Disorders of Haemostasis Flashcards

1
Q

Define haemostasis

A

Stopping of the flow of blood

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2
Q

3 stages of haemostasis

A

Primary Haemostasis: Formation of platelet plug
Secondary Haemostasis: Stabilisation of platelet plug (Fibrin formation)
Tertiary Haemostasis: Breakdown of platelet plug

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3
Q

What is the function of von williebrand factor

A

Involved in the tethering platelet to vascular wall involved in primary haemostasis

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4
Q

What is the name and function of the protein most involved in tertiary haemostasis

A

Plasmin. Breaks down crosslinked fibrin to fibrin degradation products

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5
Q

List common disorders of primary haemostasis

A

Thrombocytopenia
Thrombocytopathia (Platelet dysfunction)
Von Willebrand’s disease (Congenital)
Vasculopathies

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6
Q

List common disorders of secondary haemostasis

A

Anticoagulant rodenticide toxicity
Liver failure
Congenital factors e.g. Haemophilia

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7
Q

Haemophilia

A

Congenitial disease that affects clotting

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8
Q

What is the most common congenitial bleeding disorder in german shepards

A

Hemophilia A/Factor VIII Deficiency is an inherited bleeding disorder in German Shepherd Dogs and related breeds caused by a deficiency of the coagulation factor VIII (F8), a protein necessary for blood clotting.

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9
Q

What is the most common congenital bleeding disorder in doberman pincher

A

Von Willebrand Disease (vWD)

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10
Q

What are common clinical findings of thrombocytopenia

A

Petechiation
Ecchymosis
GI bleeding causing melaena
Clinical signs associated with anemia

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11
Q

Petechiation

A

pinpoint, reddish or purplish spot containing blood that appears in skin or mucous membrane as a result of localized hemorrhage

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12
Q

Ecchymosis

A

Broad localised bruises

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13
Q

Melaena

A

Blood in faeces

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14
Q

List laboratory assessment for primary haemostasis

A

Platelet count
BMBT (Buccal mucosal bleeding time)
Activated clotting time

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15
Q

What are common clinical findings of Von Willebrand Disease

A

Excessive bleeding at surgical sites
Prolonged bleeding at oestrous

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16
Q

What are common clinical findings of coagulopathies

A

Haematoma formation
Pulmonary haemorrhage
Bleeding into body cavities

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17
Q

List laboratory assessment for secondary haemostasis

A

Standard coagulation test:
Prothrombin time
Activated partial thromboplastin time
Fibrinogen
Activated clotting time

18
Q

List laboratory assessment for tertiary haemostasis

A

Fibrin degradation products

19
Q

Causes of thrombocytopenia

A

Immune mediated thrombocytopenia
Bone marrow failure
Infectious disease (Anaplasmosis/Ehrilichosis)
Increased consumption (Severe blood loss)
Breed variation

20
Q

Cocker spaniels are predisposed to have what haemostatic disorder?

A

Immune mediated thrombocytopenia

21
Q

How is immune mediated thrombocytopenia diagnosed

A

Diagnosed by exclusion
Clinical signs include surface/capillary bleeding (Primary haemostatic disorder)
Low platelet count

22
Q

Management of Immune mediated thrombocytopenia

A

Gentle handling
Blood transfusion if anemic enough
Treatment of underlying trigger if secondary
Immunosupression
Vincristine to increase number of circulating platelets

23
Q

Diagnosis of anticoagulant rodenticide toxicity

A

History of potential exposure
Lab test for secondary haemostatic disorders
Increased prothrombin time

24
Q

Treatment for anticoagulant rodenticide toxicity

A

<6 hours: emesis (vomitting), monitoring PT
Vit K1
Supportive care

25
Q

Clinical signs for liver disease

A

Coagulopathy: Cavity bleeds
Increased risk for bleeding with biopsy

26
Q

How does liver disease affect haemostasis

A

Failute to absorb Vit K1
Reduced production of clotting factors
Reduced acitvation of vitamin K dependant factors

27
Q

Which protein clotting time would you look at if confirming a diagnosis for liver disease

A

Prolonged prothrombin clotting time

28
Q

Name the parasite that can cause haemostasis disorders

A

Angiostrongylus Vasorum (French Lungworm)

29
Q

Lungworm diagnosis

A

Faecal Baermann’s test for L1 larvae (3-day pooled sample to increase sensitivity)
Faecal wet prep
In-house ELISA: IDEXX Angio Detect

30
Q

Treatment for lungworm

A

Supportive care for haemorrhage (transfusion?)
Parasite kill
Imidacloprid/ moxidectin and milbemycin licenced in UK
Steroids: for ‘worm-kill’ effect

31
Q

What is DIC

A

Disseminated Intravascular Coagulation
Dysfunction of the normal regulatory mechanisms of coagulation and fibrinolysis resulting in unregulated production of THROMBIN and self-perpetuating activation of coagulation and fibrinolysis.

32
Q

Clinical signs of DIC

A

Mixture of thrombosis and bleeding

33
Q

Treatment of DIC

A

Eliminating initiating cause
Ensuring adequate tissue perfusion
Supporting target organs susceptible to microthrombi, ischaemia or haemorrhage
Replacement of blood components

34
Q

Thrombocytopathia

A

Platelet Dysfunction
Usually associated with an underlying disease process

35
Q

Diagnosis of Thrombocytopathia

A

Normal PLT count and standard coagulation tests
Prolonged BMBT (Ddx von Willebrand’s Disease)

36
Q

Oral petechiae in a cat could be caused by?

A

Primary coagulation disorders
Thrombocytopenia
Concurrent DIC could be a differential

37
Q

PPT (activated thromboplastin time) determines which pathways?

A

Intrinsic and common pathway

38
Q

PT (prothrombin time) determines which pathways?

A

Extrinsic and common

39
Q

Prolonged PPT time with normal PT time suggest deficiency in which factors and what disease?

A

Factor 8 (VWD and haemophilia A)
Factor 9 (Haemophilia B)
Factor 11/12

40
Q

Prolonged PT time with normal PPT time suggest deficiency in which factors and what disease

A

Factor 7 (DIC/Vit K antagonism)

41
Q

What does Prolonged PT time and PPT time suggest

A

Vit K deficiency
Rodenticide toxicity
Excessive warfarin treatment
Liver disease