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RUSVM Clinical Pathology > Secondary Hemostasis > Flashcards

Secondary Hemostasis Flashcards

1
Q

Expression of which cofactors initiates coagulation?

A

Tissue factor (III)

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2
Q

Which coagulation factor drives amplification?

A

Thrombin (IIa)

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3
Q

What are the 4 VitK dependent coagulation factors?

A

2, 7, 10, 9.. coagulation time!

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4
Q

What factor increases antithrombin activity?

A

Heparin

Increase activity by 1000x

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5
Q

Where is heparin found in the body?

A

Expressed on endothelial cells and circulates in the plasma

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6
Q

If you have a protein losing enteropathy, are you hypo or hyper -coagulable?

A

Hypercoaguable –> loss of antithrombin

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7
Q

What are the two major end products of fibrinolysis ?

A

Fibrin degradation products (FDP)

D-dimers

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8
Q

When are fibrin degradation products and D-dimers increased??

A

When there is increased clotting—> increased clot breakdown

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9
Q

What is responsible for clot degradation

A

Plasmin

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10
Q

To run coagulation tests, how should blood be collected?

A

“Clean stick”

Avoid taking blood from heparinized catheter

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11
Q

Blood for coagulation tests should be collected in ??

A

Sodium citrate tube (blue top) –> calcium chelator

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12
Q

What two tests can be used to measure the intrinsic pathway?

A

Activated partial prothrombin time (PPT)

Activated clotting time (ACT)

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13
Q

What test is more sensitive for measuring the intrinsic pathway of coagulation?

A

Activated prothrombin time (70% factor deficiency to produce result)

–>ACT requires a 95% deficiency to produce a result

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14
Q

What test can be used to measure the extrinsic pathway?

A

Prothrombin time (PT)

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15
Q

What test is good to detect a vitamin k deficiency due to the short half life of its coagulation factors

A

PT -> extrinsic pathway (factor VII)

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16
Q

If you have a prolonged PT, what are your two differentials?

A

Factor VII deficiency

Common pathway deficiency

17
Q

If you have a prolonged PTT, but a normal PT, what can you infer from these results?

A

Deficiency in factors 12, 11, 9, or 8 (intrinsic pathway)

18
Q

If you have a normal PPT and and prolonged PT, what can you infer from these results?

A

Deficiency in factor VII

19
Q

If PTT is prolonged and PT is prolonged, what can you infer?

A

Deficiency in factors of the common pathway

20
Q

If there is an increase in FDP or D-dimers, what is the cause?

A

Increased fibrinolysis
Severe internal hemorrhage
Decreased FDP clearance by the liver

21
Q

What toxin is commonly associated with vitK deficiency

A

Warfarin

22
Q

What bleeding pattern do you expect in an animal with vitK deficiency?

A

Increase bleeding

  • anemia, weakness
  • hypovolemia
  • dyspnea
  • lameness
  • neurological
23
Q 
RBC: anemic (regenerative) 
PLT: normal 
MPV: normal 
PTT/ACT: prolonged 
PT: prolonged
A

Vitamin K coagulopathy

24
Q

What are common causes of DIC?

A

Induction of tissue factor -sepsis, tissue necrosis, neoplasia

Endothelial damage - exposed collagen

Proteolytic enzyme -snake venom or pancreatitis

25
Q

What are the two phases of DIC?

A

Hypercoaguable phase (thrombosis and ischemic necrosis)

Consumptive phase (bleed)

26
Q

What phase of DIC results in bleeding?

A

Consumptive phase

27
Q

What bleeding pattern is seen in DIC?

A

Mucosal due to PLT consumption

Hemorrhage due to factor consumption

28
Q

What is the cardinal change seen in DIC?

A

Thrombocytopenia

29
Q

Thrombocytopenia
Prolonged PTT/PT
Increased FDP and D-dimers
Decreased antithrombin

Hemorrhagic anemia
Schistocytes

What dis?

A

DIC

30
Q

Why are coagulopathies associated with liver disease?

A

Decreased production of coagulation factors
and/or
Production of dysfunctional platelets

31
Q

What is the classic presentation of an inherited factor deficiency?

A

Young animal with bleeding disorder

32
Q

What are the three most common inherited factor deficiencies?

A

Hemophilia A
Hemophilia B
Factor XII (Hageman’s disease )

33
Q

What common inherited factor deficiencies are associated with bleeding

A

Hemophilia A: VII

Hemophilia B: IX

34
Q

PLT: normal
BMMT: normal
PTT/ACT: prolonged
PT: normal

A

Inherited factor deficiency

RUSVM Clinical Pathology (18 decks)

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