Quiz
Lecture 29 (Disorders of secondary haemostasis)
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Questions in this quiz (27)
1What are the major mechanisms responsible for defective secondary haemostasis?
- Ainherited coagulation factor deficiencies
- Bvitamin K antagonism or deficiency
- Csevere acute or chronic liver disease
- Dexcessive fibrinolysis or fibrinogenolysis
- Evon Willebrand's disease
2Which mechanism is the most common cause of secondary haemostasis in domestic animals?
- Ainherited coagulation factor deficiencies
- Bvitamin K antagonism
- Csevere acute or chronic liver disease
- Dexcessive fibrinolysis or fibrinogenolysis
- Evon Willebrand's disease
- Fvitamin k deficiency
3Clinical signs suggestive of defective secondary haemostasis may include?
- ALarge volume bleeds
- BHaematoma formation
- CBleeding into body cavities or joints
- DPetechiae, purpura or ecchymoses in skin or mucous membranes
4In what domestic species are inherited coagulation factor deficiencies most often identified?
- Adogs
- Bcats
- Chorses
- Dcattle
- Erabbits
5Deficiencies in relation to which of the below factors are yet to be confirmed in domestic animals?
- Afactor III (tissue factor)
- Bfactor V
- Cfactor XIII
- Dhigh molecular weight kininogen (HMWK)
- Efactor XII
- Fprekallikrein
- Gfactor I
6Why does factor XI deficiency (haemophilia C) usually only cause mild bleeding?
- Abecause factor X can be activated by the extrinsic system
- Bbecause factor V can be activated by the extrinsic system
- Cbecause factor X can be activated by the intrinsic system
- Dbecause factor XI is not required for coagulation
7When might deficiencies in factor XI result in massive bleeding?
- AFollowing trauma (including surgical trauma) when sustained coagulation is required (as factor XI is required for sustained X activation)
- BWhen the disease manifests in a male (as it is inherited as an X-linked recessive disorder)
- CFactor XI has major roles in pregnancy
- DWhen the disease occurs in a Saint Bernard dog
8The most severe haemorrhage is associated with inherited deficiencies of factor(s)?
- Afactor I
- Bfactor II
- Cfactor X
- Dfactor VIII
- Efactor IX
- Fcombined factor deficiencies
- Gfactor XII
- Hfactor V
9Which inherited factor deficiency is the most common inherited coagulopathy in domestic animals and humans?
- Afactor VIII (haemophilia A)
- Bfactor IX (haemophilia B)
- Cfactor XI (haemophilia C)
- Dfactor VII
10Haemophilia 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)
- ATrue
- BFalse
11Which factors are vitamin K-dependent?
Choose the correct combination- Afactors II, VII, IX and X
- Bfactors III, VIII, IX and X
- Cfactors II, VII, IX and XI
- Dfactors II, VII, IIX and X
- Efactors I, II, IIX and XI
12A mutation in which gene (what does it encode for) causes a deficiency of the vitamin k-dependent factors?
- Aγ-glutamyl carboxylase gene
- BAcetyl-CoA carboxylase gene
- Cα-glutamyl carboxylase gene
- DPyruvate carboxylase gene
13Ingestion of which of the below can cause haemorrhage via antagonism of vitamin K epoxide reductase?
- Aanticoagulant rodenticides containing hydroxycoumarins or indandiones
- Bmouldy sweet clover (Melilotus alba) or sweet vernal grass (Anthoxanthum odoratum) containing bishydroxycoumarin
- Csulphaquinoxaline (a coccidiostat)
- Doverdose with therapeutic coumadins (eg. warfarin)
- Eparacetamol
- F2-acetoxybenzoic acid (aspirin)
- Gcholecalciferol (Vitamin D3)
14Mild intoxication by ingestion of anticoagulant rodenticides is a common cause of haemorrhage in cats and dogs. How can this be treated?
