Final Exam Review Mod 9-16 Flashcards
Heparin is measured in
Heparin is measured in
The formation or presence of a blood clot within the vascular system is termed
thrombosis.
Calcium and vitamin K play vital roles in the process of clot formation.
TRUE
The clotting cascade requires calcium at all stages—that is, calcium enables many of the steps. Vitamin K also plays a vital role in coagulation.
Which vitamin serves a vital role in coagulation?
vitamin k
Vitamin K is a fat-soluble vitamin; it promotes blood clotting by increasing synthesis of coagulation factors. Vitamin K is necessary to synthesize prothrombin (factor II), proconvertin (factor VII), plasma thromboplastin component (factor IX), and the Stuart-Prower factor (X).
Which systemic coagulant is contraindicated in patients with a history of malignant hyperthermia?
Calcium salts
Calcium salts are not given to patients with a history of malignant hyperthermia (MH) because one aspect of MH is increased calcium release from muscle cells.
If a venous clot breaks off and travels to the heart, it is called a(n)
embolus.
Agents that dissolve already formed clots are called
thrombolytics
Thrombolytics are agents used to help speed the breakdown of existing blood clots as observed in conditions such as deep-vein thrombosis (DVT), pulmonary embolism (PE), coronary artery thrombosis, and myocardial infarction.
Which solution may be used as an irrigation solution at the sterile field during an atrioventricular (AV) fistula insertion?
5000 units heparin in 1000 mL saline
Heparin is also frequently used from the sterile back table during peripheral and cardiovascular procedures. A dilute solution, such as 5000 units heparin in 1000 mL normal saline, is commonly used as a topical arterial irrigant.
Which form of anticoagulant is used for long-term management of deep vein thrombosis (DVT)?
Oral
Which one of the following is not a systemic coagulant?
Protamine sulfate
The antidote for heparin is protamine sulfate, a parenteral anticoagulant that binds with and inactivates heparin. (See Box 9-2 for a summary of systemic coagulants.)
A tiny piece of gelfoam used during a tympanoplasty procedure is called a
pledget.
If a blood clot is formed in an artery, which course of treatment is most likely?
Surgical
Arterial embolectomy may be necessary when blood clots form in the femoral, popliteal, or tibial artery. If a blood clot forms in a vein, medical treatment may be sufficient. With bed rest and the administration of a thrombolytic agent, such a clot may dissolve.
During the second stage of blood clot formation, __________ is formed.
thrombin
Stage 2: Thromboplastin converts prothrombin (known as factor II) into thrombin
Which one of the following is a systemic anticoagulant?
Heparin
During the third stage of blood clot formation, __________ is formed.
fibrin
Stage 3: Thrombin converts fibrinogen (known as factor I) to fibrin.
Which one of the following is used to correct deficiencies in the natural clotting mechanism and may be administered preoperatively or intraoperatively?
Systemic coagulants
Systemic coagulants are agents that replace deficiencies in the natural clotting mechanism. If needed, systemic coagulants are usually administered preoperatively. Occasionally, the anesthesia provider may administer a systemic coagulant intraoperatively.
Which one of the following agents is a chemical hemostatic?
Which one of the following causes a chemical burn to stop capillary bleeding?
Silver nitrate
Some hemostatic agents, such as tannic acid and silver nitrate, chemically cauterize bleeding surfaces.
A blood clot within an intact blood vessel is called a(n)
thrombus
When a blood clot, or thrombus, forms within an intact blood vessel, a mechanism in the blood acts to dissolve the clot naturally.
Which one of the following hemostatic agents creates a mechanical barrier to control bleeding?
Bone wax
Which one of the following is not a function of heparin?
Breakdown of fibrin
Heparin acts by binding to antithrombin III (AT III, a protein), which greatly increases AT III’s ability to inhibit the action of coagulation factors thrombin, Xa, and IXa. Binding with AT III enables heparin to work at several points in the clotting cascade by inhibiting factor X, interfering with prothrombin-to-thrombin conversion, and inactivating thrombin, thus preventing of fibrinogen-to-fibrin conversion. Heparin also interferes with platelet aggregation.
Which one of the following parenteral anticoagulants is used most often?
Heparin sodium
Streptokinase
is a thrombolytic medication
Which naturally occurring mechanism is the most dominant in blood?
Anticoagulants are the most dominant because they keep the blood in liquid form and not clotted (dried up).
