TRALI?
Sepsis
Transfusion-associated circulatory overload (TACO)
Post-transfusion purpura (PTP)
Anaphylactic transfusion reaction
Hemolytic transfusion reaction
30s - Q12
Which of the following is NOT part of the diagnostic criteria for TRALI according to the 2019 Delphi panel?
Non-cardiogenic pulmonary edema
Onset within 6 hours of transfusion
Hypoxemia
Detection of anti-HLA antibodies in the patient
Bilateral pulmonary infiltrates
30s - Q13
Which therapeutic approach has shown some promise in limiting reactive oxygen species (ROS) damage in TRALI?
Administration of corticosteroids
High-dose intravenous ascorbic acid
Administration of immunoglobulins
Use of diuretics
Platelet transfusion
30s - Q14
What is the key distinction between immune and non-immune TRALI?
Presence of anti-HLA antibodies in immune TRALI
Delayed onset in non-immune TRALI
Use of fresh frozen plasma in non-immune TRALI
Absence of neutrophil involvement in immune TRALI
Involvement of eosinophils in non-immune TRALI
30s - Q15
How does leukoreduction help reduce TRALI incidence?
By eliminating bacterial contamination in blood products
By preventing hemolysis of RBCs
By reducing platelet concentration in plasma
By removing anti-HLA antibodies from plasma
By filtering out leukocyte-derived mediators that contribute to TRALI
30s