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Surgery I > Blood Products > Flashcards

Blood Products Flashcards

1
Q

What are the three kinds of blood products?

A

Whole + Plasma + Platelets

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2
Q

Products: Whole blood

A

Fresh or Stored = Packed RBC’s

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3
Q

Products: Plasma

A

Fresh frozen plasma
– and –
Cryoprecipitate

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4
Q

Products: Platelets

A

Fresh whole blood
Platelet rich plasma
Cyroperserved platelets
Lyophilized platelets

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5
Q

What is the dose for whole blood?

A

1ml per pound per point PCV

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6
Q

How much crystalloid isotonic fluid needs to be given to off set loss of 100 ml of water?

A

300 ml of crytalloids

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7
Q

What is within whole blood?

A

RBC’s + WBCs + Clotting factors + Albumin + Platelets

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8
Q

What happens when you refrigerate whole blood?

A

WBCS + Platelets become non-functional

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9
Q

When should whole blood be given?

A

Anemia + Hypoproteinemia + Thrombocytopenia

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10
Q

What is within packed RBC’s?

A

RBCs + Small amount of plasma + Anticoagulant

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11
Q

How much packed RBCs does 450 ml whole blood give?

A

200 ml

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12
Q

What is the dose for packed RBCs?

A

6 to 10 ml/kg

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13
Q

What is the reason for giving packed RBC’s?

A

Clinically symptomatic anemia

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14
Q

How soon after collection does fresh plasma need to be frozen

A

8 hours

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15
Q

When is fresh frozen plasma used?

A

replace coagulation factors + immunoglobulin is needed
Acquired disorders
Inherited factor deficiencies

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16
Q

What should fresh frozen plasma not be used for?

A

Volume expansion

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17
Q

What is the dose for fresh frozen plasma?

A

6 to 10 ml/kg

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18
Q

What is within fresh frozen plasma?

A

All clotting factors

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19
Q

What is the shelf life of fresh frozen plasma?

A

Normal freezer = 3 months

-30 = 1 year

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20
Q

What is cyroprecipitate?

A

White precipitate forms after thawing fresh plasma

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21
Q

What is contained within cryoprecipitate?

A

vWF + clotting factors 13 + 8

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22
Q

What is a clinical disease that cyroprecipitate is best for?

A

von willebrand’s disease

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23
Q

What is the dose for cryoprecipitate?

A

1 unit per 10 kg BW

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24
Q

What are the indications for a platelet transfusion?

