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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
Q

Why are many units of platelets needed?

A

Rapidly destroyed by IMTP + DIC

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26
Q

What is the dose for platelet transfusion?

A

1 unit per 10 kg BW

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27
Q

What is oxyglobin?

A

Ultrapurified, polymerized hemoglobin of bovine origin in LRS

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28
Q

What does giving oxyglobin do?

A

Increase oxygen carrying capacity of blood

Delivers more oxygen to damaged tissues

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29
Q

What is the max dose of oxyglobin?

A

30 ml/kg

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30
Q

What is a blood type?

A

RBC alloantigen, usually to membrane glycolipid

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31
Q

How many blood types do dogs have?

A

13

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32
Q

What are the strongest dog blood types immunologically?

A

1.1 + 1.2

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33
Q

What does it mean to be a canine universal donor?

A

Negative for DEA 1.1 + 1.2 + 7

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34
Q

What are the feline blood types?

A

A + B + AB

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35
Q

What is the dominant feline blood type?

A

A

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36
Q

What donors can be allowed for a cat with AB?

A

A + AB

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37
Q

Why are transfusions so dangerous in cats?

A

Naturally occurring alloantibodies to Type A or B cells

Blood typing is a must before a transfusion

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38
Q

What is the most common feline blood type in the US?

A

A (99%)

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39
Q

What is the equine universal donor?

A

There is none

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40
Q

How many blood types do horses have?

A

Seven

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41
Q

What are the most immunogenic horse blood types?

A

Aa + Qa

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42
Q

What are the best breeds of horses for being a blood donor?

A

Standardbred
– or –
Quarter horse geldings

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43
Q

Why should mares be avoided with blood transfusions?

A

Can develope blood type alloantibodies during pregnancy

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44
Q

How many blood types do cattle have?

A

11 blood types

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45
Q

What is J antigen? What animals is it in?

A

Cow + Goat

Lipid found in body fluid and is absorbed onto erythrocytes

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46
Q

Do newborn calves have J antigen?

A

No, get it around 6 months of age

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47
Q

How many blood types do sheep have?

A

7

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48
Q

How many blood types do goats have?

A

5

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49
Q

How much must a dog weight to be a donor?

A

over 27kg

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50
Q

What are dog blood donors screened for?

A 
E. Canis 
B. Canis 
Dirofilaria 
RMSF 
Lyme
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51
Q

What breed of dog is the best donor? Why?

A

Greyhounds

High hematocrits + Easy to get to jugular

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52
Q

What is the age range for dog donors?

A

1 to 10 years old

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53
Q

What is the weight requirement of a cat to be a blood donor?

A

over 5 kg

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54
Q

What are cat blood donors screened for?

A

FeLV
FIV
Bartonella henslea
Hemobartonella felis

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55
Q

What workups are done routinely on both dog and cat blood donors?

A

Complete PE each donation
CBC/chem + fecal yearly
Vaccinated on schedule
Heartworm testing + treatment

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56
Q

How is blood donated from dogs?

A

No sedation - Blood bag (gravity flow)

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57
Q

How is blood donated from cats?

A

Sedation (AVOID ACE)
- may affect platelet function
Use peripheral vein

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58
Q

What is the donation limit for both a cat and a dog?

A

only once in a 3 week time period

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59
Q

What is a storage lesion?

A

Adverse biochemical changes in stored RBCS
Decreased: ATP - pH - 2,3-DPG
Increased: Lactic acid

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60
Q

What is the preservative put into stored blood?

A

CPDA-1

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61
Q

How long can whole blood be stored with CPDA?

A

35 days

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62
Q

Why can’t heparin be used with whole blood?

A

Inactivates platelets

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63
Q

How long does Packed RBC’s last?

A

21 days with CPDA-1

64
Q

How long does fresh frozen plasma last?

A

1 year

65
Q

What two tests can be done for cross matching?

A

Hemolysis + Agglutination

66
Q

Term: Major crossmatch

A

Alloab’s in recipent’s plasma against donor

67
Q

Term: Minor crossmatch

A

Alloab’s in donor’s plasma against recipent

68
Q

Who must have typing and crossmatching before a transfusion?

A

CATS

69
Q

What are the big four DO NOTS in transfusions?

A

Add any medications
use calicum-containing solutions
Hyper/Hypotonic solutions
Use glass containers

70
Q

What does calcium solutions do to blood?

A

Coagulation

71
Q

What happens with the use of hyper/hypotonic solutions during a transfusion?

A

RBC’s rupture

72
Q

Why can glass containers be used in blood transfusions?

A

Activates platelets + clotting factors
Decreases ATP + 2,3-DPG
Increases risk for air embolism

73
Q

What are the two ways which transfusions can occur?

