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Small Animal Medicine > SA Med Transfusion CSV > Flashcards

SA Med Transfusion CSV Flashcards

1
Q

~

~Why do we transfuse patients?

A

Replace blood components

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2
Q

~

~When transfusing what are the main components of blood we use?

A

RBC’s

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3
Q

~

~What major Dz’s can be managed with transfusion therapy?

A

IMHA

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4
Q

~

~What is the minimum PCV that most anesthesiologist want for Sx?

A

22% for non-elective Sx

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5
Q

~

~What percent loss of blood volume can a healthy animal tolerate with out CS?

A

20%

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6
Q

~

~What is the blood volume of a dog?

A

90ml/kg

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7
Q

~

~With Peracute blood loss (with in minutes up to an hour) what change will you see in HCT?

A

No change in HCT

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8
Q

~

~After fluid shifts (ICF/ECF) in a blood loss event what happens to HCT?

A

Decrease

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9
Q

~

~What Dz conditions may result in a need for transfusion?

A

Anemia

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10
Q

~

~What test can be done to determine if there is a thrombocytopathia?

A

BMBT

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11
Q

~

~What is the #1 rule of transfusion therapy?

A

Give only what they need when they need it

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12
Q

~

~What is in whole blood?

A

All cellular & plasma components of blood

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13
Q

~

~What are they components therapy products available?

A

PRBC’s

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14
Q

~

~When you give whole blood to a pt what do they get?

A

RBC’s

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15
Q

~

~What are the indications for transfusing whole blood?

A

Combined RBC & Plasma deficiency

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16
Q

~

~What two Dz conditions occurring together call for transfusion of whole blood?

A

Anemia &

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17
Q

~

~When is whole blood considered fresh?

A

Used with in 8hrs of collection

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18
Q

~

~How long can whole blood be stored?

A

21-28days

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19
Q

~

~When is whole blood considered “stored”?

A

Used >8 after collection

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20
Q

~

~How is Packed Red Blood Cells processed?

A

450ml fresh whole blood stored in CPDA +/- optisol spun down to make 1unit = 250ml of PRBC’s

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21
Q

~

~When is transfusion with PRBC’s indicated?

A

Anemia!

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22
Q

~

~What are the 3 big clinical signs of Anemia?

A

Tachypnea

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23
Q

~

~When transfusing with PRBC’s why are you choosing this product?

A

Restore O2 carrying capacity

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24
Q

~

~How long can PRBC’s be stored?

A

about 42 days in refrigerator

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25
Q

~

~What are the three types of plasma available for transfusion?

A

Fresh

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26
Q

~

~When is Plasma considered Fresh?

A

Processed from 450mL of fresh whole blood and used within 6hrs of collection

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27
Q

~

~When is plasma considered FFP?

A

when used within 1yr of collection

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28
Q

~

~When is plasma considered just “frozen”?

A

When used > 1yr after collection

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29
Q

~

~How long can Plasma be frozen for after that first year?

A

4 additional years

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30
Q

~

~What is the max dose of plasma?

A

20ml/kg/day

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31
Q

~

~What does FFP have in it?

A

All coagulation factors & other proteins

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32
Q

~

~What can you NOT treat with a plasma transfusion (any kind)?

A

Hypoalbunemia - cant give enough to raise albumin levels adequately with out going over max dose

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33
Q

~

~Other than how long it has been frozen what is the difference between FFP & Frozen Plasma?

A

Frozen Plasma lacks coagulation factor 8

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34
Q

~

~What is the life span of refrigerated Platelets?

A

1 week

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35
Q

~

~What are the indications of giving platelets?

A

Thrombocytopenia —> Hemorrhage

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36
Q

~

~What is the best way to get funcitonal platelets to a pt?

A

Fresh Whole Blood

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37
Q

~

~What are the other options when giving platelets?

A

Cryopreserved platelets

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38
Q

~

~What is the issue with the “other” options to give platelets?

A

In Vitro function is either impaired or very short (hrs)

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39
Q

~

~What does Cryoprecipitate contain?

A

Fibrinogen

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40
Q

~

~What is one example of when you would give cryoprecipitate?

A

vWF/Hemophillic dog needing Sx

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41
Q

~

~What are the general indications for giving Cryoprecipitate?

A

Bleeding dogs w/ specific plasma protein defeciencies

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42
Q

~

~What does cryoprecipitate come from?

A

1 unit of Fresh Plasma spun again then frozen

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43
Q

~

~What is Cryo-poor plasma?

A

What is left after cryoprecipitate is made

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44
Q

~

~What is the indication for using Cryo-poor plasma?

A

She doesnt think there is one just use FFP if not needing specific Cryoprecipitate

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45
Q

~

~What types of Albumin are available in Vet Med?

A

Lyophilized canine albumin (5% & 16%)

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46
Q

~

~What are the clinical signs of low Albumin?

A

Edema

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47
Q

~

~What is the big risk with giving Human serum albumin to animals?

A

High risk of Anaphalaxis

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48
Q

~

~What are the indications for transfusing Albumin?

A

Raise Albumin levels in critically ill

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49
Q

~

~What other products do we have to give pt’s oncotic support?

A

Colloids

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50
Q

~

~What is a really good indication for transfusing Albumin?

A

Chronically Low BP that nothing else has helped

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51
Q

~

~What is the main risk of giving any biological transfusion product?

A

Hypersensitivity Reactions

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52
Q

~

~What options are available for transfusing Leukocytes?

A

Only Fresh Whole Blood due to their very short 1/2 life - generally not preformed

53
Q

~

~What is the signalment of animals can be used for blood donors?

A

Healthy

54
Q

~

~What specific tests results do you need for a blood donor?

A

PCV>35%

55
Q

~

~What is the most common component of anticoagulant solutions used in blood products?

A

Sodium Citrate

56
Q

~

~Why is Citrate so important in anticoagulant solutions?

A

Citrate chelates calcium —> inhibiting calcium dependent coagulaiton

57
Q

~

~What coagulation factor is Calcium?

A

Factor IV

58
Q

~

~What are the two main anticoagulant solutions for blood products?

A

ACD - Acid-citrate- dextrose

59
Q

~

~What does the Dextrose do in ACD/CPD?

A

Nutrition for RBC’s

60
Q

~

~What does Acid/Phosphate do in ACD/CPD?

A

Optimizes pH for RBC survival

61
Q

~

~What is the ratio to use for anticoagulant:blood when making blood products?

A

1:9

62
Q

~

~Should you sedate your blood donors?

A

No just keep calm

63
Q

~

~How should blood donors be positioned when giving blood?

A

Sternal or lateral recumbancy

64
Q

~

~What type of prep is used and what vein?

A

Sterile prep of Jugular Vein

65
Q

~

~What type of bag, where should the needle be & what type of procedure?

A

Anticoagulation Bag

66
Q

~

~How can you make sure you are getting exactly 450ml of whole blood in the bag?

A

Use a gram scale

67
Q

~

~How many blood types of dogs are there?

A

More than a dozen

68
Q

~

~Do dogs have natural alloantibodies to blood types?

A

NO!

69
Q

~

~How can you identify a dog’s antigen group?

A

Serological testing

70
Q

~

~With Dog kennel side blood typing tests what are we testing for?

A

(+ or -) for DEA type 1 antigens

71
Q

~

~What is the most common blood antigen in dogs?

A

1.1 62% have it

72
Q

~

~What are the other types of DEA that you would want to test for in donors?

A

3

73
Q

~

~Which dogs most commonly have DEA types 3 & 5?

A

Greyhounds & Japanese breeds

74
Q

~

~What is interesting about DEA type 7?

A

It is a circulating antigen and attaches to RBC instead of being integrated into cell membrane

75
Q

~

~What is DAL?

A

DAL system is prevalent in Dalmations & Antibodies to DAL produce acute reactions in dogs with out it

76
Q

~

~How do you test for DEA types other than 1?

A

Send out serology cannot do in house

77
Q

~

~What are the three feline blood types?

A

A

78
Q

~

~Do cats have naturally occurring alloantibodies what does this mean?

A

YES! This means you must always test donors & recipients even on their 1st transfusion

79
Q

~

~What type of alloantibodies do cats with Type A blood have?

A

Weak “anti-B” antibodies - they will have a reaction if given type B blood

80
Q

~

~What type of alloantibodies do cats with Type B blood have?

A

Strong “anti-A” antibodies - they can die if given type A blood

81
Q

~

~What type of alloantibodies do cats with Type AB blood have?

A

None! They are universal recipients of PRBC’s (not whole blood)

82
Q

~

~What antibody type is primarily responsible for hemagglutination reactions?

A

IgM

83
Q

~

~What antibody type is primarily responsible for hemolytic reactions?

A

IgA or IgM

84
Q

~

~What cat breeds all have type A blood?

A

Siamese

85
Q

~

~What cat breeds have the less common type B blood?

A

British breeds (but not all of them)

86
Q

~

~What is Neonatal isoerythrolysis?

A

Kittens w/ type A or AB born to queen w/ type B —> get alloantibodies against there blood from milk —> Anti-A antibodies cause hemolysis & possibly death

87
Q

~

~What can be done to prevent Neonatal isoerythrolysis?

A

Test Queen & Tom if she is B & he is A/AB then do not let kittens nurse (hand rear them)

88
Q

~

~What are the 2 steps to confirming compatibility of blood donor/recipeint?

A
  1. Obtain blood type
89
Q

~

~When obtaining blood type what do you do?

A

Test for type

90
Q

~

~When determining if there are circulating antibody specific for blood types not expressed by recipient RBC’s what do you do?

A

Major & Minor cross match test

91
Q

~

~What are the two types of blood typing tests available cage side that give instant results?

A

Card style agglutination test

92
Q

~

~What is a major crossmatch TQ?

A

Assesses compatibility between DONOR RBC’s & patient/recipient PLASMA/SERUM

93
Q

~

~What is a minor crossmatch TQ?

A

Assesses compatibility between DONOR PLASMA/SERUM & patient/recipient RBC’s

94
Q

~

~Does compatible cross matching rule out the possibility of an adverse transfusion reaction?

A

NO!

95
Q

~

~What does cross matching determine?

A

Serological compatibility

96
Q

~

~What specifically is cross matching testing for?

A

Natural alloantibodies (cats)

97
Q

~

~What are you looking for in a cross match test?

A

Hemolysis &/or Agglutination

98
Q

~

~What is the difference between rouleaux formation and Agglutination?

A

Rouleaux - RBC’s stacked like coins

99
Q

~

~Is there a magic PCV level that automatically indicates transfusion?

A

No based on CS & Judgement of pt/case

100
Q

~

~When should you transfuse Plasma?

A

Severe bleeding due to a factor deficiency

101
Q

~

~When should you transfuse component replacements?

A

Deficit causing clinical signs

102
Q

~

~How do you transfuse blood products?

A

Wear Gloves!

103
Q

~

~What is the Rate at which you should infuse blood products?

A

0.25-1ml/kg/hr for 1st 20 minutes

104
Q

~

~How long can blood products sit at room temp before they must be discarded?

A

No more than 4 hrs

105
Q

~

~When will acute reactions occur during transfusion?

A

With in the first 20 min!

106
Q

~

~What should you monitor & what indicated a reaction during transfusion?

A

Mentation —>dull/obtunded

107
Q

~

~How often should you monitor during transfusion?

A

Every 5min for the first 30 then every 15 until done

108
Q

~

~What are two types of Autologous transfusions?

A

Planned self transfusion

109
Q

~

~When would you do a planned self transfusion?

A

When Sx in planed a few wks in advance and you anticipate possible large hemorrhage

110
Q

~

~When would you do an Emergency Auto transfusion & how?

A

Blood salvaged intra-op or from body cavity

111
Q

~

~When will you NEVER do an emergency Auto transfusion?`

A

NOT neoplastic effusions (like ruptured HSA)

112
Q

~

~What are the most common types of immunologic transfusion reactions?

A

Acute Hemolytic

113
Q

~

~What are the less common types of immunologic transfusion reactions?

A

Delayed

114
Q

~

~What is an immunologic acute hemolytic transfusion reaction & CS?

A

T2 hypersensitivity

115
Q

~

~What is an immunologic acute Non-hemolytic transfusion reaction & CS?

A

T1 hypersensitivity

116
Q

~

~What is an immunologic delayed transfusion reaction & CS?

A

Extravascular hemolysis 2-21 days post

117
Q

~

~What is an immunologic Purpura transfusion reaction & CS?

A

Thrombocytopenia 1 wk post

118
Q

~

~What are non immunologic transfusion reaction?

A

Anaphylactoid

119
Q

~

~What is an Anaphylactoid non-immunologic transfusion reaction & CS?

A

Too rapid infusion

120
Q

~

~What is a TACO non-immunologic transfusion reaction & what is it from?

A

Transfusion

121
Q

~

~When is Citrate Intoxication a big risk?

A

After massive transfusions

122
Q

~

~What qualifies as a massive transfusion?

A

Replacing the entire blood volume in 24hrs or

123
Q

~

~When is hyperammonemia or Acidosis transfusion reactions most common?

A

When using older blood products

124
Q

~

~What is treatment for transfusion reactions?

A

Stop/slow down

125
Q

~

~What is Oxyglobin?

A

Cell free bovine derived Hg

126
Q

~

~What is Oxyglobin used for?

A

Increase O2 & CO2 transport ONLY

127
Q

~

~What are some good things about it Oxyglobin?

A

Significant colloidal Effect

128
Q

~

~What is bad about Oxyglobin?

A

Not readily available

Small Animal Medicine (3 decks)

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