Heme

Question 1

Fibrin is usually elevated in sepsis until what point?

Answer 1

DIC

Question 2

What is HELLP syndrome?

Answer 2

Hemolysis
Elevated
Liver enzymes
Low PLT

Preeclampsia can cause this. You have spastic vasoconstriction and fibrin deposits in capillary beds

Question 3

HELLP treatment is?

Answer 3

Prevent seizures
Fluids and electrolytes
Blood if needed
Control BP
Give dexamethasone ( due to the immune response)
Deliver baby
Monitor LFT/Renal fx
Plasma exchange
Liver transplant

Question 4

HIT occurs how long after heparin administration?

Answer 4

4-10 days

Question 5

How do you know if a patient has HIT?

Answer 5

A drop of 50% in PLT 4-10 days after administration

Question 6

What is your concern with HiT?

Answer 6

Clots!

Question 7

How do you treat HiT?

Answer 7

No heparin or lovenox

Give argotroban until PLT back to baseline

Don’t give PLT unless bleeding due to clot risk. FFP and Cryo are acceptable to give

Question 8

TTP signs and symptoms include:

Answer 8

The Pentad: fever, bleeding, low PLT, renal Dx, and neurological Dx

They will also have hemolytic anemia

Question 9

Transfuse PRBCs early in these 2 types of patients

Answer 9

CAD patients and bleeding patients