A

Uncontrolled/Life-threatening hemorrhage

Severe thrombocytopenia + thrombopathia

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25
Why are many units of platelets needed?
Rapidly destroyed by IMTP + DIC
26
What is the dose for platelet transfusion?
1 unit per 10 kg BW
27
What is oxyglobin?
Ultrapurified, polymerized hemoglobin of bovine origin in LRS
28
What does giving oxyglobin do?
Increase oxygen carrying capacity of blood | Delivers more oxygen to damaged tissues
29
What is the max dose of oxyglobin?
30 ml/kg
30
What is a blood type?
RBC alloantigen, usually to membrane glycolipid
31
How many blood types do dogs have?
13
32
What are the strongest dog blood types immunologically?
1.1 + 1.2
33
What does it mean to be a canine universal donor?
Negative for DEA 1.1 + 1.2 + 7
34
What are the feline blood types?
A + B + AB
35
What is the dominant feline blood type?
A
36
What donors can be allowed for a cat with AB?
A + AB
37
Why are transfusions so dangerous in cats?
Naturally occurring alloantibodies to Type A or B cells | Blood typing is a must before a transfusion
38
What is the most common feline blood type in the US?
A (99%)
39
What is the equine universal donor?
There is none
40
How many blood types do horses have?
Seven
41
What are the most immunogenic horse blood types?
Aa + Qa
42
What are the best breeds of horses for being a blood donor?
Standardbred -- or -- Quarter horse geldings
43
Why should mares be avoided with blood transfusions?
Can develope blood type alloantibodies during pregnancy
44
How many blood types do cattle have?
11 blood types
45
What is J antigen? What animals is it in?
Cow + Goat | Lipid found in body fluid and is absorbed onto erythrocytes
46
Do newborn calves have J antigen?
No, get it around 6 months of age
47
How many blood types do sheep have?
7
48
How many blood types do goats have?
5
49
How much must a dog weight to be a donor?
over 27kg
50
What are dog blood donors screened for?
``` E. Canis B. Canis Dirofilaria RMSF Lyme ```
51
What breed of dog is the best donor? Why?
Greyhounds | High hematocrits + Easy to get to jugular
52
What is the age range for dog donors?
1 to 10 years old
53
What is the weight requirement of a cat to be a blood donor?
over 5 kg
54
What are cat blood donors screened for?
FeLV FIV Bartonella henslea Hemobartonella felis
55
What workups are done routinely on both dog and cat blood donors?
Complete PE each donation CBC/chem + fecal yearly Vaccinated on schedule Heartworm testing + treatment
56
How is blood donated from dogs?
No sedation - Blood bag (gravity flow)
57
How is blood donated from cats?
Sedation (AVOID ACE) - may affect platelet function Use peripheral vein
58
What is the donation limit for both a cat and a dog?
only once in a 3 week time period
59
What is a storage lesion?
Adverse biochemical changes in stored RBCS Decreased: ATP - pH - 2,3-DPG Increased: Lactic acid
60
What is the preservative put into stored blood?
CPDA-1
61
How long can whole blood be stored with CPDA?
35 days
62
Why can't heparin be used with whole blood?
Inactivates platelets
63
How long does Packed RBC's last?
21 days with CPDA-1
64
How long does fresh frozen plasma last?
1 year
65
What two tests can be done for cross matching?
Hemolysis + Agglutination
66
Term: Major crossmatch
Alloab's in recipent's plasma against donor
67
Term: Minor crossmatch
Alloab's in donor's plasma against recipent
68
Who must have typing and crossmatching before a transfusion?
CATS
69
What are the big four DO NOTS in transfusions?
Add any medications use calicum-containing solutions Hyper/Hypotonic solutions Use glass containers
70
What does calcium solutions do to blood?
Coagulation
71
What happens with the use of hyper/hypotonic solutions during a transfusion?
RBC's rupture
72
Why can glass containers be used in blood transfusions?
Activates platelets + clotting factors Decreases ATP + 2,3-DPG Increases risk for air embolism
73
What are the two ways which transfusions can occur?
IV -- or -- Intraosseous
74
When would an intraosseous transfusion be done?
Young animals -- or -- Vascular collapse
75
How should the transfusion be started?
If massive hemorrhage is occurring give blood as fast as possible otherwise - 0.25ml/kg for first 30 min w/ TPR every 5 to 10
76
If there is no signs of reaction what is the next step in the transfusion process?
Increase hourly rate to whatever it will take to give the unit in four hours TPR every 30 min
77
What is the signs of volume overload?
Tachypneic + Dyspneic + Tachycardic | Fluid from the nose
78
What is the dosing for Plasma/
4 to 6 ml/min
79
What are the tests done post-transfussion?
PCV/TS Blood lactate Vitals
80
What is an acute immunologic transfusion reaction?
Acute hemolytic reaction
81
What is a delayed immunologic transfussion reaction?
Post-transfusion purpura
82
What is transfusion associated fever?
increase in 1 degree F from pre-transfusion temp
83
What happens if a transfusion reaction occurs?
Stop transfusion! TPR Maintain venous access Short acting glucocorticoids + Diphenhydramine + Oxygen
84
What are the contraindications for a blood transfusion?
Previous transfusion Unable to cross match a cat Chronic severe anemia Cardiopulmonary disease
85
What is the protocal for an animal with cardiopulmonary disease that needs a transfusion?
Packed RBCs Dont go over the rate of 4 ml/kg/hr pre-med with diuretic
86
When are clinical signs of post-operative hemorrhage finally visiable?
25 to 30% blood volume loos
87
What are the signs of post-operative hemorrhage?
Tachycardia Hypotension Prolonged CRT
88
What are complications with the patient that can impede in coagulation?
``` Hepatic disease Splenectomy Post-operative peritonitis Doberman pinchers IMTP IMHA Rat poisoning ```
89
What is the most common coagulopathy in dogs?
Von Willebrand's disease
90
What is the highest occurance, what breed?
``` Dobermans German shephards Standard poodles Shetlands Goldens ```
