IMHA

Question 1

Method of action for rivaroxaban

Answer 1

Inhibits factor Xa and prothrombinase activity

Indirectly inhibits platelet aggregation induced by thrombin

Question 2

Method of action for mycophenolate mofetil

Answer 2

Prodrug of mycophenolic acid
Inhibitor of inosine-5’-monphosphate dehydrogenase
Depletes guanosine in T and B lymphocytes -suppresses cell-mediated immune response and antibody formation

Also inhibits glycosylation and adhesion molecule expression

Question 3

Method of action of clopidogrel

Answer 3

Prodrug transformed to CAM which binds to platelet ADP receptor (P2Y12). Irreversibly alters ADP for whole of lifetime

Reduces activation by ADP
Inhibits activation of gpIIb/IIIa

Question 4

According to the ACVIM consensus what is the first step of IMHA diagnosis

Answer 4

> or = 2 signs of immune mediated destruction

•Speherocytes
•Positive SAT without washing
•Positive DAT or FC
Or
Positive SAT that persists with washing

Question 5

According to the ACVIM IMHA consensus, if the first step has been met what would be the next step to confirm IMHA diagnosis

Answer 5

> or = 1 sign of hemolysis
•hyperbilirubinemia, significant bilirubinuria or icterus without functional hepatic disease, post-hepatic cholestasis or sepsis
•haemoglobinemia
•hemoglobinuria
•Erythrocyte ghost cells

If yes to 1 or more of these =IMHA