Bleeding (British Lady) Flashcards
What are the 3 problems related to bleeding?
Epistaxis
Melena
Red urine
Epistaxis
Bleeding from the nasal cavity or the nares
Melena
Passing digested blood
From diet (red meat), swallowing blood, GI bleeding
Red urine
Hematuria (true blood in the urine)
Hemaglobinuria (Hb in the urine, not overt blood)
Myoglobinuria (dark red/ brown, broken down m. proteins)
Local dz causing epistaxis
Neoplasia, fungal infection, FBs
Lymphocytic-plasmacytic rhinitis
Local vasculitis
Severe dental dz
Idiopathic
Systemic dz causing epistaxis
Coagulopathy
Hypertension
Polycythemia
Hyperviscosity
Systemic vasculitis
What causes primary and local melena?
Primary GI dz from neoplasia, parasites, FB and inflammatory
Systemic dz causing melena (secondary)
Coagulopathy
Systemic vasculitis
Systemic dz causing ulceration: hypoadrenocorticism, mast cell tumor, liver dz, uremia and drugs
What does dysuria and poillakiuris confirm?
Lower UT dz of the bladder, urethra, prostate
Local causes of hematuria
Bacterial cystitis
Urinary calculi
Prostatitis
Idiopathic cystitis (cats)
Polyps
Bladder neoplasia (transitional cell carcinoma)
Neoplasia of the renal pelvis
Idiopathic renal hemorrhage
Vascular anomalies
Bleeding disorderss
Abnormality of the vessel wall (trauma, vasculitis)
Reduced platelet numbers (thrombocytopenia)
Platelet dysfunction (lack of vWF)
Defect in the extrinsic or intrinsic coagulation cascade
What does impaired coagulation lead to?
Bleeding
What does ↓ hemostatic modulation and fibrinolysis lead to?
Thromboemboli
CS of bleeding disorders
↓ platelet numbers or impaired platelet function (bleeding from mucosal surfaces)
Clotting factor deficiencies (deeper tissue and body cavity hemorrhages)
Common causes of bleeding disorders
Immune-mediated thrombocytopenia
vWB dz
Drug-induced platelet dynsfunction
Rodenticide poisoning
Infectious thrombocytopenia
Angiostrongylus vasorum
Platelet count (dx of bleeding disorders)
Absolute count (hematology machines)
8-15 plates per HPF (x100)
50 x 10^9 = 3-4 platelets per HPF
Multiple platelet clumps in the feathered edge tells you what?
Number adequate for hemostatsis
Thrombocytopenia
Inadequate production: BM disorders, drugs
Excessive consumption: DIC
Excessive destruction: immune mediated
What causes thrombocytopenia
Erlichia, babesia, angiostrongylus, anaplasma
Platelet function defects
vWB dz, Drugs (NSAIDs)
Systemic disorders (uremia, liver dz, pancreatitis, dysproteinemia)
Buccal bleeding time (dx of bleeding disorders)
Crude screening test for platelet abnormalities
Standard cut made with spring-loaded lancet
<4 mins in dogs and <3mins in cats
Platelet function dx
Crude measure: clot retraction
Clot should separate from the serum and contract to 50% of the OG vol by 4-6 hrs
von Willebrand’s factor
Measure on citrated plasma, frozen in plastic tubes after immediate separation from RBCs
Coagulation defects
Hereditary factor deficiency
Acquired multiple factor deficiencies (DIC and liver dz)
Vitamin K disorders (epoxide)
Vitamin K disorders
Warfarin/rodenticide toxicity
Malabsorption of vit. K
Liver dz
Devon rex coagulopathy
Dx of coagulation factor disorders
Whole blood clotting time (WBCT)
Activated clotting time (ACT)
Activated partial thromboplastin time (APTT)
Prothrombin time (PT)
Thrombin time (TT)
