Exam 1 Flashcards
4 things a TEG identifies within minutes:
- Coagulation Cascade
- Platelet function
- Platelet-fibrin interactions
- Fibrinolysis
What does the R-value in a TEG measure?
Reaction time: time required for initial fibrin formation
Straight line on left: beginning until 2mm amplitude
What (2) influence the R-time and what is normal?
- Clotting factors
- Anticoagulants
5-10 minutes
Normal TEG values depend on:
Which activator is being used: Tissue factor or Celite Activator
How long does it usually take for a TEG to result?
45-60 minutes
Which coagulation pathways are measured by the R value?
All- intrinsic, extrinsic, final common
What measurement is used to identify the end of the R value?
Amplitude increasing by 2 mm
A short R value indicates ______ coagulation, while a long R value indicates ______ coagulation.
increased, decreased
K value measures:
TEG tracing from 2-20mm; from end of R value to 20mm
-identifies speed of clot formation
What factor most commonly influences K value?
Fibrinogen or Factor 1
What should be given to patients with a prolonged K value?
Cryoprecipitate
What is the Alpha angle? normal measurement?
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
What should be given to patients with a decreased alpha angle?
Cryoprecipitate (fibrinogen deficiency)
Maximum Amplitude (MA) is the _________ measured width which identifies the ________ clot strength.
Largest, maximum
What determines the maximum amplitude?
- Platelet function
- cross linking of fibrin
- Fctrs II/III w platelet/fibrin interactions
What is a normal maximum amplitude (MA) value?
50-60mm
What (2) should be given to patients with a low maximum amplitude?
platelets or DDAVP
Coagulation occurs during what two points on the TEG?
R value through MA
Which 3 things on a TEG identify clot strength?
K, Alpha angle, and MA
What is LY on a TEG?
Lysis index: percent reduction in MA after 30 minutes; 0-7.5% can be a 30 or 60 min measurement
What does the LY value on a TEG identify?
Clot stability, measures fibrinolysis
What should be given to patients with increased LY30?
TXA or Amicar due to increased clot degradation
TEG values (R, K, alpha angle, MA, LY) for hypercoagulation:
R: decr.
K: decr.
Alpha angle: incr.
MA: incr.
LY: ~
TEG values (R, K, alpha angle, MA, LY) for hypocoagulation:
R: incr.
K: incr.
Alpha angle: decr.
MA: decr.
LY: incr.
What does this TEG indicate?
Hemorrhagic: Low clotting factor function
-likely hemophilia or anticoagulation
Abnormal: prolonged R value
What does this TEG indicate?
Hemorrhagic: Low platelet function
-likely thrombocytopenia or platelet blocker
Abnormal: increased K, decreased MA
What does this TEG indicate?
Hemorrhagic: Low fibrinogen
Abnormal: prolonged K, decreased angle
What does this TEG indicate?
Fibrinolysis!
Abnormal: progressively decreased MA, increased LY
What does this TEG indicate?
Hypercoagulation
Abnormal: decr. R + K, incr. MA + angle
What does this TEG indicate?
Hypercoagulation with primary fibrinolysis; DIC!
How much weight is gained during each trimester + total?
1st: 1-2 kg
2nd: 5-6 kg
3rd: 5-6 kg
Total: 11-14 kg
What parts make up most of the weight gained during pregnancy?
- fetus + placenta ~4kg
- fat deposits + protein ~4 kg
- ~1kg each: blood/interstitial volume, uterus, and amniotic fluid
