Hemotologic Emergencies

Question 1

What history is sometimes seen with anemia?

Answer 1

Anorexia
Pica
Lethargy
Collapse
Syncope
See if they are on any medications
Exposures to parasites, toxins, or heat
Any recent blood loss (hematuria, melena, hematochezia, epistaxis, hemoptysis)

Question 2

What physical exam findings are seen with anemia?

Answer 2

Pale mucous membranes
Ecchymoses
Grade I-II/ VI heart murmur 
Bounding pulses
Tachycardia
Rectal exams show melena

Question 3

What PCV indicates severe anemia in the dog?

Answer 3

< 18%

Question 4

What PCV indicates moderate anemia In the dog?

Answer 4

18-29%

Question 5

What PCV indicates mild anemia in the dog?

Answer 5

30-36%

Question 6

What red blood cell parameters indicate regenerative anemia?

Answer 6

Macrocytic (increased MCV)
Hypochromic (decreased MCHC)
Retticulocyte count > 60,000
Reticulocyte index > 2.5

Question 7

What values are seen with hemolytic anemia?

Answer 7

Strong to moderate regenerative response
Leukocytosis
Neutrophilia with left shift
Monocytosis

Question 8

What is a normal manual platelet count? What is a clinically significant thrombocytopenia on manual count?

Answer 8

8-12/ hpf

3-4/ hpf is clinically significant

Question 9

What is the difference between blood loss and hemolysis with hypoproteinemia?

Answer 9

Blood loss will usually have hypoproteinemia

Hemolysis will be normal

Question 10

What is measured with ACT?

Answer 10

Intrinsic and common pathway

Question 11

What is measured with PT?

Answer 11

Extrinsic and common pathway

Question 12

What is measured with PTT?

Answer 12

Intrinsic and common pathway

Question 13

What rate should be used for red blood cell administration?

Answer 13

5-10 mL/kg/hr

Question 14

When should you be checking PCV after giving a blood transfusion?

Answer 14

1hr, 24 hr, 72hr

Question 15

What immunosuppressive drugs can be used in patients with IMHA that continue to display anema?

Answer 15

Pred
Dex
Azathiaprine
Cyclophoshamide
Mycophenolate 
Splenectomy in cases refractory or with clinical signs
Leflunomide
Cyclosporine
If patient is stable, wean off meds by 25% every 2 weeks through 6 weeks

Question 16

What PCV indicated severe anemia in the cat?

Answer 16

< 14%

Question 17

What PCV indicated moderate anemia in the cat?

Answer 17

15-19%

Question 18

What PCV indicated mild anemia in the cat?

Answer 18

20-24%

Question 19

What medication is useful for cat with non-responsive IMHA?

Answer 19

Chlorambucil

Question 20

What is considered a mild thrombocytopenia in the dog?

Answer 20

<100000

Question 21

What is considered a moderate thrombocytopenia in the dog?

Answer 21

<60,000

Question 22

What is considered a severe thrombocytopenia in the dog?

Answer 22

< 30,000

Associated with increased risk of hemorrhage

Question 23

What is the equivalent of 1 platelet per high powered field?

Answer 23

15,000

Question 24

What is normal buccal mucosal time in dogs?

Answer 24

2-3 minutes

Prolonged with thrombocytopenia, thrombocytopathia, von Willebrand’s

Question 25

What breeds are associated with factor I deficiency?

Answer 25

Saint Bernards Vizslas Collies Borzois

Question 26

What breeds are associated with factor II deficiency?

Answer 26

Boxers Cocker Spaniels Devon Rex cats

Question 27

What breeds are associated with factor VII deficiency?

Answer 27

``` Beagles Alaskan Malamutes miniatures Schnauzers Boxers English Bulldogs ```

Question 28

What breeds are associated with factor VIII deficiency?

Answer 28

mixed breeds | Devon Short Hair

Question 29

What places should you check for on physical exam for coagulopathies?

Answer 29

``` Subcutaneous tissues Muscles Hematoma Petechia Ecchymoses on oral, scleral, penile, vulvar, conjunctival mm) Joints Icterus ```

Question 30

What signs are seen with coagulopathies?

Answer 30

Hematomas are common Bleeding is localized, common in muscles and joints Delayed at first then start again Petechiae are rare

Question 31

What signs are seen with platelet or vascular disorders?

Answer 31

Petechiae are common Bleeding in multiple locations, mucous membranes common Prolonged bleeding time from cuts Hematomas are rare

Question 32

What is the recommended treatment for von Willebrands? What is a suitable alternative?

Answer 32

Cryoprecipitate is ideal | Fresh frozen plasma is an alternative

Question 33

How should yunnan baiyao be dosed?

Answer 33

5 days on, 5 days off

Question 34

What is the prognosis for DIC?

Answer 34

Guarded to poor

Question 35

What is the most common cause of hemoperitoneum?

Answer 35

Trauma (HBC, kicked, gunshots, dog fight, foreign body)

Question 36

When should whole red blood cells be given to patients?

Answer 36

When PCV < 25%

Question 37

When should plasma be administered to patients?

Answer 37

When TS < 4.0