Lecture 11 - Hemostasis part 3 Flashcards
List the causes of Vitamin K deficiencies and antagonism.
“BAIL Moldy”
Warfarin inhibits the synthesis of active forms of Vitamin-K dependent clotting factors: ?
2, 7, 9, 10
What are the clinical signs of Vitamin K deficiency and antagonism?
What are the laboratory features of Vitamin K deficiency and antagonism?
As well as:
Prolonged PT (initially b/c Factor 7 has shortest half life)
Prolonged PTT/aCT
In an animal with suspicious medical history or rat poison exposure, and an increased PT only you should consider what as apart of your DDx?
Warfarin exposure
B/c the PT will be the first test to be prolonged/abnormal b/c Factor 7 has the shorted half life.
The animal may not show signs of bleeding yet.
DIC is an acquired syndrome characterized by the _________ activation of __________ with loss of __________ arising from different causes. It can originate from ___________ and cause damage which IF sufficiently severe can produce organ dysfunction.
DIC is secondary to conditions that continually activate _______ and ________
intravascular, coagulation, localization
microvasculature
coagulation, fibrinolysis
What are the causes of DIC?
Describe the phases of DIC.
What are the clinical signs of DIC?
In a case of DIC, serum biochemistry changes depend on the?
Primary disease and location of microthrombosis
List the laboratory findings in a case of DIC
List the coagulopathies of liver disease.
What are the inherited factor deficiencies?
Hemophilia A is a deficiency or defect in coagulation factor ?
Is this condition common?
How does this deficiency occur?
What species is this condition seen in?
8
This is the most common coagulopathy in animals and humans
Sex-linked recessive mode of inheritance. Males are clinically affected and females are carriers (no clinical signs)
Dogs, cats, horses, and cattle
What are the clinical signs of Hemophilia A?
Mild, moderate, or severe bleeding. Correlates with severity of Factor 8 deficiency.
What are the laboratory findings of Hemophilia A?
Prolonged PTT
Normal PT
Normal PLT count
Normal bleeding time
Hemophilia B is a deficiency or defect in coagulation factor ?
How does this deficiency occur?
What species is this condition seen in?
9
Sex-linked recessive mode of inheritance. Males are clinically affected and females are carriers (no clinical signs)
Dogs, cats; larger breeds are more severely affected.
What are the clinical signs of Hemophilia B?
Similar to Hemophilia A
What are the laboratory findings of Hemophilia B?
Similar to Hemophilia A
Prolonged PTT
Normal PT (<6 m old normally have lower F8 and F9 than adults; Test > 6 min)
Hageman’s Disease is the most common inherited coagulopathy in which species?
Define this condition. What are the clinical signs? What are the laboratory results?
Cats
This is a deficiency in coagulation factor 12.
Cats are asymptomatic
Coagulation test results: Normal PT, Prolonged PTT.
Thromboembolic disease is characterized by?
Thrombosis
Altered blood flow
Endothelial injury
Hypercoagulability
Thrombus formation involves a sequence of events similar to the formation of a ______________ _____. The difference is that thrombus formation continues _________ by mechanisms that usually dissolve the plug after it has served its purpose.
hemostasis plug, unrestricted
Are you able to distinguish between thromboembolic disease and early DIC?
No because both have similar lab test abnormalities
List the examples of Endothelial injury/dysfunction that cause thromboembolic disease.
List the examples of blood stasis that cause thromboembolic disease.
List the examples of hypercoaguable states that cause thromboembolic disease.
What are the clinical signs in the following thromboembolic diseases:
1. Saddle thrombus
2. Pulmonary embolism
3. Renal infarction
- Rear limb weakness
- Dyspnea
- Hematuria
In a case of Thromboembolic disease, what would you find in your lab diagnostics?
- Why do these results rule out rodenticide toxicity?
* The absence of prolongation in PT rules out rodenticide toxicity.
* Because Factor VII has the shortest half-life, approximately 6 hours, and as a result the extrinsic pathway (measured by PT), F7 will be the first to show prolonged clotting time. Since the PT is not prolonged, rodenticide (anticoagulant) toxicity is ruled out. - DDx 1: Hemophilia.
* Very rare in the cat and unlikely in a cat of this age without previous clinical signs related to bleeding. DDx2: Factor XII (Hageman factor) deficiency.
* This condition does not result in clinical signs of bleeding, but may result in prolongation of aPTT. It is thought to be
an inherited incompletely dominant trait.
In a case of rodenticide toxicity, PT is prolonged due to?
Factor 7 deficiency
As rodenticide toxicity progress, the _______ becomes prolonged as well.
aPTT
In a case of rodenticide toxicity, Vitamin K-independent factors are not affected because there is a time lag (due to their half life), of anywhere from ___ hours up to ___ days between exposure to the toxin and development of ______
* ______ or ______, bleeding into ____, _____ and _____
cavities, the ______ system and/or ____
12, 7, bleeding, internal, external, joints, thoracic, abdominal, urinary, GIT
DIC?
