Approach To Anemia And Tranfusion Medicine

Question 1

Pediatric animals have lower PCV T/F

Answer 1

T

Question 2

Pregnant animals have lower PCT. T/F

Answer 2

T

Question 3

Which breed of dog can lose significant blood and not appear anemic?

Answer 3

Sighthounds

They have higher than reference range HCT

Question 4

Patients which are not symptomatic donot need blood products. T/F

Answer 4

T

Question 5

There is no PCV below which patients always need blood. T/F

Answer 5

T

Question 6

3 main categories of anemia?

Answer 6

• Lack of production
• Blood loss
• Increased destruction

Question 7

TP will be low in which type of anemia?

Answer 7

Blood loss

Question 8

Why animals with anemia due to LACK OF PRODUCTION have less clinical signs?

Answer 8

As they get anemic SLOWLY

Question 9

Product of choice in following type of anemias.
Lack of production?
Blood loss?
Increased destruction?

Answer 9

• Lack of production → pRBC
• Blood loss → Whole blood
• Increased destruction → pRBC

Question 10

All animals should be blood typed. T/F

Answer 10

T

Question 11

You should cross match before every tranfusion, especially in cats except ______

Answer 11

In emergencies

Question 12

What happens if you give type A blood to Type B Cat?

Answer 12

It will kill them

Question 13

_______ is indicated in case of documented coagulopathy

Answer 13

PLASMA

Question 14

Three types of plasma?

Answer 14

FFP
Frozen plasma
Cryo-poor plasma

Question 15

Which plasma can you use for anti-coagulant rodenticide toxicity?

Answer 15

All three

Question 16

Which plasma can you use for Hemophilia or VWD disease?

Answer 16

Only FFP

You cannot use others as they donot have labile clotting factors

Question 17

Standard plasma dose is _____ ml/kg

Answer 17

6-15

Question 18

If plasma has albumin, then why is it not a good option for treatment of hypoalbuminemia?

Answer 18

You need a big dose i.e. 45 ml/kg to raise albumin by 1 g/dl

Question 19

Best blood product for platelets ?

Answer 19

WHOLE BLOOD

Question 20

Donot hang blood product for >___ hrs

Answer 20

4

Question 21

If you spike it, you have ____ hours to use it

Answer 21

24

Question 22

Always use BLOOD FILTER when administering blood. T/F

Answer 22

T

Question 23

To points to consider while thawing Plasma?

Answer 23

• Thaw in warm water bath at < 98 F

- Must be handled carefully to avoid breakage of plastic bag

Question 24

The only compatible FLUID which can be administered in same line with blood products is ________

Answer 24

0.9% NaCl

It is acceptable to have any other type of fluid being given to dog at same time but should be in different IV LINE

Question 25

RBCs should be pumped or free dripped.

Answer 25

Should ideally be free dripped

Cats can receive on a syringe pump with a HEMONATE filter

Question 26

Monitoring frequency when pet is getting blood products?

Answer 26

Q15 min for 1st hour, then hourly thereafter

Question 27

Rate of tranfusion ?

Answer 27

< 1 ml/kg for first 15 min , then rate can be increased to get it done in <4 hr

Question 28

Incidence % of reactions with RBC products.

Answer 28

~ 18%

Question 29

Most common sign of transfusion reaction is _______

Answer 29

Temperature spike

I.e. > 1.5 F change from normal

Question 30

What to do if pet does show temp. Spike with tranfusion and it is >1.5 F from normal?

Answer 30

• stop transfusion → double check the COLOR and TYPE of blood → draw small blood sample and make sure there is no NEW HEMOLYSIS

If vitals are normal, there is no new hemolysis and you have NO concerns about blood, then you can restart at SLOWER RATE

Question 31

What to do if there is HYPOTENSION, VOMIT, HEMOLYSIS or other worrisome signs with transfusion?

Answer 31

Stop transfusion → save sample from pet and bag for retype, cross match (to r/o hemolytic immune transfusion reaction)& possible culture (to r/o septic reaction)

Question 32

Facial swelling and itching are common reactions to transfusion . T/F

Answer 32

FALSE

They are rare

Diphenhydramine is TOC (blood can be restarted slowly but should not be continued if there are signs of ANAPHYLAXIS )