Term
Four main functions of platelets? |
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Definition
- Maintain vascular integrity by sealing endothelial defects
- Helping to stop bleeding- form platelet plug
- Contribute to membrane lipid procoagulant activity- secondary hemostasis (coagulation)
- Promote vascular healing through the release of platelet derived growth factors (PDGF)
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Term
Platelets play a role in inflammation through the release of soluble mediators such as? |
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Definition
Serotonin and various modulators of neutrophil function |
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Term
Platelets are produced in the bone marrow from a precursor cell called a?
This occurs in a process called? |
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Definition
Megakaryocyte
Cytoplasmic Demarcation |
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Term
Differentiation of megakaryocytes from stem cells is regulated by what hormone? |
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Definition
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Term
Circulating thrombopoietin levels apper to be inversely correlated with platelet levels
True/False? |
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Definition
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Term
In dogs, what is the estimated amout of platelets in systemic circulation? |
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Definition
2/3 to 3/4
There is free exchange between the splenic and circulating pools |
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Term
Circulating platelets have an average circulating lifespan of how many days? |
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Definition
3 to 7
Old platelets are remeoved from the body through phagocytosis by macrophages |
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Term
By far, the most common and most important platelet abnormality is what clinical finding? |
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Definition
Reduced platelet count or thrombocytopenia |
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Term
What are the two most important tests for evaluating and assesing platelets? |
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Definition
Platelet count and evaluation of the blood film for adequate platelet numbers |
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Term
Automated platelet counts are reliable for dogs but not for most other domestic specis.
True/False? |
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Definition
True
Platelets from other specis are prone to clump, which would alter the automated platelet counter
When mild to moderate thrombocytopenia is noted in a dog, it should be flaged as suspect and recounted |
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Term
Why are automated platelet conters particularly unrelialbe in cats? |
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Definition
Because of the great variability in platelet size in addition to the tendency of cat platelets to aggregate |
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Term
When scanning a blood film to estimate the relative platelet number, how many platelets should a monolayer contain under oil immersion (100x) |
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Definition
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Term
BMBT stands for what?
What is it used for?
It is only a value when platelet counts are above what level per ul? |
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Definition
Buccal Mucosal Bleeding Time
Test to determine adequacy of endothelial cell and platelet function. More sensitive for platelet function.
75,000/ ul |
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Term
What is the process for performing the BMBT test?
What is the reference range for a dogs and cat for BMBT time? |
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Definition
A "bleeding time device" that creates a standardized incision is utilized. The test is performed on the patients upper lip buccal mucosa. The patient is non-anesthetized. Blood seeps from the incision, and a paper towel is used to soak it up without blocking the incision. The time from incision to cessation is the BMBT.
1.8 to 4.2 minutes |
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Term
MPV is usually proportional to the platlet number?
True/False? |
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Definition
False. It is inversly proportional to platelet number |
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Term
What is the normal MPV for a dog and cat? |
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Definition
Dog: 6 to 10 femtoliters
Cat: 12 to 18 femtoliters |
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Term
Elevation in MPV is suggestive of active (responsive) platelet production. Artifactual increases occure with EDTA, when platelets are refrigerated, or if there is delayed exposure to anticoagulant.
MPV is best measured from blood collected into what, and stored at what temperature? |
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Definition
Citrate and stored at 370C until analyzed |
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Term
When would it be probable to see a decreased MPV? |
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Definition
Very early in the course of immune mediated thrombocytopenia and with bone marrow failure |
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Term
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Definition
Platelet Distrubution Width
An index of variation in platelet size, used to determine the presence of abnormally sized platelets |
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Term
The clinical hallmark of thrombocytopenia is the occurrence of what? |
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Definition
Petechiae- capillary or postcapillary venule hemorrhage
Coalescing petechiae are called purpura |
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Term
What are the four mechanisms resulting in thrombocytopenia? |
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Definition
- Sequestration
- Hypoproliferation
- Consumption
- Destruction
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Term
Sequestration is associated with what two conditions? |
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Definition
Hypersplenism and splenomegaly |
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Term
What are some signs seen with a hypoproliferative platelet disorder? |
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Definition
- Very low peripheral platelet counts (<50,000/ul)
- Bone marrows are nearly devoid of megakaryocytes
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Term
What are the 5 possible causes to a hypoproliferative thrombocytopenia? |
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Definition
- Infections- Ehrlichia, FIV, FeLV
- Drugs and Chemicals- NSAIDs, estrogen, sulfadiazine
- Vaccines
- Toxins
- Immune-mediated marrow disease
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Term
Consumptive thrombocytopenias are seen with DIC and occur secondary to severe systemic inflammation.
