Lab Tech Exam 1 Flashcards
Blood group antigens may react with what in the plasma of another animal
Antibodies
Structures on the surface of erythrocytes
Genetically determined and referred to as blood group …
Antigens
This reaction can occur with blood transfusions as a result of variation in blood group antigens between the recipient and donor
Antigen-antibody reaction
Feline blood types (3, letters)
A, B, AB
Greater than 90% of cats in US are blood type….
A
This blood type is more common in certain purebred cats
Type B
This blood type is rare in cats
AB
Naturally occurring antibodies against other blood types are found in all cats by the time they are how old?
A few weeks old
Cats with blood type B have strong antibodies against what type?
Type B cats can suffer fatal reactions if given this type of blood.
Type A
Cats with type A blood have weak antibodies against what type?
Type A cats generally have a mild reaction if given this type of blood.
Type B
This cat blood type lacks naturally occurring antibodies and can safely receive blood from the other 2 types.
Type AB
This cat blood type is a universal recipient
Type AB
Condition that occurs if mom has antibodies against kitten’s blood type.
Ex: type A or AB kittens born to type B dams
Kitten ingests the maternal anti-A antibodies in colostrum which causes hemolysis in kitten
CX: acute death, fading kittens, tail-tip necrosis
Neonatal isoerythrolysis
Canine blood types
DEA 1.1, 1.2, 3, 4, 5, 6, 7, 8
DEA stands for what
Dog erythrocyte antigen
Dogs can be ….. for either (not both) DEA 1.1 or 1.2 or they are …. for both.
Positive
Negative
Most dogs do or do not have naturally occurring alloantibodies against erythrocyte antigens like humans.
Do not
These are antibodies against an antigen that exists in alternative forms.
Alloantibodies
In canines, antibodies can develop and result in a …….. transfusion reaction in as little as a week after the original transfusion.
Delayed
The majors antigens for dogs are which 3 blood types?
DEA 1.1, 1.2, & 7
Transfusion reactions are more or less likely to occur if blood positive for DEA 1.1, 1.2, or 7 is transfused to negative dogs.
More likely
Approximately 50% of dogs are positive for ….
DEA 1.1
First time canine transfusion of non-cross matched or typed blood produces a reaction rate of approx…
15%
Subsequent transfusion reaction rates for dogs show what trend?
Increase significantly
What should be done before transfusing any dog with a history of a blood transfusion?
Cross-match
Breeds more commonly DEA 1.1 positive are (2)
Golden retrievers and Labradors
Blood from dogs that are DEA ….. negative is not likely to cause a problem in most dogs, but donors should be typed for all antigens.
DEA 1.1 negative
What canine blood type is the true universal donor?
DEA 4
This species has no apparent blood type
Ferrets
8 major blood groups in horses
QUACKD PT
Are there any universal blood types for horses?
None
These can be present as a result of vaccinations containing equine tissue or transplacental immunization.
They are also naturally occurring.
Antibodies
Should cross matching be done before the first transfusion in horses?
Yes!
Transfusion reactions in horses are commonly
Fatal
This condition seen in nursing offspring can also occur in horses.
Isoerythrolysis
11 bovine blood groups
A B C F J L M R S T Z
This bovine blood group is polymorphic, with more than 60 different antigens
Group B
These antibodies are the only common natural antibodies in cattle
Anti-J antibodies
These donors minimize transfusion reactions
J-negative
Bovine erythrocytes have little tendency to ……., therefore lyric cross match screening is required
Agglutinate
7 ovine blood groups
A B C D M R X
These ovine naturally occurring antibodies may be present
R
Ovine RBCs have little tendency to ……, similar to cattle
Agglutinate
Bovines have antibodies against what other species RBCs?
Ovine - don’t bottle feed a sheep with cow colostrum
5 major blood systems in goats
A B C J M
This society regulates:
Standardization of nomenclature of blood typing universally
Standardization of testing reagents for blood typing
Insure consistency in typing, testing, blood groups and other blood group research
International Society of Animal Genetics
This reaction may occur even when animals are administered blood of a compatible type.
