Transfusion Medicine

Question 1

What is hemostasis?

Answer 1

blood coagulation

Question 2

What are 2 forms or of hemostasis?

Answer 2

primary and secondary

Question 3

What is primary hemostasis?

Answer 3

a form of coagulation where the vessel spasms and begins the formation of a platelet plug

Question 4

what are some examples of primary hemostatic coagulation tests?

Answer 4

platelet counts, bleeding times (buccal mucosal bleeding time, toe nail bleed time)

Question 5

Which coagulation test checks the platelet numbers?

Answer 5

platelet count

Question 6

Which coagulation test checks for platelet function?

Answer 6

bleeding time

Question 7

What is secondary hemostasis?

Answer 7

when coagulation cascade ends in fibrin formation

Question 8

What are some example of Secondary Hemostatic Coagulation test?

Answer 8

capillary coagulation, ACT, PT, PTT, PIVKA

Question 9

what test is commonly used to dx IMHA?

Answer 9

autoagglutination/saline test

Question 10

how do you perform a saline test that tests for autoagglutination?

Answer 10

1 gt blood from EDTA tube with 1 gt of saline, mix and look for agglutination within 1 minutes

Question 11

What is crossmatching?

Answer 11

a procedure of mixing patient sample with donor sample to see if donor blood is compatible with recipient blood

Question 12

how much does a dog need to weigh in order to donate blood?

Answer 12

> 50 lbs

Question 13

at which age should a dog retire who donates blood?

Answer 13

7 years

Question 14

Which species needs to be sedated in order to donate blood and why?

Answer 14

cats, due to behavior/being fractious

Question 15

why do we normally want to AVOID sedation if possible when a pet is donating blood?

Answer 15

because it can interfere with platelet function

Question 16

how much blood can a dog donate and how often?

Answer 16

can donate up to 16 mls/kg every 3 weeks

Question 17

how much does a cat need to weigh to donate blood?

Answer 17

> 8 lbs

Question 18

How much blood can a cat safely donate and how often?

Answer 18

40-60 mls every 3 weeks (11-13 mls/kg)

Question 19

when typing animals, how is blood type determined?

Answer 19

by the specific antigens found on the surface of the RBCs

Question 20

name the 3 categories of antibodies

Answer 20

naturally occurring, acquired, pathogenic

Question 21

what is another name for Neonatal Isoerythrolysis?

Answer 21

alloimmune hemolytic anemia

Question 22

what is NI (neonatal isoerythrolysis?

Answer 22

what a negative female breeds with a positive male and the offspring have positive blood. the offspring absorbs antibodies to positive blood through moms negative colostrum which causes hemolytic dz and eventually death of the offspring

Question 23

What does DEA stand for?

Answer 23

Dog Erythrocyte Antigen

Question 24

What is the most common canine blood type?

Answer 24

DEA 4 positive

Question 25

What is the rarest canine blood type?

Answer 25

DEA 3 positive

Question 26

Which canine blood types are the ONLY ones (with dog blood) that can have acute hemolytic reactions?

Answer 26

DEA 1.1 and DEA 1.2 negative

Question 27

Why must cats ALWAYS be crossmatched before a transfusion?

Answer 27

because they have very strong alloantibodies and with have a reaction with the wrong type

Question 28

What are the 3 feline blood types?

Answer 28

A, B, AB

Question 29

which feline blood type contains weak antibodies?

Answer 29

Type A

Question 30

Which feline blood type contains strong antibodies?

Answer 30

Type B (B=bad!)

Question 31

which feline blood type does not contain antibodies?

Answer 31

Type AB

Question 32

What type of cell is responsible for life threatening transfusion reactions?

Answer 32

alloantibodies

Question 33

When determining compatibility doing a crossmatch, what will you look for?

Answer 33

agglutination or hemolysis

Question 34

Name some common anticoagulants used to mix with blood for a transfusion

Answer 34

CPDA, CPD, ACD, Heparin, and Sodium Citrate

Question 35

Which anticoagulants are not recommended for transfusion blood and why?

Answer 35

Heparin and Sodium Citrate, because they do not contain any preservatives

Question 36

What fluids can you dilute pRBCs with?

Answer 36

0.9% saline

Question 37

What is Fresh Whole Blood (FWB)?

Answer 37

blood recently collected from the animal whole, not spun down or separated

Question 38

How long is FWB considered "fresh"?

Answer 38

up until after 8 hours of collection

Question 39

What are packed red blood cells (pRBCs)?

Answer 39

concentrated source of RBCs that remain in a small amount of plasma post centrifugation of whole blood

Question 40

Why is it important to not transfuse pRBCs in the same line or catheter as LRS?

Answer 40

because it will cause clotting (calcium in LRS binds w/anticoagulant)

Question 41

what is the main indication for giving a pRBC transfusion

Answer 41

anemia

Question 42

Which blood componant is frozen and contains coagulation factors but no functional platelets and is COMMONLY used?

Answer 42

FFP (Fresh Frozen Plasma)

Question 43

What are the 2 main types of transfusion reactions?

Answer 43

immunological and non-immunological

Question 44

what are the 2 categories of immunological transfusion reactions?

Answer 44

hemolytic and non-hemolytic

Question 45

Give some examples of hemolytic transfusion reaction

Answer 45

acute hemolytic rxns, delayed hemolytic rxns, neonatal isoerythrolysis

Question 46

give some examples of a non-hemolytic transfusion rxn

Answer 46

acute hypersensitivity, immunosuppression, acute leukocyte/platelet hypersensitivity, neonatal thrombocytopenic purpura

Question 47

give some examples of non-immunological reactions

Answer 47

circulatory overload, hemolysis (shaking blood bag), bacterial contamination, hypocalcemia, hyperammonia and acidosis, hypothermia, embolism, dz, hemosiderosis

Question 48

when performing vitals on any patient, but especially a transfusion patient, what is extremely important to monitor/observe in addition to TPR?

Answer 48

pulse quality (strong, weak, thready, snappy), respiratory quality/effort, patient's mentation (BAR, QAR, sedated, depressed, sleeping, obtunded)

Question 49

What is the most severe type of transfusion reaction?

Answer 49

Acute Hemolytic Reaction

Question 50

How many days post-transfusion can a delayed hemolytic reaction occur?

Answer 50

3-21 days post transfusion

Question 51

How can you avoid an acute hemolytic reaction

Answer 51

crossmatching and blood typing

Question 52

What species most commonly has an acute hemolytic reaction?

Answer 52

cats

Question 53

What reactions can be seen with cardiovascular patients and how would you treat it?

Answer 53

volume overload, stop transfusion and possibly give Lasix