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Pathophysiology > Clotting/Bleeding > Flashcards

Clotting/Bleeding Flashcards

1
Q

Normal range of platelets

A

150,000-400,000

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2
Q

Thrombus

A

Blot clot

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3
Q

Thrombosis

A

Clot starts obstructing blood in the vein

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4
Q

Major factors in clotting process

A

Injured tissue
Platelets
Coagulation Factors

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5
Q

Thrombocytopenia

A

A low number of platelets

Fewer than 100,000

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6
Q

Where is thrombopoieten made?

A

Liver

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7
Q

What does thrombopoieten do?

A

Stimulates bone marrow to make more platelets

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8
Q

What is thrombopoieten

A

Hormone

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9
Q

Spleen and platelet relationship

A

1/3 of platelets are housed in the Spleen

Lysis dead platelets

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10
Q

Thrombocytosis

A

Excessive number of platelets

Greater than 750,000

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11
Q

When the Spleen is sick how does that relate to platelets?

A

The Spleen keeps platelets resulting in Thrombocytopenia (B/c none are in blood)

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12
Q

Hemostasis

A

a protective mechanism whereby the formation of a thrombus prevents excess blood loss

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13
Q

3 Major steps of clotting process (Hemostasis)

A

Vasoconstriction
Platelet Plug
Blood Coagulation

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14
Q

Final clotting pathway

A

Prothrombin > Thrombin > Fibrinogen > Fibrin

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15
Q

Final pathway is started by which coagulation factor?

A

Factor X

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16
Q

Coagulation factors are synthesized in the ___

A

Liver

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17
Q

The coagulation cascade is part of ___

A

Secondary Hemostasis

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18
Q

Platelets are part of ___

A

Primary Hemostasis

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19
Q

What is the purpose of the coagulation cascade?

A

Form fibrin strands that reinforce the platelet plug

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20
Q

When you have hypertension what type of coagulation cascade would you see happen?

A

Intrinsic

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21
Q

When you cut yourself what type of coagulation cascade would you see happen?

A

Extrinsic

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22
Q

When does clotting happen?

A

When there is vascular injury

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23
Q

Vasoconstriction

A

Reduces blood flow to the effected area

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24
Q

Platelet plug formation

A

Primary Hemostasis
Facilitated by Von Willebrand’s Factor (a protein)
Takes 3-7 minutes to form

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25
Q

Blood coagulation

A

Coagulation factors activated
Secondary Hemostasis
Extrinsic/Intrinsic

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26
Q

Extrinsic Pathway is activated when __

A

Damaged tissues release tissue factor

Injury from the outside of the body

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27
Q

Intrinsic Pathway is activated by ___

A

Exposed collagen

Injury to the surface of the vessel from inside the vessel

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28
Q

2 main factors that can cause an Intrinsic pathway to start

A

Turbulent blood flow (Hypertension)

Stasis of blood flow (Hypotension)

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29
Q

Examples of Intrinsic Pathway

A

Arteriosclerosis

Atrial Fibrillation

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30
Q

Example of Extrinsic Pathway

A

Laceration

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31
Q

Lab test for Extrinsic Pathway

A

PT

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32
Q

Lab test for Intrinsic Pathway

A

PTT

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33
Q

Normal range for PT

A

10-14 sec.

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34
Q

Normal range for PTT

A

25-40 sec.

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35
Q

INR

A

International Normalized Ratio

36
Q

Fibrinolysis

A

Process of breakdown of clot

37
Q

3 substances that break down clots

A

Plasmin
Plasminogen
Tissue Plasminogen Activator (tPA)

38
Q

3 Parts of Virchow’s Triad

A

Hypercoagulability
Stasis blood flow
Endothelial Injury

39
Q

Arterial Thrombi referred as ___

A

White thrombi

Why? Rich in platelets

40
Q

Venous thrombi referred as ___

A

Red thrombi

Why? Rich in RBCs

41
Q

Clotting disorders can be ___ or ____

A

Localized or Systemic

42
Q

Factors that increase susceptibility of Clot Formation

A 
Estrogen
Atrial Fibrillation
Stasis
Stenosis
Cancer
Atherosclerosis
43
Q

Biggest risk of Atrial Fibrillation

A

Stroke

44
Q

Disease Processes related to Arterial Thrombosis

A

Myocardial Infarction

CVA

45
Q

Clinical Manifestation of Arterial Thrombosis

A 
Cold
No pulse
Pallor
Weakness
Lack of Movement
46
Q

Risk factors of Atrial Thrombosis

A

High BP
High cholesterol diet
Sedentary lifestyle
Advanced age

47
Q

Virchow’s Triad is associated with _ _ _

A

DVT

48
Q

Biggest risk with DVT

A

Pulmonary Embolism

49
Q

Clinical Manifestations of DVT

A 
Calf pain
Unilateral/Bilateral
Sudden chest pain
Dyspena
Bloody Sputum
Irregular Heart Beat
Red color
Edema
50
Q

Homan’s sign

A

Calf pain on dorsi flexion

51
Q

What would have if you have a Splenectomy?

