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Flashcards in Blood Products Deck (157):
1

What are the three kinds of blood products?

Whole + Plasma + Platelets

2

Products: Whole blood

Fresh or Stored = Packed RBC's

3

Products: Plasma

Fresh frozen plasma
-- and --
Cryoprecipitate

4

Products: Platelets

Fresh whole blood
Platelet rich plasma
Cyroperserved platelets
Lyophilized platelets

5

What is the dose for whole blood?

1ml per pound per point PCV

6

How much crystalloid isotonic fluid needs to be given to off set loss of 100 ml of water?

300 ml of crytalloids

7

What is within whole blood?

RBC's + WBCs + Clotting factors + Albumin + Platelets

8

What happens when you refrigerate whole blood?

WBCS + Platelets become non-functional

9

When should whole blood be given?

Anemia + Hypoproteinemia + Thrombocytopenia

10

What is within packed RBC's?

RBCs + Small amount of plasma + Anticoagulant

11

How much packed RBCs does 450 ml whole blood give?

200 ml

12

What is the dose for packed RBCs?

6 to 10 ml/kg

13

What is the reason for giving packed RBC's?

Clinically symptomatic anemia

14

How soon after collection does fresh plasma need to be frozen

8 hours

15

When is fresh frozen plasma used?

replace coagulation factors + immunoglobulin is needed
Acquired disorders
Inherited factor deficiencies

16

What should fresh frozen plasma not be used for?

Volume expansion

17

What is the dose for fresh frozen plasma?

6 to 10 ml/kg

18

What is within fresh frozen plasma?

All clotting factors

19

What is the shelf life of fresh frozen plasma?

Normal freezer = 3 months
-30 = 1 year

20

What is cyroprecipitate?

White precipitate forms after thawing fresh plasma

21

What is contained within cryoprecipitate?

vWF + clotting factors 13 + 8

22

What is a clinical disease that cyroprecipitate is best for?

von willebrand's disease

23

What is the dose for cryoprecipitate?

1 unit per 10 kg BW

24

What are the indications for a platelet transfusion?

Uncontrolled/Life-threatening hemorrhage
Severe thrombocytopenia + thrombopathia

25

Why are many units of platelets needed?

Rapidly destroyed by IMTP + DIC

26

What is the dose for platelet transfusion?

1 unit per 10 kg BW

27

What is oxyglobin?

Ultrapurified, polymerized hemoglobin of bovine origin in LRS

28

What does giving oxyglobin do?

Increase oxygen carrying capacity of blood
Delivers more oxygen to damaged tissues

29

What is the max dose of oxyglobin?

30 ml/kg

30

What is a blood type?

RBC alloantigen, usually to membrane glycolipid

31

How many blood types do dogs have?

13

32

What are the strongest dog blood types immunologically?

1.1 + 1.2

33

What does it mean to be a canine universal donor?

Negative for DEA 1.1 + 1.2 + 7

34

What are the feline blood types?

A + B + AB

35

What is the dominant feline blood type?

A

36

What donors can be allowed for a cat with AB?

A + AB

37

Why are transfusions so dangerous in cats?

Naturally occurring alloantibodies to Type A or B cells
Blood typing is a must before a transfusion

38

What is the most common feline blood type in the US?

A (99%)

39

What is the equine universal donor?

There is none

40

How many blood types do horses have?

Seven

41

What are the most immunogenic horse blood types?

Aa + Qa

42

What are the best breeds of horses for being a blood donor?

Standardbred
-- or --
Quarter horse geldings

43

Why should mares be avoided with blood transfusions?

Can develope blood type alloantibodies during pregnancy

44

How many blood types do cattle have?

11 blood types

45

What is J antigen? What animals is it in?

Cow + Goat
Lipid found in body fluid and is absorbed onto erythrocytes

46

Do newborn calves have J antigen?

No, get it around 6 months of age

47

How many blood types do sheep have?

7

48

How many blood types do goats have?

5

49

How much must a dog weight to be a donor?

over 27kg

50

What are dog blood donors screened for?

E. Canis
B. Canis
Dirofilaria
RMSF
Lyme

51

What breed of dog is the best donor? Why?

Greyhounds
High hematocrits + Easy to get to jugular

52

What is the age range for dog donors?

1 to 10 years old

53

What is the weight requirement of a cat to be a blood donor?

over 5 kg

54

What are cat blood donors screened for?

FeLV
FIV
Bartonella henslea
Hemobartonella felis

55

What workups are done routinely on both dog and cat blood donors?

Complete PE each donation
CBC/chem + fecal yearly
Vaccinated on schedule
Heartworm testing + treatment

56

How is blood donated from dogs?

No sedation - Blood bag (gravity flow)

57

How is blood donated from cats?

