skip to main content

Transfusion-associated circulatory overload — RCPSC IM MCQ

Instant feedback + full explanation. One question, done properly.

HardGeneral IM, Ethics, CanMEDSTransfusion-associated circulatory overloadRCPSC IM

Six hours after multiple transfusions, a patient develops dyspnea, hypertension, elevated JVP and pulmonary edema with increased BNP. What is the best immediate response?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Stop transfusion, diurese and report suspected TACO

The best answer is “Stop transfusion, diurese and report suspected TACO”. The timing, hypertension, venous congestion and BNP support transfusion-associated circulatory overload. Transfusion is stopped, respiratory support and diuresis are provided, and the event is investigated and reported; TRALI more often lacks circulatory overload. Future transfusions should use slower rates, split units or prophylactic diuresis according to recurrence risk, cardiac reserve and clinical need.

Reference: Canadian Blood Services, transfusion reactions: https://professionaleducation.blood.ca/en/transfusion/clinical-guide/transfusion-reactions