A

IV
– or –
Intraosseous

74
Q

When would an intraosseous transfusion be done?

A

Young animals
– or –
Vascular collapse

75
Q

How should the transfusion be started?

A

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
Q

If there is no signs of reaction what is the next step in the transfusion process?

A

Increase hourly rate to whatever it will take to give the unit in four hours
TPR every 30 min

77
Q

What is the signs of volume overload?

A

Tachypneic + Dyspneic + Tachycardic

Fluid from the nose

78
Q

What is the dosing for Plasma/

A

4 to 6 ml/min

79
Q

What are the tests done post-transfussion?

A

PCV/TS
Blood lactate
Vitals

80
Q

What is an acute immunologic transfusion reaction?

A

Acute hemolytic reaction

81
Q

What is a delayed immunologic transfussion reaction?

A

Post-transfusion purpura

82
Q

What is transfusion associated fever?

A

increase in 1 degree F from pre-transfusion temp

83
Q

What happens if a transfusion reaction occurs?

A

Stop transfusion!
TPR
Maintain venous access
Short acting glucocorticoids + Diphenhydramine + Oxygen

84
Q

What are the contraindications for a blood transfusion?

A

Previous transfusion
Unable to cross match a cat
Chronic severe anemia
Cardiopulmonary disease

85
Q

What is the protocal for an animal with cardiopulmonary disease that needs a transfusion?

A

Packed RBCs
Dont go over the rate of 4 ml/kg/hr
pre-med with diuretic

86
Q

When are clinical signs of post-operative hemorrhage finally visiable?

A

25 to 30% blood volume loos

87
Q

What are the signs of post-operative hemorrhage?

A

Tachycardia
Hypotension
Prolonged CRT

88
Q

What are complications with the patient that can impede in coagulation?

A 
Hepatic disease 
Splenectomy 
Post-operative peritonitis 
Doberman pinchers 
IMTP 
IMHA 
Rat poisoning
89
Q

What is the most common coagulopathy in dogs?

A

Von Willebrand’s disease

90
Q

What is the highest occurance, what breed?

A 
Dobermans 
German shephards
Standard poodles 
Shetlands 
Goldens
91
Q

What is von willenbrand factors function?

A

Plasma glycoprotein needed for normal platelet adhension to sub-endothelium

92
Q

What does vWF carry?

A

F8

93
Q

What happens when there is a def. in vWF?

A

Defective platelet adhesion + Aggregation

94
Q

What type of genetic mutation is vWF disease?

A

Autosomal trait

95
Q

Describe: vWF Type 1

A

Reduced concentrations of vWF

96
Q

Describe: vWF Type 2

A

Loss of high molecular weight vWF multimers

97
Q

Describe: vWF Type 3

A

Complete absence of vWF, most severe

98
Q

Which vWF disease type is most common?

A

Type 1

99
Q

What is the definitive diagnosis for vWF disesase?

A

Determination of vWF via ELISA

100
Q

What is the treatment for vWF disease?

A

Cryoprecipitate

levels will remain elevated for 4 hours

101
Q

What is DIC?

A

Disseminated intravascular coagulation

Systemic activation of coagulation pathway

102
Q

What is seen with DIC within the body?

A

Compromised organ perfusion
Organ failure
Hypocoagulable state
Thrombosis + Hemorrhage

103
Q

What is causing the symtoms seen in DIC?

A

Widespread microvascular thrombosis

Exhaustion of platelets and coagulation factors

104
Q

What is the mortality rate of DIC in cats?

A

93%

105
Q

What is the mortality rate of DIC in dogs?

A

50 to 77%

106
Q

What are the two main causes of DIC?

A

Infectious
– and –
Non-infectious

107
Q

What are infectious possibilities for DIC?

A

Bacterial + Viral + Protozoal + Fungal

108
Q

What are the most common causes of DIC in dogs?

A

Sepsis
– and –
SIRS

109
Q

What is the clinical signs of DIC?

A

VARY - from organ failure to hemorrhage

110
Q

Which, organ failure or hemorrhage, is the most common presentation of DIC?

A

Organ failure

111
Q

What are the common signs of organ dysfunction?

A

Renal failure
Respiratory insufficency
Hepatic failure
Gi compromise

112
Q

What gold standard test for DIC?

A

None, no absolute diagnostic existis

113
Q

How do you diagnosis a dog with DIC?

A 
Underlying condition with 3 of the following:
Thrombocytopenia 
Prolonged PT +/- PTT 
Elevated D-dimers 
Hypofibrinognemia
114
Q

What is the management protocol for DIC?

