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Foundations of Anesthesia 1 > Exam 2 Coag Questions > Flashcards

Exam 2 Coag Questions Flashcards

1
Q

What are 5 procoagulants

A

Coagulation Factors
Collagen
vWF
Fibronectin
Thrombomodulin

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2
Q

Coagulation Factors are classified as what kind of mediator? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Procoagulant
Function to promote clotting/coagulation

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3
Q

What kind of mediator is collagen classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Procoagulant.
A potent and important stimulus for platelet attachment to the vessel wall.

“Tensile strength” can withstand force.

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4
Q

What kind of mediator is vWF classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Procoagulant.

Makes platelets “sticky” and allows platelets to adhere to the site of injury.

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5
Q

What kind of mediator is Fibronectic classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Procoagulant

Mediates cell adhesion

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6
Q

What kind of mediator is Thrombomodulin classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Procoagulant
Regulates anticoagulation pathway.

(per Ninja nerd, binds thrombin. Thrombin then activates Protein C. Protein C inactivates factors 5 and 8.)

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7
Q

What are 4 AntiCoagulant mediators?

A

AntiThrombin III
Protein C
Protein S
Tissue Pathway Factor Inhibitor

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8
Q

What kind of mediator is AntiThrombin III classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

AntiCoagulant
Degrades Factors 10a, 9a and 2, (12 &11?)

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9
Q

What kind of mediators are Protein C and S classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

AntiCoagulants

Protein S is a cofactor for Protein C.
Protein C degrades Factor 5 and 8.

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10
Q

What kind of mediator is Tissue Factor Pathway Inhibitor classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

AntiCoagulant
Inhibits Tissue Factor

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11
Q

What are two vasodilatory mediators

A

Nitric Oxide and Prostacyclin

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12
Q

What kind of mediator is Nitric Oxide classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Vasodilator

-Promotes smooth muscle relaxation and vasodilation
-Reduces platelet adhesion and aggregation by inhibiting binding of fibrinogen between glycoproteins
-Reduces leukocyte (WBC) adhesion

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13
Q

What kind of mediator is Prostacyclin classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Vasodilates, inhibits aggregation
Promotes smooth muscle relaxation

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14
Q

What are three vasoconstrictor mediators

A

Thromboxane A2
ADP
Serotonin

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15
Q

What kind of mediator is Thromboxane A2 classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Vasoconstrictor
vasoconstricts lol (add more later)

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16
Q

What kind of mediator is ADP classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Vasoconstrictor
vasoconstricts lol (add more later)

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17
Q

What kind of mediator is Serotonin classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Vasoconstrictor
vasoconstricts lol (add more later)

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18
Q

What are three fibrinolytic mediators?

A

Plasminogen
tPA (tissue plasminogen activator)
Urokinase

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19
Q

What kind of mediator is Plasminogen classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Fibrinolytic

Converts to plasmin

20
Q

What kind of mediator is tPA classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Fibrinolytic

Activates plasmin

21
Q

What kind of mediator is Urokinase classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Fibrinolytic

Activates plasmin

22
Q

What are two anti-fibrinolytics?

A

Plasminogen Activator Inhibitor
alpha-antiplasmin

23
Q

What kind of mediator is Plasminogen Activator Inhibitor classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Antifibrinolytic

Inactivates tPA and urokinase

24
Q

What kind of mediator is alpha-antiplasmin classified as? :
Procoagulants
AntiCoagulants
Vasodilator
Vasoconstrictor
Fibrinolytic
or Antifibrinolytic

What is their function?

A

Antifibrinolytic
Inhibits Plasmin

25
Q

What factors make up the Extrinsic Pathway

A

Factor 3 - Tissue Factor (Thromboplastin)
Factor 7 - Proconvertin Factor (labile)

26
Q

Vitamin K is created by? And is it necessary for the formation of which factors?

A

Created from bacteria in the gut and is necessary for the formation (in the liver) of Factors 2, 7, 9, 10

27
Q

What are two antifibrinolytic (anticlot breakdown) medications?

A

Aminocaproic Acid
Tranexamic Acid (TXA)

28
Q

How does Aspirin affect coagulation?

A

Directly affects the life of the platelet by !irreversibly! inhibiting cyclooxygenase (COX), resulting in decreased platelet function

29
Q

The PT lab value will be prolonged when patients have abnormalities or deficiencies in?

A

factors specific to the extrinsic (3 & 7) and common pathways (10, 9?, 2, 1)

30
Q

What is a normal INR?

A

Apex: ~1
Nagelhout: 1.5-2.5

31
Q

aPTT is used to evaluate the efficiency of the ____ and the common coagulation pathway. This includes which factors?

A

Intrinsic: 12, 11, 9, and 8
Common: 10, 5, 2, 1 and ultimately 13

31
Q

Normal ACT

A

Apex: 90-120
Nagelhout: 90-150

32
Q

ACT is used to measure?

A

Activated Clotting Time. Ability to clot. Also can be used to regulate heparin therapy.

33
Q

TEGs provide an indication of what 5 processes?

A
  1. Clot Strength
  2. Platelet number and function
  3. Intrinisic Pathway defects
  4. Thrombin formation
  5. Rate of fibrinolysis
34
Q

What are four very high risk for bleeding procedures? What should the minimum platelet count be?

A

Neurosurgery
Ocular surgery (except cataracts)
Thyroid Surgery
Prostatectomy

75,000-100,000

35
Q

What is the MABL (maximum allowable blood loss) equation?

A

MABL = EBV x (Starting Hct(or hgb) - Minimum acceptable Hct(or hgb) ) / all of the above divided by hematocrit (or hgb) level

36
Q

Which blood product carries the greatest risk for bacterial transmission?

A

platelets

37
Q

Fresh Frozen Plasma (FFP) contains?

A

All coagulation factors, especially factors 2, 7, 9, and 10
AND
naturally occurring inhibitors Protein C and S, and AntiThrombin III

38
Q

What lab values may indicate you should administer FFP?

A

PT and aPTT prolonged more than 1.5 times normal.

39
Q

Cryoprecipitate contains?

A

Fibrinogen, Factor 8 and 13.
vWF

40
Q

Describe Type 1 vWF disease and how you would treat it before surgery?

A

Mild-Moderate reduction in vWF production. Treated with Desmopressin (0.3mcg.kg)
Cryo if there is no response or availability

41
Q

Describe Type 2 vWF disease and how you would treat it before surgery?

A

vWF that is produced doesnt work well.
Bleeding patients with type 3 should be given vWF/Factor 8 concentrate or Cryo.

42
Q

Describe Type 3 vWF disease and how you would treat it before surgery?

A

Severe reduction in amount of vWF produced. First line treatment is purified factor 8 / vWF concentrate. If not available then Cryo

43
Q

What coagulation lab values would you expect in a patient with Hemophilia A? What would be the treatment before surgery?

A

PTT increased and PT normal

Factor 8 concentrate before surgery (or cryo)

44
Q

What coagulation lab values would you expect in a patient with Hemophilia B? What would be the treatment before surgery?

A

Foundations of Anesthesia 1 (17 decks)

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