Hematology Flashcards
In the awake, non anesthetized patient suspected of having a hemolytic post-transfusion reaction, the most characteristic signs are:
a) Diffuse bleeding and hypotension.
b) Oliguria and hemoglobinuria.
c) Nausea and vomiting.
d) Fever and chills.
B
The incidence of post-operative venous thromboembolism is increased in patients with genetically determined procoagulant states. The following are all procoagulant states, EXCEPT:
a) antithrombin-III deficiency
b) resistance to activated protein C (Factor V Leiden)
c) antiphospholipid antibodies (lupus anticoagulant)
d) hypohomocystinemia
D
What factor is deficient in Hemophilia A?
Factor VIII
Hemophilia A Treatment (2)
- Desmopressin
- If not available, cryoprecipitate
What factor is deficient in Hemophilia B?
Factor IX
Treatment for Von Willebrand Disease
- Desmopressin
- Factor VIII Concentrate
- Cryoprecipitate in severe refractory cases
Causes of Vitamin K deficiency (5)
- Warfarin
- Poor nutrition
- Changes in intestinal flora
- TPN
- Biliary obstruction
Laboratory signs of DIC (6)
- Increased PT
- Increased aPTT
- Increased INR
- Decreased platelet activity
- Decreased fibrinogen
- Increased D-dimer
How to diagnose HITT?
- Screen with the 4T scoring
- Serotonin release test or ELISA or platelet-activation test
What does cryoprecipitate replace?
VWF, fibrinogen, and some clotting factors
One unit of blood increases the Hct by how much?
3 to 4%
What platelet count is associated with spontaneous bleeding?
<20,000
What is the cause microcytic anemia until proven otherwise?
Colon cancer
When should aspirin administration be discontinued preoperatively?
1 week
What can move the oxyhemoglobin dissociation curve to the right? (3)
Acidosis; 2,3-DPG; fever; elevated PCO2 (to the right means greater ability to
release the O2 to the tissues)
67-year-old patient with liver failure and s/p fall in the operating
room for an exploratory laparotomy; the patient develops
progressive oozing; the PT and PTT are normalized; platelets =
300,000; fibrinogen = 49.7
Dibrinogen
8-year-old boy with hemophilia A with spontaneous bruising and
nosebleed
Dactor 8
7-year-old boy with hemophilia B with large right knee hemoarthrosis
Factor 9
23-year-old woman with von Willebrand’s disease who develops
bleeding complications
First try DDAVP; then cryoprecipitate prn
What is DIC
Activation of the coagulation cascade leading to thrombosis and consumption leading to bleeding
