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Hemolymphatics > Haemostatic Disorders - Approach & Txt > Flashcards

Haemostatic Disorders - Approach & Txt Flashcards

1
Q

Hemostasis is the process which causes…

A

bleeding to stop

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2
Q

Coagulation is the formation

A

of a clot

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3
Q

What are the 4 stages of hemostasis?

A

Vasoconstriction
Platelet plug formation
Clot formation
Fibrinolysis

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4
Q

Explain the process of hemostasis - Simple.

A
  1. Exposed collagen binds & activates platelets
  2. Platelet factors are released
  3. Factors attract more platelets
  4. Platelets aggregate into platelet plug.
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5
Q

What are signs of primary hemostatic disorders?

A

cutaneous bleeding
mucosal bleeding
excessive bleeding post-trauma or Sx
CNS or ocular bleeding

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6
Q

Primary hemostatic disorders impact blood vessels/endothelium how?

A

vasculopathy
Vasculitis
increased vessel fragility

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7
Q

Primary hemostatic disorders impact thrombocytopenia how?

A
  • lack platelet production
  • increased platelet destruction
  • consumption
  • sequestration
  • loss
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8
Q

What are some ways Primary hemostatic disorders with thrombocytopathy occur?

A
  • hereditary
  • drug-induced
  • gammopathies
  • uremia
  • infectious agents
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9
Q

Tests to assess primary hemostasis include…

A

-hematology and blood smear exam to assess platelet numbers
- BMBT if PLT & coags normal
- vWF assays
- platelet function tests
- viscoelastic testing
- histopath

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10
Q

What are the most common primary hemostatic disorders?

A

Immune-mediated thrombocytopenia
Von Willebrand’s Disease

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11
Q

Immune-mediated thrombocytopenia is an

A

acquired condition

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12
Q

Von Willebrand’s diseases is an

A

inherited disease

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13
Q

immune-mediated thrombocytopenia (IMT) can be

A

primary/idiopathic
Secondary

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14
Q

If a patient has IMT, what are some very important things that must be remembered when working with that patient?

A
  • No IM, SQ injections
  • No jugular samples
  • No FNA/cystocentesis, etc.
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15
Q

What txts are available for IMT?

A
  • immunosuppressive therapy/drugs
  • IV fluid therapy/blood transfusion
  • gastroprotectant if GI bleeding
  • supportive txt
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16
Q

What immunosuppressive drug should never be used in cats?

A

Azathioprine

17
Q

What are the 3 subtypes of Von Willebrand’s?

A

Type I: partial quantitative deficiency, residual vWF has normal structure & function
Type II: selective loss of large vWF multimers, decrease PLT-vWF & collagen interactions
Type III: complete vWF deficiency

18
Q

What are some congenital coagulopathies?

A

FVIII - Hemophilia A
FIX - Hemophilia B
FXII deficiency

19
Q

What are some acquired coagulopathies?

A
  • severe protein-losing disorders (PLN, PLE)
  • warfarin or heparin admin overzealously
  • rodenticide toxicity
  • liver insufficiency
20
Q

What are some tests used to assess secondary hemostasis?

A

APTT, PT, individual coagulation factor assessments, TEG, ROTEM

21
Q

What are the most common secondary hemostatic disorders?

A
  • rodenticide toxicity
  • liver insufficiency
  • DIC
  • infectious causes - Angiostrongylus vasorum, lepto
  • hemophilia A/B
  • feline FXII deficiency
22
Q

Vit K is an important cofactor for production of…

A

Factors II, VII, IX, X

23
Q

What breeds are predisposed to inheriting vit K deficiency?

A

labradors
devon rex

24
Q

What is an acquired vit k deficiency?

A

Rodenticide toxicity

25
Q

What clinical signs appear with rodenticide toxicity?

A

Epistaxis
Melena
Hematomas,
Hematuria
Pulmonary bleeding
Hemothorax
Etc.

26
Q

What are some txts for secondary hemostatic disorder?

A

supportive txt
whole blood or pRBC transfusion as needed
Vit K txt
replacement of coagulation factors - plasma transfusion

27
Q

What is a tertiary hemostatic disorder?

A

An imbalance between activators and inhibitors of fibrinolysis, which results in thrombosis or hemorrhage

28
Q

What are tests to assess tertiary hemostasis?

A
  • Fibrinogen levels
  • Fibrin degradation products (FDPs)
  • D-Dimers
  • Thrombin Time (TT)
  • TEG
29
Q

TEG or ROTEM are used to assess…

A

global coagulation

30
Q

What factors affect TEG/ROTEM?

A

Thrombocytopenia
low or high RBC/PCV/Hct
Hyperfibrinogemia
Trace of activator & handling conditions

31
Q

What is one of the most common tertiary hemostatic disorders?

A

Hyperfibrinolysis in Greyhounds

Hemolymphatics (21 decks)

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