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PCS VI > Exam 1 - Transfusion Medicine > Flashcards

Exam 1 - Transfusion Medicine Flashcards

1
Q

how are blood groups defined?

A

defined by the inherited antigens on the surface of the red blood cell that are SPECIES SPECIFIC & vary in immunogenicity & clinical significance

important to know for immunologic transfusion reactions!

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2
Q

what are the most significant blood types in dogs?

A

dog erythrocyte antigen 0 DEA 1.1 & DEA 1.2

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3
Q

what dog blood type is extremely antigen?

A

DEA 1.1

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4
Q

how many blood group types are recognized in canines?

A

7+

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5
Q

what is the Dal part of canine blood types?

A

separate antigen with no correlation to known DEA antigens - needs further investigation to determine its significance

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6
Q

do you expect a transfusion reaction if you give a recipient DEA 1.1+ dog donor DEA 1.1+ blood?

A

no response

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7
Q

do you expect a transfusion reaction if you give a recipient DEA 1.1+ dog donor DEA 1.1- blood?

A

nope

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8
Q

do you expect a transfusion reaction if you give a recipient DEA 1.11 dog donor DEA 1.1+ blood?

A

YES - antibody formation!!!!!!

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9
Q

do you expect a transfusion reaction if you give a recipient DEA 1.1- dog donor DEA 1.1- blood?

A

no response

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10
Q

what are the blood types we see in cats?

A

type A, type B, & type AB

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11
Q

what cat blood type do you have to be careful with blood transfusions?

A

type B cats have a strong, potentially fatal reaction to type A donors

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12
Q

what is the MiK antigen in cat blood types?

A

newly discovered antigen independent of the AB system that may contribute to hemolytic reactions in typed patients

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13
Q

what antibodies do cats with type A (A antigen) blood have?

A

anti-B antibody

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14
Q

what antibodies do cats with type B (B antigen) blood have?

A

anti-A antibody

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15
Q

what is the desirable donor blood type of horses? why?

A

AaCa - most common blood type & less likely to have circulating antibodies

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16
Q

T/F: a small percentage of horses have naturally occurring antibodies making them a poor donor

A

true

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17
Q

what is the donkey factor?

A

auto-antibody present in many horses so donkeys shouldn’t receive horse plasma unless they are pre-screened!!!

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18
Q

for large animal blood transfusions, which animals are compatible & which aren’t?

A

alpacas & llamas are COMPATIBLE

sheep & goats are NOT compatible

pigs are only compatible with pigs

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19
Q

what situations should blood typing be done for companion animals?

A

recommended for all canine & feline patient red cell transfusions & plasma cell transfusions for cats

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20
Q

what do blood typing tests look for?

A

visible hemagluttination reaction between patient RBC antigens & a known reagent antisera

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21
Q

what bed-side blood typing tests are available for companion animals?

A

canine DEA 1.1 & feline type A, type B, & type AB

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22
Q

why do we use blood typing in horses?

A

used to select donors - want AaCa with no alloantibodies

also used to screen mares for NI 30 days before parturition

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23
Q

what is a major cross match? how is it done?

A

major cross match is used for detecting antibodies in recipient plasma

mix the donor RBC with recipient plasma & evaluate for agglutination

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24
Q

what is a minor cross match? how is it done?

A

minor cross match is used to detect antibodies in donor plasma

you mix the donor plasma with the recipient RBC & evaluate for agglutination

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25
Q

how is cross matching done in horses?

A

same as companion animals but you also check for hemolysins by adding the complement - one commercially available equine cross match kit

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26
Q

what blood typing do we do for ruminants? why?

A

don’t routinely type the donor, but ideally the donors would be j-factor negative

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27
Q

T/F: usually, ruminants get one ‘free’ transfusion before sensitization occurs

A

true - subsequent transfusions may be more rapidly broken down

28
Q

when is cross-matching recommended prior to giving a blood transfusion?

A

patient has an unknown transfusion history

patient has had a hemolytic reaction on a prior transfusion regardless of a time lapse

more than 3 days since prior transfusion

if the patient is a donkey, mule, or hinny

recipient horse that is known AaQa negative - they are more likely to have naturally occurring alloantibodies

29
Q

when doing a whole blood transfusion, what happens to the blood collected after 24 hours?

A

loss of coagulation factors & platelets

30
Q

how long do anticoagulant products last when collecting whole blood?

A

sodium citrate - 24 hours
ACD - 3 weeks
CPDA - 5 weeks

31
Q

what receptacle is best used when collecting blood from a donor animal for a transfusion?

A

plastic bags are better than glass bottles because glass will activate platelets

32
Q

what is the effect of storage on whole blood products?

A

decreased oxygen release to tissues because of decreased 2-3 DPG (significant after 10 days of storage)

2-3 DPG can take 4-24 hours to be restored

hyperkalemia

33
Q

how much blood can a donor horse give?

A

20ml/kg every 3 weeks

34
Q

if you are considering doing a blood transfusion for a horse in acute need, what parameters are you looking at?

A

clinical signs & lactate (NOT PCV/TP!!!!!!!)

35
Q

how much blood do you give to a horse with a chronic illness for a transfusion?

