IMMUNOSEROLOGY

Questions and Answers

What is the maximum age for an allogeneic donor according to the criteria, if the state law does not specify a maximum age?

70 years

65 years

80 years

No maximum age (correct)

Which of the following medications irreversibly affects platelet function and is mentioned in the context of platelet pooling?

Warfarin

Clopidogrel

Aspirin (correct)

Heparin

What is the minimum weight criterion for an allogeneic donor?

100 lb / 45 kg

130 lb / 60 kg

110 lb / 50 kg (correct)

120 lb / 55 kg

What is the maximum oral temperature allowed for an allogeneic donor?

37.5°C Signup and view all the answers

Which blood pressure reading was previously defined by AABB but is now determined by the institution?

180/100 mmHg Signup and view all the answers

What hemoglobin level is required as a minimum for an allogeneic donor?

12.5 g/dL Signup and view all the answers

What is the maximum amount of whole blood that can be collected per kilogram of body weight from a donor?

10.5 mL Signup and view all the answers

What is the recommended donor interval for whole blood donation?

8 weeks Signup and view all the answers

How long should the site be scrubbed before the collection of donor blood?

30 seconds Signup and view all the answers

Who must evaluate the medications of a potential donor?

Medical Doctor (MD) Signup and view all the answers

Which of the following is NOT listed as a step in the collection of donor blood?

Brand recommendation Signup and view all the answers

What technique should be used to ensure a sterile collection site?

Iodine scrub Signup and view all the answers

Which of these statements about donor blood collection is incorrect?

Whole blood can be collected from donors every 6 weeks. Signup and view all the answers

What is a consideration that must be addressed during the donor selection process?

Donor's previous donation history Signup and view all the answers

What is the maximum duration for which CPDA-1 can be effective as an anticoagulant?

35 days Signup and view all the answers

Which of the following conditions does NOT indicate a donor deferral due to bloodborne pathogen risk?

History of hypertension Signup and view all the answers

What is the primary purpose of rejuvenating solutions in blood storage?

To restore 2, 3-DPG and ATP Signup and view all the answers

Which of the following is NOT a characteristic of autologous blood donations?

Donor must be hepatitis-negative Signup and view all the answers

What happens to a unit of blood if a rejuvenating solution is used and not frozen within 24 hours?

It can be stored at 1-6°C but requires washing before transfusion Signup and view all the answers

Which process specifically refers to the separation and collection of plasma from whole blood?

Plasmapheresis Signup and view all the answers

How long can blood units with additives be stored effectively?

42 days Signup and view all the answers

Which component of blood does cytapheresis primarily collect?

White blood cells Signup and view all the answers

What is a reason for deferring a potential blood donor for one year?

Tattoo from a non-regulated facility Signup and view all the answers

Which of the following is NOT a criterion for a one-year donor deferral?

Having a body piercing at a licensed facility Signup and view all the answers

What deferral period applies to a donor with a previous diagnosis of malaria?

3 years Signup and view all the answers

Which condition would result in an indefinite deferral from donating blood?

Past infection of hepatitis C Signup and view all the answers

What is the duration of deferral for a donor who had mucous membrane exposure to blood?

1 year Signup and view all the answers

Which of the following scenarios leads to an indefinite deferral due to the risk of bloodborne pathogens?

Confirmed positive test for anti-HTLV Signup and view all the answers

What is a common deferral reason for a potential donor that involves sexual contact?

Sexual contact with someone symptomatic for any viral hepatitis Signup and view all the answers

What duration of deferral applies for someone with a tattoo done in a regulated facility?

No deferral Signup and view all the answers

If a recipient developed post-transfusion hepatitis, what is the deferral consequence for the donor?

Indefinite Signup and view all the answers

What is the temperature threshold above which a unit of blood cannot be returned and reissued?

10°C Signup and view all the answers

Which of the following indicates a procedure to process washed red cells?

Saline washes with an automated instrument Signup and view all the answers

What significant test is performed to resolve discrepancies in donor blood processing?

Weak D determination Signup and view all the answers

What role do clinically significant antibodies play in donor blood processing?

They indicate potential transfusion reactions. Signup and view all the answers

What component is primarily focused on when conducting a plasma removal procedure in blood processing?

Red cell integrity Signup and view all the answers

Which factor is NOT relevant if the seal of a blood unit is disturbed during processing or storage?

