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Clinical I > Hemostasis and Hemopathology > Flashcards

Hemostasis and Hemopathology Flashcards

1
Q

What is hemostasis?

A

The stoppage of bleeding from an injured blood vessel

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2
Q

What are the 3 functional components of hemostasis?

A
  • Vascular
  • Platelets (primary hemostasis) for minor breaks in vessel endothelium
  • Coagulation (secondary hemostasis) for larger breaks in vessel integrity
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3
Q

How does the vascular component of hemostasis reduce blood flow?

A

Local vasoconstriction and the compression of injured vessels by blood pushed out (from the vessels) into the surrounding tissues

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4
Q

How does the platelet component of hemostasis reduce blood flow?

A

Hemostatic plugs, and releasing factors that augment vasoconstriction and initiate vessel wall repair

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5
Q

How does the coagulation component of hemostasis reduce blood flow?

A

By forming a fibrin mesh to stabilize the platelet plug; the fibrin in the blood is inactive until it is needed

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6
Q

What is coagulation?

A

A sequential cascade of enzymatic reactions

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7
Q

Where are the coagulation factors created?

A

The 12 factors are created in the liver

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8
Q

What factor is everywhere in the coagulation cascade?

A

Factor IV, calcium

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9
Q

How do anticoagulants work?

A

By binding calcium, coagulation factor IV

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10
Q

What factors are in the intrinsic pathway of the coagulation cascade?

A

12, 11, 9, and 8 Walmart system - Things don’t cost $12, they cost $11.98

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11
Q

What factors are in the common pathway of the coagulation cascade?

A

10, 1, 5, 2, and 13. Common denominators of 10 - 10 and 1, 5 and 2. If not, you’re out of luck, you’ve got 13

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12
Q

What factors are in the extrinsic pathway of the coagulation cascade?

A

3 and 7 Extras

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13
Q

When is the intrinsic system activated?

A

When endothelium is disrupted; can be by exposed collagen, PF3 (platelet factor 3) release, or endotoxin

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14
Q

What is an endotoxin?

A

The cell wall of a gram negative bacteria; an animal may start clotting with out an injury due to an endotoxin (this is called sepsis)

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15
Q

What is the extrinsic system initiated by?

A

Tissue thromboplastin (Factor III), released by injured tissues, factor VII is then activated by factor III

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16
Q

What is the common pathway activated by? What does it result in?

A

The intrinsic and/or extrinsic systems and results in the fibrin clot

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17
Q

What is fibrinolysis?

A

Dissolution of a clot

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18
Q

Fibrin is digested by plasmin (an enzyme), creating what?

A

Fibrin degradation products (FDPs)

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19
Q

When does plasmin formation begin?

A

When the coagulation cascade is initiated

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20
Q

On average, how many platelets should be present per oil immersion field in a normal blood smear?

A

10-12

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21
Q

What is BMBT and how is it tested?

A
  • Buccal Mucosal Bleeding Time - Make 2 parallel incisions of equal length and depth in the buccal mucosa and blot every 30-60 seconds without touching the skin; should clot within 1-5 minutes
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22
Q

What are three clinical evaluations of bleeding disorders?

A
  • Platelet estimate in blood smear
  • BMBT test
  • Toe Nail Bleeding Time (TNBT test)
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23
Q

What are the tests used to test the intrinsic pathway?

A
  • Whole Blood Clotting Test (WBCT)
  • Activated Clotting Time (ACT)
  • Activated Partial Thromboplastin Time (APTT)
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24
Q

How is a WBCT performed?

A

It is a simple screening test where you place blood in a test tube and rock gently every 30-60 seconds; dog blood should clot in 2-10 minutes, horse blood should clot in 4-15 minutes

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25
Q

When is an ACT test not considered diagnostic?

A

If the blood clots within normal limits

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26
Q

When is an APTT test considered to be an abnormal result of this test?

A

If the clotting time is more than 25% longer than the control (Normal in a dog - 17-35 sec)

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27
Q

What test can be used to test the extrinsic pathway?

A

The One Stage Prothrombin Test (OSPT); results should be within 25% of the control results

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28
Q

What is the most common in-clinic test for extrinsic coagulation?

A

The OSPT

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29
Q

What are some other reference lab tests for coagulation?

A
  • Fibrinogen concentration
  • Fibrin Degradation Products (FDP)
  • Factor assays
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30
Q

What are the vitamin K dependent factors?

