Emergency and Critical Care Quiz
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Questions and Answers

What is the primary characteristic of anemia?

  • Increased oxygen-carrying capacity in the blood
  • Abnormal white blood cell count
  • Decreased oxygen-carrying capacity in the blood (correct)
  • Elevated hemoglobin levels

    • What is anemia considered in terms of diagnosis?

  • A normal variation in blood parameters
  • A symptom of an underlying disease
  • A laboratory abnormality requiring further investigation (correct)
  • A diagnosis itself

    • What are the three main mechanisms of anemia?

  • Infection, inflammation, and immunodeficiency
  • Hemolysis, ineffective erythropoiesis, and blood loss (correct)
  • Hemostasis, thrombosis, and coagulopathy
  • Blood loss, infection, and inflammation

    • What is an example of abnormal hemostasis that can lead to anemia?

    <p>Thrombocytopenia</p> Signup and view all the answers

    What is a common cause of blood loss anemia?

    <p>Surgery</p> Signup and view all the answers

    What is NOT a main cause of anemia?

    <p>Infectious disease</p> Signup and view all the answers

    What is an example of a disease that can lead to anemia due to abnormal hemostasis?

    <p>Von Willebrand disease</p> Signup and view all the answers

    What is the primary consequence of anemia?

    <p>Decreased oxygen delivery to tissues</p> Signup and view all the answers

    What is refractory anemia caused by?

    <p>Chronic renal failure</p> Signup and view all the answers

    What is a common symptom of anemia due to hemorrhagic losses?

    <p>External bleeding</p> Signup and view all the answers

    What can cause ineffective erythropoiesis?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of hemolytic anemia?

    <p>Icterus</p> Signup and view all the answers

    What can cause hemolysis?

    <p>All of the above</p> Signup and view all the answers

    What is a sign of hyperacute hemorrhage?

    <p>Circulatory collapse</p> Signup and view all the answers

    What is a characteristic of anemia due to ineffective erythropoiesis?

    <p>Signs depend on the underlying pathology</p> Signup and view all the answers

    What is a common clinical sign of anemia?

    <p>Pallor</p> Signup and view all the answers

    What is a potential cause of coagulopathy due to vitamin K deficiency?

    <p>Rodenticide toxicity</p> Signup and view all the answers

    Which of the following factors is NOT evaluated by the Prothrombin Time (PT) test?

    <p>Factor III</p> Signup and view all the answers

    What is a common clinical sign of coagulopathies?

    <p>Hematomas and bleeding into subcutaneous tissues</p> Signup and view all the answers

    Which of the following is a congenital cause of coagulopathies?

    <p>Deficiency in various clotting factors</p> Signup and view all the answers

    What is the purpose of the Activated Partial Thromboplastin Time (APTT) test?

    <p>To evaluate factors III, VIII, X, V, II, and fibrinogen</p> Signup and view all the answers

    What is a potential consequence of fibrinolysis?

    <p>Bleeding</p> Signup and view all the answers

    Which of the following tests evaluates coagulation time?

    <p>Activated Clotting Time (ACT)</p> Signup and view all the answers

    What is a potential cause of acquired coagulopathies?

    <p>Hepatopathy</p> Signup and view all the answers

    What laboratory test is used to examine erythrocyte morphology?

    <p>Blood smear</p> Signup and view all the answers

    What is the primary goal of intensive fluid therapy in hyperacute bleeds?

    <p>To maintain perfusion</p> Signup and view all the answers

    What determines the transfusion volumes in anemic patients?

    <p>Degree of anemia</p> Signup and view all the answers

    What is the importance of slow transfusion initiation?

    <p>To prevent reactions</p> Signup and view all the answers

    What is the definition of coagulopathies?

    <p>A clinical syndrome resulting from a deficiency in clotting factors</p> Signup and view all the answers

    What is the primary purpose of blood transfusion in anemic patients?

    <p>To support the treatment of anemia</p> Signup and view all the answers

    What is the significance of monitoring for reactions during blood transfusion?

    <p>To monitor for reactions and prevent adverse effects</p> Signup and view all the answers

    What laboratory test is used to evaluate the overall health of the animal?

    <p>Total protein</p> Signup and view all the answers

    What is the recommended dose of vitamin K1 for treating rodenticide toxicity?

    <p>2-5 mg/kg/day</p> Signup and view all the answers

    What should be monitored while administering vitamin K1 for rodenticide toxicity?

    <p>Clotting times (PT/APTT)</p> Signup and view all the answers

    In cases of severe bleeding, what may be considered in addition to vitamin K1 for rodenticide toxicity?

    <p>Fresh frozen plasma (FFP)</p> Signup and view all the answers

    What is the primary goal of treating disseminated intravascular coagulation (DIC)?

    <p>Treating the primary cause</p> Signup and view all the answers

    What may be used to improve the patient's condition in disseminated intravascular coagulation (DIC)?

    <p>Fresh frozen plasma (FFP), heparin, packed red blood cells (pRBCs), or whole blood</p> Signup and view all the answers

    What is the recommended treatment for severe liver disease?

