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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
What would give you prolonged A**PTT**?
* Hemophilia * Rodenticide * DIC * Liver dz.
26
What are FDP & D-dimer tests used for?
Confirming DIC * Tests evaluate for system fibrinolysis & is often + in dogs & cats w/ DIC
27
List the **Vit. K dependent** clotting factors? Disease that can lead to Vit. K deficiency & therefore clotting disorders?
* Factors 2, 7, 9 & 10 * Rodenticides * Malabsorption due to: * obstructive cholestasis * inflitrative intestinal dz. * liver dz.
28
List the 4 causes of Thrombocytopenia. | (Big broad ones!)
* Decreased production * Increased destruction * Increased consumption * Increased sequestration
29
**List some causes of 2° Immune mediated thrombocytopenia** (ITP)
* **RMSF** * ***Ehrlichia*** * ***A. platys***
30
**What is the most common cause of spontaneous bleeding in the dog?**
**ITP** **(Rare in cats)**
31
**How low must the platelet count be in order to have** **petechiae**? **Spontaneous bleeding**?
* **\< 50,000 ⇒ Petechiae** * **\< 30,000 ⇒ spontaneous bleeding in dogs** * **\< 5,000 ⇒ spontaneous bleeding in cats**
32
What are your TX goals for ITP?
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
**Which drugs will increase platelet numbers in 3-5 days & give you "baby platelets"?**
**Vincristine**
34
What is the prognosis for ITP?
* 70% respond to therapy & 25% recurrence rate * Poorer prognosis if have: Evan's Syndrome or severe blood loss
35
What is the most common **inherited** bleeding disorder in DOGS?
von Willebrand's Disease
36
**Dobies gets _______ vWD & they have a ______ concentration of normal vWF.**
1. **Type I** 2. **decreased**
37
How can you DX **vWD**?
* Normal platelet count * Most hemostatic screens are normal ( _+_ APTT) * Prolonged BMBT * Abnormal PFA * Quantification of vWF (specialized coag labs)
38
**What drug can you give to patients with vWD before SX or during a bleeding episode?**
**Desmopressin acetate (DDAVP)** ## Footnote causes a massive release of vWF from endothelial cells
39
What blood products should be given to vWD dogs?
* Fresh frozen plasma * Whole fresh blood * Cryoprecipitate
40
List common rodenticides that are Vit. K antagonists.
* Warfarin * Diphacinone * Brodifacoum * Bromadiolone
41
C/S of Rodenticide poisoning?
* Acute collapse * _+_ HX of ingestion * Coughing * Thoracic pain * Dyspnea * Pale mucous membranes * Signs of **2° hemostatic defects**
42
Which bleeding test is better for DX Rodenticide poisoning? Why?
OS**PT** ## Footnote It will be prolonged before clinical bleeding begins & before APTT
43
How can you administer Vit. K1 therapy (**Phytonadione**)?
* multiple SQ sites w/ a small gauge needle (hospital) * Oral (once dog is stable) * Long term (depending on product ingested)
44
When should you recheck OS**PT** in patients that you have been treating for rodenticide poisoning?
* Recheck OS**PT** 1-2 d. after finishing Vit. K treatment * If prolonged, continue Vit. K longer

Small Animal Med. I (18 decks)

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