Jvim Hemolymph Sc 2

Front 1

Fresh frozen plasma becomes frozen plasma after when

Back 1

a. 1 year
52

Front 2

Was a difference noted with TEG when comparing fresh frozen plasma to frozen plasma

Back 2

a. No, the plasma remained hemostaticall active when evaluated by TEG for 5 years
b. Although not clinically significant, factors VIII, X were lower in frozen plasma compared to FFP, OSPT and APTT were longer and fibrinogen was lower, AT was increased
53

Front 3

What percentage of humans with nephrotic syndrome experience thromboembolic complications

Back 3

a. 42%
54

Front 4

What is the reported percentage of thromboembolic complications in dogs with PLN

Back 4

a. 22%
55

Front 5

Are antithrombin levels, UPC, or serum albumin levels predictive of dogs that will experience thromboembolic complications

Back 5

a. No
56

Front 6

What is the one test that can measure hypercoagulability

Back 6

a. TEG
57

Front 7

Dogs with PLN were more or less hypercoagulable when compared to controls

Back 7

a. More hypercoagulable
58

Front 8

What was the proposed mechanism for hypercoagulability in dogs with PLN

Back 8

a. Interaction between platelets and fibrin amplification and propagation phases of clot formation (in the study was not influenced by PCV or platelet count)
59

Front 9

Humans with PLN have been found to have what factors to promote hypercoagulability

Back 9

a. Decreased AT, increased platelets, increased platelet activation, increased fibrinogen, increased factors V and VIII, increased vonwillebrands factor, and vascular stasis
60

Front 10

What is the mechanism of action behind IMTP

Back 10

a. Antibodies form against platelets leading to their destruction/phagocytosis by macrophages
61

Front 11

At what level does spontaneous hemorrhage occur

Back 11

a. 30-50K
62

Front 12

Is there any difference in hospital time or platelet recovery time in dogs that received prednisone + vincristine vs. prednisone + IVIG

Back 12

a. No, was the same, median hospitalization was 4 days and platelet recovery time was 2.5 days
63

Front 13

What is the overall mechanism of action for vincristine

Back 13

a. Vinca alkaloid that inhibits microtubule formation (binds to tubulin) of the mitotic spindle and thereby inhibits cellular division
b. Mechanism behind increasing platelets is unknown but theorized to expedite thrombopoiesis and decreased phagocytosis of opsonized platelets
64

Front 14

What are the adverse side effects from vincristine

Back 14

a. Myelosuppression, phlebitis if extravasated
65

Front 15

What is the MOA for IVIG

Back 15

a. Binds to the Fc receptor on mononuclear cells
66

Front 16

What are the adverse effects of IVIG

Back 16

a. Fever, anaphylaxis, thrombocytopenia
67

Front 17

What is a type 2 error

Back 17

a. When a statistical difference cannot be obtained despite its existence because of small sample size
68

Front 18

IMHA is what type of autoimmune response

Back 18

a. Type 2 because antibody mediated
69

Front 19

What is the cutoff value for spherocytes in supporting IMHA

Back 19

a. 5 per HPF
70

Front 20

What doses of GCC have been reported to have a higher rate of side effects/ complications with little benefit

Back 20

a. 2 mg/kg BID
71

Front 21

What are the two most common 2nd tier drugs reported as therapy for IMHA

Back 21

a. Cyclosporine and Azathioprine
72

Front 22

Which immunosuppressive is NOT recommended

Back 22

a. Cyclophosphamide
73

Front 23

Is there published evidence that conclusively supports using azathioprine vs. cyclosporine

Back 23

a. No, conflicting studies that show GCC are just as effective by themselves
74

Front 24

What two drugs are reported to have better clinical outcomes when used in the treatment of IMHA

Back 24

a. Heparin, aspirin
75

Front 25

When using TEG, dogs with CPSS were considered hypo or hypercoagulable

Back 25

a. Hypercoagulable as they had shorter k values, steeper angles, and increased MA
76

Front 26

What clinical attribute was associated with dogs with CPSS to be hypercoagulable

Back 26

a. If they had hepatic encephalopathy
77

Front 27

What is the proposed mechanism behind dogs that were hypercoagulable

Back 27

a. Increased bacterial translocation secondary to hepatic encephalopathy, leading to systemic inflammation; altered vascular flow
78

Front 28

Was PT or aPTT predictive of those dogs that would be hypercoagulable

Back 28

a. No, was often prolonged-> fibrinogen concentration more closely mirrored it
79

Front 29

What percentage of dogs with IMHA have evidence of thrombi on necropsy

Back 29

a. 80%
80

Front 30

What are antiphospholipid antibodies

Back 30

a. Antibodies (immunoglobulins) that target phospholipids or proteins that bind to phospholipids
81

Front 31

What is antiphospholipid syndrome

Back 31

a. Human condition characterized by autoimmune disease that has increased evidence of recurrent thrombosis
82

Front 32

Did dogs with IMHA, spontaneous thrombosis, and HAC have increased levels of antiphospholipids compared to controls

Back 32

a. Yes
83

Front 33

Is there an association between antiphospholipid antibodies and dogs that develop thromboembolic complications

Back 33

a. No
84

Front 34

What is Scott Syndrome

Back 34

a. Impaired externalization of phosphatidylserine of the platelet and therefore lack of prothrombinase- develop a predisposition to bleeding (postoperative and nontraumatic bleeding)
85

Front 35

How does one diagnose Scott Syndrome

Back 35

a. Will see altered platelet aggregation under arteriolar flow, indicating platelet dysfunction- all coags, vonWillebrand factor, and TEG will be normal
86

Front 36

What breed of dogs are susceptible to Scott Syndrome

Back 36

a. German Shepherd, autosomal recessive inheritance, affects males > females
87

Front 37

What antibody is most commonly involved in IMTP and what proteins are targeted on the platelet

Back 37

a. IgG; glycoprotein IIb and IIIa
88

Front 38

What vaccine is commonly associated with IMTP in people

Back 38

a. Measles, mumps, rubella (MMR)- can cause a nadir at 21 days of as low as 1K platelets
89

Front 39

What veterinary vaccines have been associated with thrombocytopenia

Back 39

a. Distemper and hepatitis vaccines, rarely go below 100K
90

Front 40

Is there evidence that vaccines cause IMTP in veterinary medicine

Back 40

a. No
91

Front 41

What prostaglandin has been shown to reversibly inhibit platelet activation

Back 41

a. PGE1
92

Front 42

How does this prostaglandin inhibit platelet activation

Back 42

a. Increases cAMP concentrations
93

Front 43

How does the addition of PGE1 to platelet concentrates help with making platelet rich plasma

Back 43

a. Decreases platelet activation and made platelet resuspension easier and faster, did not affect hemostasis when the product was dilted in plasma
94

Front 44

What is a Sonoclot

Back 44

a. Cage-side device that can measure blood viscosity and evaluate entire hemostasis process quantitatively and qualitatively
95

Front 45

When heparin was used in dogs and the dogs were monitored with the Sonoclot, which other test closely mirrored the results of the sonoclot

Back 45

a. aPTT (both were sensitive and specific)