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RUSVM Clinical Pathology > Transfusion Medicine > Flashcards

Transfusion Medicine Flashcards

1
Q

What kind of transfusion is given to patients suffering from hemorrhage, erythrocyte destruction, or decreased RBC production?

(anemia)

A

RBC transfusion

*Goal is to minimize destruction of donated RBCs

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2
Q

What kind of transfusion would be given to patients with Vit K agonist rodenticide toxicity, hemophilia, or DIC?

(coagulopathies)

A

Plasma transfusion

*Goal is to minimize destruction of recipient’s RBCs

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3
Q

You begin a blood transfusion on an anemic patient, and within a few minutes the patient has hemoglobinuria and hemoglobinemia. What should you do?

A

Stop the transfusion and begin supportive care!

This is an acute hemolytic reaction causing intravascular hemolysis. These reactions are severe.

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4
Q

You perform a blood transfusion on a hospital patient, and about 24 hours later you note yellow serum and bilirubin in the urine. What kind of reaction is this?

A

Delayed hemolytic reaction (extravascular hemolysis)

*No intervention needed. Monitor.

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5
Q

You begin a blood transfusion on a patient who develops a fever and facial swelling, and begins vomiting within 15 minutes of starting treatment. How should you proceed?

A

Decrease infusion rate

*This is a non-hemolytic hypersensitivity reaction. Can give diphenhydramine to alleviate symptoms.

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6
Q

Acute hemolytic reactions to blood transfusions, characterized by hemoglobinemia, ^HR, ^RR, weak pulse, hypoxia (tremors, convulsions), and vomiting can lead to what issues?

A

DIC, hypotension, shock, acute renal failure, death

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7
Q

How can we prevent transfusion reactions by identifying inherited antigenic proteins on the RBC surface?

A

Blood testing

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8
Q

How can we prevent transfusion reactions by identifying circulating antibodies in the plasma?

A

Cross-matching

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9
Q

When performing a blood typing on a dog, are we more worried about finding DEA 1 or DEA 4?

A

DEA 1

Highly immunogenic and causes severe reactions (agglutination and hemolysis). 65% of dogs have this gene.

(DEA 4 is in 98% of dogs and is non-immunogenic)

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10
Q

What blood antigen is present in 93% of dogs, requiring cross-matching of donors even if they have a compatible blood type?

A

Dal

*Look to dalmations to find a compatible donor

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11
Q

What are the 2 feline blood systems?

A

AB group (they’re either A, B, or both)

Mik system (most cats have this too)

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12
Q

T/F: Like dogs, cats can get one free transfusion without blood typing and cross-matching.

A

FALSE

Cats already have the Ab to the other blood antigen

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13
Q

A North American breed of cat has blood type A has been transfused with blood from a type B donor. What kind of reaction do you expect.

A

Not so bad. Type A cats have weak isoantibodies against type B antigen.

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14
Q

A British breed cat has blood type B and has been transfused with blood from a type A cat. What kind of reaction will this cat have?

A

SEVERE and lethal! Type B cats have strong isoantibodies against type A antigen.

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15
Q

If a blood type B queen is mated with a type A or AB tom, what consequence does this have for the kittens?

A

Risk of neonatal isoerythrolysis due to production of type A or AB kittens.

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16
Q

Why are some purebred cats universal recipients, but not donors?

A

They are blood type AB

17
Q

About 6% of cats don’t have the Mik antigen. These cats have anti-Mik alloantibodies and may suffer from an acute hemolytic reaction if transfused with blood from a Mik positive cat, even if the AB blood type matches. How can this be prevented?

A

Cross-match all donor/recipients prior to transfusion!

18
Q

T/F: Pre-existing isoantibodies in large animals are rare and single, un-crossmatched whole blood transfusions tend to be well tolerated.

A

TRUE

*Cross match for repeated transfusions or plasma transfusions.

19
Q

Large animal blood typing is impractical and transfusions are uncommon except in this species:

A

Equine

20
Q

Equines have 7 blood systems, each with multiple antigens, for over 400,000 combinations. Which antigens are highly immunogenic and are implicated in neonatal isoerythrolysis?

A

Aa and Qa

21
Q

What medical practice can sensitize a cow to foreign RBC antigens and may result in neonatal isoerythrolysis in calves?

A

Vaccinations of blood origin

22
Q

Repeated transfusions in large animals require what compatibility test to prevent reactions?

A

Crossmatching only! Too many blood types to even bother with typing (except horses)

23
Q

If a patient is given antiserum that has antibodies against RBC antigen A, and you see agglutination, what blood type is the patient?

A

Type A

24
Q

Blood from this donor is given to a DEA positive recipient. What kind of reaction will occur?

A

No reaction. This dog is DEA negative.

25
Q

Blood from this donor is given to a DEA negative recipient. What kind of reaction will occur?

A

Severe reaction! This donor is DEA positive.

26
Q

A crossmatch is the final test of compatibility between a donor and a patient prior to tranfusion. What components are tested in the major crossmatch?

A

Recipient’s serum and donor’s RBCs

27
Q

You perform a major crossmatch on a potential recipient and donor. Should you proceed with the transfusion?

A

No! The recipient has antibodies against the donor’s RBCs.

28
Q

Why are minor crossmatches rarely performed?

A

Test the recipient’s RBCs against the donor’s serum, but since the volume of serum transfused is usually low, there’s not enough Ab in the donor serum to cause a significant problem.

29
Q

You perform a crossmatch on 2 equine patients and see hemolysis in the glass tube. What kind of result does this indicate and should you proceed with the transfusion?

A

This is a positive result. DO NOT PROCEED.

30
Q

You are performing a crossmatch on 2 feline patients. There is no macro-agglutination in the glass tube and no agglutination present on the microscope slide. What kind of result is this and should you proceed with the transfusion?

A

This is a negative result. PROCEED.

31
Q

T/F: Crossmatching will detect even very low antibody titers.

A

FALSE

Doesn’t detect low titers, so reactions are not 100% preventable.

32
Q

While small animals have agglutinating antibodies, horses have:

A

Agglutinating and hemolytic antibodies

RUSVM Clinical Pathology (13 decks)

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