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Clinical Pathology Exam 1 > Sample's Material > Flashcards

Sample's Material Flashcards

1
Q

What is the major regulatory enzyme for Thrombopoiesis?

A

Thrombopoietin

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2
Q

Where does Thombopoietin come from?

A

Continually produced by the liver, bone marrow, endothelium ect.

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3
Q

______ stimulates megakaryocyte production and differentiation

A

Thrombopoietin

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4
Q

Thrombopoietin binds to _____ in ciruclation

A

Platelets

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5
Q

When _____ numbers decrease there isn’t enough in ciruclation to pick up the thrombopoeitin, leading to increased thrombopoietin free in plasma that ciruclates to the bone marrow and stimulates production of _____

A

Platelets

Megakaryocytes

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6
Q

Platelets are part of _____ hemostasis

A

Primary

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7
Q

_____ Provides a surface for which secondary hemostasis occurs on

A

Platelets

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8
Q

How long does it take to form the primary hemostatic plug?

A

3-5 minutes

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9
Q

In the formation of the primary hemostatic plug, platelets adhere to exposed ______

A

Subendothelium

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10
Q

Once platelets adhere to subendothelium they undergo ____, leading to a shape change

A

Activation

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11
Q

After platelets are activated, they begin to secrete _____

A

Granules

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12
Q

After platelets have activated and secreted granules, they _____ to form a platelet plug

A

Aggregate

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13
Q

For platelets to adhere to the subendothelium they require ______Factor

A

Von Willebrand factor

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14
Q

Von Willebrand factor binds to ____ on the platelet surface and forms a bridge between the platelets and subendothelium

A

GP1b

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15
Q

During primary hemostasis, when platelets ____ , they start to undergo shape changes where they grow long extensions and increase their surface area by 3-5%

A

Activation

*Increase their surface area

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16
Q

The majority of negatively charged phospholipids are kept on the inside of the platelet, but when the platelet becomes activated they _____ their membrane in order to carry the negative charge on the outside

A

Flip

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17
Q

After platelets become activated, what two things are secreted in their granules?

A

Von Willibrand factor

Calcium

*Von willebrand factor calls more platelets to the site

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18
Q

During activation platelets secrete _____ which comes and coats the top of the negatively charged platelets, so the platelets become positively charged

A

Calcium

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19
Q

Calcium is secreted in platelet granules that coat the platelet with a positive charge which is important for creating the surface for the _____ factors to come down and bind to form fibrin

A

Coagulation

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20
Q

Once the granules are stimulated to form platelet aggregation, _____ binds to the platelets and starts bridging the adjacent platelets.

A

Fibrinogen

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21
Q

When _____ binds to activated platelets and bridges adjacent platelets is when you get formation of the platelet plug

A

Fibrinogen

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22
Q

True/False: Platelet aggregation is a reversible process

A

False

*Irreversible

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23
Q

Platelets provide a surface for formation and deposition of ____

A

Fibrin

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24
Q

Platelets activate their cytoskeleton to _____ the clot in order to facilitate wound closure and vessel patency

A

Retract

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25
Q

What laboratory tests are used to assess platelet concentration?

A

Blood Smear

Hematology analyzers

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26
Q

Spontaneous hemorrhage occurs when platelet numbers decrease below ______

A

20,000

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27
Q

What laboratory tests do we use to access platelet morphology?

A

Blood Smear

Hematology Analyzers

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28
Q

Increased MPV suggests increased ______

A

Thrombopoiesis

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29
Q

What does the presence of macrothromobocytes suggest?

A

Increased platelet production

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30
Q

What are the tests used in the clinical setting to evaluate platelet function?

A

Bleeding tests

*Buccal mucosal bleeding time or cuticle (toenail) bleeding time

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31
Q

What test do we use to access platelet production?

A

Bone Marrow Aspirate

*see if there are megakaryocytes or megakaryoblasts

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32
Q

In a thrombocytopenic patient, how should healthy bone marrow respond?

A

Production of Platelet precursors

*Megakaryocytes and Megakaryoblasts

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33
Q

What are the 5 mechanisms of Thrombocytopenia?

A

Production

Destruction

Sequestration

Loss

Consumption

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34
Q

Differential Diagnosis for Thrombocytopenia due to Loss of blood?

