Final Flashcards
What are the hospital classifications?
Acute, chronic, children’s, obstetrical, mental health
Governance structure of the Hospital
Governing board, administration, medical staff, community served.
Hospital classifications
Government, non-profit, proprietary
Hemostasis
Dynamic process of blood clot formation at the site of vascular injury.
What are the stages of hemostasis?
Primary, secondary and tertiary
What are the phases of hemostasis?
Initiation and formation of the platelet plug
Propagation by the coagulation cascade
Termination by antithrombotic mechanism
Fibrinolysis
What are the three pathways to the coagulation cascade?
Intrinsic, extrinsic and common.
Extrinsic Coagulation
The “quick fix” in 10-15 seconds. Tissue Factors
Intrinsic Coagulation
Larger clot with lots of thrombin in 1-6 min. Contact Factors
Common Coagulation
Prothrombin to thrombin; fibrinogen to fibrin.
What are the most common laboratory assessments?
CBC, aPTT, PT/INR, bleeding time, TT, Platelet function/adhesion/aggregation, fibrinogen levels, Factor assays
What is the normal platelet level?
150-400k
What platelet count leads to spontaneous bleeding?
Less than 20k
What platelet count causes thrombocytosis?
More than 400k
What affects Bleeding Time?
Von Willibrands, ASA, NSAIDS
What does aPTT test?
Activated Partial Thromboplastin Time:
Intrinsic and the contact factors (XI, XII, VII, and IX) and Common (Factors II, prothrombin, V, X and I, fibrinogen).
What affects the aPTT?
Heparin, long term abx therapy, liver dz, malabsorption, cancer, infections, hemophilias, von Willebrand’s dz.
What does PT/INR Test?
Extrinsic: Tissue factor and Factor VII
Common: Factors II, V, X and fribinogen, Vitamin K dependent factors: II, VII, IX, X
What is a normal INR?
0.8-1.2
When is it safe to extract a single tooth?
If the INR is less than 3
Difference between aPTT and INR?
aPTT is intrinsic, INR is extrinsic.
What are thrombocytes?
Platelets from the bone marrow.
How long do thrombocytes last in circulation?
8-10 days.
What are the qualitative disorders of platelets?
Affecting bone marrow or liver dx, splenic sequestration, VonW dz, aspirin, NSAIDS, clopidogrel, COX 2 inhibitors, uremia.
What are quantitiative disorders of platelets?
Inherited or congenital. Rare!
Inherited Coagulopathies
Hemophilia A, B and C