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Hemostasis Flashcards

1
Q
A
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2
Q

define hemostasis

A

physiologic process by which a blood clot is formed

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3
Q

define thrombosis

A

term used when hemostasis becomes pathologic

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4
Q

vessel function in hemostasis

A
  • normally nonthrombogenic
  • vasoconstrict when stimulated
  • endothelial damage -> collagen exposure
  • store/relase of vWF
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5
Q

components of primary hemostasis

A

platelet and vessel functions

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6
Q

where are platelets produced? by what cell?

A

in the bone marrow by megakaryocytes

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7
Q

an increased MPV signifies

A

active/accelerated thrombopoiesis

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8
Q

platelet activation

A
  1. platelets adhere to subendothelial vWF
  2. adherance and thrombin promote platelet activation and cause secretion of granule contents, formation of thromboxane
  3. platelet aggregation occurs, producing a platelet plug
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9
Q

components of secondary hemostasis

A

coagulation factors

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10
Q

what is the term for the inactive coagulation factors in circulation?

A

zymogens

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11
Q

where are coagulation factors synthesized

A

the liver

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12
Q

what does an “a” after a factor roman numeral indicate?

A

the coagulation factor is activated

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13
Q

Which coagulation factors are a part of the intrinsic pathway?

A

XII, XI, IX, VIII

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14
Q

which coagulation factors are a part of the extrinsic pathway?

A

VII
and TF

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15
Q

which coagulation factors are a part of the common pathway

A

X, V, II, I

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16
Q

What initiates coagulation?

A

TF on fibroblasts

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17
Q

which blood tube is best to evaluate secondary coagulation?

A

Blue Top Tube (Sodium Citrate)

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18
Q

How is coagulation controlled

A

a balance between blood flow, fibrinolysis, plasma inhibitors, protein C and S, and Clearance

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19
Q

what type of deficiency is associated with mucle, joint, and body cavity hematoma?

A

coagulation factor deficiencies
secondary hemostasis

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20
Q

what deficiency does petechiae suggest?

A

platelet or vessel defects
primary hemostasis

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21
Q

what deficiency does ecchymosis suggest?

A

primary and/or secondary defect

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22
Q

What type of anticoagulant should you use for platelet counts?

A

EDTA

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23
Q

What type of anticoagulant should you use for coagulation tests?

A

Na Citrate

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24
Q

Sample Prep for hemostasis:

A
  • separate plasma within 30 minutes of collection
  • keep samples at 4C
  • test within 3 hours
  • plasma may be frozen in small alliquots for submission to outside labs
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25
Ways to perform a platelet count
* smear estimate * automated count * interpretation
26
You (can/cannot) get an accurate platelet count when clumping is present
cannot
27
what is BMBT used for
in vivo screening test for disorders of primary hemostasis (including vWD)
28
What is a platelet Ab test used for
Tests for platelet-bound IgG. Used for Dx of Immune thrombocytopenia (ITP)
29
APTT measures what portion of the hemostasis pathway? What factors are included?
intrinsic. XII, XI, IX, VIII
30
OSPT/PT measures what portion of the coagulation pathway? what factors are included?
extrinsic, VII
31
prolonged APTT signifies dificiencies in...
intrinsic or common pathway (XII, XI, IX, VIII, X, V, II, I)
32
prolonged OSPT/PT signifies deficiencies in...
extrinsic or common pathway (VII, X, V, II, I)
33
TT measures deficiencies in which pathway. Which factor(s)?
common (F I specifically!)
34
prolonges results of TT signifies...
* fibrinogen deficiency (FI) * dysfibroginemia (fibrinogen not performing nromal function) * presence of inhibitors
35
What does a fibrinogen assay measure?
fibrinogen (not fibrin!)
36
How can you evaluate fibrinolysis
FDP and D-dimers
37
FDP assay detects breakdown of products of...
fibrinogen and fibrin
38
D-dimer assay detects breakdown products of...
fibrin
39
Which assay is more specific, FDP or D-dimer?
D-dimer assay
40
What does TEG evaluate?
all of hemostasis -> coagulation system, platelet function, and fibrinolysis
41
Types of disorders of hemostasis
1. vascular 2. platelet 3. coagulation
42
Acquired vascular disorders
secondary to other disease process mechanisms (endotoxin, viral infection, Rickerrsial infection, immune mediated) need to find out the underlying cause to Tx
43
Ex of inherited vasculer disorder
Ehlers Danlos syndrome
44
Quantitative cinical platelet disorder
number of platelets is abnormal (thrombocytopenia and thrombocytosis)
45
Qualitative clinical platelet disorder
Platelets cannot perform their function (hereditary and acquired)
46
Mechanisms of Thrombocytopenia
* decreased platelet production * increased platelet destruction * incresed platelet consumption * sequestration of platelets * other
47
causes of decreased platelet production
drugs, infections, estrogen, bracken fern, myelophthesic disease of bone marrow
48
causes of increased platelet destruction
immune mediated
49
causes of increased platelet consumption
DIC, wounds, hemorrhage
50
causes of Sequestration of platelets
splenomegaly, septicemia
51
Reactive thrombocytosis
secondary to inflammation, iron deficiency most common
52
essential thrombocytopenia
primary - neoplasia rare
53
Inherited Qualitative platelet disorders
* basset hound thrombopathy * chediak higashi syndrome * vWD (most common)
54
Acquired Qualitative platelet disorders
* Drugs - aspirin, NSAIDs * Disease (renal Dz with uremia, myeloproliferative Dz, dysproteinemia, severe hepatic Dz)
55
vWD Type 1
partial quantitative deficiency of vWF
56
vWD Type 2
Qualitative abnormality +/- deficiency of vWF high molecular weight multimers
57
vWD Type 3
no detectable vWF
58
How does Aspirin affect platelet function?
Blocks Cyclooxygenase which reduces the production of Thromboxane A2 (necessary for platelet function)
59
Hemophilia Type A
hereditary coagulopathy - deficient FVIII causing variable severity of bleeding
60
Hemophilia B
hereditary coagulopathy - deficient FIX causing severe bleeding
61
At what age would you expect to see Hemophilia A and Hemophilia B?
young animals (inherited Dz)
62
Vitamin K antagonists (Rodenticide) affect which coagulation factors?
II, VII, IX, X
63
How does liver Dz cause hemostatic abnormalities?
**Decreased synthesis** of coagulation factors, antiplasmin, antithrombin, and thromobopoietin **Decreased clearance** of FDP, activated coagulation factores, and plasminogen activators **Platelet Dysfunction**
64
How does Renal Dz cause hemostatic abnormalities?
**Nephrotic Syndrome** -> protein losing nephropathy -> loss of antithrombin and low molecular weight coagulation factors **Uremia** (kidneys can't filter waste, causing build up of toxins in the blood) -> platelet dysfunction
65
Characteristics of DIC
Elevated OSPT anf APPT low platelets increased D-dimers and FDP Fibrinogen decreased, normal, or increased

CLINICAL PATHOLOGY (6 decks)

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