American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary method to prevent Febrile Nonhemolytic Transfusion Reaction?

1. Leukoreduction of packed red blood cells and platelets before storage

2. Pre-transfusion platelet count

3. Using fresh frozen plasma

4. Administering antihistamines before transfusion

The correct answer is: Leukoreduction of packed red blood cells and platelets before storage

Leukoreduction of packed red blood cells and platelets before storage is the primary method to prevent Febrile Nonhemolytic Transfusion Reaction. This reaction is commonly attributed to the recipient's immune response to white blood cells (WBCs) that may remain in blood products. During the leukoreduction process, the white blood cells are removed from the blood components, thus significantly reducing the likelihood of triggering an immune response that could lead to febrile reactions. This technique not only helps mitigate the risk of febrile nonhemolytic reactions but also enhances overall transfusion safety and can reduce the incidence of other transfusion-related complications. The other methods mentioned do not specifically address the prevention of febrile nonhemolytic transfusion reactions in the same effective manner. Monitoring platelet counts or using fresh frozen plasma may be relevant in different contexts of transfusion therapy, but they do not directly target the immune response associated with WBCs. Administering antihistamines before transfusion can help alleviate allergic reactions but is not effective in preventing febrile nonhemolytic transfusion reactions, as these are not mediated by histamine. Thus, leukoreduction stands out as the most effective and primary preventive strategy for this specific