Coagulopathies

Question 1

Thrombotic Thrombocytopenic Purpura (TTP) hereditary deficiency?

Answer 1

ADAMTS 13 Deficiency

Question 2

What is the Thrombotic Thrombocytopenic Purpura (TTP) pentad?

Answer 2

• Fever
• Thrombocytopenia
• Renal Failure
• Neurologic findings
• Anemia

Question 3

What is the tx for Thrombotic Thrombocytopenic Purpura (TTP)?

Answer 3

Plasmapheresis

Question 4

Thrombocytopenia diagnostic test?

Answer 4

Examination of peripheral smear

Question 5

Thrombocytopenia treatment?

Answer 5

• Treat underlying cause

- Platelet transfusion (ultimate tx)

Question 6

What is the pathophysiology of Idiopathic Thrombocytopenic Purpura (ITP)?

Answer 6

Autoimmune antibody formation against host platelets

Question 7

With Idiopathic Thrombocytopenic Purpura (ITP) the reticuloendothelial system binds to what?

Answer 7

Self-immunoglobulins attached to the platelets

Question 8

Acute Idiopathic Thrombocytopenic Purpura (ITP) seen in who and precedes what?

Answer 8

Children and viral infection

Question 9

Platelet and CBC findings for Acute Idiopathic Thrombocytopenic Purpura (ITP)?

Answer 9

• Platelet count is low
• CBC is normal
• No schistocytes

Question 10

Tx for Idiopathic Thrombocytopenic Purpura (ITP)?

Answer 10

• Adrenal corticosteroids #1

- IV immunoglobulin #2

Question 11

What occurs with platelets with Heparin-Induced Thrombocytopenia?

Answer 11

Drop-in platelets a few days after heparin administration, will lead to clots

Question 12

Acute Hemolytic Uremic Syndrome (HUS) is characterized by?

Answer 12

• Hemolytic anemia
• Thrombocytopenia
• Severe renal failure

Question 13

Hemolytic Uremic Syndrome (HUS) is the MCC of?

Answer 13

Acute renal failure in children (<5 yrs of age)

Question 14

What is the leading cause of Hemolytic Uremic Syndrome (HUS)?

Answer 14

E. Coli

Question 15

What are some general characteristics of Disseminated intravascular coagulation (DIC)?

Answer 15

Bleeding and thrombosis occurring simultaneously.

• Consumption of platelets, fibrin, and coag factors
• Fibrinolytic mechanisms are activated resulting in hemorrhage

Question 16

Disseminated intravascular coagulation (DIC) is MC in what patients?

Answer 16

Critically ill, ICU pts.

Question 17

MCC of Disseminated intravascular coagulation (DIC)?

Answer 17

Gram-negative sepsis (ie. elderly with UTI infection)

Question 18

What is a complication with Disseminated intravascular coagulation (DIC)?

Answer 18

Amniotic fluid emboli

Question 19

Rattlesnake venom can causes what?

Answer 19

Disseminated intravascular coagulation (DIC)

Question 20

What lab test as decreased with Disseminated intravascular coagulation (DIC)?

Answer 20

Fibrinogen level and platelet count

Question 21

Tx for Disseminated intravascular coagulation (DIC)?

Answer 21

• Cryoprecepitate- replaces clotting factors and fibrinogen

- FFP- replaces all clotting factors

Question 22

What is a cause of inherited hypercoagulable state?

Answer 22

Antiphospholipid antibody syndrome (APAS)

Question 23

What is the presentation of antiphospholipid antibody syndrome (APAS)?

Answer 23

• Arterial or venous thrombosis (DVT in arms)

- Recurrent fetal loss (multiple miscarriages)

Question 24

What is Von Willebrand Disease (vWD)

Answer 24

• MC inherited bleeding disorder (autosomal dominant disorder)
• Factor XIII defect

Question 25

Treatment for type 1 Von Willebrand Disease (vWD)?

Answer 25

Desmopressin (DDAVP)

Question 26

Treatment for type 3 Von Willebrand Disease (vWD)?

Answer 26

Factor VIII concentrates

Question 27

What is not recommended for tx for Von Willebrand Disease (vWD) and why?

Answer 27

• Cryoprecipitate (risk of viral transmission)

Question 28

What is the MC inherited hypercoagulability disorder among Caucasians?

Answer 28

Factor V Leiden

Question 29

Clinical finding of Factor V Leiden?

Answer 29

Thromboembolism (DVT and PE are MC)