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Clinical II > Lecture Exam 1 > Flashcards

Lecture Exam 1 Flashcards

1
Q

About how much water makes up the body’s weight?

A

60%, which is all dependent on age, sex and degree of obesity is applicable

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2
Q

What are the different fluid compartments in the body?

A
  • Intracellular
  • Extracellular
  • Transcellular
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3
Q

What is considered part of the intracellular compartments?

A
  • 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
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4
Q

What is considered part of the extracellular compartments?

A
  • All fluids outside the cells
  • Makes up about 20% of body weight
  • Separated by a capillary membrane
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5
Q

What fluids are included in the extracellular compartments?

A
  • 3/4 interstitial fluid

- 1/4 extracellular fluid in blood plasma

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6
Q

What is the Gibbs-Donnan Effect?

A

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

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7
Q

What is considered part of the transcellular compartments?

A
  • Includes synovial, peritoneal, pericardial, intraocular and cerebrospinal fluids
  • Specialized body fluids that make up <1% of body weight
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8
Q

How is fluid exchange between compartments regulated?

A

Through osmosis

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9
Q

What is osmosis?

A

The net diffusion of water from a regent of high water concentration to one that has a low water concentration

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10
Q

What is plasma osmolarity?

A

About 280-302 mOsm/L and is based on the amount of particles in suspension

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11
Q

What is osmotic pressure?

A

The precise amount of pressure that is required to prevent osmosis

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12
Q

What are the different kinds of osmotic pressures?

A
  • Isotonic
  • Hypertonic
  • Hypotonic
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13
Q

What is isotonic pressure?

A
  • The cell is normal and the concentration of fluid is equal to that of plasma
  • No net loss or gain
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14
Q

What is hypertonic pressure?

A

The cell shrinks due to the fluid concentration being greater than that of plasma

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15
Q

What is hypotonic pressure?

A

When the cell expands due to the concentration of fluid being less than plasma

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16
Q

What organ in the body is the most important organ to maintain water balance and hemostasis?

A

The kidney

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17
Q

What is the minimum systolic blood pressure for the kidney to remain working?

A

Blood must enter the glomerular capillaries at about 70 mm Hg to function properly

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18
Q

What is the functional unit of the kidney?

A

The nephron

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19
Q

What is the order of renal blood supply?

A

Renal artery > interlobar artery > arcuate artery > interlobular artery > intralobular artery

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20
Q

What are the clinical signs of a urinary tract disorder?

A
  • Pollakiuria
  • Incontinence or inappropriate urination
  • Dysuria or stranguria
  • Hematuria
  • Polyuriria and polydipsia
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21
Q

What are the different kinds of urinary tract disorders?

A
  • Lower urinary tract infection
  • Urolithiasis
  • Urinary tract obstruction
  • Feline lower urinary tract disease
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22
Q

What is a UTI?

A

Microbial colonization of the urinary bladder and/or proximal portion of the urethra

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23
Q

What animals are affected by UTI’s?

A
  • 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
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24
Q

Is it normal to find bacteria is an animal’s urinary tract?

A

Some bacteria is normal to find in a dog, but there should be no bacteria found in a cat’s urinary tract

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25
Q

What is the range for culture abnormalities of colony forming bacteria in a urine culture for a dog?

A
  • Cystocentesis: > 1,000
  • Catheterization: > 10,000
  • Voided: > 100,000
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26
Q

What is the range for culture abnormalities of colony forming bacteria in a urine culture for a cat?

A
  • Cystocentesis/Catheterization: > 1,000

- Voided: > 10,000

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27
Q

What is the most common cause of a UTI?

A

Aerobic bacteria

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28
Q

What are the most common (>50 %) bacterias responsible for UTI’s?

A

E. Coli, staph and proteus

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29
Q

What are some less common types of bacteria responsible for UTI’s?

A

Streptococcus, klebsiella, enterobacter, pseudomonas, cornynacterium

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30
Q

What kinds of bladder stones are canine’s prone to?

A
  • Struvites
  • Calcium oxalate
  • Purines
  • Urates
  • Cystines
  • Silicas (Jacks)
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31
Q

What are the common bladder stones of felines?

A
  • Struvites
  • Calcium oxalate
  • Urates
  • Cystines
  • Silicas (Jacks)
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32
Q

What breed of dog are over represented for purine and urate bladder stones?

A

Dalmatians

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33
Q

What are the main causes of bladder stones?

A
  • 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
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34
Q

What causes the supersaturation of urine?

A
  • Increased dietary intake of crystal-producing minerals
  • Reduced solubility of crystals due to pH
  • Concentrated urine enhancing crystal concentration
  • Congenital abnormalities
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35
Q

What causes delayed passage of crystals through the urinary tract?

A
  • 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
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36
Q

What would cause the reduction of normally present crystal growth inhibitors in the bladder?

A

The presence of extra citrate or phosphorus

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37
Q

What breeds are more prone to struvite bladder stones?

A

Female mini schnauzers, dachshunds, poodles, scottish terriers, beagles, pekingese, and corgis as well as any female breed of cats

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38
Q

How can bladder stones be treated?

A

Urohydropropulsion, shockwave lithotripsy, cystotomy or medical dissolution

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39
Q

Which type of bladder stones can NOT be treated by medical dissolution?

A

Calcium oxalate stones

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40
Q

How can struvite bladder stones be prevented?

A

By the promotion of a more acidic urine with drugs such as methionine and ammonium chloride or with a acidifying, magnesium restricted diet

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41
Q

What breeds are more prone to calcium oxalate bladder stones?

A

Male mini schauzers, lhasa apsos, and yorkies, as well as male himalayan and persian cats

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42
Q

How can calcium oxalate bladder stones be prevented?

A

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

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43
Q

What causes urate bladder stones?

A

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

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44
Q

What breeds are more prone to urate bladder stones?

A

Dalmatians and english bulldogs as well as mini schnauzers and yorkis which are at risk for liver shunts

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45
Q

How can urate bladder stones be prevented?

A

With a low purine, alkalinizing diet

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46
Q

What is a urinary tract obstruction?

A

Restricted urine flow from the kidneys through the urinary tract to the external urethral orifice

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47
Q

Which gender is more prone to urinary tract obstruction?

A

Males due to the anatomical distance from the bladder to the urethra

48
Q

What is a clinical sign of urinary tract obstruction?

A

Elevation of uremia, which is a nitrogenous waste compound that is normally eliminated by the kidneys

49
Q

What are some causes of urinary tract obstruction?

A
  • 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
50
Q

What is the most common obstruction site in the urinary tract?

A

The urethra

51
Q

How should a urinary obstruction be treated?

A

As a medical emergency because it can be life threatening

52
Q

What is feline lower urinary tract disease aka FLUTD?

A

A term to describe a variety of conditions that affect the bladder and urethra of cats

53
Q

What are the signs of FLUTD in a cat?

A

Cats with FLUTD most often show signs of difficulty and pain when urinating, increased frequency of urination, and blood in the urine

54
Q

What is idiopathic cystitis?

A

Non-infectious, inflammatory lower urinary tract disease which often resolves itself regardless of treatment with stress playing an important part in flare ups

55
Q

What is the aim of transfusion medicine?

A

To save the lives of patients through the safe use of blood products

56
Q

What are some examples of blood products?

A
  • Whole blood
  • Packed RBC
  • Fresh frozen plasma
  • Frozen plasma
  • Platelet rich plasma
  • Platelet concentrate
  • Oxyglobin
57
Q

What is the purpose of whole blood transfusion?

A

It provides RBC’s to carry oxygen to tissue

58
Q

What is whole blood?

A

A natural colloid volume expander that provides a source of proteins and coagulation factors to a patient

59
Q

What does fresh whole blood contain?

A

RBC’s, plasma proteins and ALL clotting factors

60
Q

What does stored whole blood contain?

A

RBC’s, plasma proteins and stable clotting factors but NO platelets or coagulation factors V or VIII

61
Q

What is the refrigerated shelf life of whole blood?

A

Up to 35 days

62
Q

What is packed RBC’s?

A

Whole blood that is prepared by special centrifuge separation in a bag of red cells from the plasma

63
Q

What is the purpose of PRBC’s?

A

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

64
Q

What is the PCV range of a bag of PRBC’s?

A

70-80% while a normal PCV is 30-50%

65
Q

What is the refrigerated shelf life or PRBC’s?

A

21-42 days depending on the anticoagulant used to prepare

66
Q

What is the preferred anticoagulant for PRBC’s?

A

Acid Citrate Dextrose Solution

67
Q

Do PRBC’s need to be diluted any further?

A

No because they are preserved with an additive solution, but if using fluids along with blood products, use 0.9 % saline

68
Q

What fluids should be avoided with using PRBC’s?

A

Calcium containing fluids such as LRS and hypotonic fluids such as D5W

69
Q

What is the dosage guide line for PRBC’s?

A

Dose = 80 (K9) or 70 (Fel) x BW (kg) x (desired PCV - patient’s PCV) / donor PCV

70
Q

What is fresh frozen plasma?

A

Plasma that has been separated from whole blood through centrifugation within 8 hours of collection of whole blood

71
Q

What does FFP contain?

A

All coagulation factors and plasma proteins, fats, carbohydrates and minerals

72
Q

What should the PCV of FFP be?

A

<1% of RBC

73
Q

What is FFP used for?

A

To aid in controlling bleeding patients who need coagulation factors, volume expansion, and proteinemia

74
Q

How should whole blood and PRBC’s be thawed?

A

Allowed to sit on a counter to come to room temperature or use warm water bath to slowly warm

75
Q

What is the refrigerated shelf life of FFP?

A

1 year

76
Q

What is the dose for FFP and FP?

A

10-15 ml/kg

77
Q

How should FFP, FP and cryoprecipitate be thawed?

A

In a 37C water bath in a waterproof plastic bag

78
Q

What is the transfusion rate of FFP?