A

0.08 X BWkg X [(PCV desired - PCV recipient)/(PCV donor)

36
Q

when are packed red blood cells indicated for a transfusion?

A

treatment of anemia - deficiency of red blood cells or hemoglobin (anemia may be well-tolerated, acute vs. chronic)

37
Q

T/F: no transfusion trigger has been identified in veterinary medicine

A

true

38
Q

what are the different formulas used for dosing packed red blood cells for transfusions in dogs?

A

volume administered = 90 ml/kg X BWkg X [(desired PCV - actual PCV)/(donor PCV)]

volume administered = 1.5mL X desired % increase in PCV X BWkg

10-20 ml/kg

39
Q

what are your options to wash RBC for foals with neonatal isoerythrolysis?

A

cell saver, centrifuge, & sedimentation

40
Q

what blood product should you use for a foal with neonatal isoerythrolysis?

A

use the DAM RBC - washed red blood cells

41
Q

why do we see a decrease in regeneration in an animal that received a blood transfusion?

A

if you give them enough blood to restore their normal PCV, this decreases their own regenerative response

42
Q

T/F: donor RBCs will have a shorter life span

A

true

43
Q

T/F: increased volumes used for transfusions are associated with a greater potential for transfusion reactions

A

true

44
Q

what is the dose used for plasma transfusions?

A

10-20 ml/kg

45
Q

how long can plasma be stored as a blood product?

A

stored for 1 year & can be thawed & re-frozen within 1 hours

46
Q

how is fresh frozen plasma collected?

A

removed from the RBC & frozen within 24 hours - contains therapeutic levels of labile & non-labile factors

47
Q

what is the most common indication of plasma transfusions for horses? what are some other examples of times you would give it?

A

failure of passive transfer in the neonate (foal)

boutique plasma in farms with endemic diseases - plasma containing r. equii antibodies

administration of boutique plasma in specific disease - west nile & botulism

enterocolitis with protein loss - palliative measure

48
Q

what are some indications for a platelet transfusion?

A

<10,000 platelets

<20,000 with active bleeding

<50,000 with a planned invasive procedure

documented thrombocytopathia

49
Q

what is an autotransfusion?

A

collecting autologous blood from a cavity, filtering it, & returning it to the patient’s vascular space

50
Q

T/F: transfusion reactions are uncommon in horses & ruminants

A

true

51
Q

when do we see transfusion reactions in dogs?

A

3.3-13% in dogs receiving pRBCs or fresh whole blood

we use conservative or restrictive methods have been documented to decrease incidence of reactions

52
Q

what is the most common immunologic transfusion reaction seen?

A

non-hemolytic febrile reaction

followed by hemolytic reactions

53
Q

why do non-hemolytic febrile transfusion reactions occur? what is it defined as? what do you do for your patient if it happens?

A

result of proteins & WBCs in unit - increase in patient’s temperature by 1°C, but typically self-limiting

discontinue transfusion & wait for resolution & then restart the transfusion at a slower rate

54
Q

why do hemolytic transfusion reactions occur? what is it defined as? what do you do for your patient if it happens?

A

incompatibility with RBC - patient develops hemoglobinemia, hemoglobinuria, & shock

discontinue transfusion & cross-match the patient to a new unit

55
Q

animals with kind of disease have a greater risk for transfusion reactions?

A

patients with immune-mediated disease

56
Q

what was the effect of premedication for patients receiving a blood transfusion?

A

administration of diphenhydramine and/or corticosteroid did not decrease occurrence - but diphenhydramine did reduce the occurrence of type I hypersensitivity reactions (allergic)

57
Q

what premedication is used for horses before a blood transfusion? is there any risks associated with this?

A

horses & foals - flunixin meglumine often given

nephrotoxicity from flunixin is a concern

58
Q

what monitoring is done during transfusions?

A

temperature, heart rate, & respiratory rate taken every 10 minutes for the first 30 minutes & then at every hour starting at an hour until the transfusion is finished

59
Q

what is the maximum rate of a transfusion?

A

total volume to be given / 3.4125

60
Q

what is the transfusion rate you use for the first 20 minutes? what about the following 40 minutes?

A

max rate / 4

max rate / 2

61
Q

what is the target amount of time you should aim for when doing a blood transfusion?

A

done over 4 hours

62
Q

what can you do for anemic puppies & kittens?

A

they typically are anemic due to intestinal parasites - bitch or queen are excellent donors, but for sure type the queen & kittens

63
Q

T/F: in horses, you can easily sediment & remove red blood cells by letting a bag hang for 3-4 hours

A

true - acid-citrate dextrose bags

appropriate for storage from 21-28 days

64
Q

when would you see an immediate transfusion reaction in a cat in regards to giving specific blood types?

A

doing a major cross match & the donor has A antigens & the recipient is type B & has B antigens & will immediately form anti-A antibodies

65
Q

in doing a minor cross match, when would you see an immediate transfusion reaction in cat blood types?

A

donor has a-antigens & anti-b antibodies & the recipient is a type B cat

66
Q

why may an animal have a delayed reaction on the next blood transfusion?

A

the first transfusion the animal becomes sensitized & forms antibodies

PCS VI (22 decks)

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