    <p>Vitamin K1 and FFP</p> Signup and view all the answers

    How often should fresh frozen plasma (FFP) be administered in severe cases of rodenticide toxicity?

    <p>Every 8-24 hours</p> Signup and view all the answers

    What is the dose of fresh frozen plasma (FFP) in severe cases of rodenticide toxicity?

    <p>6-20 ml/kg</p> Signup and view all the answers

    Study Notes

    Anemia

    • Anemia is a condition characterized by decreased oxygen-carrying capacity in the blood due to low levels of hemoglobin and red blood cells.
    • It is not a diagnosis itself, but a laboratory abnormality requiring further investigation to identify the underlying cause.
    • The three main mechanisms of anemia are blood loss, hemolysis, and ineffective erythropoiesis.

    Main Causes of Anemia

    • Blood loss:
      • Normal hemostasis: trauma, surgery, parasitosis, NSAIDs, steroids, neoplasms, etc.
      • Abnormal hemostasis: thrombocytopenia, thrombocytopathy (von Willebrand disease), coagulopathies (DIC, hepatopathy, rodenticide toxicity, etc.)
    • Hemolysis:
      • Congenital, infectious, immune, chemical (zinc, copper, sulphonamides), hypophosphatemia-induced, mechanical (DIC), neoplastic (hemangiosarcoma, histiocytosis)
    • Ineffective erythropoiesis:
      • Refractory anemias: chemicals, chronic renal failure, chronic illnesses (organ dysfunction, infection, cancer, idiopathic), etc.
      • Non-refractory anemias: aplastic anemia, pancytopenia, drug- or chemical-induced, infectious, immune, neoplastic, radiation-induced, congenital anemia, malabsorption or cobalamin deficiency, idiopathic anemia, etc.

    Diagnosis of Anemia

    • Clinical signs include pale mucosa, lethargy, weakness, anorexia.
    • Hemorrhagic losses may present with signs of external, internal, or occult bleeding.
    • Hyperacute hemorrhage may lead to circulatory collapse, while internal bleeding or gastrointestinal bleeding can be harder to interpret.
    • Hemolytic anemia may be accompanied by icterus, hemoglobinemia, or pigmenturia.
    • Signs of anemia due to ineffective erythropoiesis depend on the underlying pathology.
    • Laboratory testing includes hematocrit, total protein, blood smear, platelet count, coagulation parameters, and examination of erythrocyte morphology.

    Treatment of Anemia

    • Treatment depends on the cause, severity, and progression of the anemia.
    • Hyperacute bleeds require intensive fluid therapy to maintain perfusion before considering blood transfusion.
    • Transfusion of fresh whole blood or blood products is indicated in many clinical situations.
    • Transfusion volumes depend on the degree of anemia, clinical condition, and size of the animal.
    • Slow transfusion initiation, monitoring for reactions, and appropriate rates based on the animal's status are essential.

    Coagulopathies

    • Coagulopathies are a clinical syndrome resulting from a deficiency in clotting factors of the secondary hemostasis system.
    • Causes of coagulopathies:
      • Acquired:
        • Vitamin K deficiency or antagonism (rodenticide toxicity).
        • Hepatopathy.
        • Disseminated Intravascular Coagulation (DIC).
        • Anticoagulant administration (heparin, etc.).
      • Congenital:
        • Deficiencies in various clotting factors (Factor I, II, VII, VIII, IX, X, XI, XII) in specific dog breeds.

    Diagnosis of Coagulopathies

    • Diagnostic tests:
      • Activated clotting time (ACT): evaluates factors XII, XI, IX, VIII, X, V, II, and fibrinogen.
      • Prothrombin time (PT): sensitive test for the same factors.
      • Activated partial thromboplastin time (APTT): evaluates factors III, VIII, X, V, II, and fibrinogen.
      • Fibrin degradation products (FDPs) and D-dimer for evaluating fibrinolysis.
    • Clinical signs:
      • Hematomas and bleeding into subcutaneous tissues, body cavities, muscles, and joints.

    Treatment of Coagulopathies

    • Treatment for rodenticide toxicity:
      • Administer vitamin K1 (phytonadione) at a dose of 2-5 mg/kg/day orally or subcutaneously for several weeks.
      • Follow-up check of clotting times (PT/APTT).
      • In cases of intense bleeding, severe anemia, or bleeding in vital organs, consider simultaneous administration of fresh frozen plasma (FFP) at a dose of 6-20 ml/kg every 8-24 hours.
    • Treatment for severe liver disease:
      • Administer vitamin K1 and FFP while organ dysfunction persists.
    • Treatment for Disseminated Intravascular Coagulation (DIC):
      • Critical to treat the primary cause.
      • Administration of fresh frozen plasma (FFP), heparin, packed red blood cells (pRBCs), or whole blood may improve the patient's condition.

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    Description

    This quiz is designed to test your knowledge of emergency and critical care concepts, covering topics such as emergency procedures and critical care methods. It is intended for students of the Faculty of Agricultural and Veterinary Sciences at the Lebanese University. The quiz is led by Dr. Walid Darwiche.

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