Coagulation Flashcards

1
Q

Method of coag

A

endothelial damage exposes procoag factors -> haemostatic response -> plt aggregation

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2
Q

What coag factors are prod by endothelial cells

A

PGI2, VWF, plasminogen activators, thrombomodulin

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3
Q

platelet adhesion

A
direct = Glp1a
indirect = Glp1b and vwf
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4
Q

how to platelets attach to each other

A

Glp2b and Glp3a (fibronogen R)

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5
Q

what does plt adhesion cause

A

release of ADP and thromboxane A2 (-> aggregation)

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6
Q

arachidonic acid -> ____ (+via)

A

-> endoperoxidases (via COX)

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7
Q

what are endoperoxidases conv to

A
  • > thromboxane A2 (stim agg)

- > PGI2 (inhib agg)

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8
Q

aspirin vs NSAIDS

A

aspirin - irrev inhib COX

NSAIDs - rev

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9
Q

actions of thrombin

A

activates F7, F8, F5, plt, F11, F13 (-> propogation)

catylises fibronogen -> fibrin

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10
Q

why is vit K important in coag

A

req as co-enz for lots of liver prod factors (2,7,9,10)

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11
Q

3 physiological anticoag

A

TFPI - stop F7-F7a (no initiation)
Prot c/Prot s - bind to thrombomodulin - stop 8->8a and 5->5a
antithrombin - stop prothrombin->thrombin and 10->10a

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12
Q

sympto of platelet disorders

A

petechiae, purpura, sml bruises, no haemoarthrosis

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13
Q

sympto of coag F disorders

A

bleeding in soft tissues (joints/muscles), large bruises

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14
Q

inheritance of haemophilia

A

X linked congen def of F8 (A) or F9 (B)

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15
Q

signs / sympto haemophilia

A

long APTT, normal PT, haemoarthrosis, soft tissue haematomas

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16
Q

inheritance of VWD

A
T1/2 = auto dom
T3 = auto rec
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17
Q

Signs sympto of VWD

A

mucocutaneous bleeding, dec plt count, inc bleeding time, inc APTT, normal PT

18
Q

types of VWD

A

T1 - patrial
T2 - qualitative
T3 - total

19
Q

causes of vit K def (5)

A
malnut
malabs
biliary obs
warfarin (most common)
antibiotics
20
Q

causes of DIC

A

activation of coag + fibrinolysis by sepsis/trauma/obstetric comp

21
Q

findings in DIC

A

long APTT/TT/PT, dec fibrinogen/platelets

22
Q

Tx for VWD

A

desmopressin

23
Q

What factors is Vit K needed for

A

2,7,9,10 (buses to south ken)

24
Q

what factor goes first in vit K def

25
important DDX in vit K def
``` liver disease ( would -> dec plt count) scurvy ( -> corkscrew hair) ```
26
most common prothrombotic disorder
F5 lieden
27
signature of F5 lieden
thrombosis in weird places
28
inheritance of prot c/s def
auto dom
29
what is prot c/s associated with
warfarin induced skin necrosis
30
how would you give heparin
``` unfractionated = IV LMWH = SC ```
31
monitoring for heparin
unfrac - (variable kinetics) monitor APTT or anti-Xa | LMWH - none
32
safest anticoag to use in preg
LMWH
33
how would you give DOAC
oral
34
monitoring for DOAC
none (short half life)
35
DOAC in preg?
no - cross placenta
36
3 doac that are anti X-a
rivaroxaban, apixaban, edoxaban
37
1 doac that is anti II-a
dibagatran
38
what falls first in warfarin
prot c/s - is procoag initially
39
what pro-coag factor falls first in warfarin
7
40
what factor falls lats in warfarin
11
41
warfarin in preg?
never - teratogenic
42
monitoring in warfarin
monitor INR daily (aim for 2-3) | if 5-9 - omit dose and give oral vit K