Clin Path- Blood Groups Transfusions and Polycythemia.txt

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Mawad
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287240
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Clin Path- Blood Groups Transfusions and Polycythemia.txt
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2014-10-27 17:54:19
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blood transfusions
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vet med
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  1. Genetically determined glycolipids and glycoproteins on the surface of RBCs.
    blood group antigens
  2. A group of antigens related genetically as alleles or closely linked genes; antigens are biochemically similar.
    blood group system
  3. Antibodies to blood group antigens not expressed in that individual.
    Naturally-occurring antibodies
  4. Type B cats have _______________ antibodies.
    naturally-occurring anti-A
  5. Development of antibodies against an antigen that exists in alternate forms in a species and induces an immune response in an individual lacking the antigen.
    alloimmunity
  6. Alloimmunity occurs as a result of... (3)
    blood transfusion, vaccination with blood products, or sensitization of the dam transplacentally or from exposure at birth
  7. Antibodies against an antigen that exists in alternate forms in a species and induces an immune response in an individual lacking the antigen.
    alloantibodies
  8. An antigen that exists in alternate forms in a species and induces an immune response in an individual lacking the antibody.
    alloantigen
  9. 2 uses of blood groups.
    testing for blood transfusions (cross-matching) and predicting maternal-fetal incompatibility (neonatal isoerythrolysis)
  10. What are the major canine blood groups used in the US?
    DEA 1.1, 1.2, or 1.3 positive or negative
  11. The ideal dog blood donor can be what blood type(s)?
    DEA 1.1, 1.2, 1.3 (not tested for in US), or 7 negative
  12. What are the blood types in cats?
    A, B, or AB
  13. DO NOT give type ___ blood to a type ___ cat.
    A;B
  14. What are the 2 basic blood typing procedures and their respective components?
    • Agglutination test- RBCs+species specific serum
    • Hemolytic test- RBCs+species specific serum+complement
  15. What is the most specific blood typing test and its components?
    Indirect Coombs' test- patient RBCs+ species specific antibody (typing sera)+ antiglobulin (Coombs' reagent)
  16. Define a major cross-match and a minor cross-match.
    • major: donor cells + recipient serum
    • minor recipient cells + donor serum
  17. Cross-matching assures that...
    there will not be an immediate transfusion reaction
  18. When must you do a cross-match prior to transfusion, and when is it optional?
    • Dog do not have naturally-occurring antibodies, so they do not need to be cross-matched unless they have had a previous transfusion.
    • Cats must always have a cross-match because they may have naturally-occurring antibodies (especially purebred cats)
  19. When neonatal isoerythrolysis occurs, maternal antibodies bind to neonatal RBCs and cause...
    intra- or extravascular hemolysis
  20. Antibodies from the dam can reach the foal's circulation by...; therefore,...
    ingestion of colostrum; cross-match the sire's RBCs with the dam's serum and provide alternate colostrum is necessary
  21. Type A or AB kittens born to a type B queen may present with...
    tail tip necrosis
  22. Laboratory findings associated with neonatal isoerythrolysis? (3)
    regenerative anemia, hemoglobinemia/uria (intravascular hemolysis), bilirubinemia/uria
  23. What is the rule of thumb with blood component therapy and its meaning?
    transfuse the patient, not the laboratory value; replace what has been lost, destroyed, or is not being produced ONLY when clinical signs warrant
  24. What are the 3 goals of blood component replacement?
    increase O2 carry capacity, replace coagulation factors, or volume replacement
  25. 6 reasons to provide a blood or blood component transfusion.
    • 1. rapid blood loss
    • 2. severe, chronic nonregenerative anemia
    • 3. IMHA ONLY if the anemia is life-threatening
    • 4. coagulation factor deficiency- FP, FFP, or CRYO
    • 5. Hypoprotenemia- FP, FFP, stored plasma
    • 6. THrombocytopenia- platelet rich plasma (PRP), platelet concentrates
  26. When do you transfuse whole blood?
    when whole blood is lost or when coagulation factors and RBCs are needed
  27. When do you transfuse packed red blood cells?
    when volume overload is a risk or when other components are not needed
  28. What are the components of fresh plasma or fresh frozen plasma?
    albumin, clotting factors, von Willebrand factor (VWF)
  29. When do you transfuse fresh or fresh frozen plasma?
    coagulopathies due to rodenticide toxicity, hemophilia, DC, or von Willebrands disease; hypoalbuminemia
  30. When do you use stored plasma?
    rodenticide toxicity
  31. What is the difference between stored plasma and fresh or fresh frozen plasma?
    stored plasma does not contain factors V, VIII, or VWF
  32. Cryoprecipitate contains...(4) and is used for...
    factor VIII, von Willebrand factor, fibrinogen, and fibronectin; hemophilia A, von Willebrands disease, or hypofibrinogenemia
