Fall 2011 - Clin Path - Test 1 - Quiz 2

Front 1

hyperplasia vs neoplasia

Back 1

hyperplasia
- proliferation of cells in response to a stimuli
- remove the stimuli and it goes back to normal

neoplasia
- proliferation of cells after cessation of stimuli
- benign
- malignant (characerized by invasion/ metastasis)

Front 2

define hemaatopoietic neoplasia

Back 2

neoplasia of hematopoietic cell origin

Front 3

define cancer

Back 3

malignant neoplasia

characterized by invasion or metastasis

Front 4

define leukemia

Back 4

malignant neoplasm arising from hematopoietic cells in the bone marrow (or spleen)

spleen is also a hematopoietic organ and a lymphoid organ, not just a bag of red cells

typically with significant #s of neoplastic cells in circulation
“Leukemia” is also sometimes used to describe any condition in which neoplastic cells are present in circulation

Front 5

define lymphoma

Back 5

(aka malignant lymphoma, lymphosarcoma) – malignant solid tissue neoplasm arising in lymphoid tissue(s) outside the bone marrow (neoplasm of lymphocytes)

Front 6

normal hematopoietic differentiation

Back 6

Front 7

lymphoid vs myeloid neoplasia

Back 7

Lymphoid neoplasia
- Lymphoid (lymphocytic) leukemias
- Lymphomas
- Plasma cell tumors (secrete immunoglobulins)


Myeloid neoplasia
- Myeloid (myelogenous) leukemias
- Myelodysplastic syndromes
- Other myeloid neoplasms

Front 8

lymphoma

Back 8

It is not one dz, it is a spectrum of diseases


Many different forms, depending on:
- Anatomic location
- Cell type (B v. T v. NK)
- Cellular morphology (sometimes small or sometimes big)
- Histologic pattern
- Stage (how disseminated it is in terms of anatomic location)
- Biologic behavior
- Response to therapy

Front 9

how do you dx lymphoma

Back 9

Diagnosis usually based on FNA cytology +/or biopsy and histopathology


Dx typically followed by clinical staging (how advanced is the disease?) and immunophenotyping (ID of cell type using antibodies)

Front 10

histopath vs cytology

Back 10

Histopath
- Chunk of tissue
- Tissue architecture is intact



Cytology
- Sample lesion
- Fast, cheap, good cell morphology
- No architecture (can be limiting)
- Not limiting in lymphoma

Front 11

laboratory abnormalities assoc with lymphoma

Back 11

Laboratory abnormalities are variable

Hematology – nonregenerative anemia is common

Chemistry – some forms of LSA are associated with hypercalcemia

Front 12

Back 12

left = high grade lymphoma
- more aggressive
- Big not well differented cells
- More aggressive
- Higher mitotic rate (notice mitotic figure)


right = low grade lymphoma
- less aggressive
- Smaller cells
- Lower mitotic rate
- Less biologic aggressive behavior

Front 13

Back 13

high grade lymphoma

notice mitotic figure/
lower cytoplasm : nucleus

Front 14

what is leukemia

Back 14

malignant neoplasm arising from hematopoietic cells in the bone marrow (or spleen) typically with significant numbers of neoplastic cells in circulation

Front 15

basic classification of leukemias (what cells they arise from)

Back 15

lymphoid or myeloid

chronic or acute

lymphoid leukemias
- B or T cell origin

myeloid leukemias
- erythroid
- granulocytic
- monocytic
- megakaryocytic

Front 16

what is a blast crisis

Back 16

when a chronic leukemia transforms into a more acute form (some additional mutation)

Front 17

Lymphoid vs Myeloid neoplasia *what cancers are included in each*

Back 17

lymphoid
- lymphomas
- lymphocytic leukemias
- plasma cell tumors

Myeoloid neoplasia
- myeloid leukemias
- myelodysplastic syndromes
- other myeloid neoplasms

Front 18

what is lymphoma

what variables affect the form?

how do you dx

Back 18

malignant solid tissue lymphoid neoplasm arising in lymphoid tissue(s) outside the bone marrow

variables include
- anatomic distribution
- immunophenotype (B or T vs. non B or T)
- cellular morphology
- histologic pattern
- stage
- biologic behavior
- response to therapy

initial dx
- aspiration cytology +/or biopsy/ histopath
- followed by clinical staging and immunophenotyping

Front 19

what laboratory values are assoc with lymphoma

Back 19

hematology and chemisty are variable

Front 20

what underlying factors are associated with lymphoma

Back 20

cats
- FeLk

cattle
- BLV
- persistent lymphocytosis
- lymphoid neoplasia

Front 21

with _____ leukemias, the cell of origin is easy to identify.