- Avitamin K1 administration
- Badministration of warfarin
- Cadministration of prednisolone
- Dvitamin D3 administration
- ECartrophen (DMOAD) administration
15Dietary vitamin K deficiency although rare, is most commonly reported in what species of domestic animals?
- Adogs
- Bcats
- Chorses
- Dsheep
- Erabbits
16What can cause vitamin K deficiency?
- Acomplete extrahepatic bile duct obstruction
- Bexocrine pancreatic insufficiency
- Cintestinal malabsorption
- Dchronic lipid maldigestion/malabsorption syndromes
- Elong term oral antibiotic use
- Fprolonged anorexia or malnutrition
- Gdiabetes
- Hdiarrhoea
17Which coagulation factors are deficient in the inherited coagulopathy recognised in Devon rex cats?
- AII, VII, IX and X
- BIII, VII, IX and XI
- CII, VI, X, XII
- DI, V, VI, X
18Where in the body are most of the coagulation factors produced?
- Aliver
- Bspleen
- Cbone marrow
- Dendothelial cells
- Emacrophages
19What percentage reduction of functional liver mass causes significant decreases in coagulation factor activity?
- A≥70%
- B≥40%
- C≥60%
- D≤45%
20Surprisingly, 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)
- ATrue
- BFalse
21What is mandatory before subjecting an animal with known hepatic disease to a liver biopsy or other invasive surgery?
- ALaboratory tests of haemostatic capacity
- BRadiography
- CLeukogram
- DPhysical exam
22Why are animals with significant hepatic disease not only at risk of haemorrhage but also at risk of thrombosis?
- AHepatocytes synthesise anticoagulants, fibrinolytic agents and fibrinolytic inhibitors
- BThe liver is responsible for clearance from the circulation of many of the activated products of coagulation and fibrinolysis
- CMost of the coagulation factors are synthesised by hepatocytes
- DThe liver is responsible for the maturation of platelets
23Why would excessive fibrinolysis be an issue?
- APremature breakdown of secondary haemostatic fibrin plugs
- BCan result in the formation of a thrombus
- CPremature breakdown of primary haemostatic platelet plugs
24[blank_start]Fibrinolysis[blank_end]- enzymatic lysis of fibrin by plasmin
[blank_start]Fibrinogenolysis[blank_end]- enzymatic lysis of fibrinogen by plasmin- AFibrinolysis
- BFibrinogenolysis
- CFibrinocatalase
25In which conditions is excessive fibrinogenolysis thought to be a contributor to defective secondary haemostasis in domestic animals?
- Asnake envenomation - e.g. Eastern and Western diamondback rattlesnakes
- Badministration of plasminogen activators - e.g. t-PA, streptokinase
- Cexcessive endothelial release of t-PA - e.g. shock, heat stroke, severe tissue trauma
- DDisseminated intravascular coagulation (DIC)
- Eprolonged anorexia or malnutrition
- Fanticoagulant rodenticides containing hydroxycoumarins or indandiones
26In which condition is excessive fibrinolysis a contributor to defective secondary haemostasis in domestic animals?
- ADisseminated intravascular coagulation (DIC)
- Bsnake envenomation - e.g. Eastern and Western diamondback rattlesnakes
- Cadministration of plasminogen activators - e.g. t-PA, streptokinase
- Dexcessive endothelial release of t-PA - e.g. shock, heat stroke, severe tissue trauma
- Eprolonged anorexia or malnutrition
27In what circumstances might a dog develop deficiency of vitamin K?
- Aprolonged anorexia or malnutrition
- Blong term antibiotics (which can kill off gut bacteria, which synthesise vit K)
- Cchronic lipid maldigestion/malabsorption syndromes (eg. bile duct obstruction)
- Dingestion of anticoagulant rodenticides
- Esnake envenomation - e.g. Eastern and Western diamondback rattlesnakes
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- DVM2 HLI (Semester 1) (Pathology (Jenny's lectures)) Quiz on Lecture 29 (Disorders of secondary haemostasis), created by Kathryn Borg on 15/04/2016.
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- Kathryn Borg
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