Hematology - TopHat

Question 1

An absolute reticulocyte count above ___ is consistent with regenerative anemia in a dog.

a. 200,000
b. 8,000

c, 20,000

d. 80,000

Answer 1

d. 80,000

Question 2

An absolute reticulocyte count above ____ is consistent with a regenerative anemia in a cat.

a. 500
b. 2,000
c. 80,000
d. 50,000

Answer 2

d. 50,000

Question 3

How would you characterize this patients anemia?

a. Microcytic, hypochromic, and nonregenerative
b. Macrocytic, hypochromic, and regenerative
c. Microcytic, hypochromic, and regenerative
d. Normocytic, normochromic, and nonregenerative

Answer 3

c. Microcytic, hypochromic, and regenerative

Question 4

What type of anemia do you think Kira has and what do you suspect its cause is?

a. Nonregenerative anemia due to her unregulated diabetes
b. Regenerative anemia due to hemolysis
c. Nonregerative anemia due to underlying cancer
d. Regenerative anemia due to blood loss

Answer 4

d. Regenerative anemia due to blood loss

Question 5

Which of the following clinicopathologic findings would support your suspicion that your patient has IMHA?

a. Microcytosis, hypoproteinemia, and thrombocytosis
b. Hyperbilirubinemia, hypophosphatemia, and hyperglycemia
c. This is a silly question. There is one definitive diagnostic test for IMHA: Coomb’s test
d. Hyperbilirubinemia, autoagglutination, and spherocytes
e. Leujopenia, hemoglobinemia, and a negative Commb’s test

Answer 5

d. Hyperbilirubinemia, autoagglutination, and spherocytosis

Question 6

Which of the following should be ruled out before making a diagnosis of primary IMHA (may be multiple answers)?

a. Non-immune hemolysis due to zinc toxicity
b. Secondary immune hemolysis due to Babesia infection
c. Non-immune hemolysis due to hyperkalemia
d. Secondary immune hemolysis due to lymphoma

Answer 6

a, b, and d

Question 7

What is the frontline immunosuppressive therapy in IMHA?

a. aspirin
b. Glucocorticoids
c. Azathioprine
d. Heparin
e. Cyclosporine

Answer 7

b. Glucocorticoids

Question 8

What is the most common reason for sudden death in IMHA?

a. Secondary infection
b. Thrombosis
c. Arrhythmia
d. Blood loss

Answer 8

b. thrombosis

Question 9

Duke is a 9 year old MC 40kg mixed breed dog. He has a HCT of 19% and spherocytes on his CBC. He is icteric, lethargic, tachypneic, and tachycardic. His PT and aPTT are within normal limits. What blood product do you want to give Duke?

a. Stored whole blood
b. Fresh frozen plasma
c. Frozen plasma
d. Packed red blood cells
e. No transfusion

Answer 9

d. Packed red blood cells

Question 10

Malaika is a 10 yearold FS DLH. Her HCT is 18% and she has stage 3 CKD. Her RR is 20 when not purring, HR is 150, and BP is 130 mmHg. Her temperature is 100 degrees F. What blood product do you want to give Malaika?

a. stored whole blood
b. fresh frozen plasma
c. frozen plasma
d. packed red blood cells
e. no transfusion

Answer 10

e. no transfusion

Question 11

Sarge is a 1 year old MC DSH. His HCT is 12%. He is icteric, vomiting, and lethargic. His HR is 220, RR 50 temperature is 98 degrees F, and his BP is 90 mmHg. You do a blood smear and find evidence of Mycoplasma. What blood product do you want to give Sarge?

a. stored whole blood
b. fresh whole blood
c. fresh frozen plasma
d. packed red blood cells
e. no transfusion

Answer 11

d. Packed red blood cells

Question 12

Jenny is a 4 year old FS German Shepherd that is presenting with a 1 week history of lethargy, inappetance, and vomiting. She is tachypneic with harsh lung sounds. Her HCT is 42%, platelet estimate is greater than 200,000, PT and aPTT are prolonged. What blood product do you want to give Jenny?

a. stored whole blood
b. fresh frozen plasma
c. packed red blood cells
d. no transfusion

Answer 12

b. Fresh frozen plasma

Question 13

Which of the following is NOT a player in primary hemostasis?

