Managing Immune-mediated Haemolytic Anaemia

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AC/0309/20
SMS code: a33230

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1) Which one of the following medications is the mainstay of treatment of IMHA in dogs? *

1 point

Corticosteroids

Azathioprine

Cyclophosphamide

Cyclosporine

Mycophenolate mophetil

2) Which one of the following statements regarding medications for IMHA is INCORRECT? *

1 point

Cyclosporine suppresses T cells and inflammatory cytokines

Cyclosporine has a rapid onset of action

Azathioprine suppresses T-cell function

Azathioprine has a rapid onset of action

Bone marrow suppression occurs with azathioprine and leflunomaide

3) Which one of the following characteristics of DEA 1 is most clinically relevant? *

1 point

DEA1 is an allele.

DEA1 is present in 30 – 60% of dogs.

There is a breed variablility in the prevalence of DEA 1.

DEA 1 is a heamagglutinin.

DEA 1 is an alloantibody.

04) Which one of the following staements regarding transfusion therapy in dogs is INCORRECT? *

1 point

Transfusion is indicated if a patient with anaemia has an elevated respiratory and heart rate.

Transfusion is indicated if a patient with anaemia has a packed cell volume (PCV) of 13% or lower.

If the dog has never had a transfusion before it can be done without cross-matching.

If the patient is four days or more out from a recent transfusion, you don’t need to cross match.

Blood from multiple donors can safely be given in the first 3 days without expecting a haemolytic transfusion reaction.

5) Which of the following statement regarding complications of IMHA is INCORRECT? *

1 point

Systemic inflammation is caused by the haemolysis.

Only infectious causes of haemolysis causes systemic inflammation.

Thromboembolisms is a very prevalent cause of mortality in IMHA.

Corticosteroids are procoagulable.

Inflammation causes hypercoagulation.

6) A cross match test will determine if a reaction between the recipient and donor will occur but will not identify the antigen. Which one of the following statements is CORRECT?

1 point

The cross match is done in as a major cross match looking for recipient antibodies.

A Major cross match is Donor RBC into recipient plasma.

A Major cross match is Recipient RBC into donor plasma.

A cross match is definitive for a safe transfusion.

Washing of the red blood cells is only necessary of the patient has IMHA.

Clear selection

7) Which one of the following statements regarding transfusion reactions is INCORRECT? *

1 point

Delayed transfusion reactions occur when there is a lower level of alloantibodies.

Delayed transfusion reactions occur when the response to the antibody is not haemolytic in nature.

Blood typing can determine the presence of a known antigen.

Shortened red cell lifespans have been described with DEA 3, 5 and 7.

Only the DEA antigen group is responsible for transfusion reactions.

8) Which one of the following statements regarding blood transfusion and blood products for IMHA is CORRECT? *

1 point

Consensus recommends that packed red blood cells (pRBC) not older than 7 – 10 days are transfused.

Consensus recommends that whole blood is transfused - not older than 7- 10 days.

Consensus recommends that fresh whole blood is transfused.

Consensus recommend that fresh frozen plasma is used to limit the development of DIC.

Consensus recommend that the number of transfusions given is related to the degree of mortality and should be used sparingly.

9) Which one of the following statements regarding the use of prednisolone treatment for IMHA is INCORRECT? *

1 point

Prednisolone is used at 4 – 6 mg / kg divided BID for initiation of treatment.

Prednisolone should be administered at 50 - 60mg/m2 for dogs >25kg.

The prednisolone dose is relatively lower, in mg/kg ,for larger heavier dogs.

When the PCV has remained stable and >30% for 2 weeks after starting treatment then it is recommended to start decreasing the dose of prednisolone by 25%.

Continues increasing a dosage decrease of 25% of the current dose every 3 weeks is recommended.

10) Which one of the following statements regarding thromboprophylactic drugs is INCORRECT? *

1 point

Thromboprophylaxis is strongly recommended in all patients with IMHA without exception.

Treatment should be initiated at time of diagnosis and continued until the patient is in remission and no longer on prednisolone.

The greatest risk for thrombosis is within the first 2 weeks after initiation of treatment.

Dogs with IMHA are predisposed to venous thromboembolism.

Anticoagulants as well as antiplatelet drugs are suggested in the first 2 weeks.

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