91
What is von willenbrand factors function?
Plasma glycoprotein needed for normal platelet adhension to sub-endothelium
92
What does vWF carry?
F8
93
What happens when there is a def. in vWF?
Defective platelet adhesion + Aggregation
94
What type of genetic mutation is vWF disease?
Autosomal trait
95
Describe: vWF Type 1
Reduced concentrations of vWF
96
Describe: vWF Type 2
Loss of high molecular weight vWF multimers
97
Describe: vWF Type 3
Complete absence of vWF, most severe
98
Which vWF disease type is most common?
Type 1
99
What is the definitive diagnosis for vWF disesase?
Determination of vWF via ELISA
100
What is the treatment for vWF disease?
Cryoprecipitate | levels will remain elevated for 4 hours
101
What is DIC?
Disseminated intravascular coagulation | Systemic activation of coagulation pathway
102
What is seen with DIC within the body?
Compromised organ perfusion Organ failure Hypocoagulable state Thrombosis + Hemorrhage
103
What is causing the symtoms seen in DIC?
Widespread microvascular thrombosis | Exhaustion of platelets and coagulation factors
104
What is the mortality rate of DIC in cats?
93%
105
What is the mortality rate of DIC in dogs?
50 to 77%
106
What are the two main causes of DIC?
Infectious -- and -- Non-infectious
107
What are infectious possibilities for DIC?
Bacterial + Viral + Protozoal + Fungal
108
What are the most common causes of DIC in dogs?
Sepsis -- and -- SIRS
109
What is the clinical signs of DIC?
VARY - from organ failure to hemorrhage
110
Which, organ failure or hemorrhage, is the most common presentation of DIC?
Organ failure
111
What are the common signs of organ dysfunction?
Renal failure Respiratory insufficency Hepatic failure Gi compromise
112
What gold standard test for DIC?
None, no absolute diagnostic existis
113
How do you diagnosis a dog with DIC?
``` Underlying condition with 3 of the following: Thrombocytopenia Prolonged PT +/- PTT Elevated D-dimers Hypofibrinognemia ```
114
What is the management protocol for DIC?
``` Aggressive and early Support organs susceptible to ischemia Treat underlying condition Remove ischemic/necrotic tissue Immunosuppressive thearpy ```
115
What organs are most sensitive to ischemia?
Kidneys + Lungs + GI
116
What are the six componetnts to ICU therapy of DIC?
``` Fluids Oxygen Enteral nutrition Antacids/Antibiotivs Blood transfusion Heparin ```
117
What occurs with rodenticide toxicity?
Block vitamin K metabolism = inability to produce dependent clotting factors
118
What are the vitamin k dependent clotting factors?
2 - 7 - 9 - 10
119
What are the two agent categories that can cause rodentacide posioning?
First generation - Warfarin | Second generation - Brodifacoum
120
How do first generation rodentacides work?
less toxic | Need to intake several dose over several days to be toxis
121
How do second generation rodentacides work>
lethal after first ingestion
122
What are the two forms of primary hemostasis?
Thrombocytopenia -- and -- Thombopathia
123
What can cause thrombocutopenia?
``` Decreased production (Drug, viral, radiation) Increased destruction (IMTP) Consumption (DIC_ ```
124
What can cause thrombopathia?
Acquired: Drugs - hepatic disease + Snake venom + DIC Congenital: vWD
125
What is seen generally with primary hemostasis disorders?
Decreased platelet numbers or desfunction | Ecchymosis + Spontaneous bleeding
126
What is seen generally with secondary hemostasis disorders?
Low concentration of coagulation factors | Hematomas + Spontaneous belleding into sub-q
127
What is different about acquired disorders?
Affect primary and secondary
128
What are examples of acquired secondary hemostatic disease?
``` Vitamin K def. DIC Hemodilution Sever hypothermia Shock Massive trauma ```
129
What are examples of Congenital secondary hemostatic diseases?
vWD | Hemophilia A
130
What breed of dog gets hemophila A?
German shephard
131
What breed of dog gets vWF disease?
Doberman's
132
Term: Thrombocytopenia
Decreased platelet number
133
Term: Thrombopathia
Dysfunction
134
What are diagnostic tests for coagulopathies?
``` Platelet count Buccal bleeding time PT/PTT ACT Fibrnogen FDP D- dimers ```
135
Term: Pseudothrombocytopenia
Artifact, falsely low platelet count | Platelet aggregation or clumping
136
What is buccal mucosal bleeding time?
Duration of hemorrhage resulting from small standardized injury
137
What is the normal bleeding time for a dog?
1.7 to 4.2 minutes
138
What is the normal bleeding time for a cat?
1.4 to 2.4
139
What does the buccal mucosal bleeding time tell you?
Relfects in vivo PRIMARY hemostatsis
140
Term: PTT
Prolongation = defect in intrinsic +/- common pathway
141
Term: PT
Prolongation = Defect in extrinsic +/- commmon pathway
142
Term: ACT
Activated clotting time Whole blood in tube with clay --> acitvates F8 Time till first clot
143
What is a normal ACT for dog?
144
What is a normal ACT for cat?
145
What is the importance of fibrinogen?
End point of all assays - PT + pTT + ACT
146
What is considered severely decreased fibrinogen?
147
What is normal fibrinogen?
200 to 300
148
What is fibrinogen? (class of molecule)
Acute phase protein
149
What is occurring if there is an increased level of fibrinogen?
Inflammation
150
What are FDPs?
Fibrinogen degradation products | Plasmin lysiss fibrinogen + fribin + cross-linked fibrin
151
What does FDP indicate?
Plasmin activation
152
What does elevated concentrations mean?
Increased fibrinolysis
153
What is occurring symptomatically with increased FDP?
inhibited clotting + induced platelet dysfunction = bleeding
154
What is an elevated FDP suggestive of?
DIC + Neoplasia + Sepsis + Heatstroke + GDV + SIRS + IMHA
155
What is a D-dimer indicative of?
Acitvation of thrombin and plasmin
156
What is D-dimber an indicator for?
DIC + Thromboembolism in dogs
157
What are your medical vasoconstrictors?
Epi + Phenylephrine

Surgery I (17 decks)

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