a. Platelets
b. von Willebrand factor
c. Endothelium
d. Factor IX

Answer 13

d. factor IX

Question 14

In a severely thrombocytopenic dog, what signs of bleeding might you see?

a. Epistaxis
b. Hemoabdomen
c. Melena
d. Hemoptysis

Answer 14

a, c, and d

Question 15

What is the most common acquired disorder of primary hemostasis?

a. rodenticide toxicity
b. von Willebrand disease
c. thrombocytopenia
d. liver disease

Answer 15

c. thrombocytopenia

Question 16

What ITP treatment is available that increases platelet count but would have no use in IMHA?

a. azathioprine
b. mycophenolate
c. vincristine
d. prednisone

Answer 16

c. vincristine

Question 17

What is the most common hereditary disorder of primary hemostasis?

a. melena
b. abdominal cavity hemorrhage
c. von Willebrand disease
d. macrothrombocytopenia
e. platelet count +/- vWF testing
f. Rodenticide toxicity
g. platelet consumption

Answer 17

c. von Willebrand disease

Question 18

Which of the follwing is a cause of acquired thrombocytopenia?

a. melena
b. abdominal cavity hemorrhage
c. von Willebrand disease
d. macrothrombocytopenia
e. platelet count +/- vWF testing
f. Rodenticide toxicity
g. platelet consumption

Answer 18

g. platelet consumption

Question 19

You would conduct a BMBT after the following:

a. melena
b. abdominal cavity hemorrhage
c. von Willebrand disease
d. macrothrombocytopenia
e. platelet count +/- vWF testing
f. Rodenticide toxicity
g. platelet consumption

Answer 19

e. platelet count +/- vWF testing

Question 20

Which of the following is a sign of a primary hemostatic defect?

a. melena
b. abdominal cavity hemorrhage
c. von Willebrand disease
d. macrothrombocytopenia
e. platelet count +/- vWF testing
f. Rodenticide toxicity
g. platelet consumption

Answer 20

a. melena

Question 21

What blood products contain viable platelets?

a. stored whole blood
b. platelet rich plasma
c. fresh frozen plasma
d. fresh whole blood
e. platelet concentrate

Answer 21

b. platele rich plasma
d. fresh whole blood
e. platelet concentrate

Question 22

Brutus is a 9 year old male castrated goldendoodle. He presented for a nose bleed. He has already been worked up for nasal disease and his platelet count and clotting times are normal. What do you want to do next with Brutus?

a. BMBT
b. vWF testing
c. Chemistry panel
d. Hmm… all of the above sound like good ideas

Answer 22

d. Hmm… all of the above sound like good ideas

Question 23

Who are the key players in primary hemostasis, defects in which would lead to prolonged BMBT?

a. Coagulation factor X, fibroblasts, von Willebrand factor
b. Endothelium/vasculature, platelets, tissue factor
c. fibroblasts, platelets, von Willebrand factor
d. Endothelium/vasculature, platelets, von Willebrand factor

Answer 23

d. Endothelium/vasculature, platelets, von Willebrand factor

Question 24

Which model of secondary hemostasis better reflects your lab testing like PT and aPTT?

a. Traditional waterfall/cascade model
b. Cell-based model

Answer 24

a. Traditional waterfall/cascade model

Question 25

Which model better reflects secondary hemostasis as it happens in the dog or cat?

a. Waterfall/cascade model
b. Cell-based model

Answer 25

b. Cell-based model

Question 26

Which of the following diseases is better explained by the cell-based model than the waterfall model?

a. von Willebrand disease
b. ITP
c. Hemophilia A
d. Fibrinogen deficiency

Answer 26

c. Hemophilia A

Question 27

Which blood products contain FVIII?

a. fresh whole blood
b. stored whole blood
c. fresh frozen plasma
d. frozen plasma
e. packed red cells

Answer 27

a. Fresh whole blood
c. fresh frozen plasma

Question 28

What inhibitor of thrombin is decreased during a disease process where albumin is lost/not absorbed? The end result is risk of ______.

a. Protein C, bleeding
b. Protein S, clotting
c. Antithrombin, clotting
d. Tissue factor pathway inhibitor, bleeding

Answer 28

c. antithrombin, clotting