Kathryn Borg
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DVM2 HLI (Semester 1) (Pathology (Jenny's lectures)) Quiz am Lecture 29 (Disorders of secondary haemostasis), erstellt von Kathryn Borg am 15/04/2016.

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Kathryn Borg
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Lecture 29 (Disorders of secondary haemostasis)

Lecture 29 (Disorders of secondary haemostasis)

Frage 1 von 27

1

What are the major mechanisms responsible for defective secondary haemostasis?

Wähle eine oder mehr der folgenden:

  • inherited coagulation factor deficiencies

  • vitamin K antagonism or deficiency

  • severe acute or chronic liver disease

  • excessive fibrinolysis or fibrinogenolysis

  • von Willebrand's disease

Erklärung

Frage 2 von 27

1

Which mechanism is the most common cause of secondary haemostasis in domestic animals?

Wähle eine der folgenden:

  • inherited coagulation factor deficiencies

  • vitamin K antagonism

  • severe acute or chronic liver disease

  • excessive fibrinolysis or fibrinogenolysis

  • von Willebrand's disease

  • vitamin k deficiency

Erklärung

Frage 3 von 27

1

Clinical signs suggestive of defective secondary haemostasis may include?

Wähle eine oder mehr der folgenden:

  • Large volume bleeds

  • Haematoma formation

  • Bleeding into body cavities or joints

  • Petechiae, purpura or ecchymoses in skin or mucous membranes

Erklärung

Frage 4 von 27

1

In what domestic species are inherited coagulation factor deficiencies most often identified?

Wähle eine der folgenden:

  • dogs

  • cats

  • horses

  • cattle

  • rabbits

Erklärung

Frage 5 von 27

1

Deficiencies in relation to which of the below factors are yet to be confirmed in domestic animals?

Wähle eine oder mehr der folgenden:

  • factor III (tissue factor)

  • factor V

  • factor XIII

  • high molecular weight kininogen (HMWK)

  • factor XII

  • prekallikrein

  • factor I

Erklärung

Frage 6 von 27

1

Why does factor XI deficiency (haemophilia C) usually only cause mild bleeding?

Wähle eine der folgenden:

  • because factor X can be activated by the extrinsic system

  • because factor V can be activated by the extrinsic system

  • because factor X can be activated by the intrinsic system

  • because factor XI is not required for coagulation

Erklärung

Frage 7 von 27

1

When might deficiencies in factor XI result in massive bleeding?

Wähle eine der folgenden:

  • Following trauma (including surgical trauma) when sustained coagulation is required (as factor XI is required for sustained X activation)

  • When the disease manifests in a male (as it is inherited as an X-linked recessive disorder)

  • Factor XI has major roles in pregnancy

  • When the disease occurs in a Saint Bernard dog

Erklärung

Frage 8 von 27

1

The most severe haemorrhage is associated with inherited deficiencies of factor(s)?

Wähle eine oder mehr der folgenden:

  • factor I

  • factor II

  • factor X

  • factor VIII

  • factor IX

  • combined factor deficiencies

  • factor XII

  • factor V

Erklärung

Frage 9 von 27

1

Which inherited factor deficiency is the most common inherited coagulopathy in domestic animals and humans?

Wähle eine der folgenden:

  • factor VIII (haemophilia A)

  • factor IX (haemophilia B)

  • factor XI (haemophilia C)

  • factor VII

Erklärung

Frage 10 von 27

1

Haemophilia A it is inherited as an X-linked recessive disorder and manifests almost exclusively in hemizygous females (usually in the first six months of post-natal life)

Wähle eins der folgenden:

  • WAHR
  • FALSCH

Erklärung

Frage 11 von 27

1

Which factors are vitamin K-dependent?
Choose the correct combination

Wähle eine der folgenden:

  • factors II, VII, IX and X

  • factors III, VIII, IX and X

  • factors II, VII, IX and XI

  • factors II, VII, IIX and X

  • factors I, II, IIX and XI

Erklärung

Frage 12 von 27

1

A mutation in which gene (what does it encode for) causes a deficiency of the vitamin k-dependent factors?

Wähle eine der folgenden:

  • γ-glutamyl carboxylase gene

  • Acetyl-CoA carboxylase gene

  • α-glutamyl carboxylase gene

  • Pyruvate carboxylase gene

Erklärung

Frage 13 von 27

1

Ingestion of which of the below can cause haemorrhage via antagonism of vitamin K epoxide reductase?

Wähle eine oder mehr der folgenden:

  • anticoagulant rodenticides containing hydroxycoumarins or indandiones

  • mouldy sweet clover (Melilotus alba) or sweet vernal grass (Anthoxanthum odoratum) containing bishydroxycoumarin

  • sulphaquinoxaline (a coccidiostat)

  • overdose with therapeutic coumadins (eg. warfarin)

  • paracetamol

  • 2-acetoxybenzoic acid (aspirin)

  • cholecalciferol (Vitamin D3)

Erklärung

Frage 14 von 27

1

Mild intoxication by ingestion of anticoagulant rodenticides is a common cause of haemorrhage in cats and dogs. How can this be treated?

