Chapter 19 part 2 blood Flashcards
What disorders occur from excess clot formation?
Thromboembolic disorders
What are two types of hemostatic disorders?
Thromboembolic disorders and bleeding disorders
Thromboembolic disorders can occur due to ________, ________, _____
atherosclerosis inflammation
hemostasis
Atherosclerosis and inflammation do what to endothelium lining?
make it rough (more stuff sticks)
What are two things that can cause hemostasis?
long flights and bedridden
What are two types of thromboembolic disorders?
thrombus and Embolus
what disorder occurs from a persistent blood clot in an unbroken blood vessel?
thrombus
Large blood clots can occlude BVs causing downstream ______ which will lead to _____ _____?
ischemia
cellular death
What disorder occurs when a thrombus breaks off and is free floating in the blood?
Embolus
When an embolus gets stuck in a small vessel is causes an ________
embolism
If there is an embolus stuck in heart brain or lungs the patient is at risk for? (3)
MI, CVA, and PE
What hemostatic disorder involves the prevention of normal clot formation?
bleeding disorders
What are 4 factors that could cause a bleeding disorder?
platelet deficiency
Clotting factor deficit
liver dysfunction
hemophilia
What disorder involves a blood clot in a deep vein, usually leg or pelvis?
DVT
What are symptoms of DVT? (7)
red
hot
pain
swelling
loss of function
enlarged vein in affected area
increased size
What are risk factors for DVT? (legit a million)
restricted mobility
paralyzed
injured
sedentary
OCP/Smoking
Post Op
Elderly
Pregnant
Vein obstruction
Cancer
Long drive
flight
genetic
Hx
What are genetic factors that can cause DVT (3)
Factor V leiden
Protein C and S
and antithrombin
What are complications of DVT? (4)
Recurrent VTE (30%)
post thrombotic syndrome (ulcer)
Risk of PE
death
How do you diagnose DVT?
ultrasound
What are ways to prevent DVT? (6)
Exercise
healthy weight
anticoagulants
compression socks
venodynes
ASA (aspirin)
What are treatments for DVT? (2)
anticoagulants
thrombolysis
What disorder occurs from a blood clot in the lung and may be life threatening?
PE
What are symptoms of PE? (3)
SOB
CP
Cough
What drugs prevent excess clotting and are known as blood thinners?
Anticoagulants
What are the 5 anticoagulant drugs?
Aspirin
Heparin
Warfarin
DOACs
tPA
What anticoagulant drug is a Antiprostaglandin that inhibits thromboxane A2 formation, platelet aggregation, and platelet formation (white clot)
ASA (acetylsalicylic acid)
What are the risks of ASA?
GI and intercranial bleeding
What anticoagulant drug is SC/IV injectable, has rapid action, and prevents venous thrombosis (red clot)?
Heparin
What are the risks of Heparin?
Heparin induced thrombocytopenia (HIT)
— Ab destory platelets
What anticoagulant drug is PO in evening, and blocks Vitamin K in producing clotting factors?
Warfarin
Warfarin can be difficult to regulate including having ______ _________
dietary restrictions (no leafy greens!!)
What are two examples of DOACs (Direct oral anticoagulants)
Rivaroxaban (Xarelto)
Apixaban (Eliquis)
What is kinda sucky about DOACs?
$$$$$$$$, short acting
what anticoagulant drug is a thrombolytic that dissolves blood clots and can be given IV bolus/infusion?
tPA (Tissue plasminogen activator .. alteplase)
Why is the timing of tPA so important?
Have to use it <90 min from symptom onset ischemic CVA) or risk brain bleed
What disorders occur from an inference of clotting and abnormal bleeding?
Bleeding disorders
What are the 3 bleeding disorders?
Thrombocytopenia
Impaired liver function
hemophilia
What bleeding disorder involves platelets less than 150,000 due to bone marrow malignancy, drugs, or ionizing radiation?
thrombocytopenia
What happens if platelet count is less than 10,000
spontaneous bleeding
Thrombocytopenia includes small pinpoint hemorrhage on skin called________
petechiae
How do you treat thrombocytopenia?
platelet transfusion
What bleeding disorder involves being unable to synthesize clotting facotr leading to bleeding?
impaired liver function
What problems cause impaired liver function?
Vit K deficiency, hepatitis, or cirrhosis
What bleeding disorder involves bleeding into tissues/joints?
hemophilia
What are the Factors different hemophilia types effect?
A_____
B_____
C_____
A = Factor VIII
B = Factor IX
C = Factor XI (least severe)
What kind of hemophilia is X linked in males?
A&B
How do you treat hemophilia (2)
transfuse fresh plasma, inject deficient factor
What is a rare blood disorder with widespread clotting and severe bleeding?
Disseminated Intravascular Coagulation
What are the two steps of DIC?
1) small clots occlude BV, shut done major organ blood supply
2) platelet and clotting factors used up = uncontrolled bleeding
What would your lab levels look like with DIC? (5)
prolonged Coag time
Thrombocytopenia
high FDPs
High D Dimers
Schistocytes on smear
what causes DIC? (7)
pregnancy
speticemia
incompatible blood trans
burns
liver disease
pancreatitis
cancer (leukemia)
what are the symptoms of DIC (4)
uncontrolled bleeding
bruising
confusion
Fever > 103
What are complications of DIC (3)
CVA, Shock, excess bleeding
What are treatments for DIC (3)
Iv fluids, tranfusions of blood, anticoags
What is the treatment for blood loss due to surgery or injury?
blood tranfusions
A blood transfusion compensates for blood loss to maintain bloods O2 _______ _________
carrying capacity
If you lose 15-30% of blood volume you are …
pale and weak
If you lose >30% of blood volume you undergo ….
severe shock and death
What is it called when you replace lost blood volume by replacing it with normal saline or ringers solution?
infusion
What is it called when you replace lost Blood volume with more blood/ blood components?
transfusion
What doing a blood transfusion it is rare to _____
use whole blood
What doing a blood transfusion what restores O2?
PRBCs
What are highly specific molecular markers on external RBC surfaces (unique) called?
antigens
What is it called with the blood antigen is exposed to antibody?
agglutination (clumping)
Presence/absence of A, B, Rh antigens on RBCs surface are used to …
Categorize human blood
What are the 4 kinds of blood types?
A
B
O
AB
Type A blood has…
an A Ag
Type B blood has…
B Ag
Type O blood has…
NO Ag
Type AB blood has…
both A and B Ag
The rhesus blood group D antigen is the …
Rh Factor +/-
What percentage of people are rh +
85%
Type AB blood is also known as the …
universal recipient
Type O blood is also known as the …
universal donor
You test blood typing by mixing ______ with Ag and checking for agglutination
blood with antiserum
if clot .. Ag present
A Rh - mom and Rh+ dad baby have increased risk for what because of Rh-/+ exposure via placental exposure?
Hemolytic disease of the newborn
The Rh- mom becomes sensitized to Rh+ which causes …
Rh Ab made and cross the placenta to fetal blood
Abs that cross the placenta interact with baby causing ….
hemolysis of RBC
how do you treat HDN?
exchange transfusion (give Rh- blood) … fixed in 6 weeks
How do you prevent HDN?
RhoGAM (has ABs against Rh antigens
— give injections during pregnancy, prior to delivery, and postdelivery
— inactivates fetal Rh Ag, prevents mom sensitization
