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Pathology > Hemostasis > Flashcards

Hemostasis Flashcards

1
Q

Define Hemostasis…

A 
sealing an injured vessel to prevent blood loss
Can be: 
1. Physiological
2. Surgical
3. Pathological
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2
Q

What is the Pathological form of Hemostasis?

A

Thrombosis

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3
Q

What are the requirements for Thrombosis?

A
  1. vascular wall -> endothelium
  2. platelets -> primary CLOT and THROMBUS component
  3. coagulation cascade
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4
Q

True/False: The extracellular matrix has low thrombogenicity.

A

False - the extracellular matrix has high thrombogenicity

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5
Q

What is Endothelin?

A

A secretion factor that is a potent endothelium-derived vasoconstrictor.

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6
Q

What is the end result of Primary Hemostasis?

A

Creating a Primary Hemostatic Plug

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7
Q

What are the 5 MAIN steps of Primary Hemostasis following injury?

A
  1. Platelet Aggregation
  2. Change in Platelet shape
  3. Granule Release
  4. Recruitment
  5. Primary Hemostatic Plug formation
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8
Q

What is the purpose of Secondary Hemostasis?

A

Creating THROMBIN

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9
Q

Why is thrombin so important?

A

It cleaves circulating fibrinogen into fibrin.

It also recruits more platelets and stimulates further granule release.

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10
Q

What does Fibrin do?

A

Fibrin wraps around the aggregated platelets and forms the Secondary Hemostatic Plug

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11
Q

What is the difference btw the Primary Hemostatic and Secondary Hemostatic Plug?

A

Secondary Hemostatic Plug lasts longer!

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12
Q

What are the 2 molecules released that limit the hemostatic plug to the site of injury?

A
  1. t-PA

2. thrombomodulin

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13
Q

If you do NOT stop the coagulation cascade, it may lead to…

A

Thrombus

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14
Q

What is Thrombus?

A

Aggregate of platelets, fibrin and entrapped blood cells.

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15
Q

What is the difference between a Thrombus and a Blood Clot?

A

Thrombus is attached to the vascular wall

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16
Q

What are the distinguishing characteristics of a thrombus vs. a post-mortem blood clot?

A

Thrombus:
surface: more dull and granular
attached to the vessel wall

Post-Mortem Clot:
Red/Pale/Shiny and smooth
Not attached to the vessel wall

17
Q

Cats with Cardiomyopathy will have a thickened left side of the heart. Where is a thrombus more likely to develop?

A

in the Left Atrium

18
Q

What are the 5 thrombi that we are most likely to encounter in veterinary medicine?

A
  1. mural thrombus
  2. pulmonary thrombus
  3. verminous thrombus
  4. saddle thrombus
  5. vena cava thrombus
19
Q

Where is a mural thrombus located?

A

Heart Endothelium

20
Q

Where is a Pulmonary Thrombus located?

A

Pulmonary Artery…duh!

21
Q

Pulmonary thrombosis is most common seen in dogs. What are 2 predisposing conditions to pulmonary thrombosis in canines?

A
  1. severe renal glomerular disease

2. severe heartworm disease

22
Q

Severe renal glomerular disease results is a protein losing nephropathy, causing proteinuria. What anticoagulant protein is significantly lost in this condition?

A

Antithrombin III - a MAJOR inhibitor of thrombin

Antithrombin III allows the blood to remain more fluid-like.

23
Q

What parasite is the most likely cause of Verminous Thrombus in Horses?

A

Strongylus vulgaris infection

24
Q

What are the main arteries that are likely to develop verminous thrombus in horses?

A

Cecal/Colonic as.

Cranial Mesenteric a.

25
Q

If the cecal/colonic as. develop verminous thrombus in Strongylus vulgaris infections, what are the resulting consequences?

A

Ischemic damage to the intestine –> infarction –> death

26
Q

Cats with Hypertrophic Cardiomyopathy are likely to develop a thrombus in the Left Atrium. This can cause Saddle Thrombus. Where is Saddle Thrombus located and what are the clinical signs?

A

Location: trifurcation of the abdominal aorta
CS: acute onset of Left-Sided congestive heart failure, respiratory distress, pelvic paralysis

27
Q

What is an Embolus?

A

Any type of intravascular particle that travels through circulation distal to the site of origin

28
Q

What is the mechanism of development for vena cava thrombus in cattle?

A

Grain overload –> ruminal acidosis –> rumen mucosal damage –> ruminal bacteria are able to reach circulation via the portal v. –> hepatic abscess close to the Caudal Vena Cava –> vena cava thrombus

29
Q

What are the outcomes of thrombi?

A
  1. lysis
  2. propagation
  3. embolization
  4. organization/recanalization
30
Q

You are working Emergency rotation when a 3 year old pitbull terrier is brought in presenting with:
acute onset of neurological disease and severe pain
and dies shortly after. You get permission from the owner to perform a necropsy and find areas of necrosis in the spinal cord. You suspect spinal cord infarcts. What type of embolism is present and what are the resulting consequences?

A

Obliterating emboli made of fibrinocartilage –> ischemia myelomalacia –> hemorrhage and necrosis –> death

31
Q

Histologically, if you see adipose cells and haematopoetic cell precursors you have a…

A

Fat Embolism

32
Q

Fat Embolisms are common complications of…

A

bone fracture fragments that reach systemic circulation causing pulmonary embolism

33
Q

Upon performance of a cattle necropsy, you find a friable, patent material localized and attached to the Right Tricuspid valve. At the pulmonary artery you find a septic embolism and development of severe pulmonary abscess.

What caused the death of this cow?

A

bacterial valvular endocarditis of the right atrioventricular valve

**Chronic, suppurative conditions –> inflammation –> bacteremia –> bacteria localize in the heart valves –> septic thrombi attach to the valves –> pieces break off and septic emboli get stuck in the pulmonary a. –> severe pulmonary abscess

34
Q

Histophilus someone can cause neurological diseases, arthritis, pneumonia, myocarditis, and vasculitis. Which of these leads to endothelial damage, predisposing the vasculature to thrombi formation?

A

Vasculitis –> endothelial damage –> predisposing the vasculature to thrombi formation

35
Q

What is the name of the condition from Histophilus somni infection that results in thrombi formation in the brain?

A

Thrombotic meningoencephalitis (TME)

36
Q

DIC is a very important condition that veterinarians must know! What is the ultimate result of DIC and what causes it?

A

The Result: DEATH! DIC is fatal!

Present in many diseases –> Endothelial damage –> WIDESPREAD COAGULATION CASCADE –> fibrin-thrombi EVERYWHERE! –> systemic hypoxia –> multi-organ failure
–> death

37
Q

The Fibrin-Thrombi are stained by what?

A

PTAH Stain

38
Q

What is an Infarct?

A

localized ischemic/necrosis hypoxic injury caused by occlusion of an artery/vein

Pathology (14 decks)

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