Coagulopathy Flashcards
(32 cards)
Factor I deficiency
- Deficiency
- Results of routine screening tests
-Afibrinogenemia; hypofibrinogenimia; dysfibrinogenemia
- Increase PT, PTT, ACT
- decrease to normal fibrinogen
Factor II deficiency
- Hypoprothrombinemia
- Increase PT, ATT, ACT
- Normal fibrinogen
Factor VII deficiency
- Hypoproconvertinemia
- Increase PT
- Normal PTT, ACT, fibrinogen
Factor VIII deficiency
- Hemophilia A
- Increase PTT, ACT
- Normal PT, fibrinogen
Factor IX deficiency
- Hemophilia B (Christmas disease)
- Increase PTT, ACT
- Normal PT, fibrinogen
Factor X deficiency
- Stuart-Prower deficiency
- Increase PT, PTT, ACT
- Normal fibrnogen
Factor XI deficiency
- Hemophilia C
- Increase PTT, ACT
- Normal PT, fibrinogen
Factor XII deficiency
- Hageman trait
- Incrase PTT, ACT
- Normal PT, fibrinogen
Factor XIII deficiency
- Normal PT, APP, ACT, Fibrinogen
Factor II, VII, IX, and X deficiency
- Combined vitamin K-dependent factor deficiency.
- Doc in Devon Rex, 1 lab
- Increase PT, PTT, ACT
- Normal fibrinogen
Tranexamic acid and aminocaproic acid: MOA
Lysine analogues, they exert their mechanism of action by competitively binding C-terminal lysine sites on plasminogen. As a result of lysine analogue binding plasminogen is prevented from binding fibrin and plasmin formation is inhibited.
inhibiting plasminogen activators and preventing plasmin from degrading fibrin clots, thus stabilizing clots against fibrinolysis
SE: Hpotension and gastrointestinal signs, weakness, myonecrosis, myoglobinuria and rhabdomyolysis are dose dependent adverse reactions (in human aminocarproic acid).
Vomiting at high dose (TXA).
Bernard–Soulier syndrome
- type of defect
- specific mechanism
- breed affected
- clinical relevance
- Extrinsic Adhesion
- GPIb/V/IX deficiency
- Cocker spaniel
- Severe bleeding
Glanzmann thrombasthenia
- type of defect
- specific mechanism
- breed affected
- clinical relevance
- Intrinsic Aggregation
- Absence or deficiency of GPIIbIIIa
- Great Pyrenees and otterhounds
- Spontaneous mucosal haemorrhage
Scott Syndrome
- type of defect
- specific mechanism
- breed affected
- clinical relevance
- Intrinsic Procoagulant deficiency
- Impaired PS externalisation
- ⇓ prothrombinase
- German shepherd dog
- Postoperative haemorrhage and epistaxis
P2Y12 receptor disorder
- type of defect
- specific mechanism
- breed affected
- clinical relevance
- Intrinsic Prevention of agonist action
- Impaired binding of ADP → reduced fibrinogen binding
- Greater Swiss mountain dog
Ca1DAG-GEFI thrombopathia
- type of defect
- specific mechanism
- breed affected
- clinical relevance
- Intrinsic Signalling Prevents GPIIb-IIIa conformation change for fibrinogen binding
- Basset hound, Landseer and spitz
Chediak-Higashi
- type of defect
- specific mechanism
- breed affected
- clinical relevance
-Intrinsic Granular storage pool deficiency Agonist deficiency.
-Absent aggregation response to collagen
- Persian cats
- Prolonged bleeding times
Delta-storage pool disease
- type of defect
- specific mechanism
- breed affected
- clinical relevance
-Intrinsic Granular storage pool deficiency
-Dense granule deficiency of ADP
-American cocker spaniel
-Postoperative haemorrhage
Type I vWD
- Breeds affected
- Multimer concentration
- Multimeric size
- Clinical importance
- Diagnosis
- Doberman, corgi, Airedale terrier, and various others breeds
- Low Full spectrum of sizes
- Mild to moderate bleeding tendency
- Dx: Genetic test, Plasma vWF antigen ELISA (Borderline: 50 to 69% Abnormal:0 to 49%, not specific for vWD), Plasma vWF CBA ELISA (CBA in normal/type 1 dogs=50 to 170%)
Type II vWD
- Breeds affected
- Multimer concentration
- Multimeric size
- Clinical importance
-German short haired pointer
-Variable Absence of large multimers
-Moderate to severe bleeding tendency
-DX: Plasma vWF CBA ELISA Type 2 dogs typically >2.0
Type III vWD
- Breeds affected
- Multimer concentration
- Multimeric size
- Clinical importance
- Dutch kooiker, Scottish terrier, Shetland sheepdog
- Marked reduction or absence of all multimers N/A
- Mild to severe bleeding
- Dx: Plasma vWF antigen ELISA (Borderline: 50 to 69% Abnormal:0 to 49%, not specific for vWD)
Platelet count WNL, aPTT long, PT - WNL, Fibrinogen -WNL. DDX?
Intrinsic factor defects:
Factor VIII (hemophilia A)
Factor IX (hemophilia B)
Factor XI
Contact pathway factors:
Factor XII (Hageman trait)
Prekallikrein
HMW kininogen
Platelet count WNL, PT long, aPTT - WNL, Fibrnogen WNL - DDX?
Fac VII deficiency
Platelet count - WNL, aPTT and PT long, fibrinogen - WNL
Common pathway or combined defects:
Common path:
- Fac II
- Fac V
- Fac X
Combined vit K def
- Fac II, VI, IX, X
