Coagulation patho

Question 1

DVT + cerebral thrombosis + recurrent pregnancy loss =?

Answer 1

Factor V Leiden

Question 2

Factor V Leiden. What type of mutation of adenine?

Answer 2

DNR point mutation

Question 3

Factor V Leiden. Sequence of amino acid mutations.

Answer 3

Guanine– > adenine DNR point mutation –> Arg506Gln mutation near the cleavage site

Question 4

What coag. factor is persistently increased in Leiden V factor?

Answer 4

thrombin

Question 5

Vitamin K dependent factors?

Answer 5

II, VII, IX, X

Question 6

Warfarin affects coagulation factor …………., not …………….

Answer 6

carboxylation, not synthesis

Question 7

When occurs warfarin-induced skin necrosis?

Answer 7

within first few days of warfarin therapy

Question 8

How to prevent warfarin-induces skin necrosis?

Answer 8

add heparin within first few days of warfarin therapy ,,heparin bridge’’

Question 9

Why there is a risk of warfarin-induced skin necrosis in case of C/S deficiency?

Answer 9

Protein C has very short half life. When warfarin starts to work, K dependent coag. factors exerts their effect, because protein C is decreased almost 50proc within first day of warfarin therapy

Question 10

Gram negative –> sepsis. Reason?

Answer 10

LPS activate coagulation cascade

Question 11

Why LPS triggers coagulation cascade?

Answer 11

LPS is as procoagulant

Question 12

DIC signs (5)

Answer 12

oozing from vascular catheters, echymosis/petechiae, mucocutaneous bleeding; end organ damage

Question 13

splenic sequestration: what count of PLT in serum and symptoms?

Answer 13

above 30k, no bleeding

Question 14

Uremia cause ……………….. platelet disorder.

Answer 14

qualitative

Question 15

Which parameter would be impaired in coagulopathy due to uremia?

Answer 15

Bleeding time. Others are normal

Question 16

Bleeding time is prolonged in ……………. and ………….. disorders

Answer 16

platelet qualitative and quantitative platelet defects

Question 17

Thrombocytopenia + venous thrombosis + medication =?

Answer 17

heparin-induced thrombocytopenia and thrombosis

Question 18

When manifest HITT?

Answer 18

5-10 days after initiation of heparin

Question 19

platelet factor 4 (PF4) is released from ……….

Answer 19

alpha granules in platelets

Question 20

2 functions of PF4?

Answer 20

role in platelet agregation;

inactivate heparin

Question 21

complex in HITT consisted of (3)

Answer 21

PF4 + heparin + IgG to this complex

Question 22

What happens when HITT complex is formed?

Answer 22

It binds via IgG Fc region to platelets –> activation –> further releasea of PF4 –> widespread activation of platelets –> thrombocytopenia with venous thrombosis