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RESP > 16. Coagulation Disorders > Flashcards

16. Coagulation Disorders Flashcards

1
Q

What is the treatment for bleeding disorders?

A

Recombinant purified coagulation factors

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2
Q

What does APTT test?

A

Intrinsic pathway

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3
Q

What test examines the extrinsic pathway?

A

PT

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4
Q

Why is vitamin K necessary for clotting?

A

Vitamin K dependent proteases in the liver need it to produce gla domains on the ends of clotting factors

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5
Q

What conditions result from a vitamin K deficiency?

A

Bruising

Haemorrhagic disease of newborn

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6
Q

What causes a vitamin K deficiency?

A

Antibiotic overdose

Alcoholic liver disease

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7
Q

What is the MOA of Warfarin?

A

Prevents Gla domain function in coagulation enzymes by inhibiting vitamin K
Complexes needed to clot aren’t produced

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8
Q

What is the MOA of heparin?

A

Boosts antithrombin function:
binds to antithrombin and alters it to recognise thrombin and factor Xa
Binds AT and thrombin together

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9
Q

Where is heparin sulphate found?

A

Endothelial cells

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10
Q

What is the composition of unfractionated heparin?

A

Different length polysaccharides

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11
Q

What is the function of factor XIII and what kind of enzyme is it?

A

Strengthens clots

Transglutaminase

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12
Q

What is the MOA of dabigatran?

A

Directly inhibits thrombin

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13
Q

What is the MOA of rivaroxaban?

A

Inhibits factor Xa

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14
Q

what is the benefit of DOACs over warfarin or heparin?

A

Antidote is available

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15
Q

What converts plasminogen to plasmin?

A

Tissue plasminogen activator

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16
Q

What type of cell releases TPA?

A

Intact endothelial cells

17
Q

What is d-dimer?

A

Specific degradation fragment of cross-linked fibrin made when plasmin degrades a thrombus

18
Q

What is the use of d-dimers in diagnosis?

A

Normal d-dimers exclude a thrombotic effect

Elevated does not mean there has been a DVT or PE

19
Q

How is fibrinolysis controlled?

A

TPA requires fibrin as a cofactor
Plasminogen Activator Inhibitor turns off TPA
Antiplasmin targets plasmin

20
Q

What is recombinant TPA used for?

A

Rapidly degrade thrombi eg. ischaemic stroke

21
Q

Name 3 forms of recombinant TPA

A

Alteplase
Reteplase (longer half life)
Tenecteplase (more specific to fibrin)

22
Q

Why is recombinant TPA only safe within 4 hours after an ischaemic stroke?

A

After that it can cause haemorrhage due to blood vessel damage

23
Q

Name an anti-fibrinolytic agent

A

Tranexamic acid

24
Q

What is the MOA of tranexamic acid?

A

Synthetic lysine analogue

Slows the covertion of plasminogen to plasmin to reduce bleeding in trauma, surgery and childbirth

RESP (17 decks)

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