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Clinical Pathology > 11: Coagulopathies > Flashcards

11: Coagulopathies Flashcards

1
Q

Which kind of conditions cause increased platelet consumption?

A

Inflammatory

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2
Q

Which condition is consumptive thrombocytopenia associated with?

A

DIC

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3
Q

Which conditions are mild thrombocytopenia associated with?

A

Vasculitis, endocarditis, intravascular coagulation

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4
Q

What causes primary IMTP?

A

Idiopathic

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5
Q

What are some causes of secondary IMTP?

A

Drugs, neoplasia, infection e.g. anaplasma

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6
Q

What is signalment for IMTP?

A

Cockers, Mini Poodles, OES esp young and middle aged

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7
Q

What are clinical signs of IMTP?

A

Primary coagulopathy signs + lethargy, weakness, fever, hepato/splenomegaly, lymphadenopathy

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8
Q

What is also seen on bloods in IMTP?

A

Left-shifted neutrophilia

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9
Q

What is IMTP + IMHA called?

A

Evans’ syndrome

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10
Q

How do you diagnose IMTP?

A

Rule out others, search other causes

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11
Q

How do you treat IMTP?

A

Preds then wean off. Sometimes transfusions or platelet-rich plasma.

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12
Q

Which drug can increase platelet production?

A

Vincristine

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13
Q

Why do you do splenectomy in IMTP?

A

Spleen is destroying platelets

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14
Q

What is mortality of IMTP?

A

30%

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15
Q

What do plasma blood products contain?

A

vWF and clotting factors

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16
Q

What is lifespan of plasma?

A

Short

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17
Q

What is a problem with platelet-rich plasma?

A

Hard to prepare

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18
Q

What drug can cause reduced bone marrow platelet production in cats?

A

Azathioprine

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19
Q

What are some infections that can cause reduced bone marrow platelet production?

A

FIV, FeLV, FIP, distemper, parvo, lepto, anaplasma

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20
Q

How common is immune-mediated megakaryocyte production?

A

Rare

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21
Q

What are two types of inherited thrombocytopathia?

A

vWD, Chediak-Higashi syndrome

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22
Q

How common is acquired thrombocytopathia?

A

Not common

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23
Q

What are three causes of acquired thrombocytopathia?

A

Hyperglobulinaemia, neoplasia, NSAIDs

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24
Q

What species is vWD the most common in?

A

Rare in cats, the most common coagulopathy in dogs

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25
Q

What is platelet count like in vWD?

A

Normal

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26
Q

How do you test for vWD?

A

Assay and genetic testing

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27
Q

How do you treat vWD?

A

Palliative e.g. desmopressin, minimise trauma

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28
Q

How does desmopressin work to treat vWD?

A

Causes vWF release

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29
Q

How does desmopressin affect BMBT?

A

Short term (4h) reduction

30
Q

How reliable is desmopressin to treat vWD?

A

Not very

31
Q

What is haemophilia A a deficiency of?

A

Factor VIII

32
Q

Which sex gets haemophilia A?

A

Sex linked, males > females

33
Q

What is severity of signs like in haemophilia A?

A

Severity of signs variable

34
Q

How are APTT and OSPT affected in haemophilia A?

A

APTT increased, OSPT normal

35
Q

How do you test for haemophilia A?

A

Factor VIII

36
Q

What is treatment for haemophilia A?

A

None

37
Q

What are some complications of haemophilia A?

A

Intra-articular or body cavity bleeds

38
Q

What is the most common inherited secondary coagulopathy?

A

Haemophilia A

39
Q

What is the most common cause of secondary coagulopathy?

A

Hepatic disease

40
Q

What are two causes of vitamin K rodenticide?

A

Diet deficiency or rodenticide

41
Q

Which tumours produce heparin?

A

Mast cell

42
Q

Which antibodies can cause secondary coagulopathy?

A

To clotting factors

43
Q

How do rodenticides work?

A

Inhibit epoxide reductases so inactive vit K can’t be converted to activated so clotting factors can’t be activated

44
Q

What is platelet count like in rodenticides?

A

Normal or mildly reduced

45
Q

How do you diagnose rodenticide poisoning?

A

Coagulation testing

46
Q

Which test becomes abnormal first following rodenticide poisoning?

A

OSPT (II, VII, X)

47
Q

Which tests become prolonged in rodenticide poisoning?

A

APTT, WBCT, ACT

48
Q

How do you treat rodenticide poisoning?

A

More active vitamin K sub cut then orally for 1-6 weeks, but check 2d after stopping treatment

49
Q

How do you treat severe cases of rodenticide poisoning?

A

Fresh blood or plasma

50
Q

Which types of haemostasis do angiostrongylus and DIC both affect?

A

Primary and secondary

51
Q

What causes DIC?

A

Marked inflammatory response leading to small vessel clots

52
Q

What blood components are consumed in DIC?

A

All platelets and clotting factors

53
Q

What are clinical signs like in DIC?

A

Subtle initially, then associated with end organ damage e.g. kidney, CNS

54
Q

How do you diagnose DIC?

A

Low platelets and fibrinogen, high D dimers, prolonged OSPT and APTT

55
Q

How do you treat DIC?

A

Underlying cause, with oxygen, fluids, heparin, transfusions

56
Q

What is prognosis for DIC?

A

Poor

57
Q

How do you diagnose A vasorum?

A

Larvae or a snap test - prolonged OSPT, APTT, thrombocytopenia, elevated D dimers

58
Q

How do you treat A vasorum?

A

Fenbendazole, imidocloprid, moxidectin, +/- pred

59
Q

What condition can cause blood stasis in cats?

A

Hypertrophic cardiomyopathy

60
Q

What are two conditions that can cause decreased anticoagulant factors?

A

Cushing’s or protein-losing nephropathy

61
Q

Which condition causes increased endogenous procoagulants?

A

IMHA

62
Q

Where is vWF found?

A

Subendothelial matrix

63
Q

What two things does vWF anchor platelets to?

A

Injury and each other

64
Q

Which factor does vWF bind to to initiate secondary clot formation?

A

Factor VIII

65
Q

What is type 1 vWD?

A

All multimers present but low conc

66
Q

Which kind of vW glycoproteins are more functional?

A

Larger

67
Q

Which breed gets type 1 vWD?

A

Doberman

68
Q

What is type 2 vWD?

A

Large monomers lost

69
Q

Which breed gets type 2 vWD?

A

German short haired pointer

70
Q

What is type 3 vWD?

A

Lack all multimers

71
Q

Which breed gets type 3 vWD?

A

Scottish terriers, shetland sheepdogs, chesapeake bay retrievers

Clinical Pathology (30 decks)

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