Coagulation and Blood Transfusion

Question 1

Universal FFP donor

Answer 1

AB +

Question 2

Vitamin K dependent coagulation factors

Answer 2

IX, VII, X, II (9, 7, 10, 2)

Question 3

Extrinsic factors produced in the liver that require vitamin K for biosynthesis

Answer 3

VII (7)

Question 4

Factors of final common pathway

Answer 4

V, X, II, I, XIII
(5, 10, 2, 1, 13)

Question 5

Extrinsic pathway factors

Answer 5

III, VII
(3, 7)

Question 6

How does heparin work?

Answer 6

*Anticoagulant8

-Inhibits intrinsic and final common pathway

-Binds to Antithrombin, greatly accelerating its anticoagulant ability 1,000 fold

-Heparin/antithrombin complex neutralizes thrombin (II) and activated factors IX, X, XI, and XII

-Also inhibits platelet function (secondary antiplatelet function)

Factor IIa and Xa antagonist
-Indirect (antithrombin cofactor)

Question 7

DIC patient. What would you administer before taking to OR? Choose 3

Answer 7

-FFP
-Platelets
-Cryoprecipitate

-IV fluids

Question 8

Coagulation factors
Collagen
vWF
Fibronectin

Answer 8

Procoagulant

Question 9

Antithrombin III
Protein C
Protein S
Tissue pathway factor inhibitor
Thrombomodulin

Answer 9

Anticoagulant

Question 10

Plasminogen
tPA
Urokinase

Answer 10

Fibrinolytics

Question 11

Alpha-antiplasmin
Plasminogen activator inhibitor

Answer 11

Antifibrinolytics

Question 12

Thromboxane A2
ADP
Serotonin

Answer 12

Vasoconstrictors

Question 13

Nitric oxide
Prostacyclin

Answer 13

Vasodilators

Question 14

Formula for Maximum allowable blood loss (MABL)

Answer 14

MABL = EBV x (Starting Hgb-minimum acceptable Hgb)/ Starting Hgb

Question 15

EBV for an adult male

Answer 15

70 ml/kg

Question 16

EBV for an adult female

Answer 16

65 ml/kg

Question 17

EBV for a child 1-6 yrs

Answer 17

75 ml/kg

Question 18

EBV for a child <1 year

Answer 18

80 ml/kg

Question 19

EBV for an infant

Answer 19

85 ml/kg

Question 20

EBV for a preemie

Answer 20

90-100 ml/kg

Question 21

Minimum platelet count for patient undergoing craniotomy

Answer 21

75,000-100,000 mm3

Question 22

Hemophilia A, what factor is missing

Answer 22

VIII
(8)

Question 23

Hemophilia B, what factor is missing

Answer 23

IX
(9)

Question 24

What can you give to someone with hemophilia A undergoing surgery

Answer 24

Factor VIII > cryo > FFP

Desmopressin (mild-mod dz)

TXA or aminocaproic acid

Factor VII

Question 25

What can you give to someone with hemophilia B undergoing surgery

Answer 25

Factor IX, FFP

TXA or aminoproic acid

Factor VII

Question 26

What lab values do you measure related to Warfarin

Answer 26

PT/INR (extrinsic, common final pathway)

Question 27

Treatment for for Von Willebrand disease

Answer 27

Type 1: Desmopressin (vWF, VIII)
Type 2/3: vWF concentrate

TXA: adjunctive therapy
Cryo: VIII, vWF, I, XIII (type 1, 2, 3)

Question 28

How much does Hgb change with each unit of blood given?

Answer 28

Hgb: 1 g/dl

Hct: 2-3%