Coagulation- A Surgical Perspective

Question 1

3 stages of hemostasis

Answer 1

vascular, platelet, and coagulation phase

Question 2

__________ may be recommended for those who bruise easily, have excessive bleeding,or take medications after a stroke or heart attack that can alter platelet function; to detect resistance to aspirin or clopidogrel; and before certain surgeries

Answer 2

Platelet function tests

Question 3

_____ = (patient PT/ mean normal PT) ^ ISI

Answer 3

International Normalized Ratio (INR)

Question 4

Common causes of prolonged PT

Answer 4

Warfarin use, Vitamin K deficiency, liver disease

Question 5

Tests the rate of conversion of Factor VII to VIIa; measures effectiveness of the extrinsic and common pathway (normal 12-13 secs)

Answer 5

Prothrombin time

Question 6

stage of hemostasis where Formation of a loose and temporary platelet aggregate at the site of injury. Platelets bind to collagen. After the activation, platelets change their shape and in the presence of fibrinogen, aggregate to form the hemostatic Primary platelet plug

Answer 6

platelet phase

Question 7

about 15% of the hemophilia population, tend to have bleeding episodes after injuries. •They may also experience occasional bleeding episodes without obvious cause. These are called “spontaneous bleeding episodes

Answer 7

moderate hemophilia

Question 8

about 60% of the hemophilia population, have bleeding following an injury and may have frequent spontaneous bleeding episodes, often into the joints and muscles

Answer 8

severe hemophilia

Question 9

stage of hemostasis where conversion of fibrinogen to fibrin happens, fibrin binds the platelets to form a clot, and formation of a fibrin mesh that tightly binds to the platelet aggregate which gives rise to a more stable hemostatic plug (clot)

Answer 9

coagulation phase

Question 10

Shortage of von Willebrand factor: most common form

Answer 10

Type 1 VWD

Question 11

50,000-100,000 platelets

Answer 11

Mild Thrombocytopenia

Question 12

flawed von Willebrand factor (usually mild): less common

Answer 12

Type 2 VWD

Question 13

International sensitivity index determined for each batch of thromboplastin reagents by manufactures

Answer 13

ISI

Question 14

_______ and _______ constitute over 90 % of all congenital bleeding disorders

Answer 14

Hemophilias A and B, Von Willebrand’s Disease

Question 15

Teeth can be extracted with patients with Hemophilia A and B under the cover of _______ or _______ that inhibit fibrinolysis

Answer 15

epsilon (aminocaproic acid) or tranexamic acid

Question 16

100,000-140,000 platelets

Answer 16

Thrombocytopenia

Question 17

Clotting Factor VIII deficiency.

Answer 17

Hemophilia A

Question 18

_______ measures the levels or functional activity of one or more coagulation factors

Answer 18

Clotting Factor Assays

Question 19

T/F: Bleeding disorders maybe either congenital or acquired

Answer 19

True

Question 20

T/F: Congenital bleeding disorders are more common than acquired bleeding disorders

Answer 20

False

Question 21

_____ elevates bleeding time

Answer 21

Thrombocytopenia (decreased platelet count)

Question 22

<50,000 platelets

Answer 22

Severe Thrombocytopenia

Question 23

common test performed to evaluate hemostasis

Answer 23

Platelet count (CBC), bleeding time, PT, APTT (activated partial thromboplastin time), INR (international normalized ratio)

Question 24

(6% to 49% factor level) usually have problems with bleeding only after serious injury, trauma, or surgery.

Answer 24

mild hemophilia

Question 25

Clotting Factor IX deficiency

Answer 25

Hemophilia B (Christmas disease)

Question 26

Vessel Wall Integrity, Adequate Numbers of Platelets, Proper Functioning Platelets, Adequate Levels of Clotting Factors, Proper Function of Fibrinolytic Pathway are all factors affecting ______

Answer 26

normal hemostasis mechanism

Question 27

How long a precise nick takes to stop bleeding; Provides assessment of platelet function; Normal –2 to 9 minutes; Platelet dysfunction –9 to 15 minutes

Answer 27

Bleeding time

Question 28

Congenital deficiencies of intrinsic system, Von Willebrand disease, liver cirrhosis, Vitamin K deficiency, heparin therapy, and coumadin therapy are common causes of prolonged ______

Answer 28

aPTT

Question 29

stage of hemostasis characterized by vasoconstriction of damaged vessel that diminishes blood flow

Answer 29

vascular phase

Question 30

<20,000 platelets

Answer 30

Spontaneous bleeding

Question 31

complete lack of von Willebrand factor (more severe): rare

Answer 31

Type 3 VWD

Question 32

monitors patient’s response to heparin therapy; measures effectiveness of the intrinsic and common pathway (Normal Value: 30-40 secs)

Answer 32

Activated Partial Thromboplastin Time (aPTT)

Question 33

process where partial or complete dissolution of the hemostatic plug by plasma occurs

Answer 33

clot dissolution