Haemostatic Disorders - Approach & Txt Flashcards
(31 cards)
Hemostasis is the process which causes…
bleeding to stop
Coagulation is the formation
of a clot
What are the 4 stages of hemostasis?
Vasoconstriction
Platelet plug formation
Clot formation
Fibrinolysis
Explain the process of hemostasis - Simple.
- Exposed collagen binds & activates platelets
- Platelet factors are released
- Factors attract more platelets
- Platelets aggregate into platelet plug.
What are signs of primary hemostatic disorders?
cutaneous bleeding
mucosal bleeding
excessive bleeding post-trauma or Sx
CNS or ocular bleeding
Primary hemostatic disorders impact blood vessels/endothelium how?
vasculopathy
Vasculitis
increased vessel fragility
Primary hemostatic disorders impact thrombocytopenia how?
- lack platelet production
- increased platelet destruction
- consumption
- sequestration
- loss
What are some ways Primary hemostatic disorders with thrombocytopathy occur?
- hereditary
- drug-induced
- gammopathies
- uremia
- infectious agents
Tests to assess primary hemostasis include…
-hematology and blood smear exam to assess platelet numbers
- BMBT if PLT & coags normal
- vWF assays
- platelet function tests
- viscoelastic testing
- histopath
What are the most common primary hemostatic disorders?
Immune-mediated thrombocytopenia
Von Willebrand’s Disease
Immune-mediated thrombocytopenia is an
acquired condition
Von Willebrand’s diseases is an
inherited disease
immune-mediated thrombocytopenia (IMT) can be
primary/idiopathic
Secondary
If a patient has IMT, what are some very important things that must be remembered when working with that patient?
- No IM, SQ injections
- No jugular samples
- No FNA/cystocentesis, etc.
What txts are available for IMT?
- immunosuppressive therapy/drugs
- IV fluid therapy/blood transfusion
- gastroprotectant if GI bleeding
- supportive txt
What immunosuppressive drug should never be used in cats?
Azathioprine
What are the 3 subtypes of Von Willebrand’s?
Type I: partial quantitative deficiency, residual vWF has normal structure & function
Type II: selective loss of large vWF multimers, decrease PLT-vWF & collagen interactions
Type III: complete vWF deficiency
What are some congenital coagulopathies?
FVIII - Hemophilia A
FIX - Hemophilia B
FXII deficiency
What are some acquired coagulopathies?
- severe protein-losing disorders (PLN, PLE)
- warfarin or heparin admin overzealously
- rodenticide toxicity
- liver insufficiency
What are some tests used to assess secondary hemostasis?
APTT, PT, individual coagulation factor assessments, TEG, ROTEM
What are the most common secondary hemostatic disorders?
- rodenticide toxicity
- liver insufficiency
- DIC
- infectious causes - Angiostrongylus vasorum, lepto
- hemophilia A/B
- feline FXII deficiency
Vit K is an important cofactor for production of…
Factors II, VII, IX, X
What breeds are predisposed to inheriting vit K deficiency?
labradors
devon rex
What is an acquired vit k deficiency?
Rodenticide toxicity