A

2, 7, 9, and 10

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31
Q

What is the most common cause of vitamin K deficiency?

A

Rodenticide ingestion

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32
Q

What is von Willebrand’s factor needed for?

A

Platelet adhesion to subendothelium and stabilizing and preventing rapid clearance of factor VIII

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33
Q

What is the most common inherited bleeding disorder in dogs, but is rare in cats?

A

von Willebrand’s disease

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34
Q

Which breed most commonly gets von Willebrand’s disease?

A

Dobermans and Rottweilers

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35
Q

Which breeds have clotting factor defects of Factor I?

A

St. Bernards and Borzois

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36
Q

Which breed has clotting factor defects of Factor II?

A

Boxers

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37
Q

Which breeds have clotting factor defects of Factor VII?

A

Beagles and Malamutes

38
Q

Which breeds have clotting factor defects of Factor VIII? What is this defect also known as?

A
  • Many breeds - Hemophilia Type A
39
Q

Which breeds have clotting factor defects of Factor IX? What is this defect also known as?

A
  • Many breeds of dogs, and domestic shorthair and British shorthair cats - Hemophilia Type B
40
Q

Which breed has clotting factor defects of Factor X?

A

Cocker Spaniels

41
Q

Which breeds have clotting factor defects of Factor XI?

A

English Springer Spaniels, Great Pyrenees, Kerry Blue Terrier

42
Q

What is disseminated intravascular coagulation (DIC)?

A

Complex hemostatic defect with enhanced coagulation and fibrinolysis secondary to severe systemic disease

43
Q

What does DIC create?

A

Fibrin strands within blood vessels, increased blood pressure, which causes hemolysis

44
Q

What is the prognosis for DIC?

A

Poor to grave; it is not a bleeding problem but a clotting problem, the animal’s blot clots so much that it eventually runs out of clotting factor

45
Q

What is anisocytosis?

A

Variation in red blood cell size

46
Q

What is poikilocytosis?

A

Variation in red blood cell shape

47
Q

What are the 15 different kinds pf poikilocytosis?

A
  • Spherocyte - Heniz Body (Schmauch’s Bodies) - Ghost Cell - Eccentrocyte - Acanthocyte - Echinocyte - Blister Cells - Keratocyte - Stomatocyte - Ovaloctye - Dacryocyte - Target Cells (Codocyte) - Torocyte - Bar Cells (Knizocyte) - Schistocyte
48
Q

What is polychromasia?

A

Variation in cell color; immature RBC’s have less hemoglobin than mature cells

49
Q

What does the presence of polychromasia cells indicate?

A

Active erythropoiesis and a regenerative response to anemia, or the body is trying to replace loses faster than it can keep up with

50
Q

What is hypocromasia?

A

Abnormal decrease in the hemoglobin content of RBC’s most often associated with iron deficiency

51
Q

Which species’ cells are especially prone to Heinz bodies? Meaning their hemoglobin can be damaged easier than other animals

A

Feline

52
Q

Dacryocytes can occur in dogs with __________ disorders

A

Myeloproliferative

53
Q

Target cells may also be seen as an artifact in __________ solutions

A

Hypertonic

54
Q

What is an inclusion?

A

Something included inside the RBC

55
Q

What species normally has Howell-Jolly bodies in up to 1% of its red blood cells?

A

Cats

56
Q

Large numbers of basophilic-stippled RBCs along with nucleated RBCs out of proportion to the anemia suggest ______________

A

Lead poisoning

57
Q

What are the 6 inclusions a red blood cell can have?

A
  • Howell-Jolly Body - Pappenheimer Body (Hemosiderin) - Basophilic Stippling - Distemper Viral Inclusions - Cytauxzoon felis - Anaplasma marginale
58
Q

What are the 5 artifacts that may be found in red blood cells?

A
  • Agglutination - Stain Precipitate - Refractile Artifact - Pseudoinclusion - Rouleaux
59
Q

What are the 4 leukocyte abnormalities that may be observed?

A
  • Pelger Huet Anomlay - Hypersegmented Neutrophils - Toxic Neutrophils - Barr Bodies
60
Q

What is a spherocyte?

A

A small spherical RBC with a reduced ratio of cell surface area to cytoplasmic volume; spherocytosis may suggest immune-mediated hemolyic anemia

61
Q

What is a Heinz Body?

A

It consists of hemoglobin precipitated by oxidant drugs, plant toxins, or chemicals causing small projections on one side of the cell

62
Q

What are some of the causes of Heinz bodies?