This is why cross matching must be done.
Transfusion reaction
This type of testing is used is further document compatibility between blood donor and recipient
Cross matching
Blood typing focuses on the …. on the surface of the RBCS.
Antigens
Cross matching focuses on ….. in the plasma.
Antibodies
Blood typing: if the patient sample shows agglutination in the well marked Type A, the cat tested has blood group …
A
Blood typing: if the patient sample shows agglutination in both patient wells, the cat tested has blood group….
AB
Dogs can be checked for DEA …. In house using commercially available card
DEA 1.1
To fully blood type dogs, bloods needs to be….
Sent to outside lab
Blood typing for large animals is ……..for routine analysis before transfusion.
Impractical
Large animal blood can be typed by
Sending to outside lab
Blood typing does not eliminate the need for this test
Cross matching
There are other undetectable factors that can cause incompatibility (3)
Immune-mediated diseases
RBCS diseases
Previous transfusions from 4 days prior
A blood cross match (BCM) is performed to detect ……… Imcompatibility. (Remember: use red top tube for cross matching)
Serological
This type of cross match tests the recipient’s serum for antibodies to the donor’s RBCs.
Since the main aim of the transfusion is to provide the recipient with RBCs, it is most important that the recipient’s serum antibodies do not destroy these cells and in doing so evoke a reaction.
Major cross match
This type of cross match assesses the risk of recipient cell destruction by the donor serum.
Much smaller risk because volume of transfused serum will comprise only a small volume of the recipient’s total serum.
Minor cross match
How much blood is needed for a cross match?
What type of tube should it be placed in?
1 ml from both donor and recipient
Both in EDTA tubes (purple top)
After obtaining blood from the donor and recipient, what is the next step in a cross match?
Separate the plasma from the red cells via centrifugation of both tubes, at blood speed (very slow) for 10 min
For cross match: after blood has been centrifuged, what is the next step?
Separate plasma and packed red cells into 4 separate plastic tubes, labeled donor plasma, recipient plasma, donor RBCs, recipient RBCs.
Cross match: after the serum and RBCs are in separate tubes, what is the next step?
Suspend 0.2 mls of donor and recipient RBCs into 4.8 mls of 0.9% saline in separate syringes and gently mix.
Cross match: what is the next step after rinsing the RBCs of the donor and recipient?
Prepare 4 slides: donor and recipient controls, minor and major cross matches.
What do the control slides contain for the cross match?
Donor control: 1 drop of donor plasma, 1 drop of donor rinsed RBCs
Recipient control: 1 drop of recipient plasma, 1 drop of recipient rinsed RBCs
What is on the minor cross match slide?
1 drop recipient rinsed RBCs
1 drop donor plasma
What is on the major cross match slide?
1 drop recipient plasma
1 drop donor rinsed RBCs
After slides have been made for cross matching, what should be done?
Mix gently and examine both grossly and microscopically (high dry) for hemolysis and agglutination. Rouleaux formation is normal.
If the recipient control is auto-agglutinating, should a cross match be performed?
No
Which control slide will allow you to look for auto-agglutination?
Recipient
The cross match is what type of agglutination reaction?
Type 1 hypersensitivity
Which control will allow you to observe the unit for RBC viability, bacteria, hemolysis, etc?
Donor control
What is involved in the rapid method for cross matching?
1 drop donor blood (EDTA), 1 drop of recipient SERUM, 2 drops saline
Place on glass slide and swirl
Equal volumes needed for accuracy
Agglutination must be differentiated from what by microscopic analysis?
Rouleaux formation
When RBCs look like cluster of grapes, what is this?
Agglutination
When RBCs are stacked like coins, this is
Rouleaux formation
These are characteristics are true of what?
Thorough PE, CBC, comprehensive chemistry, serology, nutritionally sound, parasite free, fully vaccinated, on monthly hep and flea/tick prevention
Blood donors
What is the ideal weight for a dog blood donor?