A

Nothing to lysis dead platelets or house extra - Thrombocytosis (b/c too many platelets in the blood)

52
Q

What happens when the bone marrow is growing rapidly?

A

Too much thrombopoietnen > too many platelets > Hypercoagulation

53
Q

Myeloproliferative disorders

A

Bone marrow growing new tissue rapidly

Ex. Leukemia

54
Q

Primary Thrombocytosis

A

Essential Thrombocytosis
Occurs in bone marrow
Cause unknown
Increase clot formation

55
Q

Secondary Thrombocytosis

A

Reactive Thrombocytosis
Caused by primary
Does not cause excess clotting
Dysfunctional platelets > Not clot right > bleeding

56
Q

Increase coagulation activity

A

Stasis of blood flow
Increase of PROcoagulation factors
Decrease in ANTIcoagulation factors

57
Q

Stasis of blood flow causes:

A 
Sedentary lifestyle
Heart failure > low CO
Post operative
Immobility
Atrial Fibrillation
58
Q

Examples of PROcoagulation factors

A

Estrogen (Pregnant, Postpartum, Oral Contraceptives)
Cancer
Antiphospholipid syndrome (unknown cause)

59
Q

Assessing for Clotting

A 
Medication Review (oral contraceptives, estrogen supplements)
Medical history (Cancer, MI, Stroke)
Social History (smoking)
Family history (hemophilia)
CBC > include platelet count
PT
PTT
60
Q

Pulmonary Embolism Clinical Manifestations

A

Chest pain
Dyspnea
Tachycardia

61
Q

5 “P”s of Arterial Thombosis

A 
Pain
Pallor
Paresthesia
Pulesness
Poikelothermia
62
Q

Poikelothermia

A

The inability to regulate body temp.

63
Q

Paresthesia

A

Abnormal dermal sensation

Chilling, tingling, burning, numbness

64
Q

What is INR

A

Standardized measurement of clotting

65
Q

D-dimer

A

Measures fibrin degradation products

Elevation indicates recent clotting activity

66
Q

What can cause bleeding?

A

Thrombocytopenia
Vitamin K deficiency
Clotting disorders (Hemophilia)
Cirrhosis of Liver

67
Q

Thrombocytopenia can be caused by:

A

Decreased platelet synthesis in bone marrow
Holding of platelets in spleen
Decrease platelet lifespan

68
Q

Anti-platelet therapy

A

Aspirin

NSAIDS

69
Q

Petechiae

A

Small, pinpoint bleeding

Resemble rash

70
Q

Hemophilia also called

A

Von Willebrand’s Disease

71
Q

Acquired defective coagulation

A

Liver disease - Alcoholic Cirrhosis

72
Q

Some coagulation factors need ___ to function

A

Vitamin K

73
Q

Purpura

A

Large areas of bleeding

74
Q

Spontaneous bleeding

A

Nosebleed (Epistaxis)

75
Q

Clinical Manifestations of Bleeding

A

Petechiae
Purpura
Spontaneous bleeding
Hemouria

76
Q

Labs for bleeding

A

CBC
PT
PTT

77
Q

Immune Thrombocytopenia Purpura (ITP)

A

Autoimmune disorder > Platelets attacked by Immune
Causes bleeding
Acute ITP > Children after viral infection
Chronic > Adults
No treatment
Associated with Lupus or AIDS

78
Q

Hemophilia

A

Genetic
Hemophilia A most common
X linked recessive > Males
Causes bleeding

79
Q

Hemophilia A factor deficiency

A

Factor VIII (8)

80
Q

Hemophilia B factor deficiency

A

Factor IX (9)

81
Q

Clinical manifestation of Hemophilia

A 
Bleeding does not occur unless provoked by trauma
Spontaneous Bleeding
Joint, Soft tissues, GI tract
Decrease profusion (b/c blood loss)
All test normal except PTT (b/c intrinsic)
82
Q

DIC

A

Swinging door
Clot formation and bleeding
Most common is Sepsis & Septic Shock
Use up of coagulation factors > depletion of coagulation factors

83
Q

DIC Clinical Manifestations

A 
Petechiae
Positive D-dimer
PT & PTT prolonged
Internal bleeding
Thrombocytopenia
84
Q

Primary Prevention for bleeding

A

Genetic screening

Injury Prevention

85
Q

Primary Prevention for clotting

A

Hydration
Not smoking
Exercise

Pathophysiology (12 decks)

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