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Clinical Labs > Coagulation/ABG/Rheumatology > Flashcards

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
Q

Edoxaban (savaysa, lixiana)

A

Factor Xa inhibitor. Oral

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26
Q

Dabigatran (pradaxa)

A

Oral direct thrombin inhibitor

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27
Q

Vitamin K dependent factors

A

2, 7, 9, 10 and protein C and S.

28
Q

Treatment of supratherapeutic INR

A

Vitamin K, fresh frozen plasma, prothrombin complex concentrate, recombinant factor VII.

29
Q

Normal PO2

A

80-100

30
Q

Critical PO2

A

less than 60

31
Q

Critical O2 saturation

A

less than 90%

32
Q

Normal pH

A

7.35-7.45

33
Q

Critical pH

A

less than 7.25 and more than 7.55

34
Q

Normal PCO2

A

35-45

35
Q

Critical PCO2

A

Less than 20 and more than 60

36
Q

Normal Bicarb

A

22-26

37
Q

Critical Bicarb

A

less than 15 and more than 40

38
Q

Normal anion gap

A

12

39
Q

Compensated metabolic acidosis

A

PCO2 will be the same as the decimal point of the pH.

40
Q

High anion gap

A

Methanol, uremia, DKA, propylene glycol, Iron, lactic acidosis, ethanol, salicylate

41
Q

Compensated Metabolic Alkalosis

A

PCO2 incrases 0.7 for every 1 increase in bicarb.

42
Q

Hypovolemic Hypochloremic Metabolic Alkalosis

A

Urine chloride is less than 20. Fluid responsive. Usually caused by vomiting or thiazide/loop diuretics.

43
Q

Metabolic alkalosis due to mineralcorticoid excess

A

Urine chloride is more than 30. Volume expansion due to a renin-secreting tumor.

44
Q

Causes of respiratory alkalosis

A

Anxiety, gram negative sepsis, liver failure, salicylate poisoning, pregnancy, high altitude.

45
Q

noninflammatory joint findings

A

Yellow fluid, with less than 200 WBC (

46
Q

Inflammatory joint findings

A

Yellow/opaque, 2,000-100,000 WBC (>50% PMNs), negative culture.

47
Q

Septic Joint findings

A

Yellow/green, 15,000 to >100,000 WBC (>75% PMNs), positive cultures.

48
Q

Monosodium Urate

A

Gout. NEGATIVE birefringment. Needle shaped.

49
Q

Calcium Pyrophosphate

A

Pseudogout. POSITIVE birefringment. Rhomboid shaped.

50
Q

Diseases associated with Rheumatoid Factor

A

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
Q

Diseases associated with positive ANA

A

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
Q

RA antibodies

A

ANA, RF, anti-CCP

53
Q

SLE antibodies

A

ANA, Anti-sm. Anti-dsDNA

54
Q

Sjogren’s antibodies

A

ANA, anti-ro/SSA, anti-LA/SSB

55
Q

systemic sclerosis antibodies

A

ANA, anti-SCL-70, ACA

56
Q

CREST antibodies

A

ANA, ACA

57
Q

Anti-dsDNA

A

SLE

58
Q

Anti-sm

A

SLE

59
Q

anti-ro/SSA, anti-LA/SSB

A

Sjogren syndrome

60
Q

Anticentromere (ACA)

A

CREST

61
Q

Anti-SCL-70

A

Systemic sclerosis

62
Q

ESR/CRP

A

Nonspecific inflammatory markers. Associated with giant cell temporal arteritis.

63
Q

Polymyalgia Rheumatica

A

ESR > 40

64
Q

HLA-b27

A

Ankylosing spondylitis. Can also be elevated in reactive arthritis, psoriatic arthritis and arthritis associated with IBD

65
Q

Antiphospholipid antibodies

A

SLE

Clinical Labs (3 decks)

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