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IHO Week 6 (Final) > Clinical Aspects of Coagulation - Nikcovich > Flashcards

Clinical Aspects of Coagulation - Nikcovich Flashcards

1
Q

What is Hemostasis?

A

Dynamic Interaction between vascular endothelium, platelets, procoagulant factors, and anticoagulant factors

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2
Q

What is a normal platelet count?

A

150-400K

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3
Q

What happens if the platelet count is

A

Increased risk of mucocutaneous bleeding and CNS hemorrhage

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4
Q

What is more important than the actual number of platelets?

A

Platelet surface area

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5
Q

What is the most common reason for impaired platelet function?

A

Aspirin

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6
Q

What is INR used for?

A

Prothrombin Time used to measure warfarin efficacy

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7
Q

What is aPTT used for?

A

Measure heparin efficacy of unfractionated heparin

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8
Q

What is a Chromogenic Xa assay used for?

A

Measure heparin levels; useful in the presence of lupus anti-coag or anti-phospholipid antibody

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9
Q

What is PFA-100 used for?

A

Platelet Function Assay that measures platelet response to ADP, collagen, epinephrine

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10
Q

What is Bleeding Time used for?

A

Measure Platelet Function (WORST TEST)

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11
Q

How long does aspirin’s effect last?

A

10 days, irreversible –> Treatment: Platelet Transfusion

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12
Q

What is the mechanism of warfarin?

A

Interferes with vitamin K dependent secondary glycosylation of factors II, VII, IX, X

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13
Q

How do you reverse warfarin?

A

Time
Vitamin K
Fresh Frozen Plasma

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14
Q

What are the characteristics of Unfractionated Heparin (UFH)?

A

Unpredictable Absorption
IV or SQ
Dosage based on body weight
Daily aPTT

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15
Q

What are the characteristics of LMWH?

A

Reliable absorption
SQ
Expensive
No need to monitor

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16
Q

When is Clopidogrel used?

A

Cardiac Stents
Strokes
Bleeding
TTP

17
Q

When is tPA used?

A

Direct Fibrinolysis
Stroke
PE
MI

18
Q

When is Vitamin K used?

A

Reverses Warfarin

19
Q

What is the treatment for von Willebrand’s Disease?

A

DDAVP to increase vWF production by vascular endothelium

20
Q

What does Fresh Frozen Plasma contain?

A

All coagulant factors in normal levels

Used to reverse warfarin, replace factors due to liver disease, or DIC

21
Q

What does Cryoprecipitant contain?

A

Fibrinogen, vWF, Factor VIII, Factor XIII, Fibronectin

22
Q

What is the best way to initiate anti-coagulation?

A

UFH or LMWH plus warfarin for 4-5 days then warfarin monotherapy to fully affect prothrombin (Factor II)

23
Q

What is a High INR (via low factor VII) a surrogate marker for?

A

Depleted Protein C

24
Q

A 52 y.o. male with atrial fibrillation who is managed with metoprolol, digoxin, and warfarin develops epistaxis and an INR of 10. How will you treat him?

A

Low dose Vitamin K

2 mg PO for 1 day

25
Q

What can interfere with INR measurement leading to false readings and what else needs to be monitored while on warfarin?

A

Antiphospholipid Antibody

Factor II Level

IHO Week 6 (Final) (11 decks)

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