P19 - Tertiary Hemostatic Disorders

Question 1

thrombin clotting time (TCT) prolonged

Answer 1

• in common pathway

- conversion of fibrinogen to fibrin is slow

Question 2

tertiary hemostasis goal

Answer 2

• lysis of fibrin clot

Question 3

disseminated intravascular coagulation (DIC) abnormalities

Answer 3

• platelet count 50,000 - 90,000

- prolonged PT, PTT, ACT, BMBT (everything)

Question 4

DIC means

Answer 4

• formation of multiple thrombi in the body secondary to: inflammation, neoplasia, infection, extracellular parasites

Question 5

cells involved in tertiary hemostasis

Answer 5

• endothelial cells (generate tPA)

Question 6

major inhibitors of tertiary hemostasis (2)

Answer 6

• thrombin activatable fibrinolytic inhibitor in liver

- polyphosphates produced by platelets

Question 7

abnormal tests results of DIC (3)

Answer 7

• thrombocytopenia
• prolonged PT, PTT, ACT, BMBT
• increased FDPs and D-dimers

Question 8

platelet count that is indicative of DIC

Answer 8

• 50,000 - 90,000

Question 9

fibrinolysis

Answer 9

• lysis of fibrin clot after repair of vessel

Question 10

D-dimers

Answer 10

• enzymatic digestion of cross linked fibrin monomers

Question 11

purpura hemorrhagica

Answer 11

• aseptic vasculitis throughout the body

- not truly a hemostatic disorder

Question 12

clinical pathology abnormalities of purpura hemorrhagica (3)

Answer 12

• bleeding horse
• low PCV
• other coagulation tests are WRI

Question 13

causes of purpura hemorrhagica

Answer 13

• streptococcus equi respiratory infections and vaccination

- Ag-ab complexes deposits on vascular basement