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Y3 MOD clinical pathology > Transfusion medicine > Flashcards

Transfusion medicine Flashcards

1
Q

How can you assess if a patient needs a blood transfusion?

A
  • Based on clinical signs

- Signs suggestive of reduced oxygen perfusion to tissues

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2
Q

What are some clinical signs of reduced oxygen perfusion to tissues?

A

Tachycardia
Tachypnoea
Lethargy
Weakness

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3
Q

Before a blood transfusion what needs to be assessed in terms of a patients circulating volume?

A

Need to be normovolaemic

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4
Q

Before transfusing following acute haemorrhage what needs to be considered?

A

Following acute haemorrhage, there is a lag-period (~24h) before a decrease in PCV is seen so the PCV of an acutely bleeding dog may not reflect its true oxygen carrying capacity

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5
Q

Which blood product should be used in:

  1. blood loss
  2. haemolysis
  3. coagulopathy
A
  1. Replace with whole blood
  2. Replace with packed red cells
  3. Replace with fresh frozen plasma, regular plasma, or cryoprecipitate depending on the cause
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6
Q

How do the components of the following differ:

  • whole blood
  • packed red cells
  • fresh frozen plasma
A
  • 60% plasma, 40% red cells
  • 20% plasma, 80% red cells
  • 99.9% plasma (clotting factors + VWF)
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7
Q

UK pet blood bank

- after 6 hours post collection there is no longer any … left in the blood product

A

Platelets

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8
Q

Describe how fresh frozen plasma is acquired, used and stored

A
  • Centrifuge whole blood within 6-8 hours of donation
  • It contains most clotting factors (including vWF) and thus can be used in the majority of coagulopathies
  • Has a shelf like of 1 year when frozen
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9
Q

Describe how frozen/regular plasma is acquired, used and stored

A
  • either plasma that has been acquired >6-8 hours after donation or fresh frozen plasma that is greater that has been stored for more than one year
  • it contains the majority of clotting factors although has reduced numbers of the labile clotting factors (V + VIII)
  • it does have the vitamin K dependent clotting factors (II, VII, IX, X) thus can be used in brodifacoum rodenticide toxicity
  • has a shelf life of 5 years
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10
Q

If you do not know a dogs blood type which should be administered?

A

DEA 1 -ve

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11
Q

If you do not know a cats blood type which should be administered

A

Imperative to give type-matched blood to cats prior to transfusion

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12
Q

Which hypersensitivity reaction is involved in blood transfusions?

A

Type II

- antibodies against the antigens on red cell surface membranes

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13
Q

Following a blood transfusion what will occur if your recipient has antibodies against the antigen on the donor RBCs?

A

There will be a haemolytic reaction – RBCs will be removed By the monocytic macrophage reaction of the spleen

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14
Q

Which blood canine blood type is the universal donor and why?

A

DEA 1-ve

- contain no antigens on their surface

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15
Q

What happens if a sensitised DEA 1-ve dogs receives DEA 1+ve blood?

A

If the sensitised recipient receives further red blood cells with the same antigen 3-5 days after the previous transfusion, then an acute haemolytic reaction occurs as the recipient already has auto-antibodies present.

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16
Q

What does DEA stand for?

A

Dog erythrocyte antigen

17
Q

What will be the reaction of a DEA 1 +ve dog receive DEA 1-ve blood?

A

Will not demonstrated any signs and will not become sensitised

18
Q

What will be the reaction of a DEA 1 –ve dog receiving DEA 1 +ve blood?

A

Will have a very mild, delayed reaction but will subsequently become sensitised

19
Q

Which dog breed usually has DEA 1-ve blood and makes good donors?

A

Greyhounds

20
Q

Describe the blood typing system in cats

A

Based on the A/B system with A being dominant to B and AB being polygenic – most cats are type A

21
Q

Why is it imperative to blood type match cats?

A

They can have a fatal acute haemolytic reaction due to the presence of naturally occurring auto-antibodies

22
Q

Giving type B cats type A blood is?

A

BAD – severe acute haemolytic reaction

23
Q

Giving type A cats type B blood is?

A

not As Bad – milder, delayed reaction

24
Q

How can you blood type a patient?

A
  • Card or cassette based method
  • A line at both the DEA 1 and Control line = DEA 1 +ve
  • A line at just the control line = DEA 1 -ve
25
Q

What is cross matching?

A
  • Detects more haematological (Type II HS) incompatibilities than typing
  • Blood typing will only detect DEA 1 and A/B, whereas cross matching will detect the majority of antibody-antigen incompatibilities
26
Q

Describe a major cross match

A

Recipient antibodies against donor red cells - haemolytic reaction, dont give blood

27
Q

Describe a minor cross match

A

Donor antibodies against recipient red cells - can still give blood

28
Q

When is it imperative to cross match a patient?

A

If they have had a previous transfusion

  • unless within the first 3-5 days after previous transfusion
  • the only way you can do it without cross matching is if you give it blood from the same donor
29
Q

How should you cross match a patient?

A
  • Laboratory method is gold standard
  • Straightforward but time-consuming manually
  • In-house gel based methods are inaccurate and not recommended
30
Q

How should a blood transfusion be administered?

A
  • Intra venous
  • Intra-osseous also acceptable (into bone marrow)
  • All products administered at a slow rate initially, building up thereafter
  • Maintaining sterility is vital as blood is an excellent growth medium for bacteria
31
Q

How fast should a transfusion be delivered?

A
  • 0.5-1ml/kg/hr for first 15-30 mins
  • Increasing to 4-6ml/kg/hr thereafter
  • Can be given as fast as possible in an emergency situation
32
Q

Why can an IV only be flushed with saline?

A

Calcium containing fluids can form clots

33
Q

When giving a transfusion what needs to be monitored in the patient?

A
  • signs of transfusion reactions during and after administration
  • HR, RR, temperature
  • signs of anaphylaxis such as swelling, urticaria, nausea, vomiting

Y3 MOD clinical pathology (10 decks)

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