Presence of leukocytes in the blood unit Signup and view all the answers

What is the primary purpose of apheresis red blood cells?

To ensure hemoglobin levels exceed 60g Signup and view all the answers

What is the consequence of breaking the seal on the original unit of blood?

The expiration date shortens to 24 hours Signup and view all the answers

Which component can be prepared from a unit of blood primarily used to prevent allergic reactions?

FFP Signup and view all the answers

What is the key characteristic of IgA deficient patients treated to prevent anaphylactic shock?

They receive blood products with anti-IgA removed Signup and view all the answers

What type of testing is performed to identify the presence of Hepatitis C in blood donations?

NAT Testing Signup and view all the answers

What is the role of complement removal in maternal blood preparation for neonatal transfusions?

To prevent transfusion reactions Signup and view all the answers

What is the expected reaction when testing a Bombay phenotype with Anti-H serum?

No agglutination occurs with Anti-H serum. Signup and view all the answers

What laboratory finding is typically associated with Rouleaux formation?

Increased serum proteins. Signup and view all the answers

Which of the following scenarios might enhance the detection of antibodies in a 'Mini' Cold Panel?

Testing at lower temperatures. Signup and view all the answers

In elderly patients, what is a common problem related to antibody production?

Underproduction of antibodies. Signup and view all the answers

What type of antibodies may react with cells in patients with a cold-reacting antibody phenomenon?

Cold-reacting antibodies only. Signup and view all the answers

What condition may cause antibody production not to reach optimal levels in newborns?

Underdeveloped immune system. Signup and view all the answers

Which antibody is specifically associated with unexpected reactions at colder temperatures?

Anti-I Signup and view all the answers

What is the primary purpose of using saline replacement in testing?

To differentiate between rouleaux and agglutination Signup and view all the answers

Which cells must be transfused in the case of an ABO discrepancy until it is resolved?

Group O cells Signup and view all the answers

In a Mini Cold Panel, which test is expected to react with O cells when testing for anti-H, -M, -N, -P I, and Lewis antibodies?

O Cells Signup and view all the answers

What is the significance of testing with O Cord Cells when available?

To enhance the detection of cold antibodies Signup and view all the answers

Which of the following antibodies would NOT be expected in a Mini Cold Panel?

Anti-Rh Signup and view all the answers

When performing serum tests, what result indicates the presence of anti-A or anti-B antibodies?

Positive reaction with A/B Cells Signup and view all the answers

What reaction does saline replacement help clarify during blood testing?

Normal agglutination vs. Rouleaux formation Signup and view all the answers

What result indicates that the unknown cells possess the corresponding antigen for anti-A sera?

Agglutination with anti-A Signup and view all the answers

Which blood group is indicated by the reagents showing '+' with anti-A and '0' with anti-B?

Group A Signup and view all the answers

Which statement is true regarding subgroups like A3 and Ax in relation to antigen types?

They contain less A antigen and more H antigen. Signup and view all the answers

What does '0' signify in a blood typing test with both anti-A and anti-B reagents?

The absence of both A and B antigens. Signup and view all the answers

What conclusion can be drawn if there is agglutination with both anti-A and anti-B reagents?

The sample belongs to Group AB. Signup and view all the answers

What interpretation can be made from unknown cells that show no agglutination with any antisera?

The cells lack antigens for both A and B. Signup and view all the answers

In serum typing, what does the designation 'Anti-A' specifically relate to?

Antibodies against A antigens. Signup and view all the answers

What is the expected result when testing a Group B blood sample against anti-B reagents?

Agglutination with anti-B. Signup and view all the answers

Which statement about Rh antibodies is correct?

IgG forms of Rh antibodies can agglutinate at 37C. Signup and view all the answers

What problem may arise when using enzyme-treated cells with anti-C or anti-E antibodies?

Decreased reactivity with clinically significant antibodies. Signup and view all the answers

What is true regarding Lewis blood group antigens?

Plasma antigens can adsorb onto red blood cells. Signup and view all the answers

Which statement about storage effects on P1 antigen is accurate?

P1 antigen strength deteriorates upon storage. Signup and view all the answers

How does prewarming affect the activity of antibodies?

It can decrease the activity of some clinically significant antibodies. Signup and view all the answers

Which antibodies are considered cold antibodies that may not always react at body temperature?