Wähle eine der folgenden:

  • vitamin K1 administration

  • administration of warfarin

  • administration of prednisolone

  • vitamin D3 administration

  • Cartrophen (DMOAD) administration

Erklärung

Frage 15 von 27

1

Dietary vitamin K deficiency although rare, is most commonly reported in what species of domestic animals?

Wähle eine der folgenden:

  • dogs

  • cats

  • horses

  • sheep

  • rabbits

Erklärung

Frage 16 von 27

1

What can cause vitamin K deficiency?

Wähle eine oder mehr der folgenden:

  • complete extrahepatic bile duct obstruction

  • exocrine pancreatic insufficiency

  • intestinal malabsorption

  • chronic lipid maldigestion/malabsorption syndromes

  • long term oral antibiotic use

  • prolonged anorexia or malnutrition

  • diabetes

  • diarrhoea

Erklärung

Frage 17 von 27

1

Which coagulation factors are deficient in the inherited coagulopathy recognised in Devon rex cats?

Wähle eine der folgenden:

  • II, VII, IX and X

  • III, VII, IX and XI

  • II, VI, X, XII

  • I, V, VI, X

Erklärung

Frage 18 von 27

1

Where in the body are most of the coagulation factors produced?

Wähle eine der folgenden:

  • liver

  • spleen

  • bone marrow

  • endothelial cells

  • macrophages

Erklärung

Frage 19 von 27

1

What percentage reduction of functional liver mass causes significant decreases in coagulation factor activity?

Wähle eine der folgenden:

  • ≥70%

  • ≥40%

  • ≥60%

  • ≤45%

Erklärung

Frage 20 von 27

1

Surprisingly, most animals with hepatic disease of enough severity to cause inadequate synthesis of coagulation factors do not bleed spontaneously, instead, they are at risk of uncontrollable haemorrhage if haemostatic capacity is challenged (e.g. if a liver biopsy is undertaken)

Wähle eins der folgenden:

  • WAHR
  • FALSCH

Erklärung

Frage 21 von 27

1

What is mandatory before subjecting an animal with known hepatic disease to a liver biopsy or other invasive surgery?

Wähle eine der folgenden:

  • Laboratory tests of haemostatic capacity

  • Radiography

  • Leukogram

  • Physical exam

Erklärung

Frage 22 von 27

1

Why are animals with significant hepatic disease not only at risk of haemorrhage but also at risk of thrombosis?

Wähle eine oder mehr der folgenden:

  • Hepatocytes synthesise anticoagulants, fibrinolytic agents and fibrinolytic inhibitors

  • The liver is responsible for clearance from the circulation of many of the activated products of coagulation and fibrinolysis

  • Most of the coagulation factors are synthesised by hepatocytes

  • The liver is responsible for the maturation of platelets

Erklärung

Frage 23 von 27

1

Why would excessive fibrinolysis be an issue?

Wähle eine der folgenden:

  • Premature breakdown of secondary haemostatic fibrin plugs

  • Can result in the formation of a thrombus

  • Premature breakdown of primary haemostatic platelet plugs

Erklärung

Frage 24 von 27

1

- enzymatic lysis of fibrin by plasmin

- enzymatic lysis of fibrinogen by plasmin

Klicke und ziehe, um den Text zu vervollständigen.

    Fibrinolysis
    Fibrinogenolysis
    Fibrinocatalase

Erklärung

Frage 25 von 27

1

In which conditions is excessive fibrinogenolysis thought to be a contributor to defective secondary haemostasis in domestic animals?

Wähle eine oder mehr der folgenden:

  • snake envenomation - e.g. Eastern and Western diamondback rattlesnakes

  • administration of plasminogen activators - e.g. t-PA, streptokinase

  • excessive endothelial release of t-PA - e.g. shock, heat stroke, severe tissue trauma

  • Disseminated intravascular coagulation (DIC)

  • prolonged anorexia or malnutrition

  • anticoagulant rodenticides containing hydroxycoumarins or indandiones

Erklärung

Frage 26 von 27

1

In which condition is excessive fibrinolysis a contributor to defective secondary haemostasis in domestic animals?

Wähle eine oder mehr der folgenden:

  • Disseminated intravascular coagulation (DIC)

  • snake envenomation - e.g. Eastern and Western diamondback rattlesnakes

  • administration of plasminogen activators - e.g. t-PA, streptokinase

  • excessive endothelial release of t-PA - e.g. shock, heat stroke, severe tissue trauma

  • prolonged anorexia or malnutrition

Erklärung

Frage 27 von 27

1

In what circumstances might a dog develop deficiency of vitamin K?

Wähle eine oder mehr der folgenden:

  • prolonged anorexia or malnutrition

  • long term antibiotics (which can kill off gut bacteria, which synthesise vit K)

  • chronic lipid maldigestion/malabsorption syndromes (eg. bile duct obstruction)

  • ingestion of anticoagulant rodenticides

  • snake envenomation - e.g. Eastern and Western diamondback rattlesnakes

Erklärung

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