Clotting and platelets Flashcards
When do you use IIb/IIIa inhibitors?
Unstable angina
Several days after stent placement
NON-STEMI treated medically
Side effect of dipyridamole?
Headache. Need to know
Thrombocytopenia need to rule out what?
FOLATE AND B12 and ALCOHOL
HIT IS 4 star topic. Talk about mechanism?
Lab?
Thrombosis with thrombocytopenia
Platelet count cut in half
Heparin forms complexes with platelet factor 4
Antibodies against the complex cause platelet activation and aggregation
Platelets removed from circulation
SO YOU ARE HYPERCOAGULABLE
Tx of HIT?
Stop heparin (duh)
Give lepirudin or argatroban (direct thrombin inhibitor) (B/c thrombosis)
transition to Warfarin
ITP is 4 star topic Immune thrombocytopenia. What do you see with labs? Tx?
Antiplatelet antibodies cause it
less than 50,000
Tx? Kids self limited
Adults: steroids, IVIG, plasmapheresis
TTP-HUS is 4 star. Thromboic Thombocytopenic
Mechanism?
OH ok
Mechasnism is metalloprotease is low, so platelets aggregate
Associated with EHEC.
What do you see with TTP?
Hemolysis, uremia, thrombocytopenia, neurologic sequelae, FEVER
Pentad in TTP (HUS is the triad so no neuro symptoms or fever) MUST KNOW
Tx HUS-TTP?
Steroids, plasmapheresis, FFP
What is antiphospholipid syndrome?
When do you get?
Pregnancy, lupus, other stuff
Thrombosis happens b/c damage to endothelium
HELLP syndrome?
Hemolysis, Elevate Liver, Low Platelets
HTN (b/c associated with preeclempsia)
Tx? Deliver baby
Labs with Von willebrands?
High PTT, High BT, normal platelet count (platelets just can’t bind)
Low ristocetin cofactor activity
H and P in von willebrands?
Easy bruising, MENNORHAGIA, muscusal bleeding
Clotting factors not from liver?
vWF not from liver neither is Factor XIII, so still up in liver failure
H&P for DIC?
Jaundice, b/c hemolysis form thrombin that cells go through
Cyanosis
Hypotension
Uncontrolled bleeding
