CPT Haem Revision Flashcards

1
Q

What do platelets release on activation?

A
ADP
TXA
Serotonin
Calcium
Change shape = express GpIIb/IIIa
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2
Q

5-HT function

A

Platelet chemotaxis

Release by active platlets

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3
Q

TXA/ADP function

A

Activates other platelets

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4
Q

Platelet diameter

A

1-4 micrometer

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5
Q

Platelet lifespan

A

8-14 days

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6
Q

Primary Haemostasis

A
Injury to vessel wall
Vasoconstriction
Exposed collagen
VWF binds to collagen
VWF binds to platelets via Gp1b
Platelet activation = express GpIIb/IIIa
Fibrinogen binds to these receptors
Further platelets bind to fibrinogen
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7
Q

Bernard Soulier Syndrome

A

Lack of Gp1b

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8
Q

Glanzmanns syndrome

A

Lack of GpIIb/IIIa

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9
Q

Treatment for Bernard Soulier and Glanzmanns

A

Platelets or novoseven (recombinant factor VIIa) or transxamic acid

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10
Q

VWD types

A
Mild = mild to moderate deficiency
Moderate = present but defective
Severe = absent
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11
Q

VWD Inheritance

A

Autosomal inheritance

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12
Q

VWD Treatment

A

DDAVP if mild
Tranexamic acid
VWF containing concentrate

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13
Q

Intrinsic Pathway

A

12->12a converts 11->11a converts 9->9a.
9-> 9a requires XIa and calcium
9a converts 10-> 10a with calcium and 8

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14
Q

Extrinsic Pathway

A

TF(3) converts VII -> VIIa

VIIa converts 10-> 10a

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15
Q

Function of 10a

A

With 5 and calcium converts prothrombin into thrombin
Thrombin converts fibrinogen into fibrin
Factor 13a helps fibrin form stable clot
13a comes from thrombin producing 13

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16
Q

APTT

A

Intrinsic = 12,11,9 with 8 = 10

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17
Q

PT

A

Extrinsic = TF + 7 = 10

18
Q

Bleeding Time

A

Platelet Function

3-10 mins

19
Q

Thrombin Time

A

Common Pathway

20
Q

Severe haemophillia treatment

A

Factor VIII Prophylactic

21
Q

Mild and moderate Haemophillia treatment

A

DDAVP for mild haemolphillia A

Factor concentrate

22
Q

What holds plasminogen in its state

A

Alpha 2 antiplasmin

23
Q

What converts plasminogen -> plasmin?

A

tissue plasminogen activator

Released by endothelial cells

24
Q

Antithrombin inhibits what?

A
Thrombin
VII
IX
Xa
XI
25
Examples of a SERPIN
Antithrombin | serpin protease inhibitor
26
Increased anti-thrombin activity
Heparin 5-10,000 fold Stops clot
27
Protein S
Co-factor of protein C
28
Protein C and S
Inactivate Va and VIIIa
29
Increased Protein C activity
Thrombomodulin | 20,000
30
Consanguinity
Increases incidence of rare bleeding disorders 10-20 x
31
Prothrombin Deficiency
XI, VII, V, X, II
32
Factor XI deficiency
Jewish Avoid transexamic acid Tx = factor conc
33
Factor VII deficiency
Low dose recomb fVIIa 15-30ug/kg Levels rise in pregnancy mild don't need replacement
34
Factor V deficiency
Check plasma VIII levels | Tx = FFP plasma solvent detergent = octaplas
35
Factor V and VIII
ERGIC = abnormality of cellular transport | Tx - VIII, DDAVP, plasma
36
Fibrinogen Deficiency
Umbilical cord bleeding Pregnancy abrupt miscarriage, abruption, PPH Tx = fibrinogen replacement, aim >1 during pregnancy, aim >2 for delivery
37
Factor II
Vitamin K dependent factor | Tx = plasma, PTCC
38
Factor X deficiency
Prophylaxis = PTCC, plasma
39
Factor XIII deficiency
- bleeding from birth - prolonged umbilical stump bleeding - Tx = cryo or plasma
40
Vitamin K Dependent Factor Deficiency
II, VII, IX, X PTCC Plasma Check vitamin c as neonate = haemorrhagic disease of newborn