Hemostasis Flashcards
what are the 3 basic mechanisms of anemia
red cell loss
red cell destruction / lysis
lack of marrow production
what is something that could cause red cell loss
hemorrhage
what is something that can cause red cell destruction / lysis
hemolysis
what is something that can cause a lack of marrow production
bone marrow disease or suppression
what is the result of a lack of marrow production
limits the production of RBCs
if the bone marrow is normal, what would you expect to see with anemia
the body actively trying to correct the loss of RBCs through regenerative efforts
what type(s) of anemia are seen with regenerative anemias
hemorrhage
hemolysis
what is typically seen on a blood smear of a regenerative anemia
increase in reticulocytes present
which type of anemia is non-regenerative
bone marrow disease or suppression
what can be used to determine if the regenerative anemia is from blood loss or hemolysis
serum protein
why is low serum proteins indicative of a hemorrhage anemia
loss of RBCs and plasma proteins because it is leaking out of the capillaries
why is normal serum protein indicative of hemolysis anemia
the RBCs and plasma proteins will still be present within the circulatory system
what type of cell will stain blue
polychromasia
what causes polychromasia
recently released cells still with mRNA from the bone marrow (reticulocytes)
other than blue stain, what type of stain can be used to identify reticulocytes
vital stain
describe the cells when they first leave the bone marrow
larger
not fully hemoglobinized
blue in color
what is platelet adhesion
when a platelet adheres to the subendothelium
what protein is responsible for starting platelet adhesion
Von Willebrand Factor
what is formed through platelet - platelet adhesion
platelet plug
what process is done to form the platelet plug
platelet aggregation
what protein is responsible for platelet aggregation
fibrinogen
what are the differential diagnoses with primary hemostasis
platelet number
platelet function
Von Willebrand Disease
what is platelet number in clinical terms
thrombocytopenia
what acts as a catalyst for fibrin formation
platelets
what are the coagulation factors of the intrinsic pathway
XII (12)
XI (11)
IX(9)
VIII (8)
*X (10)
what are the coagulation factor(s) of the extrinsic pathway
VII (7)
*X(10)
what are the coagulation factors of the common pathway
X (10)
V(5)
II(2)
I (1)
what protein is factor 1
fibrinogen
what does fibrinogen turn into? what is its use?
fibrinogen –> fibrin
clot formation
which coagulation factor has the shortest half life
VII (7)
what is secondary hemostasis
formation of the fibrin clot
what is the differential diagnosis list for secondary hemostasis problems
reduction in one or more of the factors
presence of an anticoagulant (rare)
what are some defects of primary hemostasis
petechiae
eccyhmoses
epistaxis
what are some defects of secondary hemostasis
hematoma formation
hemothorax
hemoabdomen
what is not significant in determining primary or secondary defects
excessive bleeding due to trauma
what “older” test can be done to test all primary hemostatic defects
buccal mucosal bleeding time
what “emergency” test could be done to screen for secondary hemostatic defects
Activated Clotting Time (ACT)
what are 2 routine coagulation tests used now
PT (Prothrombin time)
PTT (Partial thromboplastin time)
which routine coagulation test is used to activate/ evaluate the extrinsic pathway
PT (prothrombin time)
which routine coagulation test is used to activate/ evaluate the intrinsic pathway
PTT (partial thromboplastin time)
what is used in the PT test to activate the clotting cascade
factor 7
what is used in the PTT test to activate the clotting cascade
factor 12
which tube is used to run a PT or PTT test
blue top tube
what is used in a blue top tube which makes it ideal for PT and PTT tests
citrate – reacts with Ca which is needed to clot
true or false:
factors must generally be increased by 30% of normal to prolong times
false
decreased to prolong times
what is the ideal way to handle a PT / PTT test to ensure the best / most accurate results
separate plasma within 1 hour
run test within 4 hours
what are the 4 top secondary hemostatic diseases
vitamin K antagonism / deficiency
severe hepatic disease
consumptive coagulopathy
inherited coagulation factor deficiency
what are the 2 main consumptive coagulopathy disorders
disseminated intravascular coagulation (DIC)
localized consumption
what is the most common secondary hemostatic disease
vitamin K deficiency / antagonism
what factors is vitamin K necessary for activation
II
VII
IX
X
what are the 2 ways for vitamin K deficiency
absence (uncommon)
antagonism (rodenticide poisoning)
why is liver disease often seen with vitamin K issues
vitamin K is fat soluble and needs bile for transportation / breakdown and often blocks the bile ducts
how long does it take for an animal with vitamin K antagonism to respond to treatment with vitamin K
a few hours
why is knowing the half life of vitamin K important when treating a rodenticide patient
will determine how long you need to treat an animal
what are 2 ways liver disease impacts hemostasis
makes coagulation factors – damage would decrease the amount made
colistatic liver disease– bile issues
what would you expect to see on test results of and animal with liver disease causing secondary hemostatic disease
increased PT
increased PTT
*history and clinical signs are important
