Diseases Associated with Blood Loss or Hemostatic Dysfunction Flashcards

1
Q

A 10 year old Quarter horse gelding presents with a history of acute blood loss secondary to a distal limb laceration approximately 12 hours ago. The owners have been trying to control the bleeding with bandages and wraps. On presentation, the heart rate is 60 bpm, respiratory rate 30 breaths per minute and the temperature 38 C. The mucous membranes are pale pink and the capillary refill time is 2 seconds. There are decreased gastrointestinal boryborygmi. The PCV is 19% and TP 5.9 g/dl and the peripheral lactate is 3 mmol/L. The blood loss from the limb is stabilized. What would be your recommended emergency treatment for reversing the sequalae of severe hemorrhagic shock?

A

2-4 ml/kg of 7.2 % sodium chloride IV, followed by 40-80 ml/kg of isotonic crystolloids IV

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

What peripheral signs of erythrocyte regeneration are characteristic of ruminant after hemorrhage?

A

Erythrocyte polychromasia
Basophilic stippling
Howell-Jolly Bodies
Occoasional Nucleated RBC (within 4 days of onset)

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

What samples are used for the major and minor crossmatch?

A

Major cross match : Donor cells with recipient serum
Minor cross match: Recipient cells with donor serum

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

If a ruminant blood donor is incompatible with the recipient serum, what is the typical finding from the crossmatch?

A

hemolysis

Cattle do not show agglutinins like the horse

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

What is the estimated blood loss for a 500 Kg Holstein cow that had the PCV drop from 36% to 12 %?

A

27 liters of estimated blood loss

Assuming that 8% of the body weight is the blood volume

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

How many liters of whole blood would you deliver to a 50 kg goat who was estimated to have lost 2 liters of blood? The goal is to sufficiently maintain life until the bone marrow responds.

A

400-800 ml

Estimated dose for replacing 20-40% of the losses.

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

If a severe transfusion reaction occurs, what is the recommended emergency treatment?

A

epinephrine 0.01-0.02 mg/kg

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

After an acute blood loss, when does the bone marrow normally begin to replace the lost cells?

A

5 days

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

What are the most common causes of hemoperitonmeum in the horse?

A
  • Splenic trauma
  • reproductive tract and assoicated vessels
  • neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What breed(s) of horses from a recent retrospective study on hemoperitoneum were overrepresented?

A

Thoroughbreds and Arabians

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

What typical clinicopathologic abnormalities are identified in cases of hemoperitoneum?

A

anemia and hypoproteinemia
neutrophilia, lymphopenia
thrombocytopenia
hypocacleumia and azotemia

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

What is the typical PCV and TP of a hemorrhagic adbdominal effusion?

A

18% PCV
3.2 g/dl total protein

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

What are the three most common causes of GI hemorrhage (chronic blood loss) in ruminants?

A
  • abomosal lymphoma in cattle
  • parasitism
  • abomasal ulceration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which intestinal parasite of ruminants has been associated with significant hemorrahge shortly after anthlemtic treatment?

A

*Haemonchus contorus

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

How would serum ferritin be expected to change in a ruminant with an increased total iron-binding capacity and a reduction in marrow iron?

A

It will be reduced. Hypoferremia will be present.

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

What is the mechanism of disease for an NSAID associated right dorsal colitis?

A

NSAIDs inhibit cyclooxygenase (COX1>COX2) and inhibit prostaglandi E production, which can result in ishemic GI mucosal damage and delayed mucosal healing.

17
Q

What are the two interrelated components ( functions) associated with hemostasis?

A
  • coagulation (arrest bleeding from damaged vessel)
  • fibrinolysis ( keep blood vessels open to maintain nutrient flow)
18
Q

What are the key steps of coaugulation that occur when a blood vessel is damaged?

A
  1. vasoconstriction
  2. platets adherence to the subendothelial collagen
  3. platelet membrane conformation change
  4. platelet aggregation, contraction and granule secretion (basic platelet reaction)
  5. Platlet phospholipoprotein (PF3) provides surface to catlyze interactions among activiated coag. proteins = thrombin formation
19
Q

The extrinsic coagulation pathway is initiated by what factor?

A

lioprotein tissue factor (TF) which is found widely distributed in most tissues

20
Q

How is the intrinsic coagulation pathway inititiated?

A

blood is exposed to a negatively charged surface (activated platelet)

21
Q

Both the intrinsic and extrinsic coagulation pathway culminate in the formation of what factor?

A

activated factor X (Xa) which leads to thrombin

22
Q

What is the primary physiological inhibitor of thrombin and Xa?

A
  • antithrombin II (AT III)
  • It provides 70% of the anticoagulant activity of plasma
23
Q

Which factors are inhibited by the protein C system?

A

Factor V and VIII

24
Q

What is the primary plasma protein responsible for fibrin degredation?

A

plasmin (plasminogen zymogen)

25
Q

What is the most important factor that determines the rate of fibrinolysis?

A

fibrin formation