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Clinical Pathology - Exam 2 > Blood Transfusion & Crossmatching...and the Kidney > Flashcards

Blood Transfusion & Crossmatching...and the Kidney Flashcards

1
Q

What are the 2 Canine Blood Systems we care about?

A

DEA and DAl

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2
Q

What are the 5 DEA blood types we should know?

A

1.1, 1.2, 4, 6, and 7

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3
Q

What is so cool about DEA 1.1?

A

Highly Pathogenic - strong ! Makes up about 45% of the population

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4
Q

What is so cool about DEA 1.2?

A

Highly Pathogenic! Makes up about 20% of the population

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5
Q

What Blood types are the Universal DONORS for Canines?

A

DEA 4 & 6 are Non-Immunogenic and DEA 7 is Mildly Immunogenic!

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6
Q

What animal is the DAL Blood System in?

A

DALmatian

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7
Q

Dalmatians are at risk for acute and delayed onset of hemolytic transfusion reactions. - T/F

A

True.

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8
Q

What are the Feline Blood Types?

A

A
B
AB

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9
Q

T/F - All cats will carry an antigen from the B group, and most carry an MIK antigen.

A

FALSE! All cats carry an antigen from the AB group!

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10
Q

What is the most common blood type of a cat?

A

Type A - >95% of cats

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11
Q

Type B blood in feline is less common and in British breeds. What happens if you give a Cat with Type B blood, Type A plasma in a transfusion?

A

Severe and lethal transfusion reactions.

Risk of neonatal isoerythrolysis.

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12
Q

What blood type is the universal RECIPIENT for felines?

A

Type AB - usually found in purebred cats.

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13
Q

What large animal is it most practical to use blood typing in?

A

Horses

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14
Q

What large animals are the transfusion exception?

A

Horses

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15
Q

Crossmatching is required for…

A

repeated transfusions and plasma transfusions

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16
Q

Blood-typing is looking at…

A

RBC antigens.

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17
Q

Cross-matching is looking at…

A

antibodies against RBCs.

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18
Q

Are there universal donors in equine blood groups?

A

NOPE

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19
Q

What are the highly immunogenic Equine blood groups?

A

Aa and Qa

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20
Q

Aa and Qa equine blood-types are implicated in…

A

neonatal isoerythrolysis

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21
Q

In Bovine blood typing, vaccinations of blood origin may…

A

sensitize a cow to foreigh RBC antigens and result in NI in subsequent calves

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22
Q

If you see agglutination during a blood typing test, the result is…

A

POSITIVE REACTION!!!

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23
Q

What are the 2 common types of blood typing methods?

A

Blood typing cards (Agglutination = Positive)

Blood Typing Dipsticks (Line = Positive)

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24
Q

Describe major crossmatch and its clinical purpose…

A

Major crossmatch = final check of compatibility btwn a patient and a donor prior to transfusion
Patient serum + Donor RBCs

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25
Q

Need to transfuse a Patient with Anti-B serum and the donor is Type A…do you get agglutination?

A

NOPE! Safe to transfuse!

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26
Q

How do you interpret a crossmatch?

A

Negative crossmatch = no agglutination or hemolysis; recipient is NOT likely to have a transfusion –> SAFE!
Positive Crossmatch = agglutination –> DO NOT TRANSFUSE

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27
Q

Cross matching does NOT detect what?

A

low antibody titers and adverse reactions are NOT preventable

28
Q

A dog presents on emergency; no history; blood-typing indicates the dog & donor are both DEA 1.1 negative. What does best practice indicate?

A

Perform a CrossMatch

29
Q

Donor selection for Dogs must be…

A

DEA 1.1, DEA 1.2 negative or DEA 4, DEA 6 positive

30
Q

Donor selection for Cats must be…

A

Type A donor or Type B donor

31
Q

Donor selection for Horses must be…

A

Type Aa and Qa negative; young geldings; mare: never transfused and never pregnant

32
Q

Immune-mediated hemolytic transfusion therapy can be acute or delayed. When it is acute, you get….When it is delayed, you get….

A

Acute –> intravascular hemolysis; severe reactions followed by DIC, hypotension, shock, acute renal failure and death
Delayed –> Extravascular hemolysis; mild reaction; occurs >24hrs up to 2-3 weeks post-trans.; CS: icterus, hyper-Br-emia/uria, fever, anorexia, positive coomb’s test

33
Q

Allergic and febrile transfusion therapy reactions are…

A

non-hemolytic and common; occur within 15 minutes to a few hrs.
CS: vomiting, nausea, diarrhea, abdominal pain, tremors, urticaria, pruritis, and erythema

34
Q

Which analytes are reported on a chemistry reflect chemistry function?

A

BUN; Creatinine

Ph, Ca2+ and Mg2+

35
Q

Describe production, reabsorption and excretion of BUN…

A

Production: Protein –> NH3 (in the gut)
Reabsorption: as Urea
Excretion: excretion product!

36
Q

Describe production, reabsorption and excretion of Creatinine…

A

Production: Creatine stores energy as phosphocreatine in ms. –> creatinine; decreased muscle mass and catabolism
Reabsorption: NONE
Excretion: excretion product - excreted unchanged by the kidneys!

37
Q

What can cause decreased serum BUN?

A

low protein diets, liver failure, portosystemic shunts, and/or increased excretion

38
Q

T/F - Creatinine is a good determinant of renal disease being reversible/irreversible.

A

FALSE! It is NOT a good determinant of renal disease reversibility/irreversibility.

39
Q

Interpreting USG…Isosthenuiric & Azotemic =

A

Renal failure

40
Q

Interpreting USG…Isosthenuric w/out Azotemia =

A

Need further assessment!
Animal could be well hydrated and USG is appropriate.
Other factors/diseases preventing the kidneys from concentrating the urine appropriately.

41
Q

Interpreting USG…Hypersthenuric & Azotemic =

A

renal insufficiency

42
Q

Fill in the blank…
Aldosterone causes increased resorption of ______ & _____ and increased excretion of ______ through the _____________.

A

Aldosterone causes increased resorption of Na+ and H20 and increased excretion of K+ through the distal tubules.

43
Q

What are your differentials when the kidneys have lost their concentrating ability?

A 
Diabetes Insipidus
Anatagonism of ADH secretion
Excess Solute
Loss of Renal Medullary Conc. Gradient
Diuresis
Hypoadrenocorticism
Decreased Ca2+
Liver disease
Decreased Protein
44
Q

What clinical findings do you see with Pre-Renal Azotemia? What causes it? What are the common characteristics associated with it?

A

Increased BUN, concentrated USG (>1.012) –> Hemorrhage into GIT –> Decreased GFR
Cause: decreased renal blood perfusion resulting in Decr. GFR
Characteristics: Dehydration, Shock, Cardiovascular Disease

45
Q

What clinical findings do you see with Renal Azotemia? What causes it? What are the common characteristics associated with it?

A

Increased BUN, Increase Creatinine, Isosthenuric –> Hyposthenuric USG (1.008-1.012 or

46
Q

What are the most common neoplasia associated with Renal Azotemia?

A

lymphomas and carcinomas

47
Q

Why is Creatinine a better method for accessing GFR?

A

0% of Creatinine is reabsorbed; approximately 40% of BUN is reabsorbed

48
Q

What clinical findings do you see with Post-Renal Azotemia? What causes it? What are the common characteristics associated with it?

A

Increased BUN/Creatinine with a VARIABLE USG depending on time.
Cause: obstruction of urinary outflow or bladder rupture*
*Bladder rupture also associated w/ Decr. Na/Cl and Increased K/Mg

49
Q

Acute Renal Disease characteristics…

A 
oliguria/anuria
Increased K+ and PO4
severe metabolic acidosis
proteinuria
granular casts
50
Q

Chronic Renal Insufficiency characteristics…

A

azotemic w/out the ability to concentrate urine, anemic and acidotic
-Horses usually have High Ca2+ too

51
Q

Renal Failure characteristics…

A 
isosthenuric
marked azotemia
Increased PO4 and K+
metabolic acidosis
uremia - DEATH!
HYPERCALCEMIA**
52
Q

In renal failure with hypercalcemia, it will cause ________ and chronically leads to mineralization of the _________________.

A

In renal failure with hypercalcemia, it will cause kidney disease and chronically leads to mineralization of the renal tubules.

53
Q

The 3 types of Proteinuria…

A

Pre-renal, Renal, and Post-Renal

54
Q

What are the 2 types of Pre-Renal Proteinuria?

A

Overflow (Preglomerular)

Functional (Transient)

55
Q

Preglomerular Proteinuria occurs when…

A

small proteins (hemoglobin, myoglobin, and Bence Jones proteins) pass through the glomerular barrier

56
Q

Functional (Transient) proteinuria is due to…

A

fever
seizures
CHF
exercise

57
Q

What are the 3 types of Renal Proteinuria?

A

Tubular
Interstitial
Glomerular

58
Q

Tubular Renal Proteinuria…

A

small amounts of proteinuria due to the tubules inadequately reabsorbing protein and putting it back into the blood

59
Q

Interstitial renal proteinuria…

A

causes exudation of protein into the urinary space

Ex: Acute Interstitial Nephritis

60
Q

glomerular renal proteinuria is caused by…

A

caused by immune complex glomerulopathy or amyloidosis

61
Q

What does glomerular renal proteinuria cause?

A

causes disease –> high protein loss +/- concurrent loss of antithrombin III –> hypercoagulable state –> DIC

62
Q

Post-renal proteinuria can be…

A

urinary - renal pelvis, ureter, urinary bladder, and urethra

extra-urinary = genital tract and external genitalia

63
Q

What are the causes of proteinuria?

A

fever and exercise
urinary pH > 7
UTI and UTInflammation
Hematuria and glomerular disease

64
Q

T/F- Urinary pH > 7 will ALWAYS cause a positive dipstick proteinuria.

A

TRUTH!

65
Q

What is the significance of the Protein: Creatinine Ratio?

A

determines if there is significant renal tubular or glomerular protein loss

Clinical Pathology - Exam 2 (7 decks)

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