At least 60lbs
What blood type is best to have for a dog blood donor?
DEA 4, or DEA 1.1 and DEA 1.2 negative
These tests are used as additional screening for what?
Thyroid profile, distemper, parvovirus, rv titer, brucellosis, trypanosomiasis, vWD, babesia canis and babesia gibsoni, leishmania
Additional screening for a blood donor
What is the ideal weight for a cat blood donor?
Over 10 lb
Should the cat be an indoor or outdoor cat or does it matter?
Strictly indoors
These additional screening tests are used for what?
Thyroid profile, FIP, toxoplasmosis, cytauxzoon, hemotrophic feline mycoplasma, bartonella spp.
Cat blood donor
For blood collection, does the donor need to be sedated?
Donor sedated if necessary, not necessary in most dogs once used to routine
Does the site of collection for blood need surgically prepped?
Yes
What vein is used as the collection site in dogs and cats?
Jugular
Blood collection should be performed rapidly and without interruption. True or false?
True
Using a single vein puncture of vein during blood collection avoids what?
Excessive activation of clotting cascade and damage to RBCs.
This blood collection set has an evacuated blood collection bottle. Separate collection set is needed.
Acid citrate dextrose, ACD
This blood collection set has plastic blood pack units, and attached needle should be used.
Citrate phosphate dextrose, CPD
Vacuum bottles: care is taken not to lose ……… at time of venipuncture.
Vacuum
A 19 ga butterfly needle and large syringe containing desired anticoagulant is used for blood collection in what species?
Cat
If using one of these two anticoagulants, blood must be used within 24-48 hours.
They lack RBC preservative resulting in marked increase in pH, decrease in RBC adenosine triphosphate.
Heparin or sodium citrate
Heparin and sodium citrate lack RBC preservative. What does this do to the blood? (2 things)
Marked increase in pH
Decrease in RBC adenosine triphosphate.
Which 2 blood collection kits would you use for blood being stored over 48 hours?
Acid citrate dextrose, ACD
Citrate phosphate dextrose, CPD
When using acid citrate dextrose, ACD, or citrate phosphate dextrose, CPD, what temp should the blood be stored at?
1-6 degrees C
Storage temperature for blood cannot vary by more than
2 degrees C
During storage of blood, what should be done?
Gently mixed periodically
What anticoagulant effectively stores whole blood for 21 days?
ACD
What anticoagulant stores whole blood for 21 days?
CPD
CPDA-1 with added RBC preservative adenosine effectively stores whole blood for how long?
35-45 days
What are the components of blood?
Erythrocytes
Leukocytes
Platelets
Plasma
Anemia, need antibodies, thrombocytopenia, clotting disorder, hypoproteinemia (hypoalbuminemia) are all indications for what?
Blood transfusion
Severe anemia, severe bleeding, thrombocytopenia, coagulopathies (DIC, warfin), factor deficiencies, severe hypoproteinemia are all indications that the patient needs what component of blood for a transfusion?
Fresh whole blood
This can be collected in house inexpensively
Fresh whole blood
Finding a donor is time restrictive if needed for an emergency situation
Not ideal for conditions where volume overload is a concern
These are cons for which what type of transfusion?
Fresh whole blood
These are indications for what type of transfusion?
Need RBCs, increase O2 delivery
Need plasma proteins (oncotic volume expansion)
Need stable coagulation factors (fibrinogen)
Stored whole blood
These type of component for transfusions:
Can be kept on hand for emergencies
Shelf life approx 35 days
Roughly 45 min to properly bring to room temp
Stored whole blood
These are indications to use what component for a transfusion?
Anemia with normal plasma volume
Major indication is decreased O2-carrying capability
It is administered rapidly with less risk of creating volume overload
Stored packed RBCs
This component for transfusions:
Reduces the frequency of transfusion reactions
Supplies RBCs only
Has a shelf life of roughly 35 days
Stored packed RBCs
These are characteristics of what type of transfusion component?
