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Clinical Pathology - Exam 2 > Blood Transfusion & Crossmatching...and the Kidney > Flashcards

Blood Transfusion & Crossmatching...and the Kidney Flashcards

(65 cards)

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1
Q

What are the 2 Canine Blood Systems we care about?

A

DEA and DAl

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2
Q

What are the 5 DEA blood types we should know?

A

1.1, 1.2, 4, 6, and 7

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3
Q

What is so cool about DEA 1.1?

A

Highly Pathogenic - strong ! Makes up about 45% of the population

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4
Q

What is so cool about DEA 1.2?

A

Highly Pathogenic! Makes up about 20% of the population

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5
Q

What Blood types are the Universal DONORS for Canines?

A

DEA 4 & 6 are Non-Immunogenic and DEA 7 is Mildly Immunogenic!

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6
Q

What animal is the DAL Blood System in?

A

DALmatian

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7
Q

Dalmatians are at risk for acute and delayed onset of hemolytic transfusion reactions. - T/F

A

True.

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8
Q

What are the Feline Blood Types?

A

A
B
AB

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9
Q

T/F - All cats will carry an antigen from the B group, and most carry an MIK antigen.

A

FALSE! All cats carry an antigen from the AB group!

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10
Q

What is the most common blood type of a cat?

A

Type A - >95% of cats

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11
Q

Type B blood in feline is less common and in British breeds. What happens if you give a Cat with Type B blood, Type A plasma in a transfusion?

A

Severe and lethal transfusion reactions.

Risk of neonatal isoerythrolysis.

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12
Q

What blood type is the universal RECIPIENT for felines?

A

Type AB - usually found in purebred cats.

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13
Q

What large animal is it most practical to use blood typing in?

A

Horses

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14
Q

What large animals are the transfusion exception?

A

Horses

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15
Q

Crossmatching is required for…

A

repeated transfusions and plasma transfusions

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16
Q

Blood-typing is looking at…

A

RBC antigens.

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17
Q

Cross-matching is looking at…

A

antibodies against RBCs.

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18
Q

Are there universal donors in equine blood groups?

A

NOPE

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19
Q

What are the highly immunogenic Equine blood groups?

A

Aa and Qa

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20
Q

Aa and Qa equine blood-types are implicated in…

A

neonatal isoerythrolysis

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21
Q

In Bovine blood typing, vaccinations of blood origin may…

A

sensitize a cow to foreigh RBC antigens and result in NI in subsequent calves

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22
Q

If you see agglutination during a blood typing test, the result is…

A

POSITIVE REACTION!!!

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23
Q

What are the 2 common types of blood typing methods?

A

Blood typing cards (Agglutination = Positive)

Blood Typing Dipsticks (Line = Positive)

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24
Q

Describe major crossmatch and its clinical purpose…

A

Major crossmatch = final check of compatibility btwn a patient and a donor prior to transfusion
Patient serum + Donor RBCs