Sedation (AVOID ACE)
- may affect platelet function
Use peripheral vein

58

What is the donation limit for both a cat and a dog?

only once in a 3 week time period

59

What is a storage lesion?

Adverse biochemical changes in stored RBCS
Decreased: ATP - pH - 2,3-DPG
Increased: Lactic acid

60

What is the preservative put into stored blood?

CPDA-1

61

How long can whole blood be stored with CPDA?

35 days

62

Why can't heparin be used with whole blood?

Inactivates platelets

63

How long does Packed RBC's last?

21 days with CPDA-1

64

How long does fresh frozen plasma last?

1 year

65

What two tests can be done for cross matching?

Hemolysis + Agglutination

66

Term: Major crossmatch

Alloab's in recipent's plasma against donor

67

Term: Minor crossmatch

Alloab's in donor's plasma against recipent

68

Who must have typing and crossmatching before a transfusion?

CATS

69

What are the big four DO NOTS in transfusions?

Add any medications
use calicum-containing solutions
Hyper/Hypotonic solutions
Use glass containers

70

What does calcium solutions do to blood?

Coagulation

71

What happens with the use of hyper/hypotonic solutions during a transfusion?

RBC's rupture

72

Why can glass containers be used in blood transfusions?

Activates platelets + clotting factors
Decreases ATP + 2,3-DPG
Increases risk for air embolism

73

What are the two ways which transfusions can occur?

IV
-- or --
Intraosseous

74

When would an intraosseous transfusion be done?

Young animals
-- or --
Vascular collapse

75

How should the transfusion be started?

If massive hemorrhage is occurring give blood as fast as possible
otherwise -
0.25ml/kg for first 30 min w/ TPR every 5 to 10

76

If there is no signs of reaction what is the next step in the transfusion process?

Increase hourly rate to whatever it will take to give the unit in four hours
TPR every 30 min

77

What is the signs of volume overload?

Tachypneic + Dyspneic + Tachycardic
Fluid from the nose

78

What is the dosing for Plasma/

4 to 6 ml/min

79

What are the tests done post-transfussion?

PCV/TS
Blood lactate
Vitals

80

What is an acute immunologic transfusion reaction?

Acute hemolytic reaction

81

What is a delayed immunologic transfussion reaction?

Post-transfusion purpura

82

What is transfusion associated fever?

increase in 1 degree F from pre-transfusion temp

83

What happens if a transfusion reaction occurs?

Stop transfusion!
TPR
Maintain venous access
Short acting glucocorticoids + Diphenhydramine + Oxygen

84

What are the contraindications for a blood transfusion?

Previous transfusion
Unable to cross match a cat
Chronic severe anemia
Cardiopulmonary disease

85

What is the protocal for an animal with cardiopulmonary disease that needs a transfusion?

Packed RBCs
Dont go over the rate of 4 ml/kg/hr
pre-med with diuretic

86

When are clinical signs of post-operative hemorrhage finally visiable?

25 to 30% blood volume loos

87

What are the signs of post-operative hemorrhage?

Tachycardia
Hypotension
Prolonged CRT

88

What are complications with the patient that can impede in coagulation?

Hepatic disease
Splenectomy
Post-operative peritonitis
Doberman pinchers
IMTP
IMHA
Rat poisoning

89

What is the most common coagulopathy in dogs?

Von Willebrand's disease

90

What is the highest occurance, what breed?

Dobermans
German shephards
Standard poodles
Shetlands
Goldens

91

What is von willenbrand factors function?

Plasma glycoprotein needed for normal platelet adhension to sub-endothelium

92

What does vWF carry?

F8

93

What happens when there is a def. in vWF?

Defective platelet adhesion + Aggregation

94

What type of genetic mutation is vWF disease?

Autosomal trait

95

Describe: vWF Type 1

Reduced concentrations of vWF

96

Describe: vWF Type 2

Loss of high molecular weight vWF multimers

97

Describe: vWF Type 3

Complete absence of vWF, most severe

98

Which vWF disease type is most common?

Type 1

99

What is the definitive diagnosis for vWF disesase?

Determination of vWF via ELISA

100

What is the treatment for vWF disease?

Cryoprecipitate
levels will remain elevated for 4 hours

101

What is DIC?

Disseminated intravascular coagulation
Systemic activation of coagulation pathway

102

What is seen with DIC within the body?

Compromised organ perfusion
Organ failure
Hypocoagulable state
Thrombosis + Hemorrhage

103

What is causing the symtoms seen in DIC?

Widespread microvascular thrombosis
Exhaustion of platelets and coagulation factors

104

What is the mortality rate of DIC in cats?

93%

105

What is the mortality rate of DIC in dogs?

50 to 77%

106

What are the two main causes of DIC?

Infectious
-- and --
Non-infectious

107

What are infectious possibilities for DIC?

