Term
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Definition
| Pleuripotent precursor for all hematopoietic cells |
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Term
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Definition
-differentiate into LYMPHOID STEM CELL AND MYELOID STEM CELL (CFU-GEMM)
-Capable of self replication and differentiation; |
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Term
| What are stimulation factors of pleuripotent stem cell? |
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Definition
| multi-CSF (IL3) and GM-CSF |
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Definition
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Definition
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Definition
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Definition
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Term
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Definition
- Kidney is a major source of EPO;
- Production is stimulated by hypoxia
- Affects primarily CFU-E;
- Major factor in RBC differentiation and proliferation
- Enhances hemoglobin synthesis and rapid release of RBCs from the BM |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| What do differentiating neutrophils look like? |
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Definition
| clear cytoplasm, production enhanced by G-CSF; |
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Term
| Eosinophil precursors look like? |
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Definition
| dense, pink granular cytoplasm; production is enhanced by IL-5 |
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Term
| Basophil precursors look like? |
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Definition
| fine, basophilic granular cytoplasm; production is enhanced by IL-4 |
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Term
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Definition
CFU-GM + low[GM-CSF] = CFU-M
CFU-M + M-CSF => Monoblasts
Less than 5% of nucleated cells in bone marrow; |
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Term
| Megakaryocytic series? What are early production factors? |
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Definition
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Term
| Megakaryocytic series? What are LATE STAGE production factors? |
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Definition
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Term
| Is BM a major site of lymphocyte production? |
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Definition
No
Dogs <5 %
Cats<15 %
Small and intermediate lymphocytes and low numbers of plasma cells |
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Term
| What are 4 indications for BM evaluation? |
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Definition
1. Peripheral cytopenias
2. Unexplained elevation in peripheral blood
3. Abnormal cells in circulation
4. Suspected bone neoplasm |
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Term
| Types of peripheral cytopenia that would indicate BM evaluation? |
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Definition
- Nonregenerative anemia (not anemia of chronic inflamm. dz, not anemia of chronic renal failure, not any anemia in the horse);
- Persistent neutropenia
- Thrombocytopenia (depends) look at production vs. destruction or loss. |
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Term
| What kinds of unexplained elevations in cell numbers can there be? |
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Definition
-Leukocytosis (any cell line)
- Thrombocytosis, unless can be explained by chronic GI bleed, nonregenerative IMHA OR OTHER LESS COMMON CAUSES;
