Acquired Coagulation Disorders Flashcards
Specific Factor Inhibitors Causes
Therapy for factor deficiency
Postpartum
Medications
Specific Factor Inhibitors Clinical Presentation
Bleeding
No Response to Therapy - biggest clue to developing inhibitor
Specific Factor Inhibitors Laboratory Testing
Increases (prolonged) in associated screening tests
Inhibitor titer
Correction/Partial Correction with saline
Specific Factor Inhibitors Therapy
Overcome inhibitor
Non-human factor concentrate (bovine or porcine)
Plasmapheresis
Lupus Inhibitor Causes
Antibody directed against phospholipid
SLE
Medications
Immune disorders
Lupus Inhibitor Clinical Presentation
Usually thrombosis
Lupus Inhibitor Laboratory Testing
APTT - prolonged
Lupus Inhibitor Therapy
Steroids - first line of therapies
Vitamin K Deficiency Causes
No carboxylation of Vitamin K dependent factors
Dietary
Malabsorption
Coumadin therapy
Vitamin K Deficiency Clinical Presentation
Bleeding
Vitamin K Deficiency Laboratory Testing
PT - prolong
APTT - prolonged
BT - normal
TT - normal
Fibrinogen - normal
Vitamin K Deficiency Therapy
Vitamin K
Disseminated Intravascular Coagulation (DIC) Laboratory
PT - prolonged (factor consumption)
APTT - prolonged (factor consumption)
FSP/D-Dimer - fibrinolysis (positive)
TT - prolonged (factor consumption & increased FSP)
Fibrin monomer - positive
Abnormal ELT (Euglobulin Lysis Time) - fibrinolysis
Fragments on PBS (RBC frags on smear)
DIC Treatment
Underlying cause
Replace factors
Heparin
Anti-platelet drugs
Primary Fibrinolysis Cause
Increased fibrinolysis without increased clotting
Associated with extensive trauma
TPA released - breakdown of fibrinogen
Primary Fibrinolysis Clinical Presentation
Bleeding
Primary Fibrinolysis Laboratory Testing
PT - prolonged
APTT - prolonged
TT - prolonged
FSP - increased
Platelet Count - Normal (important to distinguish btwn DIC)
Primary Fibrinolysis THerapy
Treat underlying cause
Supportive
Liver Disease Cause
Cause of liver disease (such as alcoholism)
Decreased Factor synthesis
Increased toxins - due to liver unable to keep up
Decreased liver clearance of FSP
Liver Disease Clinical Presentation
Bleeding
Liver Disease Laboratory Testing
PT - prolonged
APTT - prolonged
TT - prolonged
FSP - increased
Platelet Count - normal to abnormal
Liver Disease Therapy
Treat underlying cause
Supportive
