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TCD Content > Clotting Disorders > Flashcards

Clotting Disorders Flashcards

1
Q

What is the role of the coagulation cascade?

A

Clots blood

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2
Q

What is the role of the plasminogen/ plasmin system?

A

Dissolves clots

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3
Q

What is the role of Factor XIII?

A

Stabilises fibrin clot

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4
Q

What impact does warfarin have?

A

Reduces coagulation factors

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5
Q

What impact does heparin have?

A

Acts to inhibit the coagulation cascade (similar action to antithrombin - a natural inhibitors)

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6
Q

What is the role of recombinant tissue plasminogen activator (rtPA)?

A

Increases plasmin activity

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7
Q

Name 4 blood tests which should be ordered for a bleeding patient.

A
  1. FBC with platelet count
  2. PT
  3. APTT
  4. Fibrinogen
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8
Q

How can you determine if the issue is due to a factor deficiency or the present of a coagulation factor inhibitor?

A

50/50 mixture study of patient/ normal plasma

If corrects = deficiency
If no correction = inhibitor

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9
Q

Which clotting factors affect APTT?

A

VIII, IX, XI, XII and von Willebrand factor

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10
Q

Which factor is implicated in Haemophilia A?

A

FVIII

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11
Q

Which factor is implicated in Haemophilia B?

A

FIX

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12
Q

List some basic principles in the treatment of haemophilia

A
  1. Treatment centre/ multidisciplinary
  2. . Treat early (if in doubt, treat)
  3. Fast Track triage in A&E
  4. Do not wait for clinical signs to develop
  5. Take care of veins
  6. Avoid drugs like aspirin
  7. Early home therapy
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13
Q

What does R.I.C.E stand for?

A

Rest, Immobilise, Cool, Elevate

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14
Q

In what form do factors VIII and IX come when treating haemophilia?

A

Recombinant

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15
Q

Describe the distribution of recombinant factor VIII

A

Large molecule so small distribution

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16
Q

How often does recombinant factor VIII need to be given?

A

Half life of 8 hours so once to three times daily

17
Q

Describe the distribution of recombinant factor IX

A

Small molecule so large distribution

18
Q

How often does recombinant factor IX need to be given?

A

Half life 18-25 hours so once daily

19
Q

What is desmopressin (DDAVP) used for? And how does it work?

A

Haemophilia A only. It releases stored factor VII and so is useful for mild haemophiliacs. It raises VIII by 2 or 3 times. It should be tested with a trial of the drug since it has a variable effect. Can be given SC, IV or IN

20
Q

What is transexamic acid used for? And how does it work?

A

Haemophilia A and B. It is an anti-fibrinolytic. It is given orally

21
Q

What would prompt the progression from primary prophylactic treatment of haemophilia to secondary?

A

After 3 joint bleeds have occurred

22
Q

What is the commonest coagulopathy?

A

Von Willebrand’s Disease

TCD Content (6 decks)

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