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primary function of hemostasis
Formation of plt plug
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Secondary function of hemostasis
formation of stable fibrin clot
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Fibrinolysis
break down of clot
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contents and uses of a BTT
Citrate-intrinsic, extrinsic and common, von Williebrands factor, must be full
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contents and uses of a RTT
No contents, activated clotting time and liver function tests
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contents and uses of a DET
Must be full Intrinsic and common eval.
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contents and uses of a LTT
EDTA-Plt counts, primary hemostasis
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The order of tubes for a vacutainer
RTT, LTT BTT DET
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Extrinsic pathway
Requires an outside tissue factor for activation reacts with F VII ==Prothrombin
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Intrinsic pathway
all compnents needed are in the blood, XII, XI, IX, VIII
activated by contact with collagen, edotoxin platelet products, ends in prothrombinase
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Common Pathway
Ectrinsic and intrinsic converge strated by prothrombinase
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how does prothrombin become fibrin?
Prothrombin->thrombin->fibrinogen-> Fibrin
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what are the three mechanisms of thrombocytopenia and an example
- Decreased production-----> BM Toxin
- Increased Destruction-----> Immune mediated Disease
- Increased Consumption--->DIC
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2 diseases that cause thromboembolism due to roughend endothelium in small animals
- Cardiomyopathy in cats
- heartworm in dogs
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vitamin K dependant factors
2,7, 9, 10
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what coag. Factors does the liver produce
all except for part of factor 8 vWF
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what caog factors are produced by the endothelium and plts
8 and vWF
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Aquired Primary vascular hemostasis defects
- vasculitis
- collagen deficency
- extensive vascular injury
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Primacry hemostasis vascular inherited defects
vWB dz factor not produced by endothelium
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Primary hemostasis plt plug defects
- Acquired-DIC, Drugs (asprin), Uremia
- inherited- vWB Dz (plts fail to stick to subendothelial collagen
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Primary Hemostasis signs
- petechia
- ecchymosis
- bleeding MM
- bleeds out after venipuncture
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Secondary acquired hemostasis defects
- Vitamin K deficiency-warfarin poisonings
- Liver dz/failure
- DIC
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Hereditary secondary hemostasis defects
- hemofilias (born without ability to make factors)
- vWB dz
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Clinical signs of secondary hemostasis defects
- Hematomas
- bleeding into muscles joints and body cavities
- delayed bleeding after venipuncture
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Acquired Fibrinolysis defects
- Liver failure (cant clear FDP's)
- DIC
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Thromboembolic disorders def
clot forms, breaks off from point of origin and loges somewhere else in circulation, (heart attack and stroke)
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Causes of Thromboemlic disorders
- Roughend endothelium
- Protein C def- down regulated fibrinolysis
- Nephrotic sybdrine--loss of antithrombin III
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BMBT
- buccal mucosal bleeding time
- Evaluates Primary hemostasis
- best test for plt dysfunction
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ACT
- Activated clotting time
- norms 60-90 sec in dog <65 sec in the cat
- evals secondary hemostasuss best inhouse test for secondary defects
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PTT
- Partial thromboplastin time
- evals 2ndary hemostasis, intrinsisc and common pathways
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PT
- prothrombin time
- evals 2ndary hemostasis, extrinsic and common
- best test for warfarin
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TT
- thrombin time
- detects decreases in fibrinogen and thrombin inhibition by FDP's
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FDP's Test
test for fibrinolysis-amount of FDP's
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Why do we stage lymphoid tumors
- Prognosis
- treatment protocol
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Diffuse tumor
cells deep in tissue
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Nodulare tumor
walled of cells
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