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Block Vb > Hematology - Transfusions > Flashcards

Hematology - Transfusions Flashcards

1
Q

What volume of whole blood is needed to raise the PCV by 1%?

A

2 mL/kg

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2
Q

What volume of pRBC is needed to raise the PCV by 1%?

A

1 mL/kg

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3
Q

What factors are present in fresh frozen plasma vs frozen plasma?

A

Fresh frozen has all coag factors, albumin, and Ig.

Frozen plasma is similar but lacks V and VIII.

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4
Q

How long can frozen plasma be stored?

A

5 years at 20 C

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5
Q

How is cryoprecipitate made?

A

Prepared from fresh frozen plasma

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6
Q

What factors are present in cryoprecipitate?

A

All coag factors if used within 8 hours of thaw.

Concentrated VIII, vWF, and fibrinogen.

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7
Q

What is the main difference between cryoprecipitate and cryopoor plasma?

A

Cryopoor lacks VIII, vWF, and fibrinogen (but these are concentrated in cryoprecipitate).

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8
Q

How is platelet rich plasma prepared?

A

Differential centrifugation of fresh whole blood within 2 hours of collection.

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9
Q

How long is platelet rich plasma good for?

A

24 hours at 20-24 C/

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10
Q

What plasma products can be stored at -20C with a shelf life of 1 year?

A

Fresh frozen plasma, cryoprecipitate, and cryopoor plasma.

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11
Q

Fresh frozen plasma should not be used as the first line of treatment for what condition? Why?

A

Hypoalbuminemia.

Albumin is so dilute in this sample that it would take 45 mL/kg to increase serum albumin by 1 g/dL.

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12
Q

What are the main blood types of dogs?

A

DEA 1.1, 1.2, 7, and 4.

DEA 1.1 is most common - if positive = Type A.

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13
Q

What is Dal?

A

Dal is present in 93% of dogs, but commonly absent in Dalmatians, shih tzus, and Dobermans. Sensitized Dal negative dogs could have acute and delayed hemolytic reactions.

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14
Q

How are dogs blood typed?

A

Cards or alvedia quick tests.

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15
Q

What are the different cat blood types?

A

Type A (most common)
Type B
Mlk Ag

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16
Q

Type A cats have Anti-B antibodies that are _____ compared to the Anti-A antibodies of Type B cats that are _____.

A

Anti-B antibodies - weak IgG and IgM

Anti-A antibodies - strong hemagglutinins and hemolysis (IgM)

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17
Q

What happens when mlk negative cats receive mlk positive blood?

A

Ag:Ab –> acute hemolytic conditions.

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18
Q

Do you need to cross match all dogs? What about cats?

A

Dogs - very unlikely to react to first transfusion, but should cross match if receiving >1.
Cats - ALWAYS cross match!!!

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19
Q

What is the RBC lifespan when A blood –> A cat? B blood –> A cat? A blood –> B cat?

A

A –> A = 1 month
B –> A = 2 days, risk of hemolytic rxn
A –> B = 1 hr, FATAL in most cases

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20
Q

What type of blood should be given to an AB cat?

A

AB if possible, otherwise A (since it carries the weaker anti-B-Ab)

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21
Q

What is major cross matching vs minor?

A

Major: mix donor RBC with recipient serum.
Minor: mix recipient RBC with donor serum.

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22
Q

How is a simple major crossmatch performed?

A

2 drops recipient blood:1 drop donor blood and check for agglutination/hemolysis

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23
Q

When should a simple major crossmatch be performed?

A

When a crude match must be made in an emergency.

24
Q

Acute hemolytic reactions are type __ hypersensitivity against the ____ RBC antigen.

A

Acute hemolytic reactions are type II hypersensitivity against the donor RBC antigen.

25
Q

What mediators are involved in type II hypersensitivity?

A

IgG, IgM, complement

26
Q

What are the clinical signs associated with acute hemolytic reactions?

A

Agitation, tachycardia, tachypnea, pyrexia, vomiting, hypotensive sock…

27
Q

T/F: Death is slow and rare in acute hemolytic reactions.

A

False - it frequently occurs and does so rapidly.

28
Q

What is the treatment for acute hemolytic reactions?

A

Stop the transfusion, provide IVF and supportive care.

29
Q

What type of hypersensitivity is an acute febrile non-hemolytic reaction?

A

Type II hypersensitivity

30
Q

What is the interaction causes acute febrile non-hemolytic reactions?

A

Ab against donor leukocytes or platelets.

31
Q

What are the clinical signs of acute febrile non-hemolytic reactions?

A

Vomiting, tachypnea, fever.

32
Q

What is the treatment for acute febrile non-hemolytic reactions?

A

Stop transfusion - see resolution - continue slowly with close monitoring.

33
Q

How long does an acute febrile non-hemolytic reaction last?

A

30 minutes to 20 hours

34
Q

Acute hypersensitivity reactions are type __.

A

Acute hypersensitivity reactions are type 1.

35
Q

What mediators are responsible for type I hypersensitivity?

A

IgE and mast cells

36
Q

What is the most common blood product associated with type I hypersensitivity? By what mechanism?

A

Plasma transfusion.

Transfusion –> mast cell stimulation –> vasoactive substances released.

37
Q

What are the signs of acute hypersensitivity (type I)?

A

Urticaria, pruritic, facial edema, rarely death

38
Q

What are the treatments for type I hypersensitivity?

A

Discontinue transfusion, antihistamines, epinephrine if severe.

39
Q

What is TRALI? Is it seen in vet med?

A

Transfusion related acute lung injury - non-cardiogenic pulmonary edema
Only reported in human medicine

40
Q

What are the treatments for TRALI?

A

Stop transfusion, supplement oxygen, intermittent positive ventilation.

41
Q

What are examples of acute non-immunologic reactions to blood transfusions?

A 
Hypocalcemia
Embolism
Circulatory overload
Bacterial infection
Hyperammonemia
Hypothermia
Hemolysis secondary to physical/thermal RBC damage
42
Q

What are 2 forms of delayed non-immunologic reactions?

A

Disease transmission

Immunosuppression

43
Q

How can we prevent complications associated with transfusions?

A 
Blood typing and cross matching
Use of components
Screening of donors
Appropriate storage and delivery of blood
Prophylactic diphenhydramine
44
Q

Should you give steroids to prevent hypersensitivity/complications?

A

NO! There is no scientific reason to!

45
Q

What are the key monitoring parameters during a transfusion?

A

Temperature, HR, RR and effort, BP, vomiting, urticaria, angioedema, pruritus.

46
Q

What products should be used to treat anemia?

A

pRBC or whole blood

47
Q

What products should be used to treat a coagulopathy with concurrent anemia?

A

Fresh whole blood

48
Q

What product for vWF disease?

A

Cryoprecipitate

49
Q

What product for hemophilia A (VIII deficiency)?

A

Cryoprecipitate

50
Q

What product for hemophilia B (IX deficiency)?

A

Cryopoor plasma

51
Q

What product for vitamin K antagonism/rodenticide toxicity?

A

Frozen plasma

52
Q

What product for liver failure?

A

Fresh frozen plasma

53
Q

What product for DIC?

A

Fresh frozen plasma

54
Q

What product for sepsis or SIRS?

A

Fresh frozen plasma

55
Q

What product for hypoalbuminemia?

A

PLASMA PRODUCTS SHOULD NOT BE USED AS THE 1st LINE OF TX!

Block Vb (2 decks)

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