Why is it sometimes difficult to dx.

Back 21

chronic leukemia
- b/c well differentiated cells

sometims hard to tell if cells are neoplastic or reactive

dx often one of exclusion

Front 22

______ are characterized high numbers of blasts in the bone marrow

why is it sometimes difficult to dx

Back 22

acute leukemias (> 20-30% of neucleated cells)

the specific lineage usually cant be determined by routine micro exam b/c poorly differentiated

ID by immunophenotyping and/or cytochemical staining

Front 23

what is MDS

Back 23

myelodysplastic syndrome

clonal myeloid proliferation characterized by ineffective hematopoiesis

doesn't meet traditional definition for acute leukemia
- MDS is characterixed by increased apoptosis compared to AML

clasically dx by findings of
- < 20-30% of blasts in bone marrow
- cytopenia of > 1 cell line
- morphological evidence of dyshematopoiesis

Front 24

how do you differentiate lymphoma from lymphocytic leukemia

Back 24

Front 25

how do you differentiate b/w chronic and acute leukemias

Back 25

Front 26

where does lymphoma start & where can it spread?

leukemia?

Back 26

Lymphoma
- start anywhere
- spread to bone marrow/blood

leukemia
- starts in bone marrow/spleen/blood and can spread anywhere

Front 27

Which leukemia is often characterized by neutropenia, thrombocytopenia, and anemia

Back 27

acute

Front 28

which leukemia is often characterized by non-regenerative animea but not pancytopenia

Back 28

chronic

Front 29

2 main forms of plasma cell tumors

Back 29

plasmacytoma
- solid tumors that typically involve skin or mm
- usually benign
- excision normally curative

mult myeloma
- typically arise from bone marrow
- secrete large amts of Ig leading to hyperglobulinemia
- dx based on finding at least 2 of the following
1) markedly increased numbers of plasma cells in bone marrow, esp in aggregates (plasma cells must be at least 30% of nucleated cells in the marrow)
2) monoclonal gammopathy
3) radiographic evidence of osteolysis (osteoclasts support growth of myeloma cells)
4) light chain proteinuria (don't react with dipstick protein indicators, require electrophoresis and immunoprecipitation)
- may also see hypercalcemia, lesions assoc with hyperglobulinemia (hemorrhage due to secondary platelet dysfxn, renal amyloidosis, hyperviscosity syndrome), cytopenias due to high numbers of neoplastic cells in bone marrow

Front 30

immunophenotyping

Back 30

use of antibodies to recognize specific molecules expressed on different cell types to determine identity of cell population

immunohistochemistry
immunocytochemistry
flow cytometry

Front 31

clonality assays

Back 31

PCR for lymphocyte antigen receptor gene arrangements

exploits the fact that neoplastic cells are monoclonal whereas reactive cells are polyclonal

highly sensitive and specific test

valuabe for dx lymphoid neoplasia

most useful in distinguishing lymphoid neoplasia (lymphoma or lymphocytic leukemia from non-neoplastic lymphoid proliferations

Front 32

Back 32

plasma cell neoplasia

Multiple myeloma
– malignancy of plasma cells, usually arises in bone marrow

Plasmacytoma
– solid tumors
- Cutaneous
- Extra-cutaneous (often @ mucous membranes)
- Variable biologic behavior

Front 33

diagnostic criteria for multiple myeloma

Back 33

Front 34

what are some tumors of hematopoietic but not considered hematopoietic neoplasms

Back 34

Mast cell tumors

Histiocytic tumors
- Macrophages
- Dendritic cells

Front 35

1. With _____ leukemia, ou will see a high lymphocyte count.


2. With _____ leukemia, where neoplastic cells are blasts, you may get errors b/c machine doesn't know how to count them.

