Diagnostics

Question 1

TEG

Answer 1

R- reaction time, time of onset to fibrin formation
K-rate of fibrin formation
alpha- rate of fibrin formation
MA- strength of clot
Lys30 and Lys60- percentage of the fibrin clot that has lysed at 30 and 60 minutes

Question 2

ROTEM

Answer 2

CT- clot time
CFT- clot formation time
MCF- maximum clot firmness

Question 3

Hypercoagulable

Answer 3

Time until onset of fibrin formation- short R/CT
Rate of fibrin formation- short K, high alpha/ short CFT
Strength of fibrin clot- high MA/ MCF

Question 4

Hypocoagulable

Answer 4

Time until onset of fibrin formation- long R/CT
Rate of fibrin formation- long K, low alpha/ long CFT
Strength of fibrin clot- low MA/MCF

Question 5

How does hct affect TEG results?

Answer 5

Lower hematocrits lead to hypercoagulable tracings with higher hematocrits causing the opposite trend. This is thought to be an artifact of the change in red blood cell number versus reflecting a real change in vivo. This severely impacts the use of this test to diagnose hyper- and hypercoagulable disorders in anemic or polycythemic patients.

Question 7

pH equation

Answer 7

pH= pKa + log [HCO3-/(PCO2 x SC)]

When HCO3- goes up/down, PCO2 should go up/down to keep pH stable

Question 8

HCO3-

Answer 8

Lower value = lower H+ buffering capacity

Normal range: 22-29 mEq/L
Metabolic Acidosis: <22mEq/L

Question 9

Base excess

Answer 9

The amount of acid or base necessary to titrate 1L of blood to a pH of 7.4 if PCO2 is held constant.

Reflective of no respiratory component of the organisms buffer systems

-2 +/- mEq/L

Question 10

Understand acid/base disorders

Answer 10

Question 11

Increased Anion Gap

Answer 11

-Diabetic ketoacidosis
-Uremia
-Ethylene glycol intoxication
-L-Lactic acidosis

Question 12

Normal or Low Anion Metabolic Acidosis

Answer 12

-Renal bicarbonate loss
-GI bicarbonate loss
-Dilutional acidosis
-Addison’s Disease
-Hypoalbuminemia

Question 13

AFAST sites

Answer 13

-diaphragmatico-hepatic: diaphragm, liver, gallbladder, ventral stomach
-cystocolic: urinary bladder, colon
-hepato-renal: coddle liver low, right kidney, duodenum
-spleno-renal: spleen, left kidney, intestines
-umbilical: intestines, spleen

Question 14

Pulse pressure

Answer 14

The difference between systolic and diastolic arterial blood pressure
Should be 40 mmHg

Determinants of pulse pressure are arterial compliance, stroke volume and preload