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SA DX & TX I > Exam 3 - Disorders of Secondary Hemostasis > Flashcards

Exam 3 - Disorders of Secondary Hemostasis Flashcards

1
Q

what is TF? why is it important?

A

tissue factor - present on membrane of most cells & is released when trauma occurs activation factor VII - the main activator of coagulation

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2
Q

what is the main factor that serves as the activation factor of coagulation?

A

factor VII

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3
Q

what is responsible for the production of factor VIII?

A

vascular endothelial cells - still requires liver function for activation

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4
Q

what factors are included in the intrinsic pathway?

A

XII, XI, IX, VIII

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5
Q

what factors are included in the extrinsic pathway?

A

VII

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6
Q

what factors are included in the common pathway?

A

X, V, II, I

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7
Q

T/F: a single factor must be <30% to cause a prolongation of PT/PTT

A

true

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8
Q

what is the pathogenesis of anticoagulant rodenticide toxicity?

A

rodenticides inhibit the enzyme that regenerates vitamin K

vitamin K is essential for factors II, VII, IX, & X

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9
Q

when do animals develop clinical signs from anticoagulant rodenticide toxicity?

A

1-4 days

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10
Q

how is anticoagulant rodenticide toxicity diagnosed?

A

based on Pt, PTT, & history of exposure

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11
Q

what are some examples of anticoagulant rodenticides?

A

warfarin, diphacinone, brodifaccoum

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11
Q

what are some examples of anticoagulant rodenticides?

A

warfarin, diphacinone, brodifaccoum

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12
Q

what coagulation test is the first to be prolonged in anticoagulant rodenticide toxicity? why?

A

PT

factor VII has the shortest half-life, so it’s affected first

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13
Q

what is the treatment for recent ingestion of anticoagulant rodenticide?

A

induce vomiting, give activated charcoal, & treat with vitamin k1

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14
Q

what are the 7 disorders covered for disorders of secondary hemostasis?

A
  1. vitamin k antagonist rodenticide toxicity
  2. vitamin k deficiency
  3. liver dysfunction
  4. inherited coagulation factor deficiencies
  5. disseminated intravascular coagulation
  6. drugs
  7. snake envenomation
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15
Q

what does PT evaluate?

A

extrinsic & common pathways - factors VII, X, V, II, & I

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16
Q

PT may be prolonged due to deficiency/dysfunction of what 2 factors?

A

VII & X

17
Q

other than factor deficiency/dysfunction, what other conditions can cause a prolonged PT?

A

liver dysfunction, disseminated intravascular coagulation, heparin administration, or hypofibrinogenemia

18
Q

what does PTT evaluate?

A

intrinsic & common pathways - factors XII, XI, IX, VIII, X, V, II, & I

19
Q

PTT may be prolonged due to deficiency/dysfunction of what factors?

A

factors VIII, IX, XII, XI, II, V, X

20
Q

PTT may be prolonged due to deficiency/dysfunction of what factors?

A

factors VIII, IX, XII, XI, II, V, X

21
Q

other than factor deficiency/dysfunction, what other conditions can cause a prolonged PTT?

A

heparin therapy, liver dysfunction, hypofibrinogenemia, dysfibrinogenemia, or DIC

22
Q

what does the activated clotting time assess?

A

intrinsic & common pathways

23
Q

what is hemophilia a?

A

congenital deficiency of factor VIII that is x-linked, so it’s carried by females & manifested in males

24
Q

what clinical signs are commonly seen in hemophilia a?

A

severe, spontaneous bleeding, bleeding into joints & skeletal muscle is common, some patients die within a few weeks of life

25
Q

what abnormalities are seen on diagnostic tests for patients with hemophilia a?

A

prolonged PTT with a normal PT

26
Q

what is the treatment for hemophilia a?

A

give fresh plasma or cryoprecipitate which contain factor VIII to control bleeding

27
Q

how is hemophilia a diagnosed?

A

confirmed with specific factor assay

28
Q

what abnormalities are seen on diagnostic tests for patients with hemophilia b?

A

prolonged PTT with a normal PT

29
Q

what is hemophilia b?

A

uncommon congenital deficiency of factor IX occurring in dogs & cats

30
Q

what is hageman deficiency?

A

factor XII deficiency especially common in cats

31
Q

what abnormalities are seen on diagnostic tests for patients with hageman deficiency?

A

prolonged PTT - but patients don’t bleed abnormally

32
Q

factors II, VII, IX, & X are made in the liver but require what for the final step of synthesis?

A

vitamin K

33
Q

what enzyme is inhibited in anticoagulant rodenticide toxicity?

A

vitamin K epoxide reductase - responsible for vitamin K regeneration

34
Q

why is vitamin k not given IM or IV?

A

IM - not given because of hematoma formation

IV - avoid due to risk of anaphylaxis or heinz bodies formation

35
Q

what can cause vitamin k deficiency?

A

severe cholestatic liver disease, severe small intestinal disease

36
Q

how do you treat vitamin k deficiency?

A

supplement with subcutaneous vitamin K

37
Q

what is DIC?

A

mixed disorder of primary & secondary hemostasis

caused by abnormal activation of the coagulation system & an imbalance between coagulation & fibrinolysis resulting in the formation of thrombi in circulation causing consumption of platelets & coagulation factors

38
Q

what abnormalities are seen on diagnostic tests for patients with DIC?

A

thrombocytopenia, prolonged PTT and/or PT, normal to low fibrinogen, elevated d-dimers, & decreased antithrombin concentration

schistocytes on blood smear

39
Q

what therapy is used for treating DIC?

A

aimed at treating the underlying cause, halting abnormal coagulation, maintaining organ perfusion, & preventing secondary complications

40
Q

prior to doing a liver biopsy, what is critical to evaluate?

A

coagulation panel

41
Q

what bleeding disorder is a common congenital coagulopathy of cats? what symptoms do they have?

A

hageman deficiency - factor XII

typically asymptomatic

SA DX & TX I (59 decks)

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