Back 35

1. chronic

2. acute

Front 36

Immunophenotyping LSA

Back 36

Front 37

mechanisms of dz in the bone marrow

Back 37

hypoplasia

hyperplasia

dysplasia (messed up somehow making cells look wrong)

aplasia

neoplasia

myelophthisis

infection

Front 38

indications for bone marrow exam

Back 38

unexplained cytopenias of one or more of the major hematopoietic lineages
- anemia
- thrombocytopenia
- neutropenia
*help determine the mechanism of cytopenia*


unexplained presence of abnormal cells in circulation
- blasts
- other immature cells (nRBC, immature granulocytes)
- cells of abnormal morphology
- well differentiated cells not normally found in circulation (ex mast cells)
*helps determine mechanism causing presence of abnormal cells*


cancer staging or monitoring
- staging most commonly for lymphoma


reasonable suspicion of neopolasia or infection in bone marrow
- ex mult myeloma (esp in pt with monoclonal gammopathy), tick borne dz, fungal dz

Front 39

contraindications and complications of bone marrow

Back 39

main contraindication = unnecessary bx

anesthesia is usually a greater risk than the collection procedure

thrombocytopenia isn't a contraindication

complications rare
- iatrogenic infection
- iatrogenic frx

Front 40

what do you do with the bone marrow sample

Back 40

cytology & histopathology

if only 1 choice, cytology is the better choice (esp if highly cellular sample)

cytology
- faster
- less expensive
- excellent cellular morphologic detail
- no tissue architecture
- less reliable measure of marrow cellularity

histopath
- preservation of tissue architecture
- more reliable assessment of marrow cellularity
- slower
- more expensive
- inferior cellular morphologic detail

Front 41

preferred sites of bone marrow sample collection

Back 41

crest of ilium

proximal humerus (cats/ small dogs)

trochanteric fossa of femur

sternum, tuber coxae (horses)

Front 42

bone marrow aspirate sample collection.

what do you need to put in syringe before attaching syringe to needle

how much sample do you need

Back 42

0.3 ml EDTA

small amt (<0.5 ml) of marrow

Front 43

marrow cytologic interpretation

Back 43

microscopic evaluation
- cell #'s, types, morphology
- iron stores
- +/- organisms

need CBC (and preferrably a blood smear from same day as marrow collection) and thorough clinical work-up to fully interpret bone marrow findings

Front 44

what do you need to interpret bone marrow findings

Back 44

a concurrent CBC and thorough clinical work up

Front 45

marrow cytology interpretation

what do you look at under low power?

high power?

Back 45

low power
- overall cellularity
- megakaryocyte #s
- iron stores
- initial impression of M:E ratio

high power
- detailed evaluation of M:E ratio
- #'s of minor cell populations (lymphocytes, plasma cells, macrophages, +/- others such as mast cells, osteoclasts, neoplastic cells)
- cellular detail (maturation morphology)
- +/- organisms

Front 46

normal marrow cellularity

Back 46

age dependent

juvenile = 75%

adult = 25%

remaining non-hematopoietic is mostly fat

Front 47

how do you assess marrow cellularity (cytologic preparations)

Back 47

on the basis of unit particles (small chunks of tissue)

how much of the unit particles consist of hematopoietic tissue instead of fat

to a lesser degree on the density of individual hematopoietic cells in the monolayer of the slide

Front 48

causes of increased marrow cellularity

decreased marrow cellualrity

Back 48

increased
- hyperplasia of one or more hematopoietic lineages
- neoplasia


decreased
- hypoplasia of one or more hematopoietic lilneages
- fibrosis

Front 49

what do you look at in marrow cytology for cellular composition

Back 49

evaluating 3 main marrow hematopoietic lineages (megakaryocytic, erythroid, granulocytic) as well as other cell types normally found in lower #s (lymphocytes, plasma cells, and macrophages)

mature megakaryocytes large with abundant slightly eosinophilic cytoplasm

immature megakaryocytes smaller with less abundant more basophilic cytoplasm

Front 50

marrow hyperplasia witih increased M:E is

Back 50

myeloid hyperplasia

Front 51

marrow hypoplasia with increased M:E is

Back 51

erythroid hypoplasia

Front 52

bone marrow exam

What is the M:E ratio

Back 52

Rough estimate (subjective)

Quantitative assessment
100- v. 500- v. 1000-cell count

The M:E in most normal dogs and cats is apx. 1:1 to 2:1.