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25
Need to transfuse a Patient with Anti-B serum and the donor is Type A...do you get agglutination?
NOPE! Safe to transfuse!
26
How do you interpret a crossmatch?
Negative crossmatch = no agglutination or hemolysis; recipient is NOT likely to have a transfusion --> SAFE! Positive Crossmatch = agglutination --> DO NOT TRANSFUSE
27
Cross matching does NOT detect what?
low antibody titers and adverse reactions are NOT preventable
28
A dog presents on emergency; no history; blood-typing indicates the dog & donor are both DEA 1.1 negative. What does best practice indicate?
Perform a CrossMatch
29
Donor selection for Dogs must be...
DEA 1.1, DEA 1.2 negative or DEA 4, DEA 6 positive
30
Donor selection for Cats must be...
Type A donor or Type B donor
31
Donor selection for Horses must be...
Type Aa and Qa negative; young geldings; mare: never transfused and never pregnant
32
Immune-mediated hemolytic transfusion therapy can be acute or delayed. When it is acute, you get....When it is delayed, you get....
Acute --> intravascular hemolysis; severe reactions followed by DIC, hypotension, shock, acute renal failure and death Delayed --> Extravascular hemolysis; mild reaction; occurs >24hrs up to 2-3 weeks post-trans.; CS: icterus, hyper-Br-emia/uria, fever, anorexia, positive coomb's test
33
Allergic and febrile transfusion therapy reactions are...
non-hemolytic and common; occur within 15 minutes to a few hrs. CS: vomiting, nausea, diarrhea, abdominal pain, tremors, urticaria, pruritis, and erythema
34
Which analytes are reported on a chemistry reflect chemistry function?
BUN; Creatinine | Ph, Ca2+ and Mg2+
35
Describe production, reabsorption and excretion of BUN...
Production: Protein --> NH3 (in the gut) Reabsorption: as Urea Excretion: excretion product!
36
Describe production, reabsorption and excretion of Creatinine...
Production: Creatine stores energy as phosphocreatine in ms. --> creatinine; decreased muscle mass and catabolism Reabsorption: NONE Excretion: excretion product - excreted unchanged by the kidneys!
37
What can cause decreased serum BUN?
low protein diets, liver failure, portosystemic shunts, and/or increased excretion
38
T/F - Creatinine is a good determinant of renal disease being reversible/irreversible.
FALSE! It is NOT a good determinant of renal disease reversibility/irreversibility.
39
Interpreting USG...Isosthenuiric & Azotemic =
Renal failure
40
Interpreting USG...Isosthenuric w/out Azotemia =
Need further assessment! Animal could be well hydrated and USG is appropriate. Other factors/diseases preventing the kidneys from concentrating the urine appropriately.
41
Interpreting USG...Hypersthenuric & Azotemic =
renal insufficiency
42
Fill in the blank... Aldosterone causes increased resorption of ______ & _____ and increased excretion of ______ through the _____________.
Aldosterone causes increased resorption of Na+ and H20 and increased excretion of K+ through the distal tubules.
43
What are your differentials when the kidneys have lost their concentrating ability?
``` Diabetes Insipidus Anatagonism of ADH secretion Excess Solute Loss of Renal Medullary Conc. Gradient Diuresis Hypoadrenocorticism Decreased Ca2+ Liver disease Decreased Protein ```
44
What clinical findings do you see with Pre-Renal Azotemia? What causes it? What are the common characteristics associated with it?
Increased BUN, concentrated USG (>1.012) --> Hemorrhage into GIT --> Decreased GFR Cause: decreased renal blood perfusion resulting in Decr. GFR Characteristics: Dehydration, Shock, Cardiovascular Disease
45
What clinical findings do you see with Renal Azotemia? What causes it? What are the common characteristics associated with it?
Increased BUN, Increase Creatinine, Isosthenuric --> Hyposthenuric USG (1.008-1.012 or
46
What are the most common neoplasia associated with Renal Azotemia?
lymphomas and carcinomas
47
Why is Creatinine a better method for accessing GFR?
0% of Creatinine is reabsorbed; approximately 40% of BUN is reabsorbed
48
What clinical findings do you see with Post-Renal Azotemia? What causes it? What are the common characteristics associated with it?
Increased BUN/Creatinine with a VARIABLE USG depending on time. Cause: obstruction of urinary outflow or bladder rupture* *Bladder rupture also associated w/ Decr. Na/Cl and Increased K/Mg
49
Acute Renal Disease characteristics...
``` oliguria/anuria Increased K+ and PO4 severe metabolic acidosis proteinuria granular casts ```
50
Chronic Renal Insufficiency characteristics...
azotemic w/out the ability to concentrate urine, anemic and acidotic -Horses usually have High Ca2+ too
51
Renal Failure characteristics...
``` isosthenuric marked azotemia Increased PO4 and K+ metabolic acidosis uremia - DEATH! HYPERCALCEMIA** ```
52
In renal failure with hypercalcemia, it will cause ________ and chronically leads to mineralization of the _________________.
In renal failure with hypercalcemia, it will cause kidney disease and chronically leads to mineralization of the renal tubules.
53
The 3 types of Proteinuria...
Pre-renal, Renal, and Post-Renal
54
What are the 2 types of Pre-Renal Proteinuria?
Overflow (Preglomerular) | Functional (Transient)
55
Preglomerular Proteinuria occurs when...
small proteins (hemoglobin, myoglobin, and Bence Jones proteins) pass through the glomerular barrier
56
Functional (Transient) proteinuria is due to...
fever seizures CHF exercise
57
What are the 3 types of Renal Proteinuria?
Tubular Interstitial Glomerular
58
Tubular Renal Proteinuria...
small amounts of proteinuria due to the tubules inadequately reabsorbing protein and putting it back into the blood
59
Interstitial renal proteinuria...
causes exudation of protein into the urinary space | Ex: Acute Interstitial Nephritis
60
glomerular renal proteinuria is caused by...
caused by immune complex glomerulopathy or amyloidosis
61
What does glomerular renal proteinuria cause?
causes disease --> high protein loss +/- concurrent loss of antithrombin III --> hypercoagulable state --> DIC
62
Post-renal proteinuria can be...
urinary - renal pelvis, ureter, urinary bladder, and urethra | extra-urinary = genital tract and external genitalia
63
What are the causes of proteinuria?
fever and exercise urinary pH > 7 UTI and UTInflammation Hematuria and glomerular disease
64
T/F- Urinary pH > 7 will ALWAYS cause a positive dipstick proteinuria.
TRUTH!
65
What is the significance of the Protein: Creatinine Ratio?
determines if there is significant renal tubular or glomerular protein loss

Clinical Pathology - Exam 2 (7 decks)

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