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Clinical Pathology > 10: Haemostasis > Flashcards

10: Haemostasis Flashcards

1
Q

How do platelets adhere to the vessel wall?

A

By vWF

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2
Q

What is the end point of platelet plug formation?

A

Fibrinogen to fibrin

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3
Q

What happens to blood vessels immediately following injury?

A

Reflex vasoconstriction

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4
Q

Where is vWF exposed from following injury?

A

The subendothelial matrix

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5
Q

Where are clotting factors produced?

A

Liver

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6
Q

Which factors require vitamin K?

A

II, VII, IX, X

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7
Q

What is the target for rodenticides?

A

Vitamin K

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8
Q

What is the end-point of the coagnulation cascade?

A

Produce thrombin to catalyse fibrin production

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9
Q

Which tests evaluate the intrinsic and common pathways?

A

APTT/ACT

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10
Q

Which test evaulates the extrinsic pathway?

A

OSPT

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11
Q

What activates the intrinsic pathway?

A

Negatively charged surface

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12
Q

What activates the extrinsic pathway?

A

Tissue factor

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13
Q

Which pathway is the most important initiator of secondary coagulation?

A

Extrinsic

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14
Q

What activates factor VII?

A

Exposure to tissue factor

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15
Q

What does factor VII activation cause?

A

Rapid thrombin burst

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16
Q

What is the function of the intrinsic pathway?

A

Amplification - causes cascade of activation via common pathway

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17
Q

Which factors does thrombin activate?

A

V, VIII, IX but also their inhibitors protein C and protein X

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18
Q

How does factor XIII stabilise the clot?

A

Forms covalent bonds that crosslink fibrin

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19
Q

Which breed gets hyperfibrinolytic disorders?

A

Greyhounds

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20
Q

What is activated by fibrinogen to cause fibrinolysis?

A

Plasmin

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21
Q

What does fibrinolysis result in production of?

A

FDPs e.g. D dimers

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22
Q

What are clinical signs or primary coagulation disorder?

A

Petechiae/ecchymoses, epistaxis, GI bleed

23
Q

Below what platelet count do you see clinical signs in primary coagulation disorder?

A

30-50

24
Q

Why are signs more severe in secondary coagulation disorder?

A

No stabilisation

25
Q

What are some complications of secondary coagulation disorders?

A

Cavity bleed, haematomas

26
Q

What should you test if primary coagulation disorder?

A

Platelets

27
Q

What should you test if secondary coagulation disorder?

A

Clotting factors

28
Q

What is a normal number of platelets per 100x field?

A

10-15

29
Q

Below what platelet count per 100x field is there a risk of bleeding?

A

3-5

30
Q

Which test should you not do in thrombocytopenia?

A

BMBT - check platelet count first

31
Q

Why shouldn’t you do a cuticle bleed test in primary coagulation disorder?

A

If accidentally cut and arteriole it will involve secondary haemostasis so not a good test

32
Q

Which are the most important tests for secondary haemostasis?

A

OSPT and APTT

33
Q

How should you prepare the sample for secondary haemotasis test?

A

Non-clotted, citrate not EDTA

34
Q

Which pathways does whole blood clotting times evaulate?

A

Intrinsic and common

35
Q

Why is whole blood clotting time crude and insensitive?

A

Lots of other things influence, need adequate platelets to work

36
Q

How does drawing blood into glass tube activate clotting?

A

Has -ve charge

37
Q

How is activated clotting time more controlled than whole blood?

A

Temperature and diatomaceous earth for charge

38
Q

What is the problem with activated clotting time test?

A

Still needs platelets, insensitive

39
Q

Which pathways does APTT test?

A

Intrinsic and common

40
Q

What’s an advantage of APTT test?

A

Doesn’t need platelets (but still not sensitive)

41
Q

Above what % of reference control time is APTT abnormal?

A

20-25%

42
Q

Which pathways does OSPT activate?

A

Extrinsic and common

43
Q

WHat is the difference between OSPT and APTT?

A

OSPT provides TF as activator

44
Q

What test do you do if you suspect fibrinogen deficiency/dysfunction?

A

Thrombin clotting time

45
Q

How do you do the thrombin clotting time test?

A

Add thrombin to patients plasma to convert fibrinogen to fibrin

46
Q

How do you detect FDPs?

A

Latex agglutination

47
Q

What levels are FDPs normally?

A

Lowe

48
Q

Under what conditions are FDPs high?

A

With fibrinolysis e.g. DIC, iliac thrombosis, internal haemorrhage

49
Q

Why are FDP levels influenced by liver or kidney dysfunction?

A

This is how they are normally removed

50
Q

In what condition are D-dimers high?

A

DIC

51
Q

In what condition are D-dimers midrange?

A

Non-specific e.g. neoplasia, inflammation

52
Q

What are D-dimers produced from?

A

Cross-linked fibrin

53
Q

What does TEG test evaulate?

A

Clot formation and breakdown (clotting time and size)

54
Q

What does TEG assess that other tests can’t?

A

Hypercoagulability and hyperfibrinolysis

Clinical Pathology (30 decks)

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