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ClinLab > Coagulation > Flashcards

Coagulation Flashcards

1
Q

What is the 3 step in maintaining hemostasis during an injury?

Which of the following is considered primary vs secondary hemostasis?

A
  1. vascular spasm
  2. platelet plug formation (primary hemostasis)
  3. blood coagulation (secondary hemostasis)
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2
Q

If a patient presents with petechiae, ecchymoses and bleeds from minor cuts what type of defect does he have?

A

platelet/vascular defect

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3
Q

If a patient presents with hemarthroses or hematomas, what type of defect does he have?

A

coagulation defect

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4
Q

What is the 3 steps in the platelet plug formation?

Which of the following steps is reversible?

A
  1. Adhesion
  2. activation (reversible)
  3. aggregation
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5
Q

What substance is important in platelet aggregation?

A

fibrinogen

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6
Q

Normal values for the following:

RBC
Hgb
Hct
WBC
Plts
-Thrombocytopenia/mild/severe
A 
RBC = 4-5.5 x 10^6
Hgb = 12-15 g/dL
Hct = 36-45%
WBC = 5-10x10^3
Plts = 150-400x10^3
Thrombocytopenia = <150,000
Mild = 50-100,000
Severe = <50,000
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7
Q

When measuring bleeding time what is the normal value and what signifies a prolonged bleeding time?

A
  • Normal value 3-10 minutes

- > 10 minutes = prolonged

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8
Q

Bleeding time is only prolonged due to what 3 things

A
  • low platelet count
  • vWD
  • bad test
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9
Q

What medication is a COX inhibitor and works by inhibiting platelet activation?

A

Aspirin

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10
Q

What are 3 P2Y12 inhibitors that work by inhibiting platelet activation?

A
  • Plavix
  • Effient
  • Brilinta
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11
Q

What are the 3 GPIIb/IIIa inhibitors that works by inhibiting platelet aggregation?

A
  • Abciximab
  • Integrillin
  • Tirofiban
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12
Q

What medication is a PDE5 inhibitor that works to inhibit platelet aggregation?

A

aarenox

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13
Q

What are the 4 vitamin K dependent factors?

A

II, VII, IX, X

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14
Q

What 3 factors are NOT produced in the liver?

A

III, IV, VIII

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15
Q

What are the names of the following factors?

II
IIa
I
Ia

A

II - prothrombin
IIa - thrombin
I - fibrinogen
Ia - fibrin

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16
Q

What factors make up the intrinsic pathway?

A

XII, XI, IX, VIII, X

12, 11, 9, 8, 10

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17
Q

What factor make up the extrinsic pathway?

A

VII

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18
Q

What factors make up the common pathway?

A

X, II, I

19
Q

Fondaparinux, Eliquis, Xaralto are what type of medications?

A

Factor Xa inhibitors

20
Q

Lovenox, Fragmin (LMWH) or Heparin are what type of medications?

A

Factor Xa inhibitor

21
Q

Angiomax or Argatroban are what type of medications?

A

Antithrombin (IIa) agents

22
Q

Coumadin (Warfarin) is what type of medication?

A

Vitamin K Antagonist

23
Q

Deficiency in the following 4 substances makes you hypercoagulable.

A
  • Protein C
  • Protein S
  • AT
  • Factor XIIa
24
Q

What 2 proteins are important in inhibiting Factor VIII and Factor V?

A
  • Protein C

- Protein S

25
Q

What substance breaks down fibrin?

What is the product of this break down depending on if a fibrin clot has been formed already or not?

A

Plasmin

  • if fibrin clot formed = D-dimer
  • if just fibrin = fibrin split products (FSP)
26
Q

What is thrombin time used for?

A

evaluate the part of the hemostatic process where soluble fibrinogen is changed into fibrin threads

27
Q

What is the normal value for PT?

A

11-15 seconds

28
Q 
What is normal value for INR?
Therapeutic range? 
Therapeutic range for mechanical valve? 
What is ideal for surgery?
What INR has an unacceptable high risk of bleeding?
A 
Normal = <1.0
Therapeutic = 2-3
Mechanical valve = 2.5-3.5
Surgery = <1.5
High risk of bleeding = >5
29
Q

What is the normal value for PTT?

A

25-40 seconds

30
Q

If you add a patient’s plasma with a normal pooled plasma and the PT/PTT comes out NORMAL what does this mean?

A

Factor deficiency

31
Q

If you add a patient’s plasma with a normal pooled plasma and the PT/PTT comes out PROLONGED what does this mean?

A

Factor inhibitor issue

32
Q

If you add a patient’s plasma with a factor specific deficient plasma and the PT/PTT comes out PROLONGED what does this mean?

A

Factor deficiency

*of the known Factor missing in sample

33
Q

If you add a patient’s plasma with a factor specific deficient plasma and the PT/PTT comes out NORMAL what does this mean?

A

Factor normal

*Factor missing in sample

34
Q

80-85% of patients with Hemophilia have deficiency of which factor?

Which lab test is affected?

a. platelet count
b. bleeding time
c. PT/INR
d. PTT

A
  • Factor VIII

d. PTT

35
Q

Hemophilia B (Christmas Disease) accounts for 10-15% of all hemophiliacs. It is a result of a deficiency in what factor?

Which lab test is affected?

a. platelet count
b. bleeding time
c. PT/INR
d. PTT

A
  • Factor IX

d. PTT

36
Q

If a patient is on coumadin which lab results will be affected?

a. platelet count
b. bleeding time
c. PT/INR
d. PTT

A

c. PT/INR

d. PTT

37
Q

What is the MOA of action of Lovenox (LMWH)? Which lab test is affected?

a. platelet count
b. bleeding time
c. PT/INR
d. PTT

A

-activates antithrombin III which blocks thrombin (Factor IIa)

a. PT/INR
d. PTT

38
Q

If a patient has liver disease which lab test is affected?

a. platelet count
b. bleeding time
c. PT/INR
d. PTT

A

c. PT/INR

d. PTT

39
Q

If a patient had DIC what lab test is affected?

a. platelet count
b. bleeding time
c. PT/INR
d. PTT

A

All of them

40
Q

For DIC what special test should you do to look for low fibrinogen levels?

A

TT time

41
Q

Platelet adheres to the damaged area through which specific receptors?

A

GPIIb/IIIa, GPIb, GPIa/GPIIa

42
Q

If you would like to monitor therapy for coumadin or heparin what pathway should you measure?

A
  • coumadin = extrinsic pathway

- heparin = intrinsic pathway

43
Q

This condition is characterized by pathological activation of coagulation blood clotting mechanisms that happens in response to disease leading to the formation of small blood clots inside the blood vessels.

A

Disseminated Intravascular Coagulation (DIC)

ClinLab (11 decks)

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