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45 Cards in this Set

  • Front
  • Back
Fresh frozen plasma becomes frozen plasma after when

a. 1 year
Was a difference noted with TEG when comparing fresh frozen plasma to frozen plasma

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
What percentage of humans with nephrotic syndrome experience thromboembolic complications

a. 42%
What is the reported percentage of thromboembolic complications in dogs with PLN

a. 22%
Are antithrombin levels, UPC, or serum albumin levels predictive of dogs that will experience thromboembolic complications

a. No
What is the one test that can measure hypercoagulability

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

a. More hypercoagulable
What was the proposed mechanism for hypercoagulability in dogs with PLN

a. Interaction between platelets and fibrin amplification and propagation phases of clot formation (in the study was not influenced by PCV or platelet count)
Humans with PLN have been found to have what factors to promote hypercoagulability

a. Decreased AT, increased platelets, increased platelet activation, increased fibrinogen, increased factors V and VIII, increased vonwillebrands factor, and vascular stasis
What is the mechanism of action behind IMTP

a. Antibodies form against platelets leading to their destruction/phagocytosis by macrophages
At what level does spontaneous hemorrhage occur

a. 30-50K
Is there any difference in hospital time or platelet recovery time in dogs that received prednisone + vincristine vs. prednisone + IVIG

a. No, was the same, median hospitalization was 4 days and platelet recovery time was 2.5 days
What is the overall mechanism of action for vincristine

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
What are the adverse side effects from vincristine

a. Myelosuppression, phlebitis if extravasated
What is the MOA for IVIG

a. Binds to the Fc receptor on mononuclear cells
What are the adverse effects of IVIG

a. Fever, anaphylaxis, thrombocytopenia
What is a type 2 error

a. When a statistical difference cannot be obtained despite its existence because of small sample size
IMHA is what type of autoimmune response

a. Type 2 because antibody mediated
What is the cutoff value for spherocytes in supporting IMHA

a. 5 per HPF
What doses of GCC have been reported to have a higher rate of side effects/ complications with little benefit

a. 2 mg/kg BID
What are the two most common 2nd tier drugs reported as therapy for IMHA

a. Cyclosporine and Azathioprine
Which immunosuppressive is NOT recommended

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

a. No, conflicting studies that show GCC are just as effective by themselves
What two drugs are reported to have better clinical outcomes when used in the treatment of IMHA

a. Heparin, aspirin
When using TEG, dogs with CPSS were considered hypo or hypercoagulable

a. Hypercoagulable as they had shorter k values, steeper angles, and increased MA
What clinical attribute was associated with dogs with CPSS to be hypercoagulable

a. If they had hepatic encephalopathy
What is the proposed mechanism behind dogs that were hypercoagulable

a. Increased bacterial translocation secondary to hepatic encephalopathy, leading to systemic inflammation; altered vascular flow
Was PT or aPTT predictive of those dogs that would be hypercoagulable

a. No, was often prolonged-> fibrinogen concentration more closely mirrored it
What percentage of dogs with IMHA have evidence of thrombi on necropsy

a. 80%
What are antiphospholipid antibodies

a. Antibodies (immunoglobulins) that target phospholipids or proteins that bind to phospholipids
What is antiphospholipid syndrome

a. Human condition characterized by autoimmune disease that has increased evidence of recurrent thrombosis
Did dogs with IMHA, spontaneous thrombosis, and HAC have increased levels of antiphospholipids compared to controls

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

a. No
What is Scott Syndrome

a. Impaired externalization of phosphatidylserine of the platelet and therefore lack of prothrombinase- develop a predisposition to bleeding (postoperative and nontraumatic bleeding)
How does one diagnose Scott Syndrome

a. Will see altered platelet aggregation under arteriolar flow, indicating platelet dysfunction- all coags, vonWillebrand factor, and TEG will be normal
What breed of dogs are susceptible to Scott Syndrome

a. German Shepherd, autosomal recessive inheritance, affects males > females
What antibody is most commonly involved in IMTP and what proteins are targeted on the platelet

a. IgG; glycoprotein IIb and IIIa
What vaccine is commonly associated with IMTP in people

a. Measles, mumps, rubella (MMR)- can cause a nadir at 21 days of as low as 1K platelets
What veterinary vaccines have been associated with thrombocytopenia

a. Distemper and hepatitis vaccines, rarely go below 100K
Is there evidence that vaccines cause IMTP in veterinary medicine

a. No
What prostaglandin has been shown to reversibly inhibit platelet activation

a. PGE1
How does this prostaglandin inhibit platelet activation

a. Increases cAMP concentrations
How does the addition of PGE1 to platelet concentrates help with making platelet rich plasma

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

a. Cage-side device that can measure blood viscosity and evaluate entire hemostasis process quantitatively and qualitatively
When heparin was used in dogs and the dogs were monitored with the Sonoclot, which other test closely mirrored the results of the sonoclot

a. aPTT (both were sensitive and specific)