-Erythrocytosis (polycythemia) |
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Term
| What are 5 common causes for erythrocytosis (polycythemia)? |
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Definition
1. Neoplasia (renal, liver, polycythemia vera)
2. Cardiovascular dz
3. Blood gasses (tissue hypoxia)
4. Need to measure EPO levels (where?)
5. BM evaluation is of no or little value |
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Term
| What are some abnormal cells in circulation? |
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Definition
1. Hematopoietic blast cells;
2. Dysplastic changes in blood cells
3. Non-hematopoietic cells in circulation |
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Term
| What can cause hypersegmented neutrophils? |
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Definition
1. Prolonged maturation in sirculation (due to corticosteroid therapy?)
2. Bone marrow dz (dysplasia, neoplasia) |
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Term
| What are some reasons to suspect neoplasia in bone marrow? |
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Definition
1. Clinical staging of lymphoma?
2. Unexplained hypercalcemia
3. Monoclonal gammopathy |
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Term
| What is Monoclonal Gammopathy? |
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Definition
1. p is hyperproteinemic (hyperglobulinemic)
2. SPE identify production of single immunoglobulin
3. Most often associated with B-cell neoplasm (Multiple myeloma, BM needed for diagnosis)
4. Ehrlichia canis (difficult to distinguish from multiple myeloma) |
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Term
| What do we evluate in BM at low magnification? |
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Definition
cellularity
iron content
Megakaryocyte numbers |
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Term
| What do we evaluate in the BM under high magnification? |
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Definition
Erythroid series;
Myeloid series;
% blast cells |
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Term
| What is normal, increased and decreased cellularity? |
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Definition
Cellularity is the ratio of fat to cells in unit particle and normal is 50/50
1. Increased cellularity is >75% cells (this is normal response to increased oeripheral demand; neoplastic process)
2. Decreased cellularity >75% fat (suspect BM damage with decreased cell production) |
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Term
| How do we evaluate iron content? |
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Definition
Iron stains dark blue to black;
Evaluation of iron is only important in anemic animals;
Increased: Hemolytic anemia, anemia of CID; Decreased erythrocyte production; post transfusion)
Decreased: (Iron defficiency anemia (chronic blood loss)
Iron is not normally detected in MB of cats; |
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Term
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Definition
Anemia of chronic infectious disease: most common cause of nonregenerative anemia in animals;
PCV rarely goes below 25% in dogs and 15% in cats; |
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Term
| What is etiology of anemia of CID? |
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Definition
- Inflammatory cytokines (primarily from MACROPHAGES) inhibit RBC production;
- Sequestration of iron in marrow MACROPHAGES;
- Decreased erythrocyte life-span. |
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Term
| How do we evaluate the number and morphology of Megakaryocytes? |
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Definition
-1 to 3 per 10x view (mostly mature)
- Increased numbers (peripheral destruction, utilization or sequestration)
- Decreased numbers (production problem in marrow due to Neoplasia or IMT (rare) |
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Term
| Materials needed for BM aspirate? |
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Definition
| Anticoagulant (5% EDTA or Heparin Sulfate); 2% Lidocaine for local anesthesia; 12 CC Syringe; a petri dish or other clear container or bowl; Hematocrit tubes, Clear microscopic slides; Diff Quik, Hema QuikII or other stain; |
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Term
| What are common sites for BM aspirate? |
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Definition
| Dorsal crest on the wing of ilium (preferred); in very small cats, puppies - craniolateral apect of the greater tubercle of the humerus or Trochanteric fossa of the proximal femur. |
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Term
| Erythroid cell series evaluation: |
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Definition
| Should comprise about 1/2 of hematopoietic cells (only count nucleated cells); Numbers relative to myeloid cells; 90% should be mature (rubricytes and metarubricytes) |
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Term
| When do we suspect erythroid hyperplasia or myloid hypoplasia? |
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Definition
| When <20% blast erythroid cells and more erythroid cells than myeloid. |
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Term
| Evaluation of myeloid series: |
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Definition
| Should comprise about 1/2 of all precursors relative to erythroid cells; 90% should be mature myelocytes metamyelocytes, blasts and segmented cells; |
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Term
| Are all animals with hemolitic disease icteric? |
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Definition
1. due to hyperbillirubinemia;
2. equine plasma has high icteric index normally;
3.other domestic animals show high icteric index when the content of billirubin in the blood exceeds the liver's capacity to clear it;
5. Icterus will be seen in extracvascular and intravascular hemolysis because billirubinemia is seen in both; |
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Term
| List in order where access billirubin accumulates in the body? |
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Definition
1. Urine and feces;
2. Plasma;
3. Mucocutaneous (Tbil>2 mg/dL) |
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Term
| What are some lab findings in a dog with IMHA? |
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Definition
- Decreased RBC and PCV (98% OF DOGS HAVE <25%);
- Decreased Hemoglobin (unless intravascular hemolysis)
- Increased MCV with marked Anisocytosis;
- Marked Leukocytosis with left shift +/- toxicity)
(if Leukocyte count is > 60k->poor prognosis; Monocytosis and Thrombocytopenia may be present);
- Agglutination is possible;
- >65% of dogs with IMHA show regenerative response (look for Retics)
- High numbers of spherocytes;
- Polychromatophilic cells;
- Biochemistry profile may show: elevated liver enzymes; high T. Billi, low Albumin |
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Term
| Are all IMHAs regenerative? |
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Definition
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Term
| Does an animal with positive autoagglutination test need a Coomb's test? |
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Definition
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Term
| List three ways by which infectious diseases cause hemolysis? |
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Definition
1. Cytauxzoon felis (due to DIC and thromboembolic dz)
2. Babesia (parasite in RBC, destroys the cell);
3. Mycoplasma haemofelis (organism inside RBC, destroys cells) |
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Term
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Definition
1. Due to oxidative damage:
2. Toxic, osmotic, and misc. causes of hemolysis: Acute Zn toxicity, envenomation, hypophosphatemia, hypo-osmolar hemolysis. |
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Term
| What findings on a peripheral blood film are suggestive of fragmentation hemolysis? |
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Definition
1. Schistocytes (by fibrin strand, whn passing through the liver or spleen);
2. Keratocytes,
3. Thrombocytopenia;
4. Acanthocytes |
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Term
| What are causes of fragmentation hemolysis? |
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Definition
1. Often subcinical and secondary to other disease
2. Mechanical injury to cells: DIC, Caval syndrome, Glomerulonephritis;
3. Endothelial injury: HSA, Vsculitis, Splenic or hepatic disease;
4. Thermal injury: heat stroke, severe burns;
5. Osmotic injury: near drowning in fresh water; |
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Term
| In RBCs, what are three tragets of oxidative damage? |
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Definition
1. Globin portion of hemoglobin;
2. Membrane portion of RBC;
3. Iron portion of hemoglobin |
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Term
| Does methemoglobinemia cause hemolysis? |
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Definition
| No, it reduces oxygenation of blood. |
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Term
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Definition
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Term
| What findings on a peripheral blood film are suggestive of oxidative damage? |
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Definition
Heinz bodies=oxidized Hemoglobin (cats may have small number in normal blood);
Eccentrocytes, pyknocytes;
Methemoglobin (Fe3+);
Hemoglobin crystals; |
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Term
| List three common causes of oxidative RBC damage? |
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Definition
1. Acetaminophen (Tylenol, paracetamol)
2. Allium genus (onions, garlic)
3. Red maple |
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Term
| What species can commonly have Heinz bodies and what is the reason for their formation? |
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Definition
Cats, up to 10% of RBCs may have Heinz bodies;
Prone to HB accumulation due to more SH groups per globin molecule, non-sinusoidal spleen; Many cats may have Hb INCREASE W/O HEMOLYSIS DUE TO hYPERTHYROIDISM, dIABETIS MELLITUS, lYMPHOMA. |
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Term
| List three diseases in cats that may be associated with increased Heinz body formation, but not associated with hemolysis? |
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Definition
Hyperthyroidism,
Diabetes mellitus,
Lymphoma |
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Term
| How does one diagnose a Heinz body hemolytic anemia? |
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Definition
History of oxidant exposure;
Anemia;
Methemoglobinemia (Filter paper test);
New Methylene blue stain;
Evidence of Morphologic changes: Eccentrocytes on blood fils and increased number of Heinz bodies; |
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Term
| Durinf diabetic ketoacidosis whar electrolytes are particularly important to watch? |
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Definition
| K, Phos, Mg. Supplement with fluids if needed. Hypophosphatemia can cause intravascular hemolysis. |
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Term
| Why is hemolysis a possible complication of tube feeding a lipidotic or TPN administration? |
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Definition
| Due to starvation-refeeding syndrome, hypophosphatemia may occure, causing hemolysis. |
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Term
| What is a typical signalment of animals with Zn toxicity? |
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Definition
commonly young dog with history of indiscretion;
Vomiting, dark melena-like stool, diarrhea, lethargy, pale membranes.
-May look like IMHA (rEGEN ANEMIA, SPHEROCYTES, INFLAM. LEUKOGRAM, aLWAYS COOMBS NEGATIVE) |
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Term
| List three common causes of Zn toxicity? |
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Definition
| Coins,, Zn induced antibody binding of RBCs, Heinz body formation |
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Term
| What disease do hematologic findings of Zn toxicity mimic? |
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Definition
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Term
| When do we need a crossmatch? |
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Definition
Ideally, before any transfusion;
Not needed if first transfusion (or those with 2 days of 1st)
Should be done for all subsequent transfusions |
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Term
| Transfusion protocol in dogs? |
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Definition
| Use EDA 1 Negative blood or use DEA type-matched blood; |
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Term
| What are anti-erythrocyte antibodies? |
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Definition
- Naturally present, preformed molecules (carbohydrate Ag);
- Formed after sensitization (carbohydrate or protein Antigens)
- Antibody differences influence transfusion reactions |
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Term
| What are 4 types of transfusion reactions? |
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Definition
1. Acute vs. Delayed;
2. Severe vs. Mild;
3. Intra- vs. Extra-vascular
4. In vivo vs. In vitro |
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Term
| What are three categories of blood types in cats? |
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Definition
| A, B,, AB (A is most common, AB is very rare <1%) |
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Term
| Tpe A cats have the following hemolytic transfusion reactions: |
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Definition
- preformed antibodies are present in 35 %;
- lower titer;
- Ab are directed against RBC B Antigen;
Hemolysins;
-IgM = IgG;
Responsible for minor transfusion reactions;
-RBC removal: ~ 2 days; |
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Term
| Type B cats transfused even a small amount of type A blood will have: |
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Definition
1 a severe acute hemolytic reaction and for NI (Neonatal Isoerythrolysis);
-Preformed Ab present in n95 %,
- High titer;
- Directed against RBC A Ag;
- Hemolysisns, Hemagglutinins;
- IgM > IgG
- RBC removal ~ 1 hour |
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Term
| Feline and Canine blood groups? |
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Definition
Feline (1 bloodgroup, 3 blood types)
Canine (12 bloodgroups, many blood types) |
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Term
| Percent of cats with tyoe A, B, AB blood? |
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Definition
A (75-95%)
B (2-25%)
AB (<1%) |
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Term
| What bloodtype is up to 60% in some breeds of cats? |
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Definition
type B:
Exotic shorthair, British shorthair, Cornish Rex, Devon Rex. |
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Term
| How many canine blood groups do we know and what group is of major clinical significance? |
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Definition
-At least 12 groups,
- One is of clinical significance (DEA 1.1, 1.2)
- No Preformed antibodies are in the blood of dogs, but transfusion of unmatched blood of both types may produce acute, severe reaction.
