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Small Animal Med. I > Disorders of Hemostasis - Green > Flashcards

Disorders of Hemostasis - Green Flashcards

1
Q

Which species get coagulopathies more frequently?

A

Dogs > cats

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2
Q

What is the most common bleeding disorder?

A

ITP

(Immune Mediated Thrombocytopenia)

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3
Q

What is the most common spontaneous bleeding disorder in DOGS?

A

Thrombocytopenia

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4
Q

Is DIC a primary disease?

A

NO!

It’s the end result of an inflammatory process that causes consumption of platelets & coagulation factors

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5
Q

vWD _______ causes spontaneous bleeding.

A

Rarely

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6
Q

Characteristics of the Primary hemostatic plug.

A
  • Short-lived (secs)
  • Unstable
  • Forms the framework 2° hemostasis
  • Platelets (deficiencies or malfxn)
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7
Q

What is the mediator of Secondary Hemostasis?

A

Clotting Factors

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8
Q

Which clotting factor has the shortest t1/2 of all the coagulation factors?

A

Factor VII

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9
Q

Which factors are involved in the Intrinsic Pathway?

A

“Not $12. It’s $11.98!”

  • Factors 12, 11, 9 & 8
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10
Q

What factors are involved in the Extrinsic Pathway?

A

Factors 3 & 7

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11
Q

What DX test looks at the Extrinsic Pathway?

A

OSPT

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12
Q

1° Hemostatic defects cause _________ or ________.

A

Platelet or vascular disorders

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13
Q

2° Hemostatic defects cause _______________.

A

Clotting factor deficiencies

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14
Q

C/S of 1° Hemostatic Defects?

A
  • Petechia, ecchymoses
  • Melena
  • Hematuria
  • Hematochezia
  • Epistaxis
  • Prolonged bleeding time after venipuncture
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15
Q

What is the most common cause of 1° Hemostatic Defects?

A

Thrombocytopenia

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16
Q

What is the most common Thrombocytopathia?

A

vWD

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17
Q

C/S of 2° Hemostatic Defects?

A
  • Deep bleeding (big bleeds)
  • Hemoabdomen
  • Hemothorax
  • Deep hematomas
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18
Q

What is the most common cause of 2° Hemostatic Disorders?

A

Rodenticide toxicity & Liver dz.

19
Q

Minimium database for 1° Hemostatic Defect?

A
  • Blood smear
  • Platelet count
  • BMBT
  • PFA (platelet fxn assay)
20
Q

Diagnostic tests for 2° Hemostatic defects?

A
  • ACT (activated coagulation time)
  • OSPT (one stage prothrombin time)
  • APTT (activated partial thromboplastin time)
21
Q

How do you perfom a platelet count estimate on a blood smear?

A

# of platelets per 100X field x 15,000 = platelets/uL

(to estimate counts 10 different areas)

22
Q

What is the normal BMBT?

What would cause it to be delayed?

A
  • Normal⇒ 2-3 mins.
  • Abnormal
    • thrombocytopenia
    • platelet dysfxn (thrombocytopathia)
    • vasculitis
23
Q

What would give you prolonged ACT?

A
  • Hemophilias
  • Rodenticide
  • DIC
  • Liver dz.
24
Q

What would give you prolonged OSPT?

A
  • Rodenticides
  • DIC
  • + Liver dz.
25
Q

What would give you prolonged APTT?

A
  • Hemophilia
  • Rodenticide
  • DIC
  • Liver dz.
26
Q

What are FDP & D-dimer tests used for?

A

Confirming DIC

  • Tests evaluate for system fibrinolysis & is often + in dogs & cats w/ DIC
27
Q

List the Vit. K dependent clotting factors?

Disease that can lead to Vit. K deficiency & therefore clotting disorders?

A
  • Factors 2, 7, 9 & 10
  • Rodenticides
  • Malabsorption due to:
    • obstructive cholestasis
    • inflitrative intestinal dz.
    • liver dz.
28
Q

List the 4 causes of Thrombocytopenia.

(Big broad ones!)

A
  • Decreased production
  • Increased destruction
  • Increased consumption
  • Increased sequestration
29
Q

List some causes of 2° Immune mediated thrombocytopenia (ITP)

A
  • RMSF
  • Ehrlichia
  • A. platys
30
Q

What is the most common cause of spontaneous bleeding in the dog?

A

ITP

(Rare in cats)

31
Q

How low must the platelet count be in order to have petechiae?

Spontaneous bleeding?

A
  • < 50,000 ⇒ Petechiae
  • < 30,000 ⇒ spontaneous bleeding in dogs
  • < 5,000 ⇒ spontaneous bleeding in cats
32
Q

What are your TX goals for ITP?

A
  1. Stop platelet destruction ⇒ Immunosuppression
  2. Reduce blood loss
    • cage rest
    • GI protectants
    • Minimize venipuncture/avoid large vein
    • Minimize other percutaneous procedures
  3. Maintain tissue oxygenation
    • Transfusions if needed
    • Monitor for developement of IMHA
  4. Provide adequate perfusion
    • IV fluids
    • Check BP
33
Q

Which drugs will increase platelet numbers in 3-5 days & give you “baby platelets”?

A

Vincristine

34
Q

What is the prognosis for ITP?

A
  • 70% respond to therapy & 25% recurrence rate
    • Poorer prognosis if have: Evan’s Syndrome or severe blood loss
35
Q

What is the most common inherited bleeding disorder in DOGS?

A

von Willebrand’s Disease

36
Q

Dobies gets _______ vWD & they have a ______ concentration of normal vWF.

A
  1. Type I
  2. decreased
37
Q

How can you DX vWD?

A
  • Normal platelet count
  • Most hemostatic screens are normal ( + APTT)
  • Prolonged BMBT
  • Abnormal PFA
  • Quantification of vWF (specialized coag labs)
38
Q

What drug can you give to patients with vWD before SX or during a bleeding episode?

A

Desmopressin acetate (DDAVP)

causes a massive release of vWF from endothelial cells

39
Q

What blood products should be given to vWD dogs?

A
  • Fresh frozen plasma
  • Whole fresh blood
  • Cryoprecipitate
40
Q

List common rodenticides that are Vit. K antagonists.

A
  • Warfarin
  • Diphacinone
  • Brodifacoum
  • Bromadiolone
41
Q

C/S of Rodenticide poisoning?

A
  • Acute collapse
  • + HX of ingestion
  • Coughing
  • Thoracic pain
  • Dyspnea
  • Pale mucous membranes
  • Signs of 2° hemostatic defects
42
Q

Which bleeding test is better for DX Rodenticide poisoning?

Why?

A

OSPT

It will be prolonged before clinical bleeding begins & before APTT

43
Q

How can you administer Vit. K1 therapy (Phytonadione)?

A
  • multiple SQ sites w/ a small gauge needle (hospital)
  • Oral (once dog is stable)
  • Long term (depending on product ingested)
44
Q

When should you recheck OSPT in patients that

you have been treating for rodenticide poisoning?

A
  • Recheck OSPT 1-2 d. after finishing Vit. K treatment
  • If prolonged, continue Vit. K longer

Small Animal Med. I (18 decks)

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