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OB Anesthesia > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

4 things a TEG identifies within minutes:

A
  1. Coagulation Cascade
  2. Platelet function
  3. Platelet-fibrin interactions
  4. Fibrinolysis
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2
Q

What does the R-value in a TEG measure?

A

Reaction time: time required for initial fibrin formation
Straight line on left: beginning until 2mm amplitude

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3
Q

What (2) influence the R-time and what is normal?

A
  1. Clotting factors
  2. Anticoagulants
    5-10 minutes
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4
Q

Normal TEG values depend on:

A

Which activator is being used: Tissue factor or Celite Activator

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5
Q

How long does it usually take for a TEG to result?

A

45-60 minutes

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6
Q

Which coagulation pathways are measured by the R value?

A

All- intrinsic, extrinsic, final common

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7
Q

What measurement is used to identify the end of the R value?

A

Amplitude increasing by 2 mm

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8
Q

A short R value indicates ______ coagulation, while a long R value indicates ______ coagulation.

A

increased, decreased

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9
Q

K value measures:

A

TEG tracing from 2-20mm; from end of R value to 20mm
-identifies speed of clot formation

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10
Q

What factor most commonly influences K value?

A

Fibrinogen or Factor 1

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11
Q

What should be given to patients with a prolonged K value?

A

Cryoprecipitate

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12
Q

What is the Alpha angle? normal measurement?

A

measures the horizontal axis and the tangent to the tracing at 20mm. Speed of clot formation via fibrin build up and cross linking. Also depends on K/Fibrinogen.
normal: 45-65 degrees

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13
Q

What should be given to patients with a decreased alpha angle?

A

Cryoprecipitate (fibrinogen deficiency)

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14
Q

Maximum Amplitude (MA) is the _________ measured width which identifies the ________ clot strength.

A

Largest, maximum

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15
Q

What determines the maximum amplitude?

A
  1. Platelet function
  2. cross linking of fibrin
  3. Fctrs II/III w platelet/fibrin interactions
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16
Q

What is a normal maximum amplitude (MA) value?

A

50-60mm

17
Q

What (2) should be given to patients with a low maximum amplitude?

A

platelets or DDAVP

18
Q

Coagulation occurs during what two points on the TEG?

A

R value through MA

19
Q

Which 3 things on a TEG identify clot strength?

A

K, Alpha angle, and MA

20
Q

What is LY on a TEG?

A

Lysis index: percent reduction in MA after 30 minutes; 0-7.5% can be a 30 or 60 min measurement

21
Q

What does the LY value on a TEG identify?

A

Clot stability, measures fibrinolysis

22
Q

What should be given to patients with increased LY30?

A

TXA or Amicar due to increased clot degradation

23
Q

TEG values (R, K, alpha angle, MA, LY) for hypercoagulation:

A

R: decr.
K: decr.
Alpha angle: incr.
MA: incr.
LY: ~

24
Q

TEG values (R, K, alpha angle, MA, LY) for hypocoagulation:

A

R: incr.
K: incr.
Alpha angle: decr.
MA: decr.
LY: incr.

25
Q

What does this TEG indicate?

A

Hemorrhagic: Low clotting factor function
-likely hemophilia or anticoagulation
Abnormal: prolonged R value

26
Q

What does this TEG indicate?

A

Hemorrhagic: Low platelet function
-likely thrombocytopenia or platelet blocker
Abnormal: increased K, decreased MA

27
Q

What does this TEG indicate?

A

Hemorrhagic: Low fibrinogen
Abnormal: prolonged K, decreased angle

28
Q

What does this TEG indicate?

A

Fibrinolysis!
Abnormal: progressively decreased MA, increased LY

29
Q

What does this TEG indicate?

A

Hypercoagulation

Abnormal: decr. R + K, incr. MA + angle

30
Q

What does this TEG indicate?

A

Hypercoagulation with primary fibrinolysis; DIC!

31
Q

How much weight is gained during each trimester + total?

A

1st: 1-2 kg
2nd: 5-6 kg
3rd: 5-6 kg
Total: 11-14 kg

32
Q

What parts make up most of the weight gained during pregnancy?

A
  1. fetus + placenta ~4kg
  2. fat deposits + protein ~4 kg
  3. ~1kg each: blood/interstitial volume, uterus, and amniotic fluid
33
Q
A

OB Anesthesia (1 decks)

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