A

Hemorrhage

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35
Q

Two differential diagnoses for Thrombocytopenia due to Consumption of platelets

A

DIC

Vasculitis- ex. Ehrlichia and FIP

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36
Q

Differential Diagnosis for Thrombocytopenia due to Destruction

A

Immune-mediated Thrombocytopenia

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37
Q

Differntial Diagnoses for Thrombocytopenia due to Decreased Production

A

Bone Marrow Hypoplasia

Neoplasia- ex. Leukemia

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38
Q

Differential Diagnosis for Thrombocytopenia due to Sequestration

A

Splenomegaly

Splenic Torsion

Splenic neoplasia

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39
Q

Thrombocytopenia due to ______ is the only one that causes severe thrombocytopenia

A

Destruction

*Immune mediated thrombocytopenia

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40
Q

What are the two major mechanisms for Thrombocytosis?

A

Increased production

Increased distribution in plasma

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41
Q

What 4 diseases may cause reactive thrombocytosis?

A

Chronic inflammatory disease

Iron deficiency anemia

Chronic hemorrhage

IMHA

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42
Q

What 3 situations may cause reactive thrombocytosis?

A

Rebound from thrombocytopenia

Post-splenectomy

Excitement and exercise- splenic contraction

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43
Q

What mechanism is involved in Von Willebrands disease?

A

Decreased platelet adhesion

*Defects in the adhesion molecule that binds platelets during initiation of platelet plug- platelets float away and platelet plug is not formed

44
Q

Von Willebrand is a carrier for Factor ____

A

VIII

45
Q

True/False: In Von Willebrands disease the CBC will show a normal platelet count

A

True

46
Q

In Von Willebrand disease, there will be a ____ bleeding time

A

Prolonged

47
Q

What test would you run to confirm Von Willebrand disease?

A

Analyze Plasma for Von Willebrand Factor

48
Q

What is the platelet associated bleeding pattern for Von Willebrand disease?

A

Prolonged Bleeding

49
Q

What are the 4 Vitamin K dependent factors?

A

II, VII, IX, X

*KNOW THIS

50
Q

What are the major blood systems in the dog?

A

Dog Erythrocyte Antigen (DEA)

Dal blood system

51
Q

What are the two common DEA blood types in dogs?

A

DEA 1.1

DEA 1.2

*45% of population is DEA 1.1

52
Q

What are the most antigenic blood types in the dog?

A

DEA 1.1

DEA 1.2

53
Q

Do dogs have naturally occuring isoantibodies?

A

No

*1st exposure stimulates antibody production

54
Q

What blood type is not always expressed in Dalmations?

A

Dal

*Ubituitous in all dogs except some dalmations lack the Dal antigen

55
Q

What are the major blood systems in the cat?

A

The AB group system

The Mik system

56
Q

Do cats have naturally occuring isoantibodies?

A

Yes

*All cats have naturally occuring alloantibodies

57
Q

True/False: You shoud blood type all cats prior to transfusion

A

True

58
Q

What Feline Blood type is associated with strong isoantibodies?

A

Type A

*Strong natural isoantibodies against type A. Do not give type A blood to a type B cat

59
Q

True/False: It is okay to give type A blood to a type B cat

A

False

*cat will die due to strong antibodies against type A blood

60
Q

True/False: You can give type B blood to a Type A cat without having a major reaction

A

True

*weak antibodies against type B blood

61
Q

What are the 2 most antigenic blood types in the horse?

A

Aa and Qa

*implicated in neonatal isoerythrolysis

62
Q

In a Major crossmatch, what is tested in the recipient and the donor?

A

Recipient- serum

Donor- Red Blood cells

63
Q

Identifies antibodies against RBC antigens in the plasma of the recipient or donor

A

Crossmatching

64
Q

When interpreting a crossmatch you should look for what two things?

A

Hemolysis

Agglutination

65
Q

Whe performing a crossmatch, if there is agglutination it is a ____ crossmatch

A

Positive

66
Q

No agglutination or hemolysis means you have a ____ crossmatch

A

Negative

67
Q

If crossmatching comes back negative, due to no agglutination or hemolysis, the recipient is ____ to have a transfusion reaction from the donors Red blood cells

A

Not likely

68
Q

In a crossmatch if agglutination or hemolysis are detected it is a _____ crossmatch

A

Positive

69
Q

If a crossmatch comes back positive with agglutiation or hemolysis, the recipient is ____ for a transfusion reaction

A

at risk

*DO NOT TRANSFUSE

70
Q

When a mare develops antibodies against the red blood cell antigens of her foal due to mating with a sire that has genes for offending red blood cell antigens

A

Equine Neonatal Isoerythrolysis

71
Q

True/False: In neonatal isoerythrolysis the foal is born healthy but can become sick after ingestion of the mares colostrum

A

True

72
Q

In what disease do foals ingest mares colostrum and absorb antibodies against their red blood cell antigens

A

Equine Neonatal Isoerythrolysis

73
Q

Transfusion reaction that leads to mild extravascular hemolysis that occurs up to 3 weeks post-transfusion

A

Delayed hemolytic immune mediated reaction

74
Q

Why might you get coagulopathy in a patient with liver disease?