A 
Aggressive and early 
Support organs susceptible to ischemia 
Treat underlying condition 
Remove ischemic/necrotic tissue 
Immunosuppressive thearpy
115
Q

What organs are most sensitive to ischemia?

A

Kidneys + Lungs + GI

116
Q

What are the six componetnts to ICU therapy of DIC?

A 
Fluids 
Oxygen 
Enteral nutrition 
Antacids/Antibiotivs 
Blood transfusion 
Heparin
117
Q

What occurs with rodenticide toxicity?

A

Block vitamin K metabolism = inability to produce dependent clotting factors

118
Q

What are the vitamin k dependent clotting factors?

A

2 - 7 - 9 - 10

119
Q

What are the two agent categories that can cause rodentacide posioning?

A

First generation - Warfarin

Second generation - Brodifacoum

120
Q

How do first generation rodentacides work?

A

less toxic

Need to intake several dose over several days to be toxis

121
Q

How do second generation rodentacides work>

A

lethal after first ingestion

122
Q

What are the two forms of primary hemostasis?

A

Thrombocytopenia
– and –
Thombopathia

123
Q

What can cause thrombocutopenia?

A 
Decreased production (Drug, viral, radiation)
Increased destruction (IMTP) 
Consumption (DIC_
124
Q

What can cause thrombopathia?

A

Acquired: Drugs - hepatic disease + Snake venom + DIC
Congenital: vWD

125
Q

What is seen generally with primary hemostasis disorders?

A

Decreased platelet numbers or desfunction

Ecchymosis + Spontaneous bleeding

126
Q

What is seen generally with secondary hemostasis disorders?

A

Low concentration of coagulation factors

Hematomas + Spontaneous belleding into sub-q

127
Q

What is different about acquired disorders?

A

Affect primary and secondary

128
Q

What are examples of acquired secondary hemostatic disease?

A 
Vitamin K def. 
DIC 
Hemodilution 
Sever hypothermia 
Shock 
Massive trauma
129
Q

What are examples of Congenital secondary hemostatic diseases?

A

vWD

Hemophilia A

130
Q

What breed of dog gets hemophila A?

A

German shephard

131
Q

What breed of dog gets vWF disease?

A

Doberman’s

132
Q

Term: Thrombocytopenia

A

Decreased platelet number

133
Q

Term: Thrombopathia

A

Dysfunction

134
Q

What are diagnostic tests for coagulopathies?

A 
Platelet count 
Buccal bleeding time 
PT/PTT 
ACT 
Fibrnogen 
FDP 
D- dimers
135
Q

Term: Pseudothrombocytopenia

A

Artifact, falsely low platelet count

Platelet aggregation or clumping

136
Q

What is buccal mucosal bleeding time?

A

Duration of hemorrhage resulting from small standardized injury

137
Q

What is the normal bleeding time for a dog?

A

1.7 to 4.2 minutes

138
Q

What is the normal bleeding time for a cat?

A

1.4 to 2.4

139
Q

What does the buccal mucosal bleeding time tell you?

A

Relfects in vivo PRIMARY hemostatsis

140
Q

Term: PTT

A

Prolongation = defect in intrinsic +/- common pathway

141
Q

Term: PT

A

Prolongation = Defect in extrinsic +/- commmon pathway

142
Q

Term: ACT

A

Activated clotting time
Whole blood in tube with clay –> acitvates F8
Time till first clot

143
Q

What is a normal ACT for dog?

A
144
Q

What is a normal ACT for cat?

A
145
Q

What is the importance of fibrinogen?

A

End point of all assays - PT + pTT + ACT

146
Q

What is considered severely decreased fibrinogen?

A
147
Q

What is normal fibrinogen?

A

200 to 300

148
Q

What is fibrinogen? (class of molecule)

A

Acute phase protein

149
Q

What is occurring if there is an increased level of fibrinogen?

A

Inflammation

150
Q

What are FDPs?

A

Fibrinogen degradation products

Plasmin lysiss fibrinogen + fribin + cross-linked fibrin

151
Q

What does FDP indicate?

A

Plasmin activation

152
Q

What does elevated concentrations mean?

A

Increased fibrinolysis

153
Q

What is occurring symptomatically with increased FDP?

A

inhibited clotting + induced platelet dysfunction = bleeding

154
Q

What is an elevated FDP suggestive of?

A

DIC + Neoplasia + Sepsis + Heatstroke + GDV + SIRS + IMHA

155
Q

What is a D-dimer indicative of?

A

Acitvation of thrombin and plasmin

156
Q

What is D-dimber an indicator for?

A

DIC + Thromboembolism in dogs

157
Q

What are your medical vasoconstrictors?

A

Epi + Phenylephrine

Surgery I (17 decks)

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