Hematology

Question 1

What is created in primary hemostasis?

Answer 1

Platelet plug

Question 2

What molecules are released from collagen that causes the platelets to adhere to the endothelium?

Answer 2

vWF and GP1a

Question 3

What defects can occur with primary hemostasis?

Answer 3

Decreased platelets, poorly functioning platelets, lack of vWF

Question 4

What defects can occur with secondary hemostasis?

Answer 4

Lack of one or more coag factors

Question 5

What CxS do you see with a primary hemostasis defect?

Answer 5

Petechia ad ecchymosis, oozing from mucosal sites

Question 6

What CxS do you see with a secondary hemostasis defect?

Answer 6

Bleeding into a body cavity, large SQ hematoma

Question 7

What is the platelet count for a 1* hemostasis defect?

Answer 7

Normal >140,000 p/uL

Question 8

What test assesses the intrinsic pathway of 2* hemostasis?

Answer 8

aPTT

Question 9

What test assesses the common pathway of 2* hemostasis?

Answer 9

fibrinogen

Question 10

What are some possible causes of thrombocytopenia?

Answer 10

Bone marrow disease, hemorrhage, sequestration, consumption, destruction

Question 11

Which cause leads to the most severe thrombocytopenia?

Answer 11

Destruction/immune mediated

Question 12

What is the typically platelet count of an animal with immune mediated thrombocytopenia?

Answer 12

<15,000/uL

Question 13

What does a positive 4DX test indicate?

Answer 13

Exposure to the antigen

Question 14

What are some rickettsial diseases that may cause IMTP?

Answer 14

Ehrlichia canid/platys, anaplasma phagocytophilum, rocky mountain spotted fever

Question 15

How do you treat IMTP?

Answer 15

Doxycycline (For rickettsia), prednisone, cage rest

Question 16

T/F: It is not safe to venipuncture the jugular on animals with IMTP

Answer 16

True

Question 17

What is the mechanism of mycophenolate mofetil (Cellcept)?

Answer 17

Inhibits the synthesis of guanosine nucleotides for rapid onset of enzyme suppression

Question 18

T/F: DIC is always secondary to something else

Answer 18

True

Question 19

What are the 4 vitamin K dependent coag factors?

Answer 19

10, 9, 7, 3

Question 20

What coag factor has the shortest half life?

Answer 20

VII

Question 21

What are the CxS of IMHA?

Answer 21

lethargy, weakness, tachypnea, tachycardia, anorexia, fever

Question 22

What tests can be performed to provide information towards IMHA?

Answer 22

PCV/TP, examine the blood in the EDTA tube, blood smear, coombs test

Question 23

What three tests are used to identify IMHA?

Answer 23

Autoagluttination, spherocytes, positive coombs test

Question 24

What are the therapeutic goals when treating IMHA?

Answer 24

Specific, supportive, symptomatic

Question 25

What are some underlying causes that may lead to IMHA?

Answer 25

infection, neoplasia, drug reaction, venom

Question 26

How do you eliminate potential risk factors for IMHA?

Answer 26

Cure infection, avoid immunogenic drugs, withhold vxns

Question 27

What cells does prednisone target?

Answer 27

B cells, T cells, macrophages

Question 28

What cells does azathioprine target?

Answer 28

T cells

Question 29

What cells does mycophenolate target?

Answer 29

B and T cells

Question 30

How long might it take for a patient’s PCV to be normal again?

Answer 30

4 weeks

Question 31

What are some poor prognostic indicators for IMHA?

Answer 31

Total bilirubin > 10
autoagglutination
intravascular hemolysis

Question 32

How often do you want to check the hematocrit until the PCV rises?

Answer 32

every 12-24 hours

Question 33

What should you do with the drug administration once the HCT has stabilized?

Answer 33

Taper them by 25% every 2-4 weeks

Question 34

T/F: There is no gender influence on IMHA with dogs

Answer 34

False. females have it more commonly. Cats have no gender influence

Question 35

T/F: It is common to see an inflammatory neutrophilia with cats with IMHA

Answer 35

False. Common with dogs

Question 36

T/F: it is common to see lymphocytosis in cats with IMHA

Answer 36

True