Which one of the following hemostatic agents promotes platelet aggregation leading to clot formation?
Avitene directly applied to bleeding surfaces attracts platelets to the substance, thus triggering further platelet aggregation leading to the formation of a fibrin clot.
Drugs that promote clot formation are termed
Coagulants are drugs that promote, accelerate, or make possible blood coagulation
What is the onset of heparin (in minutes)?
5 minutes
Which one of the following hemostatic agents causes adhesion formation if it comes in contact with nonbleeding tissues?
Avitene contact with nonbleeding surfaces must be avoided because adhesions may result.
dissolve existing blood clots and would be contraindicated in hemorrhage.
Thrombolytics
a dry, fibrous preparation of purified bovine corium collagen.
Avitene MCH
During the first stage of blood clot formation, __________ is formed.
Stage 1: Thromboplastin (also known as prothrombin activator) is formed.
Bone wax is used primarily in which one of the following surgical specialties?
Neurosurgery
Avitene must be applied with a __________ instrument.
Avitene should be applied with dry instruments only, because it will adhere to wet surfaces.
Which one of the following drugs is used to reverse the effect of heparin?
The antidote for heparin is protamine sulfate, a parenteral anticoagulant that binds with and inactivates heparin.
Hemostatic agents are effective against major arterial or venous bleeding.
FALSE
These agents serve as adjuncts to natural coagulation, which controls minor capillary bleeding. Thus traditional hemostatic medications are not effective against arterial or major venous bleeding.
What is the duration of heparin (in hours)?
2-4 hours
Which one of the following procedures is performed to remove a blood clot?
Arterial embolectomy
Anticoagulants are used for
Anticoagulants help prevent new clots from forming.
include Gelfilm, Gelfoam powder and sponges (Fig. 9-3), and Surgifoam.
form of absorbable gelatin?
Which hemostatic agent was developed to treat severe traumatic bleeding on the battlefield?
QuikClot was developed to treat severe traumatic bleeding on the battlefield, in trauma situations by emergency responders, and by law enforcement; it is not intended for use in the surgical setting.
What is the generic name for Coumadin?
Warfarin sodium (Coumadin), a coumarin derivative, is a widely prescribed oral anticoagulant.
Vitamin K is available as
AquaMEPHYTON.
Microfibrillar collagen hemostat is derived from
bovine corium collagen
How long does the intrinsic pathway take to form a clot?
Minutes
Which group of drugs is given intravenously to dissolve existing blood clots?
Thrombolytics are agents given intravenously to dissolve existing blood clots.
Damage to a small blood vessel results in spasm and tissue damage, which causes a series of reactions; these reactions produce
a protein called fibrin.
A “net” that traps blood cells to form a clot is called
Fibrin is a mesh of protein threads—a net that traps blood cells to form a clot.
Agents that inhibit the process of blood clot formation are called
Anticoagulants inhibit clotting.
Which one of the following hemostatic agents should be used immediately after it is reconstituted?
Thrombostat
Which one of the following hemostatic agents may be used dry or moist and is available in film, powder, and sponge forms?
Gelatin hemostatics may be used dry or moistened with saline and are available in Gelfilm and Gelfoam powder and sponges.
What is the duration of Coumadin?
The onset of action of warfarin is prolonged, usually 12 to 72 hours; its duration is 2 to 5 days.
Examples of absorbable collagen sponges are
Collastat, Helistat, Hemopad, and Instat.
Intravenous administration of _________ is associated with anaphylactic reactions and should not be attempted unless no other venue is available.
When surgery is needed urgently, vitamin K may be administered intravenously, but an increased risk of anaphylaxis exists and it takes approximately 6 hours to produce an acceptable effect.
Which one of the following is not a thrombolytic drug?
Warfarin is an oral anticoagulant.
What is the onset of Coumadin?
The onset of action of warfarin is prolonged, usually more than 2 days; its duration is 5 to 7 days.
are systemic coagulants used to replace deficiencies in the natural clotting mechanism.
Calcium salts
Examples of oxidized regenerated cellulose include
Surgicel gauze, Surgicel NuKnit (a knitted fabric), and Surgicel Fibrillar
What types of hemostatics are used on areas of capillary bleeding?
Hemostatics are topical agents.
Blood clots may dissolve naturally, because blood normally contains the clot-dissolving enzyme,
fibrinolysin.
