Question 1
Ii this case study, the type of anemia that the patient is suffering from is anemia due to excessive bleeding. When blood is lost at a faster rate than red blood cells and other components can be made, the body pulls water from tissue adjacent to the blood vessels to ensure they are filled ( Nelson & Ritchie, 2015) . This pulling of water results in the dilution of blood and resultant low hematocrit levels. The results show a positive for hemoccult test. A hemoccult test is a definitive method in detecting blood in an individual’s stool ( Goede et al., 2017) . The hemoccult test is mainly used in patients who do not have visible blood in their stool. However, for the patient, the test was done for confirmation.
The positive results mean that the patient has been losing blood through stool which may indicate a severe problem with his digestive tract. This loss of blood leads to the symptoms of anemia described. With the low concentration of oxygen-carrying red blood cells, the patient's muscle has a low supply of oxygen that causes fatigue, weakness, and sleepiness. As the body tries to get more oxygen, the patients suffer shortness of breath. The results indicate and necessitate further investigations on the patients. The most common causes of blood in stool are colon cancer and hemorrhoids. However, with a hemoglobin count of 5g/dL, the patient will need an urgent blood transfusion.
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Question 2
The patient in the case study can be a recipient for groups B+, B-, AB+, AB-, O- and O+ of blood. A patient whose blood group is B+ makes an antigen of this type and a rhesus factor. Red blood cells are marked by the kind of blood group antigens found on their surfaces ( Cooling, 2015) . These markers will react against other types of antigens introduced into the body through transfusion. Types A and B antigens are the markers of red blood cells and the primary determinants of the blood group of an individual. Based on these two types of antigens, the primary blood groups include A, B, AB, and O. A blood group O individual has no antigen on their cell surfaces. A blood group AB person has both antigens A and B ( Beck et al., 2017) . The patient can hence get blood from them as there are no antibodies against to be countered by his antigens. However, getting blood with antigen A causes a potentially fatal immune response. Blood group B will also not produce antibodies against itself in the body of the patient.
Another essential consideration for transfusion is the rhesus factor. Rhesus factor refers to a protein that is located in the red blood cells ( Paridar et al., 2016) . People with Rhesus factor are Rh-positive while those without are Rh-negative. An Rh-positive individual can get transfused with blood from individuals with Rhesus factor and those without. However, an Rh-negative merely gets blood that lacks the Rhesus factor.
Question 3
The patient rejects blood groups A- and A+ as they are not compatible. People develop antibodies against which they lack antigens in their red blood cells ( Cooling, 2015) . The blood group A+ and A- contains antigen A that case study patient, with group B, has antibodies against. This process starts to happen by the time a baby is six months old. For the patient who has blood group B+, he will develop antibodies against antigens A ( Beck et al., 2017) . The host white blood cells recognize antigen A from transfused blood as a foreign antigen and fight to eliminate it.
The reaction involving antibody and antigen occur red blood cell wall lead to lysis of the cells or their destruction. This causes incompatibility and rejection of the blood by the host and maybe fatal with extreme effects on the patient. The blood group B+ has a rhesus factor which means that there is no rhesus incompatibility. Only those people without the Rhesus factor block the protein from being introduced into the body ( Cooling, 2015) . Consequently, the patient does not block blood based on the presence of the Rhesus factor. The rhesus factor is hence a needed consideration in this transfusion.
Question 4
Receiving incompatible blood may result in a hemolytic transfusion reaction after the process of transfusion as the patient reacts. A hemolytic transfusion reaction encompasses the damage of red blood cells by the host immune mechanism ( Delaney et al., 2016) . The destruction of the red blood cells, known as hemolysis, results from the interaction between antibodies of the recipient and the antigens of the donor ( Beck et al., 2017) . The patient, who is B+ has antibodies against mechanisms for the production of antigen A. If red blood cells with antigen A gets into the patient, white blood cells will release antibodies against antigen A, and an antigen-antibody reaction will occur on donor’s red blood cells (Bahri et al., 2018) . The attack of the donor’s red blood cells by the host’s immune system causes them to burst and cause some symptoms.
Depending on the level of reaction and the amount of donor’s blood that has been rejected, there are several possible symptoms of transfusion reactions. The indications of a transfusion response include dizziness, fainting, malaise, shortness of breath, reddening skin, dark urine, itching, and back pain ( Beck et al., 2017) . While the symptoms may be non-consequential and straightforward, they may also be part of a significant complication in the recipient's body. Some of the difficulties that may result from transfusion reactions include anemia, pulmonary edema, shock, and acute kidney failure ( Bahri et al., 2018) . Care is hence required during the transfusion to avoid such life-threatening conditions.
References
Bahri, T., De Bruyn, K., Leys, R., & Weerkamp, F. (2018). Fatal Acute Hemolytic Transfusion Reaction due to Anti-War. Transfusion Medicine and Hemotherapy , 45 (6), 438-441.
Beck, T. N., Young, N. G., Erickson, M. L., & Prats, I. (2017). Rare antibody-associated hemolytic transfusion reaction and transfusion-related acute lung injury: a case report. BMC Surgery , 17 (1), 48.
Cooling, L. (2015). Blood groups in infection and host susceptibility. Clinical microbiology reviews , 28 (3), 801-870.
Delaney, M., Wendel, S., Bercovitz, R. S., Cid, J., Cohn, C., Dunbar, N. M., ... & Van De-Watering, L. (2016). Transfusion reactions: prevention, diagnosis, and treatment. The Lancet , 388 (10061), 2825-2836.
Goede, S. L., Rabeneck, L., Van Ballegooijen, M., Zauber, A. G., Passat, L. F., Hoch, J. S., ... & Lansdorp-Vogelaar, I. (2017). Harms, benefits, and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening. PloS one , 12 (3), e0172864.
Nelson, A. L., & Ritchie, J. J. (2015). Severe anemia from heavy menstrual bleeding requires heightened attention — American journal of obstetrics and gynecology , 213 (1), 97-e1.
Paridar, M., Shoushtari, M. M., Kiani, B., Nori, B., Shahjahani, M., Khosravi, A., & Far, M. J. (2016). Distribution of ABO blood groups and rhesus factor in a Large Scale Study of different cities and ethnicities in Khuzestan province, Iran. Egyptian Journal of Medical Human Genetics , 17 (1), 105-109.