Anti-P1 and other IgM antibodies. Signup and view all the answers

What characteristic is associated with allogeneic and autoadsorption methods?

Recent transfusions can interfere with autoadsorption. Signup and view all the answers

What is the potential risk when using IgG AHG for adsorption?

It can lead to missed detection of weak antibodies. Signup and view all the answers

Which statement about Anti-I is correct?

Anti-I can cause delayed transfusion reactions. Signup and view all the answers

What is true regarding Anti-M?

Anti-M requires acidification of serum for identification. Signup and view all the answers

Which of the following accurately describes Anti-U?

68% of African Americans may lack the U antigen. Signup and view all the answers

What characterizes the KELL blood group antigens?

91% of individuals in the KELL group are K negative. Signup and view all the answers

Which scenario correctly describes the interactions of Anti-S and anti-s antibodies?

Anti-S is less likely to rise and fall rapidly in titer. Signup and view all the answers

How do dosage effects relate to Anti-M antibodies?

Anti-M antibodies demonstrate stronger reactivity in homozygous conditions. Signup and view all the answers

What is the implication of enzyme treatment on Duffy antigens?

Duffy antigens are destroyed by enzyme treatment. Signup and view all the answers

What can be inferred about the antibody types and their associated reactions?

IgG antibodies are typically associated with delayed transfusion reactions. Signup and view all the answers

Which reagents are known to destroy or weaken Kell system antigens?

ZZAP and AET Signup and view all the answers

What is the main role of performing a 'last wash' control prior to elution?

To ensure no residual serum antibody contamination Signup and view all the answers

What result indicates serum antibody contamination during the 'last wash' test?

Positive test results with reagent cells Signup and view all the answers

Which method is effective for removing IgG from RBCs but does not affect complement?

Chloroquine diphosphate Signup and view all the answers

Which of the following techniques cleaves disulfide bonds to reduce IgM activity?

DTT and 2-ME Signup and view all the answers

Which statement is true regarding the effect of acid or organic solvent methods on antibodies?

They work best for both auto- and allo-reacting antibodies. Signup and view all the answers

What effect does the 'last wash' showing no reactivity have on testing results?

Indicates effective elution of antibodies Signup and view all the answers

What is the significance of using DTT in blood processing?

It destroys or diminishes the activity of IgM antibodies. Signup and view all the answers

What is the purpose of autoadsorption in antibody testing?

To separate and identify alloantibody specificity Signup and view all the answers

Which statement accurately describes allogeneic adsorption technique?

It is suitable for patients recently transfused to identify hidden antibodies. Signup and view all the answers

What is the optimal sample type used for a Direct Antiglobulin Test (DAT)?

EDTA sample Signup and view all the answers

What indicates a positive reaction in the column agglutination (gel testing)?

Cells adhering to the sides of the microwell plate Signup and view all the answers

Which type of Antihuman Globulin (AHG) is derived from immunized animals targeting multiple epitopes?

Polyclonal AHG Signup and view all the answers

What is one of the primary uses of adsorption in serological work?

To enhance the sensitivity of antibody detection Signup and view all the answers

In what scenario is autoadsorption particularly recommended?

For patients who have not been transfused recently Signup and view all the answers

What happens if cells are coated in vivo during a DAT?

Antiglobulin will react with IgG antibodies or complement. Signup and view all the answers

What is the primary purpose of washing cells multiple times before adding antiglobulin in a DAT?

To remove plasma proteins that may cause false positives. Signup and view all the answers

What is a key characteristic of positive reactions in gel testing?

Agglutinated cells do not settle, indicating reaction Signup and view all the answers

Why is it important to interpret eluate results in antibody testing?

To confirm antibody specificity and presence of antigens Signup and view all the answers

Which statement about monoclonal AHG is true?

It is produced from hybridomas. Signup and view all the answers

What is a consequence of using EDTA as an anticoagulant in blood samples?

It chelates calcium, preventing complement activation. Signup and view all the answers

What problem might arise when testing eluate results?

Misinterpretation due to the presence of interfering substances Signup and view all the answers

What does agglutination in a DAT indicate?

Antibodies may be coating the patient's red blood cells. Signup and view all the answers

What is required for patients with significant antibodies prior to blood transfusion?

