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A1 > coags > Flashcards

coags Flashcards

1
Q

procoagulant examples

A

vWF
collagen

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2
Q

anticoagulant examples

A

protein c & s
antithrombin

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3
Q

fibrinolytics

A

TPA
plasminogen
urokinase

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4
Q

antifibrinolytics

A

TXA
Aminoproic acid
Whereas TPAI and alpha 2 antiplasmin breakdown plasmin on fibrin when the clot is dissolved

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5
Q

vasoconstrictors

A

txa2
serotonin
ADP

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6
Q

vasodilators

A

NO
PG/ prostacyclin

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7
Q

4 steps of hemostasis

A

vascular spasm
platelet plug (primary hemostasis)
coagulation and fibrin formation (secondary hemostasis)
Fibrinolysis when clot is not longer needed

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8
Q

vascular anatomy

A

tunica intima, media, and externa
intima- endothelium
media- smooth muscle and elastic tissue, thicker in arteries
externa- connective tissue, thicker in veins

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9
Q

the role of NO an PG

A

NO- inhibit txa2
PG I2- inhibits vWF, txa2, and release of stored granules

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10
Q

platelet receptors

A

gb2b3a
thrombin
txa2
adp
gp1b

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11
Q

where are platelets produced

A

bone marrow by megakryocytes, 1-2 week lifespan, then cleared by macrophages

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12
Q

the role of vWF

A

platelet adhesion

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13
Q

who activate splatelets

A

ADP
TXa2

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14
Q

What initially activates platelets?

A

collagen

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15
Q

vitamin k dependent factors

A

2 7 9 10

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16
Q

intrinsic pathway

A

Slow- 6 minutes bc its the work horse
12
11
9/8

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17
Q

extrinsic pathway

A

Fast- 15 seconds
3
7

18
Q

common pathway

A

10/5
2
1

19
Q

What does d dimer measure?

A

fibrin split products

20
Q

Explain fibrinolysis

A

plasminogen ->(tpa/urokinase)-> plasmin
plasmin stops fibrin from forming fibrin strands
Then, alpha 2 antiplasmin inhibits plasmin on fibrin to stop fibrinolysis when its no longer needed

21
Q

4 things that counterbalance clot formation

A

vasodilation and wash out of vasoconstrictors adp and txa2
AT inactivates 2, 9,10,11,12
TF inhibitor neutralizes TF
Release of Protein C and S

22
Q

Normal values for pt/inr, ptt, act, d dimer

A

pt 12-14 seconds
inr 1 (ratio between pt and normal pt)
PTT 25-32 seconds
ACT 90-120
d dimer <500

23
Q

R time vs K time

A

R- R u clotting yet?
K- K, are you (fixed) strong yet?

24
Q

HI

A

heparin intrinsic

25
Q

therapeutic hepariniaation occurs when aPTT is _____ x normal

A

1.5-2.5
(normal ptt is 30)

26
Q

where is endogenous heparin produced?

A

liver
basophils
mast cells

27
Q

3 contraindications to heparin administration

A

neuro surgeries
HIT
regional anesthesia

28
Q

warfarin inhibits ___

A

2,7,9,10, protein C and S
vitamin k antagonist, so against all vitamin k dependent factors

29
Q

warfarin is ___protein bound

A

highly

30
Q

on warfarin, pt/ in goal is ___ x normal

A

2-3

31
Q

dose of warfarin reversals

A

vitamin k 10-20mgs for non emergent
1-2 units FFP, recombinant factor 7a, PT complex concentrate for high risk procedures such as intracranial

32
Q

risk factors for vitamin k deficiency

A

poor intake
antibiotic therapy kills off gi flora and vit k synthesis
biliary tract disease
liver disease
neonates

33
Q

vitamin k supplementation requires __

A

a functional liver

34
Q

antiplatelet classes

A

ADP blocker- plavix, ticagrelor
gp1b3a blockers- abciximab
cox inhibitor- asa, nsaids
cox 2 inhibitor- celecoxib

35
Q

anticoagulant classes

A

heparins- unfractionated, lmwhs
thrombin inhibitors- argatroban
factor 10 inhibitors- fondaparinux
vitamin k antagonist- warfarin

36
Q

___ is irreversable, __ are reversable

A

asa
NSAIDS

37
Q

Tranexamic acid

A

TXA
think of it as opposite to tpa
both work on plasminogen when forming plasmin
plasminogen (breaks down clots) inhibitor

38
Q

labs of DIC

A

increased pt and ptt
increased d dimer
decreased fibrinogen and antithrombin

39
Q

who is at risk for DIC

A

sepsis/ gram negative bacilli
OB- pre eclampsia, placental abruption, amniotic embolism
malignancy- adenocarincinoma leukemia, lymphoma,

40
Q

what triggers sickle cell

A

dehydration
pain
hypoxemia
acidosis
hypothermia

41
Q
A

A1 (124 decks)

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