Hem Onc Review pt2

Question 1

Heparin inhibits activity at what factors?

Answer 1

XA and IIA

Question 2

When doing massive transfusion to treat an aquired bleeding disorder, what must you also give?
Why?

Answer 2

FFP

to overcome anticoag fx of sodium citrate

Question 3

Causes of acute DIC are ____-related

What are they (2)

Answer 3

Hyperfibrinolysis
Gram neg sepsis infxn
Malignancies like APL

Question 4

Subacute/chronic causes of DIC are ____-related

What are they? (4)

Answer 4

Prothrombic (increased thrombin)
Mucinous adenocarcinomas
retained dead fetus
venous/pulm thrombosis
connective tissue disorders

Question 5

All 4 are abnormal, the PT, PTT, Platelet, & Fibrinogen lvls…what is it?

Answer 5

DIC

Question 6

Tx of DIC

Answer 6

tx underyling ds, FFP/platelets

Question 7

In DIC, what do you give for acral cyanosis, digital ischemia, migratory thrombophletbitis, or retained dead fetus?

Answer 7

Heparin

Question 8

what-shape formation of megakaryocytes in bone marrow?

Answer 8

Pseudopod

Question 9

what will prolong bleeding time >9 minutes?

Answer 9

Qualitative/quantitative platelets defect/dysfunction

Question 10

What is ITP?

tx? (3)

Answer 10

immune thrombocytopenic purpura
Pathogenic autoantibodies bind platelets, resulting in accelerated platelet clearance

Tx: steroids, if severe: splenectomy
but must also get Pneumococcal, H flu, and meningococcal vaccines 2 weeks prior

Question 11

Fever, mental status changes, renal insufficiency, microangiopathic hemolytic anemia, and thrombocytopenia is the pentad of sx for

Answer 11

Thrombotic microangiopathy

Question 12

ADAMTS-13 is found in

Answer 12

TTP

Question 13

Common finding in TTP & HUS (2)

The tx?

Answer 13

Microangiopathic hemolytic anemia, thrombocytopenia

tx for both: plasma exchange

Question 14

How to differentiate btwn TTP & HUS

Answer 14

TTP: fever, neuro defecit in adults, decreamsed adamts-13
HUS: renal insuff, usu in children, positive stool for e coli 0157-H7

Question 15

What platelet disorder has stool with e coli 0157-h7?

Answer 15

Hemolytic uremic syndrome

Question 16

What happens withi elevated homocysteine?

tx of homocystenemia

Answer 16

endothelial cell dysfunction leading to a prothrombotic surface.

tx: Folic acid

Question 17

What’s the most common protein defect?

Answer 17

factor v leiden

Question 18

inactivated protein C leads to increased factor Va in:

Answer 18

Factor V leiden

Question 19

increased fibronolysis and increased thrombin formation (related to Vit K dependent clotting factors) is found in

Answer 19

Protein C defect

Question 20

What are the vitamin k dependent clotting factors (2)

Answer 20

Va, IIIa

Question 21

What happens in antiphospholipid antibody syndrome?

Answer 21

antiphospholipid antibodies bind to endothelium and intefere with antocoagulation by messing with Annexin V

Question 22

Annexin V is messed up in what?

Answer 22

Antiphospholipid antibody syndrome

Question 23

Protein s leads to what?

Answer 23

Protein C and its sx: inc fibrinolysis, inc thrombin formation (with vit-k factors)

Question 24

Aspirin’s MoA

Answer 24

inhibits A2 synthesis from arachadonic acid

Question 25

Aspirin blocks COX #?

Answer 25

1

Question 26

aspirin and nsaids rule

Why?

Answer 26

Take aspirin either 30 min prior or 8 hours post NSAIDS

b/c can obstruct access of aspirin to serine and doing its job

Question 27

Heparin binds to what? to inhibit what?

Answer 27

Antithrombin III

Inhibits circulating thrombin and factor XA

Question 28

What test should be used with Heparin?

Should be what its normal lvl?

Answer 28

PTT

1.5-2.5 fold

Question 29

HITTS Type 2 is Ig__ mediated.

Answer 29

Ig-G

Question 30

Reverse Warfarin OD (2 ways)

Answer 30

emergency: FFP

otherwise Vit K

Question 31

MoA of Clopiodrel

Answer 31

irrev inhibits binding of ADP to its receptors on platelets.