A

Over 8-12 hours for a vWb patient, and begin 1 hour prior to anesthesia to activate platelets with a standard blood administration set

79
Q

What is frozen plasma?

A

Plasma that has been separated from whole blood through sedimentation or centrifugation no later than 5 days after the expiration of whole blood

80
Q

What does FP contain?

A

Only Vitamin K dependent coagulation factors, albumin and immunoglobulins

81
Q

What is FP used for?

A

Treating rodenticide poisoning, colostrum replacement, hypoproteinemia and severe burns

82
Q

What is the refrigerated shelf life of FP?

A

5 years

83
Q

What is platelet rich plasma?

A

Prepared from whole blood by centrifugation at a slower rate than for plasma allowing the platelets to be suspended in plasma

84
Q

What is PRP used for?

A

Treatment of cases of thrombocytopenia with decreased platelet production

85
Q

What is the shelf life of PRP?

A

Very brief as it should be transfused within hours of collection and should NOT be refrigerated as it inactivates platelet function

86
Q

What is platelet concentrate?

A

It contains high platelet concentration as well as frozen plasma and 5 ml of preservative Dimethyl sulfoxide (DMSO)

87
Q

What is the frozen shelf life of PC?

A

6 months, and thaw by allowing to come to room temperature naturally, not by water bath

88
Q

What is cryoprecipitate?

A

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

89
Q

What is cryoprecipitate used to treat?

A

Inherited coagulopathies and von Willebrand’s crisis with a dose of 1 unit/kg that can be repeated BID

90
Q

What is the frozen shelf like of cryoprecipitate?

A

1 year

91
Q

What is oxyglobin?

A

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

92
Q

What is oxyglobin used to treat?

A

Anemia due to its volume expanding factor, and is not recommended in patients where volume overload is a concern (such as heart condition patients)

93
Q

What are some conditions to remember when using oxyglobin?

A
  • 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
94
Q

What is the stored room temperature shelf life of oxyglobin?

A

3 years, and it is labeled for dog use only, although it can be used in cats, ferrets and birds

95
Q

What is DEA?

A
  • Dog erythrocyte antigen aka canine blood types

- Composed of protein chains that live on RBCs

96
Q

How many DEAs are currently noted? What is considered a dog’s universal donor?

A

13, with DEA 4 being the universal donor

97
Q

What is the most commonly found DEA?

A

DEA 1.1 (-) and DEA 1.2 (-) and are considered the next best universal donor after DEA 4

98
Q

What is the second most commonly found DEA?

A

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

99
Q

When should a dog be typed? When should they be crossmatched?

A

Before the 1st transfusion and again if receiving a 2nd, then they must also be crossmatched to avoid hemolysis of transfused blood

100
Q

T or F: Dogs have the same blood type for their whole lives.

A

False, dog blood types can change over time due to what they are exposed to

101
Q

What blood types are currently identifiable?

A

DEA 1.1, 1.2, 1.3, 3, 4, 5 and 7

102
Q

Which blood type can be identified by an in- house typing kit?

A

DEA 1.1 (+) only

103
Q

What are the feline blood types?

A

A, B, and AB, and there is no universal donor for cats

104
Q

What is the most common feline blood type?

A
  • Type A

- 99% of all cats are A and 100% of Siamese, Burnese, and Tonkinese are A

105
Q

What is the most rare feline blood type?

A
  • 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
106
Q

When should cats be typed and crossmatched?

A

Before receiving a transfusion to avoid hemolysis

107
Q

What is crossmatching?

A

A blood test that detect serologic incompatibilities

108
Q

When should a patient be crossmatched?

A

If a patient was transfused >4 days prior and if the transfusion history is unknown

109
Q

What is a major crossmatch?

A
  • 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
110
Q

What is a minor crossmatch?

A
  • Mixing of donor serum with recipient RBC

- Should be run if patient is to receive whole blood or plasma

111
Q

What is the recommended collection volume to be taken from a blood donor?

A
  • It should not exceed 25% of total volume of animal’s blood

- Typically 400-450 ml of dog and 40-50 ml from cat

112
Q

What are some possible transfusion complications?

A
  • Hemolysis
  • Allergic reactions
  • Volume overload
  • Septicemia
  • Hypocalcemia
  • Coagulopathy
  • Disease transmission
113
Q

What are some signs of transfusion reaction?

A
  • Hyperthermia
  • Tachypnea and tachycardia
  • Agitation
  • Hives
  • Vomiting
  • Hypotension
  • Shock
  • Death
114
Q

What medications should be used to treat a transfusion reaction?

A
  • Administer IV crystalloids
  • Dexamethasone SP IV
  • Benadryl IV
  • Epiephrine IV prn
115
Q

What are some common indications for transfusions in animals?

A
  • Trauma hemorrhage
  • Liver, bone marrow, auto immune disease
  • Chronic anemia or renal failure
  • Neoplasia
  • DIC
  • Rodenticide toxicity

Clinical II (11 decks)

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