Front 53

causes of increased marrow cellularity

Back 53

hyperplasia of one or more hematopoietic lineages

neoplasia

Front 54

causes of decreased marrow cellularity

Back 54

hypoplasia of one or more hematopoietic lineages

fibrosis

Front 55

bone marrow exam

what do you look at on low power (4x-10x)

Back 55

overall cellularity

megakaryocyte numbers

iron stores

inital impression of M:E ratio

Front 56

bone marrow exam

what do you look at on high power (50x-100x)

Back 56

detailed evaluation of M:E ratio

numbers of minor cell populations
- lymphocytes
- plasma cells
- macrophages
- +/- others (mast cells, osteoclasts, neoplastic cells)

cellular detail (maturation/ morphology)

+/- organisms

Front 57

normal marrow cellularity based on age

Back 57

juvenile = 75% hematopoietic tissue

adult = 25% hematopoietic tissue

Front 58

bone marrow exam

in cytologic preparations, cellularity is assessed mainly on the basis of

Back 58

unit particles (small chunks of tissue)

how much of the tissue chunks consist of hematopoietic tissue instead of fat

and to a lesser degree, the density of individual hematopoietic cells in the monolayer of the slide

Front 59

The M:E in most normal dogs and cats is approximately

Back 59

1:1 or 2:1

Front 60

what are the main cell types/ lineages assessed in the marrow evaluation

Back 60

hematopoietic lineages
- megakaryocytic
- erythroid
- granulocytic

other cell types normally found in lower numbers
- lymphocytes
- plasma cells
- macrophages

Front 61

What is the M:E in most normal cats

Back 61

1:1 or 2:1

Front 62

What is the M:E in most normal dogs?

Back 62

1:1 or 2:1

Front 63

bone marrow exam

in cytologic preparations, cellularity is assessed mainly on the basis of

Back 63

unit particles (small chunks of tissue)

how much of the tissue chunks consist of hematopoietic tissue instead of fat

and to a lesser degree, the density of individual hematopoietic cells in the monolayer of the slide

Front 64

The M:E in most normal dogs and cats is approximately

Back 64

1:1 or 2:1

Front 65

what are the main cell types/ lineages assessed in the marrow evaluation

Back 65

hematopoietic lineages
- megakaryocytic
- erythroid
- granulocytic

other cell types normally found in lower numbers
- lymphocytes
- plasma cells
- macrophages

Front 66

What is the M:E in most normal cats

Back 66

1:1 or 2:1

Front 67

What is the M:E in most normal dogs?

Back 67

1:1 or 2:1

Front 68

bone marrow exam of megakaryocytes

Back 68

majority are normally very large with abundant, slightly eosinophilic cytoplasm

immature ones are smaller and have less abundant, more basophilic cytoplasm

Front 69

bone marrow exam of erythroid and granulocytic cell numbers

Back 69

assessed on the basis of overall marrow cellularity and myeloid:erythroid ratio

Front 70

bone marrow exam

assessment of maturation of each lineage

Back 70

complete (maturation through segmented neutrophils and polychromatophilic erythrocytes)


synchronous (normal proportions of early and late stage cells

Front 71

how much of the population of nucleated cells is normally comprised of lymphocytes?

plasma cells?

macrophages?

