50. Coagulation Flashcards
Virchow triad
Venous stasis, hypercoagulopathy, endothelial lesion of blood vessels
Most common inherited prothrombotic condition
Factor V Leiden deficiency
Inability of APC to degradation of factor 5a
aPTT pathway and most imp factors
Intrinsic. 8 9
PT pathway and more important factor
Extrinsic. most imp 7
Vitamin K dependent factors
2 7 9 10 PC PS
vW disease
most common
Qualitative / quantitative deficiency
For mild cases DDAVP
PT . aPTT long
In severe cases reductions in factor 8
Hemophilia types
A 8
B 9
C 11
HIT
Mild / mod thrombocytopenia
venous arterial thrombosis
Tx. Angiomax (bivalirudin)
Dx. Serotonin release essay
Factors produce by the liver
fibrinogen, prothrombin, factor V, VII, IX, X, XI, XII, as well as protein C and S, and antithrombin
DIC MoA
Activation of factor 7 / 7a
Stop anticoagulants for neuroaxial
Clopid 7d
Warf 5 d + INR < 1.5
Dabigatran 5d
Tioclodipine 14d
Coagulation pathway
CD39
Adenosine diphosphate.
platelet inactivator (like NO prostaglandin 1)
Bernard Soulier syndrome
Absence of glycoprotein 1b, factor 9, f5 receptors
More important enzyme for regulation of hemostasis
thrombin (2a)
Protein C action
Breakdown of factor 8a and 5a
Chronic liver disease and coagulation
No changes in coagulation
Trauma induced coagulopathy
Due to activated protein C
COX 1 vs COX 2
- Ptl, kidney, gastro
- Pain and fever, bone formation
Reversible P2Y12
Ticagrelor cangrelor
Ticlopidine, clopidogrel pasugrel no
Longest and shortest half life of factors
Longest factor 2 (60h)
Shortest factor 7, PC 3-6h
Warfarin half life and effect time
40 hours
complete effect 3-4 days
Protamine and LMWH
Partially reverse (requieres molecules with more than 14 saccharides)
Contraindication for thrombolysis
Reverse of warfarin
Prothrombin complex concentrate + VK
Reverse of Rivaroxaban (xarelto)
Andexanet alpha
