Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Haematology (MOD) > Approach to the bleeding patient > Flashcards

Approach to the bleeding patient Flashcards

1
Q

When approaching the bleeding patient, the first thing to do is to identify life threatening situations. Give examples of these situations

A

Hypovolaemic shock
Severe anaemia
Brain haemorrhage
Pulmonary haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How can you stabilise a bleeding patient?

A

Control haemorrhage with wound pressure
Blood transfusion
Volume replacement wuith IVFT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

After stabilising a bleeding patient, what is the next thing to do?

A 
Collect blood samples:
Full blood count (EDTA) 
Coagulation profile
Biochem 
PCV/total protein
Blood smear
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When examining a bleeding patient, what should you consider?

A

Signalment
History - when started, any recent trauma, medications
Is bleeding local or systemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe basically how a blood vessel responds to injury

A

Vessel injury causes vessel contraction
Primary haemostasis - primary plug
Secondary haemostasis - coagulation cascade and fibrin
Tertiary haemostasis - fibrinolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Primary haemostasis involves creating a primary plug within seconds/minutes of vessel injury. What substances/factors are involved?

A

Endothelium collagen
Platelets
Von Willebrand factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tertiary haemostasis involves fibrin. What is fibrin?

A

Insoluble protein

Forms fibrous mesh that impedes blood flow (aids clotting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is fibrin formed from?

A

Fibrinogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is fibrinogen?

A

Glycoprotein circulating in blood

Converted to fibrin during injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens during primary haemostasis?

A

Formation of primary plug by Von Willebrand factor and platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What cells make von Willebrand factor?

A

Megakaryocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens during secondary haemostasis?

A

Coagulation cascade
Extrinsic activated by tissue factor, intrinsic activated by exposure of damaged endothelium
Results in fibrinogen –> Fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the third stage of haemostasis?

A

Fibrinolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does the size of an injury/defect alter haemostasis?

A

Small defect = primary haemostasis only

Large defect = requires platelets and stabilisation of clot by cross-linked fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are primary haemostasis disorders?

A

Disorders caused by platelet disorders or vasculopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the clinical signs of primary haemostatic disorders?

A

Ooze from small wounds
Petechia and ecchymoses
Bleeding from mms (epistaxis, melaena)
Signs of underlying disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common cause of abnormal bleeding in dogs?

A

Thrombocytopenia

18
Q

What are some causes of thrombocytopenia?

A

Increased platelet destruction - immune mediated (common), primary, or secondary
Increased platelet consumption
Platelet sequestration
NOT caused by platelet loss from haemorrhage

19
Q

What are some differentials for thrombocytopenia?

A 
Neoplasia
DIC (platelet consumption)
Infectious disease
Immune mediated
Breed related - may not be pathological
20
Q

What is the most common cause of marked thrombocytopenia in dogs?

A

Immune mediated thrombocytopenia (IMTP)

21
Q

Immune-mediated thrombocytopenia (IMTP) is common in dogs. Primary IMPT is usually seen in which dogs?

A

Females

Spaniels

22
Q

Immune-mediated thrombocytopenia (IMTP) is common in dogs. What can cause secondary IMTP?

A

Drug reactions - cephalosporins
Neoplasia
Viral disease
Ehrlichia or the vaccine (live virus)

23
Q

What are patients with IMTP at risk of? How can this be reduced?

A

Spontaneous haemorrhage

Reduce risk of trauma, reduce activity

24
Q

What is the treatment of IMTP?

A

If secondary treat underlying disease
Supportive
Immunosuppressives

25
Q

What immunosuppressive drugs can be given for IMTP? (Similar to IMHA)

A

Corticosteroids

Azathioprine

26
Q

What is von Willebrand disease?

A

Acquired or inherited deficiency of von Willebrand factor

27
Q

Von Willebrand disease can be acquired or inherited. What condition can cause it to be acquire?

A

Severe aortic stenosis

28
Q

Where is Von Willebrand factor synthesised and stored?

A

Endothelial cells

29
Q

Von Willebrand disease can be acquired (severe aortic stenosis) or inherited. Which breed is predisposed to this disease?

A

Dobermanns

30
Q

What tests can be used to diagnose Von Willebrand disease?

A

BMBT (buccal mucosal bleed time)
Antigenic test
vWF function assays
Genetic testing to detect carriers

31
Q

What is the treatment for von Willebrand disease?

A

Cryoprecipitate (from frozen blood plasma)

Whole blood or plasma therapy

32
Q

What are 3 types of Von Willebrand disease? Which is most common?

A

Type 1 - most common
Type 2
Type 3

33
Q

Briefly explain the 3 types of Von Willebrand disease

A

Type I - partial quantitive deficiency
Type 2 - qualitative deficiency
Type 3 - severe quantitative deficiency

34
Q

What are some symptoms of type I von Willebrand disease?

A

Bleeding from mucous membranes

Excessive bleeding/haemorrhage during surgery

35
Q

Von Willebrand disease can be inherited. What type of inheritance is it?

A

Autosomal recessive

36
Q

Platelet dysfunctions can be associated with many conditions and drugs. What group of drugs in particular?

A

NSAIDs

E.g. aspirin

37
Q

How can platelet function be tested?

A

Buccal mucosal bleeding time (BMBT)
Clot retraction
Platelet function tests (usually not available, must be carried out within 4hrs)

38
Q

Disorders of secondary haemostasis are either inherited or acquired. Which is more common?

A

Acquired

39
Q

What is haemophilia A?

A

Genetic disorder

Deficiency of Factor VIII

40
Q

What is haemophilia B?

A

Genetic disorder

Deficiency of Factor IX

41
Q

What causes extrinsic pathway defects?

A

Hepatic/hepatoiliary diseae

OR early vitamin K antagonism/deficiency

Haematology (MOD) (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions