HEME

Question 1

Findings with disseminated intravascular coagulation (DIC)

Answer 1

thrombohemorrhagic

increase in both thrombin and plasmin in the circulation which predisposes to both bleeding and clot formation

Both small and large vessels are at risk for thrombosis

elevated PT and aPTT, with thrombocytopenia
and an increased bleeding time

Anti-thrombin III and plasminogen levels will be decreased

Question 2

Antithrombin deficiency

Answer 2

is an autosomal dominant genetic disorder. Antithrombin III (ATIII) is a potent inhibitor of the coagulation cascade. It is a nonvitamin K-dependent protease that inhibits coagulation by lysing thrombin and factor Xa. ATIII activity is markedly potentiated by heparin; potentiation of its activity is the principle mechanism by which both heparin and low molecular weight heparin result in anticoagulation.
Plasma is used to replace labile factors in patients with coagulopathy and documented factor deficiency, such as congenital deficiency of antithrombin III; prothrombin; factors V, VII, IX, X, and XI; protein C or S; plasminogen or antiplasmin (choice C).
Cryoprecipitate is useful in treating factor deficiency (hemophilia A), von Willebrand’s disease (vWD), and hypofibrinogenemia and may help treat uremic bleeding (choice A).
Platelet transfusions are indicated for patients suffering from or at significant risk for bleeding as a result of thrombocytopenia or platelet dysfunction (as in renal failure or vWD), or both (choice B).

Question 3

Von Willebrand’s disease 
path
sx
labs
tx

Answer 3

von Willebrand factor that is involved in platelet aggregation and is also a carrier protein for Factor VIII.

symptoms:
petechiae, epistaxis, and mucosal bleeding.

The laboratory values 
normal PT 
normal platelet (count by not normal fxn)
INCR abnormal bleeding time
PTT may be mildly prolonged.