Coagulation Flashcards
what are the clotting factors
platelets
soluble clotting
tissue factor
collagen & phospholipids
what are anti-clotting factors
Nitric oxide Protein C&S Anti-thrombin fibrinolytics protacyclin
what is protime or PT
sensitively index measures the concentration of clotting factors in the extrinsic pathway and the common pathway, may which depend on Vit K for their activity
what is the activated partial thromboplastin time aPTT
is most sensitive to the concentration of clotting factors in the intrinsic pathway and the common pathway
What is Von Willebrand disease
most common bleeding disorder
Von Willebrand binds factor VIII and extends life of VIII
binds platelets to injured vessel endothelium
helps to insure that coagulation and healing take place at site of vessel injury
what is the clinical presentation of Von Willebrand
mucosal bleeding including epistaxis & after dental extraction
Post Op bleeding
Metromenorrhagia
Hemarthrosis
what is a critical step in the clotting cascade
factor X to Xa conversion
what does proteins C&S do
inhibits the feedback pathway for factor V
factor II is also known as
prothrombin
protime most sensitively measures which pathway and which factors
common pathway
which depends on Vitamin K for their activity: II, VII, IV, X
aPTT is most sensitive for which pathway?
intrinsic pathway and the common pathway
F XI, IX, VIII, II prothrombin
how is heparin measured
anti Xa
what is the tip off lab test for Von willibrand dz
increased aPTT
what is the most common type of Von Willebrand dz
Type 1
autosomal co-dominant
what is the best way to treat mild Von Willebrand dz
DDAVP which can be given IV or Nasal spray
More severe bleeding require what to tx VWB dz
factor replacement with cryoprecipitate
what is different about VWB type 2b
has excessively big multimers and be associated with thrombocytopenia and SHOULD NOT BE TREATED WITH DDAVP b/c this can worsen thrombocytopenia
Hemophilia A
x-linked, therefore only seen in males
Deficiency of FVIII
manifests as easy bruising or bleeding particularly hemarthoses
how is hemophilia A treated
recombinant factor VIII replacement IV
hemophilia B
x linked recessive therefore severe Sx only in males
factor IX deficiency
how is hemophilia B Tx
recombinant IX
what is Factor XI
autosomal co-dominant
+Fam HX
rare in gen public but as much a 6% of ashkenazi Jews
Only few are Symptomatic and most present in adulthood
how is factor XI tx
fresh frozen plasma