Back 71

lymphocytes: < 5% (dogs) or < 20% (cats)


plasma cells: < 2%


macrophages: < 2%

Front 72

dysplasia

Back 72

abnormal morphology

Front 73

canine bone marrow iron stores

Back 73

normally has small to moderate amts of hemosiderin

absence of bone marrow hemosiderin in dogs is an abnormality consistent with iron deficiency

Front 74

feline bone marrow iron stores

Back 74

normally doesn't have detectable hemosiderin

presence of bone marrow hemosiderin in cats is consistent with iron overload

Front 75

what organisms can occasionally be detected in the bone marrow

Back 75

bacteria

rickettsia

fungi

protozoa

Front 76

indications for bone marrow exam

Back 76

Unexplained cytopenia(s):
- Anemia
- Thrombocytopenia
- Neutropenia


Unexplained presence of abnormal cells in circulation:
- Blasts
- Other immature cells (e.g., nRBCs, immature granulocytes)
- Cells of abnormal morphology
- Well-differentiated cells not normally found in circulation (e.g., mast cells)

Cancer staging or monitoring
- e.g., Lymphoma


Look for occult disease – especially if there is reasonable suspicion of neoplasia or infection in the bone marrow
- e.g., Multiple myeloma
- High globulins without evidence of infection response can be indicative of multiple myeloma

Front 77

what is the main contraindication for bone marrow exam

Back 77

unnecessary bx

Front 78

interpretation of M:E ratio in context of overall marrow cellularity

Back 78

Front 79

Interpretation of bone marrow results for patient with nonregenerative anemia

Back 79

Front 80

bone marrow hypoplasia indicates that cytopenia is probably due to

Back 80

decreased production

Front 81

bone marrow hyperplasia with unexplained non-regenerative anemia indicates that cytopenia is probably due to

Back 81

increased destruction (usually immune mediated)

Front 82

bone marrow maturation arrest indicates that a persistent cytopenia is probably due to

Back 82

increased destruction (consistent with immune mediated disease of myelodysplastic syndrome)

Front 83

bone marrow aplasia may occur in one or more lineages and main ddx are

Back 83

immune mediated dz

toxic insult

infectious dz

idiopathic

Front 84

bone marrow microscopic interpretation of hypoplasia, hyperplasia, maturation arrest, aplasia

Back 84

Hypoplasia: cytopenia is due to decreased production

Hyperplasia: cytopenia is due to increased destruction (usually immune-mediated)

Maturation arrest: persistent cytopenia is due to increased destruction (consistent with immune-mediated disease or MDS).


Aplasia may occur in one or more lineages
Ddx include immune-mediated disease, toxic insult, infectious disease, idiopathic

Front 85

blood types

Back 85

inherited antigens (alloantigens on RBC)

various RBC membrane proteins

impt in transfusion medicine

Front 86

transfusion medicine

sensitization

Back 86

acquired alloantibodies

prior transfusion

pregnancy

certain vaccines

Front 87

which blood types are impt in dogs

Back 87

DEA 1.1

Front 88

what is the ideal canine donor?

Back 88

DEA 1.1 neg

Front 89

cat blood types

naturally occurring alloantibodies

Back 89

Type A
- weak anti-B antibody
- transfuse type A cat with type B blood and get small transfusion rxn


Type B
- strong anti-A antibody
- give small amt of type A blood, and will get life threatening transfusion rxn


Type AB
- not anti-A or anti-B

Front 90

canine blood types

Back 90

Front 91

feline blood types

Back 91

Front 92

equine blood types

Back 92

Front 93

Have type AB cat, that is anemic and needs trx

1. Have type B blood sitting around, can you give it?

2.What about type A blood?

Back 93

1. No b/c type B blood has strong anti-A antibody

2. May still have rxn but won't be life threatening

Front 94

What type of blood should you give a Type AB cat?

Back 94

type A or B packed, washed RBC

Front 95

Type B cat given washed packed type A blood

Back 95

will not stop the blood from being type A so you will still have the host response against the new cells (just not the response from the type A blood)

Front 96

true or false

a cat with type AB blood is the universal recipient of whole blood

Back 96

false

it is the universal recipient of A or B packed, washed RBC

Front 97

will there be a rxn if give type B donor blood to a type AB cat

Back 97

yes

whole blood of type B, plasma components have strong anti-A antibodies

Front 98

what equine blood types are the most impt

Back 98

Aa

Ac

Ca

Qa

Front 99

do equine blood types have naturally occurring alloantibodies?

