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A. Small Animal Medicine and Surgery > Disorders of Coagulation > Flashcards

Disorders of Coagulation Flashcards

1
Q

what are the four rule outs for thrombocytopenia?

A

consumption
destruction
production
sequestration

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2
Q

what are the spontaneous clinical signs of a problem with clotting?

A

petechiation
ecchymosis
epitaxis
GI hemorrhage
hematuria

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3
Q

what can you use to assess platelet function?

A

platelet aggregometry: not clinically available
buccal mucosal bleeding time
difficult to do

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4
Q

what are normal platelet numbers?

A

200,000-500,000/microL

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5
Q

spontaneous bleeding is rare if platelets are above ____________________

A

40,000/microL

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6
Q

how many platelets per high powered field is equal to about 15,000/microL?

A

one

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7
Q

what is buccal mucosal bleeding time prolonged with?

A

moderate thrombocytopenia
thrombocytopathia
von willebrand’s disease

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8
Q

what can lead to loss of platelets and thrombocytopenia?

A

bleeding
thrombosis
sequestration- trapped

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9
Q

what can cause destruction of platelets?

A

immune mediated thrombocytopenia

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10
Q

how common is immune mediated thrombocytopenia?

A

common

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11
Q

what can be seen on physical exam to show spontaneous bleeding?

A

petechiation, ecchymosis
epistaxis
GI hemorrhage
hematuria
ocular hemorrhage

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12
Q

what can be seen on a CBC with immune mediated thrombocytopenia?

A

severe thrombocytopenia- <15,000/microL
regenerative anemia
leukocytosis- inflammatory state

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13
Q

when should you be suspicious of a platelet function defect?

A

young dogs
platelet type bleeding

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14
Q

what is the most common inherited bleeding disorder?

A

von willebrand disease

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15
Q

what can you give to increase von willebrand factor release?

A

DDAVP (desmopressin)

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16
Q

what do you see with secondary hemostatic problems?

A

cavitary bleeding
hematomas
respiratory: hemoptysos
GI: hematemesis

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17
Q

when do PT/aPTT become prolonged?

A

> 75% of factors lost

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18
Q

if you have a prolonged PT and normal aPTT, what could be the problem?

A

factor VII deficiency

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19
Q

which factors are implicated in hemophilia?

A

factor VIII: A
factor IX: B

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20
Q

how is hemophilia transmitted?

A

sex linked recessive
more common in males

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21
Q

what can you give for excessive fibrinolysis?

A

aminocaproic acid

22
Q

what makes up virchow’s triad?

A

endothelial damage
hypercoagulability
turbulent blood flow/stasis

23
Q

what diseases are associated with hypercoagulability?

A

systemic inflammation
loss of endogenous anticoagulants
iatrogenic: corticosteroid use
neoplasia

24
Q

what are some things that cause changes in blood flow?

A

cardiac disease in cats
immobility or paralysis
compression of vessel by mass
organ torsion: vascular torsion

25
Q

how can we diagnose thrombosis?

A

index of suspicion:
underlying disease
physical exam
imaging

26
Q

why do we not use thrombolytics that much?

A

can result in bleeding

27
Q

what is disseminated intravascular coagulation?

A

coagulopathy associated with severe disease
mixed thrombosis and bleeding

28
Q

what is secondary hemostasis?

A

fibrin clot

29
Q

what is primary hemostasis?

A

platelet plug

30
Q

what happens in excessive bleeding?

A

decreased platelet numbers and function
decreased clotting factors

31
Q

what is an inherited disorder of primary hemostasis?

A

von willebrand’s disease

32
Q

how many platelets per high powered field are normal?

A

8-15

33
Q

what does buccal mucosal bleeding time assess?

A

platelet adhesion and aggregation

34
Q

what can cause decreased production of platelets?

A

bone marrow disease: aplastic anemia, myelofibrosis, neoplasia
drugs, toxins
radiation therapy

35
Q

what is directed against platelets in primary immune mediated thrombocytopenia?

A

autoantibodies

36
Q

are females or males more commonly impacted by ITP?

A

females

37
Q

how long does it take to respond to immunosuppression with prednisone?

A

4-6 days

38
Q

what does vincristine do?

A

increases platelet production by megakaryocytes
more rapid platelet count response

39
Q

what can cause acquired thrombocytopathia?

A

FIP
hyperglobulinemia
drug induced
uremia
hypo/hyperthermia
sepsis

40
Q

what is impaired in von willebrand’s disease?

A

von willebrand factor mediated platelet adhesion

41
Q

what is von willebrand factor?

A

major binding protein of platelet
stored in platelets and endothelial cells
bound to factor VIII
mediates contact of platelets with extracellular matrix

42
Q

how many types of von willebrand disease are there?

A

three
I, II, III

43
Q

what does DDAVP do?

A

stimulates von willebrand factor to release from endothelium

44
Q

what are the types of cavitary bleeding?

A

hemathrosis
hemothorax
hemoabdomen

45
Q

if there is a deficiency in factors IX and VIII, what is seen on PT/aPTT?

A

normal PT
elevated PTT

46
Q

which animals are symptomatic for hemophilia?

A

homozygotes

47
Q

what can lead to loss of endogenous anticoagulants?

A

PLN
PLE

48
Q

what drugs can cause hypercoagulability?

A

corticosteroids

49
Q

where can venous thrombi occur?

A

lungs- PTE (pulmonary thromboembolism)
legs- DVT (deep vein thrombosis)
portal vein- PVT (portal vein thrombosis)

50
Q

what triggers microvascular coagulation in disseminated intravascular coagulation?

A

systemic inflammation

51
Q

what becomes depleted in disseminated intravascular coagulation?

A

endogenous anticoagulants
clotting factors

A. Small Animal Medicine and Surgery (47 decks)

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