Bleeding

Question 1

MOA of Lovenox?

Answer 1

potentiates antithrombin which inhibits Xa

Question 2

MOA fondaparinux?

Answer 2

binds antithrombin

Question 3

Fondaparnius use? clearance?

Answer 3

HIT/renally

Question 4

Argatroban MOA?

Answer 4

direct thrombin inhibitor

Question 5

Dabigatran MOA?

Answer 5

direct thrombin inhibitor

Question 6

when to stop dabigatran before surgery?

Answer 6

2-4 days prior

Question 7

reversal of dabigatran?

Answer 7

praxbind(idracizumab)

Question 8

bivalirudin MOA?

Answer 8

direct thrombin inhibitor

Question 9

treatment for uremic platelet dysfucntion?

Answer 9

DDAVP

Question 10

treatment for ITP?

Answer 10

IVIG, exchange, steroids

Question 11

threshold to tx for ITP?

Answer 11

plt <30

Question 12

TTP/HUS sx?

Answer 12

thrombocytopenia, AKI, aMS

Question 13

diagnosis of TTP?

Answer 13

schistocytes and positive ADAMTS13

Question 14

tx for TTP?

Answer 14

exchange transfusion

Question 15

Hemophilia A deficiency? genetic?

Answer 15

factor VIII deficient/x-linked

Question 16

coags of hemophilia?

Answer 16

inc PTT, and normal PT

Question 17

ehcinocytes/burr cells

Answer 17

liver disease and uremia

Question 18

dacrocytes(teardrops)

Answer 18

myelofibrosis

Question 19

elliptocytes(oval shaped)

Answer 19

thallasemia, Fe deficiency

Question 20

acanthocytes

Answer 20

liver dz

Question 21

TEG R time ULN? give what?

Answer 21

10 min, FFP

Question 22

TEG alpha angle LLN? give what?

Answer 22

53 degrees, fibrinogen and platelets

Question 23

TEG MA LLN? give what?

Answer 23

50, platelets

Question 24

TEG LY30 what is it? ULN? give what?

Answer 24

clot stability at 30 min, lysis percentage at 30 min ULN 3%, give TXA

Question 25

DOAC benefit over warfarin?

Answer 25

less ICH, major bleeding events, fatal bleeding events. Equivalent GI bleeding except dabigatran

Question 26

patient populations at increased risk of bleeding from DOAC?

Answer 26

over 75, hepatic or renal failure, use of NSAIDS or aspirin

Question 27

can you give charcoal for DOAC and head bleed?

Answer 27

yes within 24 hours of last dose

Question 28

argatroban does what to INR?

Answer 28

falsely elevates it

Question 29

best cogaulation factor to help distinguish liver disease from DIC?

Answer 29

factor VIII

Question 30

coagulation factors which the liver is predominantly responsible for?

Answer 30

II, VII, IX, X fibrinogen, XII

Question 31

where is factor VIII made? level in liver failure? in DIC?

Answer 31

endothelium, normal or elevated, low

Question 32

why are patients with cirrhosis pro thrombotic despite elevated INR?

Answer 32

equivalent decreases in protein C, S and plasminogen

Question 33

factor VII deficiency, prolonged?

Answer 33

PT but not PTT

Question 34

factor VIII deficiency prolonged?

Answer 34

PTT x linked

Question 35

factor XI deficiency?

Answer 35

hemophilia C, prolonged PTT

Question 36

factor XII deficinecy?

Answer 36

prolonged PTT but helps with fibinolysis so if deficienct can lead to thrombosis

Question 37

menorrhagia in a young female need to be screened for what?

Answer 37

coagulation disorders

Question 38

Von williband disorder tx?

Answer 38

desmopressin

Question 39

MOA of VWD?

Answer 39

platelet adhesion dysfunction leading to problems with primary hemostasis

Question 40

hemophilia A deficiency?

Answer 40

VIII

Question 41

hemophilia B deficiency

Answer 41

IX

Question 42

ristocetin cofactor assay tests for what?

Answer 42

VWD

Question 43

mixing studies does what?

Answer 43

deliniate between factor deficiency and presence of an inhibitor

Question 44

most accurate test for hemophilia?

Answer 44

quantitative estimation of factors