Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Health Assessment SEM 2 > Exam 3: Blood Disorders > Flashcards

Exam 3: Blood Disorders Flashcards

1
Q

What is the most common hereditary bleeding disorder?

A

vWF disorder (platelet adhesion dysfunction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the S/S of vWF disorder?

A

Easy bruising
epistaxis
menorrhagia (menstrual bleeding)

patient usually unaware until questionnaire/surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What would lab values be for someone with vWF deficiency?

A
  • Normal PT & aPTT
  • Bleeding time is prolonged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the treatments for vWF deficiency?

A
  • Desmopressin
  • Factor VIII
  • cryo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does DDAVP work in regards to treatment of von Willebrand deficiency?

A

Stimulates vWF release from endothelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the dose for DDAVP?

A

0.3- 0.8 mcg/kg in 50 mL over 10-15 mins (Do not bolus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the onset & duration of DDAVP?

A
  • Onset: 30mins (max effect)
  • Duration: 6-8hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the side effects of DDAVP?

A
  • HA
  • Stupor
  • hypotension
  • tachycardia
  • hyponatremia (d/t retention of water, pt needs to be on fluid restriction)
  • water intoxication (excessive water retention… patient needs to be on water restriction for 4-6 hours after administration)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the major side effect of DDAVP?

A

Hyponatremia

Na+ 120: Confusion, restlessness, wide QRS
Na+ 115: Somnolence, nausea, elevated ST, wide QRS
Na+ 110 Seizure, coma, V-tach, V-fib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Someone that gets DDAVP needs to be on what?

A

Fluid restriction 4-6hrs after DDAVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What blood product can be utilized for vWF disease if the patient is unresponsive to DDAVP?

A

Cryoprecipitate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

1 unit of Cryo raises the ____ level by ___?

A

Fibrinogen by 50 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a potential risk factor with cryoprecipitate?

A

Increased risk of infection (not submitted to viral attenuation)

comes in 2-10 pooled units… multiple donors like platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Factor VIII concentrate made of?

A

Pool of plasma from a large number of donors.
Contains Factor VIII and vWF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is Factor VIII given?

A

Preop and during surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What blood product poses an increase risk for infection? Why?

Which blood product doesn’t have increased risk of infection?

A
  • Cryoprecipitate
  • Not sent for viral attenuation
  • F VIII undergoes viral attenuation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pts with coagulopathies undergoing neuraxial anesthesia are at increased risk for what?

A
  • epidural Hematoma
  • paralysis
  • Nerve compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the anesthesia considerations for someone with vWF deficiency?

A
  • Avoid trauma (Get the best intubator performing DL)
  • avoid IM sticks (Will cause localized tissue trauma)
  • avoid arterial lines (if feasible)
  • avoid spinals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does heparin work?

A
  • Heparin activates antithrombin III
  • AT-III will inhibit thrombin
  • negatively charged

thrombin needed to convert fibrinogen -> fibrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What labs are monitored with heparin?

A

PTT &/or ACT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the mechanism of action of Coumadin?

A

Interferes with hepatic synthesis of vitamin K-dependent factors: II, VII, IX, X

22
Q

Which factors are vitamin-K dependent?

A

II, VII, IX & X

23
Q

What is the onset for Vitamin K?

24
Q

What drugs/products can be given to reverse coumadin faster than Vit K?

A
  • Prothrombin complex concentrates
  • Factor VIIa
  • FFP
  • Cryo
25
What is the mechanism of action for fibrinolytics (UK, streptokinase & tPA)?
Convert plasminogen to plasmin, which cleaves fibrin - Causes clot dissolution
26
How do tranexamic acid (TXA), aminocaproic acid, and aprotinin work?
Inhibit conversion of plasminogen to plasmin
27
What is the best way to treat DIC?
Treat the underlying cause
28
What will labs show for someone in DIC?
- ↓PLTs - Prolonged PT, PTT & TT (thrombin time) - ↑ fibrin degradation products
29
When is antifibrinolytic therapy given to someone in DIC?
Trick question, it shouldn’t. Can lead to catastrophic thrombotic complications TX: blood components to replace coagulation factors and platelets
30
What is factor V?
- Protein for normal clotting When enough fibrin has been made, Activated protein C inactivates factor V thus stopping clot growth (negative feedback)
31
What is Factor V Leiden deficiency?
Genetic mutation of Factor 5 * Activated protein C can't stop factor V Leiden from making more fibrin Clotting disorder
32
What does Activated Protein C do?
Inactivates factor V when enough fibrin has been made
33
Who is usually tested for Factor V Leiden?
**Pregnant women.** Especially ones with unexplained late stage miscarriages
34
What anticoagulant medications could a pregnant woman with Factor V Leiden be put on?
#1 LMWH (lovenox) - warfarin - unfractionated heparin
35
What is the hallmark sign of HIT?
Plt count <100,000 Autoimmune thrombocytopenia occurs 5-14 days after initial heparin therapy and affects 5% of patients exposed to unfractionated heparin and rare cases LMWH
36
HIT results in ____ activation and potential____?
platelet; thrombosis (arterial and venous)
37
What is heparin replaced with when HIT is diagnosed?
direct-thrombin inhibitors - Argatroban - Bivalirudin - Lepirudin
38
What is Fonaparinaux & when is it used?
A synthetic Factor Xa inhibitor - used to treat VTE in HIT
39
What timing should DDAVP be given?
60 minutes before surgery
40
What type of anesthesia to use for increased risk bleeding disorders?
general anesthesia
41
What's a normal ACT level? Systemic anticoagulant goal?
150 seconds systemic anticoagulation goal 350-400
42
What do you give if Heparin not increasing ACT?
FFP provides antithrombin
43
what reverses Heparin?
Protamine positively charged polypeptide forming a stable complex neutralizing heparin
44
Sign of toxicity of TXA?
color blindness
45
Dose of TXA in adults and kids?
Adults: 1-2g IVP or in 50 mL bag * 2g bolus then additional if needed Kids: 15 mg/kg
46
What 2 reason is TXA commonly used for?
menorrhagia recurrent epistaxis
47
What's used to score sepsis/ DIC?
APACHE score
48
What is DIC?
systemic activation of the coagulation system simultaneously leading to thrombin formation and exhaustion of platelets and coagulation factors
49
What are 2 prothrombotic disorders?
HIT factor V Leiden
50
What immune complexes is HIT mediated by?
IgG antibody, platelet factor 4 (PF4), and heparin *usually clear from the circulation within 3 months
51
Plateletes developing HIT during Heparin therapy should experience substanantially increased risk for thrombosis is what percentage?
30-75%

Health Assessment SEM 2 (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions