Lecture Exam 1 Flashcards
About how much water makes up the body’s weight?
60%, which is all dependent on age, sex and degree of obesity is applicable
What are the different fluid compartments in the body?
- Intracellular
- Extracellular
- Transcellular
What is considered part of the intracellular compartments?
- All the fluids inside of the cells of the body
- Makes up about 40% of body fluid weight
- Fluid composition of each cell is similar
What is considered part of the extracellular compartments?
- All fluids outside the cells
- Makes up about 20% of body weight
- Separated by a capillary membrane
What fluids are included in the extracellular compartments?
- 3/4 interstitial fluid
- 1/4 extracellular fluid in blood plasma
What is the Gibbs-Donnan Effect?
The extra osmotic pressure of protein solutions caused by impermeable protein molecules resulting in uneven distribution of small, permeant cations and anions in blood plasma
What is considered part of the transcellular compartments?
- Includes synovial, peritoneal, pericardial, intraocular and cerebrospinal fluids
- Specialized body fluids that make up <1% of body weight
How is fluid exchange between compartments regulated?
Through osmosis
What is osmosis?
The net diffusion of water from a regent of high water concentration to one that has a low water concentration
What is plasma osmolarity?
About 280-302 mOsm/L and is based on the amount of particles in suspension
What is osmotic pressure?
The precise amount of pressure that is required to prevent osmosis
What are the different kinds of osmotic pressures?
- Isotonic
- Hypertonic
- Hypotonic
What is isotonic pressure?
- The cell is normal and the concentration of fluid is equal to that of plasma
- No net loss or gain
What is hypertonic pressure?
The cell shrinks due to the fluid concentration being greater than that of plasma
What is hypotonic pressure?
When the cell expands due to the concentration of fluid being less than plasma
What organ in the body is the most important organ to maintain water balance and hemostasis?
The kidney
What is the minimum systolic blood pressure for the kidney to remain working?
Blood must enter the glomerular capillaries at about 70 mm Hg to function properly
What is the functional unit of the kidney?
The nephron
What is the order of renal blood supply?
Renal artery > interlobar artery > arcuate artery > interlobular artery > intralobular artery
What are the clinical signs of a urinary tract disorder?
- Pollakiuria
- Incontinence or inappropriate urination
- Dysuria or stranguria
- Hematuria
- Polyuriria and polydipsia
What are the different kinds of urinary tract disorders?
- Lower urinary tract infection
- Urolithiasis
- Urinary tract obstruction
- Feline lower urinary tract disease
What is a UTI?
Microbial colonization of the urinary bladder and/or proximal portion of the urethra
What animals are affected by UTI’s?
- Common in female dogs, less common in male dogs, and uncommon in cats
- All ages are affected but it is more common in older animals
Is it normal to find bacteria is an animal’s urinary tract?
Some bacteria is normal to find in a dog, but there should be no bacteria found in a cat’s urinary tract
What is the range for culture abnormalities of colony forming bacteria in a urine culture for a dog?
- Cystocentesis: > 1,000
- Catheterization: > 10,000
- Voided: > 100,000
What is the range for culture abnormalities of colony forming bacteria in a urine culture for a cat?
- Cystocentesis/Catheterization: > 1,000
- Voided: > 10,000
What is the most common cause of a UTI?
Aerobic bacteria
What are the most common (>50 %) bacterias responsible for UTI’s?
E. Coli, staph and proteus
What are some less common types of bacteria responsible for UTI’s?
Streptococcus, klebsiella, enterobacter, pseudomonas, cornynacterium
What kinds of bladder stones are canine’s prone to?
- Struvites
- Calcium oxalate
- Purines
- Urates
- Cystines
- Silicas (Jacks)
What are the common bladder stones of felines?
- Struvites
- Calcium oxalate
- Urates
- Cystines
- Silicas (Jacks)
What breed of dog are over represented for purine and urate bladder stones?
Dalmatians
What are the main causes of bladder stones?
- Supersaturation of urine with mineral leading to crystalluria
- Delayed passage of crystals through the urinary tract
- Reduction of normally present inhibitors of crystal growth and aggregation
What causes the supersaturation of urine?
- Increased dietary intake of crystal-producing minerals
- Reduced solubility of crystals due to pH
- Concentrated urine enhancing crystal concentration
- Congenital abnormalities
What causes delayed passage of crystals through the urinary tract?
- Adherence of crystals to damage urinary mucosa
- Stationary foreign bodies such as suture or a calculus of one mineral
- Clumping of cells in the bladder
What would cause the reduction of normally present crystal growth inhibitors in the bladder?
The presence of extra citrate or phosphorus
What breeds are more prone to struvite bladder stones?
Female mini schnauzers, dachshunds, poodles, scottish terriers, beagles, pekingese, and corgis as well as any female breed of cats
How can bladder stones be treated?
Urohydropropulsion, shockwave lithotripsy, cystotomy or medical dissolution
Which type of bladder stones can NOT be treated by medical dissolution?
Calcium oxalate stones
How can struvite bladder stones be prevented?
By the promotion of a more acidic urine with drugs such as methionine and ammonium chloride or with a acidifying, magnesium restricted diet
What breeds are more prone to calcium oxalate bladder stones?
Male mini schauzers, lhasa apsos, and yorkies, as well as male himalayan and persian cats
How can calcium oxalate bladder stones be prevented?
With the promotion of a more alkaline urine with the help of drugs such as sodium bicarbonate and citrate salts and special diet CAN treat calcium oxalate crystals as long as stones have not already formed
What causes urate bladder stones?
They are formed due to an impaired conversion of uric acid to allantoin and animals with liver shunts may develop ammonium urate stones due to impaired metabolism of uric acid and ammonia
What breeds are more prone to urate bladder stones?
Dalmatians and english bulldogs as well as mini schnauzers and yorkis which are at risk for liver shunts
How can urate bladder stones be prevented?
With a low purine, alkalinizing diet
What is a urinary tract obstruction?
Restricted urine flow from the kidneys through the urinary tract to the external urethral orifice
Which gender is more prone to urinary tract obstruction?
Males due to the anatomical distance from the bladder to the urethra
What is a clinical sign of urinary tract obstruction?
Elevation of uremia, which is a nitrogenous waste compound that is normally eliminated by the kidneys
What are some causes of urinary tract obstruction?
- Intraluminal including bladder stones, urethral plugs or blood clots
- Intramural including neoplasia, fibrosis, prostate disorders, edema and ruptures
- Miscellaneous reasons such as displacement of the bladder or neurogenic lack of bladder function
What is the most common obstruction site in the urinary tract?
The urethra
How should a urinary obstruction be treated?
As a medical emergency because it can be life threatening
What is feline lower urinary tract disease aka FLUTD?
A term to describe a variety of conditions that affect the bladder and urethra of cats
What are the signs of FLUTD in a cat?
Cats with FLUTD most often show signs of difficulty and pain when urinating, increased frequency of urination, and blood in the urine
What is idiopathic cystitis?
Non-infectious, inflammatory lower urinary tract disease which often resolves itself regardless of treatment with stress playing an important part in flare ups
What is the aim of transfusion medicine?
To save the lives of patients through the safe use of blood products
What are some examples of blood products?
- Whole blood
- Packed RBC
- Fresh frozen plasma
- Frozen plasma
- Platelet rich plasma
- Platelet concentrate
- Oxyglobin
What is the purpose of whole blood transfusion?
It provides RBC’s to carry oxygen to tissue
What is whole blood?
A natural colloid volume expander that provides a source of proteins and coagulation factors to a patient
What does fresh whole blood contain?
RBC’s, plasma proteins and ALL clotting factors
What does stored whole blood contain?
RBC’s, plasma proteins and stable clotting factors but NO platelets or coagulation factors V or VIII
What is the refrigerated shelf life of whole blood?
Up to 35 days
What is packed RBC’s?
Whole blood that is prepared by special centrifuge separation in a bag of red cells from the plasma
What is the purpose of PRBC’s?
To increase circulating RBC mass, increase the oxygen carrying capacity of a recipient’s blood, and treat conditions such as ongoing hemorrhage and chronic anemia
What is the PCV range of a bag of PRBC’s?
70-80% while a normal PCV is 30-50%
What is the refrigerated shelf life or PRBC’s?
21-42 days depending on the anticoagulant used to prepare
What is the preferred anticoagulant for PRBC’s?
Acid Citrate Dextrose Solution
Do PRBC’s need to be diluted any further?
No because they are preserved with an additive solution, but if using fluids along with blood products, use 0.9 % saline
What fluids should be avoided with using PRBC’s?
Calcium containing fluids such as LRS and hypotonic fluids such as D5W
What is the dosage guide line for PRBC’s?
Dose = 80 (K9) or 70 (Fel) x BW (kg) x (desired PCV - patient’s PCV) / donor PCV
What is fresh frozen plasma?
Plasma that has been separated from whole blood through centrifugation within 8 hours of collection of whole blood
What does FFP contain?
All coagulation factors and plasma proteins, fats, carbohydrates and minerals
What should the PCV of FFP be?
<1% of RBC
What is FFP used for?
To aid in controlling bleeding patients who need coagulation factors, volume expansion, and proteinemia
How should whole blood and PRBC’s be thawed?
Allowed to sit on a counter to come to room temperature or use warm water bath to slowly warm
What is the refrigerated shelf life of FFP?
1 year
What is the dose for FFP and FP?
10-15 ml/kg
How should FFP, FP and cryoprecipitate be thawed?
In a 37C water bath in a waterproof plastic bag
What is the transfusion rate of FFP?
Over 8-12 hours for a vWb patient, and begin 1 hour prior to anesthesia to activate platelets with a standard blood administration set
What is frozen plasma?
