May 2010 Benchmark- Hemostasis Flashcards
Which clotting factors are vitamin-K dependent?
FII, FVII, FIX, FX
If you see 1 platelet average per HPF, how many platelets estimated should you have?
15,000
PLT estimate = average PLT in ten HPF x 15,000
The result of the BMBT you performed is 6 minutes. List 10 differentials for this result regardless of breed.
For any inherited disorders you mention, list one breed it is found in.
- Error in measurement
- vWF type I (Dobie and many others)
- vWF type II (German shorthair and wirehair pointers)
- vWF type III (Scottie, Shetland sheepdog, Dutch kooiker, Chesapeake Bay retriever,
Golden retriever) - Glanzmanns thrombasthenia (Otterhound, Great Pyrenees, Alaskan malamute) or
Thrombasthenic thrombopathia of Otterhounds - Storage pool diseases (Cocker spaniel, grey collies)
- Bassett hound thrombopathias (formerly canine thrombopathia)
- NSAID therapy
- Dysfibrinogenemia (Collie)
- Hepatic disease
- Pancreatic disease
- Angiostrongylus vasorum infection
- Ehrlichia canis infection
- Hyperproteinemia
- Venomous snake bite
- Uremia
- Synthetic colloid therapy
- Neoplasia
During acute hemorrhage, why does the TP tend to drop prior to the PCV?
During acute hemorrhage the TP tends to drop before the PCV as splenic contraction
and red cell release tends to maintain PCV whereas there is no such reserve of proteins
How does desmopressin acetate (DDAVP) work in terms of treatment/premedication for patients undergoing surgery who also have vWF deficiency?
Desmopressin (DDAVP): it causes release of vWF from patient’s endogenous stores
(endothelium, subendothelial matrix, megakaryocytes) via V2 receptors.
The BMBT in this patient suggests that it may be a mild type and may benefit from this
treatment. Candidates may mention treatment with Interleukin-11, although there are no
clinical trials in veterinary medicine at this time
There are three types of this disease. List the distinguishing characteristics of each type,
the bleeding potential for that type, and which breeds are typically affected.
Type I: a) all sizes of von Willebrand’s factor multimers are present, but in decreased
amount, b) bleeding is mild to moderate, c) Doberman pinscher, Basset, Cockers,
English setter, German shepards, Golden retrievers, Poodles, Shetland sheepdogs,
Welsh corgis and many others.
Type 2: a) large multimers are absent which are the most hemostatically active, b)
bleeding is typically severe, c) German shorthair and wirehair pointers.
Type 3: a) either complete absence of all sized multimers or only trace amounts, b)
bleeding is severe, c) Scottish terrier, Shetland sheepdog, Dutch Kooiker,
Chesapeake Bay retriever, Golden retriever.
What are four main categories of thrombocytopenia, and one example of each category
- Decreased production / Failure of megakaryocytopoiesis. Examples: Bone marrow neoplasia, Rickettsial diseases (Ehrlichiosis, RMSF), myelosuppressive drug administration, radiation exposure
- Sequestration. Examples: Hypothermia, hypersplenism
- Increased consumption. Examples: Acute hemorrhage, DIC, vascular leak syndrome, sepsis
- Increased destruction. Examples: Immune-mediated (ITP – primary or secondary); mechanical injury of platelets
(splenic/vascular neoplasia, heartworm disease)
What is the primary hormonal signal for megakaryocytic production and where is the hormone produced?
Thrombopoeiten
Produced in the liver
Where are three accessible sites for bone marrow aspiration?
Proximal humerus
Proximal femur
Wing of the ileum
What is the proposed mechanism of action of melatonin as it pertains to ITP?
Melatonin increases production of interleukin (IL)-1, IL-6, and tumor necrosis factor-alpha.
Both prophylactic and therapeutic melatonin administration inhibits the inflammatory
response. This inhibition may be accompanied by enhanced thymocyte proliferation and IL-2
production by melatonin. Melatonin has also been shown to possess both cellular and
humoral immunoenhancing effects, and immune responses were augmented even in the
absence of previous immunosuppression