Frozen within 6 hrs of collection
Supplies plasma proteins (oncotic volume expansion)
Supplies all coagulation factors
Does not supply via platelets
Lass chance of causing a transfusion reaction than whole blood
Shelf life 1 yr
Roughly 1 hr to thaw
Fresh frozen plasma
Is cross matching or blood typing required for plasma products?
No, not since RBCs are not present in plasma
These are indications to use what type of transfusion component?
Deficit of coag factors ( warfarin toxicity, DIC, inherited coag factors deficiencies - vWD)
Deficit of plasma proteins
Need to expand fluid volume
Need antibodies
Fresh frozen plasma
Characteristics of what type of transfusion component?
Frozen after 6 hours of collection
Supplies plasma proteins
Does not contain some of the unstable clotting factors
Roughly 1 hr to thaw
Can be stored up to 5 yrs
Frozen plasma
These are indications to use what transfusion component?
Hypoproteinemia
Colostrum replacement
Volume expansion
Frozen plasma
These are characteristics of what transfusion component?
Supplies high concentration of Factor VIII, vWD, and fibrinogen per ml than Fresh frozen plasma
Does not supply viable platelets
Roughly 2 hrs to thaw
Cryoprecipitate
Indications to use what transfusion component? Severe coagulopathy VWD Hemophilia DIC
Cryoprecipitate
Characteristics of what transfusion component:
Collected through plateletpheresis
Contains 1.0 x 10^11 platelets
Contains fresh frozen plasma as holding solution
Contains DMSO as a preservative
Shelf life 6 months
Frozen platelet concentrate
This is used for the treatment of bleeding due to thrombocytopenia
Frozen platelet concentrate
When warming blood for transfusion, it should be placed in a
Ziplock bag
Start with a water bath at what temp when warming blood
Room temp
Is it ok to microwave blood?
No
Can blood be immediately placed in hot water?
No
The temperature of the blood should not exceed what temp? Going above this can cause hemolysis?
50 degrees C
What routes are acceptable for blood administration?
IV, IP, IO
What routes are acceptable for neonatal blood administration?
IP, IO
What should be used during administration for all blood components?
Blood filter
Where should the blood filter be placed along the line?
As close to IV as possible.
Why should IV fluid pumps that close the line in the door not be used?
They can crush or lyse RBCs.
Strict asepsis is not essential during collection, storage, and administration of blood and blood products.
True or false?
False, strict asepsis is essential during all
Blood transfusions should be administered in ….. hours or less to reduce chances of contaminant bacterial growth.
4 hours or less
Administer … ml/lb of whole blood to raise the patient hematocrit by 1%.
1 ml/lb
These factors increase or reduce transfusion complications? Choosing the right blood product Recognize the signs of a reaction Use proper administration rates Blood typing and cross matching
Reduce transfusion complications
Any transfusion reaction means that the transfusion is ….. doing its intended job and has burdened an already compromised patient.
Not done its job
While receiving a transfusion, vital signs should be monitored how often?
Every 15 min
Should the desired rate of blood component being transfused be started that way?
No, slowly increase rate of delivery until desired rate - over 1 hr period
Pruritis, urticaria, restlessness, anxiety, tachypnea, tachycardia are signs of what?
Early transfusion reactions
Nausea, vomiting, fever, shock, coma, death are signs of what?
Late transfusion reactions
Cutaneous erythema is also a sign of a
Transfusion reaction
Can be seen after as little as 1 ml of administered blood Vocalization, salivation, urination, defecation Depression to recumbency Brachycardia or arrhythmias Seizures or apnea Death Clinical signs of what? In cat
Transfusion reaction
Type a blood to type b cat
What is the very first thing you should do if you suspect your patient is having a reaction?
Stop the transfusion
Patient is having a transfusion reaction and dyspnea is present, what should you do?
Administer O2
Patient is having a transfusion reaction, what injection can you give them?
Diphenhydramine IM
Tx with what approximately 30 min prior transfusion may reduce reaction
Antihistamines
Immunologic reactions result from transfusion of
Incompatible blood
Incompatible RBCs in previously unsensitized recipient will be destroyed how many days after the transfusion?
