Transfusion Medicine Lab

1. Anticoagulant rodenticides

2. Liver failure

3. DIC

What are your top three differentials for increased PT/aPTT?

1. Sepsis

2. Hypovolemia

3. Obstructive

4. Cardiogenic

5. Cortisol

What are the five causes of shock?

RBCs, clotting factors, and platelets

What does fresh whole blood provide a patient?

Clotting factors only

What does fresh frozen plasma provide a patient?

RBCs only

What does packed red blood cells provide a patient?

Clotting factors

If there is active bleeding a patient needs what?

IV crystalloids and start vitamin K1

If you suspect anticoagulant rodenticide toxicity, what should you initially treat with?

1. Citrate

2. Phosphate

3. Dextrose

4. Adenine

What is included in a blood bag?

Anticoagulant, "blood food"

Citrate is an ______________ and phosphate is _______________ in blood bags

~450 grams (mL, 1 unit of blood)

When do you stop collecting blood from a blood donor?

1:9

For smaller volumes of blood and you are using a syringe, what is the ratio of citrate:blood?

6 mL citrate and 54 mL blood

How much citrate vs blood is needed to fill a 60 mL syringe?

B (damages dog blood)

T or F: Hemo-nate filters may damage cat blood

350 mL or 450 mL (depending on which option you use to calculate?)

If a dog has a PCV/TP of 28% and 4.8 g/dL and weighs 25 kg, how much fresh whole blood should you give to the patient?

1. 1mL/kg/hr for 15 minutes (minimum 2 mL/hr)

2. If no reaction, increase rate to give total volume over 4 hours

What rate should you give blood transfusions at?

Administer fresh frozen plasma

If you give a dog fresh whole blood and there is still bleeding at the catheter site/venipuncture site, what should you do?

10 to 30 mL/kg

What is the dose of fresh frozen plasma?

Frozen plasma

When fresh frozen plasma expires it becomes what?

5 and 8

What clotting factors are lost when fresh frozen plasma becomes frozen plasma?

A

T or F: Fresh frozen plasma is still useable for 4 years past "expiration"

B (only missing factors 5 and 8, which are not vitamin K dependent clotting factors)

T or F: Frozen plasma will NOT help with anticoagulant rodenticide toxicity

A

T or F: Plasma needs a filter just like other blood products

Autotransfusion

If a patient comes in with a hemoabdomen from a hemangiosarcoma splenic rupture, how can you stabilize the patient cheaply?

A

T or F: You can use both direct aspiration and surgical aspiration for autotransfusion

1. Age of blood?

2. Contaminated? (bacterial or neoplastic cells)

3. Anticoagulant?

4. Hemothorax

What should you consider when thinking about autotransfusion?

vWD (primary or secondary hemostatic disease)

A doberman pinscher presents for an elective spay and gastropexy. Its CBC/chem/UA is all WNL. Should you have any concerns with performing surgery on this patient?

Buccal mucosal bleeding time

Evaluates platelet function and is used most often as an in-house screening test for von Willebrand's disease

3 to 4 minutes

What is the normal BMBT?

Vasopressin

____________________ binds to V2 receptor and leads to vWF to release from endothelium and binds to factor 8 (this is what helps platelets stick to each other)

Types 2 and 3

Which types of vWD will we not see in our patients because the clinical severity is so severe they typically die at a young age?

1

95% of patients with vWD have type _______

A. Low

B. Normal

Describe the (A) concentration and (B) structure of type 1 vWD

vWF antigen

When you send blood to Cornell to test for vWD, they are testing for ___________________

Normal

70 to 180 vWF:Ag% is what diagnostic range for vWD?

Borderline

50 to 69 vWF:Ag% is what diagnostic range for vWD?

Abnormal

0 to 49 vWF:Ag% is what diagnostic range for vWD?

Borderline

A patient has a BMBT of 4 minutes and 13 seconds and also has a vWF:Ag of 58%, what are they considered?

1. DDAVP

2. Cryoprecipitate

How do you pre-treat a patient for vWD prior to a surgery?

You can give cryoprecipitate quicker because a unit of cryoprecipitate is a smaller volume (also less concern for volume overload with cryoprecipitate)

What is the benefit of giving cryoprecipitate over fresh frozen plasma?

1. vWF

2. Factors 5 and 8

3. Fibrinogen

What does cryoprecipitate contain?

Packed RBCs

If a cat is losing blood (TP is normal) from an extensive flea burden, what should you treat with?

Type, crossmatch

When giving a cat a blood transfusion, you need to _________ AND ____________ first

Recipient plasma + saline washed donor RBCs

What are the components of a major crossmatch?

Saline washed recipient RBCs + donor plasma

What are the components of a minor crossmatch?

Packed RBCs and fresh whole blood

Major crossmatch is used for what types of transfusions?

Plasma transfusions

Minor crossmatch is usually unnecessary but can be used for what type of transfusion?

Bone marrow is still working and should regenerate (goal is to immediately increased oxygen carrying capacity)

If you have an anemic kitten that has a high flea burden, you raise the PCV from 9% to 19%. 19% is still anemic; however, why are you not necessarily concerned?