They must only receive antigen-negative units that are crossmatch compatible. Signup and view all the answers

Which reagent is essential for the reaction in the Direct Antiglobulin Test?

Antiglobulin Signup and view all the answers

What method is used to calculate the probability of finding antigen-negative blood units?

Multiply the percentage of each specific antigen negative unit. Signup and view all the answers

Which of the following statements about plasma transfusion is accurate?

Group O recipients can receive type A, AB, or AH plasma. Signup and view all the answers

What factor is particularly emphasized in transfusions involving women of childbearing age?

Confirmatory tests must align with the donor's label. Signup and view all the answers

How should plasma transfusion decisions be made?

By ensuring plasma does not contain corresponding antibodies to the recipient's blood type. Signup and view all the answers

In a situation where antigen-negative units are needed, what would be a reasonable expectation regarding availability?

Only a small percentage of antigen-negative units will be available. Signup and view all the answers

What is the purpose of adding check cells during the evaluation of incompatible crossmatch results?

To confirm the adherence of antibodies to antigens Signup and view all the answers

Which of the following describes the order of operations when performing antibody or antigen testing on a microwell plate?

Fix antibody, wash, add antigen, add plasma Signup and view all the answers

What information is considered clinically significant when preparing for blood typing?

List of clinically significant antibodies Signup and view all the answers

In the solid phase technique, what is the role of an antigen adhering to an antibody on the sides of the microwell?

Provides a specific site for the detection of antibodies Signup and view all the answers

What aspect must be compared to assess the reliability of current test results?

Prior tests and any difficulties encountered Signup and view all the answers

Which component is least likely to be involved in the reaction observed when plasma is added to a microwell plate containing antigen?

Filler solution for the microwell Signup and view all the answers

What is the minimum consideration regarding QC when using antisera for testing?

Ensuring antisera is from a reliable source and used on the day of testing Signup and view all the answers

Which factor is NOT part of the pre-testing evaluation for blood typing?

Presence of any current symptoms in the donor Signup and view all the answers

What is a key characteristic used to indicate severe hemolytic reactions in transfusions?

Positive direct antiglobulin test (DAT) Signup and view all the answers

Which of the following scenarios describes a delayed transfusion reaction?

Symptoms showing within hours to days after transfusion Signup and view all the answers

What is the primary reason for issuing antigen-negative blood for transfusions to infants?

To prevent Rh incompatibility Signup and view all the answers

Which blood type recipients can typically receive RBCs from type B donors?

Type B and AB Signup and view all the answers

Which of the following antibodies is commonly associated with delayed transfusion reactions?

Duffy antibodies Signup and view all the answers

What significant symptom complex characterizes transfusion-related acute lung injury (TRALI)?

Bilateral pulmonary edema without cardiac failure Signup and view all the answers

What is a common physiological event associated with transfusion reactions?

Hemoglobinemia Signup and view all the answers

How does a positive direct antiglobulin test (DAT) influence transfusion procedures?

Mandates antigen-negative blood for the infant Signup and view all the answers

Which condition must be tested in neonates for safe blood transfusion?

ABO group and unexpected antibodies Signup and view all the answers

Which symptom is most commonly associated with delayed transfusion reactions?

Fever Signup and view all the answers

What lab procedure is necessary to resolve discrepancies in donor blood processing?

Antiglobulin crossmatch Signup and view all the answers

What consequence occurs when ABO incompatible blood is transfused into a recipient with maternal antibodies?

Immediate hemolytic reaction Signup and view all the answers

What can be a direct consequence of extravascular hemolytic reactions?

Acute kidney injury Signup and view all the answers

What type of error usually leads to transfusion reactions related to blood types?

Clerical errors in blood type documentation Signup and view all the answers

What is the primary method used to test for unexpected antibodies in infants?

Mother's serum or infant's serum Signup and view all the answers

What complication can occur due to hyperbilirubinemia in transfusion reactions?

Kidney failure Signup and view all the answers

Study Notes

Donor Selection and Blood Collection

Initial steps include registration, medical history, and physical examination of the donor.
Aseptic technique requires scrubbing the site for a minimum of 30 seconds with providine-iodine.

General Information

Maximum blood collection is limited to 10.5 mL per kilogram of body weight, including samples.
A minimum interval of 8 weeks is required between whole blood donations.
Medications impacting platelet function must be evaluated by a medical doctor.

Criteria for Allogeneic Donor Selection

Age: Donors must be at least 16 years old, with no maximum age limit subject to physician evaluation.
Temperature: Oral temperature must be ≤ 37.5°C (99.5°F).
Blood Pressure: No longer specifically defined; institutions set their own standards.
Hemoglobin/Hematocrit: Minimum levels are 12.5 g/dL and 38% respectively.
Weight: Donors must weigh at least 110 lbs (50 kg).

Donor Deferral

1 Year Deferral: Includes exposures to hepatitis, HIV, and malaria; tattoos from non-regulated facilities; and sexual exposure to individuals positive for hepatitis or HIV.
3 Year Deferral: Visitors or immigrants from malaria-endemic areas; previous malaria diagnosis.
Indefinite/Permanent Deferral: History of viral hepatitis after age 11, confirmed positive tests for hepatitis or HIV, and evidence of parenteral drug use.

Common Anticoagulants and Additives

Expiration:
- ACD/CPD/CPD2: 21 days
- CPDA-1: 35 days
- Additives: 42 days
Rejuvenating Solutions:
- Restore 2, 3-DPG and ATP levels.
- Units can be frozen or stored at 1-6°C for 24 hours before transfusion.

Autologous Donations

Autologous donations are for personal use with no age limit.
Minimum standards: Hematocrit ≥ 33% and Hemoglobin ≥ 11 g/dL.
Must not have bacteremia.

Donor Blood Processing

Blood processing involves multiple tests to ensure safety and compatibility.
Key tests include:
- pH levels
- Sodium (Na+) evaluation
- Weak D determination
- Serological testing for specific antibodies such as Anti-HIV, Anti-HCV, HBV markers, and syphilis antibodies.

Changes in Plasma During Storage

Plasma experiences changes during storage, particularly at temperatures between 1-6°C.
If the unit of blood is stored above 10°C or if the seal is disturbed, it cannot be returned or reissued.

Washed Red Cell Preparation

Plasma is removed from red blood cells through automated saline washes.
This method is primarily utilized to prevent allergic reactions to plasma proteins, particularly in patients with IgA deficiency.
Important for the safety of neonatal transfusions, as it removes potentially harmful antibodies from maternal blood.

Expiration and Storage Regulations

Washed red cells expire 24 hours after the original unit's seal is broken, reinforcing the importance of proper storage conditions.

Apheresis Red Blood Cells

Hemoglobin concentration in apheresis red blood cells should be greater than 60g to qualify for use.

Reagents and Agglutination Testing

Anti-A and Anti-B reagents are used to determine blood groups through agglutination testing.
Testing typically occurs at room temperature and identifies the presence or absence of specific antigens on red blood cells.
Lack of agglutination implies that unknown cells do not possess the corresponding antigen.

Blood Group Interpretation

Cells can contain subgroups like A3 or Ax, which have reduced A antigen and increased H antigen.
Results for blood grouping:
- Anti-A positive (+) and Anti-B negative (0) indicates Group A.
- Anti-A negative (0) and Anti-B positive (+) indicates Group B.
- Anti-A positive (+) and Anti-B positive (+) indicates Group AB.
- Anti-A negative (0) and Anti-B negative (0) indicates Group O.

Serum Typing (Reverse Typing)

Reverse typing is used to confirm serological blood group through the reaction of serum with specific cells.
Bombay phenotype lacks H antigen; thus does not agglutinate with Anti-H and reacts with A1 and B cells.
Conditions like leukemia may affect serum antibodies.

Common Serum Problems

Rouleaux formation can occur due to increased serum proteins and is seen in conditions such as Waldenstrom's or multiple myeloma.
Cold reacting antibodies (e.g., anti-H, anti-I, anti-M) may cause reactions when tested at room temperature.
An elderly patient may show decreased antibody production, while newborns might not have developed optimum antibody levels.

ABO Discrepancy Management

In cases of ABO discrepancy, transfusion of group O cells is advised until the issue is resolved.

Mini Cold Panel Principle

Mini cold panels enhance the detection of anti-A and anti-B antibodies at lower temperatures and identify "cold" antibodies reacting with A1 and B cells.

Saline Replacement Use

Saline replacement helps differentiate between rouleaux and true agglutination.
Assess the presence of non-transfused 'deleted' cells in Rh typing.