A
  • Acetaminophen (cats)
  • Methylene blue in urinary acidifiers and home aquariums (cats)
  • Onion ingestion (dogs and cats)
  • Long term prednisone use (dogs)
  • Gastrointestinal disease (cats)
  • Splenectomy
63
Q

What is a ghost cell?

A

An empty cell membrane of hemolyzed RBC’s due to there being no hemoglobin present; can happen due to blood slides being prepared from hemolyzed samples

64
Q

What is an eccentrocyte?

A

The oxidation of a red blood cell membrane making the coloration off center

65
Q

What is an acanthocyte?

A

Aka a Spur cell or a Specualted cell; a cell that has irregular surface projections that can result in the changes in plasma lipids; can be caused by liver disease or splenic masses

66
Q

What is an echinocyte?

A

AKA Crenated cells; they are cells with evenly spaced projections and are a common artifact of blood slide preparation, unless the patient is dehydrated

67
Q

What are Blister cells?

A

An irregular cell due to the RBC manufactoring process; a small number is normal, but a might amount may cause an issue

68
Q

What is a Keratocyte?

A
  • A RBC with a horn life projection; a blister cell that has ruptured
69
Q

What is a stomatocyte?

A

A heriditary problem where the linear area of central pa

70
Q

What is an ovalocyte?

A

An oval shaped cell that maintains a concave central pallor

71
Q

What is a dacryocyte?

A

A RBC with a tear like shape that results from the pitting function of the spleen

72
Q

What is a codocyte or target cell?

A

Excessive cell membrane in proportion to decreased hemoglobin, which can be caused by:

  • Hypochromic anemia
  • Cholestasis liver disease
  • Bone marrow suppression
  • Post-splenectomy
73
Q

What is a torocyte?

A

AKA punched out cell, it is generally an indication of hypochromic anemia, and may occur as an artifact on a blood smear

74
Q

What is a barr cell?

A

AKA Knizocyte; due to the redundancy in the cell membrane and is an outfolding of the red blood cell membrane

75
Q

What is a schistocyte?

A

A cell that has been damaged during circulation; typically an indication of DIC but can also be hemolytic anemia, congestive heart failure, glomerulonephritis, or splenic hemangiosarcoma

76
Q

What is a howell-jolly body?

A

The nuclear remnames in RBC’s, and is common in regenerative anemia and splenectomized patients

77
Q

What is a pappenheimer body?

A

AKA hemosiderin, is due to iron accumulation in RBC’s and can indicate abnormal erythropoiesis

78
Q

What is basophilic stippling?

A

Degenerative changes in the cytoplasmic ribonucleaic acid and can occur with regenerative anemia

79
Q

What is a distemper viral inclusion?

A

Coccoid like structures within the cytoplasm of the RBC larger than Howell-Jolly bodies

80
Q

What is cytauxzoon felis?

A

A parasite that lives in the anterior of a RBC

81
Q

What is anaplasma marginale?

A

A disease of bovines, and it lives on the margin of the cell

82
Q

What is agglutination?

A

When blood cells clump together or bunch up to attack itself, it can be due to a disease process (autoimmune disease) or improper slide preparation

83
Q

What is stain precipitate?

A

When a blood slide is not rinsed properly during preparation

84
Q

What is refractile artifact?

A

When light is hitting a cell at an angle in the microscope refracting light to appear that there are holes in the cells or “bite marks” in the cell

85
Q

What is pseudoinclusion?

A

A blue tinged cell similar in appearance to a pappenheimer body; appears like a platelet layered either on top of below an RBC

86
Q

What is rouleaux?

A

The stacking of cells and can be seen in dogs or cats with hyperprotenemia

87
Q

What is a pelger huet anomlay?

A

A cosmetic genetic defect of neutrophils; AKA hypo-segmented neutrophil

88
Q

What are hypersegmented neutrophils?

A

A WBC with 5 or more lobes in a neutrophil (a normal cell has <5), usually a senescent WBC where the nucleus is being ripped apart

89
Q

What are toxic neutrophils?

A

A WBC that may have some or all of the following changes:

  • Irregularly shaped nucleus
  • Basophilic cytoplasm
  • Foamy cytoplasm
  • Dohlie bodies
90
Q

What is a Barr body?

A

A small projection off of nucleus within a segmented cell; an inactivated female X chromosome

Clinical I (12 decks)

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