Back 99

rare (Aa and Ac)

poss in Ca

no for Qa

Front 100

do K9 blood types have naturally occurring alloantibodies

Back 100

yes
- DEA 3
- DEA 5
- DEA 7

no
- DEA 1.1
- DEA 1.2
- DEA 4
- DEA 6

Front 101

do feline blood types have naturally occurring alloantibodies

Back 101

yes
- A has weak anti-B
- B has strong anti-A

no
- AB

Front 102

true or false

DEA 6 can be associated with NI

Back 102

false

its prevalance in the US is 100%

Front 103

cattle blood groups

Back 103

Cattle have 11 blood groups with over 70 identified factors


Not many of them are clinically significant

Front 104

clinically most impt blood types

Back 104

Dogs
- DEA 1.1

Cats
- A
- B
- AB

Horses
- Aa
- Ac
- Ca
- Qa

Front 105

which blood types are most impt in NI (hint: they are both equine)

Back 105

Aa & Qa

Front 106

when do you see NI in dogs, cats, and horses

Back 106

dog
- DEA 1.1+ pup born to DEA 1.1- bitch
- rare unless prior sensitization


cats
- type A or type AB born to type B queen


horses
- Aa+ foals born to Aa- mare
- Qa+ foals born to Qa- mare
- mule born to a mare bred to a jack

Front 107

what is the ideal donor for foal in NI crisis

Back 107

Qa- blood from horse that was never sensitized

or packed, washed RBC from mare

don't give blood from sire

Front 108

pretransfusion testing

Back 108

blood typing
- confirm blood type

cross matching
- determine donor-patient compatibility

Front 109

agglutination testing

Back 109

can be performed in test tube, on glass slide, or in gel

positive = RBC agglutination

patient RBC and test kit reagents

RBC & plasma from patient and donor

Front 110

hemolytic testing

Back 110

positive = RBC hemolysis

some blood typing of cattle, pigs, and camelids has hemolysis as an end point

Front 111

blood typing for dogs/ cats

Back 111

card
- test kit reagents contain either antiserum or lectins
- reagent is mixed with patient blood (EDTA)
- look for agglutination

gel
- neg = pellet
- pos = line at the top of the gel
- agglutinated RBC (pos) do not migrate through the gel and form a band at the top of the gel column
- non-agglutinated cells (neg test result) DO migrate through gel and form a button at bottom of the gel column

Front 112

major cross-match

Back 112

washed donor RBC + recipient plasma

takes 1-1.5 hrs

if agglutination = don't use
- person doing test must know their shit

can be done in test tube, on slide, with gel kit

Front 113

major vs minor incompatibility

Back 113

maj
- not safe to give

minor
- not ideal but could be okay with minor rxn

Front 114

minor cross match

Back 114

donor plasma + recipient RBC

look for agglutination

Front 115

when can you not do a crossmatch

Back 115

with IMHA

Front 116

cross matching compatibility

Back 116

Front 117

in clinical small animal practice you will perform ______ (blood typing/ cross matching/ both)

Back 117

blood typing

Front 118

in small animal clinical practice, what species can get transfusion without typing/ cross-matching

Back 118

dogs (1 time)

cats need typing and cross-matching prior to transfusion

Front 119

true or false

a patient could still have an adverse reaction despite typing and cross-matching

Back 119

true

Front 120

true or false

i am sick of making clin path flashcards

Back 120

true

Front 121

how do animals get sensitized to blood group antigens

Back 121

transfusion of whole blood or packed RBC

pregnancy (exposure of antigen neg dam to her fetus' antigen pos blood via transplacental hemorrhage)

vaccination with certain vaccines
- ex Anaplasma vaccines that contain RBC membranes

Front 122

neonatal isoerythrolysis refers to

Back 122

hemolytic anemia occurring in a neonate that acquired antibodies against its own RBC from its dam (via colostrum ingestion)

Front 123

pathogenesis of NI

Back 123

antigen neg dam bred to antigen pos sire

fetus expresses sire's antigen

dam exposed to fetal blood during gestation

dam makes antibodies to antigen she doesn't have

neonate is born

neonate ingests colostrum containing those antibodies

neonate develops hemolytic anemia

Front 124

NI can occur in

Back 124

type A and type AB kittens born to type B queens

Type Qa foals born to Type Qa neg mare (or Aa foal to Aa neg mare)

only occurs in puppies born to bitch that was transfused prior to whelping

in cattle occurs only in calves born to a cow that was previously given a RBC membrane containing vaccine