A

Decreased synthesis of coagulation factors

Production of dysfuntional factors

*Leads to a tendency for BLEEDING

75
Q

Syndrome caused by continued activation of coagulation and fibrinolysis

A

DIC

*disseminated intravascular coagulation

76
Q

Syndrome that results in thrombosis of the microvasculature and depletion of coagulation factors leading to bleeding

A

DIC

77
Q

How does the coagulation panel appear during the consumptive phase of DIC?

A

thrombocytopenia

prolonged PT and PTT

Increased FDP

*also decreased anti-thrombin and fibrinogen

78
Q

The consumptive phase of DIC leads to _____

A

Bleeding

79
Q

Phase of DIC that leads to thrombosis and organ dysfunction

A

Hypercoagulable

80
Q

What type of bleeding patterns do you expect with DIC?

A

Petechia, Ecchymosis, GI bleeding

*Massive bleeding

81
Q

DIC is caused by exposure of _____

A

Tissue factor

82
Q

What type of bleeding pattern do you expect with Warfarin toxicosis?

A

Bleeding into thoracic cavity

Bleeding into Joint cavities

Bleeding into the brain

83
Q

How does the coagulation panel appear for Warfarin?

A

normal platelet count

Prolonged PT and PTT

84
Q

What 2 tests are used to access fibrinolytic activity?

A

Fibrin Degradation products

D-dimer

85
Q

What are the two tests to access the intrinsic/common pathway? Which one is more sensitive

A

Activated Partial thromboplastin Time

Activated Clotting time

*Activated Partial Thromboplastin Time is more sensitive

86
Q

What test is used to access the extrinsic/ common pathway?

A

Prothrombin Time

87
Q

What test requires 70% deficiency of factor VII before prolongation is detected?

A

Prothrombin Time

*Extrinsic pathway

88
Q

If the Prothrombin Time is prolonged, in the extrinsic pathway test, there is a _____ deficiency

A

Factor VII

89
Q

What intrinsic pathway test requires 95% deficiency of the factor beore prolongation is detected

A

Activated Clotting Time

*Factor has to practially be wiped out

90
Q

What two intrinsic pathway tests measure the time for fibrin clot formation?

A

Activated Partial Thromboplastin Time

Activated Clotting Time

91
Q

What is the significance of a prolonged time with the Intrinsic pathway tests?

A

Deficiency of an Intrinsic or common pathway factor

*Could be any factor

92
Q

How do you collect a sample for a coagulation test?

A

Clean Stick

*avoid collection from heparinized catheter

93
Q

What tube do you use for collection of a sample for coagulation tests?

A

Sodium Citrate tube

94
Q

When do you get falsely decreased platelet concentrations on the analyzer?

A

Clumping

Too big (macrothrombocytes)

95
Q

Expression of which cofactor initiates coagulation?

A

Tissue Factor (Factor III)

96
Q

What is the key factor that promotes amplification of secondary hemostasis?

A

Thrombin

97
Q

During amplification, what four factors does Thrombin affect?

A

Va, VII, VIIIa, XI

98
Q

What three factors contribute to coagulation efficiency?

A

Calcium

Factor V

Platelet Membrane

99
Q

What coagulation factor has the shortest half life?

A

VII

100
Q

Prior to ____ of a liver, you should screen for coagulation abnormalities

A

Biopsy

101
Q

What are the 2 differentials for severe thrombocytopenia?

A

Immune mediated thrombocytopenia

DIC

102
Q

How would you differentiate between DIC and Immune mediated thrombocytopenia on a CBC?

A

Immune mediated thrombocytopenia will have a lower platelet count

103
Q

In Warfarin toxicosis, Warfarin inhibits _____ epoxide reductase

A

Vitamin K

*Warfarin inhibits the synthesis of Vitamin K. Vitamin K is needed for the blood to clot, therefore warfarin toxicosis leads to uncontrolled bleeding

104
Q

What cofactor is required for antithrombin to inactivate thrombin?

A

Heparin

105
Q

What are the two major end-products for fibrinolysis?

A

Fibrin Degradation products

D-dimers

Clinical Pathology Exam 1 (2 decks)

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