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Coagulation > Coagulation > Flashcards

Coagulation Flashcards

1
Q

Stability of a PTT test

A

4 hours

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2
Q

Stability of a heparin sample

A

separate within 1 hour and test within 2 hours

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3
Q

Stability of PT test

A

if cap 24 hours

if uncapped 4 hours

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4
Q

Factors measured using PT

A

1,2,5,7,X

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5
Q

Clinical use of PT

A

monitor oral coagulation therapy such as warfarin and Coumadin

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6
Q

What pathway is measured by PT test

A

extrinsic

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7
Q

Reagents used for PT

A

thromboplastin (neoplastic) and CaCl

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8
Q

what’s the purpose of warfarin therapy

A

to inhibit vitamin K factors

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9
Q

What are the vitamin K factors

A

2,7,9,X

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10
Q

When do we see vitamin K deficiency

A

in obstructive jaundice or sterile gut

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11
Q

Whats the half life of factor 7

A

3.5 - 5

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12
Q

What is PT sensitive to?

A

liver diseases, hyperfibrinogenemia and vitamin K deficiency

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13
Q

Whats the reference range of PT

A

11.4 - 14.4

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14
Q

What have a heparin neutralizer

A

Neoplastic for PT test

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15
Q

What does INR stands for

A

International Normalized Ratio

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16
Q

What does INR do?

A

correct PT’s reagents sensitivity due to warfarin

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17
Q

What does ISI stands for

A

International Sensitivity Index

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18
Q

How to measure INR

A

Patient PT/Mean of Lab reference ^ ISI

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19
Q

Whats the reference range of INR

A

2 - 3

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20
Q

What factors are measure in PTT

A

1,2,5,8-12

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21
Q

What factors are part of the common pathway

A

1,2,5,X

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22
Q

Whats the purpose of heparin

A

to increase antithrombin 3 which inhibits 12a,11a,9,a and 2a

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23
Q

What does lupus anticoagulant do to coagulation studies

A

prolong PTT

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24
Q

When is PTT prolonged

A

during liver diseases, hypofribrinogemia and warfarin therapy

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25
Q

Whats the reference range of PTT

A

23-34

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26
Q

Whats the purpose of mixing studies

A

to determine whether there’s a factor deficiency or an inhibitor

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27
Q

Whats the reagent used in mixing studies

A

pooled normal plasma

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28
Q

What does no/partial correction in a mixing studies indicates

A

the presence of an inhibitor

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29
Q

what does correction in a mixing studies indicates

A

the presence of an deficiency

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30
Q

Fibrinogen is ___ to the time for clot formation

A

inversely proportional

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31
Q

Clinical use of fibrinogen

A

determine dic, trauma cases and asparginase therapy

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32
Q

reference range of fibrinogen

A

185-465

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33
Q

Whats the purpose of thrombin time

A

measures the time it takes for a clot to form after an excess of thrombin has been added.

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34
Q

Clinical use of thrombin time

A

heparin contamination
dysfibrinogemia
hypofibri

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35
Q

what are the thrombin inhibitors

A

lepuridin and argatroban

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36
Q

What test do we perform if Thrombin is abnormal

A

reptilase time

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37
Q

Whats repitlase time

A

a bothrops venom that cleave fibrinopeptides A from fibrinogen

38
Q

Whats the purpose of reptilase time

A

detect fibrinogen polymerization disorders in the presence of heparin

39
Q

Whats the cause of normal reptilase time

A

heparin

40
Q

Whats the cause of equally prolonged reptilase time/thrombin

A

hypofibrino

41
Q

Whats the cause of strongly prolonged reptilase time

A

dysfribrino

42
Q

Whats the cause of slightly prolonged reptilase time

A

elevated fdp

43
Q

What test is used to determine fibrinolysis or fibrinogenolysis

A

FDP

44
Q

What happen during DIC

A

Elevated FDP and D dimers

45
Q

Secondary fibrinolysis

A

clot formation followed by fibrin dissolution

46
Q

Fibrinogenolysis

A

systemic activation of plasminogen

47
Q

Primary fibrinolysis

A

increased FDP but no D Dimers due to no degradation of cross linked fibrin, but degradation of fibrinogen

48
Q

reference range of FDP

A

<5

49
Q

Plasminogen activators , what converts plasminogen into plasmin

A

TPA
urokinase
streptokinase

50
Q

What neutralizes plasmin

A

alpha 2 antiplasmin

51
Q

what degrades fibrin clots into different products

A

plasmin

52
Q

what’s the by product of fibrin

A

d dimers

53
Q

Clinical used of D dimers

A

determine DIC

54
Q

what causes false elevation of D dimers

A

Rheumatoid factor >50

55
Q

what causes false decreased of D dimers

A

lipemia

56
Q

reference range of D dimers

A

<0.5

57
Q

Hemostasis

A

a balance that maintains the blood liquid and inside the vessels

58
Q

PLT

A

small, anuclear and disk form

59
Q

what’s the unstimulated state of plt

A

discoid

60
Q

What system does hemostasis depend on

A

Vascular
plasma coagulation factors
plt
fibrinolytic system

61
Q

What are the 4 functions of PLT

A

response to vascular injury
contributes to coagulation cascade
maintain vascular integrity
response to inflammation

62
Q

Sequence of vascular injury

A

Attraction to site due to collagen
adhesion
morphologic changes
aggregation due to phospholipid layer

63
Q

Where the coagulation factors generated from

A

liver

64
Q

what coagulation does not generates in the liver

A

Factor 8, the vW part

65
Q

where is vW produced

A

in the endothelial cells or megaK

66
Q

What activates the intrinsic pathway

A

surface contact

67
Q

what activates the extrinsic pathway

A

vascular injury

68
Q

What does primary hemostasis depend on

A

plt response and constriction (vessel wall)

69
Q

What does primary hemostasis depend on

A

cascade systems

70
Q

what factors aren’t proteins

A

calcium factor 4

thromboplastin factor 3, tissue factor

71
Q

What are the categories of coagulation factors

A

fibrinogen
prothrombin
contact famil

72
Q

Fibrinogen family

A

fibrinogen, factors 5,8,13

73
Q

Prothrombin family

A

2,7,9,X and protein C/s

74
Q

contact family

A

Pk, HMWK, Factor 12 and 11

75
Q

What factors are not measured in PT

A

3,4

76
Q

what are the advantage of a thromboplastin reagent which has a lower ISI value

A

the lower the ISI, the more responsive the reagent

77
Q

What factors aren’t measure by PTT

A

7,13

78
Q

Activators used in PTT

A

kaolin,silica and elegiac acid

79
Q

What causes prolonged PTT

A

heparin

80
Q

Whats heparin plasma cofactor

A

antithrombin 3

81
Q

Natural inhibitors

A

antithrombin 3 and protein c/s

82
Q

whats the most important inhibitor

A

antithrombin 3

83
Q

primary function of antithrombin 3

A

inactivate thrombin

84
Q

Where do we see low and high levels of anti3

A

low levels: hepatic disorders such as cirrhosis or acute hepatitis
high inflammation

85
Q

what factors does protein C/S inhibits

A

5a and 8a and PAI-1

86
Q

How is fibrinolysis accomplished

A

intrinsic, extrinsic or exogenous

87
Q

Exogenous therapeutic activation

A

streptokinase, urokinase and tpa

88
Q

main inhibitor of plasmin

A

pai -1

89
Q

main inhibitor of plasminogen

A

alpha 2 antiplasmin

90
Q

when is d dimers present

A

after degradation of fibrin clot

Coagulation (1 decks)

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