Front 125

DEA refers to

Back 125

dog erythrocyte antigen system used to classify canine blood groups

Front 126

canine blood transfusion med

Back 126

dogs can develop antibodies against any blood group antigen but only DEA 1.1 is impt

b/c most antigenic and most critical

often positive for mult DEA antigens

Front 127

where to alloantibodies come from

Back 127

naturally occurring

acquired (sensitized)

Front 128

blood groups are impt in

Back 128

transfusion med

pathogenesis of NI

verify parentage for pedigree records and breeding registries

Front 129

what is a universal blood donor

Back 129

individual having minimallly antigenic blood that could (in theory) be given to any individual of the same spp with low risk of adverse effects (O- humans)

universal donors highly desirable

Front 130

what is a universal recipient

Back 130

an individual with mult blood group antigens that could (in theory) receive blood from any other individual of the same spp with low risk of adverse effects (type AB+ humans)

these guys lucky

Front 131

animals having antibodies to a particular blood group antigen may experience an adverse rxn (such as ______) if exposed to that antigen

Back 131

hemolysis and/or anaphylaxis

Front 132

which blood type is unable to be tested for (canine)

Back 132

DEA 6

Front 133

type AB cats can be considered universal recipients of

Back 133

type A, B or AB packed RBC

not universal recipients for whole blood ro plasma

Front 134

in equine what are the most antigenic blood types (most resp for NI)

which are impt in transfusion med

Back 134

NI
- Aa
- Qa

transfusion med
- Aa
- Ac
- Ca
- Qa

Front 135

pretransfusion testing is most relevant to _____

Back 135

RBC

the transfusion of whole blood or packed RBC

Front 136

goals of pretransfusion testing are

Back 136

confirm blood type (blood typing)

determine donor and recipient compatibility (cross-matching)

Front 137

the end point (positive result) of blood typing is

cross matching

Back 137

endpoint of both is macroscopically visible agglutination of RBCs w/in seconds to minutes after reagents are mixed

no agglutination = neg


in blood typing
- RBC agglutination is caused by interactions b/w patients RBC and test kit reagents (antiserum or lectins that react w/ blood group)


cross matching
- agglutination is caused by antigen-antibody interactions b/w RBC and plasma (or serum)

Front 138

blood typing is performed using what sample

cross matching?

Back 138

typing
- EDTA anticoagulated blood

matching
- EDTA blood sample from patient and bag of whole blood or packed RBC from donor

Front 139

how do you store blood samples for transfusion use

Back 139

4C

Front 140

what diseases cause difficulties in blood typing/ crossmatching and why

Back 140

pt with marked RBC rouleaux (some animals with systemic inflammation)

agglutination due to dz (IMHA)

leavve this to laboratories with specially trained med techs

Front 141

2 types of commonly used commercially available blood typing test kits in the US

Back 141

DEA 1.1 antigen (dogs)

type A & B (cats)

in the form of cards and gels

Front 142

typing cards accurately identify (dogs)

Back 142

DEA 1.1 +

DEA 1.2 pos may have weak pos rxns (can misclassify as DEA 1.1+)

Front 143

typing cards accurately ID (cats)

Back 143

A and B cats

cats that are B or AB should undergo confirmatory testing

Front 144

gel typing accurately IDs

Back 144

reliable in dogs and cats

Front 145

which is better gel or card typing

Back 145

gel is better b/c
- results easier to interpret
- gel fixes agglutination rxn (so can view over a longer period of time)
- gels can be photocopies and photocopy placed in medical record (thus can be archived)

Front 146

why do you use cross matching

Back 146

confirm compatibility

investigate cause of adverse transfusion rxn

Front 147

what is impt about cross matching

Back 147

it does not guarantee normal donor RBC survival in recipient and do not complete eliminate risk of adverse transfusion rxn


focuses on RBC so doesn't prevent adverse leukocyte or platelet rxns

Front 148

know the tranfusion blood components and their indications (whole blood vs packed RBC vs fresh frozen plasma, etc.)

Back 148