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Flashcards in SA Med Transfusion CSV Deck (128)
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1
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~Why do we transfuse patients?

Replace blood components

2
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~When transfusing what are the main components of blood we use?

RBC’s

3
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~What major Dz’s can be managed with transfusion therapy?

IMHA

4
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~What is the minimum PCV that most anesthesiologist want for Sx?

22% for non-elective Sx

5
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~What percent loss of blood volume can a healthy animal tolerate with out CS?

20%

6
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~What is the blood volume of a dog?

90ml/kg

7
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~With Peracute blood loss (with in minutes up to an hour) what change will you see in HCT?

No change in HCT

8
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~After fluid shifts (ICF/ECF) in a blood loss event what happens to HCT?

Decrease

9
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~What Dz conditions may result in a need for transfusion?

Anemia

10
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~What test can be done to determine if there is a thrombocytopathia?

BMBT

11
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~What is the #1 rule of transfusion therapy?

Give only what they need when they need it

12
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~What is in whole blood?

All cellular & plasma components of blood

13
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~What are they components therapy products available?

PRBC’s

14
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~When you give whole blood to a pt what do they get?

RBC’s

15
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~What are the indications for transfusing whole blood?

Combined RBC & Plasma deficiency

16
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~What two Dz conditions occurring together call for transfusion of whole blood?

Anemia &

17
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~When is whole blood considered fresh?

Used with in 8hrs of collection

18
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~How long can whole blood be stored?

21-28days

19
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~When is whole blood considered “stored”?

Used >8 after collection

20
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~How is Packed Red Blood Cells processed?

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

21
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~When is transfusion with PRBC’s indicated?

Anemia!

22
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~What are the 3 big clinical signs of Anemia?

Tachypnea

23
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~When transfusing with PRBC’s why are you choosing this product?

Restore O2 carrying capacity

24
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~How long can PRBC’s be stored?

about 42 days in refrigerator

25
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~What are the three types of plasma available for transfusion?

Fresh

26
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~When is Plasma considered Fresh?

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

27
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~When is plasma considered FFP?

when used within 1yr of collection

28
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~When is plasma considered just “frozen”?

When used > 1yr after collection

29
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~How long can Plasma be frozen for after that first year?

4 additional years

30
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~What is the max dose of plasma?

20ml/kg/day

31
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~What does FFP have in it?

All coagulation factors & other proteins

32
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~What can you NOT treat with a plasma transfusion (any kind)?

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

33
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~Other than how long it has been frozen what is the difference between FFP & Frozen Plasma?

Frozen Plasma lacks coagulation factor 8

34
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~What is the life span of refrigerated Platelets?

1 week

35
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~What are the indications of giving platelets?

Thrombocytopenia —> Hemorrhage

36
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~What is the best way to get funcitonal platelets to a pt?

Fresh Whole Blood

37
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~What are the other options when giving platelets?

Cryopreserved platelets

38
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~What is the issue with the “other” options to give platelets?

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

39
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~What does Cryoprecipitate contain?

Fibrinogen

40
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~What is one example of when you would give cryoprecipitate?

vWF/Hemophillic dog needing Sx

41
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~What are the general indications for giving Cryoprecipitate?

Bleeding dogs w/ specific plasma protein defeciencies

42
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~What does cryoprecipitate come from?

1 unit of Fresh Plasma spun again then frozen

43
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~What is Cryo-poor plasma?

What is left after cryoprecipitate is made

44
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~What is the indication for using Cryo-poor plasma?

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

45
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~What types of Albumin are available in Vet Med?

Lyophilized canine albumin (5% & 16%)

46
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~What are the clinical signs of low Albumin?

Edema

47
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~What is the big risk with giving Human serum albumin to animals?

High risk of Anaphalaxis

48
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~What are the indications for transfusing Albumin?

Raise Albumin levels in critically ill

49
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~What other products do we have to give pt’s oncotic support?

Colloids

50
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~What is a really good indication for transfusing Albumin?

Chronically Low BP that nothing else has helped

51
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~What is the main risk of giving any biological transfusion product?

Hypersensitivity Reactions

52
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~What options are available for transfusing Leukocytes?

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

53
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~What is the signalment of animals can be used for blood donors?

Healthy

54
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~What specific tests results do you need for a blood donor?

PCV>35%

55
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~What is the most common component of anticoagulant solutions used in blood products?

Sodium Citrate

56
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~Why is Citrate so important in anticoagulant solutions?

Citrate chelates calcium —> inhibiting calcium dependent coagulaiton

57
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~What coagulation factor is Calcium?

Factor IV

58
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~What are the two main anticoagulant solutions for blood products?

ACD - Acid-citrate- dextrose

59
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~What does the Dextrose do in ACD/CPD?

Nutrition for RBC’s

60
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~What does Acid/Phosphate do in ACD/CPD?

Optimizes pH for RBC survival

61
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~What is the ratio to use for anticoagulant:blood when making blood products?

1:9

62
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~Should you sedate your blood donors?

No just keep calm

63
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~How should blood donors be positioned when giving blood?

Sternal or lateral recumbancy

64
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~What type of prep is used and what vein?

