Hematology: Clotting & Bleeding Disorders Flashcards
do platelets have nuclei?
no
first line of defense against blood loss?
platelets
enlarged spleens have low or high platelet count and why?
low b/c platelets are trapped
classic sign of low platelet count?
petechiae
Thrombocytopenia s/s
petechiae, purpura (subcutaneous bleeding, ecchymosis (bruising), bleeding, painful joints
purpura
large subcutaneous bleeding
ecchymosis
brusing
Thrombocytopenia
an abnormal decrease in # of platelets
Idiopathic Thrombocytopenia Purpura (ITP)
increased destruction of platelets b/c of anti platelet antibodies (Its an autoimmune response)
acute Idiopathic Thrombocytopenia Purpura (ITP) onset
affects children
chronic Idiopathic Thrombocytopenia Purpura (ITP) onset
affects adults
Thrombotic Thrombocytopenia Purpura (TTP)
combo of thrombocytopenia and hemolytic anemia
what happens with Thrombotic Thrombocytopenia Purpura (TTP)
blood clots occur
s/s of Thrombotic Thrombocytopenia Purpura (TTP)
fever, renal failure, neurologic symptoms: confusion, h/a, seizures, death
causes of Thrombotic Thrombocytopenia Purpura (TTP)
alcoholism, HIV, congenital syphilis, maternal viral infection, cancer
what does it mean if there is an increase in Mean Platelet Volume (MPV)?
body is making plts=you don’t need a blood transfusion
Thrombocythemia
increased number of platelets
causes of thrombocythemia
acute stress, anemia, polycythemia vera, chronic inflammatory diseases, its where spleen is removed
Thrombocytopathy
normal amount of plts but they don’t clot
which drugs cause thrombocytopathy (plts can’t clot)
ASA, antihistamines, NSAIDS
what chronic problem can thrombocytopathy cause?
chronic renal failure
hemostasis
the stopping of the flow of blood
hemostasis process
vasospasm (to reduce blood loss) formation of platelet plug & development of a fibrin clot
von Willebrand factor
protein that helps platelets clot
clotting cascade: extrinsic pathway
starts when blood is exposed to tissue
clotting cascade: intrinsic pathway
starts when blood comes in contact with college in the damaged vessel wall
clotting cascade: common pathway forms at what level?
10
fibrinolysis
breakdown of fibrin
plasmin
protein that lyses fibrin
Tissue Plasminogen Activators (TPA) is activated only when what is present?
active only in the presence of fibrin
fibrin
helps with clots
PT; which pathways are examined?
used to monitor coumadin levels, looks at extrinsic & common pathway in clotting
aPTT; which pathways are examined?
used to monitor heparin therapy, looks at intrinsic & common pathway in clotting
Virchow’s Triad:Thrombosis
made up of 3 factors: 1.)decreased blood flow 2.)vessel injury 3.) Changes in intrinsic properties of blood (hyper coagulability)
Hemophilia
lack of factor 8, sex-linked recessive
Hemophilia B (Christmas disease)
lack of factor 9
female genome
XX
male genome
XY
s/s Hemophilia
joint swelling, pain, limited ROM
Hemophilia treatment
factor 8 fresh dozen plasma
Disseminated Intravascular Coagulation (DIC)
clotting & hemmorage occur at same time
causes of DIC
sepsis, postpartum hemorrhage, ca, burns, shock, gram - sepsis
DIC labs (D-dimer and fibrinogen)
increased D-dimer, decreased fibrinogen
Idiopathic Thrombocytopenia Purpura (ITP) is what kind of immune response?
autoimmune