-Reactions to DEA 3,5,7 are delayed and mild.
-About 60% of dogs are DEA 1 positive, and ~40% are DEA 1 negative. |
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Term
| Dogs wich which bloodtype are considered a universal canine donor? |
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Definition
| DEA 4 positive only, Practical purposes DEA 1 negative. |
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Term
| What are clinically significant facts about canine blood transfusion protocols? |
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Definition
- Use DEA 1 neg blood or DEA 1 type-matched blood;
- Unmatched, first transfusions are usually safe;
Crossmatch all subsequent transfusions;
- Use type-specific blood for multiply transfused IMHA dogs; |
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Term
| Whad adverse effects can RBC destruction have on the body? |
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Definition
- Hemolysis: release of hemoglobin, clotting cascade initiation and DIC, Microthrombosis);
- Complement activation (C3a, C5a RELEASE, Mast cell degranulation, Catecholamine release) |
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Term
| What are two possible immunologic reactions? |
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Definition
- Hemolytic (Acute: preformed Abs present, Delayed: 2-21 days);
- Non-hemolytic (vs. other blood constituents) |
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Term
| What is a blood crossmatch test? |
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Definition
-Mix: serum of one individual with RBCs of another);
- Loof for (Hemolysis and agglutinations) |
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Term
| What is the meaning of a Positive crossmatch? |
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Definition
-Preformed antibodies detected and
- Acute hemolytic reaction is likely |
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Term
| What is the meaning of a negative crossmatch? |
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Definition
-Preformed antibodies are not detected,
-Acute hemolytic reaction is unlikely; |
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Term
| What are some things that are not excluded by the negative crossmatch? |
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Definition
- Delayed hemolytic reaction;
- Immune reaction vs. other blood components;
- Non-immunologic reaction; |
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Term
| Describe Major crossmatch? |
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Definition
| Donor RBCs are mixed with Recipient's serum |
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Term
| Describe Minor crossmatch tes? |
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Definition
| Donor serum is mixed with Recipient's RBCs |
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Term
| What are clinical indications for RBC transfusions? |
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Definition
Regenerative anemia (hemorrhage, hemolysis);
Non-regenerative anemias;
Oxygen carrying defficiencies;
Make a decision based on Clinical signs, PCV, Duration and cause of anemia). |
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Term
| How to determine if transfusion is needed to to too low of a PCV? |
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Definition
When PCV <15%,
When PCV has been reduced by half. |
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Term
| What are 4 major blood products and what do they rpovide? |
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Definition
Whole blood (RBC, clotting factors
Packed RBC (RBCs)
Fresh frozen plasma (clotting factors)
Oxyglobin (Hemoglobin) |
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Term
| List all hereditory diseases fo blood covered in class? |
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Definition
Pyruvate Kinase defficiency;
Phosphofruktokinase defficiency
Methemoglobin reductatse defficiency;
Hereditory stomatocytiosis;
Hereditory elliptosis;
Inherited neutrophil dysfunction;
Chediak-Higashi syndrome
Cyclic Hematopoiesis in grey collie dogs;
Pelger-Huet anomaly;
Inherited platelet function deficit;
Von Willebrands disease. |
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Term
| Breeds predisposed to PK Defficiency? |
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Definition
Besenji
Beagle;
West highland white terrier
Crin terrier
American Eskimo
Abyssinian cats; |
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Term
| How is PK defficiency passed on? |
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Definition
| Autosomal recessive trait |
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Term
| What clinical signs are exhibited by homozygous PK patients? |
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Definition
Decreesased ex. tolerance;
Pale mucous membranes;
Tachycardia;
Splenomegaly;
ATP-generating step is slower;
Energy metabolism is markedly impaired;
Reduced RBC lifespan;
Anemia;
Erythroid hyperplasia;
Marked reticulocytoisis in peripheral blood; |
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Term
| What is an unexplained feature of PK defficiency? |
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Definition
| The progressive development of myelofibrosis and osteosclerosis |
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Term
| What is a life expectancy of PK defficient dogs? |
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Definition
| Most die before 4 years od age due to BM failure, liver dz., Hemochromatosis and cirrosis; |
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