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Hemostasis
hemostasis
39
Veterinary Medicine
Undergraduate 2
01/26/2012

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Term
hemostasis
Definition
the process of keeping blood in its fluid state while stopping hemorrhage that occurs from trauma or disease
Term
stages of hemostasis
Definition
primary and secondary
Term
the players in primary hemostasis
Definition
platelets
vascular endothelium
von willebrands factor
Term
steps in primary hemostasis
Definition

1. Injury to blood vessel(collagen exposed)

2.platelets adhere to exposed collagen

3.platelet plug forms

4tissue factor is produced when vessel wall is damaged

5. prostaglandins are released

Term
in primary hemostasis this is required to facillitate platelet adhesion
Definition
von willebrand factor
Term
what becomes activated when the vessel wall is damaged?
Definition
extrinsic
Term
where von willebrand factor is synthesized
Definition
Endothelium
Term
von willebrand factor
Definition
a plasma protein that is only involved directly in primary hemostasis.
Term
von willebrands factor carries which factor?
Definition
factor VIII
Term
vitamin K is needed for synthesis of which factors?
Definition
II, VII, IX, X
Term
which factor is calcium?
Definition
IV
Term
coagulation factors are made in?
Definition
the liver
Term
three pathways in secondary hemostasis
Definition

Extrinsic
intrinsic

common

Term
what starts the extrinsic pathway
Definition
tissue factor from disruption of endothelium
Term
factor VII is activated to VIIa in the extrinsic pathway, factor VIIa activates what in the common pathway?
Definition
factor X
Term
intrinsic pathway is initiated by?
Definition
negative surface charde in blood vessel
Term
factors involved in intrinsic
Definition
VIII, IX, XI, X!!
Term
which activated factors in the intrinsic pathway lead to activation of common pathway
Definition
factors VIII and IX
Term
in the common pathway what causes activation of factor II(prothrombin) to thrombin?
Definition
factors X,V, and IV stick to platelets
Term
in common pathway thrombin + activated factor XII (fibrin stabilizing factor) cause???
Definition
fibrinogen(factor I) to be converted to Fibrin
Term
Fibrinolysis
Definition
the final stage of hemostasis, the breakdown of fibrin clot and return to normal blood flow.
Term
what happens in fibrinolysis?
Definition

 plasmin breaks down fibrin into:
FDPs(fibrin degradation products) and D-dimers (both of these are anticoagulants)

 

Term
Acquired Hemostatic disorders
Definition

Tickborne disease
hemangisarcoma

liver disease

kidney disease

immune-mediated disease

toxins

Term
Inherited hemostatic disorders
Definition

they are all congenital---

**VON WILLEBRANDS DISEASE**

factor VIII and factor IX deficiencies (rare)

Term
primary hemostasis disorders
Definition
Petechial hemmorrhages, ecchymoses, epistaxis, melena, urogenital bleeding, hyphema, spntaneous bleeding, surgical or injection site bleeding, hematomas
Term
secondary hemostasis disorders
Definition

 

hematomas

 

bleeding into:

Joints

cavities

muscles

 

Term
number one breed predisposed to von willebrands disease
Definition
dobermans
Term
situations that warrant hemostatic testing
Definition

excessive bleeding

pre-anestetic testing for at risk animals

anticoagulant toxin exposure

suspicion of DIC

Genetic testing for breeding

Term
tests used to evaluate primary hemostasis
Definition

CBC/blood smear/platelet estimate or count

BMBT(buccal mucosal bleeding time)

vWF ELISA

vWF DNA

Term
tests used to evaluate secondary hemostasis
Definition

PT: prothrombin time

aPTT:activated partial Thromboplastin time

ACT: activated clotting time
PIVKA: Proteins induced by vit.k absence

Term
tests used to evaluate fibrinolysis
Definition
Measurements of
FDP
D-dimers
Term
most common cause of clinical signs of bleeding in dogs
Definition
thrombocytopenia
Term
what needs to be ruled out before doing a BMBT test
Definition
thrombocytopenia
Term
Normal BMBT in dogs
Definition
2-3 minutes
Term
vWF ELISA mesures?
Definition
vWF antigen
Term
which factor has the shortest half life?
Definition
factor VII
Term
steps in PT test
Definition

draw citrate from tube into syringe
draw blood
fill citrate tube with citrate added blood

centrifuge

pull off plasma

freeze and ship on ice to lab (in red top tube)

Term
aPTT evaluates?
Definition

intrinsic and common

everything but VII

same procedure as PT

Term
ACT test procedure
Definition

Use ACT tube
draw blood and put it in ACT tube

put in warm water bath (37°C) for 60sec for dogs and 45secs for cats

at 5 sec intervals invert tube to check for a clot

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