BL Practice

Question 1

Is the first MTP involved in gout or CPDD?

Answer 1

Gout

remember gout is cool extremities and 1st MTP

Question 2

Hemophilia A

• what is it?
• PT vs PTT?
• Genetic disorder?

Answer 2

(VIII Deficiency)

most common

PT is normal, but PTT is prolonged.

X linked

Question 3

Hemophilia B

• what is it?
• PT vs PTT?
• Genetic disorder?

Answer 3

(Christmas/IX def)

PT is normal, but PTT is prolonged. (just like hem A)

Question 4

Hemophilia C

• what is it?
• PT vs PTT?
• Genetic disorder?

Answer 4

Factor XI Deficiency

AR

PT is prolonged, but PTT is normal.
(Opp of Hem A and B)

Question 5

The most commonly used treatment options in ITP include:

Answer 5

Corticosteroids
Intravenous immunoglobulin (IVIG)
Splenectomy
Rituximab 
TPO (=thrombopoetin):

Question 6

Desmopressin (DDAVP)

Answer 6

DDAVP stimulates release of von Willebrand factor and factor VIII from endothelial stores.It will temporarily increase levels of those factors 3 to 5 times.

Question 7

Argatroban

Answer 7

direct thrombin inhibitor
- used to treat Heparin-induced thrombocytopenia syndrome (HIT) (platelets <50%)

can also use Lepirudin

Question 8

anti jo Ab are associated with?

Answer 8

DM/PM

Question 9

causes of a prolonged PT and PTT

Answer 9

Liver disease
Vit K def
Warfarin

Question 10

Causes of a prolonged PTT more than protime

Answer 10

DIC

Question 11

Serine Proteases

Answer 11

1. Protein C
   
   2. Plasminogen
   3. t-PA (tissue plasminogen activator)
   4. u-PA (urokinase)

Plasmin

Question 12

Inhibitors of fibrinolysis

Answer 12

PAI-1
alpha 2- antiplasmin
TAFI (an exopeptidase)

Question 13

things factor XIII can do

Answer 13

aid TAFI and alpha 2- antiplasmin in fibrinolysis

• link D-D in DEDs together

Question 14

TFBI

Answer 14

plays a role in anticoagulation and in protection from atherosclerosis.

(part of the quaternary complex with Xa, VIIa, TF)

Question 15

What to avoid if you have VWD?

Answer 15

aspirin, NSAID’s, other platelet inhibiting drugs

Question 16

Platelet type excessive bleeding

Answer 16

nosebleed,
GI bleeding,
menorraghia

*top down

Question 17

Clotting factor

Answer 17

hemophilia,
joint bleed,
bleed into muscle or retroperitoneum

Question 18

lupus anticoagulant

Answer 18

• Common acquired abnormality → Results in hypercoaguable state.
  
  • Causes Antiphospholipid Antibody Syndrome (APS) → in vivo thrombotic disorders)

*remember: This is due to lupus anticoagulant: an IgG antibody that reacts against the phospholipid in the platelet membrane and endothelial cells.
○ PTT will NOT correct when mixed with normal plasma.

Question 19

Arterial thrombi:

Answer 19

○ Occur in high shear stress
○ Primarily platelets, few RBCs (white thrombi)
○ If large enough, cause downstream ischemia
○ Thick, high pressure, muscular
○ High oxygen

Question 20

Venous thrombi

Answer 20

○ Slow blood flow
		○ Large amounts of fibrin with lots of RBCs (red thrombi)
		○ More common with increased age
		○ Thin, low muscle
		○ Oxygen poor

Question 21

Antithrombin deficiency:

Answer 21

• Regulatory protein

* 60% of people w/ deficiency have recurrent venous thrombosis

Question 22

acquired disorders that are associated with recurrent venous or arterial thromboembolism.

Answer 22

1. Antiphospholipid Antibody Syndrome (One of the more severe)
   
   2. Malignancy (Myeloproliferative disorders)
   3. Trauma
   4. Oral contraceptives
   5. Pregnancy

Question 23

antiphospholipid antibody syndrome

Answer 23

○ Can see both venous and arterial thrombosis

Clinical Criteria:
• Vascular thrombosis:
○ 1+ clinical episodes of thrombosis
• Complications of pregnancy:
○ 1+ unexplained death of fetus > 0 wks
○ 1+ premature births of neonates <10 wks

Question 24

LMWH

Answer 24

Subcutaneous, longer half life, better bioavailability