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Coagulation/ABG/Rheumatology Flashcards

1
Q

PTT/aPTT

A

Intrinsic and the common pathway. Used to monitor heparin therapy.

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2
Q

PT

A

Extrinsic and common pathway. Used to monitor warfarin therapy.

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3
Q

INR

A

Reflection of PT

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4
Q

INR for DVT prophylaxis

A

1.8-2.5

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5
Q

INR for VTE treatment

A

2-3

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6
Q

INR for Afib

A

2-3

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7
Q

INR for mechanical heart valve

A

2.5-3.5

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8
Q

Thrombin Time

A

Assesses clotting function

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9
Q

Fibrinogen

A

identifies certian bleeding disorders

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10
Q

D-dimer

A

Is there endogenous fibrinolysis

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11
Q

Splenic Sequesteration

A

Splenomegaly due to portal hypertension (Cirrhosis) leads to thrombocytopenia.

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12
Q

Thrombotic Thrombocytopenic Purpura etiology

A

Inherited (ADAMTS-13), Drugs, pregnancy, HIV.

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13
Q

Thrombotic Thrombocytopenic Purpura Presentation

A

Microthrombi formed throughout the body. Microangiopathic hemolytic anemia, thrombocytopenia, AKI, Neuro deficits, fever. Can also present with purpura, petechiae, pallor and jaundice.

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14
Q

Thrombotic Thrombocytopenic Purpura Treatment

A

Plasma exchange

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15
Q

Hemolytic Uremic Syndrome (HUS) Etiology

A

Common in children after an infection with E. Coli 0157:H7.

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16
Q

Hemolytic Uremic Syndrome (HUS) Presentation

A

Usually presents after an episode of hemorrhagic diarrhea. Microangiopathic hemolytic anemia, thrombocytopenia, AKI.

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17
Q

Hemolytic Uremic Syndrome (HUS) Treatment

A

Adults need plasma exchange, children may need dialysis.

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18
Q

TTP-HUS findings:

A

Schistocytes, increased LDH, indirect bili. Decreased haptoglobin. Negative coombs test. PT and aPTT are both normal.

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19
Q

Causes of Impaired platelet production

A

Aplastic anemia, chemo, radiation, bone marrow inflitrates, vitamin B12/folate deficiency, Alcohol (toxic to bone marrow, nutritional deficiency, hypersplenism due to cirrhosis)

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20
Q

Enoxaparin (Lovenox)

A

LMWH given SQ

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21
Q

Warfarin

A

Coumadin

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22
Q

Fondaparinux (Arixtra)

A

Factor Xa inhibitor. Given SQ.

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23
Q

Rivaroxaban (xarelto)

A

Factor Xa inhibitor. Oral.

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24
Q

Apixaban (eliquis)

A

Factor Xa inhibitor. Oral.

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25
Edoxaban (savaysa, lixiana)
Factor Xa inhibitor. Oral
26
Dabigatran (pradaxa)
Oral direct thrombin inhibitor
27
Vitamin K dependent factors
2, 7, 9, 10 and protein C and S.
28
Treatment of supratherapeutic INR
Vitamin K, fresh frozen plasma, prothrombin complex concentrate, recombinant factor VII.
29
Normal PO2
80-100
30
Critical PO2
less than 60
31
Critical O2 saturation
less than 90%
32
Normal pH
7.35-7.45
33
Critical pH
less than 7.25 and more than 7.55
34
Normal PCO2
35-45
35
Critical PCO2
Less than 20 and more than 60
36
Normal Bicarb
22-26
37
Critical Bicarb
less than 15 and more than 40
38
Normal anion gap
12
39
Compensated metabolic acidosis
PCO2 will be the same as the decimal point of the pH.
40
High anion gap
Methanol, uremia, DKA, propylene glycol, Iron, lactic acidosis, ethanol, salicylate
41
Compensated Metabolic Alkalosis
PCO2 incrases 0.7 for every 1 increase in bicarb.
42
Hypovolemic Hypochloremic Metabolic Alkalosis
Urine chloride is less than 20. Fluid responsive. Usually caused by vomiting or thiazide/loop diuretics.
43
Metabolic alkalosis due to mineralcorticoid excess
Urine chloride is more than 30. Volume expansion due to a renin-secreting tumor.
44
Causes of respiratory alkalosis
Anxiety, gram negative sepsis, liver failure, salicylate poisoning, pregnancy, high altitude.
45
noninflammatory joint findings
Yellow fluid, with less than 200 WBC (
46
Inflammatory joint findings
Yellow/opaque, 2,000-100,000 WBC (>50% PMNs), negative culture.
47
Septic Joint findings
Yellow/green, 15,000 to >100,000 WBC (>75% PMNs), positive cultures.
48
Monosodium Urate
Gout. NEGATIVE birefringment. Needle shaped.
49
Calcium Pyrophosphate
Pseudogout. POSITIVE birefringment. Rhomboid shaped.
50
Diseases associated with Rheumatoid Factor
RA, Sjorgen's, Connective tissue diseases, SLE, polymyositis, dermatomyositis, bacterial endocarditis, Hep B/C, TB, syphilis, parasites, sarcoidosis, interstitial pulmonary fibrosis, silicosis, asbestosis, malignancies, primary biliary cholangitis.
51
Diseases associated with positive ANA
RA, SLE, sjorgen's, scleroderma, CREST, polymyositis/dermatomysitis, mixed connective tissue disease, hashimotos, grave's, autoimmune hepatitis, biliary cirrhosis, viruses (EBV, HIV, HCV, parvovirus), bacteria ( syphilis, subacute endocarditis), malignancy, IBS
52
RA antibodies
ANA, RF, anti-CCP
53
SLE antibodies
ANA, Anti-sm. Anti-dsDNA
54
Sjogren's antibodies
ANA, anti-ro/SSA, anti-LA/SSB
55
systemic sclerosis antibodies
ANA, anti-SCL-70, ACA
56
CREST antibodies
ANA, ACA
57
Anti-dsDNA
SLE
58
Anti-sm
SLE
59
anti-ro/SSA, anti-LA/SSB
Sjogren syndrome
60
Anticentromere (ACA)
CREST
61
Anti-SCL-70
Systemic sclerosis
62
ESR/CRP
Nonspecific inflammatory markers. Associated with giant cell temporal arteritis.
63
Polymyalgia Rheumatica
ESR > 40
64
HLA-b27
Ankylosing spondylitis. Can also be elevated in reactive arthritis, psoriatic arthritis and arthritis associated with IBD
65
Antiphospholipid antibodies
SLE

Clinical Labs (3 decks)

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