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zABSITE 2019 - high yield comprehensive > 2. Hematology > Flashcards

2. Hematology Flashcards

1
Q

Intrinsic pathway

A

f12 –> 9 –> 8 –> 10

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2
Q

Extrinsic pathway

A

TF, f7 –> 10

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3
Q

Fibrin

A

Links Gp2b/3a to form PLT plug

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4
Q

F13

A

Cross links fibrin

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5
Q

Thrombin functions

A
  1. Fibrinogen to fibrin
  2. Activates f5, 8
  3. Activates PLTS
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6
Q

AT3 Functions

A
  1. Inhibits thrombin

2. Inhibits f9, 10, 11

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7
Q

Protein C/S

A

Degrade 5, 8, and fibrinogen

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8
Q

TPA

A

Release by endothelium

Converts plasminogen to plasmin

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9
Q

Plasmin

A

Degrades f5, 8, fibrinogen, and fibrin

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10
Q

Factors with shortest half life

A

f7

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11
Q

Factors that loose activity when stored (not lost in FFP)

A

F5, 8

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12
Q

Only factor not made in the liver

A

f8 is made in endothelium

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13
Q

Vitamin K factors

A

2, 7, 9, 10, C, S

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14
Q

Time for Vitamin K and FFP to take effect

A

k- 12 hours

ffp- immediate

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15
Q

Half life of RBC, PLT, WBC

A

120d, 1 weeks, 1-2 days

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16
Q

PGI2/Prostacylin

A

Released from endothelium
Increases cAMP
Decreases PLT aggregation and promotes dilation

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17
Q

TXA2

A

Released from PLT
Ca release exposes Gp2b/3a
Increases PLT aggregation and promotes constriction

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18
Q

Cryo

A

vWF, f8, fibrinogen

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19
Q

FFP

A

All factors, Protein C and S, AT3

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20
Q

DDAVP

A

Cause endothelium to release f8 and vWF

21
Q

Best test for liver synthetic function

A

PT

22
Q

INR cutoff

A

> 1.5 relative c/i for surgery. > 1.3 relative c/i to central line, perc bx, eye surgery

23
Q

VWD

A

Mech: AD except t3 (AR), vWF reduced t1, defect t2, none t3
Dx: ristocetin, long BT
Tx: f8, vwf, cryo, ddavp (except t3)

24
Q

Hemophilia A

A

Mech: SLR, f8 def
Dx: long PTT
Tx: f8, cryo

25
Q

Hemophilia B

A

Mech: SLR, f9 def
Dx: long PTT
Tx: f9, cryo

26
Q

Glanzmann’s vs. Bernard Soulier TCP

A

Glanzmann’s: GP2b/3s deficiency, AR
B/S: GP1b deficiency
Tx both with PLTs

27
Q

Uremic TCP

A

Mech: Uremia inhibits VWF
Dx: clinical
Tx: HD (1st line), DDAVP (acute reversal)

28
Q

HIT

A

Mech: anti-heparin IgG destroys PLTs
Dx: ELISA, serotonin release assay
Tx: Stop heparin, give argatroban, avoid PLTs

29
Q

DIC

A

Mech: Initiated by tissue factor
Dx: Long PT, PTT, PLT, fibrinogen; high fibrin split products, d-dimer
Tx: tx underlying cause (i.e. cc’ectomy)

30
Q

ASA MOA

A

COX inhibitor in PLTS, decreases TXA2

31
Q

Clopidogrel MOA

A

ADP receptor (gp2b/3a) antagonist

32
Q

Urokinase

A

Released after prostate surgery. Activates plasminogen to plasmin.
Tx with aminocaproic acid

33
Q

F5 Leiden

A

Mech: f5 defect causing protein C resistence
Tx: heparin, warfarin

34
Q

Tx for hyperhomocysteinemia

A

Folic acid and B12

35
Q

Tx for Protein C and S def

A

Heparin and Warfarin

36
Q

Tx for AT3 deficiency

A

rec AT3, FFP followed by heparin/war

Heparin alone wont work

37
Q

Tx for P. vera

A

Tx: phlebotomy, ASA, hydroxyurea

38
Q

anti-Phospholipid Ab Syndrome

A

Mech: Ab to cardiolipin and lupus a’coagulant
Dx: long pTT, Viper venom time, f+ RPR
Tx: heparin, warfarin

39
Q

MC CO acquired hypercoag

A

Smoking

40
Q

Post op DVT tx

A

1st- war q6m
2nd- war q 1y
3rd or PE- war qlifetime

41
Q

Most common site of PE

A

Ileofemoral

42
Q

Aminocaproic acid

A

Plasmin inhibitor

Use: DIC, excess tpa

43
Q

Warfarin MOA

A

Prevents vitamin K dependent decarboxylation of glutamic residues on 2, 7, 9, 10

44
Q

MOA of SCDs

A

Decrease plasminogen inhibitor, increase TPA

45
Q

Heparin

A

MOA: Binds AT3, inhibit f2, 10
S/E: osteoporosis, alopecia
Clearance: Spleen, macrophages
Reversal: Protamine

46
Q

Anticoagulation in pregnancy

A

Heparin does not cross placenta - safe

Warfarin does cross placenta - do not use

47
Q

Pros and Cons of LMWH

A

Pros: low risk of HIT, better for CA and IBD
Cons: only inhibits 10a, not reversible

48
Q

Argatroban

A

MOA: reversible DTI
Clearance: liver
Use: HITT

zABSITE 2019 - high yield comprehensive (12 decks)

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