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Postoperative fever timing — USMLE Step 3 MCQ

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ModerateSurgery (post-operative, follow-up)Postoperative fever timingUSMLE Step 3

A 49-year-old woman has fever 6 hours after transfusion during surgery. She develops flank pain, hypotension, and dark urine. Direct antiglobulin test is positive. The transfusion was stopped. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: D — Acute hemolytic transfusion reaction

Fever, hypotension, flank pain, hemoglobinuria, and positive DAT during or shortly after transfusion indicate acute hemolytic transfusion reaction.

Reference: AABB Transfusion Reaction Guidance