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Fa: Sim 3 > 6. Thromboelastography > Flashcards

6. Thromboelastography Flashcards

1
Q

TF function

A

converts F7 to F7a

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2
Q

F7a function

A

converts F10 to F 10a

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3
Q

F10a function

A

generates thrombin

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4
Q

thrombin function

A

activates more plts and more factors to amplify clotting

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5
Q

incr plt SA =

A

incr binding
incr clotting

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6
Q

thrombin activates

A

plts
Factor 5
Factor 9

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7
Q

thrombin convert

A

fibrinogen to fibrin to reinforce the clot

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8
Q

tPA function

A

converts plasminogen to plasmin

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9
Q

plasmin function

A

breaks clot apart

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10
Q

thromboelastography

A

“recording the ability of a thrombus to change”

thrombus
ability to change
record

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11
Q

what blood is used for TEG

A

whole blood

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12
Q

what tube is needed for TEG

A

blue top

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13
Q

how long TEG results

A

15-45 mins

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14
Q

R time

A

time to beginning of start of clot formation

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15
Q

normal R time

A

5-10 mins

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16
Q

prolonged R time indicates

A

clotting factor deficiency

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17
Q

prolonged R time treatment

A

FFP

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18
Q

kinetics time

A
  • end of R to where clot reaches 20 mm
  • time to clot forming a fixed strength
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19
Q

kinetics time normal

A

1-3 mins

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20
Q

prolonged kinetics time

A

fibrinogen deficiency

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21
Q

prolonged kinetics time treatment

A

cryo

22
Q

alpha angle

A

speed of fibrin acculumlation
thrombin burst

23
Q

alpha angle normal

A

53-72 deg

24
Q

low alpha angle

A

fibrinogen deficiency

25
Q

low alpha angle treatment

A

cryo

26
Q

MA

A

measure of strength of fully formed clot

27
Q

normal MA

A

50-70 mm

28
Q

decr MA

A

plt deficiency

29
Q

decr MA treatment

A

plts
DDAVP

30
Q

LY30

A

% of fibrinolysis of clot after 30 mins

31
Q

normal LY30

A

0-8%

32
Q

high LY30

A

hyperfibrinolytic pt

33
Q

high LY30 treatment

A

TXA

34
Q

TEG pros

A

whole blood
real-time results
show prothrombosis

35
Q

TEG does not indicate

A

uremia
vW disease
apsirin

36
Q

TEG does not test

A

pt adhesion to tissue

37
Q

what does TEG test

A

self-adhesion only

38
Q

DIC

A

abnormal systemic blood clotting leading to organ failure
concomitant consumtpion to plts and factors which lead to hemorrhagic complication

39
Q

DIC S+S

A

excessive bleeding
excessive clotting

40
Q

excessive clotting features (3)

A

ARDS
renal impairement
CNS derangements

41
Q

thresholds to treat PLTs

A

< 50,000

42
Q

low PLT treat

A

1-2 units of PLTs

43
Q

firbinogen threshold

A

< 1.5-2 g/L

44
Q

low fibrinogen treatment

A

5-10 units cryo
or
2 g fibrinogen concentrate

45
Q

PT/PTT threshold

A

1.5x normal

46
Q

high PT/PTT treatment

A

15-30 mL/kg FFP

47
Q

should you treat bleeding in DIC

A

yes

48
Q

what labs for possible DIC

A

clotting panel (blue top)
TEG (blue top)

49
Q

DIC labs

A

CBC
clotting screen
serum fibrinogen
D-Dimer

50
Q

DIC lab frequency

A

6-8 hrs

51
Q

DIC treatment for lab evident DIC

A

LMWH

52
Q

blood support order DIC

A

plt
cryo/fibrinogen
FFP

Fa: Sim 3 (10 decks)

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