Blood Disorders (Exam II) Flashcards
What is the most common hereditary bleeding disorder?
vWF disorder
What are the S/S of vWF disorder?
- Easy bruising
- epistaxis
- menorrhagia
What would lab values be for someone with vWF deficiency?
- Normal PT & aPTT
- Bleeding time is prolonged
What are the treatments for vWF deficiency?
- Desmopressin (DDAVP)
- Cryoprecipitate
- Factor VIII
How does DDAVP work in regards to treatment of von Willebrand deficiency??
Stimulates vWF release from endothelial cells
What is the dose for DDAVP?
0.3 mcg/kg in 50 mL over 15-20 mins (Do not bolus)
What is the onset & duration of DDAVP?
- Onset: 30mins
- Duration: 6-8hrs
What are side effects of DDAVP?
- HA
- rubor/flushing
- hypertension? hypotension?
- tachycardia
- hyponatremia
- water intoxication (excessive water retention)
What is the most major side effect of DDAVP?
Hyponatremia
Someone that gets DDAVP needs to be on what to prevent water intox and hyponatremia?
Fluid restriction 4-6hrs before & after DDAVP
What blood product can be utilized for vWF disease if the patient is unresponsive to DDAVP?
Cryoprecipitate
1 unit of Cryo raises the ____ level by ___?
Fibrinogen by 50 mg/dL
What is a potential risk factor with cryoprecipitate?
Increased risk of infection (not submitted to viral attenuation)
What is Factor VIII concentrate made of?
Pool of plasma from a large number of donors.
What stage of surgery is Factor VIII given?
Preop or intraop
When should DDAVP be given prior to surgery?
60mins before Sx
What blood product poses an increase risk for infection? Why?
- Cryoprecipitate
- Not sent for viral attenuation
Pts with coagulopathies undergoing neuraxial anesthesia are at increased risk for what?
- Hematoma
- Nerve compression
What are the anesthesia considerations for someone with vWF deficiency?
- Avoid trauma (particularly airway)
- avoid IM sticks
- avoid arterial lines (if feasible)
- avoid spinals