Plasma that has been separated from whole blood through sedimentation or centrifugation no later than 5 days after the expiration of whole blood
What does FP contain?
Only Vitamin K dependent coagulation factors, albumin and immunoglobulins
What is FP used for?
Treating rodenticide poisoning, colostrum replacement, hypoproteinemia and severe burns
What is the refrigerated shelf life of FP?
5 years
What is platelet rich plasma?
Prepared from whole blood by centrifugation at a slower rate than for plasma allowing the platelets to be suspended in plasma
What is PRP used for?
Treatment of cases of thrombocytopenia with decreased platelet production
What is the shelf life of PRP?
Very brief as it should be transfused within hours of collection and should NOT be refrigerated as it inactivates platelet function
What is platelet concentrate?
It contains high platelet concentration as well as frozen plasma and 5 ml of preservative Dimethyl sulfoxide (DMSO)
What is the frozen shelf life of PC?
6 months, and thaw by allowing to come to room temperature naturally, not by water bath
What is cryoprecipitate?
Made from controlled thaw of fresh frozen plasma, it contains a concentration of cold, insoluable portion of plasma containing factors VIII, XIII, fibrinogen and vWF
What is cryoprecipitate used to treat?
Inherited coagulopathies and von Willebrand’s crisis with a dose of 1 unit/kg that can be repeated BID
What is the frozen shelf like of cryoprecipitate?
1 year
What is oxyglobin?
A synthetic blood product manufactured from bovine hemoglobin and modified with LRS, it’s a free hemoglobin based, oxygen carrying fluid which increases plasma and total hemoglobin which help leads to an increase in arterial oxygen content
What is oxyglobin used to treat?
Anemia due to its volume expanding factor, and is not recommended in patients where volume overload is a concern (such as heart condition patients)
What are some conditions to remember when using oxyglobin?
- The patient’s initial PCV and RBC will drop and the CVP (central venous pressure) will increase for 24 hours post infusion
- Patient may appear jaundice due to increase in bilirubin from increased hemoglobin
What is the stored room temperature shelf life of oxyglobin?
3 years, and it is labeled for dog use only, although it can be used in cats, ferrets and birds
What is DEA?
- Dog erythrocyte antigen aka canine blood types
- Composed of protein chains that live on RBCs
How many DEAs are currently noted? What is considered a dog’s universal donor?
13, with DEA 4 being the universal donor
What is the most commonly found DEA?
DEA 1.1 (-) and DEA 1.2 (-) and are considered the next best universal donor after DEA 4
What is the second most commonly found DEA?
DEA 1.1 (+) and DEA 1.2 (+), but they should be used cautiously and tested to ensure that the patient does not already have these types of blood
When should a dog be typed? When should they be crossmatched?
Before the 1st transfusion and again if receiving a 2nd, then they must also be crossmatched to avoid hemolysis of transfused blood
T or F: Dogs have the same blood type for their whole lives.
False, dog blood types can change over time due to what they are exposed to
What blood types are currently identifiable?
DEA 1.1, 1.2, 1.3, 3, 4, 5 and 7
Which blood type can be identified by an in- house typing kit?
DEA 1.1 (+) only
What are the feline blood types?
A, B, and AB, and there is no universal donor for cats
What is the most common feline blood type?
- Type A
- 99% of all cats are A and 100% of Siamese, Burnese, and Tonkinese are A
What is the most rare feline blood type?
- Type AB
- While type B is still uncommon, it can be found in 1-10% of Main Coons as well as 11-22% of Abyssinian, Birman, and Persian cats
When should cats be typed and crossmatched?
Before receiving a transfusion to avoid hemolysis
What is crossmatching?
A blood test that detect serologic incompatibilities
When should a patient be crossmatched?
If a patient was transfused >4 days prior and if the transfusion history is unknown
What is a major crossmatch?
- Mixing of recipient serum with donor RBC
- Should be done if patient is to receive a RBC product
- If test fails, it means there is a problem with the recipient sample due to the antibodies present
What is a minor crossmatch?
- Mixing of donor serum with recipient RBC
- Should be run if patient is to receive whole blood or plasma
What is the recommended collection volume to be taken from a blood donor?
- It should not exceed 25% of total volume of animal’s blood
- Typically 400-450 ml of dog and 40-50 ml from cat
What are some possible transfusion complications?
- Hemolysis
- Allergic reactions
- Volume overload
- Septicemia
- Hypocalcemia
- Coagulopathy
- Disease transmission
What are some signs of transfusion reaction?
- Hyperthermia
- Tachypnea and tachycardia
- Agitation
- Hives
- Vomiting
- Hypotension
- Shock
- Death
What medications should be used to treat a transfusion reaction?
- Administer IV crystalloids
- Dexamethasone SP IV
- Benadryl IV
- Epiephrine IV prn
What are some common indications for transfusions in animals?
- Trauma hemorrhage
- Liver, bone marrow, auto immune disease
- Chronic anemia or renal failure
- Neoplasia
- DIC
- Rodenticide toxicity
