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.systems based core clinical specialties > Bleeding > Flashcards

Bleeding Flashcards

1
Q

Classifications of bleeding

A

Induced (sx or trauma)
Spontaneous (thrombocytopenia, rodenticides)
Life threatening (trauma, hemangiosarcoma)
Mild/ self-limiting (nose bleed)

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2
Q

Petechia

A

Small pinpoint bleedings underneath the skin (on mm)

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3
Q

Ecchymosis

A

Over a larger area, well-developed bruising

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3
Q

BMBT

A

Buccal mucosal bleeding time
Evaluate platelet function

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4
Q

vWT

A

Von Willabrands factor
How platelets attach to the collagen from a vessel injury

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5
Q

APTT and PT

A

Partial thromboplastin time and Prothrombin time
ID how a certain coagulation pathway is working
Intrinsic v extrinsic cascade

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6
Q

AT3

A

Antithrombin 3
Protein made in the liver, cofactor for heparin
Inhibits factors 9, 10 and thrombin (stopping excessive clot formation)

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7
Q

Primary Hemostasis

A

Forms an unstable platelet plug stopping capillary bleeding
Need vascular endothelium, platelets, vWF

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8
Q

Secondary Hemostasis

A

Larger vascular injury
Need clotting factors to form a stable fibrin clot

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9
Q

Fibronolysis

A

Breaking down the fibrin clots

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10
Q

Platelets

A

Made in BM by megakaryocytes
Life span: 5-7d
Norm: >200,000, spontaneous bleeding <30,000

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11
Q

Clotting factors

A

Produced in liver
Some vit. K dependent (2,7,9,10: inactive form)
Extrinsic, common and intrinsic

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12
Q

Primary hemostatic dz (hereditary)

A

Thrombocytopenia (↑ BT, ↓ plates)**
Von Willebrand’s (↑ BT)
Glanzmann’s (platelets aren’t working properly)

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13
Q

Secondary hemostatic dz (acquired)

A

Hemophilia A or B (↑ACT, aPTT)
Vitamin K deficiency (↑ACT, OSPT, aPTT, ↓plates, fibrinogen and FDP)

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14
Q

Overcompensating disorders (acquired)

A

DIC (↑BT, ACT, OSPT, aPTT, FDP, ↓plate, fibrinogen)
Thrombocytosis

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15
Q

Dx primary hemostasis

A

CBC for platelets and vWF
Bloodsmear (plate count:8-10)
BMBT

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16
Q

Dx for secondary hemostasis

A

Tests for coagulation
PT (extrinsic)
ACT, APTT

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17
Q

Test tubes

A

Purple top: tubes with EDTA- prevent clotting but binding Ca
Blue top: with Ca sitrate to stop clotting

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18
Q

Dog blood types

A

12 major groups named DEA (1.1 and 1.2 most common)
Cross match after transfusion

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19
Q

T/F: Dogs do not have natural Abs against their blood

A

TRUE
less chance of reactions with blood transfusion

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20
Q

Cats blood types

A

Types A*, B and AB (universal recipient)
Have naturally occurring Abs → life threatening complications (always need cross match)

21
Q

Cat transfusion reactions

A

A → B= death
B → A= good
A or B → AB= really good

22
Q

Crossmatching reasoning

A

Naturally occurring pathogenic AB present (cats)
No naturally occurring pathogenic AB, but previously sensitized to red cell Ag (dog)

23
Q

Major cross match

A

Donor’s RBCs + recipient serum

24
Q

Initial bleeding tx

A

Blood transfusion:
Whole blood
Packed RBCs (spinning and concentrating RBCs- low anemia)
Plasma (spin, on top)
Platelets

25
Q

Transfusion rx

A

Acute v delayed
Immunologic v non (fever, vomiting, facial edema, fluid overload, dyspnea, hemolysis)

26
Q

Hemophilia A

A

Factor 8 deficiency (↑ bleeding)
Most common inherited bleeding disorder in K9s
Sex linked trait (mostly males)

27
Q

Most common breeds with Hemophilia A

A

German shepherds
Gold retrievers

28
Q

Hemophilia B (Christmas dz)

A

Factor 9 deficiency (milder dz)
Primarily in males

29
Q

CS for hemophilias

A

Weakness, dyspnea, recurrent hematomas, bleeding from loss of baby teeth

30
Q

On PE seen with hemophilia

A

Bleeding from sx site/ trauma site
Epistaxis
Signs of bleeding into the body cavity
Pale mm

31
Q

Dx hemophilias

A

HCT/ total proteins
Platelet count
APTT prolonged
Coagulant activity assays

32
Q

Tx for hemophilias

A

Transfusions (fresh frozen plasma)
Pre-op transfusions
↓ strenuous activity
Avoid anticoagulants (NSAIDs, clopidogrel)

33
Q

Von Willebrand’s Dz

A

Quantitative/ functional deficiency of vWF
Most common hereditary bleeding disorder in K9s, autosomal trait
Types 1**, 2 and 3

34
Q

Dx Von Willebrand’s Dz

A

PE
PCV, TS and platelet count
Coagulation panel
BMBT
Measure vWF in plasma

35
Q

Tx of Von Willebrand’s Dz

A

Control bleeding
Avoid unnecessary trauma/ surger
Avoid meds and correct underlying dz

36
Q

Glanzmann’s thrombastenia

A

Platelets don’t aggregate normally and no clot
Defect/ mutation in glycoprotein 2b
Odd shaped, giant plates, genetic testing

37
Q

Which breeds show Glanzmann’s?

A

Otterhounds, Great pyrenees

38
Q

Vitamin K deficiency

A

Most common cause: rodenticide
Depletion of factors → coagulopathy
Lag period of 3-5d btwn exposure and CS

39
Q

Dx for Vit. K deficiency

A

CBC, chemistry, coagulation panel (PT prolonged first, then APTT)

40
Q

Tx of Vitamin K Deficiency

A

Bleeding: transfusions and Vit. K1
No bleeding: Monitor PT (vomit, activated charcoal)

41
Q

Thrombocytopenia

A

↓ platelet production (no making enough- BM problem)
↑ platelet destruction (immune mediated), consumption (DIC) and sequestration (in spleen for a while)

42
Q

Secondary thrombocytopenia

A

Secondary to another underlying problem
Tickborne dz, infectious causes, meds, neoplasia

43
Q

Primary thrombocytopenia

A

Idiopathic
Immune mediated destruction of platelets

44
Q

Triggering factors of thrombocytopenia

A

Drugs (rimadyl, estradiol, carprofen)
Vx
Stress
Infection

45
Q

DD for thrombocytopenia

A

Tick borne dz
Neoplasia
FIV/FeLV

46
Q

Tx for thrombocytopenia

A

Tx underlying dz (sx, doxycycline)
Transfusions
Immunosuppression (prednisone)
↓ activity

47
Q

Thrombocytosis

A

↑ in # of platelets in circulation
Primary (myeloproliferatice dz)
Secondary

48
Q

Secondary thrombocytosis

A

Reactive
Neoplasia, inflamm, trauma, steroid uses, cushings’

49
Q

Dx and Tx of thrombocytosis

A

CBC, bloodsmear
Tx is to ↓ risk of thromboembolic dz

.systems based core clinical specialties (27 decks)

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