anticoagulants

Question 1

hemostasis

Answer 1

vascular injury, collagen exposed, vwf anchors plt to collagen

2. Prothrombin–>thromin IIA which activates platelets
3. thrombin IIA releases mediators TX2 and ADP which promote and uncover fibrinogen (I) and continues plt aggregating
4. ADP and TX2 activate more platelets and proteins impt for cascase
5. fibrin mesh clot formed (XIII)

Question 2

TX2 and ADP do what

Answer 2

promotes plt aggregation, uncovers fibrinogen, and activates proteins for cascade

Question 3

what blocks tx2

Answer 3

aspirin

Question 4

what activates thromin

Answer 4

prothrombin

Question 5

where are anticoag factors produced

Answer 5

liver except tissue factor, ca++ and VWF

Question 6

where is VIII:VWF produced

Answer 6

vascular endothelium

Question 7

where is tissue factor (III) produced

Answer 7

injured ells

Question 8

where is ca++ produced

Answer 8

from diet

Question 9

vit k dependent factors

Answer 9

II, VII, IX, X, protein C and S

Question 10

Pt measures

Answer 10

extrinsic pathway

Question 11

end result extrinsic pathway

Answer 11

activation of factor X

Question 12

extrinsic pathway factos

Answer 12

III (tissue factor), VII and calcium- you can by the extrinsic pathway for .37c

Question 13

primary initiator coag cascade

Answer 13

tissue factor

Question 14

what happens intinsic

Answer 14

tissue factor—>VII—>V

Question 15

VWF

Answer 15

most common inherited dysfunction, tx ddavp, ffp

Question 16

what inhibit adp

Answer 16

ticlid, plavix, persantine

Question 17

what inhibit GB IIA, IIIA

Answer 17

integrilling, reopro, aggrastat

Question 18

ptt measures

Answer 18

intrinsic pathway

Question 19

factors in intrinsic

Answer 19

XII, XI, IX, VIII- you can by the intrinsic pathway for $12 or $11.98

Question 20

what happens in intrinsic pathway

Answer 20

XII—>XI—>IX—>X

Question 21

common pathway factors

Answer 21

V, X, I, II, XII- you can buy the common pathway at a 5 and dime for 1 or 2 dollars on 13th of each month

Question 22

antithrombin inhibits

Answer 22

factors IIA and Xa, partially inhibits factors IXa, XIa, XIIa

Question 23

heparin

Answer 23

required cofactor for heparin, binds to and enhances antithrombin by 1000x

Question 24

warfarin

Answer 24

inhibits clotting factor synthesis

Question 25

coumadin inhibits

Answer 25

vit k dependent gamma carboxylase- factors II, VII, IX, X and protein C and S

Question 26

ASA

Answer 26

decreases production TXA2 and PGI2

Question 27

what drugs inhibit plt aggregation secondary to glycoprotein IIB/IIIA inhibition

Answer 27

integrillin, reopro, aggrastat

Question 28

heparin is from

Answer 28

bovine lung and pig intesting

Question 29

heparin binds to and inhibits

Answer 29

binds to AT-III, inhibits IXa, Xa, XIIa, XI, thrombin

Question 30

HIT

Answer 30

7-10 days post heparin started

Question 31

heparin vascular dose

Answer 31

3500-7000

Question 32

protamine comes from

Answer 32

salmon sperm

Question 33

1mg protamine neutralizes

Answer 33

1mg heparin

Question 34

dose of protamine

Answer 34

1mg/100u heparin

Question 35

give protamine over

Answer 35

5-10 min to prevent hypotension

Question 36

protamine does what to heparin

Answer 36

electrostatially binds

Question 37

s/e protamine

Answer 37

decreased bp, pulm htn, hypersensitivity, fish allergy

Question 38

normal fibrinogen

Answer 38

200-400

Question 39

dic what happens to fibrinogen

Answer 39

decreases

Question 40

coumadin

Answer 40

blocks conversion vit K epoxide to vit Kh2.inhibits factors (II, VII, IX, X) and proteins C and S and thrombin

Question 41

normal PT

Answer 41

10-12 sec

Question 42

coumadin works on

Answer 42

extrinsic pathway

Question 43

heparin works on

Answer 43

intrinsic pathway

Question 44

ptt norm

Answer 44

24-30 (intrinsic)

Question 45

pt normal

Answer 45

10-12 extrinsic