7-10 days
Clinical consequences of ……… transfusion reaction include rapid development of tachycardia, hypotension, vomiting, salivation, and muscle tremors.
Hemolytic
Delayed …….. reactions suspected if PCV drops unexpectedly 2-21 days after transfusion.
Hemolytic
This can also be caused by immunologic reactions to leukocyte, platelet, or plasma protein incompatibilities
Reactions between antigens and antibodies activate complement system
Release vasoactive substances responsible for trembling, vomiting, urticaria
Prior transfusion not required for these reactions to occur
Transfusion reactions
This type of transfusion reaction is principally due to vascular overload
Non-immunologic
Coughing, increased respiratory rate, respiratory distress, vomiting are signs of what?
Vascular overload
For non-immunologic transfusion reactions, the transfusion rate is reduced to approximately
1 ml/kg/hr
Should food, water, and medications be withheld during transfusion?
Yes
Transfusion induced fever is due to
Foreign proteins
Initial step of controlling transfusion induced fever is …… rate of transfusion.
Slow
This hemostatic disorder is a result of low platelet numbers caused by bone marrow injury or dysfunction.
Thrombocytopenia
Causes for what hemostatic disorder: estrogen toxicity, immune mediated, late stages of chronic viral, bacterial, or rickettsial diseases, myeloproliferative disorders, infectious, neoplasia, toxins
Thrombocytopenia, affects bone marrow
Adherence between platelets and collagen is mediated by what factor?
Von Willebrand’s factor
vWF disease is a hereditary deficiency or abnormality of vWF causing what to fail?
Platelet function
What breed is vWF disease most common in?
Dobermans
What human disease is similar to vWF disease?
Hemophilia
Clinical signs of vWF disease usually appear before what age?
6 months
Theses are clinical signs of what disorder?
Petechia, ecchymoses, hemorrhage in the retina, blood in urine or feces, epistaxis
Mechanical hemostasis disorder
What organ is the primary site for synthesis of most coag factors?
Liver
Production of coag factors is maintained at close to normal until >….. Of the normal liver mass is nonfunctional
80%
This vitamin is required for synthesis of factors II, VIII, IX, X
Vit K
Inadequate consumption or malabsorption of Bit K causes what?
Bleeding disorders
These toxins inhibit what?
Rodenticides that contain warfarin, indanediones or brodifacoum
Sulfaquinoxaline (a coccidiostat)
Dicumarol (fungal metabolite in sweet clover)
Vit K absorption
This hemostatic disorder can be due to therapeutic heparin administration, making it iatrogenic
Heparinization
This hemostatic disorder could be secondary to massive release of endogenous heparin from mast cell tumor degranulation.
Heparinization
DIC stands for what?
Disseminated intravascular coagulation
The formation of numerous tiny clots throughout the body which deplete platelet availability causes this hemostatic disorder
DIC
In this hemostatic disorder, fibrin degradation products coat the platelets and interfere with adherence to collagen
DIC - disseminated intravascular coagulation
What adult parasite would be described as having a slender anterior end with its mouth at the tip and a thickened posterior extremity?
Trichuris vulpis
In puppies, transplacental transmission is the primary route of infection for
Toxocara canis
The tapeworm that releases its eggs in packets is
Dipylidium caninum
Which of the following parasite ova is collected using a scotch tape technique?
Oxyuris equi
Which factors are part of the intrinsic pathway of the coag cascade?
XII, XI, IX, VIII
Coag factors are primarily synthesized in which organ?
Liver
Which test of the coag system requires a blood tube containing diatomaceous earth?
ACT
In an emergency situation, thrombocytopenia can quickly be detected by estimating the platelet count on a blood smear. Approximately how many platelets should be seen per oil immersion field in a normal animal for most species?
8-10
What are the coag factors involved in the common pathway of the coag cascade?
X, V, II, I
What is the universal donor blood group of dogs?
DEA 4 positive only
