Disorders of Coagulation Flashcards
what are the four rule outs for thrombocytopenia?
consumption
destruction
production
sequestration
what are the spontaneous clinical signs of a problem with clotting?
petechiation
ecchymosis
epitaxis
GI hemorrhage
hematuria
what can you use to assess platelet function?
platelet aggregometry: not clinically available
buccal mucosal bleeding time
difficult to do
what are normal platelet numbers?
200,000-500,000/microL
spontaneous bleeding is rare if platelets are above ____________________
40,000/microL
how many platelets per high powered field is equal to about 15,000/microL?
one
what is buccal mucosal bleeding time prolonged with?
moderate thrombocytopenia
thrombocytopathia
von willebrand’s disease
what can lead to loss of platelets and thrombocytopenia?
bleeding
thrombosis
sequestration- trapped
what can cause destruction of platelets?
immune mediated thrombocytopenia
how common is immune mediated thrombocytopenia?
common
what can be seen on physical exam to show spontaneous bleeding?
petechiation, ecchymosis
epistaxis
GI hemorrhage
hematuria
ocular hemorrhage
what can be seen on a CBC with immune mediated thrombocytopenia?
severe thrombocytopenia- <15,000/microL
regenerative anemia
leukocytosis- inflammatory state
when should you be suspicious of a platelet function defect?
young dogs
platelet type bleeding
what is the most common inherited bleeding disorder?
von willebrand disease
what can you give to increase von willebrand factor release?
DDAVP (desmopressin)
what do you see with secondary hemostatic problems?
cavitary bleeding
hematomas
respiratory: hemoptysos
GI: hematemesis
when do PT/aPTT become prolonged?
> 75% of factors lost
if you have a prolonged PT and normal aPTT, what could be the problem?
factor VII deficiency
which factors are implicated in hemophilia?
factor VIII: A
factor IX: B
how is hemophilia transmitted?
sex linked recessive
more common in males