AP BIOLOGY

Detailed explanation-1: -For IMHA patients, packed RBC products, which provide RBCs without unnecessary plasma, are preferable to whole blood, although whole blood is acceptable in an emergency.

Detailed explanation-2: -The transfusion of packed red cells is carried out to prevent manifest anemia-related tissue hypoxia. The administration of packed red cells is the “ultima ratio” of anemia treatment, employed to achieve the primary treatment goal in cases where causal treatment of the anemia is either not feasible or inadequate.

Detailed explanation-3: -Packed red blood cell transfusions are indicated in the setting of severe anemia with hemodynamic instability, severe hypoxia, or acute end-organ injury. The final hematocrit measurement after transfusion should not exceed a value > 30% because blood viscosity will increase at higher values.

Detailed explanation-4: -IMHA is treated with immunosuppressive medications, anti-thrombotic medications, and supportive therapy including blood transfusions. Multiple blood transfusions are often needed to stabilize the patient while waiting for immunosuppressive medications to take effect.

Detailed explanation-5: -Corticosteroids, usually prednisone, are given at the initial dose of 1.0–1.5 mg/kg/day for 1–3 weeks until hemoglobin levels greater than 10 g/dL are reached. Response occurs mainly during the second week, and if none or minimal improvement is observed in the third week, this therapy is assumed to be ineffective.