  33. Characteristics of an ideal canine blood donor.
    1-6 years old, large breed, >40% PCV, neutered, good physical health, never pregnant, heartworm negative, no previous transfusions, DEA 1.1, 1.2 and 7 negative, vaccinated, negative for RBC and WBC parasites
  34. Characteristics of an ideal feline blood donor.
    1-6 years old, 10# body weight, >35% PCV, neutered, good physical health, never pregnant, type A for DSH and DLH, type B for purebred, vaccinated, negative for FeLV, FIP, FIV, and blood cell parasites
  35. Describe blood donor collection.
    jugular vein, site is surgically prepared, collected aseptically
  36. What type of bag is donor blood collected in?
    one containing citrate phosphate dextrose adenine (CPDA-1)
  37. Describe transfusion of blood.
    • 1. warm blood to 37°C
    • 2. administer blood through jugular, cephalic, or saphenous vein, intramedullary, or intraperitoneally
  38. An acute hemolytic immunological reaction to transfusion is due to _______, and clinical signs include... (9)
    RBC incompatibility; feer, restlessness, salivation, urticaria (hives), tremors, vomiting, incontinence, tachycardia, convulsions
  39. What do you do in the case of an acute hemolytic immunological reaction to transfusion?
    stop transfusion, administer fluids and corticosteroids
  40. The clinical signs of an acute non-hemolytic immunological reaction to transfusion are... (3)
    urticaria fever, anaphylaxis
  41. What do you do in the case of an acute non-hemolytic immunological reaction to transfusion?
    stop transfusion, (anaphylaxis)administer fluids, corticosteroids, and antihistamines, (urticaria) administer corticosteroids and antihistamines
  42. A delayed immunological response to transfusion is caused by...
    development of recipient antibodies to donor RBC antigens
  43. Delayed immunological reaction to transfusion results in _______, which causes the following clinical signs... (3)
    extravascular hemolysis; jaundice, decreased PCV, billirubinuria (usually mild and go unnoticed by owner)
  44. Acute or delayed nonimmunological response to transfusion can be caused by... (6)
    circulatory overload, endotoxic shock, disease transmission, coagulation, embolism
  45. Circulatory overload causes the following clinical signs... (5)
    cough,, pulmonary edema, vomiting, urticaria, serous nasal discharge
  46. With relative erythrocytosis, RBC mass is _______, and RBCs are ________________ per unit volume of circulating blood.
    normal; more concentrated
  47. What are the 2 potential causes of relative erythrocytosis?
    dehydration, splenic contraction
  48. Erythrocytosis due to dehydration is _________ and results from __________.
    hemoconcentration; loss of fluid from the intravascular space (decreased plasma volume)
  49. Laboratory findings associated with hemoconcentration? (5)
    increased PCV, TP, BUN, creatinine, and urine specific gravity
  50. What causes erythrocytosis due to splenic contraction?
    excitement and epinephrine release, pain, or exercise
  51. Laboratory findings associated with erythrocytosis due to splenic contraction? (2)
    increased PCV and normal TP
  52. Superficial reddening of skin; dilation of blood capillaries.
    erythrema
  53. Absolute erythrocytosis is when the RBC mass is ________ due to ________________.
    increased; increased erythropoiesis
  54. Which absolute eryhtrocytosis, plasma volume is __________, and overall blood volume is___________.
    normal; increased
  55. Secondary erythrocytosis is due to ______________.
    increased EPO production
  56. When is increased EPO production an appropriate response? When is it inappropriate?
    • Appropriate: some cardiac and pulmonary disease, high altitude, and methemoglobinemia
    • Inappropriate: renal tumors or cysts
  57. Primary erythrocytosis, or ___________, is an uncommon _________ characterized by.......
    polycythemia vera; myeloproliferative disorder; production of RBCs independent of EPO
  58. Clinical features of primary erythrocytosis are...(5)
    erythema of the skin and mucous membranes, polyuria/polydipsia, lethargy, neurologic disorders, and bleeding episodes
  59. A mutation of the ________ gene resulting in ______________________ that causes primary erythrocytosis.
    JAK2; constitutive activation of a kinase
  60. If the partial pressure of oxygen is less than 60mmHg, it indicates _________, and hemoglobin oxygen saturation <95% indicates __________, supporting a diagnosis of ______.
    hypoxemia; tissue hypoxia; secondary erythrocytosis
  61. EPO levels should be __________ in secondary erythrocytois and __________ in primary erythrocytosis.
    increased; low to low-normal

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