Rh Antibodies and Their Characteristics

IgG antibodies are clinically significant and may react at 37°C as well as with anti-human globulin (AHG).
Specific anti-C, -c, -E antibodies show stronger reactions with enzyme-treated cells.

Lewis Blood Group System

Lewis antigens (Lea, Leb) are plasma antigens that adsorb onto RBCs; they are absent in cord blood.
Antibodies such as anti-P1 and anti-I can exist as cold IgM antibodies; they show dosage and may not react with enzyme-treated cells.

Antibody Characteristics by Blood Type

Anti-M and anti-S are often IgG antibodies that can cause hemolytic disease of the fetus and newborn (HDFN).
Duffy antigens (Fy3, Fy4) are co-dominant alleles, with Fya and Fyb being destroyed by enzymes, impacting antigen typing and clinical significance.

Kell Blood Group System

Codominant alleles K and k are part of the Kell system; 91% of individuals are K-negative, affecting transfusion compatibility and antigen typing.

Antibody Characteristics and Identification

Direct Antiglobulin Test (DAT) assesses the presence of antibodies or complement on red blood cells (RBCs).
Positive DAT indicates cells coated with antibodies; antiglobulin reacts with IgG or complement.
Optimal sample for DAT is EDTA, which prevents complement activation.
Various methods exist for antibody inactivation, including sulfhydryl reagents, which can destroy or weaken specific antigens.

Serological Testing and Methods

AHG (Antihuman Globulin) reagents include polyclonal (variety of epitopes) and monoclonal (single epitope) antibodies.
Last wash control is essential to minimize serum contamination prior to elution.
Positive reactivity in last wash indicates residual serum antibodies; requires retesting.

Adsorption Techniques

Adsorption separates multiple antibodies, removes autoantibodies to reveal underlying alloantibodies.
Autoadsorption is suitable for patients recently transfused, while allogeneic adsorptions use donor cells for those not recently transfused.
Eluate results help confirm antibody specificity and antigen presence on RBCs.

Additional Technologies for Detecting Antigen-Antibody Reactions

Column agglutination and gel testing used for serological work with controlled conditions, autocontrol is not needed.
Solid phase testing involves fixing antibodies or antigens to microwell plates, where binding occurs, followed by washing and addition of check cells.

Evaluating Transfusion Compatibility

Crossmatch evaluation is essential for transfusion and involves analyzing any clinically significant antibodies and previous transfusion reactions.
D-negative individuals should only receive D-negative RBCs; emergencies may allow administering D-positive if necessary.
Antigen typing ensures patients with significant antibodies receive antigen-negative compatible units.

Plasma Transfusion Guidelines

Plasma transfusions should match patient antibodies; AB plasma can be given to any blood group, while Group O can receive other types.
Probability calculations help in identifying compatible units by assessing antigen-negative percentages.

Blood Transfusion Considerations

Recipients of red blood cells (RBCs) and plasma must be identified based on ABO and Rh compatibility to avoid transfusion reactions.
Clerical errors in transfusion processes are common with the ABO system, potentially leading to serious complications.
The most frequent symptom of a transfusion reaction is fever.

Physiological Events in Transfusion Reactions

Hemoglobinemia: Presence of free hemoglobin in the blood.
Hemoglobinuria: Hemoglobin in urine, indicating renal damage.
Hyperbilirubinemia: Elevated bilirubin levels due to hemolysis.
Severe outcomes can include kidney failure and potentially death.

Neonatal Crossmatch Protocol

Initial testing for neonates under 4 months involves determining ABO group and Rh type.
Unexpected antibodies testing can be performed using either the infant's or mother's serum/plasma.
No crossmatch or repeat ABO/Rh testing is required for neonates during hospitalization if the initial antibody screen is negative.
Blood given should be group "O", ABO identical, or compatible, and D compatible.

Delayed Transfusion Reactions

Often result from anamnestic responses to significant antibodies like Rh, Kell, Kidd, and Duffy, occurring after transfusion completion.
Symptoms can manifest hours to days post-transfusion with no expected increase in hemoglobin levels.
A positive Direct Antiglobulin Test (DAT) is a key indicator, often associated with Kidd antibodies.

Characterized by acute respiratory insufficiency and bilateral pulmonary edema observable in X-ray results.
Symptoms typically include chills, fever, hypotension, and no indication of cardiac failure.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.