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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
Blood coagulation
Coagulation factors activated Secondary Hemostasis Extrinsic/Intrinsic
26
Extrinsic Pathway is activated when __
Damaged tissues release tissue factor | Injury from the outside of the body
27
Intrinsic Pathway is activated by ___
Exposed collagen | Injury to the surface of the vessel from inside the vessel
28
2 main factors that can cause an Intrinsic pathway to start
Turbulent blood flow (Hypertension) | Stasis of blood flow (Hypotension)
29
Examples of Intrinsic Pathway
Arteriosclerosis | Atrial Fibrillation
30
Example of Extrinsic Pathway
Laceration
31
Lab test for Extrinsic Pathway
PT
32
Lab test for Intrinsic Pathway
PTT
33
Normal range for PT
10-14 sec.
34
Normal range for PTT
25-40 sec.
35
INR
International Normalized Ratio
36
Fibrinolysis
Process of breakdown of clot
37
3 substances that break down clots
Plasmin Plasminogen Tissue Plasminogen Activator (tPA)
38
3 Parts of Virchow's Triad
Hypercoagulability Stasis blood flow Endothelial Injury
39
Arterial Thrombi referred as ___
White thrombi | Why? Rich in platelets
40
Venous thrombi referred as ___
Red thrombi | Why? Rich in RBCs
41
Clotting disorders can be ___ or ____
Localized or Systemic
42
Factors that increase susceptibility of Clot Formation
``` Estrogen Atrial Fibrillation Stasis Stenosis Cancer Atherosclerosis ```
43
Biggest risk of Atrial Fibrillation
Stroke
44
Disease Processes related to Arterial Thrombosis
Myocardial Infarction | CVA
45
Clinical Manifestation of Arterial Thrombosis
``` Cold No pulse Pallor Weakness Lack of Movement ```
46
Risk factors of Atrial Thrombosis
High BP High cholesterol diet Sedentary lifestyle Advanced age
47
Virchow's Triad is associated with _ _ _
DVT
48
Biggest risk with DVT
Pulmonary Embolism
49
Clinical Manifestations of DVT
``` Calf pain Unilateral/Bilateral Sudden chest pain Dyspena Bloody Sputum Irregular Heart Beat Red color Edema ```
50
Homan's sign
Calf pain on dorsi flexion
51
What would have if you have a Splenectomy?
Nothing to lysis dead platelets or house extra - Thrombocytosis (b/c too many platelets in the blood)
52
What happens when the bone marrow is growing rapidly?
Too much thrombopoietnen > too many platelets > Hypercoagulation
53
Myeloproliferative disorders
Bone marrow growing new tissue rapidly | Ex. Leukemia
54
Primary Thrombocytosis
Essential Thrombocytosis Occurs in bone marrow Cause unknown Increase clot formation
55
Secondary Thrombocytosis
Reactive Thrombocytosis Caused by primary Does not cause excess clotting Dysfunctional platelets > Not clot right > bleeding
56
Increase coagulation activity
Stasis of blood flow Increase of PROcoagulation factors Decrease in ANTIcoagulation factors
57
Stasis of blood flow causes:
``` Sedentary lifestyle Heart failure > low CO Post operative Immobility Atrial Fibrillation ```
58
Examples of PROcoagulation factors
Estrogen (Pregnant, Postpartum, Oral Contraceptives) Cancer Antiphospholipid syndrome (unknown cause)
59
Assessing for Clotting
``` Medication Review (oral contraceptives, estrogen supplements) Medical history (Cancer, MI, Stroke) Social History (smoking) Family history (hemophilia) CBC > include platelet count PT PTT ```
60
Pulmonary Embolism Clinical Manifestations
Chest pain Dyspnea Tachycardia
61
5 "P"s of Arterial Thombosis
``` Pain Pallor Paresthesia Pulesness Poikelothermia ```
62
Poikelothermia
The inability to regulate body temp.
63
Paresthesia
Abnormal dermal sensation | Chilling, tingling, burning, numbness
64
What is INR
Standardized measurement of clotting
65
D-dimer
Measures fibrin degradation products | Elevation indicates recent clotting activity
66
What can cause bleeding?
Thrombocytopenia Vitamin K deficiency Clotting disorders (Hemophilia) Cirrhosis of Liver
67
Thrombocytopenia can be caused by:
Decreased platelet synthesis in bone marrow Holding of platelets in spleen Decrease platelet lifespan
68
Anti-platelet therapy
Aspirin | NSAIDS
69
Petechiae
Small, pinpoint bleeding | Resemble rash
70
Hemophilia also called
Von Willebrand's Disease
71
Acquired defective coagulation
Liver disease - Alcoholic Cirrhosis
72
Some coagulation factors need ___ to function
Vitamin K
73
Purpura
Large areas of bleeding
74
Spontaneous bleeding
Nosebleed (Epistaxis)
75
Clinical Manifestations of Bleeding
Petechiae Purpura Spontaneous bleeding Hemouria
76
Labs for bleeding
CBC PT PTT
77
Immune Thrombocytopenia Purpura (ITP)
Autoimmune disorder > Platelets attacked by Immune Causes bleeding Acute ITP > Children after viral infection Chronic > Adults No treatment Associated with Lupus or AIDS
78
Hemophilia
Genetic Hemophilia A most common X linked recessive > Males Causes bleeding
79
Hemophilia A factor deficiency
Factor VIII (8)
80
Hemophilia B factor deficiency
Factor IX (9)
81
Clinical manifestation of Hemophilia
``` 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
DIC
Swinging door Clot formation and bleeding Most common is Sepsis & Septic Shock Use up of coagulation factors > depletion of coagulation factors
83
DIC Clinical Manifestations
``` Petechiae Positive D-dimer PT & PTT prolonged Internal bleeding Thrombocytopenia ```
84
Primary Prevention for bleeding
Genetic screening | Injury Prevention
85
Primary Prevention for clotting
Hydration Not smoking Exercise

Pathophysiology (12 decks)

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