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ipap > Heme 1 Cram 2 > Flashcards

Heme 1 Cram 2 Flashcards

1
Q

Micro

A 
ITFTSLR
T: UDU
A: DDUDDNL
I: DUDUDUH
L: UNU
S: UNU
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2
Q

Macro

A 
HMBFMH
12: DUDNUU
P: DUDNUU
F: DUNDNU
B: DUNDUU
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3
Q

Blood Transfusion

A 
O-O
A-OA
B-OB
AB: ALL
\+ only to +
- to +/-
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4
Q

What three steps make the initial platelet plug

What two phases are required

A

Adhesion Activation Aggregation

Vascular Platelet

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5
Q

Primary hemostasis

Secondary hemostasis

A

Endothelium damage: AAA, initial plug

Clotting cascade, plug reinforced w/ fibrin mesh

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6
Q

What are the 3 phases of hemostasis

A

Vascular: spasm

Platelet: release of vWF, carrier of F8= platelet adhesion

Coagulation: thrombin activates fibrinogen to form insoluble fibrin= thrombus/clot

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7
Q

During Platelet phase, what do they secrete

What is the final common location for platelet to platelet aggregation

A

ADP- activates G2b3a for fibrinogen acceptance
Thromboxane- constrictor

G1b3a

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8
Q

Intrinsic pathway includes ? factors

Extrinsic pathway includes ? factors

Common pathway includes ? factors

A

12 11 9 8

3 7

10 5 2 1

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9
Q

What is the only factor present in all pathways?

There is no Factor #?

A

Factor 4- Ca ions, accelerates clotting pathway
Citrus acid added to bind Ca and prevent clotting

6: Prothrombinase= combo of 5 and 10

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10
Q

What is the end result of the Common pathway?

Thrombin is a cofactor due to it being necessary for the activation of ?

A

Cross linked fibrin

5 8 11 13

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11
Q

What is Factor 13

What factors are vital to the common pathway

A

Fibrin stabilizing factor- combines w/ thrombin and Ca= cross link fibrin

1 2 4 5 10 13

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12
Q

Factor 4

Factor 3

Factor 2

Factor 1

A

Ca

Tissue factor

Prothrombin

Fibrinogen

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13
Q

? test assess intrinsic pathway

? test assesses extrinsic pathway

A

PTT

PT

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14
Q

? are the Vit K dependent factors

Deficiency of Vit K leads to ?

A

2 7 9 10 C/S

Prolonged PT

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15
Q

Why is coumadin, the Vit K antagonist, used as heparin bridge therapy

DIC means ? factor is completely depleted meaning there is no ?

A

Transient hypercoag, Protein C dec faster than other factors

Fibrinogen, no bridge during aggregation

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16
Q

Where is vWF made

What is Von Willebrand Dz

A

Endothelium

Defect platelet function (no plug)
Coagulation d/o (no F8 stabilization)

17
Q

Hemophilia C is deficient ?

What is the hallmark of bleeding d/o

A

Factor 11

Hemarthrosis w/ pain

18
Q

Platelet count below ? is at risk for spontaneous massive bleeds

What are life threatening hematomas

A

10K

Compartment
Airway
Retroperitoneal
CNA

19
Q

Coagulation factor problems are associated w/ ? vessels

PTT >100sec means?

A

Large

Risk for spot bleeds

20
Q

PT tests extrinsic path but does not test ? factor

INR range for DVT, PE, Afib or vascular heart Dz

INR range for mechanical heart valve or recurrent MI

A

3

2-3

2.5-3.5

21
Q

Only hemophilia ? can be in females

Severe, mod and mild hemophilia

A

C

S: 2-4/mon <1%, early Dx
M: 4-6/yr 1-5%, Dx 5-6
Mild: rare >5% Dx later
Mod: spot hemarthrosis
Mild: spot hemorrhage
22
Q

Hemophilia Tx

Key lab finding of VWDz

A

Factor replacement
DDAVP for mild Hem A

Inc PTT

23
Q

3 classifications of VWDz

A

1: quant
2: qual ABMN; Absence Rather bind w/ Gp1b May/not form strong bond No carrying F8
3: quant

24
Q

How is VWDz Tx

Circulating anticoagulants MC neutralize ? factors

A

DDAVP for Mild Type 1 and 2a/2b
Recombinant vWF for others

2 5 8 9 (Int)

25
Q

When is Circulating Anticoag Dx considered

How is it Tx

A

Excessive bleeding w/ prolonged PTT/PT that doesn’t correct w/ mixing test

+hemophilia: recombinatn F7
-hemophilia: Cyclo CCS Rituximab

26
Q

Coagulopathy of liver Dz affects all factors except ?

If this one exception IS affected, what Dx is considered

A

8, norm or inc

DIC

27
Q

What is the difference in mild/mod and sev Coagulopathy of LIver Dz

A

MIld: Inc PT, N PTT
Sev: Inc PT and PTT

28
Q

Define DIC

A

Excess Tissue Factor- too much thrombin and fibrin

Tx:
ABX for sepsis
Chemo for Ca
If sepsis was first: Protein C to regulate thrombin activity)

29
Q

DIC is initially ? and later ?

What is the body’s natural anticoagulant to prevent over clotting?

A

Bleeding, Ischemia

Anti-thrombin 3

30
Q

DIC score > ? relates w/ higher mortality

When would anticoag therapy be indicated in DIC

A

5 or more

Arterial thromboemboli w/ mural
Migratory thrombophlebitis w/ Trousseeau

31
Q

How is pseudothrombocytopenia (platelet clumping) r/o

MC cause of immune thrombocytpoenia

A

Repeat platelet count in EDTA tube (sodium citrate)

ITP
Acute: kids
Chronic: adults

32
Q

What PE finding is not common in ITP

Where are Sxs seen in sequence

A

Splenomegaly

Skin- lack of this= low risk for cranial bleeds
Mucous membrane
Viscer

33
Q

How is ITP Tx

A

New onset w/ <25K: CCS, possible IVIG/anti-D

Intracranial/GI bleed- platelet transfusion

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