Bacterial + Viral + Protozoal + Fungal

108

What are the most common causes of DIC in dogs?

Sepsis
-- and --
SIRS

109

What is the clinical signs of DIC?

VARY - from organ failure to hemorrhage

110

Which, organ failure or hemorrhage, is the most common presentation of DIC?

Organ failure

111

What are the common signs of organ dysfunction?

Renal failure
Respiratory insufficency
Hepatic failure
Gi compromise

112

What gold standard test for DIC?

None, no absolute diagnostic existis

113

How do you diagnosis a dog with DIC?

Underlying condition with 3 of the following:
Thrombocytopenia
Prolonged PT +/- PTT
Elevated D-dimers
Hypofibrinognemia

114

What is the management protocol for DIC?

Aggressive and early
Support organs susceptible to ischemia
Treat underlying condition
Remove ischemic/necrotic tissue
Immunosuppressive thearpy

115

What organs are most sensitive to ischemia?

Kidneys + Lungs + GI

116

What are the six componetnts to ICU therapy of DIC?

Fluids
Oxygen
Enteral nutrition
Antacids/Antibiotivs
Blood transfusion
Heparin

117

What occurs with rodenticide toxicity?

Block vitamin K metabolism = inability to produce dependent clotting factors

118

What are the vitamin k dependent clotting factors?

2 - 7 - 9 - 10

119

What are the two agent categories that can cause rodentacide posioning?

First generation - Warfarin
Second generation - Brodifacoum

120

How do first generation rodentacides work?

less toxic
Need to intake several dose over several days to be toxis

121

How do second generation rodentacides work>

lethal after first ingestion

122

What are the two forms of primary hemostasis?

Thrombocytopenia
-- and --
Thombopathia

123

What can cause thrombocutopenia?

Decreased production (Drug, viral, radiation)
Increased destruction (IMTP)
Consumption (DIC_

124

What can cause thrombopathia?

Acquired: Drugs - hepatic disease + Snake venom + DIC
Congenital: vWD

125

What is seen generally with primary hemostasis disorders?

Decreased platelet numbers or desfunction
Ecchymosis + Spontaneous bleeding

126

What is seen generally with secondary hemostasis disorders?

Low concentration of coagulation factors
Hematomas + Spontaneous belleding into sub-q

127

What is different about acquired disorders?

Affect primary and secondary

128

What are examples of acquired secondary hemostatic disease?

Vitamin K def.
DIC
Hemodilution
Sever hypothermia
Shock
Massive trauma

129

What are examples of Congenital secondary hemostatic diseases?

vWD
Hemophilia A

130

What breed of dog gets hemophila A?

German shephard

131

What breed of dog gets vWF disease?

Doberman's

132

Term: Thrombocytopenia

Decreased platelet number

133

Term: Thrombopathia

Dysfunction

134

What are diagnostic tests for coagulopathies?

Platelet count
Buccal bleeding time
PT/PTT
ACT
Fibrnogen
FDP
D- dimers

135

Term: Pseudothrombocytopenia

Artifact, falsely low platelet count
Platelet aggregation or clumping

136

What is buccal mucosal bleeding time?

Duration of hemorrhage resulting from small standardized injury

137

What is the normal bleeding time for a dog?

1.7 to 4.2 minutes

138

What is the normal bleeding time for a cat?

1.4 to 2.4

139

What does the buccal mucosal bleeding time tell you?

Relfects in vivo PRIMARY hemostatsis

140

Term: PTT

Prolongation = defect in intrinsic +/- common pathway

141

Term: PT

Prolongation = Defect in extrinsic +/- commmon pathway

142

Term: ACT

Activated clotting time
Whole blood in tube with clay --> acitvates F8
Time till first clot

143

What is a normal ACT for dog?

144

What is a normal ACT for cat?

145

What is the importance of fibrinogen?

End point of all assays - PT + pTT + ACT

146

What is considered severely decreased fibrinogen?

147

What is normal fibrinogen?

200 to 300

148

What is fibrinogen? (class of molecule)

Acute phase protein

149

What is occurring if there is an increased level of fibrinogen?

Inflammation

150

What are FDPs?

Fibrinogen degradation products
Plasmin lysiss fibrinogen + fribin + cross-linked fibrin

151

What does FDP indicate?

Plasmin activation

152

What does elevated concentrations mean?

Increased fibrinolysis

153

What is occurring symptomatically with increased FDP?

inhibited clotting + induced platelet dysfunction = bleeding

154

What is an elevated FDP suggestive of?

DIC + Neoplasia + Sepsis + Heatstroke + GDV + SIRS + IMHA

155

What is a D-dimer indicative of?

Acitvation of thrombin and plasmin

156

What is D-dimber an indicator for?

DIC + Thromboembolism in dogs

157

What are your medical vasoconstrictors?

Epi + Phenylephrine