What are the clinical features that are commonly seen with this disorder? |
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Definition
Peripheral thrombocytopenias range (50,000 to 150,000/ul)
Bone marrow megakaryocytes are normal in number
In dogs, often increased numbers of red cell schizocytes |
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Term
DIC is confirmed with a DIC panel. What 5 tests does the panel include? |
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Definition
- Prothrombin time (PT)
- Activated partial thromboplastin time (APTT)
- Fibrin split products
- Platelet count
- Fibrinogen levels
If any three of the five are abnormal, DIC is considered to be present |
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Term
What is the difference between primary and secondary immune-mediated thrombocytopenia? |
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Definition
Primary- idiopathic anti-platelet antibodies which cause accelerated destruction
Secondary- clinically identical to primary but occurs in association with any of a number of underlying disorders such as systemic immune disease, neoplasia, infectious disease, and vaccination. |
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Term
What does the platelet count and bone marrow look like with a destruction thrombocytopenia? |
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Definition
- Very low peripheral platelet counts (<50,000/ul)
- Normal to increased numbers of bone marrow megakaryocytes
In some cases, antibodies can be directed against platelet precursors and this condition can't be differentiated from a hypoproliferative disorder. |
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Term
What are the 3 categories of throbocytosis? |
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Definition
- Primary or essential
- Secondary
- Physiological
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Term
What are the caracteristics of each throbocytosis category?
Primary, secondary, and physiological |
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Definition
Primary- characterized by a persistent thrombocytosis (>100,000/ul), primarily a disorder of dogs presenting with a bleeding thrombosis. May present with either regenerative or non-regenerative anemia
Secondary- Transiently increased platelet counts in patients with other primary disorders such as blood loss, gastrointestinal disease, fractures, immune-mediated disorders and others
Physiological- Increased mobilization of platelets from splenic and pulmonary pools, occurs as a result of exercise or epinephrine injection |
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Term
What is the definition of thrombocytopathies? |
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Definition
Conditions where platelet counts are near normal (>100,000/ul) but platelet function is impaired |
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Term
Out of all the tests, which one is usually an abnormal clinical finding with a thrombocytopathy |
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Definition
Near normal platelet counts, normal PT APTT, normal fibrin split products, and normal fibrinogen levels.
The BMBT is prolonged |
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Term
Thrombocytopathies may be aquired or inherited. What are some causes of acquired thrombocytopathy? |
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Definition
- Uremia
- Infectious (FeLV, Ehrlichia)
- Snakebite
- Hepatic disease
- Various neoplasms
- Drugs (NSAIDs, antibiotics, calcium channel blockers, dextrans, and colloids)
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Term
What are the different types of inherited thrombocytopathies? |
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Definition
- Von Willebrand's Disease (vWd)- most important
- Basset Hound thrombopathia
- Canine thrombasthenic thrombopathia of Otterhounds and Great Pyrenees
- Spitz thrombopathia
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Term
What are the characteristics of the three categories of Von Willebrand's disease? |
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Definition
- Type 1:
- observed in many canine breeds and cats, mild bleeding tendency
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Type 2:
- Type 3:
- Scottish Terriers, Chesapeake Bay Retrievers, and Shetland Sheep Dogs, moderate bleeding tendency. vWf is usually 0% of normal
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Term
When is definitive diagnosis established with vWd? |
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Definition
When species specific vWf is reduced to less that 50% of normal. |
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