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BioScience II > Coagulation PPT- Josh > Flashcards

Coagulation PPT- Josh Flashcards

1
Q

Layers of vessel

outer to inner

A
  • Tunica Adventitia
  • Tunica media
  • Tunica Intima
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2
Q

Name the coag factors

  • I
  • II
  • III
  • IV
  • V
  • VII
  • VIII
  • IX
  • X
  • XI
  • XII
  • XIII
A
  1. fibrinogen
  2. Prothrombin
  3. Tissue factor
  4. Calcium
  5. Proaccelerator
  6. nothing
  7. Procovertin
  8. Antihemophiliac factor (and vWf)
  9. Christmas Factor
  10. Stuart-power factor
  11. Plasma thromboplastin
  12. Hageman factor
  13. Fibrin-stabalizing factor
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3
Q

Lab Testing:

What is normal PT/INR?

A

11-12.5 sec

0.8-1.1

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4
Q

Lab Testing:

What pathways does PT/INR measure

A

both common & Extrensic

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5
Q

Lab Testing:

what factors does PT/INR measure

A

III, VII (extrensic)

X, V, II,I (common)

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6
Q

Lab Testing:

normal aPTT

A

30-40 sec

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7
Q

Lab Testing:

what pathways does aPTT monitor

A

both common and Intrinsic

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8
Q

Lab Testing:

so what factors does aPTT monitor

A

XII, XI, IX, VIII (INTRENSIC)

X, V, II, I (COMMON)

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9
Q

Lab Testing:

what are normal values for Fibrinogen?

A

200-400 mg/dL

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10
Q

Lab Testing:

what pathway does fibrinogen monitor

A

common pathway

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11
Q

Lab Testing:

what factors are monitored w/ fibrinogen

A

X, V, II, I

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12
Q

Lab Testing:

A fibrinogen level of what is associated w/spontaneous bleeding

A

< 100 mg/dL

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13
Q

Lab Testing:

what is normal fibrin split products

A

< 10 mg/L

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14
Q

Lab Testing:

Fibrin split products is a direct indication of what?

A

direct indication of activity of fibrinolytic activity

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15
Q

Lab Testing:

what is normal Bleeding time

A

1-9 min

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16
Q

Lab Testing:

what does bleeding time evaluate

A

platelet function/quality and vascular constriction capability

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17
Q

Lab Testing:

Bleeding time does not provide accurate _____ count

A

platelet count

18
Q

Lab Testing:

what is a wider-encompassing test of clot formation, stability, and lysis

A

Thromboelastography

(TEG)

19
Q

TEG:

name the main components of the TEG

A
  1. Coagulation
  2. fibrinolysis
  3. Clotting time
  4. clot kinetics
  5. Clot strength
  6. Lysis time
20
Q

TEG pic

A
21
Q

during the fluid resucitation or massive blood transfusion, that is ___ fluid volume in 24 hrs, or ___ fluid volume in 3 hours, causes coagulation factors and platelets to become significantly diluted

A

1

1/2

22
Q

what is the depletion of platelets secondary to markedly increased platelet consumption from coagulation pathway activity?

A

thrombocytopenia

23
Q

Thrombocytopenia may lead to microthrombi, resulting in purpura called what?

A

thrombocytopenic purpura

24
Q

what can occur if the entire coagulation pathway is activated

A

DIC

25
Q

What is platelet levels with DIC for

MILD

MODERATE
SEVERE

A
  • MILD- 70,000-150,000
  • MODERATE- 40,000-70,000
  • SEVERE- 20,000-40,000
26
Q

thrombocytopenia:

vascular occlusion by thrombi formation is unusual w/DIC, and the typical manifestation is what?

A

hemorrhage

27
Q

thrombocytopenia:

HELLP follows the same pathway as DIC, but is also combined with what?

A

RBC hemolysis

and

elevated liver enzymes

28
Q

DIC:

what is the only effective treatment?

A

treatment of teh underlying cause

29
Q

DIC:

what is supportive therapy

A

Plasma and Platelet transfusions

30
Q

What are 2 types of Autoimmune Coagulopathy

A
  • Posttransfusion Purpura
  • Drug induced Autoimmune Thrombocytopenic Purpura
31
Q

Autoimmune

what causes posttranfusion purpura

A

Exposure to blood products or some drugs that may induce antibody formation

32
Q

Autoimmune Coagulopathy:

in DIATP the drugs can act what?

A

a binding agent for the antibodies to adhere to platelets

33
Q

Autoimmune Coagulopathy:

Heparin-Induced Thrombocytopenia

What are the 2 types

A
  • Tyoe I- nonimmune HIT- Seen on 1st day of heparim therapy (transient an dclinically insignificant
  • Type II- Immune mediated HIT- formation of antibodies to heparin-platelet factor 4 complex
34
Q

Autoimmune Coagulopathy:

HIT tyoe 2 occurs when

A

5-10 days after heparin use

and can been seen if heparin therapy is restarted w/in 20 days of previous exposure

35
Q

Autoimmune Coagulopathy:

Anesthestic management

A
  • Poss platelet transfusion
  • D/C precipitating drug
  • Hold Warfarin and oral contraceptives
  • Delay CV sx
36
Q

Autoimmune Coagulopathy:

if thrombotic even occurs, administer what?

A

direct thrombin inhibitor

(argatroban and bivalirudin)

37
Q

Coagulopathy in SIRS:

this is caused by what?

A

arises w/ the initiation of the imflammatory responses secondary to infection and decreased blood flow secondary to vasodilation

(AKA coag cascade activated)

38
Q

Coagulopathy in SIRS:

what is management ?

A
  • keep Hgb 7-9
  • FFP for sx
  • Keep platelets > 50,000
    *
39
Q

Coagulopathy:

Preop interview

A
  • ? hx of bleeding
  • ? hx of bleeding gims w/ dental sx
  • ? hx of liver insufficiency or malnutrition
  • Coag workup
  • Discuss transfusion possibility
40
Q
A

BioScience II (39 decks)

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