Sterile prep of Jugular Vein

65
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~What type of bag, where should the needle be & what type of procedure?

Anticoagulation Bag

66
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~How can you make sure you are getting exactly 450ml of whole blood in the bag?

Use a gram scale

67
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~How many blood types of dogs are there?

More than a dozen

68
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~Do dogs have natural alloantibodies to blood types?

NO!

69
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~How can you identify a dog’s antigen group?

Serological testing

70
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~With Dog kennel side blood typing tests what are we testing for?

(+ or -) for DEA type 1 antigens

71
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~What is the most common blood antigen in dogs?

1.1 62% have it

72
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~What are the other types of DEA that you would want to test for in donors?

3

73
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~Which dogs most commonly have DEA types 3 & 5?

Greyhounds & Japanese breeds

74
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~What is interesting about DEA type 7?

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

75
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~What is DAL?

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

76
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~How do you test for DEA types other than 1?

Send out serology cannot do in house

77
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~What are the three feline blood types?

A

78
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~Do cats have naturally occurring alloantibodies what does this mean?

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

79
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~What type of alloantibodies do cats with Type A blood have?

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

80
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~What type of alloantibodies do cats with Type B blood have?

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

81
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~What type of alloantibodies do cats with Type AB blood have?

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

82
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~What antibody type is primarily responsible for hemagglutination reactions?

IgM

83
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~What antibody type is primarily responsible for hemolytic reactions?

IgA or IgM

84
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~What cat breeds all have type A blood?

Siamese

85
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~What cat breeds have the less common type B blood?

British breeds (but not all of them)

86
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~What is Neonatal isoerythrolysis?

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
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~What can be done to prevent Neonatal isoerythrolysis?

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

88
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~What are the 2 steps to confirming compatibility of blood donor/recipeint?

1. Obtain blood type

89
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~When obtaining blood type what do you do?

Test for type

90
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~When determining if there are circulating antibody specific for blood types not expressed by recipient RBC’s what do you do?

Major & Minor cross match test

91
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~What are the two types of blood typing tests available cage side that give instant results?

Card style agglutination test

92
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~What is a major crossmatch TQ?

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

93
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~What is a minor crossmatch TQ?

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

94
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~Does compatible cross matching rule out the possibility of an adverse transfusion reaction?

NO!

95
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~What does cross matching determine?

Serological compatibility

96
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~What specifically is cross matching testing for?

Natural alloantibodies (cats)

97
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~What are you looking for in a cross match test?

Hemolysis &/or Agglutination

98
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~What is the difference between rouleaux formation and Agglutination?

Rouleaux - RBC’s stacked like coins

99
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~Is there a magic PCV level that automatically indicates transfusion?

No based on CS & Judgement of pt/case

100
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~When should you transfuse Plasma?

Severe bleeding due to a factor deficiency

101
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~When should you transfuse component replacements?

Deficit causing clinical signs

102
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~How do you transfuse blood products?

Wear Gloves!

103
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~What is the Rate at which you should infuse blood products?

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

104
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~How long can blood products sit at room temp before they must be discarded?

No more than 4 hrs

105
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~When will acute reactions occur during transfusion?

With in the first 20 min!

106
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~What should you monitor & what indicated a reaction during transfusion?

Mentation —>dull/obtunded

107
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~How often should you monitor during transfusion?

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

108
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~What are two types of Autologous transfusions?

Planned self transfusion

109
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~When would you do a planned self transfusion?

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

110
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~When would you do an Emergency Auto transfusion & how?

Blood salvaged intra-op or from body cavity

111
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~When will you NEVER do an emergency Auto transfusion?`

NOT neoplastic effusions (like ruptured HSA)

112
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~What are the most common types of immunologic transfusion reactions?

Acute Hemolytic

113
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~What are the less common types of immunologic transfusion reactions?

Delayed

114
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~What is an immunologic acute hemolytic transfusion reaction & CS?

T2 hypersensitivity

115
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~What is an immunologic acute Non-hemolytic transfusion reaction & CS?

T1 hypersensitivity

116
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~What is an immunologic delayed transfusion reaction & CS?

Extravascular hemolysis 2-21 days post

117
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~What is an immunologic Purpura transfusion reaction & CS?

Thrombocytopenia 1 wk post

118
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~What are non immunologic transfusion reaction?

Anaphylactoid

119
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~What is an Anaphylactoid non-immunologic transfusion reaction & CS?

Too rapid infusion

120
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~What is a TACO non-immunologic transfusion reaction & what is it from?

Transfusion

121
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~When is Citrate Intoxication a big risk?

After massive transfusions

122
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~What qualifies as a massive transfusion?

Replacing the entire blood volume in 24hrs or

123
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~When is hyperammonemia or Acidosis transfusion reactions most common?

When using older blood products

124
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~What is treatment for transfusion reactions?

Stop/slow down

125
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~What is Oxyglobin?

Cell free bovine derived Hg

126
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~What is Oxyglobin used for?

Increase O2 & CO2 transport ONLY

127
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~What are some good things about it Oxyglobin?

Significant colloidal Effect

128
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~What is bad about Oxyglobin?

Not readily available